Peds Test 3

An adolescent tells the nurse that the area below his knee has been hurting for several weeks. The nurse should obtain history information about participation in which of the following? 1. Soccer. 2. Golf. 3. Diving. 4. Swimming.

1. Soccer.

Which statement made by the mother of a child with cystic fibrosis should indicate to a nurse that the mother is in need of further teaching regarding the administration of pancreatic enzymes? 1. "I'll crush the capsules and mix with my child's food." 2. "The capsule can be broken and its contents sprinkled onto food." 3. "I may need to give more enzymes with larger meals." 4. "I will administer the enzymes 30 minutes after the meal."

1. "I'll crush the capsules and mix with my child's food."

A school-age boy with a spinal cord injury is moved to the rehabilitation unit. The nurse notes that the child tends to refuse to cooperate in care and to be hostile. The nurse interprets this behavior as indicative of which of the following? 1. A stage of grief reaction. 2. A phase of rebellion. 3. A reaction to sensory overload. 4. A response to too much attention.

1. A stage of grief reaction.

A nurse is caring for a child who has cellulitis on the hand. Which of the following actions should the nurse take? 1. Administer oral antibiotics 2. Cleanse area using Burrow solution 3. Prepare for cryotherapy 4. Apply a topical antifungal medication

1. Administer oral antibiotics

The nurse is caring for a lethargic 4-year-old who is a victim of a near-drowning accident. The nurse should first: 1. Administer oxygen. 2. Institute rewarming. 3. Prepare for intubation. 4. Start an intravenous infusion.

1. Administer oxygen.

A 4-year-old child has had a ventriculoperitoneal shunt in place since birth. The parents called the triage nurse at the child's primary health-care provider and stated that when the child awoke, he complained of a "bad" headache, and he vomited shortly thereafter. Which of the following actions by the nurse is appropriate? 1. Advise the parents to have the child seen in the emergency department. 2. Make an afternoon appointment for the child to see the health-care provider. 3. Tell the parents to give the child electrolyte replacement therapy instead of food. 4. Inform the parents that they should call back if the child also develops diarrhea.

1. Advise the parents to have the child seen in the emergency department.

A nurse is assessing a child who has a concussion. Which of the following findings should the nurse expect? Select all that apply. 1. Amnesia 2. Systemic hypertension 3. Bradycardia 4. Respiratory depression 5. Confusion

1. Amnesia 3. Bradycardia 4. Respiratory depression 5. Confusion

The nurse in the newborn nursery is performing the admission assessment on a neonate. Which assessment finding indicates the neonate may have congenital hip dysplasia? 1. Asymmetry of the gluteal and thigh fat folds 2. Trendelenburg sign 3. Telescoping of the affected limb 4. Lordosis

1. Asymmetry of the gluteal and thigh fat folds

A school-age client sustains a basilar skull fracture. Which symptom is a priority for this nurse to assess for when providing care to this client? 1. Cerebral spinal fluid leakage from the nose or ears 2. Headache 3. Transient confusion 4. Periorbital ecchymosis

1. Cerebral spinal fluid leakage from the nose or ears

The nurse is caring for a pediatric client diagnosed with eczema. Which topical medication order does the nurse anticipate for this client? 1. Corticosteroids 2. Retinoids 3. Antifungals 4. Antibacterials

1. Corticosteroids

An 8-year-old child diagnosed with osteomyelitis is being cared for at home with IV antibiotics that are being administered by a home-care nurse via a peripheral intravenous central catheter (PICC). The home-care nurse should immediately call the emergency contact number if the child exhibits which of the following signs/symptoms? Select all that apply. 1. Dyspnea 2. Chest pain 3. Tachycardia 4. Hypertension 5. Hyperthermia

1. Dyspnea 2. Chest pain 3. Tachycardia 5. Hyperthermia

A nurse is assessing an infant who has eczema. Which of the following findings should the nurse expect? Select all that apply. 1. Generalized distribution 2. Papules 3. Ecchymosis in flexural areas 4. Crusting lesions 5. Keratosis pilaris

1. Generalized distribution 2. Papules 4. Crusting lesions

The nurse is assessing a child diagnosed with a brain tumor. Which of the following signs and symptoms should the nurse expect the child to demonstrate? Select all that apply. 1. Head tilt. 2. Vomiting. 3. Polydipsia. 4. Lethargy. 5. Increased appetite. 6. Increased pulse.

1. Head tilt. 2. Vomiting. 4. Lethargy.

A nurse is caring for a child who has absence seizures. Which of the following findings should the nurse expect? Select all that apply. 1. Loss of consciousness 2. Appearance of daydreaming 3. Dropping held objects 4. Falling on the floor 5. Having a piercing cry

1. Loss of consciousness 2. Appearance of daydreaming 3. Dropping held objects

A nurse is caring for a child who just experienced a generalized seizure. Which of the following is the priority action for the nurse to take? 1. Maintain the child in a side-lying position 2. Loosen the child's restrictive clothing 3. Reorient the child to the environment 4. Note the time and characteristics of the child's seizure

1. Maintain the child in a side-lying position

The nurse notes documentation that a child is exhibiting an inability to flex the leg when the thigh is flexed anteriorly at the hip. Which condition does the nurse suspect? 1. Meningitis 2. Spinal cord injury 3. Intracranial bleeding 4. Decreased cerebral blood flow

1. Meningitis

With a group of new parents, the nurse is reviewing treatment for viral illnesses such as influenza. Which statement by the parents indicates appropriate understanding of the teaching session? 1. Some over-the-counter medications contain aspirin. 2. Acetaminophen is good for treatment of fevers in young children. 3. I can use ibuprofen as needed when my child has aches and pains. 4. Aspirin is acceptable if my child does not have a virus.

1. Some over-the-counter medications contain aspirin

The mother of a child with Duchenne's mus- cular dystrophy asks about the chance that her next child will have the disease. The nurse responds based on the understanding of which of the following? 1. Sons have a 50% chance of being affected. 2. Daughters have a 1 in 4 chance of being carriers. 3. Each child has a 1 in 4 chance of developing the disease. 4. Each child has a 50% chance of being a carrier.

1. Sons have a 50% chance of being affected.

The clinic nurse is reviewing the health care provider's prescription for a child who has been diagnosed with scabies. Lindane has been prescribed for the child. The nurse questions the prescription if which is noted in the child's record? 1. The child is 18 months old. 2. The child is being bottle-fed. 3. A sibling is using lindane for the treatment of scabies. 4. The child has a history of frequent respiratory infections.

1. The child is 18 months old.

A child is admitted with a fracture of the femur and placed in skeletal traction. What should the nurse assess first? 1. The pull of traction on the pin. 2. The Ace bandage. 3. The pin sites for signs of infection. 4. The dressings for tightness.

1. The pull of traction on the pin.

The nurse is examining a 12-month-old who is brought to the clinic for persistent diaper rash. The nurse finds perianal inflammation with bright red scaly plaques and small papules. Satellite lesions are also present. What is the most likely cause of this clients diaper rash? 1. Impetigo (staph) 2. Candida albicans (yeast) 3. Urine and feces 4. Infrequent diapering

2. Candida albicans (yeast)

The nurse is inserting a nasogastric (NG) tube in a child admitted with head trauma. The nurse should explain to the parents that the NG tube will be used for what purpose? 1. Administer medications. 2. Decompress the stomach. 3. Obtain gastric specimens for analysis. 4. Provide adequate nutrition.

2. Decompress the stomach.

When developing the teaching plan for parents using the Pavlik harness with their child, what should be the nurse's initial step? 1. Assessing the parents' current coping strategies. 2. Determining the parents' knowledge about the device. 3. Providing the parents with written instructions. 4. Giving the parents a list of community resources.

2. Determining the parents' knowledge about the device.

An infant returns from surgery for correction of bilateral congenital clubfeet. The infant has bilateral long-leg casts. The toes on both feet are edematous, but there is color, sensitivity, and movement to them. Which action by the nurse is the most appropriate? 1. Call the healthcare provider to report the edema. 2. Elevate the legs on pillows. 3. Apply a warm, moist pack to the feet. 4. Encourage movement of toes

2. Elevate the legs on pillows.

A child is ready for discharge after surgery for a myelomeningocele repair. Before discharge, the nurse works with the parents to establish a catheterization schedule to prevent urinary tract infection. With what frequency should the nurse instruct the parents to catheterize the child? 1. Every 12 hours 2. Every 34 hours 3. Every 68 hours 4. Every 1012 hours

2. Every 34 hours

The nurse is admitting a toddler with the diagnosis of near-drowning in a neighbor's heated swimming pool to the emergency department. The nurse should assess the child for: 1. Hypothermia. 2. Hypoxia. 3. Fluid aspiration. 4. Cutaneous capillary paralysis.

2. Hypoxia.

Assessment of a school-age child with Guillain-Barré syndrome reveals absent gag and cough reflexes. Which of the following nursing diagnoses should receive the highest priority during the acute phase? 1. Risk for infection due to altered immune system. 2. Ineffective breathing pattern related to neuromuscular impairment. 3. Impaired swallowing related to neuromuscular impairment. 4. Total urinary incontinence related to fluid losses.

2. Ineffective breathing pattern related to neuromuscular impairment.

A nurse is caring for a toddler client who is diagnosed with scabies and prescribed a 5 percent permethrin lotion. How will the nurse apply this lotion when administering it to the toddler? 1. To the scalp only 2. Over the entire body from the chin down, as well as on the scalp and forehead 3. Only on the areas with evidence of scabies activity 4. Only on the hands

2. Over the entire body from the chin down, as well as on the scalp and forehead

A nurse is developing an in-service about viral and bacterial meningitis. The nurse should include that the introduction of which of the following immunizations decreased the incidence of bacterial meningitis in children? Select all that apply. 1. Inactivated polio vaccine (IPV) 2. Pneumococcal conjugate vaccine {PCV} 3. Diphtheria and tetanus toxoids and accellular pertussis vaccine (DTaP) 4. Haemophilus influenza type B (Hib) vaccine 5. Trivalent inactivated influenza vaccine (TIV)

2. Pneumococcal conjugate vaccine {PCV} 4. Haemophilus influenza type B (Hib) vaccine

A pediatric client sustains a minor burn. When teaching the family the treatment for this burn, the nurse would teach that the clients diet should be high in which substance? 1. Fats 2. Protein 3. Minerals 4. Carbohydrates

2. Protein

A toddler-age client has a tonic-clonic seizure while in a crib in the hospital. The clients jaw is clamped. Which nursing action is the priority? 1. Place a padded tongue blade between the childs jaws. 2. Stay with the child and observe the respiratory status. 3. Prepare the suction equipment. 4. Restrain the child to prevent injury.

2. Stay with the child and observe the respiratory status.

A nurse is assessing a preschool-age child for developmental dysplasia of the hip. Which of the following assessments should the nurse include? 1. Barlow test 2. Trendelenburg sign 3. Manipulation of the foot and ankle 4. Ortolani test

2. Trendelenburg sign

A 10-year old child is admitted to the hospital with complications related to chickenpox. The nurse should do which of the following to prevent the transmission of the infection to other children on the unit? Select all that apply. 1. Place the child on contact isolation. 2. Wear a gown, mask, and gloves before entering the room. 3. Place the child in a room with a 10-year-old who has had chickenpox. 4. Place the child in a negative air-flow room. Maintain isolation until lesions have disappeared.

2. Wear a gown, mask, and gloves before entering the room. 4. Place the child in a negative air-flow room. Maintain isolation until lesions have disappeared.

A school-age child who has received burns over 60% of his body is to receive 2,000 mL of I.V. fluid over the next 8 hours. At what rate (in milliliters per hour) should the nurse set the infusion pump?

250 mL/hr

An adolescent girl with a seizure disorder controlled with phenytoin (Dilantin) and carbamazepine (Tegretol) asks the nurse about getting married and having children. Which of the following responses by the nurse would be most appropriate? 1. "You probably shouldn't consider having children until your seizures are cured." 2. "Your children won't necessarily have an increased risk of seizure disorder." 3. "When you decide to have children, talk to the doctor about changing your medication." 4. "Women who have seizure disorders com- monly have a difficult time conceiving."

3. "When you decide to have children, talk to the doctor about changing your medication."

A nurse is providing health promotion/disease prevention education to a group of parents at a neighborhood clinic. Which of the following information should the nurse include in the teaching? 1. The rotavirus vaccine will protect their children from the infection that causes meningitis. 2. Aspirin should be administered to children who are sick with viral illnesses. 3. A well-padded helmet should be worn by any child who plays a contact sport or rides a bicycle. 4. The parent should carefully check the tongue for injury whenever a child experiences severe head trauma.

3. A well-padded helmet should be worn by any child who plays a contact sport or rides a bicycle.

The nurse is monitoring a child with burns during treatment for burn shock. Which assessment provides the most accurate guide to determine the adequate of fluid resuscitation? 1. Skin turgor 2. Level of edema at burn site. 3. Adequate of capillary filling. 4. Amount of fluid tolerated in 24 hours.

3. Adequate of capillary filling.

The parent of a child with spastic cerebral palsy and a communication disorder tells the nurse, "He seems so restless. I think he is in pain." The nurse should: 1. Assess the child for pain using the Faces, Legs, Activity, Cry, Consolability (FLACC) scale. 2. Assess the child using the pediatric FACES scale. 3. Administer the pain medication which is ordered to be given as needed and assess the response. 4. Notify the primary care provider of the change in behavior.

3. Administer the pain medication which is ordered to be given as needed and assess the response.

A 5-year-old child brought to the clinic with several superficial sores on the front of the left leg is diagnosed with impetigo. Which of the following instructions should the nurse give the parent? 1. Wash the child's legs gently three times per day with a mild soap. 2. Cover the sores with loose gauze. 3. Allow the child to go back to school after 24 hours of treatment. 4. Have the child return to the clinic the next week for a follow-up examination.

3. Allow the child to go back to school after 24 hours of treatment.

A preschooler with a fractured femur of the left leg in traction tells the nurse that his leg hurts. It is too early for pain medication. The nurse should: 1. Place a pillow under the child's buttocks to provide support. 2. Remove the weight from the left leg. 3. Assess the feet for signs of neurovascular impairment. 4. Reposition the pulleys so the traction is looser.

3. Assess the feet for signs of neurovascular impairment.

An adolescent is being admitted to the pediatric intensive care unit following rod placement for a diagnosis of scoliosis. Which of the following assessments is highest priority for the nurse to perform? 1. Pain level 2. Intravenous flow rate 3. Blood loss 4. Electrolyte values

3. Blood loss

During the recovery management phase of burn treatment, which is the most common complication seen in children? 1. Shock 2. Metabolic acidosis 3. Burn-wound infection 4. Asphyxia

3. Burn-wound infection

The nurse is teaching family members how to care for their infant in a Pavlik harness to treat congenital developmental dysplasia of the hip. Which statement will the nurse include in the teaching session? 1. Apply lotion or powder to minimize skin irritation. 2. Put clothing over the harness for maximum effectiveness of the device. 3. Check at least two or three times a day for red areas under the straps. 4. Place a diaper over the harness, preferably using a thin, superabsorbent, disposable diaper.

3. Check at least two or three times a day for red areas under the straps

When teaching an adolescent with a seizure disorder who is receiving valproic acid (Depakene), which sign or symptom should the nurse instruct the client to report to the health care provider? 1. Three episodes of diarrhea. 2. Loss of appetite. 3. Jaundice. 4. Sore throat.

3. Jaundice.

The nurse is examining an infant for hip placement and has abducted her flexed legs. The nurse should next: 1. Rotate the hips. 2. Extend the legs. 3. Listen for a "click." 4. Palpate the hips for a mass.

3. Listen for a "click."

Which action should the nurse take when providing postoperative nursing care to a child after insertion of a ventriculoperitoneal shunt? 1. Administer narcotics for pain control. 2. Check the urine for glucose and protein. 3. Monitoring for increased temperature. 4. Test cerebrospinal fluid leakage for protein.

3. Monitoring for increased temperature.

The nurse is assigned to care for an 8-year-old child with a diagnosis of a basilar skull fracture. The nurse receives the health care provider's prescriptions and should contact the HCP to question which prescription? 1. Obtain daily weight. 2. Provide clear liquid intake. 3. Nasotracheal suction as needed. 4. Maintain a patent intravenous line.

3. Nasotracheal suction as needed.

The nurse judges that the mother understands the term cerebral palsy when she describes it as a term applied to impaired movement resulting from which of the following? 1. Injury to the cerebrum caused by viral infection. 2. Malformed blood vessels in the ventricles caused by inheritance. 3. Nonprogressive brain damage caused by injury. 4. Inflammatory brain disease caused by metabolic imbalances.

3. Nonprogressive brain damage caused by injury.

A school-age client is admitted to the hospital with osteomyelitis. Which statement regarding the treatment of osteomyelitis is most appropriate for the nurse to share with the parents? 1. Cultures should be done immediately after the first dose of antibiotic infuses. 2. Antibiotics are ineffective against this virus. 3. Methicillin is the antibiotic of choice. 4. Antibiotic therapy should continue for 36 weeks

4. Antibiotic therapy should continue for 36 weeks

A clinic nurse has a follow-up appointment with an adolescent with juvenile idiopathic arthritis (JIA). What topic should be the nurse's top priority? 1. Sleep patterns. 2. Participation in daily exercise. 3. Information regarding JIA support groups. 4. Avoidance of alcohol use.

4. Avoidance of alcohol use.

The physician orders carbamazapine extended release (Tegretol-XR) for a client with a cerebral palsy who also has a seizure disorder. The client has a gastrostomy feeding tube, and carbamazapine is on the hospital's "no crush" list. In order to administer the medication, the nurse should: 1. Cut the medication into four pieces that can be placed in the feeding tube. 2. Dissolve the medication in 30 mL's of juice. 3. Ask the pharmacist for an oral suspension. 4. Contact the primary care provider to change the order.

4. Contact the primary care provider to change the order.

A preschool-age child with juvenile idiopathic arthritis (JIA) has become withdrawn, and the mother asks the nurse what she should do. Which of the following suggestions by the nurse would be most appropriate? 1. Introduce the child to other children her age who also have JIA. 2. Tell the mother to spend extra time with the child and less time with her other children. 3. Recommend that the mother send the child to see a counselor for therapy. 4. Encourage the mother to be supportive and understanding of the child.

4. Encourage the mother to be supportive and understanding of the child.

A child who has undergone spinal fusion for scoliosis complains of abdominal discomfort and begins to have episodes of vomiting. On further assessment, the nurse notes abdominal distention. On the basis of these findings, the nurse should take which action? 1. Administer an antiemetic. 2. Increase the intravenous fluids. 3. Place the child in a Sims' position. 4. Notify the health care provider (HCP).

4. Notify the health care provider (HCP).

A child has a right femur fracture caused by a motor vehicle crash and is placed in skin traction temporarily until surgery can be performed. During assessment, the nurse notes that the dorsals pedis pulse is absent on the right foot. Which action should the nurse take? 1. Administer an analgesic. 2. Release the skin traction 3. Apply ice to the extremity. 4. Notify the health care provider.

4. Notify the health care provider.

A child is diagnosed with Reye's syndrome. The nurse creates a nursing care plan for the child and should include with intervention in the plan? 1. Assessing hearing loss. 2. Monitoring urine output. 3. Changing body position every 2 hours. 4. Providing a quiet atmosphere with dimmed lighting.

4. Providing a quiet atmosphere with dimmed lighting.

When assessing the development of a 15-month-old child with cerebral palsy, which of the following milestones should the nurse expect a toddler of this age to have achieved? 1. Walking up steps. 2. Using a spoon. 3. Copying a circle. 4. Putting a block in cup.

4. Putting a block in cup.

A nurse is caring for a child who is suspected of having Legg-Calve-Perthes disease. The nurse should prepare the child for which of the following diagnostic procedures? 1. Bone biopsy 2. Genetic testing 3. MRI 4. Radiographs

4. Radiographs

At the 2 week well-child visit a parent states, "My baby seems to keep his head tilted to the right." The nurse should further assess the: 1. Fontanel. 2. Cervical vertebrae. 3. Trapezius muscle. 4. Sternocleidomastoid muscle.

4. Sternocleidomastoid muscle.

When developing the teaching plan for the mother of a 2-year-old child diagnosed with scabies, which of the following points should the nurse expect to include? 1. The floors of the house should be cleaned with a damp mop. 2. The child should be held frequently. 3. Itching should cease in a few days. 4. The entire family should be treated.

4. The entire family should be treated.

Which of the following statements obtained from the nursing history of a toddler should alert the nurse to suspect that the child has had a febrile seizure? 1. The child has had a low-grade fever for several weeks. 2. The family history is negative for convulsions. 3. The seizure resulted in respiratory arrest. 4. The seizure occurred when the child had a respiratory infection.

4. The seizure occurred when the child had a respiratory infection.

A baby is admitted to the neonatal intensive care unit following closure of a myelomeningocele. Which of the following patient care goals should the nurse include in the nursing care plan? The baby will: 1. maintain supine positioning. 2. have normal elimination patterns. 3. exhibit a normal startle re ex. 4. consume feedings and gain weight.

4. consume feedings and gain weight.

A child with meningitis is to receive 1,000 mL of dextrose 5% in normal saline over 12 hours. At what rate in milliliters per hour should the nurse set the pump? Round your answer to the nearest whole number. ________________________ mL/hour.

83

A nurse is providing teaching to the parent of a child who is to have an electroencephalogram (EEG) Which of the following responses should the nurse include in the teaching? 1. "Decaffeinated beverages should be offered on the morning of the procedure" 2. "Do not wash your child's hair the night before the procedure" 3. "Withhold all foods the morning of the procedure" 4. "Give your child an analgesic the night before the procedure"

1. "Decaffeinated beverages should be offered on the morning of the procedure"

The nurse teaches the mother of a young child with Duchenne's muscular dystrophy about the disease and its management. Which of the following statements by the mother indicates successful teaching? 1. "My son will probably be unable to walk independently by the time he is 9 to 11 years old." 2. "Muscle relaxants are effective for some children; I hope they can help my son." 3. "When my son is a little older, he can have surgery to improve his ability to walk." 4. "I need to help my son be as active as possible to prevent progression of the disease."

1. "My son will probably be unable to walk independently by the time he is 9 to 11 years old."

A mother telephones the nurse at her child's primary health-care provider and states, "My child spilled my coffee on her arm. About one-half of the forearm is red, and there are 2 or 3 blisters that have developed. What should I do?" Which of the following is the best response for the nurse to give? 1. "Run cool water over the burned area and then call me back." 2. "Apply ice to the blisters for ten minutes on and ten minutes off." 3. "Proceed to the emergency department for a complete assessment." 4. "Cover the burned area with petroleum jelly and

1. "Run cool water over the burned area and then call me back."

The school nurse is providing care to a school-age client who experienced a sprain of the right ankle on the playground. Which intervention is appropriate for the nurse to implement for this client? 1. Apply ice to the extremity 2. Apply a warm, moist pack to the extremity 3. Perform passive range of motion to the extremity 4. Lower the extremity to below the level of the heart

1. Apply ice to the extremity

A nurse is assessing a child who is mildly mentally retarded. The best indication of how a mentally retarded child is progressing can be obtained by observing him: 1. At school with his teacher. 2. At home with his family. 3. In the clinic with his mother. 4. Playing soccer with his friends.

1. At school with his teacher.

A nurse is caring for a child who has celebral palsy. Which of the following medications should the nurse expect to administer to treat painful muscle spasms? Select all that apply. 1. Baclofen 2. Diazepam 3. Ozybutynin 4. Methotrexate 5. Prednisone

1. Baclofen 2. Diazepam

When assessing a female adolescent for scoliosis, what should the nurse ask the client to do? 1. Bend forward at the waist with arms hanging freely. 2. Lie flat on the floor and extend her legs straight from the trunk. 3. Sit in a chair while lifting her feet and legs to a right angle with the trunk. 4. Stand against a wall while pressing the length of her back against the wall.

1. Bend forward at the waist with arms hanging freely.

Two months after an adolescent's thoracic spinal cord injury, he complains of a pounding headache. The nurse notes that the client's arms and face are flushed and he is diaphoretic. What should the nurse do next? 1. Check the patency of the urinary catheter. 2. Lower the adolescent's head below his knees. 3. Place the adolescent flat on his back. 4. Prepare to administer epinephrine subcutaneously.

1. Check the patency of the urinary catheter.

A 12-year-old child is being assessed in the emergency department for possible Reye syndrome. The child was diagnosed with influenza by a primary health-care provider 2 weeks earlier. Which of the following ndings would the nurse expect to see? Select all that apply. 1. Child's Babinski reflex is positive. 2. Child has had vomiting episodes for the past 24 hr. 3. Child's serum ammonia levels are markedly lower than normal. 4. Child was administered ibuprofen (Advil) when the child had the flu. 5. Child is unusually argumentative and aggressive.

1. Child's Babinski reflex is positive. 2. Child has had vomiting episodes for the past 24 hr. 5. Child is unusually argumentative and aggressive.

A 9-year-old child is in the hospital in skin traction a er sustaining a simple fracture of the femur. Which of the following assessments should the nurse make during rounds with the child's orthopedist? The nurse should assess the: (Select all that apply.) 1. Child's level of pain. 2. Child's bowel sounds. 3. Capillary re ll of the child's toes. 4. Skin under the ace bandage for signs of skin breakdown. 5. Wound for signs of redness, edema, ecchymosis, drainage, and approximation.

1. Child's level of pain. 2. Child's bowel sounds. 3. Capillary re ll of the child's toes. 4. Skin under the ace bandage for signs of skin breakdown.

A nurse is caring for an adolescent who has acne and a prescription for isotretinoin from the dermatologist. Which of the following laboratory findings should the nurse plan to monitor? 1. Cholesterol and triglycerides 2. BUN and Creatinine 3. Serum potassium 4. Serum sodium

1. Cholesterol and triglycerides

The nurse is teaching a group of students about wound healing. Which items will the nurse include as occurring during the hemostasis and inflammation stage of wound healing? Select all that apply. 1. Clot formation to seal the wound 2. Production of collagen and granulation tissue 3. Scar formation and strengthening 4. Release of inflammatory mediators by platelets 5. Swelling as a result of increased capillary permeability

1. Clot formation to seal the wound 2. Production of collagen and granulation tissue 5. Swelling as a result of increased capillary permeability

An adolescent sustains a T3 spinal cord injury. After insertion of an intravenous line, a nasogastric tube, and an indwelling urinary (Foley) catheter, the adolescent is admitted to the intensive care unit. What should the nurse do next when assessment reveals that the adolescent's feet and legs are cool to the touch? 1. Cover the adolescent's legs with blankets. 2. Report this finding to the physician immediately. 3. Reposition the adolescent's legs. 4. Lay the adolescent flat to aid circulation.

1. Cover the adolescent's legs with blankets.

When making rounds on the pediatric neurology unit, the nurse manager notes that when giving I.V. medications many of the staff nurses are disconnecting the flush syringe first and then clamping the intermittent infusion device. The nurse is concerned that the nurses do not understand the benefits of positive pressure technique and turbu- lence flow flush in preventing clots. After discussing the problem with the staff educator which intervention would be the most effective way to improve the nursing practice? 1. Create a poster presentation on the topic with a required post test. 2. Send a group email discussing the importance of clamping the device first. 3. Ask each nurse if they are aware that their practice is not current. 4. Post an evidence-based article on the unit.

1. Create a poster presentation on the topic with a required post test.

A child who was intubated after a cran- iotomy now shows signs of decreased level of consciousness. The physician orders manual hyperventilation to keep the PaCo2 between 25 and 29 mm Hg and the PaO2 between 80 and 100 mm Hg. The nurse interprets this order based on the understanding that this action will accomplish which of the following? 1. Decrease intracranial pressure. 2. Ensure a patent airway. 3. Lower the arousal level. 4. Produce hypoxia.

1. Decrease intracranial pressure.

A neonate, who was delivered by Cesarean section for a breech presentation, is being examined in the neonatal nursery. For which of the following complications should the nurse carefully assess the baby? 1. Developmental dysplasia of the hips (DDH) 2. Legg-Calve-Perthes (LCP) 3. Duchenne muscular dystrophy (DMD) 4. Slipped capital femoral epiphysis (SCFE)

1. Developmental dysplasia of the hips (DDH)

A pediatric client is hospitalized with a severe case of impetigo contagiosa. Which antibiotic does the nurse anticipate the healthcare provider will order for this client? 1. Dicloxacillin (Pathocil) 2. Rifampin (Rifadin) 3. Sulfamethoxazole and trimethoprim (Bactrim) 4. Metronidazole (Flagyl)

1. Dicloxacillin (Pathocil)

The mother of an infant with myelomeningocele asks if her baby is likely to have any other defects. The nurse responds based on the understanding that myelomeningocele is commonly associated with which disorder? 1. Excessive cerebrospinal fluid within the cranial cavity. 2. Abnormally small head. 3. Congenital absence of the cranial vault. 4. Overriding of the cranial sutures.

1. Excessive cerebrospinal fluid within the cranial cavity.

A child sustains a traumatic brain injury and is monitored in the pediatric intensive-care unit (PICU). The nurse is using the Glasgow Coma Scale to assess the child. Which items will the nurse assess when using this tool? Select all that apply. 1. Eye opening 2. Verbal response 3. Motor response 4. Head circumference 5. Pulse oximetry

1. Eye opening 2. Verbal response 3. Motor response

A nurse is teaching a group of parents about the rise factors for seizures. Which of the following factors should the nurse include in the teaching? Select all that apply. 1. Febrile episodes 2. Hypoglycemia 3. Sodium Imbalances 4. Low Serum lead levels 5. Presence of diphtheria

1. Febrile episodes 2. Hypoglycemia 3. Sodium Imbalances

An ambulatory 11-month-old child has been diagnosed with osteomyelitis. Which of the following signs/symptoms would the nurse expect to see? 1. Feeding problems 2. Pain 3. Warmth at the site 4. Limp

1. Feeding problems

The mother of a 3-year-old child arrives at a clinic and tells the nurse that the child has been scratching the skin continuously and has developed a rash. The nurse assesses the child and suspects the presence of scabies. The nurse bases this suspicion on which finding noted on assessment of the child's skin? 1. Fine grayish red lines 2. Purple-colored lesions 3. Thick, honey-colored crusts 4. Clusters of fluid-filled vesicles

1. Fine grayish red lines

Which sign should lead the nurse to suspect that a child with meningitis has developed disseminated intravascular coagulation? 1. Hemorrhagic skin rash. 2. Edema. 3. Cyanosis. 4. Dyspnea on exertion.

1. Hemorrhagic skin rash.

After a plaster cast has been applied to the arm of a child with a fractured right humerus, the nurse completes discharge teaching. The nurse should evaluate the teaching as successful when the mother agrees to seek medical advice if the child experiences which of the following? 1. Inability to extend the fingers on the right hand. 2. Vomiting after the cast is applied. 3. Coolness and dampness of the cast after 5 hours. 4. Fussiness with complaints that the cast is heavy.

1. Inability to extend the fingers on the right hand.

A 3-year-old child is admitted to the pediatric unit in skeletal traction after fracturing the femur. Which of the following orders should the nurse request from the child's primary health-care practitioner? 1. Jacket restraint when not accompanied by parent 2. Liquid diet 3. Active range of motion exercises of lower extremities 4. Foley catheter

1. Jacket restraint when not accompanied by parent

A 1-month-old infant is seen in a clinic and is diagnosed with developmental dysplasia of the hip. On assessment the nurse understand that which finding should be noted in this condition? 1. Limited range of motion in the affected hip 2. An apparent lengthened femur on the affected side 3. Asymmetrical adduction of the affected hip when the infant is placed supine with the knees and hips flexed 4. Symmetry of the gluteal skin folds when the infant is placed prone and the legs are extended against the examining table

1. Limited range of motion in the affected hip

The nurse assesses the family's ability to cope with the child's cerebral palsy. Which action should alert the nurse to the possibility of their inability to cope with the disease? 1. Limiting interaction with extended family and friends. 2. Learning measures to meet the child's physical needs. 3. Requesting teaching about cerebral palsy in general. 4. Not seeking financial help to pay for medical bills.

1. Limiting interaction with extended family and friends.

A nurse is reviewing cerebrospinal fluid analysis for a client who has suspected meningitis. Which of the following findings should the nurse identify as indicating viral meningitis? Select all that apply. 1. Negative Gram stain 2. Normal glucose content 3. Cloudy color 4. Decreased WBC count 5. Normal protein content

1. Negative Gram stain 2. Normal glucose content 5. Normal protein content

A child with a known seizure disorder is hospitalized for an appendectomy. While assisting the child back from the restroom, the child begins tonic-clonic movements. The nurse should take which actions in order of priority from first to last? 1. Note the time. 2. Clear the area of potentially harmful objects and pad the head. 3. Ease the child to the floor. 4. Roll the child to the side.

1. Note the time. 3. Ease the child to the floor. 2. Clear the area of potentially harmful objects and pad the head. 4. Roll the child to the side.

The nurse is giving care to an infant with a brain tumor. The nurse observes the infant arch the back. The nurse should: 1. Notify the physician 2. Stroke the back to release the arching 3. Pad the side rails of the crib 4. Place the child prone

1. Notify the physician

A child diagnosed with a mild traumatic brain injury is being sedated with a mild sedative so that pain and anxiety are minimized. Which nursing interventions are appropriate for this child? Select all that apply. 1. Place a continuous-pulse oximetry monitor on the child. 2. Place the child in a room near the nurses station. 3. Allow for several visitors to remain at the childs bedside. 4. Use soft restraints if the child becomes confused. 5. Use sedation around the clock to decrease agitation

1. Place a continuous-pulse oximetry monitor on the child. 2. Place the child in a room near the nurses station.

A nurse is caring for a client who has been suspected meningitis and a decreased level of consciousness. Which of the following actions by the nurse is appropriate? 1. Place the client on NPO status 2. Prepare the client for a liver biopsy 3. Position the client dorsal recumbent 4. Put the client in a protective environment

1. Place the client on NPO status

The nurse is educating the parents of a child who has been diagnosed with febrile seizures. Which of the following actions should the nurse advise the parents is important for them to perform if their child has another seizure? 1. Protect the child's head. 2. Restrain the child's arms and legs. 3. Place a tongue blade in the child's mouth. 4. Administer mouth-to-mouth resuscitation.

1. Protect the child's head.

A nurse is caring for a child who has contact dermatitis due to poison ivy. Which of the following actions should the nurse take? Select all that apply. 1. Remove the clothing over the rash. 2. Initiate contact isolation precautions while the rash is present 3. Expose the rash to a heat lamp for 15 min 4. Cleanse the affected skin with hydrogen peroxide solution 5. Apply calamine lotion to the skin.

1. Remove the clothing over the rash. 5. Apply calamine lotion to the skin.

A nurse is caring for an adolescent who has a closed head injury. Which of the following findings are indications of increased intracranial pressure (ICP)? Select all that apply. 1. Report of headache 2. Alteration of pupillary response 3. Increased motor response 4. Increased sleeping 5. Increased sensory response.

1. Report of headache 2. Alteration of pupillary response 4. Increased sleeping

A baby is preoperative for closure of a myelomeningocele. Which of the following is the baby's priority nursing diagnosis? 1. Risk for Infection 2. Impaired Physical Mobility 3. Risk for Latex Allergy 4. Bowel Incontinence

1. Risk for Infection

A nurse is in the emergency department assessing a child following a motor-vehicle crash. The child is unresponsive, has spontaneous respirations of 22/min, and has a laceration on the forehead that is bleeding. Which of the following should the nurse take first? 1. Stabilize the child's neck. 2. Clean the child's laceration with soap and water. 3. Implement seizure precautions for the child. 4. Initiate IV access for the child.

1. Stabilize the child's neck.

The nurse is providing care to a toddler client who is diagnosed with osteogenesis imperfect. Which nursing intervention is appropriate for this client? 1. Support of the trunk and extremities when moving 2. Traction care 3. Cast care 4. Postop spinal surgery care

1. Support of the trunk and extremities when moving

The nurse educator is describing the pediatric differences associated with the anatomy and physiology of the neurologic system to a group of nursing students. Which statements made by the class indicate appropriate understanding of this topic after the teaching session? Select all that apply. 1. The bones of the cranium are connected by connective tissue to allow for brain growth. 2. The spine of infants is excessively mobile due to immature neck muscles and incompletely developed vertebral bodies. 3. Maturation of the nerves continues until age 10. 4. Myelination is complete at birth, 5. Myelination proceeds in a cephalocaudal direction

1. The bones of the cranium are connected by connective tissue to allow for brain growth. 2. The spine of infants is excessively mobile due to immature neck muscles and incompletely developed vertebral bodies. 5. Myelination proceeds in a cephalocaudal direction

The nurse is providing care to a pediatric client who is diagnosed with psoriasis. Which clinical manifestations does the nurse anticipate upon assessment of this client? Select all that apply. 1. Thick, silvery, scaly erythematous plaque 2. Pruritus 3. Dry skin, likely to crack and fissure 4. Fragile skin and blisters 5. Irregular border surrounded by normal skin

1. Thick, silvery, scaly erythematous plaque 2. Pruritus 5. Irregular border surrounded by normal skin

A nurse is reviewing treatment options with the parent of a child who has worsening seizures. Which of the following treatment options should the nurse include in the discussion? Select all that apply. 1. Vagal nerve stimulator 2. Additional antiepileptic medications 3. Corpus callosotomy 4. Focal resection 5. Radiation therapy

1. Vagal nerve stimulator 2. Additional antiepileptic medications 3. Corpus callosotomy 4. Focal resection

When teaching an adolescent with facial acne about skin care, the nurse should instruct the adolescent to: 1. Wash the face twice a day with mild soap and water. 2. Remove whiteheads and comedones after washing his face with antibacterial soap. 3. Apply vitamin E ointment twice daily to the affected skin. 4. Apply tretinoin (Retin-A) daily in the morning and expose the face to the sun.

1. Wash the face twice a day with mild soap and water.

The nurse has completed discharge teaching for the family of a child diagnosed with Legg-Calve-Perthes disease. Which statement by the family indicates the need for further education? 1. Were glad this will only take about six weeks to correct. 2. We understand swimming is a good sport for Legg-Calve-Perthes. 3. We know to watch for areas on the skin the brace may rub. 4. We understand that abduction of the affected leg is important.

1. Were glad this will only take about six weeks to correct

The nurse completes parent education related to treatment for a pediatric client with congenital clubfoot. Which statement by the parents indicates the need for further education? 1. Were happy this is the only cast our baby will need. 2. Well watch for any swelling of the feet while the casts are on. 3. Well keep the casts dry. 4. Were getting a special car seat to accommodate the casts

1. Were happy this is the only cast our baby will need

After teaching the family of a child with scoliosis who needs to wear a Boston brace, which of the following activities, if stated by the child and family as occasions appropriate for removal of the brace, indicates successful teaching? 1. When bathing, for about 1 hour per day. 2. While eating, for a total of 3 hours a day. 3. During school, for about 8 hours a day. 4. When sleeping, for a total of 10 hours a day.

1. When bathing, for about 1 hour per day.

A mother telephones her 8-month-old baby's primary health-care provider and informs the triage nurse, "My baby has a diaper rash. I have been putting baby powder on the rash, but it doesn't seem to be getting any better. What should I do?" Which of the following responses by the nurse is most appropriate? 1. "It is important that you stop using the powder. If the baby breathes it in, it will make the baby very sick." 2. "Exposing the rash to the air often helps. I would suggest leaving the baby's diaper off for ten minutes every few hours. That should help." 3. "I would suggest that you switch to cornstarch from the powder. The natural properties in the cornstarch are healing." 4. "I am making an appointment for the baby to be seen. It is very rare for babies to develop diaper rashes when they are at your baby's age."

2. "Exposing the rash to the air often helps. I would suggest leaving the baby's diaper off for ten minutes every few hours. That should help."

A 4-year-old child sustains a fall at home. After an x-ray examination, the child is determined to have a fractured arm and a plaster cast is applied. The nurse provides instruction to the parents regarding care for the child's cast. Which statement by the parents indicates a need for further instruction? 1. "The cast may feel warm as the cast dries." 2. "I can use lotion or powder around the cast edges to relieve itching." 3. "A small amount of white shoe polish can touch up a soiled white cast." 4. "If the cast becomes wet, a blow dryer set on the cool setting may be used to dry the cast."

2. "I can use lotion or powder around the cast edges to relieve itching."

The mother of a 10-year-old child telephones the child's primary health-care provider's office. The mother informs the nurse, "A spider bit my daughter a couple of days ago, and today it is looking really bad. The bite is oozing, and the skin around the bite is red and painful." Which of the following statements by the nurse is appropriate at this time? 1. "I bet the bite is infected with a dangerous bacteria. She must be seen immediately, so that we can start her on antibiotics." 2. "I would like her to be seen today. Please cover the bite, and bring her in for an appointment." 3. "Spider bites are notorious for getting worse before they get better. It should clear up in a couple of days." 4. "It sounds like the bite has been in amed. I want you to put warm compresses on it three times a day until it gets better."

2. "I would like her to be seen today. Please cover the bite, and bring her in for an appointment."

The parents of a child tell the nurse that they feel guilty because their child almost drowned. Which of the following remarks by the nurse would be most appropriate? 1. "I can understand why you feel guilty, but these things happen." 2. "Tell me a little bit more about your feelings of guilt." 3. "You should not have taken your eyes off of your child." 4. "You really shouldn't feel guilty; you're lucky because your child will be all right."

2. "Tell me a little bit more about your feelings of guilt."

After teaching the parents of a child with febrile seizures about methods to lower temperature other than using medication, which of the following statements indicates successful teaching? 1. "We'll add extra blankets when he complains of being cold." 2. "We'll wrap him in a blanket if he starts shivering." 3. "We'll make the bath water cold enough to make him shiver." 4. "We'll use a solution of half alcohol and half water when sponging him."

2. "We'll wrap him in a blanket if he starts shivering."

The mother asks the nurse about using a car seat for her toddler who is in a hip spica cast. The nurse should tell the mother: 1. "You can use a seat belt because of the spica cast." 2. "You will need a specially designed car seat for your toddler." 3. "You can still use the car seat you already have." 4. "You'll need to get a special release from the police so that a car seat won't be needed."

2. "You will need a specially designed car seat for your toddler."

A teenager has been in an automobile accident. The parents are advised that their child has experienced a cerebral contusion. When they ask what that means, the nurse should provide which of the following explanations? 1. "Your child has ruptured a blood vessel between the layers that protect the brain from injury." 2. "Your child has a bruise of the brain tissue." 3. "Your child has a fracture in one part of the skull." 4. "Your child has a great deal of swelling of the part of the brain that is called the brain stem."

2. "Your child has a bruise of the brain tissue."

The mother of a 4-year-old child with juvenile idiopathic arthritis (JIA) is worried that her child will have to stop attending preschool because of the illness. Which of the following responses by the nurse would be most appropriate? 1. "It may be difficult for your child to attend school because of the side effects of the medications he will be prescribed." 2. "Your child should be encouraged to attend school, but he'll need extra time to work out early morning stiffness." 3. "You should keep your child at home from school whenever he experiences discomfort or pain in his joints." 4. "Your child will probably need to wear splints and braces so that his joints will be supported properly."

2. "Your child should be encouraged to attend school, but he'll need extra time to work out early morning stiffness."

The nurse is assessing a 9-year-old child who has third-degree burns as shown below. Using the "Rule of Nines" adapted for children, the nurse estimates that the extent of burns for this child is: 1. 9%. 2. 14%. 3. 18%. 4. 24%.

2. 14%.

Which child would be the best roommate for a 9-year-old child with myelodysplasia who is hospitalized for a foot infection? 1. A 13-year-old with juvenile idiopathic arthritis. 2. A 10-year-old with a fractured femur. 3. An 8-year-old status post-appendectomy. 4. A 6-year-old with bacterial meningitis.

2. A 10-year-old with a fractured femur.

The nurse caring for a child who sustained a burn injury plans care based on which pediatric considerations associated with this injury? Select all that apply. 1. Scarring is less severe in a child than in an adult. 2. A delay in growth may occur after a burn injury. 3. An immature immune system presents an increased risk of infection for infants and young children. 4. Fluid resuscitation is unnecessary unless the burned area is more than 25% of the total body surface area. 5. The lower portion of body fluid to body mass in a child increases the risk of cardiovascular problems. 6. Infants and young children are at increased risk for protein and calorie deficiency because they have smaller muscle mass and less body fat than adults.

2. A delay in growth may occur after a burn injury. 3. An immature immune system presents an increased risk of infection for infants and young children. 6. Infants and young children are at increased risk for protein and calorie deficiency because they have smaller muscle mass and less body fat than adults.

The nurse reports to the physician signs of increased intracranial pressure in an infant with a myelomeningocele who has which of the following? 1. Minimal lower extremity movement. 2. A high-pitched cry. 3. Overflow voiding only. 4. A fontanel that blues with crying.

2. A high-pitched cry.

An infant is hospitalized following a febrile seizure. When a nurse teaches the infant's family about the prevention of future seizures, what would be the nurse's best recommendation? 1. Place the child in a tepid bath during the next febrile illness. 2. Administer antipyretics around the clock the next time the child has a fever. 3. Contact the physician for antibiotics if the child becomes feverish again. 4. Take the child's temperature frequently during the next illness.

2. Administer antipyretics around the clock the next time the child has a fever.

After surgical repair of a myelomeningocele, which position should the nurse use to prevent musculoskeletal deformity in the infant? 1. Placing the feet in flexion. 2. Allowing the hips to be abducted. 3. Maintaining knees in the neutral position. 4. Placing the legs in adduction.

2. Allowing the hips to be abducted.

A 10-year-old child has cellulitis of the calf. Which of the following interventions should the nurse educate the parents to implement? 1. Have the child use crutches when ambulating. 2. Apply warm compresses to the inflamed area. 3. Measure the depth of edema each day the child is on antibiotics. 4. Locate and culture the item that punctured the child's skin.

2. Apply warm compresses to the inflamed area.

A child with status post-Harrington rod placement for the correction of scoliosis is being cared for on the pediatric unit. The child suddenly experiences facial sweating and complains of a headache. A nurse notes also a slower heart rate on the monitor. What action should the nurse take first? 1. Call the surgeon immediately. 2. Assess patency of the urinary catheter. 3. Administer pain medication as ordered. 4. Complete a neurological assessment.

2. Assess patency of the urinary catheter.

A nurse is teaching a group of parents about preventing insect bites. Which of the following information should the nurse include in her teaching? Select all that apply. 1. Wear perfumes when outside 2. Avoid areas of tall grass 3. Wear bright-colored clothing 4. Wear insect repellent 5. Check house pets frequently

2. Avoid areas of tall grass 4. Wear insect repellent 5. Check house pets frequently

A child has been prescribed Tegretol (carbamazepine) for a seizure disorder. Which of the following information in relation to this child is essential for the nurse to consider? Select all that apply. 1. Gender 2. Behavior 3. Dental health 4. Genetic profile 5. Antibiotic prescriptions

2. Behavior 4. Genetic profile 5. Antibiotic prescriptions

What should be part of the nurse's teaching plan for a child with epilepsy being discharged on a regimen of diphenylhydantoin (Dilantin)? 1. Drinking plenty of fluids. 2. Brushing teeth after each meal. 3. Having someone be with the child during waking hours. 4. Reporting signs of infection.

2. Brushing teeth after each meal.

A breastfed baby has thrush and a bright-red diaper rash. Thee baby's mother is complaining of severe pain each time the baby feeds. The nurse suspects that which of the following organisms is likely responsible for these complaints? 1. Staphylococcus aureus 2. Candida albicans 3. Streptococcus pyogenes 4. Herpes simplex

2. Candida albicans

The nurse is caring for a pediatric client in Bryant skin traction. Which nursing intervention is most appropriate for this client? 1. Remove the adhesive traction straps daily to prevent skin breakdown. 2. Check the traction frequently to ensure that proper alignment is maintained. 3. Place the child in a prone position to maintain good alignment. 4. Move the child as infrequently as possible to maintain traction

2. Check the traction frequently to ensure that proper alignment is maintained.

In planning the discharge for a newborn diagnosed with torticollis (wry neck), the nurse should: 1. Teach the parent the side effects of botulinum toxin (BOTOX). 2. Coordinate outpatient physical therapy 3. Verify the date for corrective surgery. 4. Demonstrate the use of positioning wedges for sleep.

2. Coordinate outpatient physical therapy

The lesion on a child's face has been diagnosed as impetigo. Which of the following information should the nurse educate the parents in relation to this problem? Select all that apply. 1. Child should refrain from bathing until the lesions are completely healed. 2. Crusts should be removed several times each day using contact precautions. 3. Child must be on antibiotics for at least twenty-four hours before returning to school. 4. Meticulous handwashing must be maintained to prevent transmission to others in the family. 5. Safe dosage of Benadryl (diphenhydramine) should be administered at bedtime until the lesions resolve.

2. Crusts should be removed several times each day using contact precautions. 3. Child must be on antibiotics for at least twenty-four hours before returning to school. 4. Meticulous handwashing must be maintained to prevent transmission to others in the family.

A child is to receive I.V. antibiotics for osteomyelitis. Before the initial dose of antibiotics can be given, the nurse confirms that a blood sample for which of the following tests has been drawn? 1. Creatinine. 2. Culture. 3. Hemoglobin. 4. White blood count.

2. Culture.

A nurse is performing discharge teaching with the parents of a preschooler diagnosed with cystic fibrosis. What part of the teaching plan will best assist the parents to prevent future pulmonary infections in this child? 1. Teaching the parents proper administration of pancreatic enzymes. 2. Emphasizing the need for regular and consistent chest physiotherapy. 3. Stressing the need to seek prompt medical attention for increased work of breathing. 4. Instructing the parents to monitor the child's daily fluid intake for adequacy.

2. Emphasizing the need for regular and consistent chest physiotherapy.

A 12-year-old child has been diagnosed with athlete's foot. Which of the following information should the nurse include in the patient education regarding the disease? 1. The anaerobic bacteria that cause the infection must be treated with intravenous antibiotics. 2. Eradication of the infection can take many weeks of treatment. 3. Transmission of the mites is by direct, person-to-person contact. 4. The child must deprive the causative organism of oxygen by wearing shoes that are fully enclosed.

2. Eradication of the infection can take many weeks of treatment.

A nurse is developing a plan of care for a toddler who has cerebral palsy. Which of the following actions should the nurse include? 1. Structure interventions according to the toddler's chronological age. 2. Evaluate the toddler's need for an evaluation of hearing ability. 3. Monitor the toddler's pain level routinely using a numeric rating scale. 4. Provide total care for daily hygiene activities.

2. Evaluate the toddler's need for an evaluation of hearing ability.

Which of the following actions should be the priority when caring for a school-age child admitted to the pediatric unit with the diagnosis of Guillain- Barré syndrome? 1. Assessing the child's ability to follow simple commands. 2. Evaluating the child's bilateral muscle strength. 3. Making a game of the range-of-motion exercises. 4. Providing the child with a diversional activity.

2. Evaluating the child's bilateral muscle strength.

Before placement of a ventriculoperitoneal shunt for hydrocephalus, an infant is irritable, lethargic, and difficult to feed. To maintain the infant's nutritional status, which of the following actions would be most appropriate? 1. Feeding the infant just before doing any procedures. 2. Giving the infant small, frequent feedings. 3. Feeding the infant in a horizontal position. 4. Scheduling the feedings for every 6 hours.

2. Giving the infant small, frequent feedings.

The nurse explains to the parents of a child with a severe burn that wearing of an elastic pressure garment (Jobst stocking) during the rehabilitative stage can help with the prevention of which complication? 1. Poor circulation 2. Hypertrophic scarring 3. Pain 4. Formation of thrombus in the burn area

2. Hypertrophic scarring

A client is attending a newborn discharge class and asks a nurse about the bump on the infant's head. Upon assess- ment, the neonate has a large, diffuse swelling on the left occiput that crosses the sagittal suture line. The nurse should explain to the mother that: Select all that apply. 1. This is a collection of blood under the skull bone of the infant. 2. It is edematous swelling that overlies the periosteum. 3. It leads to hyperbilirubinemia in the infant. 4. It will require no treatment to resolve. 5. It is caused by pressure on the fetal head before delivery.

2. It is edematous swelling that overlies the periosteum. 4. It will require no treatment to resolve. 5. It is caused by pressure on the fetal head before delivery.

The nurse prepares a list of home care instructions for the parents of a child who has a plaster cast applied to the left forearm. Which instructions should be included on the list? Select all that apply. 1. Use the fingertips to lift the cast while it is drying. 2. Keep small toys and sharp objects away from the cast. 3. Use a padded ruler or another padded object to scratch the skin under the cast if it itches. 4. Place a heating pad on the lower end of the cast and over the fingers if the fingers feel cold. 5. Elevate the extremity on pillows for the first 24 to 48 hours after casting to prevent swelling. 6. Contact the health care provider (HCP) if the child complains of numbness or tingling in the extremity.

2. Keep small toys and sharp objects away from the cast. 5. Elevate the extremity on pillows for the first 24 to 48 hours after casting to prevent swelling. 6. Contact the health care provider (HCP) if the child complains of numbness or tingling in the extremity.

During the acute stage of meningitis, a 3-year-old child is restless and irritable. Which of the following would be most appropriate to institute? 1. Limiting conversation with the child. 2. Keeping extraneous noise to a minimum. 3. Allowing the child to play in the bathtub. 4. Performing treatments quickly.

2. Keeping extraneous noise to a minimum.

A nurse who witnesses an accident involving an adolescent riding a motorcycle, hitting a tree, and being thrown 30 feet into a field stops to help. The adolescent reports that he is now unable to move his legs. While waiting for the emergency medical service to arrive, what should the nurse do? 1. Flex the adolescent's knees to relieve stress on his back. 2. Leave the adolescent as he is, staying close by. 3. Remove the adolescent's helmet as soon as possible. 4. Assess the adolescent for abdominal trauma.

2. Leave the adolescent as he is, staying close by.

A nurse is caring for a child who has ICP. Which of the following actions should the nurse take? Select all that apply. 1. Suction the endotracheal tube every 2 hr. 2. Maintain a quiet environment. 3. Use two pillows to elevate the head. 4. Administer a stool softener. 5. Maintain body alignment.

2. Maintain a quiet environment. 4. Administer a stool softener. 5. Maintain body alignment.

When interviewing the parents of a 2-year-old child, a history of which of the following illnesses should lead the nurse to suspect pneumococcal meningitis? 1. Bladder infection. 2. Middle ear infection. 3. Fractured clavicle. 4. Septic arthritis.

2. Middle ear infection.

Which statement made by a parent during a well-child visit would cause the nurse to suspect the child has cerebral palsy? 1. My 6-month-old baby is rolling from back to prone now. 2. My 3-month-old seems to have floppy muscle tone. 3. My 8-month-old can sit without support. 4. My 10-month-old is not walking.

2. My 3-month-old seems to have floppy muscle tone

The child in a new hip spica cast seems to be adjusting to the cast, except that after each meal the child tells the nurse that the cast is too tight. Which of the following should the nurse plan to do? 1. Administer a laxative prior to each meal. 2. Offer smaller, more frequent meals. 3. Give the child a mechanical soft diet. 4. Offer the child more fruits and grains.

2. Offer smaller, more frequent meals.

A nurse is working with a nursing student in caring for an infant who has just returned from the surgical recovery area following a cleft lip repair. Which action by the nursing student should cause the nurse to intervene? 1. Placement of elbow restraints on the infant. 2. Offering the parents a regular bottle with which to feed the infant. 3. Positioning the infant in the semi-Fowler's position. 4. Advising the parents of a plan to administer pain medication around the clock.

2. Offering the parents a regular bottle with which to feed the infant.

A nurse is assessing a child after an open reduction of a fractured femur. Which assessment findings would indicate that the child is experiencing compartment syndrome? Select all that apply. 1. Pink, warm extremity 2. Pain not relieved by pain medication 3. Dorsalis pedis pulse present 4. Prolonged capillary-refill time with paresthesia 5. Skin appears tense.

2. Pain not relieved by pain medication 4. Prolonged capillary-refill time with paresthesia 5. Skin appears tense

A nurse is assessing an infant who has scabies. Which of the following findings should the nurse expect? Select all that apply. 1. Presence of nits on the hair shaft 2. Pencil-like marks on the hands 3. Blisters on the soles of the feet 4. Small, red bumps on the scalp 5. Pimples on the trunk

2. Pencil-like marks on the hands 3. Blisters on the soles of the feet 5. Pimples on the trunk

A child is diagnosed with epilepsy and is prescribed daily phenytoin (Dilantin). Which topic is most appropriate for the nurse to include in the discharge teaching? 1. Increasing fluid intake 2. Performing good dental hygiene 3. Decreasing intake of vitamin D 4. Taking the medication with milk

2. Performing good dental hygiene

The nurse is caring for a child in Bryant's traction. The nurse should: 1. Adjust the weights on the legs until the buttocks rest on the bed. 2. Provide frequent skin care. 3. Place a pillow under the buttocks. 4. Remove the elastic leg wraps every 8 hours for 10 minutes.

2. Provide frequent skin care.

A school nurse is preparing to teach a group of teenagers how to prevent meningitis. What aspect of meningitis prevention should the nurse be certain to include in the presentation? 1. Getting a meningitis vaccine is the only way to guarantee prevention. 2. Refraining from sharing food and drinks is a good way to prevent meningitis infection. 3. Avoiding team sports is one way to stop the spread of meningitis infection. 4. Meningitis prevention methods should be employed whenever children are in crowds.

2. Refraining from sharing food and drinks is a good way to prevent meningitis infection.

An infant with a diagnosis of hydrocephalus is scheduled for surgery. Which is the priority nursing intervention in the preoperative period? 1. Test the urine for protein. 2. Reposition the infant frequently. 3. Provide a stimulating environment. 4. Assess blood pressure every 15 minutes.

2. Reposition the infant frequently.

The nurse is providing care for a pediatric client who has a third-degree circumferential burn of the right arm. Which nursing diagnosis is the priority for this client? 1. Risk for Infection 2. Risk for Altered Tissue Perfusion 3. Risk for Altered Nutrition: Less than Body Requirements 4. Impaired Physical Mobility

2. Risk for Altered Tissue Perfusion

A 17-year-old young woman is being seen in the primary health-care provider's office for a chief complaint of acne. Which of the following diagnoses would be appropriate for the nurse to include in the client's plan of care? 1. Powerlessness 2. Risk for Ineffective Coping 3. Risk for Self-mutilation 4. Self-neglect

2. Risk for Ineffective Coping

A school-age client experiences a near-drowning episode and is admitted to the pediatric intensive-care unit (PICU). The parents express guilt over the near drowning of their child. Which response by the nurse is most appropriate? 1. You will need to watch the child more closely. 2. Tell me more about your feelings related to the accident. 3. The child will be fine, so dont worry. 4. Why did you let the child almost drown?

2. Tell me more about your feelings related to the accident.

After placing an infant with myelomeningocele in an isolette shortly after birth, which indicator should the nurse use as the best way to determine the effectiveness of this intervention? 1. The partial pressure of arterial oxygen remains between 94 and 100 mm Hg. 2. The axillary temperature remains between 97° and 98° F (36.1° and 36.7° C). 3. The bilirubin level remains stable. 4. Weight increases by about 1 oz (28.35 g) per day.

2. The axillary temperature remains between 97° and 98° F (36.1° and 36.7° C).

The nurse is helping a family plan for the discharge of their child, who will be going home in a spica cast. Which of the following points of information should be most important for the nurse to consider? 1. The bathrooms are all on the second floor. 2. The child's bedroom is on the second floor. 3. A 16-year-old sister will care for the child during the day. 4. There are three steps up to the front door.

2. The child's bedroom is on the second floor.

An infant is brought to an emergency department with a chief complaint of nausea and vomiting. Which nursing assessment finding should indicate to a nurse that the infant's dehydration is severe? 1. The infant is lethargic with a urinary output of less than 1 mL/kg/hr. 2. The infant has weak pulses, poor skin turgor, and cool, mottled skin. 3. The infant has warm skin, increased pulse, and capil- lary refill of 2 seconds. 4. The infant is irritable, with dry mucous membranes and increased respirations.

2. The infant has weak pulses, poor skin turgor, and cool, mottled skin.

The nurse is assessing a 3-month-old during a well-baby visit. Which of the following findings would warrant the nurse to recommend that the baby have an ultrasound for a possible diagnosis of developmental dysplasia of the hip (DDH)? 1. Bilateral plantar flexion 2. Unequal knee heights 3. Bilateral polydactyly 4. Positive Babinski test

2. Unequal knee heights

The nurse is teaching the parents of a child with myelomeningocele how to prevent UTIs. What should the care plan include for this child? Select all that apply. 1. Provide meticulous skin care. 2. Use the Crede's maneuver to empty the bladder. 3. Encourage frequent emptying of the bladder. 4. Assure adequate fluid intake. 5. Use tight-fitting diapers around the meatus.

2. Use the Crede's maneuver to empty the bladder. 3. Encourage frequent emptying of the bladder. 4. Assure adequate fluid intake.

A 5-year-old child with burns on the trunk and arms has no appetite. The nurse and mother develop a plan of care to stimulate the child's appetite. Which of the following suggestions made by the mother would indicate that she needs additional teaching? 1. Deciding that she will feed the child herself. 2. Withholding dessert and treats unless meals are eaten. 3. Offering the child finger foods that the child likes. 4. Serving smaller and more frequent meals.

2. Withholding dessert and treats unless meals are eaten.

A nurse is observing a child with a leg cast who is learning how to crutch walk. Which of the following assessments would lead the nurse to identify deficient knowledge as a priority nursing diagnosis for the child? While using the crutches, the child: 1. bends her elbows at all times. 2. swings her legs forward before moving the crutches. 3. keeps a space between her axillae and the underarm supports. 4. moves both crutches forward at the same time.

2. swings her legs forward before moving the crutches.

The school nurse notifies the mother of a 7-year-old girl that her child has head lice (pediculosis capitis). Which of the following information should the nurse advise the mother regarding the problem? 1. "I strongly suggest that you cut your child's hair short before using the lice medicine, and keep it short from now on." 2. "Your child will need to be kept at home until she has received the second treatment, one week after the first." 3. "After using the lice medicine, you will need to comb your child's hair with a fine-toothed comb." 4. "For up to three weeks after being treated with the lice medicine, your child may complain of itching."

3. "After using the lice medicine, you will need to comb your child's hair with a fine-toothed comb."

The parents of a child with juvenile idiopathic arthritis call the clinic nurse because the child is experiencing a painful exacerbation of the disease. The parents ask the nurse if the child can perform range-of-motion exercises at this time. The nurse should make which response? 1. "Avoid all exercise during painful periods." 2. "Range-of-motion exercises must be performed every day." 3. "Have the child perform simple isometric exercises during this time." 4. "Administer additional pain medication before performing range-of-motion exercises."

3. "Have the child perform simple isometric exercises during this time."

The nurse is providing instruction to the parents of a child with scoliosis regarding the use of a brace. Which statement by the parents indicates a need for further instruction? 1. "I will encourage my child to perform prescribed exercises." 2. "I will have my child wear soft fabric clothing under the brace." 3. "I should apply lotion under the brace to prevent skin breakdown." 4. "I should avoid the use of powder because it will cake under the brace."

3. "I should apply lotion under the brace to prevent skin breakdown."

The mother brings her child to the clinic after discharge from the hospital for Guillain-Barré syndrome. Which of the following statements by the mother indicates that she is following the discharge plan? 1. "She and her sister argue all day." 2. "I have to bribe her to get her to do her exercises." 3. "I take her to the pool where she can exercise with other children." 4. "She's missed a few of her therapy sessions because she often sleeps."

3. "I take her to the pool where she can exercise with other children."

A preschooler with a history of repaired lumbar myelomeningocele is in the emergency department with wheezing and skin rash. Which of the following questions should the nurse ask the mother first? 1. "Is your child taking any medications?" 2. "Who brought your child to the emergency department?" 3. "Is your child allergic to bananas or milk products?" 4. "What are you doing to treat your child's skin rash?"

3. "Is your child allergic to bananas or milk products?"

The mother asks the nurse whether her child with hemiparesis due to spastic cerebral palsy will be able to walk normally because he can pull himself to a standing position. Which of the following responses by the nurse would be most appropriate? 1. "Ask the doctor what he thinks at your next appointment." 2. "Maybe, maybe not. How old were you when you first walked?" 3. "It's difficult to predict, but his ability to bear weight is a positive factor." 4. "If he really wants to walk, and works hard, he probably will eventually."

3. "It's difficult to predict, but his ability to bear weight is a positive factor."

The school nurse has provided an instructional session about impetigo to parents of the children attending the school. Which statement, if made by a parent, indicates a need for further instruction? 1. "It is extremely contagious." 2. "It is most common in humid weather." 3. "Lesions most often are located on the arms and chest." 4. "It might show up in an area of broken skin, such as an insect bite."

3. "Lesions most often are located on the arms and chest."

The parents of an 18-year-old preparing to enter college ask if their daughter should have the meningococcal (MCV4) vaccine. The nurse should tell the parents: 1. "It is only necessary to have the vaccine if your daughter will be living in a dormitory." 2. "Yes, we recommend the vaccine, but it needs to be given as a series of three injections." 3. "Let's review your records. The vaccine may have already been given a few years ago." 4. "We highly recommend this vaccine, but we will need to do a pregnancy screening first."

3. "Let's review your records. The vaccine may have already been given a few years ago."

The nurse is discharging a baby with clubfoot who has had a cast applied. The nurse should provide additional teaching to the parents if they state: 1. "I should call if I see changes in the color of the toes under the cast." 2. "I should use a pillow to elevate my child's foot as he sleeps." 3. "My baby will need a series of casts to fix her foot." 4. "Having a cast should not prevent me from holding my baby."

3. "My baby will need a series of casts to fix her foot."

After teaching the parents of an infant with clubfoot requiring application of a plaster cast how to care for the cast, which of the following statements would indicate that the parents have understood the teaching? 1. "If the cast becomes soiled, we'll clean it with soap and water." 2. "We'll elevate the leg with the cast on pillows, so the leg is above heart level." 3. "We will check the color and temperature of the toes of the casted leg frequently." 4. "The petals on the edge of the cast can be removed after the first 24 hours."

3. "We will check the color and temperature of the toes of the casted leg frequently."

An 8-year-old child has been diagnosed with Legg-Calve-Perthes disease. Which of the following information should the nurse include in the patient teaching regarding the illness? 1. "You will have to stay home from school and learn from a tutor until you get better." 2. "The infection in your bone will be treated with a special medicine that you will receive through your vein." 3. "You will have to use crutches and be allowed only to walk on your healthy leg until your bones are all better." 4. "The cast must stay on your ankle and calf for a few weeks until they are fully healed."

3. "You will have to use crutches and be allowed only to walk on your healthy leg until your bones are all better."

A 10-year-old has just spilled hot liquid on his arm, and a 4-inch area on his forearm is severely burned. His mother calls the emergency department. What should the nurse advise the mother to do? 1. Keep the child warm. 2. Cover the burned area with an antibiotic cream. 3. Apply cool water to the burned area. 4. Call 911 to transport the child to the hospital.

3. Apply cool water to the burned area.

To determine whether a baby is allergic to foods, the nurse should educate parents to feed their babies employing which of the following procedures? 1. Babies' first foods should be either pureed apples or peaches. 2. The first time babies are fed solid foods, the babies should be at least 8 months of age. 3. Babies' first foods should be fed one at a time for 4 to 7 days each. 4. The first time babies are fed solid foods, the foods should be mixed with apple juice.

3. Babies' first foods should be fed one at a time for 4 to 7 days each.

A baby with myelomeningocele is admitted to the neonatal intensive care unit. Which of the following signs/symptoms would the nurse expect to see? 1. Hyperre exia 2. Ptosis 3. Bilateral lower limb paralysis 4. Marked respiratory distress

3. Bilateral lower limb paralysis

A child has been diagnosed with periorbital cellulitis. For which of the following signs/ symptoms should the nurse assess? 1. Subconjunctival hemorrhages 2. Yellow-tinged sclerae 3. Bluish streaks in tissues surrounding the eye 4. Absence of the red re ex during eye examination

3. Bluish streaks in tissues surrounding the eye

A lumbar puncture is performed on a child suspected to have bacterial meningitis, and cerebrospinal fluid (CSF) is obtained for analysis. The nurse reviews the results of the CSF analysis and determines that which results would verify the diagnosis? 1. Clear CSF, decreased pressure, and elevated protein level. 2. Clear CSF, elevated protein, and decreased glucose level. 3. Cloudy CSF, elevated protein, and decreased glucose levels. 4. Cloudy CSF, decreased protein, and decreased glucose levels.

3. Cloudy CSF, elevated protein, and decreased glucose levels.

The physician has ordered intravenous mannitol (Osmitrol) for a child with a head injury. The best indicator that the drug has been effective is: 1. Increased urine output. 2. Improved level of consciousness. 3. Decreased intracranial pressure. 4. Decreased edema.

3. Decreased intracranial pressure.

A nurse is making an initial visit to a family with a 3-year-old child with early Duchenne's mus- cular dystrophy. Which of the following findings is expected when assessing this child? 1. Contractures of the large joints. 2. Enlarged calf muscles. 3. Difficulty riding a tricycle. 4. Small, weak muscles.

3. Difficulty riding a tricycle.

When caring for a child with moderate burns from the waist down, which of the following should the nurse do when positioning the child? 1. Place the child in a position of comfort. 2. Allow the child to lie on the abdomen. 3. Ensure the application of leg splints. 4. Have the child flex the hips and knees.

3. Ensure the application of leg splints.

Anticipating that a 3-year-old child in traction will have need for diversion, what should the nurse offer the child? Synthesize 1. A video game. 2. Blocks. 3. Hand puppets. 4. Marbles.

3. Hand puppets.

Which of the following findings should lead the nurse to decide that spinal shock was resolving in the adolescent with a spinal cord injury? 1. Atonic urinary bladder. 2. Flaccid paralysis. 3. Hyperactive reflexes. 4. Widened pulse pressure.

3. Hyperactive reflexes.

An infant has a severe case of oral thrush (Candida albicans). Which nursing diagnosis is the priority for this infant? 1. Activity Intolerance Related to Oral Thrush 2. Ineffective Airway Clearance Related to Mucus 3. Ineffective Infant Feeding Pattern Related to Discomfort 4. Ineffective Breathing Pattern Related to Oral Thrush

3. Ineffective Infant Feeding Pattern Related to Discomfort

The nurse is providing teaching to a community group regarding preventative strategies to reduce the risk of burn injury. Which topics will the nurse include in the teaching session? Select all that apply. 1. Avoid contact with unknown animals and wild animals. 2. Layer children's clothing for warmth. 3. Keep infants and toddlers off the lap when drinking hot beverages or eating soup. 4. Lower the temperature settings for hot water heaters. 5. Wear light-colored clothes and avoid eating sweetened foods and beverages when outside.

3. Keep infants and toddlers off the lap when drinking hot beverages or eating soup. 4. Lower the temperature settings for hot water heaters.

A 13-year-old child has seen the school nurse several times with headache, vomiting, and difficulty walking. When calling the adolescent's mother about these symptoms, what should the nurse suggest the mother do first? 1. Schedule an appointment with the eye doctor. 2. Begin psychological counseling for her adolescent. 3. Make an appointment with the adolescent's physician. 4. Meet with the adolescent's teachers to determine academic progress.

3. Make an appointment with the adolescent's physician.

Which nursing intervention is most appropriate when caring for an infant with a myelomeningocele in the preoperative stage? 1. Placing infant supine to decrease pressure on the sac 2. Appling a heat lamp to facilitate drying and toughening of the sac 3. Measuring head circumference every shift to identify developing hydrocephalus 4. Appling a diaper to prevent contamination of the sac

3. Measuring head circumference every shift to identify developing hydrocephalus

A child is being treated with vancomycin 40 mg/kg/d I.V. divided in 3 doses for osteomyeli- tis. The primary care provider has ordered drug protocol management by pharmacy and a trough vancomycin level 30 minutes before the third dose scheduled for 9 a.m. The laboratory report returns prior to the third dose: 0830 Vancomycin 7 mcg/mL, Therapeutic range: 10-15 mcg/mL. The nurse should: 1. Administer the 9 a.m. dose. 2. Notify the primary care provider. 3. Notify the pharmacist. 4. Draw a peak drug level.

3. Notify the pharmacist.

The nurse is assisting a health care provider (HCP) examining a 3-week-old infant with developmental dysplasia of the hip. What test of sign should the nurse expect the HCP to assess? 1. Babinski's sign 2. The Moro reflex 3. Ortolani's maneuver 4. The palmar-plantar grasp

3. Ortolani's maneuver

During assessment of an adolescent who has sustained a recent thoracic spinal injury, the nurse auscultates the adolescent's abdomen. The nurse explains to the parents that this is necessary because clients with spinal cord injury often develop which of the following? 1. Abdominal cramping. 2. Hyperactive bowel sounds. 3. Paralytic ileus. 4. Profuse diarrhea.

3. Paralytic ileus.

A hospitalized preschooler with meningitis who is to be discharged becomes angry when the discharge is delayed. Which of the following play activities would be most appropriate at this time? 1. Reading the child a story. 2. Painting with watercolors. 3. Pounding on a pegboard. 4. Stacking a tower of blocks.

3. Pounding on a pegboard.

A newborn arrives in a neonatal intensive care unit with a myelomeningocele. A physician writes orders to keep the infant in the prone position. A nurse should know that the most important rationale behind this order is to: 1. Prevent infection. 2. Promote circulation in the lower extremities. 3. Prevent trauma to the meningeal sac. 4. Promote comfort.

3. Prevent trauma to the meningeal sac.

The nurse is planning care for a 3-month-old infant diagnosed with eczema. Which should be the focus of the nurses care for this infant? 1. Maintaining adequate nutrition 2. Keeping the baby content 3. Preventing infection of lesions 4. Applying antibiotics to lesions

3. Preventing infection of lesions

The nurse in the emergency department is caring for a 3-year-old child with a fractured humerus. The child is crying and screaming, "I hate you." Which of the following would be most appropriate? 1. Tell the parents they will need to wait out in the lobby. 2. Ask the charge nurse to assign this client to another nurse. 3. Reassure the parents that this a normal behavior under the circumstances. 4. Ask the parents to discipline the child so that the physician can treat her.

3. Reassure the parents that this a normal behavior under the circumstances.

A nurse is caring for a school-age client who possibly has Reye syndrome. Which of the following is a risk factor for developing Reye syndrome? 1. Recent history of infectious cystitis caused by Candida 2. Recent history of bacterial otitis media 3. Recent episode of gastroenteritis 4. Recent episode of Haemophilus influenza meningitis

3. Recent episode of gastroenteritis

After teaching a group of school teachers about seizures, the teachers role-play a scenario involving a child experiencing a generalized tonic-clonic seizure. Which of the following actions, when performed first, indicates that the nurse's teaching has been successful? 1. Asking the other children what happened before the seizure. 2. Moving the child to the nurse's office for privacy. 3. Removing any nearby objects that could harm the child. 4. Placing a padded tongue blade between the child's teeth.

3. Removing any nearby objects that could harm the child.

An 8-year-old child with juvenile idiopathic arthritis (JIA) is being admitted to the hospital for evaluation of progressively increasing symptoms. The child weighs 60 pounds and is 50 inches tall. The nurse is reconciling the medications the parent brought from home with the medications the physician has ordered. Physician Order Home meds -Ibuprofen tablet 200 mg po 4× day (for arthritis) -Purchased over the counter Cetirizine hydrochloride (Zyrtec) tablet 10 mg po daily (for allergies) Purchased over the counter Ordered meds -Ibuprofen tablet 200 mg po 4 × day -Methotrexate tablet 10 mg po every Monday 1. Have the family give the child cetirizine daily using the medication they have from home. 2. Explain the need to limit over-the-counter medications while in the hospital. 3. Request a cetirizine order from the primary care provider. 4. Contact the primary care provider to question the methotrexate.

3. Request a cetirizine order from the primary care provider.

The nurse is reviewing the record of a child with increased ICP and notes that the child has exhibited signs of decerebrate posturing. On assessment of the child, the nurse expects to note which characteristic of this type of posturing? 1. Flaccid paralysis of all extremities. 2. Adduction of the arms at the shoulders. 3. Rigid extension and pronation of the arms and legs. 4. Abnormal flexion of the upper extremities and extension and adduction of the lower extremities.

3. Rigid extension and pronation of the arms and legs.

A child with myelomeningocele, corrected at birth, is now 5 years old. Which is the priority nursing diagnosis for a child with corrected spina bifida at this age? 1. Risk for Altered Nutrition 2. Risk for Impaired Tissue PerfusionCranial 3. Risk for Altered Urinary Elimination 4. Risk for Altered Comfort

3. Risk for Altered Urinary Elimination

After a child undergoes a craniotomy for an infratentorial brain tumor, the nurse should place the child in which of the following positions to prevent undue strain on the sutures? 1. Prone. 2. Semi-Fowler's. 3. Side-lying. 4. Trendelenburg.

3. Side-lying.

Which action should the nurse do first when noting clear drainage on the child's dressing and bed linen after a craniotomy for a brain tumor? 1. Change the dressing. 2. Elevate the head of the bed. 3. Test the fluid for glucose. 4. Notify the physician.

3. Test the fluid for glucose.

A nurse is developing a plan of care with the parents of a 6-year-old girl diagnosed with a seizure disorder. To promote growth and development, the nurse should instruct the parents that: 1. The child will need activity limitation and will be unable to perform as well as her peers. 2. There is potential for a learning disability and the child may need tutoring to reach her grade level. 3. The child will likely have normal intelligence and be able to attend regular school. 4. There will be problems associated with social stigma and parents should consider home schooling.

3. The child will likely have normal intelligence and be able to attend regular school.

A 14-year-old is being screened for scoliosis. Which of the following statements about scoliosis screening is true? 1. Teenagers ages 14 to 16 should be screened yearly. 2. A shirt and shorts are worn for screening. 3. The girl is assessed standing and bending forward. 4. The girl should refrain from eating 8 hours before the examination.

3. The girl is assessed standing and bending forward.

A charge nurse is creating nursing assignments for a pediatric unit when one of the oncoming nurses calls to say, "Sorry, I'll be a few minutes late since I have a child home ill with the chickenpox." What type of assignment would be most acceptable for the nurse who will be late? 1. Any assignment is fine as long as the nurse wears a mask. 2. The nurse needs an assignment that does not include children with neutropenia. 3. The nurse should not be given an assignment and should be called off. 4. Any care assignment is acceptable, without restrictions.

3. The nurse should not be given an assignment and should be called off.

The clinic nurse is educating the parents of a 10-year-old child with scabies regarding medication administration. Which of the following information should the nurse include in the teaching? 1. The child should have been bathed at least 24 hours prior to the administration of the medication. 2. The oral medication must be administered on an empty stomach. 3. The topical medication must remain on the skin for 8 full hours. 4. The parent should readminister the medication in one week if the child continues to complain of itching.

3. The topical medication must remain on the skin for 8 full hours.

A baby has been diagnosed with atopic dermatitis (eczema). Which of the following signs/symptoms would the nurse expect to see? 1. Macular rash on the baby's back and shoulders. 2. Vesicular rash over the baby's abdomen and perineum. 3. Weepy rash over both of the baby's forearms and cheeks. 4. Scaly rash on the baby's scalp and forehead.

3. Weepy rash over both of the baby's forearms and cheeks.

A school-age child has been diagnosed with a right ankle sprain. Which of the following actions should the nurse advise the child and parents to perform? 1. Surround the ankle in a heating pad at moderate heat. 2. Position the ankle at a level below that of the heart. 3. Wrap the ankle in an ace bandage or an ankle brace. 4. Practice range of motion exercises until the pain is resolved.

3. Wrap the ankle in an ace bandage or an ankle brace.

The nurse is educating the parents of a child with Duchenne muscular dystrophy (DMD) regarding priority actions that they should take when caring for their child. Which of the following actions should the nurse include during the teaching session? Immediately report to the child's primary health-care provider if the child: 1. has diarrhea. 2. refuses to eat. 3. develops an upper respiratory infection. 4. complains of pain in any limbs.

3. develops an upper respiratory infection.

The nurse mentions that a group meeting for mothers of mentally retarded children is to be held soon. "Not retarded!" the child's mother angrily blazes, "Exceptional." When responding to this outburst, which of the following replies by the nurse would be most appropriate? 1. "'Retarded' is the commonly used and accepted term." 2. "I'm sorry if I offended you by my thoughtless remark." 3. "No matter what it's called, the condition is still the same, isn't it?" 4. "I'd like to hear more of your thoughts and feelings on that."

4. "I'd like to hear more of your thoughts and feelings on that."

A nurse is admitting a 7-month-old infant with a diagnosis of neuroblastoma to the pediatric in-patient unit. The infant is the parents' third child. The infant's father asks, "The doctor keeps talking about the genetics of the tumor. What the heck does that mean?" Which of the following responses by the nurse is appropriate? 1. "The doctor wants to determine whether any of your other children is at high risk of developing a neuroblastoma." 2. "The doctor wants to determine whether the genetic code in your baby's tumor is different from the genetic code in the rest of the baby's cells." 3. "The doctor is mandated by law to report to the health department any genetic mutation that is caused by environmental contaminants." 4. "The doctor will be better able to determine how the baby's therapy will work once the exact genetic code of the tumor is identified."

4. "The doctor will be better able to determine how the baby's therapy will work once the exact genetic code of the tumor is identified."

A nurse is caring for an infant who has myelomeningocele. Which of the following actions should the nurse include in the preoperative plan of care? 1. Assist the mother with cuddling the infant 2. Assess the infants temperature rectally 3. Place the infant in a supine position 4. Apply a sterile, moist dressing on the sac

4. Apply a sterile, moist dressing on the sac

A child with osteomyelitis is receiving IV gentamycin. The nurse should monitor which of the child's laboratory values to assess for possible toxicity from the medication? 1. Hematocrit 2. Platelet count 3. Serum sodium 4. Blood urea nitrogen

4. Blood urea nitrogen

A mother arrives at the ED with her 5-year-old child and states that the child fell off of a bunk bed. A head injury is suspected. The nurse checks the child's airway status and assesses the child for early and late signs of ICP. Which is a late sign of ICP? 1. Nausea 2. Irritability 3. Headache 4. Bradycardia

4. Bradycardia

A nurse is conducting a postoperative assessment on an infant who has just had a ventriculoperitoneal shunt placed for hydrocephalus. Which assessment finding would indicate a malfunction in the shunt? 1. Incisional pain 2. Movement of all extremities 3. Negative Brudzinski sign 4. Bulging fontanel

4. Bulging fontanel

A child hospitalized with hydrocephalus is being treated with an externalized ventricular drain (EVD). A nurse begins the afternoon assessment and discovers that the drain is positioned several inches below the child's ear level. What should be the nurse's priority action? 1. Raise the drain to the child's ear level. 2. Leave the drain as is and monitor the CSF drainage hourly. 3. Quickly elevate the head of the bed. 4. Clamp the drain and complete a neurological assessment.

4. Clamp the drain and complete a neurological assessment.

The nurse is teaching the parents of a child with developmental dysplasia of the hip (DDH) regarding the application of the Pavlik harness. Which of the following information should the nurse include in the teaching? 1. Three diapers should be worn at all times under the harness. 2. Harness should be removed for ten minutes every hour. 3. Harness should always keep the legs fully adducted. 4. Clothing should always fit loosely over the harness.

4. Clothing should always fit loosely over the harness.

When developing a teaching plan for the parents of a child with Down syndrome, the nurse focuses on activities to increase which of the follow- ing for the parents? 1. Affection for their child. 2. Responsibility for their child's welfare. 3. Understanding of their child's disability. 4. Confidence in their ability to care for their child.

4. Confidence in their ability to care for their child.

When developing the discharge plan for the parents of an infant who has undergone a myelomeningocele repair, what information is most important for the nurse to include? 1. A list of available hospital services. 2. Schedule for daily home health care. 3. Chaplain referral for psychological support. 4. Daily care required by the infant.

4. Daily care required by the infant.

The nurse is admitting a child who has been diagnosed with bacterial meningitis to the pediatric unit. The nurse should implement which type of isolation? 1. Standard precautions. 2. Contact precautions. 3. Airborne precautions. 4. Droplet precautions.

4. Droplet precautions.

A 5-year-old child, diagnosed with a greenstick fracture of the left ulna, is being discharged home from the emergency department in a fiberglass cast. Which of the following actions should the nurse make at this time? 1. Inform the parents to use a hair dryer to facilitate the drying of the cast. 2. Report the suspected child abuse case to the local child abuse agency. 3. Refer the family to a specialist to investigate the etiology for the unusual break. 4. Educate the parents to monitor the temperature and color of the child's left hand.

4. Educate the parents to monitor the temperature and color of the child's left hand.

A nurse is caring for a 4 month old infant who has meningitis. Which of the following findings is associated with this diagnosis 1. Depressed anterior fontanel 2. Constipation 3. Presence of the rooting reflex 4. High-pitched cry

4. High-pitched cry

A 12-month-old child with infantile eczema is seen at the clinic for several open lesions on the arms and legs. What should a nurse caution the child's parents against? 1. Initiating a diet free of milk products. 2. The use of topical hydrocortisone cream. 3. Adding cornstarch to bath water. 4. Immunization during eczema exacerbations.

4. Immunization during eczema exacerbations.

The nurse is planning care for a child with acute bacterial meningitis. Based on the mode of transmission of this infection, which precautionary intervention should be included in the plan of care? 1. Maintain enteric precautions 2. Maintain neutropenic precautions 3. No precautions are required as long as antibiotics have been started 4. Maintain respiratory isolation precautions for at least 24 hours after the initiation of antibiotics

4. Maintain respiratory isolation precautions for at least 24 hours after the initiation of antibiotics

An adolescent is on the football team and practices in the morning and afternoon before school starts for the year. The temperature on the field has been high. The school nurse has been called to the practice field because the adolescent is now reporting that he has muscle cramps, nau- sea, and dizziness. Which of the following actions should the school nurse do first? 1. Administer cold water with ice cubes. 2. Take the adolescent's temperature. 3. Have the adolescent go to the swimming pool. 4. Move the adolescent to a cool environment.

4. Move the adolescent to a cool environment.

A 2-month-old client has a candidal diaper rash. Which medication does the nurse anticipate will be prescribed for this client? 1. Bacitracin ointment 2. Hydrocortisone ointment 3. Desitin 4. Nystatin given topically and orally

4. Nystatin given topically and orally

A 9-month-old infant with eczema has lesions that are secondarily infected. Which of the following is most appropriate to help the parents best meet the needs of the child? 1. Preventing siblings from being in close contact. 2. Sending the child to day care as usual. 3. Playing video games for several hours each evening. 4. Playing with the child every day.

4. Playing with the child every day.

The nurse discusses with the parents how best to raise the IQ of their child with Down syndrome. Which of the following would be most appropriate? 1. Serving hearty, nutritious meals. 2. Giving vasodilator medications as prescribed. 3. Letting the child play with more able children. 4. Providing stimulating, nonthreatening life experiences.

4. Providing stimulating, nonthreatening life experiences.

A nurse performs a scoliosis screening at a local school. Which assessment finding by the nurse would least likely result in a scoliosis referral? 1. Unilateral rib hump noted when the child is bent forward. 2. Asymmetrical hip height noted when the child is standing erect. 3. Uneven wear noted on the bottom of the child's pant legs. 4. Rounded shoulders noted when the child is standing erect.

4. Rounded shoulders noted when the child is standing erect.

The nurse creates a plan of care for a child at risk for tonic-clonic seizures. In the plan of care, the nurse identifies seizure precautions and documents that which item(s) need to be placed at the child's bedside? 1. Emergency cart 2. Tracheotomy set 3. Padded tongue blade 4. Suctioning equipment and oxygen

4. Suctioning equipment and oxygen

A 4-year-old child with hydrocephalus is scheduled to have a ventroperitoneal shunt in the right side of the head. When developing the child's postoperative plan of care, the nurse should place the preschooler in which of the following positions immediately after surgery? 1. On the right side, with the foot of the bed elevated. 2. On the left side, with the head of the bed elevated. 3. Prone, with the head of the bed elevated. 4. Supine, with the head of the bed flat.

4. Supine, with the head of the bed flat.

When teaching the child with scoliosis being treated with a Boston brace about exercises, the nurse explains that the exercises are performed primarily for which of the following purposes? 1. To decrease back muscle spasms. 2. To improve the brace's traction effect. 3. To prevent spinal contractures. 4. To strengthen the back and abdominal muscles.

4. To strengthen the back and abdominal muscles.

A 16-month-old child is seen in the clinic for a checkup for the first time. The nurse notices that the toddler limps when walking. Which of the following would be appropriate to use when assessing this toddler for developmental dysplasia of the hip? 1. Ortolani's maneuver. 2. Barlow's maneuver. 3. Adam's position. 4. Trendelenburg's sign.

4. Trendelenburg's sign.

The nurse is providing education to the parents of a pediatric client who is diagnosed with tinea capitis (ringworm of the scalp). Which statement made the parents indicates an appropriate understanding of the teaching session? 1. We will give the griseofulvin on an empty stomach. 2. Were glad ringworm isnt transmitted from person to person. 3. Once the lesion is gone, we can stop the griseofulvin. 4. We will give the griseofulvin with milk or peanut butter.

4. We will give the griseofulvin with milk or peanut butter.

The school nurse is conducting pediculosis capitis (head lice) checks. Which findings would indicate a positive head check? 1. White, flaky particles throughout the entire scalp region 2. Maculopapular lesions behind the ears 3. Lesions in the scalp that extend to the hairline or neck 4. White sacs attached to the hair shafts in the occipital area

4. White sacs attached to the hair shafts in the occipital area

The school nurse is performing pediculosis capitis (head lice) assessments. Which assessment finding indicates that a child has a "positive" head check? 1. Maculopapular lesions behind the ears. 2. Lesions in the scalp that extend to the hairline or neck. 3. White flaky particles throughout the entire scalp region. 4. White sacs attached to the hair shafts in the occipital area.

4. White sacs attached to the hair shafts in the occipital area.

A nurse is caring for a school-age child who has juvenile idiopathic arthritis. Which of the following home care instructions should the nurse include in the teaching? 1. Provide extra time for completion of ADLs 2. Use cold compresses for joint pain 3. Take ibuprofen on an empty stomach 4. Remain home during periods of exacerbation 5. Perform range-of-motion exercises

5. Perform range-of-motion exercises

The nurse is caring for a pediatric client who sustained a severe burn. Determine the order of what would be done for this child when the medical team arrives on the scene. Response 1. Start intravenous fluids. Response 2. Provide for relief of pain. Response 3. Establish an airway. Response 4. Place a Foley catheter.

Response 3. Establish an airway. Response 1. Start intravenous fluids. Response 2. Provide for relief of pain. Response 4. Place a Foley catheter.

The parents of an infant with myelomeningocele ask the nurse about their child's future mental ability. What is the nurse's best response? 1. "About one-third are mentally retarded, but it's too early to tell about your child." 2. "About two-thirds are significantly retarded, and you'll know soon if this will occur." 3. "Your child will probably be of normal intelligence since he demonstrates signs of it now." 4. "You'll need to talk with the doctor about that, but you can ask later."

1. "About one-third are mentally retarded, but it's too early to tell about your child."

Which of the following statements made by the mother of a school-age child who has had a craniotomy for a brain tumor would warrant further exploration by the nurse? 1. "After this, I'll never let her out of my sight again." 2. "I hope that she'll be able to go back to school soon." 3. "I wonder how long it will be before she can ride her bike." 4. "Her best friend is eager to see her; I hope she won't be upset."

1. "After this, I'll never let her out of my sight again."

A child with newly diagnosed osteomyelitis has nausea and vomiting. The parent wishes to give the child ginger snaps to help control the nausea. The nurse should tell the parent: 1. "You can try them and see how he does." 2. "I will need to get an order." 3. "Your child needs medication for the vomiting." 4. "We discourage the use of home remedies in children."

1. "You can try them and see how he does."

A nurse is teaching a parent of an infant who has seborrheic dermatitis of the scalp. Which of the following instructions should the nurse include in her teaching? 1. "You can use petrolatum to help soften and remove patches from your infant's scalp" 2. "When patches are present, you should keep your infant away from others" 3. "You should avoid washing your infant's hair while patches are present on the scalp" 4. "When patches are present, it indications your infant has a systemic infection"

1. "You can use petrolatum to help soften and remove patches from your infant's scalp"

A school nurse is creating an informational brochure for parents regarding the treatment of head lice. What form of treatment should the nurse caution against? 1. Applying repeated doses of permethrin for as long as it takes until the infestation clears. 2. Washing all clothing and linens in hot water followed by drying them in a hot dryer. 3. Wearing gloves when washing the child's hair or inspecting for nits. 4. Removing nits daily from the child's hair with a fine-tooth comb.

1. Applying repeated doses of permethrin for as long as it takes until the infestation clears.

A nasogastric tube is ordered to be inserted for a child with severe head trauma. Diagnostic testing reveals that the child has a basilar skull fracture. What should the nurse do next? 1. Ask for the order to be changed to oral gastric tube. 2. Attempt to place the tube into the duodenum. 3. Test the gastric aspirate for blood. 4. Use extra lubrication when inserting the nasogastric tube.

1. Ask for the order to be changed to oral gastric tube.

An 8-year-old child does well after infratentorial tumor removal and is transferred back to the pediatric unit. Although she had been told about having her head shaved for surgery, she is very upset. After exploring the child's feelings, which action should the nurse take? 1. Ask the child if she'd like to wear a hat. 2. Reassure the child that her hair will grow back. 3. Explain to the child's parents that her reaction is normal. 4. Suggest that the parents buy the child a wig as a surprise.

1. Ask the child if she'd like to wear a hat.

While assessing a 3-year-old child who has had an injury to the leg, has pain, and refuses to walk, the nurse notes that the child's left thigh is swollen. What should the nurse do next? 1. Assess the neurologic status of the toes. 2. Determine the circulatory status of the upper thigh. 3. Obtain the child's vital signs. 4. Notify the physician immediately.

1. Assess the neurologic status of the toes.

A 7-year-old has been diagnosed as mentally retarded. Which of the parents' expectations for their child is realistic? Select all that apply. 1. Difficulty learning. 2. An IQ below 70. 3. Deficits in adaptive behavior. 4. Normal intellectual capacity. 5. Behavioral problems.

1. Difficulty learning. 2. An IQ below 70. 3. Deficits in adaptive behavior.

Which of the following assessments would be most important for the nurse to make initially in a school-age child being seen in the clinic who has a sore throat, muscle tenderness, arms feeling weak, and generally is not feeling well? 1. Difficulty swallowing. 2. Diet intake for the last 24 hours. 3. Exposure to illnesses. 4. Difficulty urinating.

1. Difficulty swallowing.

A lumbar puncture is performed on an infant suspected of having meningitis. Which finding does the nurse expect in the cerebral spinal fluid if the infant has meningitis? 1. Elevated white blood cell count 2. Elevated red blood cell count 3. Normal glucose 4. Decreased white blood cell count

1. Elevated white blood cell count

When developing the plan of care for an infant diagnosed with myelomeningocele and the parents who have just been informed of the infant's diagnosis, which action should the nurse include as the priority when the parents visit the infant for the first time? 1. Emphasizing the infant's normal and positive features. 2. Encouraging the parents to discuss their fears and concerns. 3. Reinforcing the doctor's explanation of the defect. 4. Having the parents feed their infant.

1. Emphasizing the infant's normal and positive features.

After talking with the parents of a child with Down syndrome, the nurse should help the parents establish which goal? 1. Encouraging self-care skills in the child. 2. Teaching the child something new each day. 3. Encouraging more lenient behavior limits for the child. 4. Achieving age-appropriate social skills.

1. Encouraging self-care skills in the child.

To meet the developmental needs of an 8-year-old child who is confined to home with osteomyelitis, what should the nurse include in the care plan? 1. Encouraging the child to communicate with schoolmates. 2. Encouraging the parents to stay with the child. 3. Allowing siblings to visit freely throughout the day. 4. Talking to the child about his interests twice daily.

1. Encouraging the child to communicate with schoolmates.

A 17-year-old female with severe nodular acne is considering treatment with isotretinoin (Accutane). Prior to beginning the medication, the nurse explains that the client will be required to: 1. Enroll in a risk management plan. 2. Have proof of a mental health evaluation. 3. Begin an effective form of birth control. 4. Temporarily give up sports.

1. Enroll in a risk management plan.

The parents of a child just diagnosed with juvenile idiopathic arthritis (JIA) tell the nurse that the diagnosis frightens them because they know nothing about the prognosis. What should the nurse include when teaching the parents about the disease? 1. Half of affected children recover without joint deformity. 2. Many affected children go into long remissions but have severe deformities. 3. The disease usually progresses to crippling rheumatoid arthritis. 4. Most affected children recover completely within a few years.

1. Half of affected children recover without joint deformity.

The nurse is planning care for a school-age child diagnosed with bacterial meningitis. Which intervention is most appropriate? 1. Keeping environmental stimuli at a minimum 2. Avoiding giving pain medications that could dull sensorium 3. Measuring head circ umference to assess developing complications 4. Having the child move the head from side to side at least every two hours

1. Keeping environmental stimuli at a minimum

The nurse has taken a health history from a school-age child who is being assessed 6 weeks' post-surgery for a benign brain tumor. The nurse should report which of the following findings to the health-care provider? 1. The child states that he fell at school three times last week. 2. The child states that has had no headache all week. 3. The child states that he did very well on yesterday's history test. 4. The child states that he has decided to join the school's swim team.

1. The child states that he fell at school three times last week.

A 12-year-old child has had a traumatic head injury from playing in a football game. He is admit- ted to the emergency department and transferred to the pediatric intensive care unit. He has an I.V. of dextrose 5% in water at a "keep-open" rate and nasal oxygen at 2 L/minute. The nurse is assessing the child at the beginning of the shift (11:00 p.m.) and reviews the Glasgow Coma Scale flow sheet below. The nurse notes that the child responds to pain, is making incomprehensible sounds, and has abnormal flexion of the limbs. What should the nurse do first? 1. Notify the physician. 2. Lower the head of the bed. 3. Increase the rate of nasal oxygen. 4. Increase the rate of the I.V. infusion.

1. Notify the physician.

Prior to surgery, a nurse is positioning a neonate with a myelomeningocele. The nurse should position the neonate in which of the following ways? Select all that apply. 1. Place the neonate in a prone position. 2. Keep a diaper over the sac. 3. Allow the neonate's feet to hang over the mattress edge. 4. Use a foam pad to maintain hip adduction. 5. Use a soft pad over the mattress.

1. Place the neonate in a prone position. 3. Allow the neonate's feet to hang over the mattress edge. 5. Use a soft pad over the mattress.

A 7-month-old child has been diagnosed with cerebral palsy (CP). Which of the following signs/ symptoms would the nurse assess as consistent with the diagnosis? 1. Positive grasp reflex 2. Pigeon chest 3. Harlequin sign 4. Circumoral cyanosis

1. Positive grasp reflex

The nurse is creating a plan of care for a child who is at risk for seizures. Which interventions apply if the child has a seizure? Select all that apply. 1. Time the seizure. 2. Restrain the child. 3. Stay with the child. 4. Place the child in a prone position. 5. Move furniture away from the child. 6. Insert a padded tongue blade in the child's mouth.

1. Time the seizure. 3. Stay with the child. 5. Move furniture away from the child.

A nurse is planning care for a child who has tinea capitis. Which of the following actions should the nurse include in the plan of care? Select all that apply. 1. Treat infected household pets 2. Use selenium sulfide shampoo 3. Cleanse are with Burrow solution 4. Administer antiviral medication 5. Use moist, warm compresses

1. Treat infected household pets 2. Use selenium sulfide shampoo

A school health nurse is screening school-age students for scoliosis. Which assessment findings indicate the need for further evaluation for scoliosis? Select all that apply. 1. Uneven shoulders and hips 2. A one-sided rib hump 3. Prominent scapula 4. Lordosis 5. Pain

1. Uneven shoulders and hips 2. A one-sided rib hump 3. Prominent scapula

A nurse teaches a child with spina bifida how to perform urinary self-catheterization. Which steps should the nurse include in the teaching? Place each correct step in sequential order. 1. Wash hands. 2. Open latex catheter package. 3. Lubricate tip of catheter. 4. Wash catheter with soap and water. 5. Cleanse perineum with Betadine swabs.

1. Wash hands. 3. Lubricate tip of catheter. 4. Wash catheter with soap and water.

The nurse is teaching a group of adolescents about care for acne vulgaris. Which interventions will the nurse include in the teaching session? Select all that apply. 1. Wash skin with mild soap and water twice a day. 2. Use astringents and vigorous scrubbing. 3. Avoid picking or squeezing the lesions. 4. Apply tretinoin (Retin-A) liberally. 5. Avoid sun exposure if on tetracycline.

1. Wash skin with mild soap and water twice a day. 3. Avoid picking or squeezing the lesions. 5. Avoid sun exposure if on tetracycline.

The parents of a child who requires skeletal traction are unable to visit their child for more than 1 hour a day because there are five other children at home and both parents work outside of the home. The nurse recognizes expressions of guilt in both parents. To help alleviate this guilt, the nurse should make which of the following remarks? 1. "I'm sure you feel guilty about not being able to visit often." 2. "It's important that you visit even for 1 hour." 3. "Not all parents can stay all the time." 4. "Perhaps you could take turns visiting for a bit longer."

2. "It's important that you visit even for 1 hour."

Nonsteroidal anti-inflammatory drugs are the first choice in treating a child with juvenile idio- pathic arthritis. Which adverse effects should the nurse include in the teaching plan for the parents? Select all that apply. 1. Weight gain. 2. Abdominal pain. 3. Blood in the stool. 4. Folic acid deficiency. 5. Reduced blood clotting ability.

2. Abdominal pain. 3. Blood in the stool. 5. Reduced blood clotting ability.

Which procedures can the nurse working on a pediatric floor safely delegate to the licensed prac- tical nurse (LPN). Select all that apply. 1. Refilling a baclofen pump. 2. Administering gastrostomy tube feedings. 3. Administering gastrostomy medications. 4. Giving an IV push medication. 5. Calling the AM blood sugars to the physician.

2. Administering gastrostomy tube feedings. 3. Administering gastrostomy medications.

A 10-year-old has 5 lb of Buck's extension traction on his left leg. The nurse should assess the child for which of the following? Select all that apply. 1. Dryness of the skin, by removing the foam wraps and boot. 2. Alignment of the shoulder, hips, and knees. 3. Frayed rope near pulleys. 4. Correct amount of traction weight on fracture. 5. Pressure on the coccyx.

2. Alignment of the shoulder, hips, and knees. 3. Frayed rope near pulleys. 4. Correct amount of traction weight on fracture. 5. Pressure on the coccyx.

A nurse is planning care for an infant with diaper dermatitis. Which of the following actions should the nurse include in her plan of care? Select all that apply. 1. Apply talcum powder with every diaper change 2. Allow the buttocks to air dry 3. Use commercial baby wipes to cleanse the area 4. Use cloth diaper until the rash is gone 5. Apply zinc oxide ointment to the affected area

2. Allow the buttocks to air dry 5. Apply zinc oxide ointment to the affected area

A parent of a child with a moderate head injury asks the nurse, "How will you know if my child is getting worse?" The nurse should tell the parents that best indicator of the child's brain function is: 1. The vital signs. 2. Level of consciousness. 3. Reactions of the pupils. 4. Motor strength.

2. Level of consciousness.

A 7-year-old child has just had a lumbar puncture in the emergency department for complaints of elevated temperature and a stiff neck. Which of the following cerebral spinal fluid findings would indicate that this child has bacterial meningitis? 1. Markedly lower than normal pressure 2. Glucose 20 mg/dL 3. White blood cell count 3 cells/mm3 4. Clear fluid

2. Glucose 20 mg/dL

A nurse is providing counseling to parents regarding an important action they can take to prevent their children from developing meningitis. Which of the following actions did the nurse suggest? 1. Have children sleep in separate beds during sleepover parties. 2. Have children receive all recommended immunizations. 3. Teach children to wash their hands after toileting and before eating. 4. Teach children to cover their faces with a tissue when they sneeze.

2. Have children receive all recommended immunizations.

The nurse should teach the mother of a child who has a new cast for a fractured radius to do which of the following for the first few days at home? 1. Use a hair dryer to dry the cast more quickly. 2. Have the child refrain from strenuous activities. 3. Check movement and sensation of the child's fingers once a day. 4. Administer acetaminophen every 8 to 12 hours for discomfort.

2. Have the child refrain from strenuous activities.

The nurse, who is admitting a neonate into the well-baby nursery, assesses the following: widely separated sagittal suture and enlarged anterior and posterior fontanels. Which of the following follow-up assessments is most important for the nurse to perform at this time? 1. Tonic neck reflex 2. Head and chest circumferences 3. Ortolani's sign 4. Red reflexes of both eyes

2. Head and chest circumferences

A nurse is assessing a child who has Legg-Calve-Perthes disease. Which of the following findings should the nurse expect? Select all that apply. 1. Longer affected leg 2. Hip stiffness 3. Intense pain 4. Limited ROM 5. Limp with walking

2. Hip stiffness 4. Limited ROM 5. Limp with walking

Parents bring a 10-month-old boy born with myelomeningocele and hydrocephalus with a ventriculoperitoneal shunt to the emergency department. His symptoms include vomiting, poor feeding, lethargy, and irritability. What interventions by the nurse are appropriate? Select all that apply. 1. Weigh the child. 2. Listen to bowel sounds. 3. Palpate the anterior fontanel. 4. Obtain vital signs. 5. Assess pitch and quality of the child's cry.

2. Listen to bowel sounds. 3. Palpate the anterior fontanel. 4. Obtain vital signs. 5. Assess pitch and quality of the child's cry.

When developing the plan of care for a child who is unconscious after a serious head injury, in which of the following positions should the nurse expect to place the child? 1. Prone with hips and knees slightly elevated. 2. Lying on the side, with the head of the bed elevated. 3. Lying on the back, in the Trendelenburg position. 4. In the semi-Fowler's position, with arms at the side.

2. Lying on the side, with the head of the bed elevated.

A 12-year-old is having surgery to repair a fractured left femur. As a part of the preoperative safety procedures, the nurse should ask the client to: 1. Point to the area of the fracture. 2. Mark the location of the fracture with an "x" and sign his name. 3. Confirm with his parents that they have signed the operative permit. 4. State the surgery risks as understood from the surgeon.

2. Mark the location of the fracture with an "x" and sign his name.

A child with a brain tumor is less responsive to verbal commands than he was when the nurse assessed the client the previous hour. The nurse should next: 1. Raise the head of the bed. 2. Notify the physician. 3. Administer an analgesic. 4. Obtain an oximeter reading.

2. Notify the physician.

A pediatric nurse is having a discussion with a father whose child has recently been diagnosed with spastic cerebral palsy. Which of the following statements by the nurse is appropriate? 1. "It must be very hard to know that your child's ability to move will decrease over time." 2. "I am sure that it is hard for you to know that your child has this disease, but at least the medicine will treat the underlying problem." 3. "The treatment plan for your child will focus on enabling him to have as normal movements as possible." 4. "The nerve stimulation of your child's legs will enable him to walk on his own when he is older."

3. "The treatment plan for your child will focus on enabling him to have as normal movements as possible."

A nurse is completing preoperative teaching with an adolescent client who is scheduled to receive spinal instrumentation for scoliosis. Which of the following information should the nurse include in the teaching. 1. "You will go home the same day as surgery" 2. "You will have minimal pain" 3. "You will need to receive blood" 4. You will not be able to eat until the day after surgery"

3. "You will need to receive blood"

A nurse is caring for a child who is taking mannitol for cerebral edema. Which of the following adverse effects should the nurse monitor the child for and report to the provider? 1. Bradycardia 2. Weight loss 3. Confusion 4. Constipation

3. Confusion

The parents of a neonate born with congenital clubfoot express feelings of helplessness and guilt, exhibiting anxiety about how the neonate will be treated. Which of the following actions by the nurse would be most appropriate initially? 1. Ask them to share these concerns with the physician. 2. Arrange a meeting with other parents whose infants have had successful clubfoot treatment. 3. Discuss the problem with the parents and the current feelings that they are experiencing. 4. Suggest that they make an appointment to talk things over with a counselor.

3. Discuss the problem with the parents and the current feelings that they are experiencing.

A 3-year-old child is hospitalized with multiple fractures as a result of a car accident. What is the best way for a nurse to assess this child's pain level? 1. Ask the child to rate pain using a numeric pain rating scale. 2. Rely on vital sign measurements as a way to verify pain ratings. 3. Employ the FACES pain scale with every nursing assessment. 4. Try to have the child describe the pain's intensity and quality.

3. Employ the FACES pain scale with every nursing assessment.

When caring for an infant who has under- gone surgical repair of a myelomeningocele, which of the following should the nurse report to the surgeon? 1. Seizures and vomiting. 2. Frontal bossing and sunset eyes. 3. Increased head circumference and bulging fontanel. 4. Irritability and shrill cry.

3. Increased head circumference and bulging fontanel.

During the initial assessment of a child admitted to the pediatric unit with osteomyelitis of the left tibia, when assessing the area over the tibia, which is an expected finding? 1. Diffuse tenderness. 2. Decreased pain. 3. Increased warmth. 4. Localized edema.

3. Increased warmth.

The nurse asks a school-age child with Guillain-Barré syndrome to cough and also assesses the child's speech for decreased volume and clarity. The underlying rationale for these assessments is to determine which of the following? 1. Inflammation of the larynx and epiglottis. 2. Increased intracranial pressure. 3. Involvement of facial and cranial nerves. 4. Regression to an earlier developmental phase.

3. Involvement of facial and cranial nerves.

When teaching the family of an older infant who has had a hip spica cast applied for developmental dysplasia of the hip, which information should the nurse include when describing the abduction stabilizer bar? 1. It can be adjusted to a position of comfort. 2. It is used to lift the child. 3. It adds strength to the cast. 4. It is necessary to turn the child.

3. It adds strength to the cast.

When developing the plan of care for a child with early Duchenne's muscular dystrophy, which of the following nursing goals is the priority? 1. Encouraging early wheelchair use. 2. Fostering social interactions. 3. Maintaining function of unaffected muscles. 4. Prevent circulatory impairment.

3. Maintaining function of unaffected muscles.

When planning home care for the child with Legg-Calvé-Perthes disease, what should be the primary focus for family teaching? 1. Need for intake of protein-rich foods. 2. Gentle stretching exercises for both legs. 3. Management of the corrective appliance. 4. Relaxation techniques for pain control.

3. Management of the corrective appliance.

A nurse is caring for a child who has muscular dystrophy. For which of the following findings should the nurse assess? Select all that apply. 1. Purposeless, involuntary, abnormal movements 2. Spinal defect and saclike protrusion 3. Muscular weakness in lower extremities 4. Unsteady, wide-based or waddling gait 5. Upward slant to the eyes

3. Muscular weakness in lower extremities 4. Unsteady, wide-based or waddling gait

A nurse notes blue sclerae during a newborn assessment. Which item will the newborn require further assessment for based on this finding? 1. Marfan syndrome 2. Achondroplasia 3. Osteogenesis imperfecta 4. Muscular dystrophy

3. Osteogenesis imperfecta

When positioning a neonate with an unprepared myelomeningocele, which of the following positions is most appropriate? 1. Supine with the hips at 90-degree flexion. 2. Right side-lying position with the knees flexed. 3. Prone with hips in abduction. 4. Supine in semi-Fowler's position with chest and abdomen elevated.

3. Prone with hips in abduction.

A preschooler with pneumonococci meningitis is receiving intravenous antibiotic therapy. When discontinuing the intravenous therapy, the nurse allows the child to apply a dressing to the area where the needle is removed. The nurse's rationale for doing so is based on the interpretation that a child in this age-group has a need to accomplish which of the following? 1. Trust those caring for her. 2. Find diversional activities. 3. Protect the image of an intact body. 4. Relieve the anxiety of separation from home.

3. Protect the image of an intact body.

A nurse who works with overweight children monitors them carefully for signs and symptoms of which of the following musculoskeletal illnesses? 1. Scoliosis 2. Legg-Calve-Perthes 3. Slipped capital femoral epiphysis 4. Duchenne muscular dystrophy

3. Slipped capital femoral epiphysis

When interacting with the mother of a child who has Duchenne's muscular dystrophy, the nurse observes behavior indicating that the mother may feel guilty about her child's condition. The nurse interprets this behavior as guilt stemming from which of the following? 1. The terminal nature of the disease. 2. The dependent behavior of the child. 3. The genetic mode of transmission. 4. The sudden onset of the disease.

3. The genetic mode of transmission.

What should the nurse include when developing the teaching plan for the parents of a child with juvenile idiopathic arthritis who is being treated with naproxen (Naprosyn)? 1. Anti-inflammatory effect will occur in approximately 8 weeks. 2. Within 24 hours, the child will have anti-inflammatory relief. 3. The nurse should be called before giving the child any over-the-counter medications. 4. If a dose is forgotten or missed, that dose is not made up.

3. The nurse should be called before giving the child any over-the-counter medications.

A nurse must change the position of an adolescent who is 2 hours' post-op rod placement for a diagnosis of scoliosis. Which of the following actions should the nurse perform? 1. Elevate the head of the bed to thirty degrees. 2. Lower the bed into the Trendelenburg position. 3. Turn the child while keeping the child's spine straight. 4. Place a pillow under the knees and keep the child supine.

3. Turn the child while keeping the child's spine straight.

A nurse is teaching a parent of a child who has pediculosis capitis. Which of the following instructions should the nurse include in the teaching? 1. Apply mayonnaise to the affected area at night. 2. Treat all household pets 3. Use an over-the-counter medication containing 1% permethrin 4. Discard the child's stuffed animals

3. Use an over-the-counter medication containing 1% permethrin

A child has been diagnosed with febrile seizures. Which of the following information should the nurse include in the parent teaching session? 1. "Whenever your child develops a fever, place him in a warm bath and pour the water over his arms and legs." 2. "Make sure to give your child high dosages of acetaminophen whenever his temperature goes above 104°F." 3. "It is very important that your child have no more seizures to prevent him from experiencing permanent injury to his brain." 4. "It should be comforting to know that most children outgrow the febrile seizures by the time they reach 6 years of age."

4. "It should be comforting to know that most children outgrow the febrile seizures by the time they reach 6 years of age."

An LVN/LPN from an orthopedic unit is floated to a child health unit. In creating assignments, which child should the charge nurse avoid assigning to the LVN/LPN? 1. A 10-year-old in traction for a fractured femur. 2. An 8-year-old child with Legg-Calvé-Perthes disease. 3. A 4-year-old with osteogenesis imperfecta. 4. A teenager receiving chemotherapy for osteosarcoma.

4. A teenager receiving chemotherapy for osteosarcoma.

A child who is experiencing high fever and neck pain is diagnosed with viral meningitis. Which of the following should the nurse include in the discharge teaching? 1. Keep the child isolated until the temperature returns to normal. 2. Pad the child's bed headboard. 3. Rent a commode for the child to use at home. 4. Administer over-the-counter analgesics as needed.

4. Administer over-the-counter analgesics as needed.

A child who limps and has pain has been found to have Legg-Calvé-Perthes disease. What should the nurse expect to include in the child's plan of care? 1. Initiation of pain control measures, especially at night when acute. 2. Promotion of ambulation despite child's discomfort in the affected hip. 3. Prevention of flexion in the affected hip and knee. 4. Avoidance of weight bearing on the head of the affected femur.

4. Avoidance of weight bearing on the head of the affected femur.

A child is placed in skeletal traction for treatment of a fractured femur. The nurse creates a plan of care and should include which intervention? 1. Ensure that all ropes are outside the pulleys. 2. Ensure that the weights are resting lightly on the floor. 3. Restrict diversional and play activities until the child is out of traction. 4. Check the health care provider's (HCP's) prescriptions for the amount fo weight to be applied.

4. Check the health care provider's (HCP's) prescriptions for the amount fo weight to be applied.

A nurse evaluates discharge teaching as successful when the parents of a school-age child with a ventriculoperitoneal shunt insertion identify which sign as signaling a blocked shunt? 1. Decreased urine output with stable intake. 2. Tense fontanel and increased head circumference. 3. Elevated temperature and reddened incisional site. 4. Irritability and increasing difficulty with eating.

4. Irritability and increasing difficulty with eating.

The father of a preschool-age child with a tentative diagnosis of juvenile idiopathic arthritis (JIA) asks about a test to definitively diagnose JIA. The nurse's response is based on knowledge of which of the following? 1. The latex fixation test is diagnostic. 2. An increased erythrocyte sedimentation rate is diagnostic. 3. A positive synovial fluid culture is diagnostic. 4. No specific laboratory test is diagnostic.

4. No specific laboratory test is diagnostic.

A school-age child is admitted to the hospital with the diagnosis of probable infratentorial brain tumor. During the child's admission to the pediatric unit, which action should the nurse anticipate taking first? 1. Eliminating the child's anxiety. 2. Implementing seizure precautions. 3. Introducing the child to other clients of the same age. 4. Preparing the child and parents for diagnostic procedures.

4. Preparing the child and parents for diagnostic procedures.

A nurse is caring for a child who is diagnosed with cerebral palsy. Which goal of therapy is most appropriate for the nurse to include in the plan of care? 1. Reversing the degenerative processes that have occurred 2. Curing the underlying defect causing the disorder 3. Preventing the spread to individuals in close contact with the child 4. Promoting optimum development

4. Promoting optimum development

A school-age client is transported to the emergency department by ambulance from the scene of a car accident. The client is alert and oriented 3; pulse, respirations, and blood pressure are stable; and the neck and back are immobilized on a backboard. The nurse sees no obvious bleeding. The client states, I cant feel or move my legs. Which injury does the nurse suspect? 1. Traumatic brain injury 2. Ruptured spleen 3. Traumatic shock 4. Spinal cord injury

4. Spinal cord injury

A 9-year-old child with Guillain-Barré syndrome requires mechanical ventilation. Which action should the nurse take? 1. Maintain the child in a supine position to prevent unnecessary nerve stimulation. 2. Transfer the child to a bedside chair three times a day to prevent postural hypotension. 3. Engage the child in vigorous passive range-of-motion exercises to prevent loss of muscle function. 4. Turn the child slowly and gently from side to side to prevent respiratory complications.

4. Turn the child slowly and gently from side to side to prevent respiratory complications.

The nurse is caring for a child with osteomy- elitis who will be receiving high-dose intravenous antibiotic therapy for 3 to 4 weeks. What should the nurse plan to monitor? 1. Blood glucose level. 2. Thrombin times. 3. Urine glucose level. 4. Urine specific gravity.

4. Urine specific gravity.

A nurse is reviewing the results of a genetic analysis performed on a child with Duchenne muscular dystrophy (DMD). Which of the following results would the nurse expect to see? 1. 46 XY, X-linked recessive inheritance 2. 46 XX, autosomal dominant inheritance 3. 46 XY, autosomal recessive inheritance 4. 46 XX, mitochondrial inheritance

1. 46 XY, X-linked recessive inheritance

After teaching the mother of a child with severe burns about the importance of specific nutritional support in burn management, which of the following, if chosen by the mother from the child's diet menu, indicates the need for further instruction? 1. Bacon, lettuce, and tomato sandwich; milk; and celery and carrot sticks. 2. Cheeseburger, cottage cheese and pineapple salad, chocolate milk, and a brownie. 3. Chicken nuggets, orange and grapefruit sections, and a vanilla milkshake. 4. Beef, bean, and cheese burrito; a banana; fruit-flavored yogurt; and skim milk.

1. Bacon, lettuce, and tomato sandwich; milk; and celery and carrot sticks.

The nurse teaches the parents of an infant with developmental dysplasia of the hip how to handle their child in a Pavlik harness. Which of the following is most appropriate? 1. Fitting the diaper under the straps. 2. Leaving the harness off while the infant sleeps. 3. Checking for skin redness under straps every other day. 4. Putting powder on the skin under the straps every day.

1. Fitting the diaper under the straps.

A child is admitted to the pediatric unit with a diagnosis of meningitis. Which of the following actions should the nurse perform? Select all that apply. 1. Raise the head of the bed. 2. Dim the lights in the room. 3. Place the child on droplet isolation. 4. Administer intravenous antibiotics, as prescribed. 5. Perform passive range-of-motion exercises of the neck.

1. Raise the head of the bed. 2. Dim the lights in the room. 3. Place the child on droplet isolation. 4. Administer intravenous antibiotics, as prescribed.

A 13-year-old girl, who has been diagnosed with scoliosis, has been ordered to wear a therapeutic brace for 20 hours each day. The nurse identifies which of the following nursing diagnoses for this child? 1. Risk for Disturbed Body Image 2. Bathing Self-care De cit 3. Risk for Impaired Urinary Elimination 4. Ineffective Breathing Pattern

1. Risk for Disturbed Body Image

An adolescent client who is diagnosed with Duchenne muscular dystrophy is seen in the clinic for a routine health visit. Which nursing diagnosis is the priority for this client? 1. Risk for Impaired Mobility Related to Hypertrophy of Muscles 2. Risk for Infection Related to Altered Immune System 3. Risk for Impaired Skin Integrity Related to Paresthesia 4. Risk for Altered Comfort Related to Effects of the Illness

1. Risk for Impaired Mobility Related to Hypertrophy of Muscles

An adolescent client must wear a brace for the correction of scoliosis. Which nursing diagnosis is most appropriate for this client? 1. Risk for Impaired Skin Integrity 2. Risk for Altered Growth and Development 3. Risk for Impaired Mobility 4. Risk for Impaired Gas Exchange

1. Risk for Impaired Skin Integrity

The parents of a child with occasional gen- eralized seizures want to send the child to summer camp. The parents contact the nurse for advice on planning for the camping experience. Which of the following activities should the nurse and family decide the child should avoid? 1. Rock climbing. 2. Hiking. 3. Swimming. 4. Tennis.

1. Rock climbing.

Which of the following would be most appropriate to institute when a school-age child with burns becomes angry and combative when it is time to change the dressings and apply mafenide acetate (Sulfamylon)? 1. Ensure parental support during the dressing changes. 2. Allow the child to assist in removing the dressings and applying the cream. 3. Give the child permission to cry during the procedure. 4. Allow the child to schedule the time for dressing changes.

2. Allow the child to assist in removing the dressings and applying the cream.

A child with spastic cerebral palsy receiving intrathecal baclofen therapy is admitted to the pediatric floor with vomiting and dehydration. The family tells the nurse that they were scheduled to refill the baclofen pump today, but had to cancel the appointment when the child became ill. The nurse should: 1. Explain that the medication should be discontinued during illness. 2. Arrange for the pump to be refilled in the hospital. 3. Reschedule the pump refill for the day of discharge. 4. Instruct caregivers to call for a refill when the low-volume alarm sounds.

2. Arrange for the pump to be refilled in the hospital.

A 16-year-old gymnast falls from the uneven parallel bars onto her right arm. The school nurse is called to the scene. The young woman points to her right forearm and states, "It really hurts there." Which of the following actions should the nurse perform at this time? Select all that apply. 1. Apply pressure to the site of point tenderness. 2. Ask the young woman to move the fingers of her right hand. 3. Compare the radial pulses on the right wrist to those on the left wrist. 4. Compare the range of motion of the right wrist to that of the left wrist. 5. Ask the young woman whether her right hand and arm feel differently from the left hand and arm.

2. Ask the young woman to move the fingers of her right hand. 3. Compare the radial pulses on the right wrist to those on the left wrist. 4. Compare the range of motion of the right wrist to that of the left wrist. 5. Ask the young woman whether her right hand and arm feel differently from the left hand and arm.

A child with spastic cerebral palsy is to begin botulinum toxin type A (Botox) injections. Which treatment goals should the health care team set for the child related to Botox? Select all that apply. 1. Improved nutritional status. 2. Decreased pain from spasticity. 3. Improved motor function. 4. Enhanced self-esteem. 5. Reduced caregiver strain and improved self-care. 6. Decreased speech impediments.

2. Decreased pain from spasticity. 3. Improved motor function. 4. Enhanced self-esteem. 5. Reduced caregiver strain and improved self-care.

The nurse is measuring a child for crutches. What should the nurse consider? Select all that apply. 1. Type of gait child will be using. 2. Degree of child's elbow flexion. 3. Space above the crutch to child's axilla. 4. Weight of the child. 5. Whether child has to use the stairs.

2. Degree of child's elbow flexion. 3. Space above the crutch to child's axilla.

A 5-year-old child who was playing with matches is admitted to the pediatric emergency department. The child has blistered burns covering both anterior thighs. Which of the following responses is consistent with the child's presentation? The depth and extent of the burns are: 1. Depth: 1°; extent: 10% 2. Depth: 2°; extent: 7% 3. Depth: 2°; extent: 18% 4. Depth: 3°; extent: 3%

2. Depth: 2°; extent: 7%

A 9-year-old is given morphine for postop- erative pain. As the nurse is assessing the client for pain 4 hours later, his mother leaves the room and the child begins to cry. The nurse's initial assessment of the child's pain is that he is: 1. Not in pain because the crying began after the mother leaves. 2. Less tolerant of pain because he is upset. 3. In pain because he is crying. 4. Not in pain because he was medicated 4 hours ago.

2. Less tolerant of pain because he is upset.

Which of the following statements by the mother of an infant with a repaired upper lumbar myelomeningocele indicates that she understands the nurse's teaching at the time of discharge? 1. "I can apply a heating pad to his lower back." 2. "I'll be sure to keep him away from other children." 3. "I will call the doctor if his urine has a funny smell." 4. "I will prop him on pillows to keep him from rolling over."

3. "I will call the doctor if his urine has a funny smell."

Parents being their 2-week-old infant to a clinic for treatment after a diagnosis of clubfoot made at birth. Which statement by the parents indicates a need for the further teaching regarding the disorder? 1. "Treatment needs to be started as soon as possible." 2. "I realize my infant will require follow-up care until fully grown." 3. "I need to bring my infant back to the clinic in 1 month for a new cast." 4. "I need to come to the clinic every week with my infant for the casting."

3. "I need to bring my infant back to the clinic in 1 month for a new cast."

During a developmental screening, the nurse finds that a 3-year-old child with cerebral palsy has arrested social and language development. The nurse tells the family: 1. "This is a sign the cerebral palsy is progressing." 2. "Your child has reached his maximum language abilities." 3. "I need to refer you for more developmental testing." 4. "We need to modify your therapy plan."

3. "I need to refer you for more developmental testing."

A nurse and nursing student are caring for a child who sustained a head injury as a result of a fall from a play structure. The nurse knows the nursing student is prepared to care for the child when the student states: 1. "I will be sure to let you know if the child's pupils become fixed and dilated." 2. "I will keep the child straight in the supine position." 3. "I will look for any changes in the child's respirations, pulse, or blood pressure." 4. "I will notify the physician if the child becomes sleepy."

3. "I will look for any changes in the child's respirations, pulse, or blood pressure."

The parents of a child with a serious head injury ask the nurse if the child is going to be all right. Which of the following responses by the nurse would be most appropriate? 1. "Children usually don't do very well after head injuries like this." 2. "Children usually recover rapidly from head injuries." 3. "It's hard to tell this early, but we'll keep you informed of the progress." 4. "That's something you'll have to talk to the doctor about."

3. "It's hard to tell this early, but we'll keep you informed of the progress."

After the nurse teaches the mother of a child with atopic dermatitis how to bathe her child, which of the following statements by the mother indicates effective teaching? 1. "I let my child play in the tub for 30 minutes every night." 2. "My child loves the bubble bath I put in the tub." 3. "When my child gets out of the tub I just pat the skin dry." 4. "I make sure my child has a bath every night."

3. "When my child gets out of the tub I just pat the skin dry."

The parents of a child recently diagnosed with cerebral palsy ask the nurse about the limitations of the disorder. The nurse responds by explaining that the limitations occur as a result of which pathophysiological process? 1. An infectious disease of the CNS. 2. An inflammation of the brain as a result of a viral illness. 3. A chronic disability characterized by impaired muscle movement and posture. 4. A congenital condition that results in moderate to severe intellectual disabilities.

3. A chronic disability characterized by impaired muscle movement and posture.

A 14-year-old has just had a plaster cast placed on his lower left leg. To provide safe cast care, the nurse should? 1. Petal the cast as soon as it is put on. 2. Keep the child in the same position for 24 hours until the cast is dry. 3. Use only the palms of the hand when handling the cast. 4. Notify the physician if the client complains of heat.

3. Use only the palms of the hand when handling the cast.

The nurse manager on a pediatric floor is reviewing national sentinel event alerts and prepar- ing recommendations for the unit. Which strategy would help reduce pediatric medication errors? Select all that apply. 1. Eliminate the pediatric satellite pharmacy. 2. Increase the steps in the medication administration procedure. 3. Utilize only oral syringes to administer oral medication. 4. Limit the size of I.V. fluid bags that can be hung on small children. 5. Reduce the available concentrations or dose strengths of high alert medications to the minimum.

3. Utilize only oral syringes to administer oral medication. 4. Limit the size of I.V. fluid bags that can be hung on small children. 5. Reduce the available concentrations or dose strengths of high alert medications to the minimum.

A 10-year-old with scoliosis has to wear a brace. The nurse should develop a teaching plan with the client to include which of the following instructions? 1. Wear the brace during waking hours. 2. Use lotions to relieve skin irritations. 3. Wear a form-fitting, sleeveless T-shirt under the brace. 4. Bathe the skin under the brace once per week.

3. Wear a form-fitting, sleeveless T-shirt under the brace.

The nurse has provided teaching to a mother whose 5-month-old has been diagnosed with atopic dermatitis (eczema). Which of the following statements by the mother indicates that teaching was successful? 1. "I make sure that my baby is clothed warmly each day." 2. "My baby's favorite toy is a fuzzy teddy bear." 3. "Today, my baby is wearing a hand-knit wool sweater that my mother knit." 4. "Tomorrow, I plan to dress my baby in a cute cotton shirt and denim jeans."

4. "Tomorrow, I plan to dress my baby in a cute cotton shirt and denim jeans."

An 8-year-old child is admitted to the emergency department with burns over 30% of the body. Which of the following orders is highest priority for the nurse to perform? 1. Injection of tetanus booster 2. Debridement of the burns 3. Application of Silvadene ointment 4. Administration of intravenous fluids

4. Administration of intravenous fluids

A topical corticosteroid is prescribed by the health care provider for a child with atopic dermatitis (eczema). Which instruction should the nurse give the parent about applying the cream? 1. Apply the cream over the entire body. 2. Apply a thick layer of cream to affected areas only. 3. Avoid cleansing the area before application of the cream. 4. Apply a thin layer of cream and rub it into the area thoroughly.

4. Apply a thin layer of cream and rub it into the area thoroughly.

Permethrin is prescribed for a child with a diagnosis of scabies. The nurse should give which instruction to the parents regarding the use of this treatment? 1. Apply the lotion to areas of the rash only. 2. Apply the lotion and leave it on for 6 hours. 3. Avoid putting clothes on the child over the lotion. 4. Apply the lotion to cool, dry skin at least 30 minutes after bathing.

4. Apply the lotion to cool, dry skin at least 30 minutes after bathing.

The nurse observes as a child with Duchenne's muscular dystrophy attempts to rise from a sitting position on the floor. After attaining a kneeling posi- tion, the child "walks" his hands up his legs to stand. The nurse documents this as which of the following? 1. Galeazzi's sign. 2. Goodell's sign. 3. Goodenough's sign. 4. Gower's sign.

4. Gower's sign.

The nurse is admitting a newly delivered neonate with meningocele into the nursery. Which of the following assessments is priority for the nurse to perform? 1. Assessment of the red re exes 2. Hard palate assessment 3. Trunk incurvation re ex 4. Head and chest circumferences

4. Head and chest circumferences

A child returns from spinal-fusion surgery. Which item is the priority assessment for this child? 1. Increased intracranial pressure 2. Seizure activity 3. Impaired pupillary response during neurological checks 4. Impaired color, sensitivity, and movement to lower extremities

4. Impaired color, sensitivity, and movement to lower extremities

A nurse is caring for a toddler who is diagnosed with hip dysplasia and has been placed in a hip spica cast. The child's mother asks the nurse why a Pavlik harness is not being used. Which of the following responses should the nurse make? 1. "The Pavlik harness is used for children with scoliosis not hip dysplasia" 2. The Pavlik harness is used for school-age children. 3. The Pavlik harness cannot be used for your child because her condition is too severe. 4. The Pavlik harness is used for infants less than 6 months in age.

4. The Pavlik harness is used for infants less than 6 months in age.