Peds Test Tasking Strategies
The mother of a child with tympanostomy tubes asks the nurse if it's safe to travel by airplane with the tubes in place. What is the nurse's best response?
"Flying with tympanostomy tubes is safe as long as the tubes are patent."
The clinic nurse is teaching an adolescent with prehypertension blood pressure (BP) readings about hypertensive risk factors. Which statement by the adolescent indicates a need for further teaching?
"I am glad I can continue to take my birth control pills."
The nurse is educating the parents of an infant diagnosed with gastroesophageal reflux (GER). Which statement by the parents indicates an understanding of appropriate care for this child while sleeping?
"I can place my infant on his back."
A mother tells the clinic nurse that she does not want her child to receive any immunizations because she has heard that they cause serious illnesses. The nurse should make which appropriate statement to the mother?
"I can see you are very concerned about your child. What do you think might happen after an immunization is given?"
The nurse is teaching an adolescent with cystic fibrosis (CF) about taking pancreatic enzymes. Which statement by the adolescent indicates a need for further teaching?
"I can take the capsules within 2 hours of eating."
The nurse is teaching the family of an adolescent newly diagnosed with type 2 diabetes mellitus about the disorder. The parents verbalize understanding of the teaching if which statement is made?
"I should begin to look for a fitness program for my child."
The clinic nurse has provided instructions to the mother of a child with a urinary tract infection. Which statements by the mother indicate a need for further instruction? Select all that apply.
"I should encourage my child to hold the urine and to urinate only 4 times each day." "I should administer the antibiotics to my child until urinary tract infection symptoms disappear."
An adolescent client who underwent emergency surgery for a ruptured appendix refuses to allow the nurse to change the abdominal dressing, saying, "Go away. There is nothing wrong with this dressing." Which nursing response would be best?
"I will draw the curtain and expose only the area on your abdomen that is needed. Can I go ahead with that?"
The nurse is teaching home care management to a parent of a 6-year-old child with asthma. Which statement by the parent indicates a need for further teaching?
"I will have my child use the peak flow meter once a week."
An infant diagnosed with eczema has lesions on the face, arms, and legs. Which statement by the parent indicates an understanding of how to meet the infant's developmental needs while treating the lesions?
"I'll set aside time each day to play and read stories to my baby."
An adolescent arrives at the emergency department with complaints of persistent epistaxis. The child and parent are both extremely anxious. Which instruction should the triage nurse provide to the child?
"Sit up and lean forward while I hold pressure on your nose."
A child has been evaluated in the clinic and found to have a foreign body in the left ear. The nurse is preparing to implement the prescription for ear irrigation. Which statement by the child's parent should cause the nurse to question the ear irrigation prescription?
"The kids were putting dried beans in their ears."
The nurse provides home care instructions to the parents of a toddler newly diagnosed with hemophilia. Which statement by the parents indicates a need for further instruction?
"We need to administer aspirin to our child if any signs of discomfort are noted."
The nurse provides home care instructions to the parents of a 6-year-old child who has asymptomatic tuberculosis (TB) and is receiving pharmacotherapy. Which statement by the parents indicates a need for further teaching?
"We will arrange for home schooling for the next 6 months."
The nurse is teaching parents of a child with a recently repaired atrial septal defect about home administration of digoxin. Which statement by the parents indicates a need for further teaching?
"We will mix the medication with some bananas."
The nurse is teaching parents of an infant with a tetralogy of Fallot about interventions for hypercyanotic episodes. Which statement by the parents indicates a need for further teaching?
"We will strictly limit our infant's activities."
A 4-year-old child is admitted to the hospital for surgery. The nurse should ask the parents which priority question to identify the adequacy of support for the child's psychosocial needs?
"Will a family member be able to stay with the child most of the time?"
A school-aged child is anxious to return to school after being hospitalized with leukemia. The child's laboratory results are as follows: 7% neutrophils, 7% nonsegmented neutrophils (bands), 1000 mm3 (1 × 109/L) for white blood cell (WBC) count. Calculate the absolute neutrophil count (ANC). Fill in the blank.
140
The nurse is reviewing cholesterol laboratory results on a child from a family with a history of heart disease. Which low-density lipoprotein (LDL) value should the nurse record as being elevated?
140 mg/dL (3.6 mmol/L)
A school-age child admitted with cellulitis is prescribed cefazolin 500 mg intravenous (IV) to be administered over 30 minutes. The cefazolin has been premixed in a 100-mL bag of normal saline. At what rate (in milliliters per hour) should the nurse set the IV infusion pump? Fill in the blank.
200 mL/hr
A child newly diagnosed with type 1 diabetes mellitus who is receiving insulin suddenly experiences signs of a hypoglycemic reaction. Which item should the nurse give to the child immediately?
8 oz of skim milk
Which surgical client is at increased risk for a wide temperature variation during surgery?
A 3-month-old infant scheduled for hernia repair
The nurse educator is teaching a group of nursing students about conditions that require a child to receive prophylactic antibiotic therapy before a dental procedure. Which child should the nurse include in the category of needing prophylactic antibiotic therapy before a dental procedure?
A child with a previous episode of infective endocarditis
The nurse is caring for a 6-year-old child with asthma. Which assessment finding requires immediate action by the nurse?
Absent breath sounds
The nurse is caring for a child with supraventricular tachycardia (SVT) that has not resolved with vagal stimulation. Which medication prescription by the primary health care provider should the nurse be prepared to administer first?
Adenosine
The nurse notes that a child with Hirschsprung's disease who is scheduled for surgery has inadequate fluid volume. The nurse should plan to implement which intervention to stabilize the child's hydration status before surgery?
Administer intravenous fluids and electrolytes
Which intervention is the priority for the nurse to implement for a child diagnosed with Wiskott-Aldrich syndrome (WAS)?
Administer platelet infusions.
Which procedure should the nurse use when instilling prescribed eye drops and ointment to a child?
Administer the drops first, wait 3 minutes, then apply the prescribed ointment.
The nurse is planning care for a child with Kawasaki's disease. Which interventions should the nurse plan to implement? Select all that apply.
Administering aspirin as prescribed Avoiding the use of bright overhead lights Administering intravenous immune globulin (IVIG) as prescribed
The nurse is planning care for a pediatric client with the diagnosis of acute respiratory distress syndrome (ARDS) and subsequent development of pulmonary edema (PE). Which interventions should the nurse expect to be prescribed? Select all that apply.
Administering furosemide Administering oxygen therapy Providing parenteral and enteral nutritional support Administering antibiotics if a bacterial infection is present
A child develops a severe anaphylactic reaction to penicillin. Which prescribed action should the nurse prepare to implement first?
Administration of epinephrine
The nurse is planning care for a child with rheumatic fever (RF). Which interventions should the nurse plan to implement? Select all that apply.
Administration of salicylates as prescribed Home care teaching about taking prophylactic antibiotics Administration of penicillin G benzathine as prescribed
A child with hemophilia is brought into the emergency department after being hit on the neck with a baseball. The nurse should immediately check the child for which finding?
Airway obstruction
The nurse would suspect that a child is experiencing complications due to decreased kidney function based on which laboratory assessment finding?
Arterial bicarbonate level 18 mEq/mL (18 mmol/L)
A mother brings her child to the emergency department because the child said that dirt flew into the eye during softball practice. The nurse should plan to assist with which action first?
Assess vision
The nurse is assigned to care for an infant diagnosed with pyloric stenosis who is receiving stomach decompression and is awaiting surgery. What is the nurse's priority of care for this child?
Assessing for signs of metabolic alkalosis
Parents ask the nurse about a sport for their school-age child with exercise-induced bronchospasm (EIB). Which sport should the nurse recommend?
Baseball
The nurse is reviewing the prescribed medications for a 10-year-old child with chronic asthma. Which medication should the nurse expect to be prescribed as first-line therapy?
Budesonide
A child is seen in the emergency department (ED) with a diagnosis of otitis media. Which face would indicate that the child rates pain as hurts "a little more?" Refer to the figure.
C
The nurse receives a telephone call from a neighbor who reports that her child just swallowed furniture polish. The nurse should instruct the mother to immediately perform which action?
Call the poison control center.
The nurse is responding to an emergency involving a child who has no pulse and is in ventricular tachycardia (VT). While waiting for help to arrive, which intervention should the nurse prepare to implement first?
Cardiopulmonary resuscitation (CPR)
Wrist restraints are applied to a child after a cleft lip repair. The nurse should implement which priority intervention regarding use of the restraints?
Check the color, sensation, and pulses distal to the restraints.
What type of preventable injury is associated with the developmental stage of a crawling infant?
Choking on objects
The nurse is assessing a child who has just returned from surgery in a hip spica cast. Which outcome is the priority?
Circulation is adequate.
The nurse is admitting a 6-month-old infant with respiratory syncytial virus (RSV) bronchiolitis. Which type of precautions should the nurse implement?
Contact and droplet
A Hispanic mother brings her child in to the clinic for evaluation after the child was treated by the use of prayers, herbs, and rituals, which failed to help the child. Based on the description of the treatments that the child received, who does the nurse decide that the child had been taken to?
Curandero
The nurse is conducting a staff-education session on congenital heart defects. Which figure of congenital heart defects best depicts a cyanotic or a right-to-left shunting of blood? Refer to Figure.
D
The nurse should suspect which condition in an infant exhibiting these signs? Refer to Figure.
Developmental dysplasia of the hip (DDH)
The nurse is caring for a 5-year-old client 3 hours after a tonsillectomy. Which drink should the nurse offer the child to encourage fluid intake?
Diluted apple juice
The nurse is teaching parents about safe use of oxygen at home for their infant with bronchopulmonary dysplasia (BPD). Which safety guidelines should be included in the teaching session? Select all that apply.
Ensure that no one smokes in the room or in the area of the oxygen tank. Keep the oxygen tank at least 5 feet (1.5 meters) from heat or electrical sources. Turn off both the volume regulator and the flow regulator when oxygen is not in use.
A child is brought into the emergency department with a diagnosis of early chickenpox (varicella). Of all of the equipment needed, which one is most important for the nurse to have ready at the bedside?
Face masks
The nurse is reviewing the results of a sweat chloride test on a 3-year-old child admitted to the hospital to rule out cystic fibrosis (CF). Which finding of sweat chloride is indicative of CF?
Greater than 60 mEq/L (60 mmol/L)
The preoperative nurse is reviewing an infant's history and physical before repair of a coarctation of the aorta. Which assessment finding should the nurse expect to be documented?
High blood pressure in the arms and low blood pressure in the legs
The nurse is assisting a school-age child with cystic fibrosis (CF) to make dietary meal choices. Which type of dietary choices should the nurse suggest?
High protein, high calorie
The nurse working in the emergency department is caring for a child suspected of having an acute asthma attack. The nurse auscultates the child's lungs and hears this sound: What sound has the nurse heard on auscultation of the lungs?
High-pitched wheezes
The nurse at a playground witnesses a child fall off a swing. The nurse rushes to the child and suspects that the child has a broken right leg. The nurse should take which priority action?
Immobilize the leg
What information should the nurse include in dietary teaching for the parents of a child with leukemia who has been prescribed vincristine?
Increase intake of whole wheat, cereals, and fruits.
The nurse is caring for a child diagnosed with syndrome of inappropriate secretion of antidiuretic hormone (SIADH). The nurse should question which primary health care provider prescription?
Increased oral fluid intake
The nurse is monitoring a child with increased intracranial pressure who has been exhibiting decorticate posturing. On data collection, the nurse notes extension of the upper and lower extremities with internal rotation of the upper arms, wrists, knees, and feet. How should the nurse interpret the child's condition?
Indicates a deterioration in neurological function
The nurse is interpreting the results of a tuberculin skin test (TST) on a child taking immunosuppressive doses of corticosteroids. Which interpretation indicates a positive result?
Induration of 6 mm
The nurse is preparing to care for a pediatric client with an intravenous solution infusing. The nurse should ensure that which item is in place to prevent fluid overload in this client?
Infusion pump
A 7-year-old child limps into the school nurse office and tells the school nurse she has abdominal pain. She tells the nurse that it started around the belly button and now is localized in the right lower quadrant. Positive rebound tenderness is present. What action should the nurse take next?
Keep the child from drinking or eating.
The nurse is repositioning a child with "unilateral" left-sided pneumonia. Which is the best position the nurse should assist the child to assume?
Left side with head slightly elevated
The emergency department nurse assists a primary health care provider in applying a cast to a child. The nurse documents that the child had which type of cast applied? Refer to figure.
Long arm cast
After an open appendectomy procedure, a school-aged child complains of nausea. What is the nurse's priority action?
Maintain the child's nothing by mouth (NPO) status and administer prescribed IV fluids.
The nurse is caring for a child who experienced significant blood loss from surgery. What is the nurse's priority action when caring for this child?
Monitor the child's intake and output (I & O) along with blood pressure.
The nurse is caring for a child with sickle cell disease who has been admitted to the hospital with vasoocclusive crisis. What is the nurse's priority of care for this child?
Monitoring for adverse effects of intravenous (IV) morphine administration
The teaching plan for a child diagnosed with human immunodeficiency virus (HIV) infection should include which instruction?
Notify the primary health care provider (PHCP) for chest congestion and cough.
The nurse is assessing peripheral pulses on an infant who just returned from having a cardiac catheterization performed through the right femoral vein. The nurse cannot palpate or obtain a Doppler dorsalis pedis pulse on the right foot. Which action should the nurse take?
Notify the primary health care provider (PHCP).
The nurse is caring for a client with external otitis. Which prescriptions should the nurse anticipate implementing as treatment for this condition? Select all that apply.
Oral analgesics Application of heat Topical steroid ear drops
The nurse is instructing an unlicensed assistive personnel (UAP) about strategies to care for a 2-year-old child admitted to the hospital in heart failure. Which instruction should the nurse provide to the UAP?
Organize care activities to promote rest periods.
A 9-year-old child diagnosed with leukemia has been prescribed cyclophosphamide. The nurse should assess for which adverse effect related to this medication?
Pain on urination
The teaching plan for a child with tinea corporis (ringworm) who is on the school wrestling team should include which measures? Select all that apply.
Perform frequent skin checks. Shower immediately after practices with soap and water.
A child presents to the emergency department with complaints of fever, a petechial rash, nausea, vomiting, headache, and nuchal rigidity. What is the triage nurse's priority action?
Place the child on isolation precautions.
The nurse should take which actions when caring for a child experiencing a seizure? Select all that apply.
Place the child on the side. Ease the child who is sitting in a wheelchair onto the floor.
The nurse is administering oral medication to a child with cerebral palsy who has compromised jaw control. Which method would facilitate administration of the liquid medication?
Place the fingers under the chin and the thumb on the cheek to open the jaw.
A mother brings her 4-year-old child to the emergency department with complaints of hematuria and easy bruising. The child is recovering from an upper respiratory infection as well. The nurse should alert the primary health care provider (PHCP) immediately about which laboratory result?
Platelet count 18,000 mm3 (18 × 109/L)
The nurse is evaluating laboratory results for a 6-month-old infant receiving furosemide and digoxin to treat heart failure. Which laboratory result requires action by the nurse?
Potassium level of 3 mEq/L (3 mmol/L)
The nurse is caring for a toddler diagnosed with intussusception. The nurse should most appropriately prepare the toddler and parents for which procedure?
Preparation for air or contrast enema
Which finding noted in the child with rheumatic fever (RF) is most important for the nurse to report to the primary health care provider?
Prolonged PR interval on the electrocardiogram monitor
The nurse should incorporate which interventions when caring for a child in this type of traction? Refer to Figure.
Provide pin care at prescribed intervals.
The nurse is providing care to parents whose child has died of sudden infant death syndrome (SIDS). Which is the most appropriate intervention for the nurse to implement?
Provide the parents the opportunity to say good-bye to their child.
The nurse is caring for a 10-year-old client who is hospitalized with acute asthma exacerbation. Which finding requires action by the nurse?
Pulse oximetry reading of 88%
Which assessment finding should the nurse expect to note in a child with hypovolemic shock?
Reduced urinary output
The nurse is monitoring a newborn of a mother with diabetes mellitus. The nurse understands that the newborn is at risk for which complication?
Respiratory distress syndrome
The nurse is caring for a child who sustained a head injury from a fall. The nurse should perform which actions in the care of the child? Select all that apply.
Restrict oral fluid intake. Elevate the head of the bed. Perform neurological assessments.
A school-aged child has contracted head lice at school. The nurse should include which instruction about treatment for head lice?
Seal nonwashable items in plastic bags for 14 days.
The nurse is providing a yearly summer educational session to parents in a local community. The topic of the session is preventive and treatment measures for poison ivy. Which instruction should the nurse provide to the parents if the child comes into contact with poison ivy?
Shower the child immediately, lathering and rinsing the child several times.
A 12-year-old with diabetes mellitus enters the emergency department complaining of extreme thirst and weakness with a respiratory rate of 32 breaths/min. The child's skin is warm and dry, and his mother states he has been urinating very frequently. What is the nurse's priority action?
Start a peripheral intravenous (IV) line.
What teaching point should the nurse include in the care plan of a child with juvenile idiopathic arthritis (JIA) taking nonsteroidal anti-inflammatory drugs (NSAIDs)?
Take the medication with food.
The nurse is reviewing the assessment findings and laboratory results of a child diagnosed with new-onset glomerulonephritis. Which finding should the nurse most likely expect to note?
Tea-colored urine
A newborn with a diagnosis of subdural hematoma is admitted to the newborn nursery. The nurse should perform which action to check for the major symptom associated with subdural hematoma?
Test for equality of extremities when stimulating reflexes.
The nurse has just administered ondansetron to a child about to receive chemotherapy. The nurse determines that the medication has been effective based on which outcome?
The child denies nausea and vomiting.
The nurse is assessing a child who is on 2 liters of oxygen because of hypoxemia due to heart failure. Which finding indicates the treatment with oxygen is effective?
The child is tolerating activities.
Which assessment finding of a child with recurrent acute otitis media (AOM) suggests that the school nurse should refer the child to the primary health care provider (PHCP)?
The child's teacher states the child is suddenly no longer participative in class discussions.
The parents of a newborn diagnosed with esophageal atresia ask the nurse to explain the diagnosis. What should the nurse tell the parents regarding this condition?
The esophagus terminates before it reaches the stomach.
The nurse is teaching the parent of an 18-month-old child about administering ear drops to the child. During return demonstration, which action by the parent indicates an understanding of the instructions?
The parent pulls the pinna of the ear down and back.
The nurse is reviewing the record of an infant admitted to the newborn nursery. The nurse notes that the primary health care provider has documented bladder exstrophy. On data collection, the nurse expects to note which finding?
Urinary bladder on the outside of the body
The nurse should include which measures in the plan of care for an infant after cleft lip (CL) and palate repair? Select all that apply.
Use elbow immobilizers. Apply petroleum jelly as prescribed to the operative site.
Which teaching point is a priority for the parents of a toddler with leukemia to include in the daily care plan?
Wash hands frequently.