Practice questions

A clinic nurse is providing teaching to the parent of a 1-month-old infant who has gastroesophageal reflux. Which of the following statements by the parent indicates an understanding of the teaching? A. "I will give lansoprazole 30 min after my baby's feedings." B. "I will lay my baby on her right side after feedings." C. "I will give my baby a bottle just before bedtime." D. "I will add rice cereal to my baby's feedings."

✔Correct answer D The parent should add 1 tsp to 1 tbsp of rice cereal per ounce of formula or expressed breast milk to thicken the feedings and decrease the number of vomiting episodes.

A nurse is caring for a toddler who has otitis media and a temperature of 39.1°C (102.4°F). Which of the following actions should the nurse take first? A. Reduce the temperature of the child's room B. Redress the child in minimal clothing C. Apply cool compresses to the child's forehead D. Administer an antipyretic to the child

✔Correct answer D When using the urgent vs. nonurgent approach to client care, the nurse should first administer an antipyretic to decrease the toddler's body temperature.

A nurse is caring for a school-aged child who has acute post-streptococcal glomerulonephritis. Which of the following manifestations should the nurse expect? A. Hypotension B. Elevated serum lipid levels C. Decreased serum potassium levels D. Hematuria

✔Correct answer D Hematuria can be detected visually in clients who have acute post-streptococcal glomerulonephritis.

A nurse is teaching about clinical manifestations of tracheomalacia to the parent of an infant who had tracheoesophageal fistula repair as a newborn. Which of the following findings should the nurse include in the teaching? A. Absence of bowel sounds B. Neck contortions C. Barking cough D. Projectile vomiting

✔Correct answer C Infants who have tracheomalacia have a weakened trachea, which can lead to collapse. Clinical manifestations of tracheomalacia include a barking cough, stridor, wheezing, cyanosis, and apnea.

A nurse is caring for a child who has glomerulonephritis. Which of the following actions should the nurse take? A. Monitor the child's blood pressure twice per day B. Maintain the child on bed rest for 3 days C. Weigh the child once each day D. Increase the child's daily intake of sodium

✔Correct answer C The nurse should weigh the child at the same time each day to monitor fluid balance. Incorrect Answers: A. Glomerulonephritis can cause hypertension that can lead to cerebral ischemia. Therefore, the nurse should monitor the child's blood pressure every 4 hours. B. The child should participate in activities as tolerated. Bed rest is not required. D. The nurse should offer the child a regular diet with moderate sodium restriction and ensure no salt is added to foods.

A nurse is caring for a child who has suspected nephrotic syndrome. Which of the following laboratory values should the nurse expect? A. Platelets 120,000/mm^3 B. Serum sodium 160 mEq/L C. Hgb 9 g/dL D. Serum cholesterol 700 mg/dL

✔Correct answer D A serum cholesterol level of 700 mg/dL is above the expected reference range. A child who has nephrotic syndrome will have high serum cholesterol findings because of the increase in plasma lipids.

A nurse is preparing to obtain an antistreptolysin O (ASO) titer from a child who has acute glomerulonephritis. The child's parent asks the nurse to explain the purpose of the test. Which of the following responses should the nurse provide? A. "The test determines the level of antibiotics in your child's blood." B. "The test tells us if your child ever had measles." C. "The test verifies the amount of albumin in your child's blood." D. "The test shows us if your child had a recent strep infection."

✔Correct answer D An ASO titer indicates the child had a recent strep infection. When determining a definitive diagnosis for acute glomerulonephritis, this must be documented because the condition is usually the result of this type of infection.

A nurse is preparing to feed an infant who has a cleft lip and palate. Which of the following actions should the nurse plan to take? A. Burp the infant at least 2 to 3 times during the feeding B. Remove the nipple from the infant's mouth if swallowing becomes audible C. Stop the feeding if formula appears in the nasal cavity of the infant D. Discourage the parents from participating in the feeding prior to a surgical repair

✔Correct answer A Infants who have a cleft lip and palate will swallow an increased amount of air during a feeding due to a lack of separation between the oral and nasal cavities. Infants should be burped after every ounce of formula consumed.

A nurse is caring for a 2-year-old child who has frequent urinary tract infections. When educating the parents about the prevention of urinary tract infections, which of the following instructions should the nurse include? A. Teach the child to wipe from front to back B. Give the child frequent bubble baths C. Urge the child to urinate every 6 hr D. Administer oxybutynin daily

✔Correct answer A The child should be taught to wipe from front to back in order to prevent bacterial contamination from the anal area entering the urethra.

A nurse is assessing a child who is postoperative and received a unit of PRBC's during a surgical procedure. Which of the following findings indicate the child is experiencing a hemolytic transfusion reaction? A. Chills and flank pain B. Pruritis and flushing C. Rales and cyanosis D. Bradycardia and diarrhea

A

A nurse is caring for a 4-month-old child who has acute otitis media and a fever of 38.3°C (101°F). Which of the following medications should the nurse administer? A. Diphenhydramine B. Furosemide C. Amoxicillin D. Ibuprofen

✔Correct answer C A child who has acute otitis media should take an antibiotic to help alleviate the infection.

You are educating nursing student regarding fluid requirements for pediatric patients who present with comorbidities. Increased need for fluid requirements would be consistent with treatment management for which conditions? SATA A. Diabetic ketoacidosis B. Congestive heart failure C. Burns D. Syndrome of inappropriate diuretic hormone E. Diabetes insipidus

A, C, E Increased fluid requirements would occur in response to DKA, DI and burns.

A nurse is caring for a preschooler who was brought to an outpatient clinic with a 2-day history of a vesicular, honey-colored crusty region around the nose and mouth. If the provider determines the lesions to be impetigo contagiosa, what should the nurse anticipate teaching the child's parent about the illness? (Select all that apply.) A. Apply a topical antibacterial ointment to the lesions B. Wash the child's bed linens daily with hot water C. Administer acyclovir oral suspension to prevent recurrence D. Allow the crust covering the infected lesions to remain intact E. Wash hands before and after contact with the affected area

Correct Answers: A, B, E Impetigo contagiosa is a bacterial infection of the skin. Therefore, the nurse should plan on teaching the child's parents about topical application of an antibacterial ointment. The parents should wash their hands before and after contact with the affected area and wash the child's bed linens daily in hot water to decrease the risk of reinfection or transmission.

A nurse is teaching the parents of a toddler who had an anaphylactic reaction to peanut butter about administering injectable epinephrine. Which of the following instructions should the nurse include? A. Common site for injection of epinephrine are the fatty tissue found in upper arm and in lower abdomen B. Administer epinephrine prior to giving your child peanut products in the future. C. No further treatment is needed after injecting the epinephrine D. You will need to increase the dosage as your child gains weight

D Epinephrine is a weight based medication that is available in dosage of 0.15mg and 0.3mg. As the child grows, it will be necessary to change the epinephrine dosage that is administered.

A nurse is teaching the guardians of an infant who has mild gastroesophageal reflux (GER). Which of the following instructions about feeding therapies should the nurse recommend? A. "Apply the infant's diaper snugly prior to feedings." B. "Administer nasogastric feedings." C. "Thicken feedings with rice cereal." D. "Place the infant in a lateral position for 1 hour after feedings."

✔Correct answer C The nurse should instruct the guardians about the correct way to thicken feedings with rice cereal. Thickened feedings with rice cereal decrease the infant's manifestations of GER and promote weight gain if needed.

A nurse is providing teaching to a parent of a preschooler who has impetigo. Which of the following statements by the parent indicates an understanding of the teaching? A. "Impetigo is caused by a virus." B. "Impetigo is contagious for 48 hours after vesicles rupture." C. "I will wash my child's clothes in hot water." D. "My child now has immunity against impetigo."

✔Correct answer C The parent should wash the child's clothes in hot water to kill bacteria. The parent should also keep the child's towels and washcloths separate from those of other members of the household.

A nurse is providing discharge teaching to the parents of a child who has nephrotic syndrome. Which of the following instructions should the nurse include in the teaching? A. Restrict the child's potassium intake B. Administer acetaminophen to the child twice daily C. Weigh the child once each week D. Keep the child away from people who have an infection

✔Correct answer D Children who have nephrotic syndrome are at increased risk for infection and should avoid contact with people who have infections.

A nurse is providing teaching for a 14-year old client who has acne. Which of the following instruction should the nurse include? A. "Use an exfoliating cleanser." B. "Keep hair off your forehead." C. "Take tetracycline after meals." D. "Squeeze acne lesions as they appear."

✔Correct answer B Hair and scalp care can provide relief from the manifestation of acne. Frequent shampooing and keeping hair away from the face can improve acne.

A nurse is assessing a child who has stage I Hodgkin disease. Which of the following findings should the nurse expect? A. Generalized petechiae B. Enlarged lymph nodes C. Chronic vomiting D. Dependent edema

✔Correct answer B Manifestations of stage I Hodgkin disease include painless enlargement of lymph nodes.

The nurse is assessing an 8-year-old boy suspected of having Rocky Mountain spotted fever. Which of the following signs and symptoms would the nurse expect to find? A. Maculopapular rash that begins on the wrists and ankles and spreads centripetally B. Spasms of the jaw muscles and arching of the back C. Circular, outward expanding rash D. Stiff neck with a positive Kernig's sign

A. Maculopapular rash that begins on the wrists and ankles and spreads centripetally RATIONALE •Rocky Mountain spotted fever starts with a fever, usually within a few days of a tick bite. Along with a headache and myalgia, a maculopapular rash develops 2-6 days after the onset of a fever. The rash first appears in the wrists and ankles, then spreads centripetally to the trunk. •Rocky mountain spotted fever is the most common rickettsial disease seen in the United states and is transmitted by ticks. It can be a life-threatening illness if undiagnosed or untreated. •Stiff neck and a positive Kernig's sign is indicative of meningitis. •Spasms of the jaw and arching of the back are signs of tetanus. •A circular outward expanding rash is a classic sign of early Lyme disease.

A nurse is teaching the parent of a preschool-aged child about the treatment for pinworms. Which of the following statements by the parent indicates an understanding of the teaching? A. "I will give my child a dose of albendazole today and again in 2 weeks." B. "I will collect specimens immediately after my child has a bowel movement." C. "I will give my child a tub bath twice each day." D. "I will place my child's bed linens in a sealed plastic bag for 7 days."

✔Correct answer A The nurse should instruct the parent to repeat the dose of albendazole in 2 weeks to eradicate the parasite and prevent reinfection.

A nurse is admitting a child who has acute lymphocytic leukemia. Which of the following laboratory values should the nurse expect? A. Platelets 500,000 mm^3 B. RBCs 2.5 million/uL C. WBCs 4,000/mm^3 D. Hct 60%

✔Correct answer B An RBC count of 2.5 million/uL is below the expected reference range. A child who has acute lymphocytic leukemia has a low RBC count.

A nurse is providing teaching to a parent of a preschooler who has tinea capitis. Which of the following instructions should the nurse include in the teaching? A. Apply aluminum acetate solution compresses to the lesions B. Apply hydrocortisone cream to the lesions twice daily C. Seal nonwashable toys in a plastic bag for 2 weeks D. Leave the medicated shampoo on the scalp for 5 to 10 minutes

✔Correct answer D The nurse should instruct the parent to use a shampoo made of 2% ketoconazole or 1% selenium sulfide for the treatment of tinea capitis. For the shampoo to be effective, the parent should leave it on the child's scalp for 5 to 10 minutes prior to rinsing.

A child is exhibiting signs of clinical dehydration. Which lab value would support a diagnosis of hypertonic dehydration? A. Plasma osmolality of 275 mOsm/L B. Serum sodium level of 135 mEq/dL C. Calculation of loss of body fluid weight at 25 ml/kg D. Serum sodium level of 150 mEq/dL

D Hypertonic dehydration would result in an increase in serum sodium levels in proportion to fluid loss. Normal range is 135-145 mEq/dL.

A nurse is planning care for a toddler who has acute gastroenteritis and was recently admitted. Which of the following should the nurse plan to provide for the child? A. Oral rehydration solution B. Bananas or applesauce C. Chicken or beef broth D. Hypertonic IV solution

✔Correct answer A The nurse should plan to provide an oral rehydration solution (ORS) to this child who has acute gastroenteritis. ORS promotes the body's reabsorption of water and sodium and is more effective and less traumatic than the administration of IV fluids for the treatment of dehydration due to diarrhea and emesis.

A nurse is caring for a toddler who is postoperative following a cleft palate repair. Which of the following actions should the nurse take? A. Restrain the toddler's arms at the elbows B. Feed the toddler with a spoon C. Monitor the toddler's oral temperature D. Weigh the toddler every 48 hours

✔Correct answer A When caring for a toddler who is postoperative following a cleft palate repair, the nurse should apply elbow restraints (unless prescribed otherwise) to prevent the toddler from rubbing or disrupting the sutured area.

A nurse is teaching the parent of a school-age child who has celiac disease. Which of the following foods selected by the parent indicates an understanding of the teaching? A. Corn tortilla with black beans B. Pizza C. Canned soup D. Hot dogs

✔Correct answer A Children who have celiac disease are placed on a gluten-free diet. Gluten is found in wheat, rye, and barley. Selecting products made from corn indicates an understanding of the teaching, as corn and beans are gluten-free foods.

A nurse is planning care for a 4-year-old child who has nephrotic syndrome. Which of the following actions should the nurse take? A. Provide thorough skin care B. Test for blood type and cross-match C. Allow ample hydrating fluids D. Maintain a low-carbohydrate diet

✔Correct answer A The nurse should provide thorough skin care for this child who has nephrotic syndrome. Skin care is especially important due to edema and the risk of infection

A nurse is creating a plan of care for a child who has leukopenia secondary to chemotherapy. Which of the following interventions should the nurse include in the plan? A. Maintain the child on bed rest B. Monitor the child for increased temperature C. Administer oxygen to the child D. Monitor the child for bleeding

✔Correct answer B Leukopenia places the child at risk of infection; therefore, the nurse should monitor the child for a fever.

A nurse is caring for a child who has a ruptured appendix. Which of the following positions should the nurse encourage the child to maintain? A. Supine B. Semi-Fowler's C. Sims' D. Orthopneic

✔Correct answer B Maintaining a semi-Fowler's position promotes adequate ventilation. Flexing the knees slightly will likely be the most comfortable position for the child. Additionally, this promotes drainage of the cecum downward into the pelvis instead of upward toward the lungs.

A nurse is caring for an 18-month-old infant who has chronic otitis media. The nurse should recognize that chronic otitis media will affect which of the following? A. Olfaction B. Visual acuity C. Speech patterns D. Hand-eye coordination

✔Correct answer C Chronic otitis media can result in hearing loss, which can affect speech development.

A nurse is caring for a preschool-age child who has mucosal ulceration after receiving chemotherapy. Which of the following actions should the nurse take? A. Place viscous lidocaine on the child's oral lesions. B. Instruct the child to use a soft-sponge toothbrush when brushing her teeth. C. Encourage the child to rinse her mouth with hydrogen peroxide every 2-4 hr. D. Give the child lemon glycerin swabs to use after each meal.

✔Correct answer B The child should use a soft-sponge toothbrush when brushing her teeth because a regular toothbrush may cause further irritation to the mucosal ulcers.

A nurse in the emergency department is caring for a 2-year-old child who was found by his parents crying and holding a container of toilet bowl cleaner. The child's lips are edematous and inflamed, and he is drooling. Which of the following is the priority action by the nurse? A. Remove the child's contaminated clothing B. Check the child's respiratory status C. Administer an antidote to the child D. Establish IV access for the child

✔Correct answer B The nurse should apply the ABC priority-setting framework, which emphasizes the basic core of human functioning: having an open airway, being able to breathe in adequate amounts of oxygen, and circulating oxygen to the body's organs via the blood. An alteration in any of these areas can indicate a threat to life and is the nurse's priority concern. When applying the ABC priority-setting framework, airway is always the highest priority because the airway must be clear for oxygen exchange to occur. Breathing is the second-highest priority because adequate ventilatory effort is essential in order for oxygen exchange to occur. Circulation is the third-highest priority because the delivery of oxygen to critical organs only occurs if the heart and blood vessels are capable of efficiently carrying oxygen to them. This child's lips are edematous and inflamed, and he is drooling. These findings indicate that the child might have swelling of the oral cavity and pharynx, which can result in a compromised airway.

A nurse is teaching the parents of a toddler who has enterobiasis about managing this parasitic disease. Which of the following pieces of information should the nurse include in the teaching? A. "You should encourage your child to take a tub bath daily." B. "You should keep your child's fingernails trimmed short." C. "You should dress your child in a 2-piece outfit at bedtime." D. "You should expect your child not to have a recurrence of the parasitic disease."

✔Correct answer B The nurse should instruct the parents to keep their child's fingernails trimmed short to minimize the collection of ova under the nails.

A nurse is caring for an infant who has a tracheoesophageal fistula. Which of the following actions should the nurse take? A. Place the infant in a lateral position B. Perform oropharyngeal suctioning C. Administer ranitidine orally D. Thicken the infant's formula

✔Correct answer B When caring for an infant who has a tracheoesophageal fistula, the nurse should perform frequent oropharyngeal suctioning to decrease the infant's risk of aspiration.

A nurse is caring for a 4-week-old infant who is 2 weeks postoperative following surgical correction of biliary atresia. Which of the following findings is an indication that the surgery was successful? A. The infant has lost 2.2 kg (1 lb) since the surgery. B. The infant has a total bilirubin level of 0.3 mg/dL. C. The infant has an aspartate aminotransferase (AST) level of 120 units/L. D. The infant's stools are gray in color.

✔Correct answer B A bilirubin level of 0.3 mg/dL is within the expected reference range and indicates the surgery was successful.

A nurse is teaching the parents of a 3-year-old child who has persistent otitis media about prevention. Which of the following statements by the parents indicates an understanding of the teaching? A. "My child should not play around others who have ear infections." B. "We should not smoke around our child." C. "My child should not swim this summer." D. "I will encourage my child to blow his nose forcefully when he has a cold."

✔Correct answer B Preventing exposure to tobacco smoke at home can prevent further episodes of ear infections because tobacco smoke can cause inflammation of the respiratory tract.

A nurse is reviewing the laboratory report of a toddler who is receiving chemotherapy for leukemia. Which of the following laboratory values should the nurse report to the provider? A. Platelets 150,000/mm^3 B. Hgb 6 g/dL C. WBC 6,000/mm^3 D. Potassium 4.5 mEq/L

✔Correct answer B This hemoglobin level is below the expected reference range and is indicative of anemia; therefore, the nurse should report this finding to the provider.

A nurse is caring for a school-age child who has glomerulonephritis. The child has decreased urinary output and a blood pressure of 160/78 mmHg and is receiving hydralazine. Which of the following lunch choices should the nurse recommend? A. 1 hot dog, 22 potato chips, and 120 mL (4 oz) of orange juice B. 1 sandwich with lettuce, tomato, and 4 slices of bacon; a small apple; and 240 mL (8 oz) of milk C. 3 oz grilled chicken, 1 cup of pear slices, and 120 mL (4 oz) of apple juice D. 1 cup of cottage cheese, a small banana, and 240 mL (8 oz) of soda

✔Correct answer C A child who has glomerulonephritis has moderate sodium restriction, and further restriction is given to foods that are high in potassium for children who have decreased urinary output. These restrictions are because the kidneys of these children are not functioning appropriately. This menu option consists of 571 g of potassium and 268 g of sodium.

A nurse is providing nutritional teaching to an adolescent client who has celiac disease. Which of the following breakfast foods should the nurse recommend? A. Plain flour pastry B. Wheat cereal C. Scrambled eggs D. Rye toast

✔Correct answer C A client who has celiac disease should be on a gluten-free diet and should avoid foods containing barley, oat, rye, and wheat; therefore, scrambled eggs are an appropriate breakfast item for the nurse to recommend to the client.

A nurse is providing teaching to the parent of a toddler who has bacterial conjunctivitis. Which of the following instructions should the nurse include? A. Clean secretions from the infected eye by wiping from the outer canthus toward the inner canthus and upward B. Keep the infected eye covered with warm compresses for the first 24 to 48 hr C. Notify the provider immediately if the sclera becomes inflamed D. Apply pressure to the outer canthus of the eye for 1 min after administering the eye drops

✔Correct answer C Although the conjunctiva becomes inflamed during this infection, the sclera should remain clear and white. If the sclera becomes inflamed, it can indicate the presence of a serious conjunctival infection, and the child should be assessed immediately by an ophthalmologist.

A nurse is caring for a 1-year-old infant who has chronic otitis media. The nurse should identify that which of the following areas is at risk of a delay in development? A. Fine motor skills B. Visual acuity C. Speech patterns D. Hand-to-eye coordination

✔Correct answer C Speech patterns are developed through auditory experiences. Chronic otitis media is a common cause of hearing impairment, which can delay the development of speech.

A nurse is obtaining a urine sample from a 5-month-old infant by applying a urine collection bag. Which of the following actions should the nurse take first? A. Apply the collection bag to the skin at the area of the symphysis pubis B. Apply the collection bag to the skin at the area of the perineum C. Wash and dry the genitalia, perineum, and surrounding skin D. Stroke the muscles on either side of the infant's spine

✔Correct answer C The first action the nurse should take is to wash and dry the genitalia, perineum, and the skin in the area to which the urine collection bag will be secured.

A nurse is providing discharge teaching to the guardian of an infant following a hypospadias repair. Which of the following instructions should the nurse include? A. Clamp the infant's catheter for 30 minutes each day B. Give the infant a tub bath once per day C. Apply antibacterial ointment to the infant's penis once per day D. Decrease the infant's fluid intake for 3 days

✔Correct answer C The nurse should instruct the guardian to apply an antibacterial ointment to the infant's penis once daily to decrease the risk of infection.

A nurse is reviewing the laboratory reports of a child with acute nephrotic syndrome who has been receiving prednisone by mouth for the past week. Which of the following findings should the nurse report to the provider? A. Serum sodium 142 mEq/L B. Serum potassium 4 mEq/L C. WBC count 3,000/mm^3 D. Platelet count 298,000/mm^3

✔Correct answer C The nurse should understand that the use of corticosteroids suppresses the child's immune system and increases the risk of infection. The nurse should identify that a WBC count of 3,000/mm^3 is below the expected reference range for a child and should report this finding to the provider.

A nurse is caring for an 8-year-old child who has acute glomerulonephritis. Which of the following findings should the nurse expect? A. Hypotension B. Stomatitis C. Bloody diarrhea D. Periorbital edema

✔Correct answer D Periorbital edema is an expected finding in a child who has glomerulonephritis. Incorrect Answers: A. Elevated blood pressure is an expected finding in a child who has acute glomerulonephritis. B. Stomatitis is an expected finding in a child who has chronic renal failure. C. Bloody diarrhea is an expected finding in a child who has hemolytic uremic syndrome.

A nurse is planning care for a 6-year-old child who is receiving chemotherapy. The child has a highlight platelet count of 20,000/mm^3. Based on this laboratory value, which of the following interventions should the nurse include in the plan of care? A. Provide foods high in iron B. Avoid people who have infections C. Administer PRN oxygen D. Encourage quiet play

✔Correct answer D A platelet count of 20,000/mm^3 will predispose the client to excessive bleeding. Quiet play will lessen the client's risk of injury, thereby reducing the chance of hemorrhage.