Quiz Questions Peds

15. Ampicillin, 75 mg/kg, is prescribed for a 22-lb child. It is available in a solution that contains 250 mg/5 mL. The nurse would administer ___ milliliters in one dose? a. 15 mL b. 20 mL c. 30 mL d. 10 mL

15 mL Rationale: Take 22lbs / 2.2 = 10kg 10kg X 75mg/kg = 750mg 750/250 mg = 3mg X 5mL = 15ml

26. Doctor's Order: Diuril 1.8 mg/kg po tid; Available: Diuril 12.5 mg caps. How many cap will you administer for each dose to a 31 lb child a. 2 caps b. 2.5 caps c. 3 caps d. 1.5 caps

2 caps Feedback: 31 lbs. divided by 2.2 to convert the child's weight into kg's (31 / 2.2= 14kg) Order is for 1.8mg per kg (1.8 X 14=25.2mg) Available: 12.5 mg caps or 25mg / 12.5 = 2 caps

9. The nurse should assign a 4 year old boy admitted to the hospital with nephrotic syndrome to a room with a a. 2 year old boy with croup b. 3 year old boy with impetigo c. 4 year old girl with conjunctivitis d. 5 year old girl with a fractured femur

5 year old girl with a fractured femur Response Feedback: Protein loss with nephrotic syndrome includes loss of globulins, i.e. immunoglobulin production, risk for infection; place child with non-infectious patient

15. When talking with a 4-year-old, the nurse observes that the child is shy and stutters. The nurse is aware that stuttering in a 4-year-old child would be considered a. A sign of delay in neurological development b. A common characteristic or a preschooler c. The result of a serious emotional problem d. An indication of a serious permanent impairment

A common characteristic or a preschooler

6. Which one of the following factors is most important in predisposing toddlers to frequent infections? a. A short straight internal ear canal and large lymph tissue are found in toddlers b. Respirations are abdominal c. Pulse and respiratory rates are slower than those in infancy d. Defense mechanisms are less efficient than those during infancy

A short straight internal ear canal and large lymph tissue are found in toddlers

6. What are expected findings with congenital clubfoot? Select all that apply. a. Affected foot exhibits little movement b. Barlow's sign on affected side c. Asymmetry of gluteal and thigh skin folds d. One foot is rotated in and down and is fixed and difficult to move

A. Affected foot exhibits little movement D. One foot is rotated in and down and is fixed and difficult to move

4. Which of the following are symptoms of Legg Calve Perthes? Select all that apply. a. Stiffness in the hip b. Swelling and redness of joints c. Referred pain to knee d. Limp after activity

A. Stiffness in the hip C. Referred pain to knee D. Limp after activity

8. The nurse getting an end-of-shift report on a child with status asthmaticus should question which intervention? a. Administer oxygen by nasal cannula to keep oxygen saturation at 100%. b. Assess intravenous (IV) maintenance fluids and site every hour. c. Notify physician for signs of increasing respiratory distress. d. Organize care to allow for uninterrupted rest periods.

Administer oxygen by nasal cannula to keep oxygen saturation at 100%. A. Correct Supplemental oxygen should not be administered to maintain oxygen saturation at 100%. Keeping the saturation around 95% is adequate. Administration of too much oxygen to a child may lead to respiratory depression by decreasing the stimulus to breathe, leading to carbon dioxide retention. B. When the child cannot take oral fluids because of respiratory distress, IV fluids are administered. The child with a continuous IV infusion must be assessed hourly to prevent complications. C. A physician should be notified of any changes indicating increasing respiratory distress. D. A child in respiratory distress is easily fatigued. Nursing care should be organized so the child can get needed rest without being disturbed.

2. At 8 am a female adolescent with acute glomerulonephritis has a blood pressure of 210/110. The previous blood pressure reading was 170/88. The client states that she is upset because her boyfriend did not visit last night. What action would the nurse take first? a. Give the client her 9 am prescription for an oral diuretic early b. Administer the PRN prescription of nifedipine (Procardia) sublingually c. Notify the nursing supervisor of the client's condition d. Attempt to calm the patient and retake the blood pressure in thirty minutes

Administer the PRN prescription of nifedipine (Procardia) sublingually Response Feedback: Procardia lowers blood pressure rapidly; stay with patient until BP lowers

9. The nurse is providing anticipatory guidance to the parents of an 18 month old girl. Which guidance will be most helpful for toilet training? a. Telling them that it is too early to start toilet training b. Assuring them that bladder control occurs first c. Telling them that curiosity is a sure sign of readiness d. Advising them to use praise, not scolding

Advising them to use praise, not scolding

6. What is an appropriate beverage for the nurse to give to a child who had a tonsillectomy earlier in the day? a. Chocolate ice cream b. Orange juice c. Cherry fruit punch d. Apple juice

Apple juice A. The child can have full liquids on the second postoperative day. B. Citrus drinks are not offered because they can irritate the throat. C. Red liquids are avoided because they give the appearance of blood if vomited. D. Correct The child can have clear, cool liquids when fully awake

2. The nurse plans to talk to a mother about toilet training a toddler, knowing that the most important factor in the process of toilet training is the: a. Child's desire to be dry b. Ability of the child to sit still c. Child's ability to discuss need to void d. Approach and attitude of the parent

Approach and attitude of the parent

20. A 20-year-old patient with a 6-year history of muscular dystrophy is hospitalized with a respiratory tract infection. Which nursing action will be included in the plan of care? a. Assist the patient with active range-of-motion (ROM) exercises b. Logroll the patient every 1 to 2 hours. c. Teach the patient about the muscle biopsy procedure. d. Provide the patient with a pureed diet.

Assist the patient with active range-of-motion (ROM) exercises Rationale: The goal for the patient with muscular dystrophy is to keep the patient active for as long as possible. The patient would not be confined to bed rest and would not require logrolling. Muscle biopsies are necessary to confirm the diagnosis but would not be ordered for a patient who already had a diagnosis. There is no indication that the patient requires a pureed diet

10. An infant's parents ask the nurse about preventing OM. What should be recommended? a. Use nasal decongestant b. Avoid tobacco smoke c. Avoid children with OM d. Bottle feed or breastfeed in supine position

Avoid tobacco smoke A Nasal decongestants are not useful in preventing OM. B. Correct: Eliminating tobacco smoke from the child's environment is essential for preventing OM and other common childhood illnesses. C. Children with uncomplicated OM are not contagious unless they show other upper respiratory infection (URI) symptoms. D. Children should be fed in an upright position to prevent OM. Also, try to get children immunized with pneumococcal vaccine.

12. The nurse understands that neutropenic precautions needed for children receiving chemotherapy is based on which actions of chemotherapeutic agents? a. Gastrointestinal upset b. Bone marrow suppression c. Decreased creatinine level d. Alopecia

Bone marrow suppression A. Although gastrointestinal upset may be an adverse effect of chemotherapy, it is not caused by all chemotherapeutic agents. No special precautions are instituted for gastrointestinal upset. B. Chemotherapy agents cause bone marrow suppression, which creates the need to institute precautions related to reduced white blood cell, red blood cell, and platelet counts. These precautions focus on preventing infection and bleeding. C. A decreased creatinine level is consistent with renal pathologic conditions, not chemotherapy. D. Not all chemotherapeutic agents cause alopecia. No precautions are taken to prevent alopecia

13. A mother in the postpartum unit expresses concern that her 3-year-old daughter will be jealous of her newborn brother. The nurse should suggest neutralizing the jealousy by: a. Allowing the daughter to watch her baby brother when the mother naps b. Explaining in simple terms that the mother must send time with the baby c. Ignoring any negative comments or actions that her daughter makes toward the baby d. Bringing home a new baby doll for her daughter when her baby brother is brought home

Bringing home a new baby doll for her daughter when her baby brother is brought home

18. A nurse is instructing parents on treatment of pediculosis (head lice). Which should the nurse include in the teaching plan? Select all that apply a. Bedding should be washed in warm water and dried on a low setting b. After treating the hair and scalp with a pediculicide, shampoo the hair with regular shampoo c. Retreat the hair and scalp with a pediculicide in 7 to 10 days d. Items that cannot be washed should be dry cleaned or sealed in plastic bags for 2 to 3 weeks e. Combs and brushes should be boiled in water for at least 10 minutes.

C. Retreat the hair and scalp with a pediculicide in 7 to 10 days D. Items that cannot be washed should be dry cleaned or sealed in plastic bags for 2 to 3 weeks E. Combs and brushes should be boiled in water for at least 10 minutes Feedback: The hair should not be shampooed for 24 hours after the treatment. Even though the kill rate is high and there is residual action, retreatment should occur after 7 to 10 days. Combs and brushes should be boiled or soaked in antilice shampoo or hot water (greater than 60° C [140° F]) for at least 10 minutes. Advise parents to wash clothing (especially hats and jackets), bedding, and linens in hot water and dry at a hot dryer setting

20. The nurse is caring for an infant whose cleft lip was repaired. Important aspects of this infant's postoperative care include which of the following? a. Arm restraints, postural drainage, mouth irrigations b. Cleansing suture line, supine and side lying positions, arm restraints c. Mouth irrigations, prone position, cleansing suture line d. Supine and side lying positions, postural drainage, arm restraints

Cleansing suture line, supine and side lying positions, arm restraints

16. The nurse is caring for a 14 month old boy with cystic fibrosis. Which of the following signs of ineffective family coping requires the most urgent intervention? a. Compliance with therapy wanes b. Family becomes overly vigilant c. Child feels fearful and isolated d. Siblings are jealous or worried

Compliance with therapy wanes Response Feedback: must be compliant if on long term antibiotics as major cause of death is from lung complications/repeated pneumonia; also will be taking pancreatic enzymes with every meal and snack-->make sure to give enzymes with the meal; can sprinkle over applesauce if unable to swallow enzymes

15. A rapid strep test has confirmed that a 5 year old girl has Group A strep infection. Which of the following interventions will the nurse have the parents do last? a. Use a cool mist vaporizer b. Encourage the child to drink fluids c. Discard the child's toothbrush d. Give the full course of antibiotics

Discard the child's toothbrush Response Feedback: Must complete meds to avoid complications such as acute glomerulonephritis or rheumatic fever; throat culture is done first--gold standard for identifying organism; if pt develops "hot potato" voice and difficulty swallowing, could be peritonsillar abcess

10. The nurse understands that surgery is needed for a 2 year old child with undescended testes because a. Future pain with urination will not occur b. Maturation of the testes starts at about age 7 c. The puboscrotal ring is more elastic at this age d. Early surgery produces less psychological damage

Early surgery produces less psychological damage

8. During discharge teaching of a child with juvenile rheumatoid arthritis, the nurse should stress to the parents the importance of obtaining which diagnostic testing? a. Hearing tests b. Eye exams c. Chest x-rays d. Fasting blood glucose tests

Eye exams Response Feedback: Feedback: Visual changes leading to blindness can occur in children with JRA. Regular eye exams (B) can help to prevent this complication. (A, C, and D) are not routinely necessary for management of JRA

12. The mother of a 2 year old calls the clinic because the child has had diarrhea for the past 2 days. The child has no emesis or fever and normal urination amounts. How should the nurse advise the mother? a. Feed the child a regular diet b. Decrease dietary fat c. Offer clear fluids for 24 hours d. Switch to the BRAT (bananas, rice, applesauce, toast) diet

Feed the child a regular diet

3. The nurse should assess a child who has had a tonsillectomy for a. Frequent swallowing b. Inspiratory stridor c. Rhonchi d. Elevated white blood cell count

Frequent swallowing A. Correct: Frequent swallowing is indicative of postoperative bleeding. B. Inspiratory stridor is characteristic of croup. C. Rhonchi are lower airway sounds indicating pneumonia. D. Assessment of blood cell counts is part of a preoperative workup

15. The nurse is planning discharge teaching for a client who has a splenectomy. Which statement does the nurse include in this client's teaching plan? a. Get yearly flu shots and the pneumococcal vaccine b. Avoid environmental allergens c. Do not play contact sports d. Avoid overeating foods high in iron

Get the yearly flu shots and the pneumococcal vaccine The spleen is the major site of B-lymphocyte maturation and antibody production. Those who undergo splenectomies for any reason have a decreased antibody-mediated immune response and are particularly susceptible to viral infections. The body responds to environmental allergens with an unspecific inflammatory process. The client is not at risk for bleeding or injury due to contact sports

2. A mother brings her 10-year-old son in due to a red rash on the child's body. A CBC is drawn and has the following values: Hgb: 12 g/dL; Hct: 24; MCV: 90; Total WBC 4.0, Polys 16.2% and Bands 5%; Platelets: 20,000. Which of the following would the nurse anticipate? a. He will need a unit of packed red blood cells b. He will need factor VIII replacement c. He will need to avoid fresh fruits and vegetables d. He will need an order for IV steroids

He will need an order for IV steroids Response Feedback: problem is ITP; Factor VIII is for hemophilia and clotting factor (ITP is platelets); he is not neutropenic nor anemic

10. The nurse is giving preoperative instructions to a 14-year-old female client who is scheduled for surgery to correct a spinal curvature. Which statement by the client best demonstrates that learning has taken place? a. I will read all the literature you gave me before surgery b. I have had surgery before when I broke my wrist in a bike accident, so I know what to expect c. All the things people have told me will help me take care of my back d. I understand that I will be in a body cast and I will show you how you taught me to turn

I understand that I will be in a body cast and I will show you how you taught me to turn Outcome of learning is best demonstrated when the client not only verbalizes an understanding but can also provide a return demonstration (D). A 14-year-old may or may not follow through with (A), and there is no measurement of that learning. Having previous surgery (B) may help the client understand the surgical process, but wrist surgery is very different from spinal surgery and emergency surgery is different from elective surgery. In (C), the client may be saying what the nurse wants to hear, without expressing any real understanding of what to do after surgery

17. The nurse is auscultation the chest of a lethargic, irritable 6 year old boy and hears wheezing. The nurse will include which teaching subject if the child is suspected of having asthma? a. I'm going to have the respiratory therapist get some of the mucus from your lungs b. I'm going to have the radiography technician take a picture of your lungs c. We're going to go take a look at your lungs to see if there are any sores on them d. I'm going to hold your hand while the phlebotomist gets blood from your arm

I'm going to have the radiography technician take a picture of your lungs

18. The nurse at a playground witnesses a child fall off a swing. The nurse rushes to the child and suspects that he has a broken right leg. The nurse should take which priority action? a. Call for an ambulance b. Remove the child's shoes c. Tell the child that everything will be fine d. Immobilize the leg

Immobilize the leg When a fracture is suspected, the area is immobilized and splinted before the victim is moved. Emergency help is called for, and the nurse should remain with the child and provide realistic reassurance. Shoes are not removed because this action can cause increased trauma. Telling the child that everything will be fine is nontherapeutic

3. The nurse is preparing a plan of care for the child with sickle cell anemia who is scheduled for hospital admission for the treatment of vaso-occlusive pain crisis. The nurse most appropriately includes in the plan of care: a. Place the child NPO b. Administer meperidine (Demerol) for pain c. Initiate an intravenous (IV) line d. Prepare for the intubation for oxygen administration

Initiate an intravenous (IV) line Response Feedback: 1st priority is getting hydrated to stop more cells from sickling and improve blood flow to cells and organs; O2 is not intubated; pain control next; almost never give Demerol (in practice given for post-op shivering)

5. During the course of treatment, a toddler is to receive an intramuscular injection. The most supportive intervention at this time would be: a. Distracting the toddler's attention with a toy car b. Involving the parents in comforting the toddler after the injection c. Explaining to the parents in detail what is being done d. Giving the toddler the choice of having the injection now or later

Involving the parents in comforting the toddler after the injection

12. The nurse is educating the parents of a 7 year old boy with asthma about the medications that have been prescribed. Which of the following drugs is generally used as an adjunct to a Beta-2 adrenergic agonist for treatment of bronchospasm? a. Ipratropium b. Montelukast c. Cromolyn d. Theophylline

Ipratropium Ipratropium (Atrovent) is an anticholinergic that has bronchodilation effect by blocking M3 acetylcholine receptors on the smooth muscle of the bronchioles; can be nebulized with beta 2 agonist

6. Which of the following should be included in the discharge instructions for a child with iron deficiency anemia? a. Take two iron supplements after missing a dose b. Iron supplements should be taken between meals with orange juice and monitor for black, tarry stools c. Increase vitamin D fortified milk consumption in infants less than 12 months of age to increase dietary iron d. Avoid foods high in vitamin C, since they decrease the absorption of iron supplements

Iron supplements should be taken between meals with orange juice and monitor for black, tarry stools Response Feedback: no milk hard to digest, can cause GI bleed; dairy interfere with iron supp absorption

5. Which of the following statements best describes pseudohypertrophic (Duchenne) muscular dystrophy? a. It is inherited as an autosomal dominant disorder b. It is characterized by a waddling gait, lordosis, and Gower's sign c. It initially presents as atrophy of the lower extremities d. Onset occurs after repeated respiratory infections

It is characterized by a waddling gait, lordosis, and Gower's sign

12. The mother of a 5-year-old expresses concern about her child who believes that "Grandma is still alive" 3 months after the grandmother's death. The nurse explains that: a. Magical thinking often accounts for a preschooler who believes that dead people will come back. b. There is a need for psychological counseling for this child and family. c. This is a form of regression exhibited by the preschooler. d. The child is in denial regarding Grandma's death.

Magical thinking often accounts for a preschooler who believes that dead people will come back

7. Which of the following is the primary nursing goal when caring for the child with erythema subitum (Roseola)? a. Experience of minimal discomfort b. Maintenance of normal body temperature c. Maintenance of skin integrity d. Minimization of long term complications

Maintenance of normal body temperature Response Feedback: Answer: Roseola typically has high fevers before rash breaks out

11. The most prevalent nutritional disorder among young children in the United States is iron deficiency anemia. A major reason for this in young children is: a. Blood disorders b. Overfeeding of milk c. Lack of adequate iron reserves from the mother d. Introduction of solid foods too early for proper absorption

Overfeeding of milk

14. The nurse is assessing the following laboratory results of a client before discharge. Which instruction does the nurse include in this client's discharge teaching plan? Test Result Hemoglobin 15 g/dL Hematocrit 45% White blood cell (WBC) count 2000/mm3 Platelet count 250,000/mm3 a. Avoid contact sports b. Do not take any aspirin c. Perform good hand hygiene d. Eat a diet high in iron

Perform good hand hygiene A normal WBC count is 5000 to 10,000/mm3. A white blood cell count of 2000/mm3 is low and makes this client at risk for infection. Good handwashing technique is the best way to prevent the transmission of infection. The other laboratory results are all within normal limits

17. The home care nurse visits a client who has a cast applied to the left lower leg. On assessment of the client, the nurse notes the presence of skin irritation from the edges of a cast. Which nursing intervention is most appropriate? a. Contact the health care provider b. Petal the cast edges with adhesive tape c. Massage the skin at the edges of the cast d. Place a small facecloth in the cast around the edges of the cast

Petal the cast edges with adhesive tape If a client with a cast has skin irritation from the edges of the cast, the nurse would petal the edges of the cast with tape to minimize the irritation. Massaging the skin will not eliminate the problem. Placing a small facecloth in the cast around the edges of the cast is not appropriate. It is not necessary to contact the health care provider

6. The nurse is aware that the play of a 5-month-old infant would probably consist of. a. Picking up a rattle or toy and putting it into the mouth b. Exploratory searching when a cuddly toy is hidden from view c. Waving "bye-bye" to the parents as a game d. Kicking a big ball across the floor

Picking up a rattle or toy and putting it into the mouth

2. Which of the following would be the most reliable indicator of a fracture in a child? a. Lack of spontaneous movement b. Point tenderness c. Bruising d. Inability to bear weight

Point tenderness

5. A 6-week-old infant is brought to the pediatrician's office with a history of frequent vomiting after feeding and failure to gain weight. The diagnosis of gastroesophageal reflux is made. While planning discharge teaching on feeding techniques with the parents, the nurse should include instructions to: a. Dilute the formula b. Position the infant at a 30 degree angle after feedings c. Change from a milk based formula to soy based formula d. Delay burping to prevent vomiting

Position the infant at a 30 degree angle after feedings

10. The nurse teaching the inservice group emphasizes that nursing care that helps prevent sickle cell crisis is: a. Limitation of activity b. Protection from infection c. High-iron, low-fat, high-protein diet d. Careful observation of all vital signs

Protection from infection

16. Which of the following is an important nursing consideration in the care of a child with celiac disease? a. Refer to a nutritionist for detailed dietary instructions and education b. Help child and family understand that diet restrictions are usually only temporary c. Teach proper handwashing and universal precautions to prevent disease transmission d. Suggest ways to cope more effectively with stress to minimize symptoms

Refer to a nutritionist for detailed dietary instructions and education

14. A 12-year-old boy with bone cancer is asking for a pain reliever. Hydrocodone with acetaminophen is on the medication list for pain. Which of the following findings would alert the nurse to withhold the medication until the physician has been contacted? a. BP of 90/80 b. Apical pulse of 60 c. Temperature of 100°F d. Respirations of 10

Respirations of 10 Before an opioid is administered, respiratory rate, blood pressure, and pulse rate should be determined. If the respiratory rate is at or below 12 breaths per minute, the nurse would know that narcotics can depress the RR and would then contact the physician

22. A 12-year-old boy admitted with metastatic cancer has been receiving chemotherapy for 3 months. His lab values include: RBC 3.8 million/mm3, WBC 2,000/mm3, Hgb 9.3 g/dL, platelets 50,000/mm3. Which of the following nursing diagnoses is MOST appropriate for this patient? a. Decreased cardiac output b. Ineffective thermoregulation. c. Risk for bleeding d. Ineffective airway clearance.

Risk for bleeding Strategy: Determine how each answer choice relates to the lab values. (1) will increase due to decreased oxygenation caused by anemia; normal RBC male: 4.3-5.9 million/mm3, female: 3.5-5.5 million/mm3; decreased with anemia, causes heart rate and respirations to increase; normal WBC 4,500-11,000/mm3; decreased leukopenia) causes susceptibility to infection; normal Hgb: male 13.5-17.5 g/dL, female 12-16 g/dL; decreased with anemia (2) no change in temperature (3) correct-due to low platelet count, normal platelets 150,000-400,000/mm3, decrease causes problems with blood clotting (4) no information about airway problems

7. Which classification of drugs is used to relieve an acute asthma episode? a. Short-acting beta2-adrenergic agonist b. Inhaled corticosteroids c. Leukotriene blockers d. Long-acting bronchodilators

Short-acting beta2-adrenergic agonist A. Correct Short-acting beta2-adrenergic agonist is the first medication administered. Later, systemic corticosteroids decrease airway inflammation in an acute asthma attack. They are given for short courses of 5 to 7 days. B. Inhaled corticosteroids are used for long-term, routine control of asthma. C. Leukotriene blockers diminish the mediator action of leukotrienes and are used for long-term, routine control of asthma in children older than 12 years. D. A long-acting bronchodilator would not relieve acute symptoms

16. A 12-year-old boy who is at the 90th percentile for weight complains of slight pain in the right thigh and knee for about a month. His complains are made worse by physical activity and he has a mild limp. He has no history of recent infections or trauma. Physical examination reveals a slight decrease in internal rotation of the right hip. There is mild right-sided metaphyseal osteopenia on radiograph. Of the following, which would be the MOST likely diagnosis in this boy? a. Transient synovitis b. Septic arthritis c. Osteomyelitis d. Slipped capital femoral epiphysis e. Legg-Calve-Perthes disease

Slipped capital femoral epiphysis Slipped Capital Femoral Epiphysis occurs as the result of acute or repetitive microtrauma to a probable abnormal femoral growth plate. It is unilateral in 40%-80% of cases and occurs during or just prior to the adolescent growth spurt (age 10 to 13 years). It is more commonly seen in boys and in very obese and/or very tall adolescents. Onset prior to age 10 years may indicate an underlying endocrine problem such as hypothyroidism. The clinical presentation is a limp with pain related to the hip joint. There may be some shortening of the involved limb, and internal rotation is limited. Biplanar radiographs or computed tomographic scans will establish the diagnosis. Mild demineralization of the metaphysis on the involved side is often associated

19. 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)? a. Aspirin is preferred if stomach upset occurs b. NSAIDs are helpful in reducing bruising associated with JIA c. Tapering doses are necessary when discontinuing this medication d. Take the medication with food

Take the medication with food Common side effects of NSAIDs include gastrointestinal irritation and bruising. NSAIDs should be taken with food to decrease stomach upset. Aspirin may cause gastric irritation. Tapering doses are not necessary for NSAIDs; however, they are recommended when discontinuing corticosteroids. (please note that although we tell students that aspirin should not be given to children due to the risk for Reye's syndrome, it is given in special circumstances such as JIA and Kawaski disease; a sign of overdose of aspirin would be tinnitus; the nurse would also need to check for GI bleeding)

19. The nurse assesses a client who is on fluticasone (Flovent) and notes oral lesions. What is the nurse's best action? a. Teach the client to rinse the mouth after Flovent use b. Have the client use a mouthwash daily c. Start the client on a broad-spectrum antibiotic d. Document the finding as a known side effect

Teach the client to rinse the mouth after Flovent use Response Feedback: sign of candidiasis; should use spacer and rinse mouth after steroid inhaler use

1. The nurse is caring for a patient hospitalized with an acute asthma attack. The nurse would be most concerned if which of the following was observed? a. The patient becomes more diaphoretic. b. The patient's respirations increase from 14 to 16 per minute. c. The patient's pulse increases from 86 to 100 beats per minute. d. The patient shows increasing pallor.

The patient's pulse increases from 86 to 100 beats per minute Feedback:: "MOST concerned" indicates a complication. 1) symptom of acute asthma attack, doesn't indicate deterioration of status; (2) expected with acute asthmatic attack, doesn't indicate deterioration of status; (3) correct-pulse increases due to decrease in oxygenation of tissues; (4) subjective symptom, unreliable indicator of deterioration of status One other ominous sign is cessation of wheezing; this could signal complete respiratory collapse

7. The parents of a child with sickle cell anemia (SCA) are concerned about subsequent children having the disease. The nurse should know that: a. SCA is not inherited b. Only the male offspring will get the disease c. There is a 25% chance of siblings having SCA d. There is a 50% chance that the female offspring will have SCA

There is a 25% chance of siblings having SCA Response Feedback: autosomal recessive; 1:4 chance of getting the disease (this is if the parents both carry trait)

9. A child with B-thalassemia is receiving chronic transfusion therapy for the treatment of this disorder. Deferoxamine (Desferal) is prescribed to be administered to the child. The nurse determines that this medication has been prescribed: a. To produce a mild sedation in the child during the transfusion b. To increase the absorption of iron in the blood c. To prevent a blood transfusion reaction d. To prevent organ damage from too much iron in body tissues

To prevent organ damage from too much iron in body tissues

13. The nurse is assessing a 5 year old girl who is anxious, has a high fever, speaks in a whisper, and sits up with her neck thrust forward. Based on these findings, which of the following actions should the nurse avoid? a. Providing 100% oxygen b. Visualizing the throat c. Making the child sit up d. Auscultating for lung sounds

Visualizing the throat Response Feedback: could trigger spasm and obstruction by epiglottis; nothing by mouth including throat culture; have intubation tray handy; this is emergency; make sure to keep environment calm; epiglottitis not commonly seen anymore due to widespread use of Hib vaccine; signs of infection are drooling, talking in a muffled voice, tripod position

9. Which vitamin supplements are necessary for children with cystic fibrosis? a. Vitamin C and calcium b. Vitamin B6 and B12 c. Magnesium d. Vitamins A, D, E, and K

Vitamins A, D, E, and K A. Vitamin C and calcium are not fat soluble. B. B6 and B12 are not fat-soluble vitamins. C. Magnesium is not a vitamin. D. Correct Fat-soluble vitamins are poorly absorbed because of deficient pancreatic enzymes in children with cystic fibrosis; therefore supplements are necessary.

5. Which assessment finding after tonsillectomy should be reported to the physician? a. Vomiting bright red blood b. Pain at surgical site c. Pain on swallowing d. The ability to only take small sips of liquids

Vomiting bright red blood A. Correct Vomiting bright red blood and swallowing frequently are signs of bleeding postoperatively and should be reported to the physician. B. It is normal for the child to have pain at the surgical site. C. It is normal for the child to have pain on swallowing. D. Only clear liquids are offered immediately after surgery, and small sips are preferred

6. When obtaining the nursing history from the mother of an infant with suspected intussusception, which of the following questions would be most helpful? a. What do the stools look like? b. When was the last time your child urinated? c. Is your child eating normally? d. Has your child had any episodes of vomiting

What do the stools look like

9. What is the most common secondary infection associated with Varicella: a. a staphylococcus skin infection b. koplik spots. c. strawberry tongue. d. a red flat macular rash on the arms and face.

a staphylococcus skin infection Answer: The most common complication in children with Varicella is secondary infections of the skin caused by staphylococcus and group A beta streptococcus due to breaks in the skin integrity

A mother tells the nurse that her 8 month old will eat only mashed potatoes and drink only milk, and she is concerned about the baby's diet, even though the baby is receiving Poly-Vi-Sol daily. The nurse recognizes that the child's diet could lead to: a. A potassium deficit b. A vitamin C deficiency c. An amino acid deficiency d. An iron deficiency anemia

d. An iron deficiency anemia Response Feedback: Too much milk leads to "milk babies:--fat but the drinking of too much milk leads to not being able to consume a diet of a variety of foods and iron deficiency; about 24 ozs. per day is maximum; no cow's milk until after 1 year old.

11. A 5 year old child, has been sent to the school nurse for urinary incontinency 3 times in the past 2 days. The nurse should recommend to her parent that the first action is to have her evaluated for which of the following? a. School phobia b. Emotional causes c. Possible urinary tract infection d. Possible structural defects of urinary tract

Possible urinary tract infection

24. The nurse is caring for an 8-year-old with second and third degree burns. Which room assignment would be best for the client? a. A 2-year-old with chickenpox b. A 4-year-old with asthma c. A 9-year-old with acute diarrhea d. A 10-year-old with methicillin resistant Stapyhlococcus aureus (MRSA)

A 4-year-old with asthma Letter b is only child not contagious

13. Which of the following are indications of severe dehydration? (Select all that apply) a. Sunken fontanel b. Diaphoresis c. Dry mucous membranes d. Weight loss of 5% e. Bradycardia f. Skin tenting

A. Sunken fontanel C. Dry mucous membranes F. Skin tenting

23. Which of the following would the nurse most likely find in a 10 year old child in the period of concrete operational thought? a. Participation in abstract thinking b. Problem solving via the scientific method c. Ability to classify similar objects d. Ability to make independent decisions

Ability to classify similar objects

27. Doctor's Order: Cleocin Oral Susp 600 mg po qid; Directions for mixing: Add 100 mL of water and shake vigorously. Each 2.5 mL will contain 100 mg of Cleocin. How many tsp of Cleocin will you administer a. 5 tsp b. 3.5 tsp c. 3 tsp d. 1 tsp

3 tsp Feedback: Each 2.5 mL = 100mg There are 5 mL in one teaspoon, so one teaspoon is double the 2.5 mL or each tsp = 200mg You wish to give 600mg each dose and you want to know how many teaspoons you are giving with each dose; therefore 3 teaspoons will equal 600mg (each tsp is 200mg, so to get to 600mg you need 3 tsps)

19. A nurse is teaching parents about prevention of diaper dermatitis. Which should the nurse include in the teaching plan? Select all that apply a. Clean the diaper area gently after every diaper change with a mild soap b. Use a protective ointment to clean dry intact skin c. Use a steroid cream after each diaper change d. Use rubber or plastic pants over the diaper. e. Wash cloth diapers in hot water with a mild soap and double rinse

A. Clean the diaper area gently after every diaper change with a mild soap B. Use a protective ointment to clean dry intact skin E. Wash cloth diapers in hot water with a mild soap and double rinse Feedback: Prompt, gentle cleaning with water and mild soap (e.g., Dove, Neutrogena Baby Soap) after each voiding or defecation rids the skin of ammonia and other irritants and decreases the chance of skin breakdown and infection. A bland, protective ointment (e.g., A&D, Balmex, Desitin, zinc oxide) can be applied to clean, dry, intact skin to help prevent diaper rash. If cloth diapers are laundered at home, the parents should wash them in hot water, using a mild soap and double rinsing. Occlusion increases the risk of systemic absorption of a steroid; thus steroid creams are rarely used for diaper dermatitis because the diaper functions as an occlusive dressing. Rubber or plastic pants increase skin breakdown by holding in moisture and should be used infrequently. A steroid cream is not recommendedFeedback: Prompt, gentle cleaning with water and mild soap (e.g., Dove, Neutrogena Baby Soap) after each voiding or defecation rids the skin of ammonia and other irritants and decreases the chance of skin breakdown and infection. A bland, protective ointment (e.g., A&D, Balmex, Desitin, zinc oxide) can be applied to clean, dry, intact skin to help prevent diaper rash. If cloth diapers are laundered at home, the parents should wash them in hot water, using a mild soap and double rinsing. Occlusion increases the risk of systemic absorption of a steroid; thus steroid creams are rarely used for diaper dermatitis because the diaper functions as an occlusive dressing. Rubber or plastic pants increase skin breakdown by holding in moisture and should be used infrequently. A steroid cream is not recommended.

22. During a well child check up, the parents of a 9 year old boy tell the nurse that their son's friends told him that soccer is a stupid game, and now he wants to play baseball. Which comment by the nurse best explains this behavior? a. The child's best friends will continue playing soccer b. Acceptance by friends, especially of the same sex, is very important at this age c. The children will cheer for each other regardless of the sport being played d. Your child will rarely talk to you about his friends

Acceptance by friends, especially of the same sex, is very important at this age

15. What should the nurse teach an adolescent who is taking tretinoin (Retin-A) to treat acne? a. The medication should be taken with meals b. Apply sunscreen before going outdoors c. Wash with benzoyl peroxide before application d. The effect of the medication should be evident within 1 week

Apply sunscreen before going outdoors A. Tretinoin is a topical medication. Application is not affected by meals. B. Tretinoin causes photosensitivity, and sunscreen should be applied before sun exposure. C. If applied together, benzoyl peroxide and tretinoin have reduced effectiveness and a potentially irritant effect. D. Optimal results from tretinoin are not achieved for 3 to 5 months

22. The nurse provides which instructions to the client about the prevention and early detection of Lyme disease? (Select all that apply) a. Wear dark clothing when walking in wooded areas b. Avoid heavily wooded areas and areas with thick underbrush c. Wear long sleeved tops and long pants with closed shoes and a hat or cap d. Bathe after being in an infested area, and inspect the body carefully for ticks e. Avoid the use of insect repellent on the skin and clothing because of its toxicity f. If a tick is found, report to the physician immediately for a blood test to detect the presence of Lyme disease

B. Avoid heavily wooded areas and areas with thick underbrush C. Wear long sleeved tops and long pants with closed shoes and a hat or cap D. Bathe after being in an infested area, and inspect the body carefully for ticks Blood test usually takes 4-6 weeks to show up disease

5. The nurse recognizes that behaviors frequently first exhibited in a 8-month-old infant include a. Smiling spontaneously, clasping hands, and keeping the head steady when sitting b. Removing some clothing, building a tower of two cubes, and stooping to pick up toys c. Drinking from a cup, using the words "mama" and "dada," and standing alone d. Being shy with strangers, playing peek-a-boo, and standing by holding onto furniture

Being shy with strangers, playing peek-a-boo, and standing by holding onto furniture Response Feedback: Stranger anxiety common in this age group (infant is able to distinguish parents from others)

1. When a child injures the epiphyseal plate from a fracture, the damage may result in which of the following? a. Bone growth disruption b. Rheumatoid arthritis c. Permanent nerve damage d. Osteomylitis

Bone growth disruption Response Feedback: fracture in the epiphyseal plate prior to plate closure can lead to shortening of one limb

1. Parents have a 23-month-old daughter who started having vomiting and diarrhea yesterday. When should the pediatrician's office be called? (Select all that apply.) a. If their daughter doesn't urinate for longer than 4 hours b. If their daughter's fontanel appears sunken c. If crying produces no tears d. When the diarrhea has been present for over 24 hours e. The toddler has a fever (>39° C [102° F]) f. If severe abdominal cramps occur

C. If crying produces no tears D. When the diarrhea has been present for over 24 hours E. The toddler has a fever (>39° C [102° F]) F. If severe abdominal cramps occur Feedback: A. If their daughter doesn't urinate for longer than 6 hours, the pediatrician should be notified. B. The fontanels disappear by 18 months of age. C. If crying produces no tears, the pediatrician should be notified. D. When the diarrhea has been present for 24 hours, the pediatrician should be notified. E. If the toddler has a fever >39 °C (102 °F), the pediatrician should be notified. F. If severe abdominal cramps occur the pediatrician should be notified

6. Which of the following should be avoided if the child has hypospadias? a. Circumcision b. Catherization c. Surgery d. Intravenous pyelography (IVP)

Circumcision

15. A school age child with acute diarrhea and mild dehydration is being given oral rehydration solutions (ORS). The child's mother calls the nurse because he is also occasionally vomiting. The nurse should recommend which of the following? a. Bring to the hospital for intravenous fluids b. Alternate giving ORS and carbonated drinks c. Continue to give ORS frequently in small amounts d. Place NPO for 8 hours and resume ORS if vomiting has subsided

Continue to give ORS frequently in small amounts

24. When caring for a 15 year old client receiving chemotherapy for leukemia, the nurse should keep in mind that an adolescent of this age will: a. Feel dependent and enjoy the "sick role" b. Be most bothered by having to limit activities c. Be preoccupied by concerns about missed schoolwork d. Feel different because of an altered body image

Feel different because of an altered body image

2. Children receiving long-term systemic corticosteroid therapy are most at risk for a. Hypotension b. Growth delays c. Dilation of blood vessels in the cheeks d. Decreased appetite and weight loss

Growth delays Response Feedback: A. Hypertension is a clinical manifestation of long-term systemic steroid administration. B. Growth delay is associated with long-term steroid use. C. Dilation of blood vessels in the cheeks is associated with an excess of topically administered steroids. D. Increased appetite and weight gain are clinical manifestations of excess systemic corticosteroid therapy

7. A 5 year old boy has celiac disease. During a routine clinic visit, the nurse knows he is following his diet when he states, a. I had hot dogs and French fries for lunch b. I had macaroni and cheese for lunch c. I had soup and crackers for dinner d. I had chicken and vegetables for lunch

I had chicken and vegetables for lunch

8. A nurse is teaching the parents of a child with Hirschsprung's disease. Which statement by the mother indicates a need for further teaching? a. My child may not have surgery until his nutritional status improves b. My child needs saline enemas to clean out his bowel before surgery c. I understand that the surgery my child requires is relatively minor d. After surgery, he'll have nothing by mouth until his bowel sounds return

I understand that the surgery my child requires is relatively minor

2. What is an appropriate statement for the nurse to make to parents of a child who has had a barium enema to correct an intussusception? a. I will call the physician when the baby passes his first stool b. I am going to dilate the anal sphincter with a gloved finger to help the baby pass the barium c. I would like you to save all the soiled diapers so I can inspect them d. Add cereal to the baby's formula to help him pass the barium

I would like you to save all the soiled diapers so I can inspect them Feedback: ApplicationèA. The physician does not need to be notified when the infant passes the first stool. B. Dilating the anal sphincter is not appropriate for the child after a barium enema. C. The nurse needs to inspect diapers after a barium enema because it is important to document the passage of barium and note the characteristics of the stool. D. After reduction, the infant is given clear liquids and the diet is gradually increased

11. A nurse is assessing the play of a 4 year old child. Which of the following best describes what the nurse would observe in the play of this preschooler? a. Plays alongside but not with playmates, taking toys away from others, using a pounding bench, and playing with a musical toy b. Interactive play, obeying limits, creating and imaginary friend, and engaging in fantasy play c. Engaging in group sports and games and playing with puppets d. Playing alone in the corner, engaged in putting a puzzle together

Interactive play, obeying limits, creating and imaginary friend, and engaging in fantasy play

4. Which of the following is the priority nursing intervention for a 6 month old infant hospitalized with diarrhea and dehydration? a. Measuring the infant's weight b. Estimating insensible fluid loss c. Collecting urine for culture and sensitivity d. Palpating the posterior fontanel

Measuring the infant's weight measuring weight best indicator for dehydration in an infant

19. When planning care for an 8 month old infant with dehydration, which of the following interventions would be the most accurate for monitoring hydration status? a. Measuring intake and output b. Monitoring daily weight c. Measuring for edema of extremities d. Assessing skin turgor

Monitoring daily weight

14. Parents of a child with lice infestation should be instructed carefully in the use of anti-lice products because of which potential side effect? a. Nephrotoxicity b. Neurotoxicity c. Ototoxicity d. Bone marrow depression

Neurotoxicity A. Antilice products are not known to be nephrotoxic. B. Because of the danger of absorption through the skin and potential for neurotoxicity, antilice treatment must be used with caution. A child with many open lesions can absorb enough to cause seizures. C. Antilice products are not ototoxic. D. Products that treat lice are not known to cause bone marrow depression

4. A recently hospitalized 2 year old client screams and shouts that he wants a "bottle." His parents are puzzled, and state that he has drank from a cup for the past year. The nurse explains that: a. Irritability is exhibited in all age groups. b. Temper tantrums often represent the child's need for parental attention. c. Various forms of punishment are necessary when such behaviors occur. d. Regression to an earlier behavior often helps the child cope with stress and anxiety.

Regression to an earlier behavior often helps the child cope with stress and anxiety

5. A child is brought to the doctor's office with coryza, conjunctivitis, and small, blue-white centered spots near the buccal mucosa. The nurse suspects which of the following infections? a. Fifth's disease b. Rubella c. Mumps d. Rubeola

Rubeola Koplick spots go with Rubeola

17. The nurse is caring for a hospitalized 4 year old boy. His parents tell the nurse that they will be back to visit at 6 p.m. When the boy asks the nurse when his parents are coming, the nurse's best response is which of the following? a. They will be here soon b. They will come after you eat dinner c. Let me show you on the clock when 6 p.m. is d. I will tell you every time I see you how much longer it will be

They will come after you eat dinner

5. A 4 year old boy is admitted with glomerulonephritis. His mother asks why his eyes are so puffy. The nurse responds, a. This is a common finding due to circulatory congestion in the kidneys b. Children cry a lot with glomerulonephritis and the puffiness should subside when he feels better c. Does he have an allergies? d. Periorbital edema is associated with hypotension

This is a common finding due to circulatory congestion in the kidneys

3. A mother expresses concern that her 2-year-old daughter has become a "finicky eater and is eating less." The nurse's best response would be: a. "She has become manipulative." b. "She is probably experiencing the stress of the 'terrible two's." c. "I can refer you to have her evaluated for an eating disorder." d. "This is expected behavior because her growth has slowed."

This is expected behavior because her growth has slowed

12. For nephrosis, prednisone is administered until which of the following occurs? a. Relapse b. Urinary tract infection is gone c. Generalized edema subsides d. Urine is free of protein and remains normal

Urine is free of protein and remains normal

1. The mother discusses with the nurse that her toddler asks every night for a bedtime story. The mother asks why the child does this. The nurse would explain that this behavior demonstrates a. Conservation b. Dependency c. Object permanence d. Ritualism

Ritualism Rituals are very important in this age group, rituals provide comfort (especially if hospitalized, try to maintain routines and comfort items such as a security blanket)

8. Which of the following measures would you teach the father to provide comfort for the child who has a pruritic rash due to chickenpox? a. Dress the child warmly to bring out the rash so that it fades quickly b. Apply cool compresses to the skin to stop the itching c. Discuss with the child the importance of not scratching the lesions d. Administer infant aspirin every 4 hours as necessary for comfort

Apply cool compresses to the skin to stop the itching Answer: Aspirin is not given to young children due to risk for Reye's syndrome; warm clothing exacerbates itching; itching is the question and how to relieve

10. When instructing the parents of a toddler about appropriate nutrition, which of the following would the nurse recommend? a. A minimum of 30 ounces of fruit juice per day for adequate vitamin C intake b. Approximately 16 to 24 ounces of milk per day c. Fat intake 40% of total calories d. Ten servings per day of yellow vegetables

Approximately 16 to 24 ounces of milk per day

1. The Center for Disease Control recommends the following regarding infants who are HIV positive: a. Follow adult immunization schedule b. Do not immunize due to HIV positive status c. Assess CD4+ counts before immunizing with MMR and varicella vaccines d. Eliminate pertussis vaccine due to risk of seizures

Assess CD4+ counts before immunizing with MMR and varicella vaccines Feedback: Routine immunizations are appropriate. CD4+ cells are monitored when deciding whether to provide live virus vaccines. If the child is severely immunocompromised, the MMR vaccine is not given. The varicella vaccine can be considered on the basis of the child's CD4+ counts. Only inactivated polio virus (IPV) should be used for HIV-infected children. Immunizations are given to infants who are HIV positive. The pertussis vaccination is not eliminated for an infant who is HIV positive

17. A 9 year old is admitted to the hospital for an emergency appendectomy. Which preoperative procedure should the nurse withhold? (Select all that apply) a. A cleansing enema b. Application of an ice bag to the abdomen c. Keeping her NPO d. Application of a heating pad e. Administration of an intravenous narcotic prior to examination f. Obtaining a blood sample for a CBC

A. A cleansing enema D. Application of a heating pad E. Administration of an intravenous narcotic prior to examination First two answers relate to rupturing the appendix; next answer is related to not giving narcotics until can fully assess the abdominal exam and where pain is located

16. The nurse is caring for a premature baby in the NICU. The mother reports that the infant's normally happy and outgoing 5 year old sister is acting sad and withdrawn. The nurse understands that due to her developmental stage, the girl is at risk for which of the following? a. Viewing her baby sister's illness as her fault b. Harming the baby c. Experiencing clinical depression d. Creating an imaginary friend to cope with the situation

Viewing her baby sister's illness as her fault

7. Based on an understanding of Erikson's stages of psychosocial development, which of the following is a priority to communicate to the parents of an infant to assist them in meeting the basic needs of infancy? a. Provide the infant with entertainment and stimulation for psychological growth b. Talk with the infant during the times when the infant is awake c. Hold the infant in a way the infant prefers d. Attend to the infant's need for comfort, security, predictability, food, and warmth

Attend to the infant's need for comfort, security, predictability, food, and warmth Response Feedback: Trust vs. mistrust: needs consistent care for needs (diapers changed on time, fed on time, is comforted/held and feels loved).

23. A child's mother tells the nurse that her child has been on steroids for several months. Which of the following vaccines is contraindicated? (Select all that apply) a. Tetanus toxoid b. Measles, Mumps, Rubella (MMR) c. Recombinant hepatitis B vaccine d. Varicella (Var) e. Injectable polio virus vaccine f. Oral polio virus vaccine

B. Measles, Mumps, Rubella (MMR) D. Varicella (Var) F. Oral polio virus vaccine

10. A 6 month old child is undergoing a routine check-up. Which of the following findings the nurse would expect to find during the assessment of this child. Select all that apply. a. Tonic neck reflex b. Presence of the anterior fontanel c. Extrusion of the tongue when receiving cereal d. Weight has doubled since birth e. Sits with support f. Grabs for rattle

B. Presence of the anterior fontanel D. Weight has doubled since birth E. Sits with support F. Grabs for rattle

18. The mother of a two month old infant with a cleft lip and palate calls the clinic. She tells the nurse that the baby has a temperature of 102 degrees, has been turning her head from side to side and has been eating poorly. What should the nurse advise her to do? a. Clean the baby's mouth with warm water b. Give the baby infant Tylenol and call back in 4 hours with the temperature c. Bring the infant into the clinic for evaluation d. Give the baby 4 ounces of water and retake her temperature in 1 hour

Bring the infant into the clinic for evaluation Risk for otitis media is higher

The nurse is assessing a 6 month old who smiles, coos, and has head lag present. The nurse should recognize which of the following? a. This is normal expectations for this age group b. The child is exhibiting an alert stage c. Developmental evaluation is needed d. The parent needs to provide more stimulation to the infant

C. Developmental evaluation is needed Response Feedback: Smiles and coos by 2 mos; head lag gone by 4 mos.

14. When obtaining a health history from the mother of an infant with celiac disease, the nurse would expect the mother to say that her baby a. Has cognitive dysfunction b. Has bulky, foul, frothy stools c. Drinks large amounts of fluid d. Voids strong, concentrated urine

Has bulky, foul, frothy stools Letter b: gluten acts a toxic substance, damage intestinal mucosa, cause diarrhea) Letter c: dehydration, DM Letter d: UTI, dehydration

The nurse has discussed appropriate support of the 6 month old infant to prevent injuries from falls. The mother who needs further educations is the mother who states: a. My child is not allowed to have his walker near the stairs b. My infant should be able to sit without support by this time c. I never leave my baby unattended on my bed d. Before my child is standing, I need to place the crib mattress at its lowest level

b. My infant should be able to sit without support by this time Response Feedback: Sits unsupported by 8 mos.

10. The nurse is preparing to administer intravenous fluids containing potassium for a child who is dehydrated. Which of the following is the most important thing for the nurse to check before administering the potassium? a. Respirations are over 14 b. The child does not have a low grade fever c. There is no nausea present; if there is nausea, withhold the potassium d. The child has a urinary output of at least 1 to 2 milliliters per hour

The child has a urinary output of at least 1 to 2 milliliters per hour

7. The nurse is assessing a 6 year old child suspected of a urinary tract infection; which of the following would be most important to ask? (Select all that apply) a. Is your child having problems bedwetting at night? b. Does your child have regular sleeping hours c. Does your child have constipation? d. Has your child ever had a urinary tract infection? e. Do other family members have the same symptoms? f. Is your child allergic to any medications? g. What are your child's favorite foods?

A. Is your child having problems bedwetting at night C. Does your child have constipation D. Has your child ever had a urinary tract infection F. Is your child allergic to any medications

7. The nurse provides anticipatory guidance to parents of a 3 year old child. Instructions should include: (Select all that apply) a. To place the child in the back seat with a front facing car seat b. The use of syrup of ipecac for accidental poisonings c. Drug and alcohol education d. The proper use of sports equipment for football e. Keeping the poison control center's number close to the phone

A. To place the child in the back seat with a front facing car seat E. Keeping the poison control center's number close to the phone

6. A 6 month old infant is scheduled for another diphtheria, tetanus, and pertussis (DTaP) immunization. According to the mother, after the previous DTaP immunization, the infant had a temperature of 102.4F on the day following the vaccine. Based on this information, what would be the most appropriate nursing action? a. Administer the vaccine and instruct the mother to give the child Tylenol for fever b. Inform the physician of the adverse reaction c. Provide a Vaccine Information Sheet after giving the vaccine for informed consent d. Note in the chart of the allergy to DTaP for further reference

Administer the vaccine and instruct the mother to give the child Tylenol for fever Response Feedback: Answer: the only contraindication to an inactive vaccine would be prior anaphylaxis to the vaccine or allergy to components in the vaccine (such as Baker's yeast allergy for Hep B)

8. Based on Erikson's developmental tasks, which of the following activities would the nurse suggest as most appropriate to foster the development of a toddler? a. Feed him lunch b. Read him a story c. Allow him to pull a talking-duck toy d. Have him watch a puppet show on television

Allow him to pull a talking-duck toy

8. The registered nurse in charge of a busy genitourinary unit should most appropriately delegate which of the following nursing tasks to the appropriate unit personnel considering budget, time, and qualifications for the employee? a. Assign unlicensed assistive personnel (UAP) to take the vital signs on a child suspected of being hypertensive and in renal failure b. Assign a registered nurse (RN) to assess an infant with hemolytic syndrome for signs of intracranial pressure c. Assign a licensed practical nurse (LPN) to teach the parents of a child with a urinary obstruction about an intravenous pyelography scheduled for their child and obtain an informed consent d. Assign an unlicensed assistive personnel (UAP) to evaluate the laboratory tests of a child with acute glomerulonephritis for hematuria and elevated serum sodium and potassium levels

Assign a registered nurse (RN) to assess an infant with hemolytic syndrome for signs of intracranial pressure Response Feedback: RNs need to do the nursing care plan: assess, plan care, teach, evaluate; should be there for all critical patients or unstable patients

21. The nurse is caring for a 10 year old with allergic conjunctivitis. The child is also at risk specifically for what other, similar problem? a. Atopic dermatitis b. Insect bite sensitivity c. Acute otitis media d. Frequent sore throats

Atopic dermatitis allergy, asthma, and atopic dermatitis follow together; if there is a family history, make sure to advise the mother to breastfeed her infant

11. Prior to the surgical repair of a tracheoesophageal fistula, the nursing interventions are mainly focused on a. Getting as much weight on as possible b. Family education regarding surgery c. Preventing aspiration pneumonia d. Body image issues the parents may have

Preventing aspiration pneumonia

4. An adolescent with a history of surgical repair for undescended testes comes to the clinic for a sport physical. Anticipatory guidance would focus on a. The adolescent's inability to produce sperm b. The adolescent future plans for college c. Technique for monthly testicular self examinations d. The need for motor vehicle safety measures

Technique for monthly testicular self examinations Response Feedback: Testicular cancer rates increased who have had undescended testes; perform TSE

15. A client with a urinary tract infection has a urine specific gravity of 1.040. Which action by the nurse is best? a. Obtain a urine culture and sensitivity b. Place the client on restricted protein intake c. Review the client's creatinine level d. Increase the client's fluid intake

Increase the client's fluid intake Response Feedback: Normal specific gravity for urine is 1.005 to 1.030. A high specific gravity can occur with dehydration, decreased kidney blood flow (often because of dehydration), and the presence of antidiuretic hormone (ADH). Increasing the client's fluid intake would be a beneficial intervention. The other interventions are not warranted

14. During a clinic visit, a 4-year-old girl suddenly screams. "Don't sit on Erin!" The parent whispers that Erin is an imaginary friend. The nurse's health teaching plans for his family should include: a. Special instructions for discipline b. Referral for counseling regarding "Erin" c. Increasing social interaction between their daughter and her peers d. Investigation by child protective services

Increasing social interaction between their daughter and her peers

3. What is the primary nursing concern for a child having an anaphylactic reaction? a. Identifying the offending allergen b. Increased cardiac output c. Ineffective breathing pattern d. Positioning to facilitate comfort

Ineffective breathing pattern A. Determining the cause of an anaphylactic reaction is important to implement the appropriate treatment, but the primary concern is the airway. B. Laryngospasms resulting in ineffective breathing patterns is a life-threatening manifestation of anaphylaxis. The primary action is to assess airway patency, respiratory rate and effort, level of consciousness, oxygen saturation, and urine output. C. During anaphylaxis, the cardiac output is decreased. D. During the acute period of anaphylaxis, the nurse's primary concern is the child's breathing. Positioning for comfort is not a primary concern during a crisis

19. The 9-year-old child is at the 98th percentile for weight and at the 40th percentile for height. The school nurse will interpret that this child is: a. Underweight or small in stature. b. Overweight or large in stature. c. Experiencing a prepubescent growth spurt. d. Normal for size.

Overweight or large in stature

20. A home care nurse visits a 3 year old child with chickenpox. The child's mother tells the nurse that the child keeps scratching the skin at night and asks the nurse what to do. The nurse tells the mother to: a. Apply generous amounts of a cortisone cream to prevent itching b. Place soft cotton gloves on the child's hands at night c. Keep the child in a warm room at night so the covers will not cause the child to scratch d. Give the child a glass of warm milk at bedtime to help the child sleep

Place soft cotton gloves on the child's hands at night

21. A school nurse prepares a lecture on puberty for 5th and 6th grade girls. She asks the group, "What is the first sign of puberty?" A student correctly replies: a. "The appearance of breast buds." b. "An increase in energy and appetite." c. "The occurrence of the first menarche." d. "Appearance of body odor."

The appearance of breast buds

17. To assess the child with severe burns for adequate perfusion, the nurse monitors a. Distal pulses b. Skin turgor c. Urine output d. Mucous membranes

Urine output A. Distal pulses may be affected by many variables. Urine output is the most reliable indicator of end-organ perfusion. B. Skin turgor is often difficult to assess on burn patients because the skin is not intact. C. Urine output reflects the adequacy of end-organ perfusion. D. Mucous membranes do not reflect end-organ perfusion

13. Which nursing assessment is applicable to the care of a child with herpetic gingivostomatitis? a. Comparison of range of motion for the upper and lower extremities b. Urine output, mucous membranes, and skin turgor c. Growth pattern since birth d. Bowel elimination pattern

Urine output, mucous membranes, and skin turgor A. An oral herpetic infection does not affect joint function. B. The child with herpetic gingivostomatitis is at risk for deficient fluid volume. Painful lesions on the mouth make drinking unpleasant and undesirable, with subsequent dehydration becoming a real danger. C. Herpetic gingivostomatitis is not a chronic disorder that would affect the child's long-term growth pattern. D. Although constipation could be caused by dehydration, it is more important to assess urine output, skin turgor, and mucous membranes to identify dehydration before constipation is a problem

3. The mother of a 10 year old boy with mild scoliosis (angle of deformity is less than 10 degrees) asks the nurse, "How long will my son have to continue his exercises before he is better?" The nurse responds a. He will need a brace so he can stop when he gets fitted b. Only for a few more months until the pain stops c. Since surgery is likely, he will not be able to exercise a month before the operation d. We won't know until his growth is complete if the curvature is improved

We won't know until his growth is complete if the curvature is improved Response Feedback: Will need rechecks as goes through growth of puberty to see if curvature is getting worse

14. A child has recurrent nephrotic syndrome. The mother reports to the nurse that she is overwhelmed with the care of her child. After the nurse discusses options with the mother, which statement by the mother indicates continued coping difficulties? a. I joined a support group like you suggested. I hope it does some good b. I'm going to ask my mother in law to come on a regular basis to allow me an afternoon out c. My husband has agreed to help me manage my son's medication d. We're going to skip his dietary restrictions one day a week to allow us both some relaxation

We're going to skip his dietary restrictions one day a week to allow us both some relaxation

11. Health teaching to prevent Lyme disease would indicate which one of the following: a. Complete the immunization series in early infancy. b. Wear long sleeves and pants tucked into socks while in wooded areas. c. Give low dose antibiotics to the child before exposure. d. Restrict activities that might lead to exposure for the child.

Wear long sleeves and pants tucked into socks while in wooded areas

10. The nurse is caring for several children in the hospital where there has been a recent outbreak of bacterial diarrhea. None of these children were admitted for diarrhea, but the nurse is aware that they may be exposed. After assessing the client population on the unit, the nurse determines that the child most susceptible to developing diarrhea would be: a. a toddler with severe combined immunodeficiency disease. b. preschooler in traction for a fractured femur. c. a school aged child with eczema. d. a teenager with frequent stools secondary to malabsorption syndrome

a toddler with severe combined immunodeficiency disease Response Feedback: due to a severely compromised immune system this makes this child the most at risk for acquiring bacterial diarrhea)

13. The nurse is caring for a 3-year-old with leukemia. The child is not eating and is losing weight as a result of nausea and mucositis stemming from the chemotherapy. Which interventions are appropriate? Select all that apply a. Providing small, frequent high-protein foods b. Administering oral viscous lidocaine before meals c. Providing cool liquids and soft foods at room temperature d. Applying a solution of Benadryl (diphenhydramine) and Maalox as prescribed to the mouth e. Rinsing mouth with half saline and half hydrogen peroxide to prevent infection

A. Providing small, frequent high-protein foods C. Providing cool liquids and soft foods at room temperature D. Applying a solution of Benadryl (diphenhydramine) and Maalox as prescribed to the mouth Rationale: High-protein, high-calorie foods should be given to the child. Protein promotes tissue healing, and calories are needed for growth. Small, frequent meals are easier for a child to handle. Viscous lidocaine is not recommended for young children, because it may depress the gag reflex and increase the risk of aspiration. Local anesthetics without alcohol, such as a solution of diphenhydramine (Benadryl) and Maalox, may be recommended. Favorite foods should not be given to a child who is nauseated, because the child will associate these foods with being sick. Cool liquids are soothing and reduce the risk of burning fragile mucosa. Soft foods are gentler on inflamed mucosa

20. The nurse is caring for four clients who had arterial blood gases (ABGs). Which laboratory value warrants immediate intervention by the nurse? a. HCO3- of 25 mEq/L b. SpO2 of 96% c. pH of 7.38 d. PaCO2 of 48 mm Hg

PaCO2 of 48 mm Hg Response Feedback: Although the nurse should note the results of all laboratory work, only a PaCO2 of 48 mm Hg is likely to culminate in serious symptoms for the client. HCO3-, SpO2, and pH levels as assessed would not be life threatening, nor would they be indicative of serious complications that would override the importance of the PaCO2 level

3. When developing a teaching plan for 12 month old infant with hypospadias and chordee repair, which of the following would the nurse expect to include as most important? a. Assisting the child to become familiar with his dressing so he will leave them alone b. Encouraging the child to ambulate as soon as possible by using favorite push pull toy c. Forcing fluids to at least 250 ml/day by offering his favorite fruit juices d. Preventing the child from disrupting the catheter by using soft restraints

Preventing the child from disrupting the catheter by using soft restraints Response Feedback: Most important part of surgery is maintenance of catheters or stents; 12 month old will explore his environment; applying soft restraints prevent the child from disrupting the catheter

4. Which intervention for treating croup at home should be taught to parents? a. Have a decongestant available to give the child when an attack occurs. b. Have the child sleep in a dry room. c. Take the child outside. d. Give the child an antibiotic at bedtime.

Take the child outside A. Decongestants are inappropriate for croup, which affects the middle airway level. B. A dry environment may contribute to symptoms. C. Correct: Taking the child into the cool, humid, night air may relieve mucosal swelling and improve symptoms. D. Croup is caused by a virus. Antibiotic treatment is not indicated

7. Teaching regarding plaster cast care for a small child whose right hand is fractured: a. The cast may feel warm as the cast dries b. Use a padded ruler or another padded object to scratch the skin under the cast if it itches c. Elevate the cast on a pillow above the level of the heart for the first 24 hours after casting to prevent swelling d. Apply lotion to the skin under the cast to keep the skin soft e. For itching under the cast, blow cool air with a hair dryer f. Cover the cast with plastic wrap before bathing g. If fingers feel numb, shaking the hand for a few minutes will get rid of symptoms

A. The cast may feel warm as the cast dries C. Elevate the cast on a pillow above the level of the heart for the first 24 hours after casting to prevent swelling E. For itching under the cast, blow cool air with a hair dryer F. Cover the cast with plastic wrap before bathing

11. A 16-year-old is brought to the Emergency Center with a crushed leg after falling off a horse. The adolescent's last tetanus toxoid booster was received eight years ago. What action should the nurse take? a. Dispense a tetanus antitoxin b. Prepare human tetanus immune globulin c. Administer tetanus toxoid booster d. Delay the tetanus toxoid booster until due

Administer tetanus toxoid booster After the completion of the initial tetanus immunization schedule, the recommended booster for an adolescent or adult is every ten years or less if a traumatic injury occurs that is contaminated by dirt, feces, soil, or saliva, such as puncture or crushing injuries, avulsions, wounds from missiles, burns, or frostbite. The adolescent's injury is considered a contaminated wound requiring prophylactic therapy, so the tetanus toxoid booster should be administered (C). (A, B, and D) are not indicated

9. A 4-year-old boy was admitted to the emergency room with a fractured right ulna and a short arm cast is applied. When preparing the parents to take the child home, which discharge instruction has the highest priority? a. Call the healthcare provider immediately if his nail beds appear blue b. Check his fingers hourly for the first 48 hours to see that he is able to move them without pain c. Be sure his arm remains above his heart for the first 24 hours d. Take his temperature q4h for the next two days and call if an elevation is noted

Call the healthcare provider immediately if his nail beds appear blue Cyanosis (A) indicates impaired circulation to fingers and should be reported immediately. Although the actions described in (B, C, and D) may be indicated, they are implemented rather excessively--and might tend to frighten the parents. It is not necessary to check the child's ability to move his fingers hourly for 2 days (B). Elevating the arm above the heart will help to decrease swelling but (C) is stated in a frightening way. It is not necessary to take the child's temperature q4h unless indicated by other symptoms

5. The nurse is caring for a child with anemia. Which of the following would indicate to the nurse that the client's condition is deteriorating? a. Circumoral pallor b. Fatigue with exertion c. Cardiac murmur d. Irritability

Cardiac murmur Response Feedback: cardiac murmur late sign; usually Hgb low (7 or <)

4. The child who is diagnosed with B-thalassemia major (Cooley's anemia) typically suffers complications from the disease and from the treatment. This child is at risk for which condition? a. Hypertrophy of the thyroid b. Hypertrophy of the thymus c. Polycythemia vera and thrombosis d. Chronic hypoxia and iron overload

Chronic hypoxia and iron overload Response Feedback: iron overload usually due to frequent transfusions; iron can deposit in organs such as the heart and cause problems

9. After teaching parents about appropriate finger foods for their 11 month old, which of the following, if identified by the parents as an appropriate food choice, indicates effective teaching? a. Crackers b. Popcorn c. Peanuts d. Hotdogs

Crackers

13. The nurse is assessing a client with numerous areas of bruising. Which question does the nurse ask to determine the cause of this finding? a. Do you take aspirin b. How often do you exercise c. Are you a vegetarian d. How often do you do your housecleaning

Do you take aspirin Platelet aggregation is essential for blood clotting. An inability to clot blood when an injury occurs can result in bleeding, which would cause bruising. Aspirin is a drug that interferes with platelet aggregation and has the ability to "plug" an extrinsic event, such as trauma. Vitamin K found in green vegetables enhances clotting factors, which would improve the ability to stop bleeding associated with an extrinsic event. Acetaminophen (Tylenol) and exercise do not inhibit clotting factors

25. When discussing nutrition, which of the following would the nurse stress for the adolescent? a. Eating foods that are high in both iron and calcium b. Eating fast foods is okay as long as healthy choices are made c. Bringing a bag lunch from home instead of eating at the school cafeteria d. Vitamin supplementation is not needed at this age

Eating foods that are high in both iron and calcium

2. For which problem should the child with chronic otitis media with effusion be evaluated a. Brain abscess b. Meningitis c. Hearing loss d. Perforation of the tympanic membrane

Hearing loss A. The infection of acute otitis media can spread to surrounding tissues, causing a brain abscess. B. The infection of acute otitis media can spread to surrounding tissues, causing meningitis. C.Correct Chronic otitis media with effusion is the most common cause of hearing loss in children. D. Inflammation and pressure from acute otitis media may result in perforation of the tympanic membrane

12. The nurse helps to ambulate a client who has anemia. Which clinical manifestation indicates that the client is not tolerating the activity? a. Blood pressure of 120/90 mm Hg b. Heart rate of 110 beats/min c. Pulse oximetry reading of 95% d. Respiratory rate of 20 breaths/min

Heart rate of 110 beats/min The red blood cells contain thousands of hemoglobin molecules. The most important feature of hemoglobin is its ability to combine loosely with oxygen. A low hemoglobin level can cause decreased oxygenation to the tissues, thus causing a compensatory increase in heart rate. The other options are close to normal range and are not indicative of not tolerating this activity

21. A brace is ordered for a young teen with scoliosis. The nurse knows that teaching has been effective if the client makes which of the following statements? a. "I will have my parents put bed-boards on my bed." b. "I should decrease my caloric intake." c. "I should only take tub baths." d. "I can remove the brace for one hour a day."

I can remove the brace for one hour a day Strategy: All answers are implementations. Determine the outcome of each answer choice. Is it desired? (1) bed-boards maintain proper vertebral alignment, but can't correct lateral curvature of scoliosis (2) diet should be high-calorie due to age of child and growth requirements; diet doesn't affect curvature of the spine (3) either tub bathing or a shower is permitted (4) correct-should be worn at all times, except when bathing

8. A mother asks the pediatric nurse about what she should begin to feed her 6-month-old infant. The correct response is: a. Egg whites are the least allergenic food to be introduced into the baby's diet. b. Rice cereal is the first solid introduced that is least allergenic of the cereals. c. Formula is the only source of nutrition given for the first year. d. Fruits and vegetables are good sources of iron.

Rice cereal is the first solid introduced that is least allergenic of the cereals

8. The nursing educator is providing an educational session on sickle cell anemia. The educator tells the nursing staff that which of the following clinical manifestations occurs in sickle cell anemia: a. Sickled cells are very small and increase the blood flow through the body b. Sickled cells are unable to flow easily through the microvasculature and their clumping obstructs blood flow c. The sickled cells cause severe bone marrow depression d. The sickled cells mix with the unsickled cells and cause the immune system to become depressed

Sickled cells are unable to flow easily through the microvasculature and their clumping obstructs blood flow

14. Bacterial pneumonia is suspected in a 4 year old boy with fever, headache, and chest pain. Which assessment finding would most likely indicate the need for this child to be hospitalized? a. Fever of 101°F b. Oxygen saturation level of 96% c. Tachypnea with retractions d. Pale skin color

Tachypnea with retractions Response Feedback: Pneumonia typically treated in outpatient with antibiotics; important to note if respiratory distress as this may be indication for hospitalization

18. A 13-year-old child comes in with mild wheezing and dry cough. The child is afebrile, pulse is 70, RR is 22, BP 100/80, pulse oximetry is 95% saturation. Which of the following would the nurse do first? a. Get ready for intubation b. Teach the parents which allergens to avoid c. Take a peak expiration flow reading d. Start O2 via nasal cannula

Take a peak expiration flow reading Response Feedback: Pulse oximetry normal; most likely early asthma attack

11. The nurse encourages the mother of a toddler with acute LTB to stay at the bedside as much as possible. The nurse's rationale for this action is primarily that a. Mothers of hospitalized toddlers often experience guilt b. Separation from mother is a major developmental threat at this age c. The mother's presence will reduce anxiety and ease child's respiratory efforts d. The mother can provide constant observations of the child's respiratory efforts

The mother's presence will reduce anxiety and ease child's respiratory efforts A. This is true, but not the best answer. B. Although true for toddlers, the main reason to keep parents at the child's bedside is to ease anxiety and therefore respiratory effort. C. The family's presence will decrease the child's distress. D. The child should have constant monitoring by cardiorespiratory monitor and noninvasive oxygen saturation monitoring, but the parent should not play this role in the hospital

1. The nurse is providing education for the prevention on early recognition of vaso-occlusive events in sickle cell anemia. Which response by a family member indicates a need for further education? a. We need to seek medical attention for abdominal pain b. We must watch for unusual headache, loss of feeling, or sudden weakness c. We should call the doctor for any fever over 102 degrees d. We must be compliant with flu and pneumococcal vaccines

We should call the doctor for any fever over 102 degrees call with any fever as it can cause dehydration and sickling; abdominal pain can be secondary to sequestration of sickled cells in liver or spleen; headache etc. could be in brain or impending stroke

1. A hospitalized 16-year-old male refuses all visits from his classmates because he is concerned with his distorted appearance. To increase the client's social interaction, what intervention is best for the nurse to initiate? a. Encourage the client to use a hand-held video game that is popular with all his friends b. Assign a 25-year-old female nursing student to offer support to the client c. Arrange for an Internet connection in the client's room for email communication d. Encourage the client's mother to arrange a surprise get together in the cafeteria

Arrange for an Internet connection in the client's room for email communication

4. The mother of a 6-month-old infant expresses concern about the effect of frequent thumb sucking on her child's teeth. After the nurse teaches her about this matter, which response by the mother indicates that the teaching has been effective? a. "Thumb sucking should be discouraged at 6 months" b. " I' ll give the baby a pacifier instead." c. "Sucking is important to the baby for their development." d. "I'll wrap the thumb in a bandage."

Sucking is important to the baby for their development

16. When changing an infant's diaper, the nurse notices small bright red papules with satellite lesions on the perineum, anterior thigh, and lower abdomen. This rash is characteristic of a. Primary Candidiasis b. Irritant contact dermatitis c. Intertrigo d. Seborrheic dermatitis

Primary candidiasis A. Small red papules with peripheral scaling in a sharply demarcated area involving the anterior thighs, lower abdomen, and perineum are characteristic of primary candidiasis. B. A shiny, parchment-like erythematous rash on the buttocks, medial thighs, mons pubis, and scrotum, but not in the folds, is suggestive of irritant contact dermatitis. C. Intertrigo is identified by a red macerated area of sharp demarcation in the groin folds. It can also develop in the gluteal and neck folds. D. Seborrheic dermatitis is recognized by salmon-colored, greasy lesions with a yellowish scale found primarily in skin-fold areas or on the scalp

20. The nurse is preparing an 8 year old child for a procedure. What is the most appropriate nursing intervention considering the child's stage of growth and development? a. Provide visual aids, such as dolls, puppets, and diagrams in the explanation b. Provide a written pamphlet for the child to review prior to the procedure c. Discourage any display of emotional outbursts d. Request that parents wait outside while the nurse provides instructions to the child

Provide visual aids, such as dolls, puppets, and diagrams in the explanation

25. A parent calls the nurse and gives the following symptoms: reddish pinpoint rash most concentrated in the axilla and groin, a high fever, flushed cheeks, abdominal pain, and a dark red tongue with white spots. The nurse suspects which of the following infections? a. Mumps b. Measles c. Scarlet fever d. Varicella

Scarlet fever Response Feedback: Measles: rash spreads from face to rest of body, becoming more prominent in upper body chickenpox: begins as macular rash, then to papular, then vesicles scarlet fever: scarlet fever from streptococcal bacterial infectionèneeds penicillin for treatment

18. A 9 year old who is in bed convalescing becomes very bored and irritable. The nurse plans activities that a school age child would like and suggests that the child: a. Play chess b. Do arithmetic puzzles c. Watch game shows on TV d. Start a collection

Start a collection

4. Which intervention is appropriate for a child receiving high doses of steroids? a. Limit activity and receive home schooling b. Substitute a killed virus vaccine for live virus vaccines c. Decrease the amount of potassium in the diet d. Monitor for seizure activity

Substitute a killed virus vaccine for live virus vaccines Response Feedback: Limiting activity and home schooling are not routine for a child receiving high doses of steroids. B. The child on high doses of steroids should not receive live virus vaccines because of immunosuppression. C. The child receiving steroids is at risk for hypokalemia and needs potassium in the diet. D. Children on steroids are not typically at risk for seizures

12. What should the parents of an infant with thrush (oral candidiasis) be taught about medication administration? a. Give nystatin suspension with a syringe without a needle b. Apply nystatin cream to the affected area twice a day c. Give nystatin before the infant is fed d. Swab nystatin suspension onto the oral mucous membranes after feedings

Swab nystatin suspension onto the oral mucous membranes after feedings A. Medication may not reach the affected areas when it is squirted into the infant's mouth. Rubbing the suspension onto the gum ensures contact with the affected areas. B. Nystatin cream is used for diaper rash caused by Candida. C. To prolong contact with the affected areas, the medication should be administered after a feeding. D. It is important to apply the nystatin suspension to the affected areas, which is best accomplished by rubbing it onto the gums and tongue, after feedings, every 6 hours, until 3 to 4 days after symptoms have disappeared

3. What is the most important information to be included in the discharge planning for an infant with gastroesophageal reflux? a. Teach parents to position the infant on the left side b. Reinforce the parents' knowledge of the infant's developmental needs c. Have the parents keep an accurate record of intake and output d. Teach the parents how to do infant cardiopulmonary resuscitation (CPR)

Teach the parents how to do infant cardiopulmonary resuscitation (CPR) Feedback: A. Correct positioning minimizes aspiration. The correct position for the infant is on the right side after feeding and supine for sleeping. B. Knowledge of developmental needs should be included in discharge planning for all hospitalized infants, but it is not the most important in this case. C. Risk of aspiration is a priority nursing diagnosis for the infant with gastroesophageal reflux. The parents must be taught infant CPR. D. Keeping a record of intake and output is not a priority and may not be necessary

9. A nurse is working with a caregiver of an infant with gastroesophageal reflux. The infant has poor weight gain, cries when awake, and is regurgitating after feedings. Which of the following interventions would the nurse recommend? a. Give larger, more frequent feedings b. Feed the infant with the infant's body in a supine position c. Hold the baby in an upright position for an hour after feedings d. Thicken the formula with a little rice cereal

Thicken the formula with a little rice cereal

13. In a non potty trained child with nephrotic syndrome, the best way to detect fluid retention is which of the following? a. Weigh child daily b. Test urine for hematuria c. Measure abdominal girth weekly d. Count the number of wet diapers

Weigh child daily Response Feedback: Daily weights are best indicator for fluid changes (i.e. edema with nephrosis)