2

13. A nurse in the school office is seeing a 7-year-old child with type 1 diabetes after gym class. The child is jittery and appears sweaty. Which intervention would the nurse advise the child to do? a. You will need to drink this 6-ounce bottle of orange juice b. You will need to sit in the office and rest after gym class c. You will need to have an extra shot of regular insulin d. You will need to skip your next dose of insulin

a. You will need to drink this 6-ounce bottle of orange juice

7. The nurse is reviewing appropriate nutritional options for a child who is receiving chemotherapy and has been prescribed a neutropenic diet. The nurse recommended which of the following? a. Bagel with cream cheese and lox b. Vanilla milkshake made with pasteurized milk c. Ham and cheese sandwich d. Sushi

b. Vanilla milkshake made with pasteurized milk

36. An 8-year-old boy and his father visit the pediatrician's office with reports of a sudden onset of abdominal pain and ...A urinalysis shows 4+ protein. On taking the boy's health history. The nurse learns that he had strep throat a little over a week ago. Assesment findings: Temp 100.6 F, RR= 22, HR=105, BP=130/89. Which condition should the nurse suspect? a. Nephrotic syndrome b. Renal agenesis c. Acute glomerulonephritis d. Polycystic kidney disease

c. Acute glomerulonephritis

44. The nurse is discussing the treatment of congenital aganglionic megacolon (Hirschsprung's disease) with the caregivers of a 3-day-old...infant who presented with abdominal distension and failure to pass meconium. Which statement is the best explanation of the treatment for this diagnosis? a. Your child will receive counseling so the underlying concerns will be addressed b. We will give enemas until they clear and then teach you how to do these at home c. Your child will be treated with oral iron preparations to correct the anemia d. The treatment for the disorder will be a surgical procedure

d. The treatment for the disorder will be a surgical procedure

22. A child is experiencing an acute exacerbation of juvenile idiopathic arthritis for which she is prescribed prednisone. The nurse teaches the parent and child this medication. Which statement by the parents indicates that the teaching was successful? a. We should not stop this medication abruptly b. This medication should be taken on an empty stomach for the best effectiveness c. This medication might cause hypoglycemia d. She might lose weight initially

a. We should not stop this medication abruptly

9. A nurse is admitting a child who has leukemia and a critically low platelet count. Based on this information which of the following precautions should the nurse initiate? a. Respiratory b. Airborne c. Bleeding d. Contact

c. Bleeding

34. The parents of a child with hemophilia ask the nurse about appropriate activities and sports that they should encourage the child to participate in. What activity would be the safest for the nurse to suggest? a. Gymnastics b. Soccer c. Swimming d. Football

c. Swimming

21. A child and her parents are being seen in the office after discharge from the hospital with a new diagnosis of type 2 diabetes When talking with the child and parents, the nurse is the best response? a. Kids can usually be managed with an oral agent, meal planning, and exercise b. You are lucky that you did not have to learn how to give yourself a shot c. A weight-loss program should be implemented and maintained d. This will resolve itself if you follow all of the doctor's directions

a. Kids can usually be managed with an oral agent, meal planning, and exercise

11. A 4-year-old child presents with varicella and vesicular rash in various stages of healing. Which statement by the parent indicates the need for further teaching? a. Once the fever has gone away my child can go back to school b. I can give my child acetaminophen for fever c. I can use cool/tepid water to sponge-bathe, my child, while the lesions are present d. I will keep my child home from school and other activities until all of the lesions have crusted over

a. Once the fever has gone away my child can go back to school

26. A nurse is caring for a 2-month-old infant who is one-day postoperative following surgical repair of a cleft lip. Which of the following actions should the nurse take? Select all that apply. a. Position the infant on their back and upright b. Encourage the parents to hold the baby c. Apply elbow restraints as ordered d. Administer Tylenol as prescribed for paine. Feed the infant milk with a strain

a. Position the infant on their back and upright b. Encourage the parents to hold the baby c. Apply elbow restraints as ordered d. Administer Tylenol as prescribed for pain

33. A child with a brain tumor has a decreased respiratory rate and is less responsive to verbal commands than he was when the nurse assessed the patient the previous hour. What should the nurse do next? a. Implement seizure precautions b. Notify the health care provider (HCP) c. Obtain an oximeter reading d. Raise the head of the bed

b. Notify the health care provider (HCP)

45. The burse is reviewing a health care provider's prescriptions for a child with sickle cell anemia who was admitted to the hospital of vaso-occlusive crisis. Which prescription documented in the child's chart should the nurse question? a. Apply nasal oxygen at 2L/minute b. Restrict fluid intake c. Avoid strain on painful joints d. Position for comfort

b. Restrict fluid intake

39. A nurse is caring for a 3-year-old child who was admitted with acute diarrhea and dehydration. Which of the following findings indicates that oral rehydration therapy has been effective? a. Respiratory rate 24/min b. Urine specific gravity 1.015 c. Heart rate 130/min d. Capillary refill greater than 3 seconds

b. Urine specific gravity 1.015

8. A nurse is providing teaching to the patient of an infant who has gastroesophageal reflux. Which of the following statements by the parent indicates an understanding of the teaching? a. "My baby's breast milk can be mixed with formula to make it thicker." b. "I should position my baby side-lying during sleep." c. "I will keep my baby in an upright position for at least 30 minutes after feedings." d. "I will have to feed my baby formula rather than breast milk.

c. "I will keep my baby in an upright position for at least 30 minutes after feedings."

23. A 3-year-old child with an upper respiratory infection and low-grade fever is being treated with acetaminophen. The nurse is reviewing important anticipatory guidance with parents. Which statement by the parents indicates the need for further teaching about this medication? a. I can give this medication rectally if my child has a fever and is having vomiting b. I will notify the provider if I notice that the whites of my child's eyes are yellow c. I can give up to 5000 mg each day by mouth if my child is irritable d. I can give this medication every 4-6 hrs for fever

c. I can give up to 5000 mg each day by mouth if my child is irritable

38. A nurse is teaching a school-age child who has type 1 diabetes mellitus about self-care. Which of the following statements by the child indicates the need for further teaching? a. I should increase my insulin when I exercise b. I should make sure to eat breakfast even if I am not feeling hungry c. I should drink a glass of milk if I am feeling irritable d. I should draw up regular insulin into the syringe before NPH insulin

c. I should drink a glass of milk if I am feeling irritable

5. The nurse discusses management with the caregiver of a toddler with acute otitis media. Which statement indicates that the caregiver needs additional teaching? a. I can give Children's Tylenol if my child is irritable b. My child should complete the entire course of antibiotics even if they seem better after a few days c. I should give my toddler one baby aspirin for pain d. I can give Children ibuprofen if my child is in pain

c. I should give my toddler one baby aspirin for pain

37. A 6-year-old child presents to the pediatric clinic with a vesicular rash and honey-crusted plaques around the nose and neck. Which of the following statements by the parent indicates the need for further teaching? a. I will remind my child to wash their hands well and frequently b. I will remind my child not to touch their face while the rash is present c. I will fill a prescription for an antiviral ointment to apply to the rash d. I will give my child a separate towel from other family members

c. I will fill a prescription for an antiviral ointment to apply to the rash

42. A nurse is caring for a 4 year old child who has had watery diarrhea for the past 3 days. Which of the following is the most appropriate...the nurse to take? a. Offer the child regular chicken broth b. Initiate oral rehydration therapy c. Start hypertonic IV solution d. Keep NPO until diarrhea subsides

b. Initiate oral rehydration therapy

19. A nurse is taking a health history for a 9-year-old with conjunctivitis. Which statement by the parents leads the nurse to suspect that the child is experiencing allergic conjunctivitis? a. He was playing out in the field during his soccer game b. He was exposed to several family members with an infection c. We have a family history of conjunctivitis d. He just recovered from an upper respiratory infection

a. He was playing out in the field during his soccer game

30. A nurse has completed an education session with parents of children diagnosed a need for additional education. a. "If we need to use the Epipen we will need to notify her physician's office the next business day." b. My child should carry their EpiPen with them at all times c. "The school nurse should be informed of my child's allergies" d. "I have found a website that marks medical alert bracelets in my daughter's favorite color."

a. "If we need to use the Epipen we will need to notify her physician's office the next business day."

2. A nurse is teaching a school-age child who has type 1 diabetes mellitus and his parents about management during an illness. Which of the following instructions should the nurse include? a. "Test the urine for ketones." b. "Limit carbohydrates during illness." c. "Withhold insulin dose if feeling nauseous." d. "Limit fluid intake during meal time."

a. "Test the urine for ketones."

1. The nurse is caring for a 10-year-old child experiencing nocturnal enuresis with no physiological cause. The child states, "I am embarrassed and I wish this could stop this right now!" How will the nurse respond? a. "There are several things we can do to help you achieve this goal." b. "You are not alone. There are almost 5 million people that have enuresis." c. "You will grow out of this eventually; you just need to be patient." d. "You can wear pull-ups to bed and, since they look like underwear, no one will know."

a. "There are several things we can do to help you achieve this goal."

43. The nurse is caring for a 2-month-old child with a fever of 101.7F. The child ..appears...Which of the following ...the nurse expect to implement as a priority? a. Administer antibiotics as prescribed b. Replace fluids orally c. Obtain urinalysis d. Obtain a specimen for a complete blood count

a. Administer antibiotics as prescribed

25. A school-age child presents to the emergency department with intermittent pain around the umbilicus and radiating to the right lower abdomen, rebound tenderness of the abdomen, low-grade fever, nausea and vomiting. Which diagnosis would be the most likely cause of this child's symptoms? a. Appendicitis b. Gastroenteritis c. Constipation d. Pyloric stenosis

a. Appendicitis

40. The nurse is reviewing triggers of sickle cell anemia with a 14-year-old male client with sickle cell anemia. Which statement by the client indicates an understanding of the teaching? Select all that apply. a. "Not getting enough sleep can worsen my condition." b. "Adequate hydration will help me to stay healthy." c. "I wash my hands frequently." d. "I have to be very careful to take my medications as directed." e. "I will need to carry a water bottle with me for after school sports.

b. "Adequate hydration will help me to stay healthy." c. "I wash my hands frequently." d. "I have to be very careful to take my medications as directed."

16. A parent calls a clinic and reports to a nurse that his 2-month-old infant is hungry more than usual but is having projectile vomiting immediately after eating. Which of the following responses should the nurse make? a. "Burp your baby more frequently during feedings." b. "Bring your baby into the clinic today." c. "Try switching to a different formula." d. "Give your infant an oral rehydration solution."

b. "Bring your baby into the clinic today."

3. The nurse is providing teaching to a child with new-onset type 1 diabetes. Which statement(s) made by the child demonstrates he understands the pathophysiology of diabetes? Select all that apply a. "If I avoid sweet foods, I will not need to take insulin." b. "Insulin injections will help maintain my glucose levels." c. "I can tell my glucose is getting high if I feel extra tired." d. "My body is attacking my liver to reduce the amount of insulin I make." e. "I do not make enough insulin on my own."

b. "Insulin injections will help maintain my glucose levels." e. "I do not make enough insulin on my own."

32. A nurse is caring for a toddler who has acute otitis media. Which of the following is the priority? a. Educate the family about antibiotic administration b. Administer analgesic medication c. Provide diversional activities for the child d. Apply an ice pack to the affected ear

b. Administer analgesic medication

17. The nurse is caring for a 4-year-old child with a new diagnosis of Type 1 Diabetes Mellitus and is distressed after an insulin injection. Which intervention is MOST appropriate for a 4-year-old child? a. Review the anatomy and physiology of diabetes with the child to help them understand their condition b. Allow the child to choose the site and give pretend insulin injection on a doll c. Explain to the child that if they avoid cookies and candy they will not need to take insulin shots d. Instruct parents to wait until their child is older before including them in managing their condition

b. Allow the child to choose the site and give pretend insulin injection on a doll

15. A nurse in an emergency department is caring for an infant who has a 2-day history of vomiting and an elevated temperature. Which of the following should the nurse recognize as the nurse reliable indicator of fluid loss? a. Respiratory Rate b. Body Weight c. Skin Integrity d. Blood Pressure

b. Body Weight

35. A nurse is caring for a child with a urinary tract infection. Which of the following should the nurse include in teaching for the child and family? Select all that apply. a. Take frequent bubble baths to cleanse the perineal area b. Complete the course of prescribed antibiotics c. Wipe perineal area front to back d. Restrict fluids e. Encourage frequent voiding

b. Complete the course of prescribed antibiotics c. Wipe perineal area front to back e. Encourage frequent voiding

31. The nurse is providing care to a child with acute abdominal pain, current-jelly-like stools and suspected intussusception. The nurse .. with the caregivers that the child will have which procedure. a. Ano-rectal pull-through procedure b. Enema with air infusion c. Abdominal surgery d. Colostomy

b. Enema with air infusion

28. The nurse is caring for a child with leukemia, a central venous access device, and chemotherapy ... Which of the following SHOULD be included in the teaching plan for the child and parents about reducing the child's risk for infections? Select all that apply. a. Encouraging frequent close contact with visitors b. Having the child sleep in a single bed and room c. Protecting the central venous access device from non-sterile access d. Encouraging frequent, thorough hand washing e. Cheering up the environment with fresh flowers and plants

b. Having the child sleep in a single bed and room c. Protecting the central venous access device from non-sterile access d. Encouraging frequent, thorough handwashing

20. A nurse is reviewing the discharge plan with the family of an 8-year child with acute lymphoblastic leukemia who is receiving chemotherapy through a central venous access device. Which instruction is a priority? a. I will use acetaminophen if my child needs an analgesic for pain b. I will notify my provider immediately if my child has a sore throat c. I will keep a written list of all my child's medical appointments d. I will keep a written document of the treatment plan

b. I will notify my provider immediately if my child has a sore throat

14. A nurse is admitting a child who has leukemia. Which of the following clients should the nurse place in the same room with this child? a. A child recovering from a ruptured appendix b. A child who has cystic fibrosis c. A child who has rheumatic fever d. A child who has nephrotic syndrome

d. A child who has nephrotic syndrome

27. A nurse is caring for a child who is postoperative following surgical removal of a Wilms tumor. Which of the following assessments is an indications to continue NPO status? a. Report of pain at the operative site b. Abdominal girth 1 cm larger than yesterday c. Passing of flatus every 30 min d. Absent bowel sounds

d. Absent bowel sounds

18. The nurse is reviewing the management of pediculosis capitis with the parents of school-age children during a presentation. ... shampoo or cream rinse, the treatment for head lice may also include which of the following? a. Removing nits from wet hair with a fine-tooth comb b. Washing all bedding and clothing in hot water (130 F or 54 C), or sealing items that cannot be washed in a plastic bag for 2 weeks c. Soaking combs and brushes in hot water with the shampoo or at least 15 minutes d. All of the above answers

d. All of the above answers

6. A nurse is caring for a child who is 2 hr postoperative following a tonsillectomy. Which of the following fluid items should the nurse offer the child at this time? a. Warm chicken broth b. Iced orange juice c. Vanilla milkshake d. Crushed ice

d. Crushed ice

10. A nurse is teaching a school-age child who has Type 1 diabetes mellitus about insulin administration. Which of the following should be included in the teaching? a. Instruct the child to mix glargine and NPH insulin in the same syringe for injection b. Instruct the child to aspirate for blood before injecting the insulin c. Instruct the child to inject the needle at a 60-degree angle d. Instruct the child to give 4-6 injections in one area of the body before switching sites

d. Instruct the child to give 4-6 injections in one area of the body before switching sites

24. The physician of a child with juvenile idiopathic arthritis asks the nurse to telephone the school to arrange a new activity program for her. A change you would anticipate arranging for the child is to: a. Be excused from all extracurricular activities b. Begin school earlier in the day than other children c. Be excused from all swimming classes d. Modify her physical exercise program

d. Modify her physical exercise program

4. An adolescent client has just been diagnosed with systemic lupus erythematosus (SLE). Following client's education about the disease, which statement by the client demonstrates an understanding of SLE? a. SLE is a rheumatic disease that mostly affects my joints b. If my SLE has been found early enough the disease process, there is a good chance that medication can cure it c. SLE only affects my skin. It seldom causes problems in any other organs. d. SLE is an autoimmune disorder that I will always have, with times of flare-ups and times of minimal to no symptoms

d. SLE is an autoimmune disorder that I will always have, with times of flare-ups and times of minimal to no symptoms

41. The home health care nurse is visting a child with renal failure undergoing continous ambulatory ... Which of the following would lead the nurse to identify a nursing diagnosis of fluid overload related to ... a. Redness at the tube insertion site b. Poor skin turgor c. Fever d. Shortness of breath

d. Shortness of breath

29. The nurse is administering a blood transfusion to a 9-year-old child with beta-thalassemia. About 30 minutes after beginning the transfusion, the child reports a rash with itching and trouble breathing. The child's temperature is now 101.2 up from a baseline of 96..., which action would the nurse do next? a. Give intravenous diphenhydramine (Benadryl) as ordered b. Collect a urine sample c. Check the child's apical pulse d. Stop transfusion

d. Stop transfusion

12. In caring for a child with nephrotic syndrome, which interventions will be most important to be included in the child's plan of care? a. Testing the urine for glucose levels regularly b. Ambulating 3 to 4 times a day c. Increasing fluid intake by 50 ml per hour d. Weighing on the same scale each day

d. Weighing on the same scale each day