401 Exam 5 NCLEX Review Qs

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

A. Limited range of motion in the affected hip

A child undergoes surgical removal of a brain tumor. During the postoperative period, the nurse is monitoring the child and notes that the child is restless, the pulse rate is elevated, and the BP is decreased significantly from the baseline. The nurse suspects that the child is in shock. Which is the most appropriate nursing action? A. Notify the HCP B. Place the child in a supine position C. Place the child in Trundelenburg's position D. Increase the flow rate of the IV fluids

A. Notify the HCP

The nurse is performing an assessment on a child admitted to the hospital with a probable diagnosis of nephrotic syndrome. Which assessment findings should the nurse expect to observe? SELECT ALL THAT APPLY A. Pallor B. Edema C. Anorexia D. Proteinuria E. Weight loss F. Decreased serum lipids

A. Pallor B. Edema C. Anorexia D. Proteinuria

The mother of a 4 yo child tells the peds nurse that the child's abdomen seems to be swollen. During further assessment of subjective data, the mother tells the nurse that the child is eating well and that the activity of the child is unchanged. The nurse, suspecting the possibility of Wilms' tumor, should avoid which during the physical assessment? A. Palpating the abdomen for mass B. Assessing urine for the presence of hematuria C. Monitoring for temp for the presence of fever D. Monitoring the BP for the presence of hypertension

A. Palpating the abdomen for mass

The nurse is reviewing a health care provider's prescriptions for a child with sickle cell anemia who was admitted to the hospital for treatment of vast-occlusive crisis. Which prescriptions documented in the child's record should the nurse question? SELECT ALL THAT APPLY A. Restrict fluid intake B. Position for comfort C. Avoid strain on painful joints D. Apply nasal oxygen at 2L/minute E. Provide a high-calorie, high protein diet F. Give meperidine, 25 mg IV, q4hours for pain

A. Restrict fluid intake F. Give meperidine, 25 mg IV, q4hours for pain

The nurse is planning care for a child with hemolytic-uremic syndrome who has been anuric and will be receiving peritoneal dialysis treatment. The nurse should plan to implement which measure? A. Restrict fluids as prescribed B. Care for the arteriovenous fistula C. Encourage foods high in K D. Administer analgesics as prescribed

A. Restrict fluids as prescribed

The nurse provides home care instructions to the parents of a child with celiac disease. The nurse should teach the parents to include which food item in the child's diet? A. Rice B. Oatmeal C. Rye toast D. Wheat toast

A. Rice

The nurse is monitoring a 3yo child for signs of increased ICP after a craniotomy. The nurse plans to monitor for which early sign of increased ICP? A. Vomiting B. Bulging anterior fontanel C. Increasing head circumference D. Complaints of a frontal headache

A. Vomiting

The nurse performing an admission assessment on a 2 year old child who has been diagnosed with nephrotic syndrome notes that which most common characteristic is associated with this syndrome? A. Hypertension B. Generalized edema C. Increased urinary output D. Frank, bright red blood in the urine

B. Generalized edema

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

B. I can use lotion or powder around the edges of the cast to relieve itching

The nurse is providing instructions to the patents of a child with scoliosis regarding the use of a brace. Which statement made by the parents indicates a need for further instruction? A. I will encourage my child to perform prescribed activities B. I will have my child wear soft fabric clothing under the brace C. I should apply lotion under the brace to prevent skin breakdown D. I should avoid the use of powder because it will cake under the brace

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

An infant has just returned to the nursing unit after surgical repair of a cleft lip on the right side. The nurse should place the infant in which best position at this time? A. Prone position B. On the stomach C. Left lateral position D. Right lateral position

C. Left lateral position

A child is hospitalized for persistent vomiting. The nurse should monitor for which problem? A. Diarrhea B. Metabolic acidosis C. Metabolic alkalosis D. Hyperactive bowel sounds

C. Metabolic alkalosis

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

C. Rigid extension and pronation of the arms and legs

The nurse is providing home care instructions to the parents of a 10 yo child with hemophilia. Which sport activity should the nurse suggest for this child? A. Soccer B. Basketball C. Swimming D. Field hockey

C. Swimming

The child has a fluid volume deficit. The nurse performs an assessment and determines that the child is improving and the deficit is resolving if which finding is noted? A. The child has no tears B. Urine specific gravity is 1.030 C. Urine output is less than 1mL/kg/hr D. Cap refill is less than 2 seconds

D. Cap refill is less than 2 seconds

The nurse provides home care instructions to the parent of a child with AIDS. Which statement by the parent indicates the need for further teaching? A. I will wash my hands frequently B. I will keep my child's immunization up to date C. I will avoid unprotected contact with my child's body fluids D. I can send my child to daycare if he has a fever as long as it is a low grade fever

D. I can send my child to daycare if he has a fever as long as it is a low grade fever

A 7 year old child is seen in a clinic, and the PHCP documents a diagnosis of primary nocturnal enuresis. The nurse should provide which information to the parents? A. Primary nocturnal enuresis does not respond to treatment B. Primary nocturnal enuresis is caused by a psych problem C. Primary nocturnal enuresis requires surgical intervention to improve the problem D. Most children outgrow the bed-wetting problem without therapeutic intervention

D. Most children outgrow the bed-wetting problem without therapeutic intervention

The nurse analyzes the lab results of a child with hemophilia. The nurse understands that which result will most likely be abnormal in this child? A. Platelet count B. Hematocrit level C. Hemoglobin level D. Partial thromboplastin time

D. Partial thromboplastin time

The nurse develops a plan of care for a child at risk for tonic-clonic seizures. In the plan of care, the nurse identifies seizure precautions and documents that which item(s) need to be placed at the child's bedside? A. Emergency cart B. Trach set C. Padded tongue blade D. Suctioning equipment and oxygen

D. Suctioning equipment and oxygen

The nurse notes documentation that a child with meningitis is exhibiting a positive Kerning's sign. Which observation is characteristic of this sign? A. The child complains of muscle and joint pain B. Petechial and purpuric rashes are noted on the child's trunk C. Neck flexion causes adduction and flexion movements of the lower extremities D. The child is not able to extend the leg when the thigh is flexed anteriorly at the hip

D. The child is not able to extend the leg when the thigh is flexed anteriorly at the hip

A diagnosis of Hodgkin's disease is suspected in a 12yo child seen in a clinic. Several diagnostic studies are performed to determine the presence of this disease. Which diagnostic test result will confirm the diagnosis of Hodgkin's disease? A. Elevated vanillylmandelic acid urinary levels B. The presence of blast cells in the bone marrow C. The presence of Epstein Barr virus in the blood D. The presence of Reed-Sternberg cells in the lymph nodes

D. The presence of Reed-Sternberg cells in the lymph nodes

The nurse is performing an assessment on a 10yo child who is suspected of having Hodgkin's disease. The nurse understands that which assessment findings are specifically characteristic of this disease? SELECT ALL THAT APPLY A. Abdominal pain B. Fever and malaise C. Anorexia and weight loss D. Painful, enlarged inguinal lymph nodes E. Painless, firm, and movable adenopathy in the cervical area

A. Abdominal pain E. Painless, firm, and movable adenopathy in the cervical area

The nurse is conducting staff in-service training on von Willebrand's disease. Which should the nurse include as characteristics of Von Willebrand's disease? SELECT ALL THAT APPLY A. Easy bruising occurs B. Gum bleeding occurs C. It is a hereditary bleeding disorder D. Treatment and care are similar to that for hemophilia E. It is characterized by extremely high creatinine levels F. The disorder causes platelets to adhere to damaged endothelium

A. Easy bruising occurs B. Gum bleeding occurs C. It is a hereditary bleeding disorder D. Treatment and care are similar to that for hemophilia F. The disorder causes platelets to adhere to damaged endothelium

The nurse analyzes the lab values of a child with leukemia who is receiving chemo. The nurse notes that the platelet count is 19500 cells/mm^3. On the basis of this result which intervention should the nurse include in the plan of care? A. Initiate bleeding precautions B. Monitor closely for signs of infection C. Monitor for temp every 4 hours D. Initiate protective isolation precautions

A. Initiate bleeding precautions

The nurse is developing a plan of care for a child who is at risk for seizures. Which interventions apply if the child has a seizure? SELECT ALL THAT APPLY A. Time the seizure B. Restrain the child C. Stay with the child D. Place the child in a prone position E. Move furniture away from the child F. Insert a padded tongue blade in the child's mouth

A. Time the seizure C. Stay with the child E. Move furniture away from the child

The nurse is assisting a HCP examining an infant with developmental dysplasia of the hip perform an Ortolani maneuver. The nurse understands that this maneuver is performed for which purpose? A. To assess for hip instability B. To assess for movement of the hips C. To push the femoral head out of the acetabulum D. To ensure that hyperextension and full range of motion exist

A. To assess for hip instability

A child with beta-thalassemia is receiving long-term blood transfusion therapy for the treatment of the disorder. Chelation therapy is prescribed as a result of too much iron from the transfusions. Which medication should the nurse anticipate to be prescribed? A. Fragmin B. Meropenem C. Metoprolol D. Deferoxamine (Demerol)

D. Deferoxamine

The clinic nurse instructs parents of a child with sickle cell anemia about the precipitating factors related to sickle cell crisis. Which, if identified by the parents as a precipitating factor, indicates the need for further instructions? A. Stress B. Trauma C. Infection D. Fluid overload

D. Fluid overload

The clinic nurse reviews the record of an infant and notes that the HCP has documented a diagnosis of suspected Hirschsprung's disease. The nurse reviews the assessment findings documented in the record, knowing that which symptom most likely led the mother to seek health care for the infant? A. Diarrhea B. Projectile vomiting C. Regurgitation feedings D. Foul-smelling ribbon-like stools

D. Foul-smelling ribbon-like stools

A child has a right femur fracture caused by a motor vehicle accident and is placed in skin traction temporarily until surgery can be performed. During assessment, the nurse notes that the dorsalis pedis pulse is absent on the right foot. Which action should the nurse take? A. Administer an analgesic B. Release the skin traction C. Apply ice to the extremity D. Notify the HCP

D. Notify the HCP

A child who has undergone spinal fusion for scoliosis complains of abdominal discomfort and begins to have episodes of vomiting. On further assessment, the nurse notes abdominal distention. On the basis of these findings, the nurse should take which action? A. Administer an antiemetic B. Increase the intravenous fluids C. Place the child in a Sim's position D. Notify the HCP

D. Notify the HCP

An infant of a mother infected with HIV is seen in the clinic each month and is being monitored for symptoms indicative of HIV infection. The nurse assesses the infant knowing that which infection is the most common opportunistic infection of children infected with HIV? A. Meningitis B. Gastroenteritis C. Cytomegalovirus infection D. Pneumocystic jiroveci pneumonia

D. Pneumocystic jiroveci pneumonia

The nurse understands that which information collected during the assessment of a child recently diagnosed with glomerulonephritis is the most often associated with the diagnosis? A. Child fell off of a bike onto the handlebars B. N/V for the last 24 hours C. Urticaria and itching for 1 week before diagnosis D. Streptococcal throat infection for 2 weeks before infection

D. Streptococcal throat infection for 2 weeks before infection

The parents of a child recently diagnosed with cerebral palsy ask the nurse about the disorder. The nurse bases the response on the understanding that cerebral palsy is which type of condition? A. An infectious disease of the central nervous syndrome B. An inflammation of the brain as a result of a viral illness C. A congenital condition that results in moderate to severe retardation D. A chronic disability characterized by impaired muscle movement and posture

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

A mother arrives in the ED with a 5 year old child and states that the child fell off of a bunk bed. A head injury is suspected, and the nurse checks the child's airway status and assesses the child for early and late signs of increased ICP. Which is a late sign? A. Nausea B. Irritability C. Headache D. Bradycardia

D. Bradycardia

The nurse is reviewing a treatment plan with the parents of a newborn with hypospadias. Which statement by the parents indicates an understanding of the plan? A. Caution should be used when straddling the infant on the hip B. Vital signs should be taken daily to check for bladder infection C. Catheterization will be necessary when the infant dos not void D. Circumcision has been delayed to save tissue for surgical repair

D. Circumcision has been delayed to save tissue for surgical repair

The nursing student is presenting a clinical conference and discusses the cause of beta-thalassemia. The nursing student informs the group that a child at greatest risk of developing this disorder is which one? A. A child of mexican descent B. A child of mediterranean descent C. A child whose intake of iron is extremely poor D. A breast-fed child of a mother with chronic anemia

B. A child of mediterranean descent

The nurse reviews the record of a child who is suspected to have glomerulonephritis and expects to note which finding that is associated with this diagnosis? A. Hypotension B. Brown-colored urine C. Low urinary specific gravity D. Low blood urea nitrogen level

B. Brown-colored urine

The nurse prepares a list of home care instructions for the parents of a child who has a plaster cast applied to the left forearm. Which instructions should be included on the list? SELECT ALL THAT APPLY A. Use the fingertips to lift the cast while it is drying B. Keep small toys and sharp objects away from the cast C. Use a padded ruler or another padded object to scratch under the cast if it itches D. Place a heating pad on the lower end of the cast and over the fingers if the fingers feel cold E. Elevate the extremity on pillows for the first 24 to 48 hours after casting to prevent swelling F. Contact the health care provider if the child complains of numbness and tingling in the extremity

B. Keep small toys and sharp objects away from the cast E. Elevate the extremity on pillows for the first 24 to 48 hours after casting to prevent swelling F. Contact the health care provider if the child complains of numbness and tingling in the extremity

The nurse is monitoring a child for bleeding after surgery for removal of a brain tumor. The nurse checks the head dressing for the presence of blood and notes a colorless drainage on the back of the dressing. Which intervention should the nurse perform immediately? A. Reinforce the dressing B. Notify the HCP C. Document the findings and continue to monitor D. Circle the area of drainage and continue to monitor

B. Notify the HCP CSF!!!

The peds nurse specialist provides a teaching session to the nursing staff regarding osteosarcoma. Which statement made by a member of the nursing staff indicates a need for further info? A. The femur is the most common site of this sarcoma B. The child does not experience pain at the primary tumor site C. Limping, if weight-bearing limb is affected, is a clinical manifestation D. The symptoms of the disease in the early stage are almost always attributed to normal growing pains

B. The child does not experience pain at the primary tumor site

A 4 yo is admitted to the hospital for abdominal pain. The mother reports that the child has been pain and excessively tired and is bruising easily. On physical exam, lymphadenopathy and hepatosplenomegaly are noted. Diagnostic studies are being performed on the child because ALL is suspected. The nurse understands that which diagnostic study should confirm this diagnosis? A. Platelet count B. Lumbar puncture C. Bone marrow biopsy D. WBC count

C. Bone marrow biopsy