Exam 3
The nurse is doing a neurologic assessment on a child whose level of consciousness has been variable since sustaining a cervical neck injury 12 hours ago. Which of the following is the most essential in this assessment? a. Reactivity of pupils b. Doll's head maneuver c. Oculovestibular response d. Funduscopic examination to identify papilledema
a. Reactivity of pupils
What is the most common piece of medical equipment that can transmit harmful microorganisms among patients? a. Thermometer b. Stethoscope c. Injection needle d. Disposable gloves
b. Stethoscope
Which of the following is the appropriate site to administer an intramuscular (IM) vaccine to a newborn? a. The dorsal gluteal muscle b. The vastus lateralis muscle c. The ventral gluteal muscle d. The biceps muscle
b. The vastus lateralis muscle
The parent of a child receiving an iron preparation tells the nurse that the child's stools are a tarry green color. The nurse should explain that this is a(n) a. symptom of iron deficiency anemia. b. adverse effect of the iron preparation. c. indicator of an iron preparation overdose. d. normally expected change resulting from the iron preparation.
d. normally expected change resulting from the iron preparation.
An important nursing consideration when caring for a child with sickle cell anemia is which of the following? a. Refer the parents and child for genetic counseling. b. Teach the parents and child how to recognize the signs and symptoms of crises. c. Help the child and family adjust to a short-term disease. d. Observe for complications of multiple blood transfusions.
b. Teach the parents and child how to recognize the signs and symptoms of crises.
If the mother of a child is hepatitis B surface antigen (HBsAg) negative, the nurse knows that the child should receive his or her first dose of the hepatitis B virus (HBV) vaccine at a. 2 months of age, at the first well-child visit. b. birth before discharge from the hospital. c. 6 months of age, at the third well-child visit. d. no time (this vaccine is not currently recommended).
b. birth before discharge from the hospital.
Strict isolation is required for a child who is hospitalized with a. mumps. b. chickenpox. c. exanthema subitum (roseola). d. erythema infectiosum (fifth disease).
b. chickenpox.
When applying wet compresses or dressings to the skin, the nurse should do which of the following? a. Apply the dressing so that the area is totally immobilized. b. Apply the dressing when it is saturated and dripping. c. Pour or syringe new solution over a dressing that has become dry. d. Apply desired solution on cotton gauze or soft cotton cloths, such as clean handkerchiefs.
d. Apply desired solution on cotton gauze or soft cotton cloths, such as clean handkerchiefs.
The nurse should recommend medical attention if a child with a slight head injury experiences which of the following? a. Vomiting b. Sleepiness c. Headache, even if slight d. Confusion or abnormal behavior
d. Confusion or abnormal behavior
You are caring for a child with hydrocephalus who is postoperative from a shunt revision. Which assessment findings is your priority for increased intracranial pressure a. Nausea and refusal to eat postoperatively b. Complain of a headache c. Irritability and wanting to sleep d. Decrease in heart rate over the last hour
d. Decrease in heart rate over the last hour
The nurse is explaining blood components to an 8-year-old child. The nurse's best description of platelets is that they do which of the following? a. Make up the liquid portion of blood b. Help keep germs from causing infection c. Carry the oxygen you breathe from your lungs to all parts of your body d. Help your body stop bleeding by forming a clot (scab) over the hurt area
d. Help your body stop bleeding by forming a clot (scab) over the hurt area
Which of the following factors promote(s) wound healing? a. Antiseptics b. Eschar formation c. Dry wound environment d. Moist, crust-free wound environment
d. Moist, crust-free wound environment
You are caring for a child on the pediatric unit with a suspected abdominal tumor. Which criteria would lead you to determine this tumor is a neuroblastoma rather than a Wilms tumor? a. Most children present with neuroblastoma around age 4 b. Neuroblastoma is a firm, contender, irregular masss confined to one side, generally deep in the flank c. Hypertension is often noted due to secretion of excess amounts of rennin by the tumor d. Most tumors develop in the adrenal gland or the retroperitoneal sympathetic chain
d. Most tumors develop in the adrenal gland or the retroperitoneal sympathetic chain
Why are infants particularly vulnerable to acceleration-deceleration head injuries? a. The anterior fontanel is not yet closed. b. The nervous tissue is not well developed. c. The scalp of the head has extensive vascularity. d. Musculoskeletal support of the head is insufficient.
d. Musculoskeletal support of the head is insufficient.
A Boy Scout sustains frostbite to his feet while out hiking in the mountains. Before he is transported to the nearest emergency treatment center, which of the following is important in managing his care? a. Gently rub his feet with hands. b. Wrap his feet in warm wet towels. c. Place his feet in hot water for 30 minutes. d. Prevent him from walking any farther.
d. Prevent him from walking any farther.
The parents of a child hospitalized with sickle cell anemia tell the nurse that they are concerned about narcotic analgesics causing addiction. The nurse should explain which of the following concerning narcotic analgesics? a. They are often ordered but not usually needed. b. When they are medically indicated, children rarely become addicted. c. They are given as a last resort because of the threat of addiction. d. They are used only if other measures, such as ice packs, are ineffective.
b. When they are medically indicated, children rarely become addicted.
The Hib conjugate vaccines protect an infant against which of the following diseases?SATA a. Bacterial meningitis b. Epiglottitis c. Bacterial pneumonia d. Septic arthritis e. Sepsis
All of the above
Which of the following best describes a neuroblastoma? a. The diagnosis is usually made after metastasis occurs. b. It is the most common brain tumor in young children. c. Older children have an improved likelihood of survival. d. Early diagnosis is usually possible because of the obvious clinical manifestations.
a. The diagnosis is usually made after metastasis occurs.
The nurse taking care of a 5 year old cancer patient with ulcerative stomatitis is getting ready to perform mouth care. Which of the following principles should be followed? SATA a. Due to pain of the stomatitis, viscous lidocaine should be used to swish the mouth three times a day b. A soft bland diet although not the favorite of the child will help with the pain c. Lemon glycerine swabs are helpful because they remind children of lemon drops d. Using a soft sponge type toothbrush will decrease the tendency for gums to bleed e. A solution of 1 tsp of baking soda and 1/2 tsp of table salt in 1 quart of water is helpful for mouth rinse
b. A soft bland diet although not the favorite of the child will help with the pain d. Using a soft sponge type toothbrush will decrease the tendency for gums to bleed e. A solution of 1 tsp of baking soda and 1/2 tsp of table salt in 1 quart of water is helpful for mouth rinse
At a visit to the pediatric clinic, a mother is concerned by her 4 year old's symptoms over the last few weeks. Which of the following symptoms described by the mother would lead the nurse to be concerned about an oncologic disorder? SATA a. Bruising in various stages, mainly on the legs b. Frequent complaints of respiratory infections, while siblings remain healthy c. Enlarged firm lymph nodes d. Asthma symptoms with increase in wheezing e. Fever for more than 1 week
b. Frequent complaints of respiratory infections, while siblings remain healthy c. Enlarged firm lymph nodes e. Fever for more than 1 week
Ringworm, frequently found in schoolchildren, is caused by which of the following? a. Virus b. Fungus c. Allergic reaction d. Bacterial infection
b. Fungus
One of the most common intestinal parasitic pathogens in the United States acquired from a contaminated water source such as a lake or swimming pool is a. Tinea capitis b. Giardia intestinalis c. Pediculosis capitus d. Enterbiasis
b. Giardia intestinalis
A child is brought to the emergency department after experiencing a seizure at school. He has no history of seizures. The father tells the nurse that he cannot believe the child has epilepsy. The nurse's best response is which of the following? a. "Epilepsy is easily treated." b. "Very few children have actual epilepsy." c. "The seizure may or may not mean that your child has epilepsy." d. "Your child has had only one convulsion; it probably won't happen again."
c. "The seizure may or may not mean that your child has epilepsy."
A child is admitted to the pediatric unit. The mother reports that the doctor says her son is anemic. What laboratory findings/manifestations would the nurse expect to see to confirm iron deficiency anemia? a. Cyanosis b. A decreased reticulocyte count c. A total iron binding capacity that is elevated above the normal range d. Decreased blood pressure changes, which are an early sign because of the compensatory mechanisms
c. A total iron binding capacity that is elevated above the normal range
Which of the following pediatric oncologic emergencies is caused by the rapid release of intracellular metabolites during the initial treatment of some cancers? a. Hyperleukocytosis b. Overwhelming infection c. Acute tumor lysis syndrome d. Superior vena cava syndrome
c. Acute tumor lysis syndrome
The nurse is admitting a young child to the hospital because bacterial meningitis is suspected. Which of the following is a priority of nursing care? a. Initiate isolation precautions as soon as diagnosis is confirmed. b. Provide environmental stimulation to keep the child awake. c. Administer antibiotic therapy as soon as it is available. d. Administer sedatives and analgesics on a preventive schedule to manage pain.
c. Administer antibiotic therapy as soon as it is available.
A 9 year old child in the ED is diagnosed with Lyme disease. The nurse anticipates that the HPC orders will include the administration of a. Cefotaxime b. Aqueous penicillin c. Doxycycline d. Trimethoprim-sulfamethoxazole
c. Doxycycline
The school nurse is caring for a child with hemophilia who fell on his arm during recess. Which of the following supportive measures should the nurse do until factor replacement therapy can be instituted? a. Apply warm, moist compresses. b. Apply a tourniquet for at least 5 minutes. c. Elevate the arm above the level of the heart. d. Begin passive range of motion unless pain is severe.
c. Elevate the arm above the level of the heart.
Which childhood vaccine provides protection against streptococcal infections such as otitis media, sinusitis, and pneumonia? a. Rotavirus vaccine b. Hib vaccine c. Pneumococcal vaccine d. MMR vaccine
c. Pneumococcal vaccine
An important role of the nurse in ambulatory settings and schools is the identification of communicable diseases for treatment and the prevention of spread. An important component is the recognition of which of the following aspects of the disease? a. Source b. Causative agent c. Prodromal stage d. Constitutional symptoms
c. Prodromal stage
The nurse understands that respiratory hygiene and cough etiquette is recommended by the Centers for Disease Control and Prevention (CDC) to prevent which of the following? a. HBV, Hib, and pertussis b. HSV, influenza, and HBV c. RSV, influenza, and adenovirus d. RSV, pertussis, and varicella
c. RSV, influenza, and adenovirus
Which of the following should the nurse include when explaining how to manage pediculosis capitis? a. Cut hair shorter if infestation and nits are severe. b. Wash all nits out of hair with a regular shampoo. c. Remove nits with a fine-tooth comb or tweezers. d. Distinguish viable from nonviable nits and remove all viable ones.
c. Remove nits with a fine-tooth comb or tweezers.
The postoperative care of a preschool child who has had a brain tumor removed should include which of the following? a. Colorless drainage is to be expected. b. Analgesics are contraindicated because of altered consciousness. c. Positioning is on the operative side in the Trendelenburg position. d. Carefully monitor fluids because of cerebral edema.
d. Carefully monitor fluids because of cerebral edema.
You are the nurse assigned to care for a child with a basilar skull fracture. Your most important nursing observation is change in level of consciousness. You will be highly alert for a. Alterations in vital signs that often appear before alterations in consciousness or focal neurologic signs b. Bleeding from the ear, which is indicative of an anterior basal skull fracture c. Seizures that are relatively uncommon in children at the time of head injury d. Changes in posturing, such as any signs of extension or flexion posturing, unusual response to stimuli, and random versus purposeful movement
d. Changes in posturing, such as any signs of extension or flexion posturing, unusual response to stimuli, and random versus purposeful movement
The school nurse is discussing prevention of acquired immunodeficiency syndrome with some adolescents. Which of the following is appropriate to include? a. The virus is easily transmitted. b. It is only transmitted through blood. c. Condoms should be used if adolescents are homosexual. d. Recreational drug users should not share needles or other equipment.
d. Recreational drug users should not share needles or other equipment.
You are working with a family that drouth their child into the pediatric clinic. The mother describes what may be a type of seizure. What subjective data will help you determine the type? SATA a The presence or absence of an aura b. If the child appeared disoriented after the seizure c. Presence of vomiting after the seizure d. The duration of the seizure e. If the seizure was related to certain foods or occurred after a certain activity
a The presence or absence of an aura b. If the child appeared disoriented after the seizure d. The duration of the seizure
The hepatitis A vaccine is now recommended at which of the following ages? a. 1 year b. 1 month c. 12 years d. It is not recommended at any age.
a. 1 year
Care of the child with a wound includes which of the following? SATA a. Applying occlusive dressings, such as hydrocolloid dressings. Dressings adhere best if a wide margin is left around the wound and the dressing is gently pressed against intact skin until it adheres b. The safest solution for cleansing and loosening sticky dressings is normal saline c. To remove a transparent or hydrocolloid dressing use one hand to hold the skin to which the dressing is secured firmly then gently raise both edges of the dressing and pull the dressing away from the skin in a parallel direction d. Wounds covering a very large area need medical attention, with the child undergoing conscious sedation and analgesia e. Puncture wounds should initially be irrigated with sterile saline, then soaked in a basin of warm soapy water for several minutes before applying a clean dressing
a. Applying occlusive dressings, such as hydrocolloid dressings. Dressings adhere best if a wide margin is left around the wound and the dressing is gently pressed against intact skin until it adheres b. The safest solution for cleansing and loosening sticky dressings is normal saline e. Puncture wounds should initially be irrigated with sterile saline, then soaked in a basin of warm soapy water for several minutes before applying a clean dressing
The Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) and American College of Obstetricians and Gynecologists has recommended that pregnant adolescents and women who are not protected against pertussis receive the tetanus, diphtheria and pertussis (Tdap) vaccine optimally at which of the following times? a. Between 27 and 36 weeks of gestation or postpartum before discharge from the hospital b. During the first pre-natal visit when pregnancy is confirmed c. The vaccine should be administered 24 hours prior to delivery d. This vaccine is only recommended during the first trimester
a. Between 27 and 36 weeks of gestation or postpartum before discharge from the hospital
When determining the etiology of a skin problem, which of the following is essential to the diagnosis of the lesions? a. Careful inspection b. Skin products used c. Type of laundry detergent d. Whether the siblings have similar lesions
a. Careful inspection
A child has an evulsed (knocked out) tooth. The parents are reluctant to try to reimplant the tooth. What should the tooth be placed in for transport to the dentist? a. Cold milk b. Cold water c. A dry, clean jar d. Warm salt water
a. Cold milk
A good understanding of enuresis will help the nurse work with children and their famlies. Which of the following teaching points should be included? SATA a. Enuresis is primarily an alteration of neuromuscular bladder functioning and as such is benign and self limiting b. Spontaneous remission of nocturnal enuresis occurs in approximately 35% of cases c. Normal bladder capacity is the child's age plus 4; therefore, normal bladder capacity for a 6 year old is 10 ounces d. Success has also been achieved with desmopressin acetate nasal spray, which reduces nighttime urinary output to a volume less than functional bladder capacity e. Parents need reassurance that bed wetting is not a manifestation of emotional disturbance but just represents willful misbehavior
a. Enuresis is primarily an alteration of neuromuscular bladder functioning and as such is benign and self limiting d. Success has also been achieved with desmopressin acetate nasal spray, which reduces nighttime urinary output to a volume less than functional bladder capacity
Which of the following vaccinations are included in health promotion during infancy? SATA a. Haemophilus influenzae type b (Hib) b. Hepatitis C virus (HCV) c. Diphtheria, tetanus, and pertussis (DTaP) d. Poliovirus e. Hepatitis B virus (HBV)
a. Haemophilus influenzae type b (Hib) c. Diphtheria, tetanus, and pertussis (DTaP) d. Poliovirus e. Hepatitis B virus (HBV)
Which childhood vaccine provides some protection against bacterial meningitis, epiglottis, and bacterial pneumonia? a. Hib vaccine b. Hepatitis B vaccine c. Varicella vaccine d. Influenza vaccine
a. Hib vaccine
Which of the following is a clinical manifestation of increased intracranial pressure (ICP) in infants? a. Irritability b. Photophobia c. Vomiting and diarrhea d. Pulsating anterior fontanel
a. Irritability
A child with lymphoma is receiving extensive radiotherapy. Which of the following is the most common side effect of this treatment? a. Malaise b. Seizures c. Neuropathy d. Lymphadenopathy
a. Malaise
You are working with a family whose 7 yo has just been diagnosed with ADHD. which statements by the mother indicate a need for further teaching? SATA a. My child will respond best to verbal instructions, since that will help him learn to pay attention and listen intently b. A consistent schedule for homework and activities will help him be organized c. I need to bring him for routine checkups while he is taking his medication because the medication can affect his appetite and growth d. I am going to ask the principal if my son can change classrooms because his current teacher has too many rules and he seems to get in trouble e. We might consider counseling because this has been stressful for the whole family
a. My child will respond best to verbal instructions, since that will help him learn to pay attention and listen intently d. I am going to ask the principal if my son can change classrooms because his current teacher has too many rules and he seems to get in trouble
The most common signs and symptoms of leukemia related to bone marrow involvement are which of the following? a. Petechiae, fever, and fatigue b. Headache, papilledema, and irritability c. Muscle wasting, weight loss, and fatigue d. Decreased intracranial pressure, psychosis, and confusion
a. Petechiae, fever, and fatigue
You are working with a new graduate and explaining prevention of infection for a child with acute lymphocytic leukemia. Which statement by this new nurse indicates understanding? a. Prophylaxis against Pneumocystis pneumonia is routinely given to most children during treatment for cancer b. If blood is drawn, firm pressure should be applied to the area for a minimum of 10 minutes c. Having a roommate with a routine surgery would be acceptable for this child d. The child should be vaccinated completely to avoid childhood diseases
a. Prophylaxis against Pneumocystis pneumonia is routinely given to most children during treatment for cancer
The parents of a child with Hodgkin disease ask how the physician will know what type of cancer their child has. Which of the following definitive signs and symptoms should the nurse describe? SATA a. The most common finding is enlarged, firm, contender, movable nodes in the supraclavicular or cervical area b. Tests include completely blood count, prothrombin time and G6PD, erythropoietin, and sedimentation rate c. Generally a bone marrow biopsy is done to look for the presence of blast cells d. The presence of Sternberg Reed cells is considered diagnostic of Hodgkin disease e. The presence of a white reflection as opposed to the normal red pupillary reflex in the pupil of a child's eye is a classic sign
a. The most common finding is enlarged, firm, contender, movable nodes in the supraclavicular or cervical area d. The presence of Sternberg Reed cells is considered diagnostic of Hodgkin disease
Which of the following is an important nursing intervention in the care of a child with bacterial conjunctivitis? a. Warm, moist compresses to remove crusts b. Oral antihistamines to minimize itching c. Continuous warm compresses to relieve discomfort d. Optic corticosteroids to reduce inflammation
a. Warm, moist compresses to remove crusts
You are working with a recent graduate on the pediatric unit. You are assigned to take care of an adolescent with beta thalassemia. The nurse needs more information about this disease if she states which of the following? SATA a. We need to check the patient's iron level to make sure he is not anemic b. I believe this is most common in those of Hispanic descent although this patient is Mediterranean c. The doctor will be prescribing deferasirox or defoxamine for chelation therapy d. This patient looks much younger than I would expect. I guess he's just a late bloomer e. I think a transfusion will be ordered since his hemoglobin is 9.0
a. We need to check the patient's iron level to make sure he is not anemic b. I believe this is most common in those of Hispanic descent although this patient is Mediterranean d. This patient looks much younger than I would expect. I guess he's just a late bloomer
The term used to describe an abnormal sensation such as burning or prickling is a. paresthesia. b. hyperesthesia. c. hypesthesia. d. anesthesia.
a. paresthesia.
The change from the exclusive use of oral polio vaccine (OPV) to the exclusive use of inactivated poliovirus vaccine (IPV) related to the rare risk of vaccine-associated polio paralysis (VAPP) from OPV has resulted in which of the following? a. An increase in the risk of VAPP b. An increased number of injections and increased cost c. A better antibody conversion than the oral formulation d. A measureable decrease in immunity in the community
b. An increased number of injections and increased cost
You are discharging a patient with hemophilia. Which of the following responses by the parents indicate an understanding of this disorder? SATA a. My child should remain active to decrease joint problems and most children with hemophilia can participate in the same activities as peers b. Care should be taken to avoid bleeding of gums, and softening the toothbrush in warm water before brushing or using a sponge tipped disposable toothbrush may be helpful c. Signs of internal bleeding should be recognized, such as headache, slurred speech, loss of consciousness, and black tarry stools d. If there is bleeding in a joint, elevation, ice, and rest should help and may prevent the need for factor VIII replacement e. All of my son's teachers need to be aware of what to do if he gets a bloody nose
b. Care should be taken to avoid bleeding of gums, and softening the toothbrush in warm water before brushing or using a sponge tipped disposable toothbrush may be helpful c. Signs of internal bleeding should be recognized, such as headache, slurred speech, loss of consciousness, and black tarry stools e. All of my son's teachers need to be aware of what to do if he gets a bloody nose
Chelation therapy is begun on a child with α-thalassemia major. The purpose of this therapy is to do which of the following? a. Treat the disease. b. Eliminate excess iron. c. Decrease risk of hypoxia. d. Manage nausea and vomiting.
b. Eliminate excess iron.
The nurse is caring for a 2-year-old girl who is unconscious but stable after a car accident. Her parents are staying at the bedside most of the time. Which of the following is an appropriate nursing intervention? a. Suggest that the parents go home until she is alert enough to know they are present. b. Encourage the parents to hold, talk, and sing to her as they usually would. c. Use ointment on her lips but do not attempt to cleanse her teeth until swallowing returns. d. Position her with proper body alignment and the head of the bed lowered 15 degrees.
b. Encourage the parents to hold, talk, and sing to her as they usually would.
A child with sickle cell anemia is admitted in a vasoocclusive crisis. Which of the following interventions should the nurse expect to see ordered? SATA a. Cold compresses to painful joints b. IV fluids started, and oral fluids encouraged c. Meperidine ordered every 4 hours for pain d. High calorie high protein diet e. Antibiotics ordered for any existing infection
b. IV fluids started, and oral fluids encouraged d. High calorie high protein diet e. Antibiotics ordered for any existing infection
As a nurse caring for children, an understanding of childhood depression is essential. Some important information about depression inclues which of the following statements? SATA a. Authorities agree that childhood depression exists and the manifestations are similar to adult depression b. Identification of the depressed child requires a careful history taking (e.g. health, growth and development, social and family health) Interviews with the child; and observations by the nurse, parents, and teachers c. If antidepressants are prescribed, the child and family need to know that antidepressants must be at a therapeutic level for 4 to 6 weeks to achieve a beneficial effect d. Depressed children often exhibit a distinctive style of thinking characterized by low self-esteem, hopelessness, poor social engagement with peers, and a tendency to explain negative events in terms of personal shortcomings e. Nurses should be aware that depression is a problem that can be easily overlooked in the schoolage child and one that can interrupt normal growth and development
b. Identification of the depressed child requires a careful history taking (e.g. health, growth and development, social and family health) Interviews with the child; and observations by the nurse, parents, and teachers d. Depressed children often exhibit a distinctive style of thinking characterized by low self-esteem, hopelessness, poor social engagement with peers, and a tendency to explain negative events in terms of personal shortcomings e. Nurses should be aware that depression is a problem that can be easily overlooked in the schoolage child and one that can interrupt normal growth and development
You are working with a pediatric nurse who has just transferred to the pediatric clinic. You are role playing phone triage related to a child with a head injury. You ascertain that the nurse needs more teaching based on what response? a. After initial physical exam, if there was no loss of consciousness with the head injury, the can be observed at home b. If there is a language barrier, written instructions can be given, followed by discharge c. Another physical exam should take place in 1 or 2 days d. Parents should call the doctor if their child has any of these signs: blurred vision, walking unsteadily, or is hard to awaken
b. If there is a language barrier, written instructions can be given, followed by discharge
Which of the following is descriptive of attention-deficit/hyperactivity disorder (ADHD)? a. Manifestations exhibited are so bizarre that the diagnosis is fairly easy. b. Manifestations affect every aspect of the child's life but are most obvious in the classroom. c. Learning disabilities associated with ADHD eventually disappear when adulthood is reached. d. Diagnosis of ADHD requires that all manifestations of the disorder are present.
b. Manifestations affect every aspect of the child's life but are most obvious in the classroom.
When hemoglobin falls sufficiently to produce clinical manifestations, the signs and symptoms are caused by a. phagocytosis. b. tissue hypoxia. c. pulmonary hypertension. d. depressed bone marrow.
b. tissue hypoxia.
Which of the following is an important nursing consideration when caring for a child with impetigo contagiosa? a. Apply topical corticosteroids to decrease inflammation. b. Examine the child under a Wood lamp for possible spread of lesions. c. Thoroughly wash hands and maintain cleanliness when caring for an infected child. d. Carefully remove dressings so as not to dislodge undermined skin, crusts, and debris.
c. Thoroughly wash hands and maintain cleanliness when caring for an infected child.
A new nurse is caring for a child with a wound and asks you to remind her about the phases of wound healing. You describe the order as a. Contraction: Fibroblast movement causes contraction of the healing area, which helps to bring wound edges closer together b. Maturation: The scar becomes pale, does not tan when exposed to sunlight, will not sweat or produce hair, and may itch c. Inflammatory phase: Erythmea, heat, edema, pain, and functional disturbance occur d. Proliferation: Fibroblasts, immature connective tissue cells, migrate to the healing site and being to secrete collagen into the meshwork spaces
c. Inflammatory phase: Erythmea, heat, edema, pain, and functional disturbance occur d. Proliferation: Fibroblasts, immature connective tissue cells, migrate to the healing site and being to secrete collagen into the meshwork spaces a. Contraction: Fibroblast movement causes contraction of the healing area, which helps to bring wound edges closer together b. Maturation: The scar becomes pale, does not tan when exposed to sunlight, will not sweat or produce hair, and may itch
Which is the most accurate genetic explanation for a family with hemophilia? a. It is a Y linked dominant disorder b. It is equally distributed among males and females c. It is an X linked recessive disorder d. It is an autosomal recessive disorder
c. It is an X linked recessive disorder
Where are Wilms tumors (nephroblastomas) located? a. Bone b. Brain c. Kidney d. Lymphatic system
c. Kidney
Nursing considerations related to the administration of chemotherapeutic drugs include which of the following? a. Anaphylaxis cannot occur because the drugs are considered toxic to normal cells. b. Infiltration will not occur unless superficial veins are used for the intravenous infusion. c. Many chemotherapeutic agents are vesicants that can cause severe cellular damage if drug infiltrates. d. Good hand washing is essential when handling chemotherapeutic drugs, but gloves are not necessary.
c. Many chemotherapeutic agents are vesicants that can cause severe cellular damage if drug infiltrates.
As the nurse assigned to a child diagnosed with bacterial meningitis, you know that a. The child will not need to be placed in isolation because antibiotics have been started b. Enteric precautions will remain in place for up to 48 hours c. Respiratory isolation will remain in place for 24 hours after antibiotics are started d. Due to headache, the child will want the head of the bed elevated with 2 pillows
c. Respiratory isolation will remain in place for 24 hours after antibiotics are started
Which of the following should be used in the care of all pediatric patients to reduce the risk of transmission of microorganisms from both recognized and unrecognized sources of infection? a. Transmission based precautions b. Airborne precautions c. Standard precautions d. Droplet precautions
c. Standard precautions
A 12-month-old child presents to the clinic for a well visit after missing several appointments. The child began her immunization schedule but has missed several follow-up appointments and immunization doses. The nurse knows that the most appropriate action is what? a. The child must receive initial immunizations from the beginning. b. The child cannot receive missed immunizations if the schedule is not followed. c. The child should only receive the missed doses of immunizations. d. The child should receive double-strength immunizations at this well visit.
c. The child should only receive the missed doses of immunizations.
Which of the following is most descriptive of the therapeutic management of osteogenic sarcoma? a. Intensive irradiation is the primary treatment. b. Amputation of the affected extremity is rarely necessary. c. Treatment usually consists of surgery and chemotherapy. d. Bone marrow transplantation offers the best chance of long-term survival.
c. Treatment usually consists of surgery and chemotherapy.
The Glasgow Coma Scale consists of an assessment of a. pupil reactivity and motor response. b. level of consciousness and verbal response. c. eye opening and verbal and motor response. d. intracranial pressure and level of consciousness.
c. eye opening and verbal and motor response.
The nurse is caring for a child with multiple injuries who is comatose. The nurse should recognize that pain a. cannot occur if the child is comatose. b. may occur if the child regains consciousness. c. requires astute nursing assessment and management. d. is best assessed by family members who are familiar with the child.
c. requires astute nursing assessment and management.
A 3-year-old child is hospitalized after submersion injury. The child's mother complains to the nurse, "This seems unnecessary when he is perfectly fine." The nurse's best reply would be which of the following? a. "He still needs a little extra oxygen." b. "I'm sure he is fine, but the doctor wants to make sure." c. "It is important to observe for possible physical reasons for the accident." d. "The reason for hospitalization is that complications could still occur."
d. "The reason for hospitalization is that complications could still occur."
A child falls on the playground and has a small laceration on the forearm. The school nurse should do which of the following to cleanse the wound? a. Slowly pour hydrogen peroxide over the wound. b. Soak the arm in warm water and soap for at least 30 minutes. c. Gently cleanse the wound with a sterile pad and a nonstinging povidone-iodine solution. d. Rinse the wound with sterile water or saline using a syringe to generate mild pressure.
d. Rinse the wound with sterile water or saline using a syringe to generate mild pressure.
Matt's mother tells the nurse that he keeps scratching the areas where he has poison ivy. The nurse's response should be based on which of the following? a. Disturbing the lesions will cause the poison ivy to spread. b. After the lesions have formed, no further damage can be done. c. Poison ivy does not itch, so this needs further investigation. d. Scratching the lesions may cause them to become secondarily infected.
d. Scratching the lesions may cause them to become secondarily infected.
The nurse suspects a child is having an adverse reaction to a blood transfusion. The first action by the nurse should be which of the following? a. Notify the physician. b. Take the vital signs and blood pressure and compare them with baseline levels. c. Dilute infusing blood with equal amounts of normal saline. d. Stop transfusion and maintain a patent intravenous line with normal saline and new tubing.
d. Stop transfusion and maintain a patent intravenous line with normal saline and new tubing.
Which vaccine do the CDC and American College of Obstetricians and Gynecologists recommend that pregnant adolescents and women who are not protected against pertussis receive optimally between 27 and 36 weeks gestation or postpartum prior to discharge from the hospital? a. DTaP b. Td c. IPV d. Tdap
d. Tdap
Chemotherapeutic drugs to treat cancer are often given in combination because a. the drugs can be given by various routes. b. the drugs can be given at different times during the day. c. patients cannot tolerate extremely high doses of single drugs. d. he drugs allow for optimum cell destruction with minimum toxic effects.
d. he drugs allow for optimum cell destruction with minimum toxic effects.