Exam2 forreal

5. The nurse is performing a routine pediatric assessment on an 11-year-old student who is being medicated for ADHD. The parent reports disruptive behavior and acting out both at school and at home. The parent asks about a possible medication increase. Which information is the most important for the nurse to acquire? 1. Whether the student is having problems sleeping 2. How often the student is getting medication 3. The student's weight and level of appetite 4. The student's perception of medication effects

2. How often the student is getting medication

18. A 17-year-old patient with influenza tells the nurse, "I can't believe I got sick. I've been taking vitamin C, vitamin D, echinacea, and some other herbal remedies to boost my immune system." Which should the nurse say in response to this patient? Select all that apply. 1. "You probably weren't taking enough of the supplements." 2. "Those supplements help with focus and attention, not disease prevention." 3. "The safe use of supplements and herbs has not been determined." 4. "The vitamins you were taking may have reduced the effectiveness of the herbs." 5. "The effectiveness of supplements and herbs against influenza has not been determined."

3. "The safe use of supplements and herbs has not been determined." 5. "The effectiveness of supplements and herbs against influenza has not been determined."

19. The nurse is writing teaching material about caring for a child with influenza. Which information should the nurse include? Select all that apply. 1. Zanamivir is only prescribed for children over 13 years old. 2. Only one antiviral has been approved by the FDA as of 2017. 3. Tamiflu can be given to children older than one on weight-based dosing. 4. Manifestations of the flu include fever, chills, headache, and myalgia (aching). 5. Medications for influenza must be given within 48 hours of the onset of symptoms.

3. Tamiflu can be given to children older than one on weight-based dosing. 4. Manifestations of the flu include fever, chills, headache, and myalgia (aching). 5. Medications for influenza must be given within 48 hours of the onset of symptoms.

14. A parent brings a child who is 8 years of age to the pediatric clinic and tells the nurse, "I think he has Tourette's syndrome. He recently began some eye-blinking and grimacing actions." Which information does the nurse provide to help the parent distinguish between transient tic of childhood and Tourette's syndrome? 1. Vocal tics frequently become chronic in children with transient tic of childhood diagnosis. 2. Transient tic of childhood begins with a high level of tic activity and usually disappears completely by age 12. 3. Tourette's syndrome is a disorder of complex motor and vocal tics that have been present for more than 1 year. 4. Tourette's syndrome is a disorder of complex motor and vocal tics that develop between the ages of 3 to 8 years.

3. Tourette's syndrome is a disorder of complex motor and vocal tics that have been present for more than 1 year.

8. The nurse is providing care for an infant with an inner ear infection. The nurse is aware that the condition has occurred multiple times in a 3-month period. Which comment by the parent indicates to the nurse that specific teaching is needed regarding the incidences of infection? 1. "I now put her to bed with a bottle." 2. "I clean her ears with cotton swabs." 3. "She likes her ears submerged while bathing." 4. "Her older brother brings colds home from school."

1. "I now put her to bed with a bottle."

19. The nurse is conducting a class for parents of children with asthma. After covering the topic of asthma triggers, the nurse asks for feedback on the information. Which statements indicate the parents understand actions to reduce asthma triggers? Select all that apply. 1. "I think that we will need to stop using the fireplace." 2. "We will be rethinking the possibility of a family pet." 3. "Now may be the time for relocating to a warmer climate." 4. "No more going outside without a mask from now on." 5. "Reorganizing our schedules will definitely reduce stress."

1. "I think that we will need to stop using the fireplace." 2. "We will be rethinking the possibility of a family pet." 5. "Reorganizing our schedules will definitely reduce stress."

9. A parent of an adolescent tells the nurse, "He had some bad habits as a child, but now he is in trouble with the law for destruction of property, stealing, and hurting animals. I think his ODD is getting worse." Which comment by the nurse is accurate? 1. "Your son has developed conduct disorder." 2. "Increasing his ADHD medication may help." 3. "Right now he needs your feedback and support." 4. "There are lawyers that specifically help troubled teens."

1. "Your son has developed conduct disorder."

2. The nurse in the newborn unit of a pediatric hospital is providing care for a neonate born at 34 weeks' gestation. The nurse is aware that the immediate risk to the neonate is which condition? 1. A lack of a phospholipid in the alveoli 2. Inability to maintain body temperature 3. Delay in closure of cardiac foramen 4. A decrease in renal function

1. A lack of a phospholipid in the alveoli

19. A parent brings an infant to the pediatric clinic and expresses concern about irritability and poor feeding, along with recent symptoms of flu lasting a few days. The nurse notices multiple raised mosquito bites on the infant. Which additional knowledge causes the nurse to suspect encephalitis? Select all that apply. 1. A recent local outbreak of West Nile fever 2. Bulging fontanels when in a quiet state 3. Signs of facial and eyelid weakness 4. Loss of deep tendon reflexes 5. Drooling instead of swallowing saliva

1. A recent local outbreak of West Nile fever 2. Bulging fontanels when in a quiet state

4. The nurse at a pediatric clinic is gathering assessment information on a school age patient who is 9 years of age. The mother expresses concern about a recent habit of handwashing to "get rid of germs." Which recommendation by the nurse is appropriate? 1. Allow the child to complete each session of handwashing. 2. Assign tasks to the child that involves putting hands in water. 3. Interrupt the handwashing by moving the child away from the sink. 4. During the handwashing, ask the child about worries and concerns.

1. Allow the child to complete each session of handwashing.

8. A third-grade teacher discusses behavioral problems with a student. The teacher states, "He walks around class making horrible sucking noises. He does not respond to me." Which information does the nurse seek from the student's parents? 1. Ask if the student has been tested by a physician for seizure disorder. 2. Inquire if the student is either diagnosed or medicated for ADHD. 3. Ascertain if the student has experienced recent illness or a fever. 4. Suggest the student be screened for possible developmental delays.

1. Ask if the student has been tested by a physician for seizure disorder.

8. The nurse is caring for a 15-year-old patient who has been diagnosed with mononucleosis. The patient asks how the infection was obtained. Which information should the nurse include when responding to the patient? 1. Drinking from the cup of a person with the infection 2. Eating contaminated food 3. Eating meat that is undercooked 4. Inhaling airborne germs, such as after someone coughs

1. Drinking from the cup of a person with the infection

15. The nurse is interviewing an adolescent patient 17 years of age who was diagnosed with cystic fibrosis (CF) as an infant. The patient shares feelings of frustration about needing to always live with parents. Which information provided by the nurse is likely to be most important to the patient? 1. How chest physiotherapy (CPT) can be performed independently 2. The availability of home meal delivery to those needing a therapeutic diet 3. Organizations that will provide transportation for persons with chronic illness 4. A list of social organizations available for young persons who have special needs

1. How chest physiotherapy (CPT) can be performed independently

20. A parent brings an adolescent who is 16 years of age to the pediatric clinic, because the patient is experiencing unusual sensations in the feet. The nurse learns the patient was diagnosed with type 1 diabetes mellitus as a toddler; glucose levels have always been erratic and difficult to control. Which assessment findings does the nurse expect based on the health history? Select all that apply. 1. Inability to identify a sharp or blunt sensation on the sole of the foot 2. Feet warm to the touch and capillary refill within normal limits 3. Problems with balance when standing without support 4. Toe nails smooth in appearance and nail beds pink in color 5. Signs of weakness during neuromuscular checks to the lower legs

1. Inability to identify a sharp or blunt sensation on the sole of the foot 3. Problems with balance when standing without support 5. Signs of weakness during neuromuscular checks to the lower legs

12. The nurse is discussing a child's diagnosis of autism (ASD) with the child's parents. The parents tell the nurse the child is completely resistant to any type of stimulation. The nurse suspects sensory processing disorder and will recommend which intervention? 1. Make a rocking horse or trampoline available to the child. 2. Place colored lights and automated toys in the child's room. 3. Set specific times of day when the child is held and cuddled. 4. Child-appropriate music is played throughout the day.

1. Make a rocking horse or trampoline available to the child.

15. A school-age child is diagnosed with hand, foot, and mouth disease. Which should the nurse instruct the parent to do when caring for the patient at home? Select all that apply. 1. Provide bland foods and fluids. 2. Offer generous amounts of oral fluids. 3. Wash clothes with hot soapy water and bleach. 4. Use acetaminophen or ibuprofen for pain control. 5. Instruct to flush the mouth with an alcohol-based mouthwash.

1. Provide bland foods and fluids. 2. Offer generous amounts of oral fluids. 4. Use acetaminophen or ibuprofen for pain control.

20. A teacher in an elementary school voices concerns to the school nurse about a student in her second-grade class. The student has recently become withdrawn from adults but constantly tries to please the teacher. Today the teacher saw bruises around his neck. Which plan does the school nurse develop and implement? Select all that apply. 1. Talk to child alone in the school clinic about any pain or concerns. 2. Inspect the back, chest, and legs in the presence of the principal. 3. Report possible child abuse with assessment findings to proper authorities. 4. Call the parents and report that authorities have been notified of abuse. 5. Develop a trusting rapport with the child.

1. Talk to child alone in the school clinic about any pain or concerns. 2. Inspect the back, chest, and legs in the presence of the principal. 3. Report possible child abuse with assessment findings to proper authorities. 5. Develop a trusting rapport with the child.

4. The nurse is presenting a class to high school females about decreasing the developmental risks related to pregnancy. Which information does the nurse consider to be most important? 1. Young women should begin taking 600 mg of calcium twice a day. 2. All females of child-bearing age should take 0.4 mg of folic acid daily. 3. Early prenatal care is essential for a healthy pregnancy and baby. 4. Important fetal development occurs before pregnancy is suspected.

2. All females of child-bearing age should take 0.4 mg of folic acid daily.

13. The nurse is providing care for a female adolescent at an in-patient facility for persons with eating disorders. The adolescent's current weight is less than 85% of ideal body weight. The adolescent appears to be unexpectedly agreeable with the interventions being implemented for weight gain. Which is an important intervention for the nurse to perform? 1. Eat with the client in order to demonstrate adequate intake. 2. Closely monitor the adolescent's bathroom behavior. 3. Allow the adolescent to select the flavor of nasogastric (NG) tube feedings. 4. Provide information about the effects of malnutrition on the body.

2. Closely monitor the adolescent's bathroom behavior.

17. The nurse in a pediatric unit is providing care for a 2-month-old infant just diagnosed with spinal muscle atrophy. Which characteristics of the condition does the nurse expect to find during physical assessment? Select all that apply. 1. Hyperreflexia in deep tendons 2. Few spontaneous movements 3. Deep, rapid respirations 4. Fasciculations of the tongue 5. Proximal muscle atrophy

2. Few spontaneous movements 4. Fasciculations of the tongue

14. The parents of three children aged 4, 6, and 9 years are preparing to travel abroad as missionaries. The children are in good health and up to date for immunizations; however, the parents are concerned about the high level of TB in the area to which they are assigned. Which recommendation does the nurse make for the protection of the children? 1. Protect the children with good nutrition. 2. Have the children receive the BCG vaccine. 3. Arrange for monthly TB testing for the family. 4. Start the children on preventive medication.

2. Have the children receive the BCG vaccine.

6. A toddler who is 2 years old is playing in the playroom at the hospital and suddenly begins to choke and cough. The nurse attending the toddler places the child in which position to dislodge a possibly inhaled object? 1. Head down and on the left side 2. Head down and on the right side 3. Head horizontal to the floor and supine 4. Head in a neutral position and prone

2. Head down and on the right side

1. A parent brings a 2-month-old baby in for a routine wellness examination. Which vaccination should the nurse prepare to administer to this patient? 1. Hepatitis A 2. Hepatitis B 3. Inactivated poliovirus 4. Measles, mumps, rubella

2. Hepatitis B

11. Parents bring a toddler who is 2-1/2 years old to the hospital because of observed difficulty with breathing. In addition, they share that at bedtime the toddler has a barky cough. The toddler is diagnosed with laryngotracheobronchitis, commonly referred to as croup. Which assessment finding does the nurse expect related to the diagnosis? 1. Fever accompanied by a congested cough 2. Inspiratory stridor heard in the upper airway 3. Elevated temperature and diaphoresis 4. Snoring sounds throughout respirations

2. Inspiratory stridor heard in the upper airway

19. The nurse at a pediatric clinic notices a female high school student has had extensive dental work and is currently exhibiting additional dental caries. The nurse also identifies the bilateral existence of Russell's sign. Based on these findings, for which comorbid manifestation will the nurse assess the student? Select all that apply. 1. Frequent absenteeism from school 2. Issues with overspending 3. Thoughts of suicide 4. Presence of cutting activity 5. Casual sexual encounters

2. Issues with overspending 3. Thoughts of suicide 4. Presence of cutting activity 5. Casual sexual encounters

13. The pediatric nurse is examining the skin of a young child and notices eight café-au-lait spots between 1.5 and 3 inches in diameter on the body, along with axillary freckling. Which recommendation does the nurse make to the parent? 1. Refrain from having additional children without counseling. 2. Make an appointment with a physician for testing and evaluation. 3. Agree to blood testing of the child to identify a defect in the NF1 gene. 4. Arrange for psychological therapy to address self-esteem problems.

2. Make an appointment with a physician for testing and evaluation.

1. The pediatric nurse is reviewing anatomy and physiology in order to have a better understanding of the pediatric respiratory system. The nurse is aware that fluid in the chest cavity can be normal. Which application of this knowledge is correct? 1. Pleural fluid is abundant at birth and decreases over the lifetime. 2. Only enough fluid is present to promote painless movement. 3. Fluid will accumulate in the plural cavity from immobility. 4. Infections such as pneumonia cause fluid in the plural cavity.

2. Only enough fluid is present to promote painless movement.

13. A 6-year-old patient is being assessed by the pediatrician for breathing difficulties. The pediatrician expresses a need for diagnostic tests to identify or rule out asthma. Which tests does the nurse anticipate ordering? 1. Throat culture 2. Pulmonary function tests 3. Electrocardiogram 4. Peak flow meter

2. Pulmonary function tests

17. The nurse is providing postoperative teaching to the parents of a preschool child after a tonsillectomy. For which events does the nurse prompt the parents to contact the physician? Select all that apply. 1. The child keeps an emesis basin close by. 2. The child is frequently swallowing without food or fluids. 3. Bright red blood is noticed in the child's mouth. 4. The child is asking for ice chips and popsicles. 5. The child refuses pain pills because it hurts to swallow.

2. The child is frequently swallowing without food or fluids. 3. Bright red blood is noticed in the child's mouth. 5. The child refuses pain pills because it hurts to swallow.

12. The nurse on a pediatric acute care unit is providing care for an infant who is 11 months of age. The infant is diagnosed with a lower respiratory infection that produces large amounts of thick secretions the infant cannot cough up. When planning to suction the infant, which factor is important to remember? 1. The parents are likely to become angry about the procedure. 2. The infant will respond negatively to a temporary loss of breath. 3. The nurse should apologize after the procedure for stress related to the procedure. 4. The nurse should have assistance to immobilize the infant during the procedure.

2. The infant will respond negatively to a temporary loss of breath.

20. A parent with a school-age child with mumps asks for information about the illness and treatment. Which information should the nurse provide? Select all that apply. 1. "There is no need to isolate the child." 2. "There are no laboratory tests to detect the mumps virus." 3. "Sometimes the complications of mumps involve the testicles." 4. "Mumps are seen by observation of swelling around the ears and jaw." 5. "Provide food and drink that is nonirritating to the mouth and surrounding glands."

3. "Sometimes the complications of mumps involve the testicles." 4. "Mumps are seen by observation of swelling around the ears and jaw." 5. "Provide food and drink that is nonirritating to the mouth and surrounding glands."

15. The nurse works in a facility where treatment of adolescents with addiction issues is the focus. A 14-year-old patient is being admitted for treatment of cocaine dependence. Which information does the nurse provide relative to the patient's withdrawal? 1. Acute symptoms of withdrawal last for 2 to 3 weeks. 2. The patient will be sedated throughout most of the process. 3. After acute withdrawal some symptoms may become chronic. 4. Close monitoring is important due to life-threatening symptoms.

3. After acute withdrawal some symptoms may become chronic.

14. A school-age child is brought to the clinic to be evaluated for a headache and stomachache. For which reason should the nurse prepare the patient to have a rapid strep test? 1. Runny nose 2. Productive cough 3. Strawberry tongue 4. Jaundiced conjunctiva

3. Strawberry tongue

7. The nurse in a pediatric clinic is assessing an infant who is 3 months old during a well-baby visit. Which assessment finding will be of greatest concern to the nurse? 1. The infant mouth breathes when crying. 2. The infant's eardrums are pink in color. 3. The infant exhibits 15-second periods of apnea. 4. The infant's respiratory rate is fast and irregular.

3. The infant exhibits 15-second periods of apnea.

5. The nurse is performing well-baby checks in a pediatric clinic. During physical examination of a 1-month-old infant, the nurse notices a dimple with a tuft of hair in the lumbar sacral area indicative of spina bifida. Which developmental delays does the nurse expect for this infant? 1. There may be issues related to bowel and bladder control. 2. Some degree of paralysis of the lower limbs is expected. 3. The infant is not expected to experience physical delays. 4. Muscles of the legs will be flaccid with some sensory loss.

3. The infant is not expected to experience physical delays.

12. The nurse is providing care for a pediatric patient who received a concussion while playing football. The patient had brief loss of consciousness and now reports a headache with a pain level of 6 on a 0 to 10 scale. The patient states, "My team plays again in five days and I should be better." Which information is vital for the patient and parents to understand? 1. A realistic timeframe regarding complete recovery 2. Type of equipment to prevent a second head injury 3. The risk of acquiring second impact syndrome 4. The potential for long-term headaches

3. The risk of acquiring second impact syndrome

4. A parent brings his school-age child to the clinic for a rash that developed over the face, trunk, and extremities. Which question should the nurse ask the parent when assessing the patient? 1. "Has the child been nauseated or has the child vomited?" 2. "How often is the child given acetaminophen, or Tylenol?" 3. "Has the child eaten any food that was not properly cooked?" 4. "Was the child exposed to anyone with a respiratory infection?"

4. "Was the child exposed to anyone with a respiratory infection?"

8. A parent brings a toddler to a pediatric clinic for advice about dealing with a fear of water. The parent shares that the toddler screams and throws a tantrum if anyone attempts to get him into a pool. The nurse also learns of an incident when the toddler was pushed into a pool. Which recommendation will the nurse make to help the toddler overcome this phobia? 1. Make sure the toddler has a safe flotation device. 2. Talk calmly as the toddler is taken slowly into the pool. 3. Plan recreation activities that do not involve water. 4. Allow the toddler to decide his own approach to the pool.

4. Allow the toddler to decide his own approach to the pool.

3. The nurse is performing a developmental assessment on a toddler at age 3 years. The nurse notices a variety of mixed developmental milestones that have been missed during the visit. Which delay does the nurse expect to be of greatest concern to the parent? 1. Difficulty putting small objects into a bottle 2. An inability to kick a ball back to the nurse 3. Difficulty with and reluctance to self-dress 4. An inability to express needs with language

4. An inability to express needs with language

1. The nurse is assessing a 7-year-old child at a pediatric clinic. The nurse notices that several developmental milestones have been missed or are late during previous visits. The parent states, "I know she is a little slow, but she will catch up quickly." Which action by the nurse is warranted? 1. Explain to the parent that rapid development takes place in infancy and early childhood. 2. Suggest activities in the home that may improve mental and physical development. 3. Recommend that the child be placed in special classes aimed at promoting development. 4. Ask the parent detailed questions about the pregnancy, birth, and early childhood health.

4. Ask the parent detailed questions about the pregnancy, birth, and early childhood health.

6. The nurse in the newborn nursery is providing care for a neonate with an open spinal cord defect. The neonate will be transported to a pediatric surgery hospital as soon as possible. Which description of the nurse's care of the neonate is correct? 1. Using aseptic technique, place a sterile plastic bag around the defect and loosely tie it closed. 2. Place the newborn prone on a loose diaper and cover the defect with a second saline-moistened diaper. 3. Position the newborn on the side with a moistened dressing on the defect; wrap the defect and newborn in a blanket. 4. Cover the defect with a sterile dressing moistened with warm sterile normal saline, using aseptic technique.

4. Cover the defect with a sterile dressing moistened with warm sterile normal saline, using aseptic technique.

10. The nurse is providing care for an infant at 3 months of age. The parent reports sudden flexor or extensor movements of the neck, trunk, and extremities occurring multiple times a day. The infant is diagnosed with infant spasms and is prescribed corticotropin (Acthar jell) therapy. Which instruction is most important for the nurse to provide for the parent? 1. Reason for weekly laboratory visits 2. Expected medication side effects 3. Signs and symptoms of infections 4. How to administer IM medication

4. How to administer IM medication

5. The pediatric nurse is preparing a teaching plan for new mothers with small infants. Which is a key point for the nurse to include in the teaching plan? 1. Infants are obligatory mouth breathers for the first month. 2. All sinuses are formed and aerating within 2 months of birth. 3. Infants are abdominal breathers until they are 12 months old. 4. Infant airways get blocked more easily than those in older children.

4. Infant airways get blocked more easily than those in older children.

15. The pediatric nurse in an acute care facility is providing care for a patient who is 12 years of age with a history of sickle cell anemia. During this hospitalization, it is determined that the patient has experienced a stroke. Which teaching is most important for the nurse to provide to the patient and parents? 1. A need for intensive physical and speech therapies 2. Reasons to have a designated social worker 3. The necessity for an individualized education plan 4. Manifestations of increased intracranial pressure

4. Manifestations of increased intracranial pressure

10. The nurse in an acute care pediatric facility is preparing to assume care of multiple patients at the change of shift. Which patient will the nurse plan to assess first? 1. The toddler who exhibits clubbing of the fingertips 2. The preschooler with pneumonia who has poor skin turgor 3. The infant who can sleep only with the head of the bed elevated 4. The infant who prefers a tripod position instead of lying down

4. The infant who prefers a tripod position instead of lying down

6. The nurse is providing care for a student who was involved in a school violence incidence. The student becomes agitated and angry on the anniversary of the event. Which action by the nurse is most helpful to the student? 1. Administer the physician-prescribed dose of propranolol (Inderal). 2. Gently and quietly try to verbally and physically soothe the student. 3. Call for a psychotherapist to come and assist the student with PTSD. 4. Offer verbal support and encourage the student to express feelings.

4. Offer verbal support and encourage the student to express feelings.

11. A nurse is caring for a school-age child who has inflammation of the right eye. Which finding, if present, would indicate to the nurse that the child has bacterial conjunctivitis rather than viral conjunctivitis? 1. Eye swelling 2. Red conjunctiva 3. Watery discharge 4. Purulent drainage

4. Purulent drainage

13. A parent brings her school-age child to the physician's office for evaluation of a sore throat, fever, headache, and fine red rough rash over both arms and abdomen. For which health problem should the nurse plan care for this patient? 1. Croup 2. Tonsillitis 3. Epiglottitis 4. Scarlet fever with strep throat

4. Scarlet fever with strep throat

What are rales? A.Fine cracking noises heard on inspiration B.Low-pitched sounds heard throughout respiration C.High-pitched sounds heard on inspiration in the upper airway D.High-pitched musical sounds heard throughout respiration

A.Fine cracking noises heard on inspiration Rales are fine cracking noises heard on inspiration. The other options refer to rhonchi, stridor, and wheezes.

With microcephaly, the head circumference is more than ____ standard deviations ____ average. A.two; below B.two; above C.three; below D.three; above

A.two; below •With microcephaly, the head circumference is more than two standard deviations below average for the child's age, sex, race, and period of gestation.

What theory of personality disorders describes the patient as stuck at a developmental age of about 7 years old? A. Biological/neurochemical B. Determined/intentional C. Cognitive/behavioral D. Psychodynamic/developmental

D. Psychodynamic/developmental •Psychodynamic/developmental theory describes someone with a personality disorder as stuck in a developmental age of about 7 years old.

20. The nurse in a pediatric clinic is assessing a toddler brought in by a parent who states, "I have noticed some increasing incidents of coughing and wheezing over the last few weeks." Auscultation by the nurse reveals some adventitious breath sounds in the upper right lobe. Which questions does the nurse ask the parent? Select all that apply. 1. "Have you noticed any missing small toys?" 2. "How often is the child allowed to self-feed?" 3. "Is there an older child who gives this child food?" 4. "Can you recall a specific time of gagging or cyanosis?" 5. "Have you noticed any foreign objects in the child's stool?"

1. "Have you noticed any missing small toys?" 3. "Is there an older child who gives this child food?" 4. "Can you recall a specific time of gagging or cyanosis?"

3. A new mother contacts the health-care provider's office to ask for guidance regarding a change in the infant's health. For which reason should the nurse direct the mother to seek immediate medical attention? 1. Difficult to arouse 2. Wetting six diapers a day 3. Breastfeeding every 3 hours 4. Sleeping for several hours in the afternoon

1. Difficult to arouse

6. A parent arrives at the family clinic seeking medical attention for his 14-year-old child. The child has a fever, malaise, nausea, and abdominal pain. Which finding should indicate to the nurse that the patient is experiencing hepatitis A? 1. Elevated serum bilirubin 2. Greater than 10% atypical lymphocytes 3. Presence of the virus in nasal secretions 4. Positive Paul-Bunnell heterophile antibody test

1. Elevated serum bilirubin

17. An adolescent is diagnosed with mononucleosis. Which teaching should the nurse provide to the parents when providing care at home? Select all that apply. 1. Encourage ample fluids. 2. Avoid all contact sports for 6 to 8 weeks. 3. Encourage rest with quiet activities and play. 4. Limit the amount of caloric intake until recovered. 5. Provide ibuprofen or acetaminophen for elevated temperature.

1. Encourage ample fluids. 2. Avoid all contact sports for 6 to 8 weeks. 3. Encourage rest with quiet activities and play. 5. Provide ibuprofen or acetaminophen for elevated temperature.

7. The nurse is caring for a school-age patient diagnosed with hepatitis A. For which reason should the nurse begin implementing contact precautions for this patient? 1. Incontinent of feces 2. Evidence of dehydration 3. Development of dark urine 4. Severe nausea and vomiting

1. Incontinent of feces

18. The NICU nurse is providing care for a neonate exhibiting manifestations of congenital Zika syndrome. Which distinct features does the nurse associate with the syndrome? Select all that apply. 1. Partially collapsed skull 2. Decreased brain tissue 3. Damage to the back of the eyes 4. Multiple joint contractures 5. Agitated body movement

1. Partially collapsed skull 2. Decreased brain tissue 3. Damage to the back of the eyes 4. Multiple joint contractures 5. Agitated body movement

2. The nurse is assessing a 4-month-old infant during a routine well-baby visit. During the neurological assessment, which finding is a reason for concern? 1. When the cheek is brushed, the head is turned toward the stimuli. 2. Toes fan out when the sole of the food is stroked upward. 3. Placing a small object in the palm inconsistently elicits a grasp. 4. A light puff of air in the face causes the eyes to close.

1. When the cheek is brushed, the head is turned toward the stimuli.

11. The nurse is collecting information about a school-age patient brought to a pediatric clinic by a parent. The parent reports several incidences of syncope. Which assessment question helps the nurse to identify a possible diagnosis of vasovagal syncope? 1. "Has your daughter been diagnosed with diabetes mellitus?" 2. "Did your child feel strange and faint after standing up?" 3. "Was your child in a stressful situation before fainting?" 4. "Does your daughter have any cardiac conditions?"

2. "Did your child feel strange and faint after standing up?"

16. The nurse is visiting the home of a patient with hepatitis B who is 1 week postpartum. Which information should the nurse include when teaching this patient? Select all that apply. 1. "Hepatitis B is only transmitted through sexual contact." 2. "The baby may have contracted hepatitis B through the pregnancy." 3. "There are no medications appropriate for children with hepatitis B." 4. "After the baby has received treatment, there is no need for follow-up." 5. "The baby should have received the hepatitis B immunization and hepatitis B immune globulin."

2. "The baby may have contracted hepatitis B through the pregnancy." 5. "The baby should have received the hepatitis B immunization and hepatitis B immune globulin."

7. The nurse is gathering health information on a child who is 8 years of age. The parent reports the child is extremely difficult to wake in the morning. Which other information will prompt the nurse to recommend screening for a sleep disorder? 1. The bedroom is shared with a sibling. 2. The nurse validates the child is obese. 3. There is a TV in the child's bedroom. 4. It is difficult to get the child to bed.

2. The nurse validates the child is obese.

10. An older patient with weeping lesions caused by herpes zoster asks if a trip to visit small grandchildren can still occur this upcoming weekend. Which should the nurse say to the patient in response? 1. "There is no reason for you to cancel your trip." 2. "You should not travel until all of the lesions are healed." 3. "Be sure to keep the lesions covered until they crust over." 4. "As long as the lesions are kept uncovered, you can travel without any issues."

3. "Be sure to keep the lesions covered until they crust over."

1. The nurse is performing a well-baby check on an infant at 6 months of age. The mother shares that the infant sometimes seems unhappy. Which question is most important for the nurse to ask the mother? 1. "Is it easy to make the baby laugh if he seems unhappy?" 2. "Can you cheer him up by playing with his favorite toys?" 3. "Do you ever remember feelings of being depressed or sad?" 4. "Are you noticing any problems with him eating or sleeping?"

3. "Do you ever remember feelings of being depressed or sad?"

16. The nurse in the emergency department of a pediatric hospital is providing care for a toddler with a sudden high fever. The parent states, "She has been grumpy all day and I thought she just needed a nap." Which finding does the nurse recognize as an indication of an immediate medical emergency? 1. The toddler keeps eyes closed or covered at all times. 2. The nurse elicits a positive Brudzinski's sign. 3. A rash of scattered red bumps is found on the skin. 4. The toddler cries when head and neck are moved.

3. A rash of scattered red bumps is found on the skin.

11. The nurse in a pediatric emergency department is providing care for a school-age child with first- and second-degree burns to the hands and arms. The parent states, "She is so fascinated with the color and movement of the flames; she just got too close." For which reason does the nurse recommend psychotherapy for this child? 1. The child is exhibiting an inability to recognize danger. 2. The child does not obey instructions to stay away from matches. 3. The child may have excessive interest in or attraction to fire. 4. The child is likely to repeat the behavior and cause worse injuries.

3. The child may have excessive interest in or attraction to fire.

7. The school nurse is called to attend to a child who is 10 years of age. The teacher reports the child panicked when asked to present a verbal book report to the class. Which intervention will the nurse initiate with the child? 1. Take the child to the clinic and report the event to the parents. 2. Place the child on a clinic bed and allow some alone time. 3. Walk with the child in the hallway and provide reassurance. 4. Join the teacher in attempting to find the source of panic.

3. Walk with the child in the hallway and provide reassurance.

5. A school-age patient with rubella is placed in droplet precautions. Which action should the nurse take when implementing these precautions? 1. Use a mask with a HEPA filter. 2. Instruct to cough into the hands. 3. Wear a mask when providing care. 4. Assign to a negative air pressure room.

3. Wear a mask when providing care.

2. The nurse learns that a 16-year-old patient has not received the human papilloma virus vaccine (HPV-Gardasil). Which should the nurse explain to the patient at this time about the vaccination? 1. "The complete vaccine can be given today." 2. "You can wait a few years before needing the vaccination." 3. "A dose can be given today with the final dose in 6 months." 4. "A dose should be given today with follow-up doses in 1 to 2 months, and the last in 6 months."

4. "A dose should be given today with follow-up doses in 1 to 2 months, and the last in 6 months."

9. An adolescent develops a fever, cough, and a maculopapular rash. Which question should the nurse ask when completing the health history with this patient? 1. "Did you receive any vaccinations recently?" 2. "Do you usually eat cold pizza left on the counter overnight?" 3. "Do you forget to wash your hands after using the bathroom?" 4. "Have you been around anyone with a cold over the last 3 weeks?"

4. "Have you been around anyone with a cold over the last 3 weeks?"

14. A middle-school teacher notifies the school nurse of a student who sleeps in class, smells of alcohol, and exhibits behavior impairment. The student tells the nurse, "I drink too much and want to quit, but I keep failing." Which recommendation does the nurse make to the student? 1. "You may be the perfect candidate for attending AA meetings." 2. "Many young people benefit from individual and group therapy." 3. "Maybe you need a few days at home to see if you can quit on your own." 4. "I am suggesting you and your parents see a doctor who can help."

4. "I am suggesting you and your parents see a doctor who can help."

3. The nurse is attending a high school sports event when a student suddenly stands and shouts, "I need to get out of here—get me out!" Which intervention by the nurse is most appropriate at this time? 1. Attempt to calm the student with quiet breathing and relaxation. 2. Identify the events that led to the student's behaviors. 3. Look for the student's parents and ask about the behavior. 4. Assist the student to a quiet place and remain with the student.

4. Assist the student to a quiet place and remain with the student.

16. The nurse is presenting a program to the parents of school-age children about prescription drug abuse among adolescents. Which information does the nurse provide to parents about preventing their children from abusing prescription drugs? 1. Most drugs are obtained cost free from friends or family members. 2. The abused drugs are not commonly found in the normal household. 3. Adolescents are at great risk for life-threatening effects from these drugs. 4. Withdrawal from this type of drug can be managed by the adolescent's family.

1. Most drugs are obtained cost free from friends or family members.

9. The school nurse is present at a school assembly when a student falls to the floor with a seizure. Which intervention does the nurse initiate when providing care to the student during the seizure? 1. Protect the student from injury related to seizure movement. 2. Remove or loosen any tight clothing around the neck or waist. 3. Provide comfort and promote resting in a quiet environment. 4. If incontinent, cover the student with a blanket or sheet.

1. Protect the student from injury related to seizure movement.

16. The nurse is providing teaching to the parent of a toddler 2 years of age diagnosed with otitis media. The toddler presented with a fever of 100.9°F (38.3°C) and does not indicate symptoms related to pain. Which information does the nurse give the parent when the physician orders 48 to 72 hours of supportive care? Select all that apply. 1. Provide age-appropriate analgesics as needed. 2. Administer all of the prescribed antibiotic. 3. Support hydration with fluid increases. 4. Monitor temperature and report increases. 5. Apply topical steroid preparations as instructed.

1. Provide age-appropriate analgesics as needed. 3. Support hydration with fluid increases. 4. Monitor temperature and report increases.

17. The nurse is providing care for a preschool child who is 4 years of age. The child is being treated for horrific abuse that occurred in the home since the child was an infant. Which comments by the child indicate to the nurse a possible dissociative disorder? Select all that apply. 1. "Someday I will live with grandma." 2. "If it hurts, I will just go away." 3. "I have a friend who always stays with me." 4. "I want a really big lunch and dinner." 5. "I can be invisible if they get mad at me."

2. "If it hurts, I will just go away." 3. "I have a friend who always stays with me." 5. "I can be invisible if they get mad at me."

what are clonic movements? A. Sustained rigid postures B. Bilateral rhythmic jerking of the extremities C. Muscle contractions causing twisting movements of the muscle groups, resulting in abnormal postures D. Muscle contractions resulting in quick, rhythmic movements that resemble dancing movements

B. Bilateral rhythmic jerking of the extremities Clonic movements involve a bilateral rhythmic jerking of the extremities.

Which of the following is an appropriate nursing intervention for a patient with OCD? A. Interrupt the child's ritual to slow increasing anxiety B. Instruct the child on how to complete thought stopping C. Refer for cognitive-behavioral or exposure therapy D. Reassure the child that you will not leave

B. Instruct the child on how to complete thought stopping •Appropriate nursing interventions for a child with obsessive-compulsive disorder include: §Do not interrupt the ritual, as this will make the child more anxious. §Instruct the child on how to complete thought stopping—child becomes aware of the thoughts and tries to stop them §Relaxation techniques §Cue cards

12. The nurse is providing care to an 8-week-old infant who has symptoms of an upper respiratory infection. Which assessment finding should indicate to the nurse that the patient is experiencing pertussis? 1. An expiratory wheeze 2. A "whoop" sound after coughing 3. Three wet diapers each day 4. Bulging fontanelles

2. A "whoop" sound after coughing

3. The nurse is providing care for an infant who is 2 months old. Which assessment finding will cause the nurse to suspect an upper respiratory infection? 1. A raspy cry and occasional cough 2. Adventitious lung sounds bilaterally 3. A stuffy nose and reddened eardrums 4. A fever, lethargy, and skin pallor

3. A stuffy nose and reddened eardrums

9. The nurse in a pediatric clinic is performing assessments on multiple infants. Which infant does the nurse recognize as being at greatest risk for a respiratory disorder? 1. The infant born at 36 weeks who exhibited respiratory problems at birth 2. The infant who was born at term and recently adopted from another country 3. The infant who sleeps all night, exhibits eczema, and has a family history of asthma 4. The infant with recurrent sore throats and both pets and smokers in the house

4. The infant with recurrent sore throats and both pets and smokers in the house

10. The nurse is counseling a parent of a child diagnosed with ADHD. The parent states, "He is now also diagnosed with oppositional defiant disorder (ODD). I don't know what to do." Which information does the nurse provide for the parent? 1. The fact that 40% to 60% of children with ADHD also have ODD. 2. The importance of not showing emotional reactions to the behaviors. 3. How to remain consistent with consequences related to ODD behaviors. 4. The need and availability of parent training for behavior management.

4. The need and availability of parent training for behavior management.

2. The school nurse in a middle school is aware of a student who takes lithium for a bipolar disorder type 1. Which observation by the nurse will indicate a need for a laboratory test? 1. The student is exhibiting multiple signs of mania. 2. The student gets a bathroom pass during every class. 3. The student shoved other students at lunch and in the hall. 4. The student is exhibiting signs of a respiratory infection.

4. The student is exhibiting signs of a respiratory infection.

18. Parents of an adolescent female are concerned about the adolescent's recent, rapid weight loss. Nursing assessment reveals the adolescent to be below the ideal weight for her height and age. Which questions will the nurse ask to help identify an eating disorder? Select all that apply. 1. "How much weight have you lost in the past 3 months?" 2. "What words would you use to describe your body right now?" 3. "Do you have a sports activity causing you to exercise excessively?" 4. "Can you tell me some of your daily thoughts about food?" 5. "Would you consider yourself to be a good student at school?"

2. "What words would you use to describe your body right now?" 3. "Do you have a sports activity causing you to exercise excessively?" 4. "Can you tell me some of your daily thoughts about food?"

18. The nurse is caring for a newborn diagnosed with esophageal atresia and tracheoesophageal fistula. Which information does the nurse provide to the parents? Select all that apply. 1. Prenatal conditions that contribute to the problem 2. The manifestation supporting the diagnosis 3. Diagnostic tests performed since the birth 4. Methods of treating the condition 5. Actions for promoting recovery

2. The manifestation supporting the diagnosis 3. Diagnostic tests performed since the birth 4. Methods of treating the condition 5. Actions for promoting recovery

4. The nurse is providing care for a school-age patient who received a head injury while playing sports. Which initial assessment finding causes the nurse greatest concern? 1. Confusion and disorientation 2. Headache with periods of nausea 3. Immediate loss of consciousness 4. Changes in breathing and heart rates

4. Changes in breathing and heart rates

What is subglottic stenosis? A.A congenital laryngeal cartilage abnormality in which the tissue is soft and floppy, collapsing in on itself B.Viral inflammation of the glottis and subglottic region C.The narrowing of the airway within the rigid cricoid cartilage D.The rapidly progressing inflammation of the larynx and epiglottis

C.The narrowing of the airway within the rigid cricoid cartilage Subglottic stenosis is the narrowing of the airway within the rigid cricoid cartilage. The other options refer to laryngomalacia, laryngotracheitis, and epiglottitis.