HC2B Exam 4
Which outcome criterion would the nurse develop for a child with CF who has ineffective airway clearance related to increased pulmonary secretions and inability to expectorate? A) Respiratory rate and rhythm within expected range B) Absence of chills and fever C) Ability to engage in age-related activities D) Ability to tolerate usual diet without vomiting
A) Respiratory rate and rhythm within expected range
A patient is scheduled to take Pancreatin. When will you administer this medication to the patient? A) Right before all meals and snacks B) Right before meals only C) Immediately after meals and snacks D) Immediately after meals only
A) Right before all meals and snacks
The nurse determines that teaching about the correct use of a Boston brace to treat scoliosis has been effective if the child and family state they will remove the brace at which times? A) When bathing, for about 1 hour per day B) While eating, for a total of 3 hours a day C) During school, for about 8 hours a day D) When sleeping, for a total of 10 hours a day
A) When bating, for about 1 hour per day
A child has RSV. What should the nurse advise the parents to do? SATA. A) Use a cool mist vaporizer B) Offer a soft-to-liquid diet C) Administer amoxicillin D) Administer acetaminophen E) Place the child on secretion precautions
A, B, D
When assessing an adolescent for scoliosis, what should the nurse ask the client to do? A) Bend forward at the waist with arms hanging freely B) Lie flat on the floor and extend the legs straight from the trunk C) Sit in a chair while lifting the feet and lefts to a right angle with the trunk D) Stand against a wall while pressing the length of the back against the wall
A) Bend forward at the waist with arms hanging freely
When should a child receive the first dose of the Hepatitis B vaccine? A) Birth B) 2 months C) 4 months D) 6 months
A) Birth
Which of the following actions can be delegated to the unlicensed assistive personnel (UAP) for a patient with cystic fibrosis? A) Charting daily weights and intake and output B) Increasing O2 during an episode of desaturation C) Instructing the parents on the correct administration of NS nebulizers D) Administering pancreatic enzymes from the home supply with each snack
A) Charting daily weights and intake and output
The nurse assesses the family's ability to cope with the child's cerebral palsy. Which action should alert the nurse to the possibility of their inability to cope with the disease? A) Limiting interaction with extended family and friends B) Learning measures to meed the child's physical needs C) Requesting teaching about cerebral palsy in general D) Seeking advice on coping on social media
A) Limiting interaction with extended family and friends
To slow the progression of the curvature, the preadolescent with scoliosis is fitted with a brace. How should the nurse respond to the parents' questions about when the brace will no longer be needed? A) After cessation of bone growth B) After the curvation has straightened C) When the iliac crests are equal levels D) When pain-free after prolonged standing
A) After cessation of bone growth
Which factor, if described by the parents of a child with cystic fibrosis (CF), indicates that the parents understand the underlying problem of the disease? A) An abnormality in the body's mucus-secreting glands B) Formation of fibrous cysts in various body organs C) Failure of the pancreatic ducts to develop properly D) Reaction to the formation of antibodies against streptococcus
A) An abnormality in the body's mucus-secreting glands
A child with cystic fibrosis is receiving gentamicin. Which nursing action is most important? A) Monitoring intake and output B) Obtaining daily weights C) Monitoring the client for indications of constipation D) Obtaining stool samples to test for occult blood
A) Monitoring intake and output
The parents of a young infant have arrived for a well child visit. The nurse begins the interview and notices that the mother becomes extremely anxious with the interview questions. Since blocks to communication can adversely effect the child's care, the nurse must look for and recognize clues that indicate communication may be less than optimal. The possible blocks to communication that may interfere with a successful interview during the well child visit are shown below. SATA. A) Long periods of silence before answering a question B) Sudden, frequent interruptions during the interview C) Concern is raised about the child's' feeding schedule D) Nervous habits that distract from the interview E) Questions are asked by both the mother and father
A, B, D
A 4 year old is scheduled for routine immunizations. As the nurse you know the physician will most likely order what vaccinations? A) DTaP (diphtheria, Tetanus, Pertussis) B) Polio C) Hepatitis B D) RV (Rotavirus) E) MMR (Measles, Mumps, Rubella) F) Hib (Haempophilus Influenzae Type B) G) Varicella
A, B, E, G
A teaching care plan to prevent transmission of RSV should include which information? SATA. A) The virus can be spread by direct contact B) The virus can be spread by indirect contact C) Palivizumab is recommended to prevent RSV for all toddlers in daycare D) The virus is typically contagious for 3 weeks E) Older children seldom spread RSV F) Frequent hand washing helps reduce the spread of RSV
A, B, F
Which GI comorbidities might you see in a patient with CF? SATA. A) Constipation B) Celiac disease C) Rectal prolapse D) Meconium ileus E) Chronic Vomiting
A, C, D
Select the systems below that are affected by cystic fibrosis: A) Reproductive B) Lymphatic C) Respiratory D) Gastrointestinal E) Neuro F) Integumentary
A, C, D, F
You're providing care to an 18-year-old male who has cystic fibrosis. Select all the possible complications this patient can experience due to cystic fibrosis: A) Blood glucose 255 mg/dL B) Hearing disturbances C) Hemoptysis D) Greasy, foul smelling stools E) Weight gain F) Meconium ileus G) Excessive mucus production H) Dyspnea I) Coughing J) Hyperoxemia K) Infertility
A, C, D, G, H, I, K
A patient with cystic fibrosis is diagnosed with pancreatic insufficiency. As the nurse you know that the patient will be lacking: SATA. A) Amylase B) Pepsin C) Protease D) Maltase E) Lipase
A, C, E
An infant is being treated for RSV at home. What should the nurse teach the parent about home care? SATA. A) Offering small amounts of fluids B) Allowing the infant to sleep in prone position C) Calling the clinic if the infant vomits D) Writing down how much the infant drinks E) Performing chest physiotherapy every 4 hours F) Watching for difficulty breathing
A, F
A school-age client with CF asks the nurse what sports she can become involved in as she becomes older. What is the best information for the nurse to provide about sports and CF? A) "The best sport is one that you will enjoy and do regularly." B) "Swimming is the best exercise for anyone with cystic fibrosis." C) "You should avoid contact sports where you might experience a blow to the chest." D) "Indoor sports have lower risks if infection than outdoor sports."
B) "Swimming is the best exercise for anyone with cystic fibrosis."
You're providing a free educational clinic to new moms about immunizations. You inform the attendees that the Measles, Mumps, and Rubella (MMR) vaccine is given? A) At 6 and 12 months B) 12 months and 4-6 years C) At 4 and 6 months D) At 2 and 12 months
B) 12 months and 4-6 years
At what age does a child starting receiving a yearly flu vaccine? A) 12 months B) 6 months C) 2 months D) 24 months
B) 6 months
A mother calls the pediatric clinic to ask when her daughter will receive the Varicella vaccine. Your answer to her question is: A) At 2, 4, and 6 months B) At 12 months and 4-6 years C) At 6 and 12 months D) At 4 months and 4-6 years
B) At 12 months and 4-6 years
When developing the plan of care for a child with CF who is scheduled to receive postural drainage, the nurse should anticipate performing postural drainage at which times? A) After meals B) Before meals C) After rest periods D) Before inhalation treatments
B) Before meals
What toy should the nurse include as part of a recreational therapy plan of care for a 3-year-old child hospitalized with pneumonia and cystic fibrosis? A) 100-piece jigsaw puzzle B) Child's favorite doll C) Fuzzy stuffed animal D) Scissors, paper, and paste
B) Child's favorite doll
During a developmental screening, the nurse finds that a toddler with cerebral palsy has arrested social and language development. What should the nurse tell the family? A) "This is a sign the cerebral palsy is progressing." B) "Your child has reached his maximum language abilities." C) "I need to refer you for more developmental testing." D) "We need to modify your therapy plan."
C) "I need to refer you for more developmental testing."
You're assisting a patient with performing chest physiotherapy. It is very important you have the patient ___________ during the therapy sessions. A) Bear down B) Use the incentive spirometer C) Huff cough D) Use a peak flow meter
C) Huff cough
In preparation for discharge, the nurse teaches the mother of an infant diagnosed with RSV about the condition and its treatment. Which statement by the mother indicates successful teaching? A) "I need to be sure to take my child's temperature every day." B) "I hope I do not get a cold from my child." C) "Next time my child gets a cold I need to listen to the chest." D) "I need to wash my hands more often."
D) "I need to wash my hands more often."
The nurses assessment of a 6-month-old infant brought to the outpatient clinic reveals a respiratory rate of 52 breaths/min, retractions, and wheezing. The mother states that her infant was doing fine until yesterday. Which action would be most appropriate? A) Administer a nebulizer treatment B) Send the infant for a chest x-ray C) Refer the infant to the emergency department D) Provide teaching about cold care to the mother
C) Refer the infant to the emergency department
A 13-year-old adolescent is diagnosed as having idiopathic scoliosis. Because exercise and avoidance of fatigue are essential components of care, which sport should the nurse suggest will be most therapeutic for this preadolescent? A) Golf B) Bowling C) Swimming D) Badminton
C) Swimming
A pediatric client with scoliosis has to wear a brace. The nurse should develop a teaching plan with the client to include which instruction? A) Wear the brace during waking hours B) Use lotions to relieve skin irritations C) Wear a form-fitting t-shirt under the brace D) Bathe the skin under the brace oncer per week
C) Wear a form-fitting t-shirt under the brace
During a routine pediatric visit, a 2 month old patient will need which of the following vaccines? SATA. A) MMR (Measles, Mumps, Rubella) B) Hepatitis A C) Hepatitis B D) DTaP (Diphtheria, Tetanus, Pertussis) E) Hib (Haemophilus Influenzae Type B) F) Varicella G) Polio H) RV (Rotavirus) I) PCV (Pneumococcal Conjugate Vaccine)
C, D, E, G, H, I
A child with CF has been admitted to the pediatric unit. What type of diet should the nurse request for the client? A) High-fat, high-carbohydrate B) High-calorie, high-protein C) High-calorie, high-carbohydrate D) High-carbohydrate, high-protein
B) High-calorie, high-protein
The nurse assesses the results of a gentamicin trough blood level for an adolescent with CF who has been treated with gentamicin several times over the last year. The drug level is high. What is the nurse's primary concern? A) The child may develop liver dysfunction B) The child may suffer hearing loss C) The medication may have been administered incorrectly D) The child may need to have a different antibiotic
B) The child may suffer hearing loss
A child with spastic cerebral palsy is to receive botulinum toxin Type A injections. Which treatment goals should the healthcare team set for the child related to botulinum toxin? SATA. A) Improved nutritional status B) Decreased pain from spasticity C) Improved motor function D) Enhanced self-esteem E) Reduced caregiver strain F) Decreased speech impediments
B, C, D, E
The parent asks the nurse whether a child with hemiparesis due to spastic cerebral palsy will be able to walk normally because he can pull himself to a standing position. Which response by the nurse would be most appropriate? A) "Ask your healthcare provider what he or she thinks at your next appointment." B) "Being able to pull to a stand really only tells us his upper-body strength is good." C) "It's difficult to predict, but his ability to bear weight is a positive factor." D) "If he really wants to walk, and works hard, he probably will eventually."
C) "It's difficult to predict, but his ability to bear weight is a positive factor."
A charge nurse is making assignments for a group of children on a pediatric unit. Which client should the nurse most avoid assigning the same nurse caring for a 2-year-old with RSV? A) An 18-month-old with RSV B) A 9-year-old 8 hours post appendectomy C) A 1-year-old with a heart defect D) A 6-year-old with sickle cell crisis
C) A 1-year-old with a heart defect
The parent of a child with spastic cerebral palsy and a communication disorder tells the nurse, "He seems so restless. I think he is in pain." Which action is most indicated? A) Assess the child for pain using the faces, legs, activity, cry, consolability (FLACC) scale B) Assess the child for pain using the pediatric FACES scale C) Administer prescribed pain medication D) Notify the healthcare provider of the change in behavior
C) Administer prescribed pain medication
An adolescent with cystic fibrosis has been hospitalized several times. On the latest admission, the client has labored respirations, fatigue, malnutrition, and failure to thrive. Which initial nursing actions are most important? A) Placing the client on bed rest and obtaining a prescription for blood gas analysis B) Implementing a high-calorie, high-protein, low-fat, vitamin-enriched diet and pancreatic granules C) Applying an oximeter and initiating respiratory therapy D) Inserting an IV line and initiating antibiotic therapy
C) Applying an oximeter and initiating respiratory therapy
A parent brings a 3-month-old infant to the clinic, reporting that the infant has a cold, is having trouble breathing, and "just does not seem to be acting right." Which action should the nurse take first? A) Check the infant's heart rate B) Weigh the infant C) Assess the infant's oxygen saturation D) Obtain more information from the parent
C) Assess the infant's oxygen saturation
A new mother asks if her infant will receive any vaccinations before they leave the hospital. The nurse knows which of the following immunizations is administered before the newborn is discharged home? A) Vitamin K B) DTaP C) Hepatitis B D) Hepatitis A
C) Hepatitis B
A 2 year-old patient with cystic fibrosis is scheduled to take Pancrelipase. How will you administer this medication? A) Orally with yogurt B) Orally with pudding C) Orally with applesauce D) Orally with ice cream
C) Orally with applesauce
A client with CF asks you, "Will I be able to have children when I grow up?" While keeping his age in mind (13-years-old), which these would be the best response? A) "You should discuss this with your parents. I will let them know you asked." B) "Most males have a significant chance of being sterile, and you won't need to consider use of contraception." C) "CF does not affect the male reproductive system; however, it does affect the female reproductive tract." D) "Although nearly 95% of males are sterile, you should discuss this with your physician and family."
D) "Although nearly 95% of males are sterile, you should discuss this with your physician and family."
You review the drugs that have been ordered to treat a client with CF for a suspected infection. You are orienting a new nurse. Which statement would you question as you review the ordered medications with her? A) "I have assessed for possible allergies or hypersensitivities." B) "I will need to monitor serum levels for some of theses medications." C) "I will verify dosage and medication compatibility with the pharmacy." D) "I will obtain a blood glucose level before administering the medications."
D) "I will obtain a blood glucose level before administering the medications."
The nurse conducts a developmental screening of a 15-month-old child with cerebral palsy. Which milestones would a nurse expect a typically developing toddler of this age to have achieved? A) Walking up steps B) Using a spoon C) Copying a circle D) Putting a block in a cup
D) Putting a block in a cup
Cystic fibrosis is an autosomal recessive genetic disorder. Which option below best describes what most likely happens for a child to develop this condition? A) One parent, who is a carrier of the mutated gene, has to pass it to the child B) One of the parents has to have cystic fibrosis in order to pass it to their offspring C) Both of the parents must have cystic fibrosis in order for the child to develop it D) Both parents, who are carriers of the mutated gene, each pass one mutated gene to the child
D) Both parents, who are carriers of the mutated gene, each pass one mutated gene to the child
The physician gives an order for a patient with cystic fibrosis to use a positive expiratory pressure (PEP) device to help with airway clearance. As the nurse you will order which device from supply: A) Incentive spirometer B) Bipap C) Peak flow meter D) Flutter valve
D) Flutter valve
You're educating the parents of an 8-month-old, who was recently diagnosed with cystic fibrosis, about the disease. You explain to the parents that the child has a gene mutation on the ____________. The gene that is specifically mutated is called? A) Endocrine glands; Hbg S gene B) Exocrine glands; CFTR gene C) Endocrine glands; Chromosome 21 D) Exocrine glands; HTT gene
B) Exocrine glands; CFTR gene
A child with CF does not like taking a pancreatic enzyme supplement with meals and snacks. The parent does not like to force the child to take the supplement. What is the most important reason for the child to take the pancreatic enzyme supplement with meals and snacks? A) The child will become dehydrated if the supplement is not taken with meals and snacks B) The child needs these pancreatic enzymes to help the digestive system absorb fats, carbohydrates, and proteins C) The child needs the pancreatic enzymes to aid in liquefying mucus to keep the lungs clear D) The child will experience severe diarrhea if the supplement is not taken as prescribed
B) The child needs these pancreatic enzymes to help the digestive system absorb fats, carbohydrates, and proteins
Which strategy is appropriate to manage GI dysfunction that patients with CF often experience? SATA. A) Restrict fat intake B) Encourage high-protein diet C) Encourage snacks between meals D) Administer fat-soluble vitamins daily E) Hold proton pump inhibitor or H2 blocker F) Breastfeeding is contraindicated in infants with CF G) Administer pancreatic enzymes with meals and snacks
B, C, D, G
You're discussing nutrition with your patient who has cystic fibrosis. You explain that it is very important the patient regularly takes fat-soluble vitamins. SATA. A) Vitamin B B) Vitamin D C) Vitamin C D) Vitamin K E) Vitamin E F) Vitamin A
B, D, E, F
The nurse assesses a parent's understanding of cerebral palsy. The nurse determines that the parent has an accurate understanding of cerebral palsy when she describes it as term applied to impaired movement resulting from which factor? A) Injury to the cerebrum caused by viral infection B) Malformed blood vessels in the ventricles caused by inheritance C) Non-progressive brain damage caused by injury D) Inflammatory brain disease caused by metabolic imbalances
C) Non-progressive brain damage caused by injury
About one hour after eating a meal, your patient, who has cystic fibrosis, starts to experience abdominal pain and bloating. Then two hours later the patient has a bowel movement. The patient's stool appears to be greasy and have a foul odor. Which medication below that is being taken by the patient is not providing a desirable outcome for this patient and needs to be re-addressed by the physician? A) Guaifenesin B) Triamcinolone C) Pancrelipase D) Polyethylene Glycol
C) Pancrelipase
When teaching the child with scoliosis being treated with a Boston brace about exercises, the nurse explains that the exercises are performed for primarily what reason? A) To decrease back muscle spasms B) To improve the brace's traction effect C) To prevent spinal contractures D) To strengthen the back and abdominal muscles
D) To strengthen the back and abdominal muscles
