HESI pedi exam
An 8-year-old girl with precocious sexual development is being treated medically with injections of luteinizing hormone-releasing hormone (LRHR) to regulate the pituitary gland. Which statement by the parents indicates that they understand the treatment? a. "We should be sure to start our daughter on birth control pills" b. "Our daughter will be on this hormone treatment the rest of her life" c. "We should encourage her to dress in clothing that suits her sexual maturity level" d. "Sexual maturity differences between my daughter and her peers will disappear within a few years"
"Sexual maturity differences between my daughter and her peers will disappear within a few years"
An infant who weighs 7.5 kg is to receive ampicillin (Omnipen) 25 mg/kg I.V. every 6 hours. How many milligrams should the nurse administer per dose? Record your answer using one decimal place.
187.5 milligrams
When assessing a child for impetigo, the nurse expects which assessment findings? a. Small, brown, benign lesions b. Honey-colored, crusted lesions c. Linear, threadlike burrows d. Circular lesions that clear centrally
B. Honey-colored, crusted lesions
A child receives a prescription for amantadine 42 mg PO BID. Amantadine is available as a 50 mg/5 mL syrup. Using a supplied calibrated measuring device, how many mL should the nurse administer per dose? (round to nearest tenth)
4.2 mL
A nurse observes a 2½-year-old child playing with another child of the same age in the playroom on the pediatric unit. What type of play should the nurse expect the children to engage in? a. Associative play b. Parallel play c. Cooperative play d. Therapeutic play
B. Parallel play
A child with iron deficiency anemia is ordered ferrous sulfate (Ferralyn), an oral iron supplement. When teaching the child and parent how to administer this preparation, the mother asks why she needs to mix the supplement with citrus juice. Which response by the nurse is best? a. "The vitamin C in the citrus juice helps with iron absorption." b. "Having food and juice in the stomach helps with iron absorption." c. "The citrus juice counteracts the unpleasant taste of the iron." d. "There isn't a specific reason for it."
A. "The vitamin C in the citrus juice helps with iron absorption."
A 14-year-old adolescent with type 1 diabetes checks his blood glucose level at 9:00 p.m. before going to bed. It has been 4 hours since his dinner and his regular insulin dose. His blood glucose level is 60 mg/dl, and he states that he feels a little shaky. What should the nurse suggest? a. A bedtime snack of an 8-oz glass of milk and graham crackers with peanut butter b. Going to sleep to decrease the metabolic demands on the body c. Taking a dose of glucagon d. Doing nothing because the glucose level is unreliable because the adolescent measured it himself
A. A bedtime snack of an 8-oz glass of milk and graham crackers with peanut butter
A child, age 5, is diagnosed with chronic renal failure. When teaching the parents about diet therapy, the nurse should instruct them to restrict which foods from the child's diet? a. Meats b. Carbohydrates c. Fats d. Dairy products
A. Meats (low protein diet for renal failure)
Which finding in a 3-year-old child with acute renal failure requires immediate follow-up? a. Potassium level of 6.5 mEq/L b. Blood pressure in right leg of 90/50 mm Hg c. Abdominal cramps d. No albumin in the urine
A. Potassium level of 6.5 mEq/L
A 10-year-old child diagnosed with acute glomerulonephritis is admitted to the pediatric unit. The nurse should ensure that which action is a part of the child's care? a. Taking vital signs every 4 hours and obtaining daily weight b. Obtaining a blood sample for electrolyte analysis every morning c. Checking every urine specimen for protein and specific gravity d. Ensuring that the child has accurate intake and output and eats a highprotein diet
A. Taking vital signs every 4 hours and obtaining daily weight
When making ethical decisions about caring for preschoolers, a nurse should remember to: a. provide beneficial care and avoid harming the child. b. make decisions that will prevent legal trouble. c. do what she would do for her own child or loved ones. d. be sure to do what the physician says.
A. provide beneficial care and avoid harming the child.
When administering gentamicin (Garamicin) to a preschooler, which monitoring schedule is best for determining the drug's effectiveness? a. A serum trough level every morning b. A serum peak level after the second dose c. A serum trough and peak level around the third dose d. Serial serum trough levels after three doses (24 hours)
C. A serum trough and peak level around the third dose
Which item in the care plan for a toddler with a seizure disorder should a nurse revise? a. Padded side rails b. Oxygen mask and bag system at bedside c. Arm restraints while asleep d. Cardiorespiratory monitoring
C. Arm restraints while asleep
The mother of an 11-month-old infant reports to the nurse that her infant sleeps much less than other children. The mother asks the nurse whether her infant is getting sufficient sleep. What should be the nurse's initial response? a. Reassure the mother that each infant's sleep needs are individual. b. Ask the mother for more information about the infant's sleep patterns. c. Instruct the mother to decrease the infant's daytime sleep to increase his nighttime sleep. d. Inform the mother that her infant's growth and development are appropriate for his age, so sleep isn't a concern.
B. Ask the mother for more information about the infant's sleep patterns.
A teenage mother brings her 1-year-old child to the pediatrician's office for a well-baby checkup. She says that her infant can't sit alone or roll over. An appropriate response by the nurse would be: a. "This is very abnormal. Your child must be sick." b. "Let's see about further developmental testing." c. "Don't worry, this is normal for her age." d. "Maybe you just haven't seen her do it."
B. "Let's see about further developmental testing."
Intraosseous infusion of a medication would be most appropriate for which child? a. An 18-month-old child with cystic fibrosis b. A 2-year-old child with a ruptured spleen and hypovolemia c. A 4-year-old child with celiac disease d. A 5-year-old child with status asthmaticus
B. A 2-year-old child with a ruptured spleen and hypovolemia
A 13-year-old with anorexia nervosa is admitted to the facility for I.V. fluid therapy and nutritional management. She says she's worried that the I.V. fluids will make her gain weight. Which nursing diagnosis is most appropriate? a. Noncompliance (dietary regimen) b. Disturbed body image c. Complicated grieving d. Grieving
B. Disturbed body image
A nurse is developing a plan to teach a mother how to reduce her infant's risk of developing otitis media. Which direction should the nurse include in the teaching plan? a. Administer antibiotics whenever the infant has a cold. b. Place the infant in an upright position when giving a bottle. c. Avoid getting the infant's ears wet while bathing or swimming. d. Clean the infant's external ear canal daily.
B. Place the infant in an upright position when giving a bottle.
A nurse notes that an infant develops arm movement before finemotor finger skills and interprets this as an example of which pattern of development? a. Cephalocaudal b. Proximodistal c. Differentiation d. Mass-to-specific
B. Proximodistal
A nurse is planning care for a 10-year-old child in the acute phase of rheumatic fever. Which activity is most appropriate for the nurse to schedule in the care plan? a. Playing ping-pong b. Reading books c. Climbing on play equipment in the playroom d. Ambulating without restrictions
B. Reading books
A child is admitted with a tentative diagnosis of clinical depression. Which assessment finding is most significant in confirming this diagnosis? a. Irritability b. Sadness c. Weight gain d. Fatigue
B. Sadness
A nurse is auscultating for heart sounds in a 2-year-old child. She notes a grade 1 heart murmur. Which characteristic best describes a grade 1 heart murmur? a. Equal in loudness to the heart sounds b. Softer than the heart sounds c. Can be heard without a stethoscope d. Associated with a precordial thrill
B. Softer than the heart sounds
A LPN/LVN is caring for a 9-year-old child who has a grave prognosis after receiving a closed injury from being struck by a car. Which health team member should approach the family about organ donation? a. Nurse-manager b. Transplant coordinator c. Emergency department nurse d. Pastoral care staff member
B. Transplant coordinator
A LPN/LVN is caring for an adolescent who underwent surgery for a perforated appendix. When caring for this adolescent, the nurse should keep in mind that the main life-stage task for an adolescent is to: a. resolve conflict with parents. b. develop an identity and independence. c. develop trust. d. plan for the future.
B. develop an identity and independence
5) When developing a care plan for an adolescent, the nurse considers the child's psychosocial needs. During adolescence, psychosocial development focuses on: a. becoming industrious. b. establishing an identity. c. achieving intimacy. d. developing initiative.
B. establishing an identity.
An infant, age 10 months, is brought to the well-baby clinic for a followup visit. The mother tells the nurse that she has been having trouble feeding her infant solid foods. To help correct this problem, the nurse should: a. point out that tongue thrusting is the infant's way of rejecting food. b. instruct the mother to place the food at the back and toward the side of the infant's mouth. c. advise the mother to puree foods if the child resists them in solid form. d. suggest that the mother force-feed the child if necessary.
B. instruct the mother to place the food at the back and toward the side of the infant's mouth.
A mother tells the nurse that her preschool-age daughter with spina bifida sneezes and gets a rash when playing with brightly colored balloons, and that recently she had an allergic reaction after eating kiwifruit and bananas. The LPN/LVN would suspect that the child may have an allergy to: a. bananas. b. latex. c. kiwifruit. d. color dyes.
B. latex
An emergency department nurse suspects neglect in a 3-year-old boy admitted for failure to thrive. Signs of neglect in the child would include: a. slapping, kicking, and punching others. b. poor hygiene and weight loss. c. loud crying and screaming. d. pulling hair and hitting.
B. poor hygiene and weight loss.
A school nurse is evaluating a 7-year-old child who is having an asthma attack. The child is cyanotic and unable to speak, with decreased breath sounds and shallow respirations. Based on these physical findings, the nurse should first: a. monitor the child with a pulse oximeter in her office. b. prepare to ventilate the child. c. return the child to class. d. contact the child's parent or guardian.
B. prepare to ventilate the child.
A child's physician orders a drug for home use. Before the child is discharged, the nurse should: a. teach the family how to adjust the drug dosage according to the child's needs. b. provide the family with the drug's name, dosage, route, and frequency of administration. c. instruct the family to encourage the child to take responsibility for ensuring timely drug administration. d. tell the family to avoid explaining the purpose of the medication to the child.
B. provide the family with the drug's name, dosage, route, and frequency of administration.
A toddler is receiving an infusion of total parenteral nutrition via a Broviac catheter. As the child plays, the I.V. tubing becomes disconnected from the catheter. What should the LPN/LVN do first? a. Turn off the infusion pump. b. Position the child on the side. c. Clamp the catheter. d. Flush the catheter with heparin.
C. Clamp the catheter
) When a LPN/LVN assesses a 2-year-old child with suspected dehydration, which condition should be reported to the physician immediately? a. Irritability for the past 12 hours b. Capillary refill less than 2 seconds c. Decreased blood pressure d. Tachycardia, dry skin, and dry mucous membranes
C. Decreased blood pressure
A 4-year-old has just returned from surgery. He has a nasogastric (NG) tube in place and is attached to intermittent suction. The child says to the nurse, "I'm going to throw up." What should the nurse do first? a. Notify the physician because the child has an NG tube. b. Immediately give the child an antiemetic I.V. c. Irrigate the NG tube to ensure patency. d. Encourage the mother to calm the child down
C. Irrigate the NG tube to ensure patency
An 8-year-old child is suspected of having meningitis. Signs of meningitis include: a. Cullen's sign. b. Koplik's spots. c. Kernig's sign. d. Chvostek's sign.
C. Kernig's sign.
To treat a child's atopic dermatitis, a physician orders a topical application of hydrocortisone cream twice daily. After medication instruction by the nurse , which statement by the parent indicates effective teaching? a. "I will spread a thick coat of hydrocortisone cream on the affected area and will wash this area once a week." b. "I will gently scrape the skin before applying the cream to promote absorption." c. "I will avoid using soap and water on the affected area and will apply an emollient cream on this area frequently." d. "I will apply a moisturizing cream sparingly and will wash the affected area frequently."
C. "I will avoid using soap and water on the affected area and will apply an emollient cream on this area frequently."
An 18-month-old boy is admitted to the pediatric unit with a diagnosis of celiac disease. What finding would the LPN/LVN expect in this child? a. A concave abdomen b. Bulges in the groin area c. A protuberant abdomen d. A palpable abdominal mass
C. A protuberant abdomen
A 6-year-old child is admitted to the pediatric unit for evaluation of recurrent abdominal pain. The child has been admitted to the pediatric unit with similar complaints several times in the past few months. The child's symptoms are vague, yet his mother provides detailed information about the problem. The nurse is suspicious of the situation. What should the nurse do next? a. Request that the parent leave the hospital unit immediately. b. Ask to speak with the child without the parent being present. c. Notify the physician and request assistance from the interdisciplinary team. d. Contact the authorities immediately.
C. Notify the physician and request assistance from the interdisciplinary team.
When developing a care plan for a child, the nurse identifies which Eriksonian stage as corresponding to Freud's oral stage of psychosexual development? a. Initiative versus guilt b. Autonomy versus shame and doubt c. Trust versus mistrust d. Industry versus inferiority
C. Trust versus mistrust
When planning care for a 7-year-old boy with Down syndrome, the LPN/ LVN should: a. plan interventions at the developmental level of a 7-year-old because that is the child's age. b. plan interventions at the developmental level of a 5-year-old because the child will have developmental delays. c. assess the child's current developmental level and plan care accordingly. d. direct all teaching to the parents because the child can't understand.
C. assess the child's current developmental level and plan care accordingly
A child, age 5, has acute lymphocytic leukemia (ALL) and is receiving induction chemotherapy consisting of vincristine (Oncovin), asparaginase (Lasparaginase [Elspar]), and prednisone (Deltasone). When teaching the parents about the adverse effects of this regimen, the nurse should stress the importance of promptly reporting: a. hair loss. b. moon face. c. blindness. d. bone pain.
C. blindness.
46) An 8-month-old infant is admitted to the pediatric unit following a fall from his high chair. The child is awake, alert, and crying. The nurse should know that a brain injury is more severe in children because of: a. increased myelination b. intracranial hypotension. c. cerebral hyperemia. d. a slightly thicker cranium.
C. cerebral hyperemia.
A 3-month-old infant just had a cleft lip and palette repair. To prevent trauma to the operative site, the nurse should: a. give the infant a pacifier to help soothe him. b. lie the infant in the prone position. c. place the infant's arms in soft elbow restraints. d. avoid touching the suture line, even to clean.
C. place the infant's arms in soft elbow restraints
A boy, age 3, develops a fever and rash and is diagnosed with rubella. His mother has just given birth to a baby girl. Which statement by the mother best indicates that she understands the implications of rubella? a. "I told my husband to give my son aspirin for his fever." b. "I'll ask the physician about giving the baby an immunization shot." c. "I don't have to worry because I've had the measles." d. "I'll call my neighbor who's 2 months pregnant and tell her not to have contact with my son."
D. "I'll call my neighbor who's 2 months pregnant and tell her not to have contact with my son."
A LPN/LVN is assessing a severely depressed adolescent. Which finding indicates a risk of suicide? a. Excessive talking b. Excessive sleepiness c. A history of cocaine use d. A preoccupation with death
D. A preoccupation with death
A 13-year-old girl is being evaluated for possible Crohn's disease. The nurse expects to prepare her for which diagnostic study? a. Genetic testing b. Cystoscopy c. Myelography d. Colonoscopy with biopsy
D. Colonoscopy with biopsy
An 11-year-old child contracted severe acute respiratory syndrome (SARS) when traveling abroad with her parents. The nurse knows she must put on personal protective equipment to protect herself while providing care. Based on the mode of SARS transmission, which personal protective equipment should the nurse wear? a. Gloves b. Gown and gloves c. Gown, gloves, and mask d. Gown, gloves, mask, and eye goggles or eye shield
D. Gown, gloves, mask, and eye goggles or eye shield
A nurse is providing care to a 5-year-old child with a fractured femur whose nursing diagnosis is Imbalanced nutrition: Less than body requirements. Which change is most likely to occur with this condition? a. Decreased protein catabolism b. Increased calorie intake c. Increased digestive enzymes d. Increased carbohydrate need
D. Increased carbohydrate need
A nurse is reviewing a care plan for an infant undergoing phototherapy for hyperbilirubinemia. Which intervention should the nurse remove from the care plan? a. Repositioning the infant frequently to expose all body surfaces b. Obtaining frequent serum bilirubin levels c. Shielding the infant's eyes with an opaque mask to prevent exposure to the light d. Performing frequent visual assessments of jaundice
D. Performing frequent visual assessments of jaundice
A female adolescent client refuses to allow male nurses to care for her while she's hospitalized. Which of these health care rights is this adolescent exerting? a. Right to competent care b. Right to have an advance directive on file c. Right to confidentiality of her medical record d. Right to privacy
D. Right to privacy
An infant, age 6 weeks, is brought to the clinic for a well-baby visit. To assess the fontanels, how should the LPN/LVN position the infant? a. Supine b. Prone c. In the left lateral position d. Seated upright
D. Seated upright
Which intervention provides the most accurate information about an infant's hydration status? a. Monitoring the infant's vital signs b. Accurately measuring intake and output c. Monitoring serum electrolyte levels d. Weighing the infant daily
D. Weighing the infant daily
A 4-month-old infant is taken to the pediatrician by his parents because they're concerned about his frequent respiratory infections, poor feeding habits, frequent vomiting, and colic. The physician notes that the infant has failed to gain expected weight and recommends that the infant have a sweat test performed to detect possible cystic fibrosis. To prepare the parents for the test, the nurse should explain that: a. the baby will need to fast before the test. b. a sample of blood will be necessary. c. a low-sodium diet is necessary for 24 hours before the test. d. a low-intensity, painless electrical current is applied to the skin
D. a low-intensity, painless electrical current is applied to the skin.
A 16 year old with acute myelocytic leukemia is receiving chemotherapy (CT) via an implanted medication port at the out-patient oncology clinic. What action should the nurse implement when the infusion is complete? a. Administer Zofran b. Obtain blood samples for RBCs, WBCs, and platelets c. Flush mediport w/ saline and heparin solution d. Initiate an infusion of normal saline
Flush mediport w/ saline and heparin solution
. A mother brings her 2-month old son to the clinic for a well-baby exam. During the assessment the nurse finds that the right testicle is not distended into the scrotum but the left is palpable. Which action should the nurse take? a. Ask if the right testis has been seen in the scrotum before b. Address possible concerns about the child's future fertility c. Schedule an IV pyelogram to validate presence of the testicle d. Prepare to obtain a catheterized urine specimen for culture
a. Ask if the right testis has been seen in the scrotum before
. A mother brings her 2 year old son to the clinic because he has been crying and pulling on his earlobe for the past 12 hours. The child's oral temperature is 101.2 F. Which intervention should the nurse implement? a. Ask the mother if the child has had a runny nose b. Cleanse purulent exudate from the affected ear canal c. Apply a topical antibiotic to the periauricle area d. Provide parent education to prevent recurrence
a. Ask the mother if the child has had a runny nose
A middle school male student was recently diagnosed with attention-deficit hyperactivity disorder (ADHD) and is having trouble with his grades. He is referred to the school nurse by the teacher because he continues to have learning problems. Which action should the school nurse take? a. Ask the parents to have the child seen by a clinical psychologist b. Ask the parents to become involved in helping the child with his homework c. Refer the child to the school counselor for educational testing d. Seek the advice of the school principle regarding the child's learning needs
a. Ask the parents to have the child seen by a clinical psychologist
A LPN/LVN is teaching a safety class for parents of preschoolers. Which injuries should the nurse include as common among preschoolers? Select all that apply. a. Automobile accidents b. Drowning c. Pedestrian accidents d. Fire e. Sexually transmitted diseases f. Homicide
a. Automobile accidents b. Drowning c. Pedestrian accidents d. Fire
The nurse is caring for a 3-year old child who has been recently diagnosed with cystic fibrosis, which discharge instruction by the nurse is most important to promote pulmonary function? a. Chest physiotherapy should be performed before meals and at bedtime b. Cough suppressants can be used up to four times a day for relief c. Oxygen should be given through a nasal cannula between 4-6 L/min d. Exercise is discouraged in order to preserve pulmonary vital capacity
a. Chest physiotherapy should be performed before meals and at bedtime
In developing a behavior modification program for an extremely aggressive 10 year old boy, what should the nurse do first? a. Determine what activities, foods, and toys the child enjoys b. Evaluate the child's previous reactions to punishment c. Provide the child with positive feedback d. Encourage other children on the unit to describe the token system
a. Determine what activities, foods, and toys the child enjoys
A 5-year-old boy with leukemia is receiving chemotherapy through a peripherally inserted central catheter (PICC). Twenty minutes after the infusion is begun, the child feels dizzy and complains of itching. Which intervention should the nurse implement first? a. Discontinue the medication infusion b. Flush IV line with saline c. Obtain emergency resuscitation equipment d. Measure current blood pressure and pulse
a. Discontinue the medication infusion
The nurse determines that an infant admitted for surgical repair of an inguinal hernia voids a urinary stream from the ventral surface of the penis. What action should the nurse take? a. Document the finding b. Palpate scrotum for testicular descent c. Assess for bladder distension d. Auscultate bowel sounds
a. Document the finding
) An 8-year-old child has just returned from the operating room after having a tonsillectomy. The nurse is preparing to do a postoperative assessment. The nurse should be alert for which signs and symptoms of bleeding? Select all that apply. a. Frequent clearing of the throat b. Breathing through the mouth c. Frequent swallowing d. Sleeping for long intervals e. Pulse rate of 98 beats/minute f. Bright red vomitus
a. Frequent clearing of the throat c. Frequent swallowing f. Bright red vomitus
While obtaining the vital signs of a 10 year old who had a tonsillectomy this morning, the nurse observes the child swallowing every 2-3 minutes. Which assessment should the nurse implement? a. Inspect the posterior oropharynx b. Assess for teeth clenching or grinding c. Touch the tonsillar pillars to stimulate the gag reflex d. Ask the child to speak to evaluate change in voice tone
a. Inspect the posterior oropharynx
A mother brings her 3-week old infant to the clinic because the baby vomits after eating and always seems hungry. Further assessment indicates that the infant's vomiting is projectile, and the child seems listless. Which additional assessment finding indicates the possibility of a life threatening complication? a. Irregular palpable pulse b. Hyperactive bowel sounds c. Underweight for age d. Crying without tears
a. Irregular palpable pulse
An adolescent who is taking antiretroviral therapy for HIV infection arrives at the clinic for a follow up visit. Which information is most important for the nurse to obtain? a. Missed medication doses b. A 24-hour dietary recall c. Barrier contraceptive use d. Ingestion of illicit drugs
a. Missed medication doses
A male infant with bronchiolitis is brought to the clinic by his mother. The infant is congested and febrile with a capillary refill of 2 seconds. Which information should the nurse discuss with the mother? a. Encourage infant to play b. Limit the amount of oral intake c. Keep infant isolated from others d. Lay infant on back for naps
c. Keep infant isolated from others
A school-aged male is brought to the school nurse after he was thrown off his bicycle into the trunk of a pine tree. The child's face and arms are speckled with embedded pine bark. He has copious tearing and complains that "there is stuff in my eyes." Which action should the nurse implement a. Patch both of child's eyes and send him to the family ophthalmologist b. Use sterile tweezers to lift bark specks from the sclera of each eye c. Instill pain relieving eye drops into each eye and keep head elevated d. Encourage the child to blink frequently to increase bilateral tearing in the eyes
a. Patch both of child's eyes and send him to the family ophthalmologist
The nurse is performing a routine assessment of a 3-year old at a community health center. Which behavior by the child should alert the nurse to request a follow-up for a possible autistic spectrum disorder? a. Performs odd repetitive behaviors b. Shows indifference to verbal stimulation c. Strokes the hair of a hand held doll d. Has a history of temper tantrums
a. Performs odd repetitive behaviors
A child diagnosed with Kawasaki disease is brought to the clinic. The mother reports that her child is irritable, refuses to eat, and has skin peeling on both his hands and feet. Which intervention should the nurse instruct the mother to implement first? a. Place the child in a quiet environment b. Make a list of foods that the child likes c. Encourage the parents to rest when possible d. Apply lotion to hands and feet
a. Place the child in a quiet environment
A 9-week-old infant is scheduled for cleft lip repair. Which information is most important for the nurse to convey to the surgeon before transporting the infant to the surgical suite? a. Red blood cell count of 2.3 million/mm3 b. White blood cell count of 10,000/mm3 c. Weight gain of 2 pounds since birth d. Urine specific gravity is 1.011
a. Red blood cell count of 2.3 million/mm3
A mother of a 3-year old boy has just given birth to a new baby girl. The little boy asks the nurse, "why is my baby sister eating my mommy's breast?" how should the nurse respond? Select all that apply a. Remind him that his mother breastfed him too b. Clarify that breastfeeding is the mother's choice c. Reassure the older brother that it does not hurt his mother d. Explain that newborns get milk from their mothers in this way e. Suggest that the baby can also drink from a bottle
a. Remind him that his mother breastfed him too c. Reassure the older brother that it does not hurt his mother d. Explain that newborns get milk from their mothers in this way
A child is suspected of having amblyopia ("lazy eye"). To help diagnose this disorder, the child will undergo which test? a. Snellen's test b. Near vision test c. Weber's test d. Peripheral vision test
a. Snellen's test
A mother brings her school-aged daughter to the pediatric clinic for evaluation of her anti-epileptic medication regimen. What information should the nurse provide to the mother? a. The medication dose will be tapered over a period of 2 weeks when being discontinued b. If seizures return, multiple medications will be prescribed for another 2 years c. A dose of valproic acid (Depakote) should be available in the event of status epilepticus d. Phenytoin (Dilantin) and phenobarbital (Luminal) should be taken for life
a. The medication dose will be tapered over a period of 2 weeks when being discontinued
. The parents of a 3-year old boy who has Duchenne muscular dystrophy ask, "How can our son have this disease? We are wondering if we should have any more children." What information should the nurse provide to parents? a. This is an inherited X-linked recessive disorder, which primarily affects male children in the family b. The striated muscle groups of males can be impacted by a lack of the protein dystrophin in their mothers c. The male infant had a viral infection that went unnoticed and untreated so muscle damage was incurred d. Birth trauma with a breech vaginal birth causes damage to the spinal cord, thus weakening the muscles
a. This is an inherited X-linked recessive disorder, which primarily affects male children in the family
The nurse provides information about the human papilloma virus (HPV) vaccine to the mother of a 14-year-old adolescent who came to the clinic this morning complaining of menstrual cramping. Which explanation should the nurse provide to support administering the HPV vaccine to the adolescent who came to the clinic this morning complaining of menstrual cramping. Which explanation should the nurse provide to support administering the HPV vaccine to the adolescent at this visit? a. Use of protective barriers during sexual activity prevents most strains of HPV infection b. Most adolescents are not honest about being sexually active c. Not all strains of HPV will be covered if given at a later date d. Immunity must be established to prevent future HPV infection and risk for cervical cancer
a. Use of protective barriers during sexual activity prevents most strains of HPV infection
A 2-week-old female infant is hospitalized for the surgical repair of an umbilical hernia. After returning to the postoperative neonatal unit, her RR and HR have increased during the last hour. Which intervention should the nurse implement? a. Notify the HCP of these findings b. Administer a PRN analgesic prescription c. Record the findings in the child's record d. Wrap the infant tightly and rock in rocking chair
b. Administer a PRN analgesic prescription
During a follow up clinical visit a mother tells the nurse that her 5 month old son who had surgical correction for tetralogy of fallot has rapid breathing, often takes a long time to eat, and requires frequent rest periods. The infant is not crying while being held and his growth is in the expected range. Which intervention should the nurse implement? a. Stimulate the infant to cry to produce cyanosis b. Auscultate heart and lungs while infant is held c. Evaluate infant for failure to thrive d. Obtain a 12-lead electrocardiogram
b. Auscultate heart and lungs while infant is held
A 3 year-old boy is receiving a weekly chemotherapy treatment. Which toy is best for the nurse to provide for this child? a. Bouncy ball b. Coloring book with crayons c. Duck that squeaks d. Remote-controlled care
b. Coloring book with crayons
A child with Grave's disease who is taking propranolol (Inderal) is seen in the clinic. The nurse should monitor the child for which therapeutic response? a. Increased weight gain b. Decreased heart rate c. Reduce headaches d. Diminished fatigue
b. Decreased heart rate
An 8-year-old male client with nephrotic syndrome is receiving salt-poor human albumin IV. Which findings indicate to the nurse that the child is manifesting a therapeutic response? a. Decreased urinary output b. Decreased periorbital edema c. Increased periods of rest d. Weight gain 0.5 kg/day
b. Decreased periorbital edema
A 2-year-old girl is brought to the clinic by her 17 year old mother. When the nurse observes that the child is drinking sweetened soda from her bottle, what information should the nurse discuss with this mother? a. A 2-year old should be speaking in 2 word phrases b. Dental caries are associated with drinking soda c. Drinking soda is related to childhood obesity d. Toddlers should be sleeping 10 hours a night e. Toddlers should be drinking from a cup by age 2
b. Dental caries are associated with drinking soda c. Drinking soda is related to childhood obesity e. Toddlers should be drinking from a cup by age 2
A nurse is reviewing a teaching plan with parents of an infant undergoing repair for a cleft lip. Which instructions are the most appropriate for the nurse to give? Select all that apply. a. Offer a pacifier as needed. b. Lay the infant on his back or side to sleep. c. Sit the infant up for each feeding. d. Loosen the arm restraints every 4 hours. e. Clean the suture line after each feeding by dabbing it with saline solution. f. Give the infant extra care and support.
b. Lay the infant on his back or side to sleep. c. Sit the infant up for each feeding. e. Clean the suture line after each feeding by dabbing it with saline solution. f. Give the infant extra care and support.
. The nurse is preparing a teaching plan for the parents of a 6 month-old infant with GERD. What instruction should the nurse include when teaching the parents measures to promote adequate nutrition? a. Alternate glucose water with formula b. Mix the formula with rice cereal c. Add multivitamins with iron to the formula d. Use water to dilute the formula
b. Mix the formula with rice cereal
The mother of a 4-month-old baby girl asks the nurse when she should introduce solid foods to her infant. The mother states, "My mother says I should put rice cereal in the baby's bottle now." The nurse should instruct the mother to introduce solid foods when her child exhibits which behavior? a. Stops rooting when hungry b. Opens mouth when food comes her way c. Awakens once for nighttime feedings d. Gives up a bottle for a cup
b. Opens mouth when food comes her way
A LPN/LVN is conducting an infant nutrition class for parents. Which foods are appropriate to introduce during the first year of life? Select all that apply. a. Sliced beef b. Pureed fruits c. Whole milk d. Rice cereal e. Strained vegetables f. Fruit juice
b. Pureed fruits d. Rice cereal e. Strained vegetables
The parents of 15-month old boy tell the nurse that they are concerned because their son brings his spoon to his mouth but does not turn it over. What action should the nurse implement first? a. Discuss referral to an occupational therapist b. Question the parents about their concern c. Tell the parents to hold the spoon correctly in the child's hand d. Suggest longer mealtimes so the child can finish eating
b. Question the parents about their concern
In assessing a 10-year old newly diagnosed with osteomyelitis, which information s most important for the nurse to obtain? a. Family history of bone disorders b. Recent occurrence of infection c. Cultural heritage and beliefs d. Occurrence of increased fluid intake
b. Recent occurrence of infection
A 6-year-old child is diagnosed with rheumatic fever and demonstrates associated chorea (sudden aimless movements of the arms and legs). Which information should the nurse provide to the parents? a. Permanent life style changes need to be made to promote safety in the home b. The chorea or movements are temporary and will eventually disappear c. Muscle tension is decreased with fine motor project skills, so these activities should be encouraged d. Consistent discipline is needed to help the child control the movements
b. The chorea or movements are temporary and will eventually disappear
. The nurse is conducting an admission assessment of an 11-month old infant with CHF who is scheduled for repair of restenosis of coarction of the aorta hat was repaired 4 days after birth. Findings include blood pressure higher in the arms than the lower extremities, pounding brachial pulses, and slightly palpable femoral pulses. What pathophysiologic mechanisms support these findings? a. The aortic semilunar valve obstructs blood flow into the systemic circulation b. The lumen of the aorta reduces the volume of the blood flow to the lower extremities c. The pulmonic valve prevents adequate blood volume into the pulmonary circulation d. An opening in the atrial septum causes a murmur due to a turbulent left to right shunt
b. The lumen of the aorta reduces the volume of the blood flow to the lower extremities
A 6-year-old boy with bronchial asthma takes the beta-adrenergic agonist agent albuterol (Proventil). The child's mother tells the nurse that she uses this medication to open her son's airway when he is having trouble breathing. What is the nurse's best response? a. Recommend that the mother bring the child in for immediate evaluation b. Advise the mother that over-use of the drug may cause chronic bronchitis c. Assure the mother that she is using the medication correctly d. Confirm that the medication helps to reduce airway inflammation
c. Assure the mother that she is using the medication correctly
When assessing a 5-year-old, which ability should the nurse expect the child to be developing at this age? a. Learning to ride a tricycle b. Tying shoelaces c. Buttoning clothes d. Cutting with scissors
b. Tying shoelaces
During a routine physical exam, a male adolescent client tells the nurse, "sometimes, my mother gets angry because I want to be with my own friends." What is the best initial response by the nurse? a. Offer reassurance that his mother's concern is normal b. Determine is his friends are engaged in unsafe behaviors c. Ask about the client's response to his mother's anger d. Offer to discuss his concerns together with his mother
c. Ask about the client's response to his mother's anger
Following admission for cardiac catheterization, the nurse is providing discharge teaching to the parents of a 2-year-old toddler with tetralogy of Fallot. What instruction should the nurse give the parents if their child becomes pale, cool, lethargic? a. Encourage oral electrolyte solution intake b. Assess the child to a recumbent position c. Contact their HCP immediately d. Provide a quiet time by holding or rocking the toddler
c. Contact their HCP immediately
While auscultating the lung sounds of a 5 year-old Chinese boy who recently completed antibiotic therapy for pneumonia, the nurse notices symmetrical, round, bruise-like blemishes on his chest. Which action is best for the nurse to take? a. Identify the antibiotic used to treat the pneumonia b. Report suspected child abuse to the proper authorities c. Inquire about the use of alternative methods of treatment d. Ask the parents if the child has been in a recent accident
c. Inquire about the use of alternative methods of treatment
A nurse is teaching a class for mothers of premature infants, and is asked about "a shot for respiratory virus." What information about plaibizumab (Synagis) is correct? a. It is required immunization for all infants under the age of 3 months b. It must be repeated every two months to be effective c. It is recommended for infants who meet established high-risk criteria d. It provides protection for one year with a single injection
c. It is recommended for infants who meet established high-risk criteria
A mother brings her 8 mo. old baby boy to clinic bc he has been vomitting and had diarrhea for last 3 days. Which assessment is most important for nurse to make? a. Assess infant abdomen for tenderness b. Determine if the infant was exposed to a virus c. Measure the infant's pulse d. Evaluate the infant's cry
c. Measure the infant's pulse
A child who is admitted to the hospital with anemia is anxious, fearful, and hyperventilating. The nurse anticipates the child developing which acid base imbalance? a. Metabolic acidosis b. Respiratory acidosis c. Respiratory alkalosis d. Metabolic alkalosis
c. Respiratory alkalosis
The mother of a 14-year old who had a below-the-knee amputation for osteosarcoma tells the nurse that her child is angry and blaming her for allowing the amputation to occur. Which response is best for the nurse to provide? a. "I will ask the HCP for a psychiatric consult for your child" b. "This type of acting out behavior is normal for adolescents" c. "It is important to focus on your child's needs at this difficult time" d. "A reaction of anger is your child's attempt to cope with this loss"
d. "A reaction of anger is your child's attempt to cope with this loss"
A 10-year-old girl who has had type 1 diabetes mellitus (DM) for the past two years tells the nurse that she would like to use a pump instead of insulin injections to manage her diabetes. Which assessment of the girl is most important for the nurse to obtain? a. Understanding of quality control process used to troubleshoot the pump b. Interpretation of fingerstick glucose levels that influence diet selections c. Knowledge of her glycosylated hemoglobin A1c levels for past year d. Ability to perform the pump for basal insulin with mealtime boluses
d. Ability to perform the pump for basal insulin with mealtime boluses
A child with pertussis is receiving azithromycin (Zithromax Injection) IV. Which intervention is most important for the nurse to include in the child's plan of care? a. Obtain vital signs at onset of fluid overload b. Change IV site dressing q3 days and PRN c. Monitor for signs of facial swelling or urticartia d. Assess for abdominal pain and vomiting
d. Assess for abdominal pain and vomiting
An adolescent's mother calls the primary HCP's office to inquire about the results of her daughter's serum test results that were drawn last week. Since it is the teenager's 18th birthday, how should the nurse respond to this mother's inquiry? a. Ask when the adolescent was last seen in the clinic b. Tell the mother to have the teenager call the clinic c. Since the serum samples were drawn last week provide the mother with the findings d. Explain that the information cannot be released without the 18-year olds permission
d. Explain that the information cannot be released without the 18-year olds permission
A male toddler is brought to the emergency center approximately three hours after swallowing tablets from his grandmother's bottle of digoxin (Lanoxin). What prescription should the nurse implement first? Administer activated charcoal orally a. Administer activated charcoal b. Prepare gastric lavage c. Obtain a 12-lead electrocardiogram d. Give IV digoxin immune fab (Digibind)
d. Give IV digoxin immune fab (Digibind)
The mother of an 11-year old boy who has juvenile arthritis tells the nurse, "I really don't want my son to become dependent on pain medication, so I only allow him to take it when he is really hurting." Which information is most important for the nurse to provide this mother? a. The child should be encouraged to rest when he experiences pain b. Encourage quiet activities such as watching television as a pain distracter c. The use of hot baths can be used as an alternative for pain medication d. Giving pain medication around the clock helps control the pain
d. Giving pain medication around the clock helps control the pain
The mother of a toddler reports to the nurse working in the pediatric clinic that her child has had a fever and sore throat for the past two days. The nurse observes several swollen red spots in the child's body, a few of which are fluid filled blisters. Which action should the nurse implement? a. Obtain fluid culture from blisters b. Administer a fever reducing salicylate c. Cover drainage vesicles with a dressing d. Implement transmission precautions
d. Implement transmission precautions
Which instructions should the nurse include in the discharge teaching plan of 7 year old girl with history of frequent urinary tract infections? a. Take frequent bubble baths b. Perform intermittent catheterization c. Check oral temperature daily d. Monitor for changes in urinary odor
d. Monitor for changes in urinary odor
A mother brings her 3 month old infant to the clinic because the baby does not sleep through the night. Which finding is most significant in planning care for this family? a. The mother is a single parent and lives with her parents b. The mother states the baby is irritable during feedings c. The infant's formula has been changed twice d. The diaper area shows severe skin breakdown
d. The diaper area shows severe skin breakdown
