HOLISTIC UNIT 3 QUIZ EXAM PT1
A male adolescent who is newly diagnosed with a seizure disorder receives a prescription for an anticonvulsant. Which statement indicates the client is at risk for non-compliance with life-long medication management? "I hope I will be able to drive while taking these pills." "My friends will think I am a freak if I take these pills." "I don't want my parents monitoring my medications." "I will take the pills at home so others will not see me."
b
The practical nurse is conducting a well-baby check of a 7-month-old infant and finds that there is an absence of babbling by the infant. Which focused assessment should the PN implement? Visual function. Auditory function. Cognitive function. Social development.
b
What age-appropriate play activity should the practical nurse suggest to the parents of a 7-month-old infant to encourage visual stimulation? Play peek-a-boo. Play pat-a-cake. Imitate animal sounds. Show how to clap hands.
a
According to Erikson's theory, what behavioral pattern should be displayed by a child who has not developed a sense of competence? Guilt. Shame. Alienation. Inferiority.
d
The practical nurse (PN) is instilling ear drops in a 2-year-old child. To straighten the external auditory canal, which direction should the PN pull the earlobe? Up and back. Down and back. Up and forward. Down and forward.
b
A mother brings her 5-month-old infant to the clinic for a well-baby visit. Which gross motor skill should the practical nurse expect to observe? Good pincer grasp. Strong grasp reflex. Builds a tower two blocks high. Able to grasp objects voluntarily.
d
How should the practical nurse respond to a mother's inquiry regarding the appropriate time to start cleaning the teeth of her 3-month-old infant? "There is no need to begin until after all of the child's baby teeth are in." "You don't have to worry about that until your child can handle a toothbrush." "You can begin now using toothpaste on a gauze pad and wiping the gums." "Begin wiping the teeth with a washcloth and water when the first tooth appears."
d
The mother of a 6-year-old brings her child to the clinic for complaints of "not feeling well." The practical nurse (PN) takes the child's vital signs and begins a general physical assessment. Which action should the PN implement first? Perform frightening and invasive procedures. Obtain the child's health history in a systems approach. Examine the child sequentially from head to toe. Determine cultural needs and differences.
d
The practical nurse (PN) is reinforcing information about Lyme disease prevention with a client who is preparing for a camping trip with family. Which statement by the client informs the PN that the client understands the instruction? "I'll make sure my son wears dark clothing on his hike." "I'll get a prescription for amoxicillin to take with us." "We should all get the Lyme disease vaccine before our trip." "We will wear long pants and long-sleeved shirts in the woods."
d
What analgesia should the practical nurse use to prepare a school-age child for a lumbar puncture (LP)? Ondansetron (Zofran) 4 mg / 5 ml PO TID. Codeine 10 mg PO 30 minutes before the procedure. A transdermal fentanyl (Duragesic) patch immediately before the procedure. EMLA (eutectic mixture of local anesthetics) 2.5 hours before the procedure.
d
Which action should the practical nurse (PN) implement to promote a toddler's nutrition during hospitalization? Allow the child to walk around during meals. Select new foods for the child from the menu. Encourage the child to finish all the food on the plate. Ask the child's parents to bring a cup and utensils from home. Submit
d
Which action should the practical nurse implemented for a child who has ingested a corrosive product? Induce vomiting using Ipecac to remove corrosive agent. Drink vinegar or lemon juice to neutralize the caustic agent. Give activated charcoal to decontaminate stomach. Telephone the poison control center and act on their advice. Submit
d
Which response should the practical nurse (PN) provide a school-age child who asks to talk with a dying sister? Talk loudly to ensure the dying client hears and recognizes others voices. Touch provides tactile presence of others if she does not respond to words. Sitting close offers the dying person the sensation of others presence. Although the dying client may not respond, she can still hear what is said. Submit
d
A school-age child with acute diarrhea and mild dehydration is being given an oral rehydration solution (ORS). The mother calls to report that the child is occasionally vomiting. What recommendation should the practical nurse provide at this time? Continue to give ORS frequently in small amounts. Alternate giving ORS and carbonated beverages. Take the child to the hospital for intravenous fluids. Place the child NPO for the next eight to nine hours.
a
Which developmental behavior should the practical nurse (PN) identify as normal for a 6-month-old infant? Rolls over completely. Creeps on all four extremities. Pulls self to a standing position. Assumes a sitting position independently.
a
An adolescent female who is leaning forward with her hands on her knees to breath tells the pracitcal nurse that she has been using triamcinolone (Azmacort) inhalation aerosol before coming to the clinic. Which action should the PN implement? Obtain vital signs and breath sounds for wheezing. Collect a blood sample for white blood cell count. Give the client a nebulizer breathing treatment. Administer another dose of Azmacort.
a
Which information should the practical nurse ensure the family understands about the care of a child with a tracheostomy? Cardiopulmonary resuscitation. Hygiene that includes showering. Tracheostomy suction for 30 seconds. Powder application around the stoma. Submit
a
The practical nurse (PN) palpates the anterior fontanel of a 14-month-old toddler and finds that it is closed. What action should the PN implement? Document the normal finding for the 14-month-old toddler. Report premature cranial suture closure to the healthcare provider. Perform a focused neurological examination. Refer the toddler for a developmental evaluation.
a
A 6-month-old female is scheduled to receive diphtheria, tetanus toxoid, and acellular pertussis vaccine (DTaP) and IPV (inactivated poliovirus vaccine) immunizations. She is recovering from a cold but is otherwise healthy and afebrile. Her 5-year-old sister is receiving chemotherapy. Which considerations should the practical nurse make for this situation? DTaP and IPV can be safely given to the infant at the scheduled time. DTaP and IPV are contraindicated because the infant has a cold. IPV is contraindicated because her sister is immunocompromised. DTaP is contraindicated because her sister is immunocompromised.
a
When reviewing the dietary guidelines for a child with nephrotic syndrome, which diet should the practical nurse reinforce with the parents? High protein. Low sodium. Low fat. High carbohydrate.
b
When caring for a hospitalized child, the practical nurse (PN) implements the plan of care based on which priority assessment? Home care and family structure. Normal growth and development. Parental involvement in providing care. Child's nutritional needs.
b
Which action should the practical nurse (PN) implement while giving a child a sponge bath to reduce fever? Bathe all the child's skin surfaces for 45 to 60 minutes. Use cold water to reduce skin surface temperature. Stop the sponge bath if the child starts to shiver. Use alcohol in bath water to enhance therapeutic response.
c
What information should the practical nurse (PN) reinforce with the mother whose child has ringworm ( Tinea )? Ringworm is not contagious. Tinea infections are indicative of poor hygiene and uncleanliness. Tinea infections are spread by direct and indirect contact. Ringworm often subsides spontaneously. Submit
c
What information should the practical nurse (PN) recommend to parents who ask about the prevention of otitis media (OM) in their infant? Refrain from exposing the infant to tobacco smoke. Use an over-the-counter nasal decongestant. Keep the infant away from children with otitis media. Bottle or breast-feed the infant in a supine position.
a
What information should the practical nurse (PN) reinforce with the parents about introducing solid foods to their infant? Begin with one tablespoon of the food. Introduce each food 4 to 7 days apart. Mix the new food with rice cereal. Remove foods when the infant refuses it.
b
A 12-year-old male is brought to the clinic after falling during a skateboarding trick. The child's vital signs are heart rate 135 beats/minute, respirations 20 breaths/minute, and blood pressure 90/60. Which finding should the practical nurse report to the healthcare provider immediately? The client complaints of his back being sore. Capillary refill is less than 2 seconds. Blood pressure is 94/68. Peripheral pulses are weak and rapid.
d
A 4-year-old girl is brought to the emergent care center with a frog-like croaking sound on inspiration. She is having difficulty breathing and has her chin thrust forward with her mouth open. She is drooling, agitated, and insists on sitting upright. What action should the practical nurse take? Make the child lie down on the stretcher and rest quietly. Examine the oral pharynx and report to the healthcare provider. Auscultate the lungs and make preparations for placing the child in a mist tent. Notify the healthcare provider and prepare for immediate intubation or tracheotomy.
d
A male adolescent who comes to the clinic for a sports physical examination is told by his pediatrician that the two freckles under his nipples are "undeveloped accessory breasts." He tells the practical nurse (PN) that he will never participate in gym because he will have to shower at school. What intervention should the PN implement? Ask the pediatrician to return to the exam room and reassure the youth. Tell the adolescents that this is not an excuse to refuse to participate in gym classes. Recommend a conference between the student, his parents, school nurse, and gym teacher. Convey sensitivity while reflecting that the two freckles are not real breasts.
d
A male adolescent who fell onto a cement surface after jumping off a fence is brought to the emergent care center with a nose bleed. Which finding should the practical nurse report to the healthcare provider immediately? Denies loss of consciousness and rates a headache as "10" on 0-10 scale. Complains of feeling tired and tries to stay awake by yawning frequently. Heart rate 72 beats/minute and reports having coffee-ground emesis. Blood pressure 130/90 and ecchymosis noted at the mastoid bone.
d
When reviewing developmental changes with the parents of a 6-month-old infant, what information should the practical nurse reinforce? Allow the infant to self-feed finger foods. Develop strategies to teach the infant to sit up. Provide a developmentally safe environment for the infant. Explain that an increased appetite occurs in next 6 months.
c
A toddler with a chronic illness that requires frequent hospitalization is likely to experience which psychosocial developmental problem? Fixation with the feelings of inadequacy. Interference with the development of autonomy. Distortion of differentiation of self from parent. Delayed language, fine-motor, and self-care skills. Submit
b
The mother of a 9-month-old girl provides the practical nurse information about her daughter's diet. Which statement by the mother may indicate why the infant has been diagnosed with iron-deficiency anemia? "She almost never drinks sugar water." "She has been on whole milk for 7 months." "She likes to chew on bread as a snack." "She doesn't like to eat peaches or pears."
b
The practical nurse (PN) is caring for a school-aged child with a fracture of the proximal third of the left femur. Following the application of a hip spica cast, which nursing intervention should the PN implement? Use the cast's abduction bar to turn the client. Assess the client for abdominal pain and gastric distress. Prepare the client for a prolonged recovery of bed rest. Turn the client prone every four hours during cast drying.
b
What information should the practical nurse reinforce with a mother whose child has a positive culture for Group A streptococcus of the throat? Give over-the-counter antihistamines until the sore throat symptoms subside. Bring the child to the clinic for a prescription for a full course of antibiotics. Offer aspirin and plenty of fluids for the streptococcal infection. Ensure the child receives the streptococcal immunization immediately. Submit
b
What secondary prevention activity should the practical nurse prepare parents for to prevent lead poisoning? Scheduling prescribed chelation therapy. Obtaining serum lead levels in children. Removing lead-based paint from older homes. Recommending a move to lead-free housing.
b
A mother is returning a demonstration for the instillation of saline nose drops for her 3-month-old infant who has nasal congestion. Which schedule is best for the practical nurse to recommend to the mother? Administer anytime the infant is congested while awake. Drop saline in nose every 4 hours during the day. Instill in both nares 20 to 30 minutes before feeding. Give when the infant is asleep and is not crying.
c
After reinforcing information to treat a sprained ankle, what statement by the adolescent indicates to the practical nurse that further instruction is needed? "Keep the leg elevated when sitting." "Wrap the ankle in an elastic bandage for support." "Apply warm compresses to the ankle for the first 24 hours." "Put an ice pack on the ankle, alternating 30 minutes on and 30 minutes off."
c
The mother calls the clinic and tells the practical nurse (PN) that her child cannot swallow a prescribed tablet that was dispensed by the local pharmacy as a whole tablet. How should the PN respond? "You can crush the tablet and put it in some food." "You should hold the child's nose closed to force her to swallow the tablets." "If a liquid form is available, the pharmacist can call for a prescription change." "If the child can't swallow the tablet, tell the child to chew it."
c
What information about Reye's syndrome should the practical nurse (PN) reinforce with the parents of a school-aged child? Vaccinate your child before the age of 7 for Reye's syndrome. Keep the child at home for 2 days after the appearance of symptoms. Avoid giving any medication containing aspirin during a viral illness. Do not provide any citrus juices during a bacterial or viral illness.
c
When reviewing the adverse effects of the DTaP (diphtheria, tetanus, and acellular pertussis) vaccine with parents whose child is being immunized, what side effect should the practical nurse convey as most common? Persistant crying and hyperpyrexia. Seizures and hyporesponsive episodes. Local erythema and edema at injection site. Vomiting and dehydration.
c
