NURS 4331 Exam 3 Review

What cardiovascular defect results in obstruction to blood flow? a. Aortic stenosis b. Tricuspid atresia c. Atrial septal defect d. Transposition of the great arteries

a. Aortic stenosis

Selective cholesterol screening is recommended for children older than the age of 2 years with which risk factor? a. Body mass index (BMI) = 95th percentile b. Blood pressure = 50th percentile c. Parent with a blood cholesterol level of 200 mg/dl d. Recently diagnosed cardiovascular disease in a 75-year-old grandparent

a. Body mass index (BMI) = 95th percentile

What primary nursing intervention should be implemented to prevent bacterial endocarditis? a. Counsel parents of high-risk children. b. Institute measures to prevent dental procedures. c. Encourage restricted mobility in susceptible children. d. Observe children for complications, such as embolism and heart failure.

a. Counsel parents of high-risk children.

To help prevent obesity, which intervention would the nurse include in an adolescent's plan of care? a. Describe a normal serving size. b. Plan a diet of 1,500 calories per day. c. Describe sources of low calorie proteins. d. Plan a diet of 2,000 calories per day.

a. Describe a normal serving size.

Which intervention would probably be most effective in preventing an adolescent from attempting suicide with an overdose again? a. Helping to learn better problem solving b. Helping to locate a close friend at school c. Assessing financial situation d. Teaching the parents to keep medicine in a locked cabinet

a. Helping to learn better problem solving

A parent of a 7-year-old girl with a repaired ventricular septal defect (VSD) calls the cardiology clinic and reports that the child is just not herself. Her appetite is decreased, she has had intermittent fevers around 38 C (100.4 F), and now her muscles and joints ache. Based on this information, how should the nurse advise the mother? a. Immediately bring the child to the clinic for evaluation. b. Come to the clinic next week on a scheduled appointment. c. Treat the signs and symptoms with acetaminophen and fluids because it is most likely a viral illness. d. Recognize that the child is trying to manipulate the parent by complaining of vague symptoms.

a. Immediately bring the child to the clinic for evaluation.

The nurse is planning care for a 6-month-old infant with a large ventricular septal defect. Which nursing diagnosis should the nurse use to help guide the care for this client? a. Ineffective tissue perfusion related to left heart dilation from increased pulmonary blood flow b. Impaired gas exchange related to a right-to-left shunt c. Impaired skin integrity related to poor peripheral circulation d. Ineffective airway clearance related to altered pulmonary status

a. Ineffective tissue perfusion related to left heart dilation from increased pulmonary blood flow

What structural defects constitute tetralogy of Fallot? a. Pulmonary stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy b. Aortic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy c. Aortic stenosis, ventricular septal defect, overriding aorta, left ventricular hypertrophy d. Pulmonary stenosis, ventricular septal defect, aortic hypertrophy, left ventricular hypertrophy

a. Pulmonary stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy

An infant with congenital heart disease is not growing and developing adequately. The nurse will institute what feeding strategy? a. Raise the caloric density of the feeding beyond 20 calories per ounce. b. Feed the infant at a minimum of every 2 hours. c. Suggest that the infant should receive commercial formula rather than breast milk. d. Increase the length of the feeding sessions to 45 to 50 minutes.

a. Raise the caloric density of the feeding beyond 20 calories per ounce.

Seventy-two hours after cardiac surgery, a young child has a temperature of 38.4 C (101.1 F). What action should the nurse perform? a. Report findings to the practitioner. b. Apply a hypothermia blanket. c. Keep the child warm with blankets. d. Record the temperature on the assessment flow sheet.

a. Report findings to the practitioner.

A nurse is teaching adolescent boys about pubertal changes. Which is the first sign of pubertal change seen with boys? a. Testicular enlargement b. Facial hair c. Scrotal enlargement d. Voice deepens

a. Testicular enlargement

Nursing care of the child with Kawasaki disease is challenging because of which occurrence? a. The child's irritability b. Predictable disease course c. Complex antibiotic therapy d. The child's ongoing requests for food

a. The child's irritability

When assessing an infant born at 32 weeks' gestation, which finding would lead the nurse to suspect that the newborn has a patent ductus arteriosus (PDA)? a. continuous murmur on auscultation b. weak, thready pulse c. decreased pulse rate d. high diastolic arterial pressure

a. continuous murmur on auscultation

What would be the most important measure to implement for an infant who develops heart failure? a. placing the infant in a semi-Fowler position b. planning ways to reduce salt intake c. keeping the infant supine and playing quiet games d. restricting milk intake daily

a. placing the infant in a semi-Fowler position

A 14-year-old boy is aware that he is dying. Which action best meets the child's need for self-esteem and sense of worth? a. providing full participation in decision making b. listening to his fears and concerns about dying c. initiating conversations about his feelings d. giving direct, honest answers to his questions

a. providing full participation in decision making

A nurse is caring for a child who is experiencing heart failure. Which assessment data was most likely seen when initially examined? a. tachycardia b. bradycardia c. polyuria d. splenomegaly

a. tachycardia

The nurse is assessing a 16-year-old girl at an annual well-clinic visit and notes the girl started menses at 13 years of age and grew 1 inch (2.5 cm) over the past year. When questioned by the young lady if this is normal, which answer should the nurse prioritize? a. "Your weight is more revealing than your height." b. "You're following expected patterns of growth." c. "You're taller than what would be expected." d. "Your height is less than expected."

b. "You're following expected patterns of growth."

During a well-child visit, the parents of an adolescent ask the nurse about how much physical activity their adolescent should engage in each day. The nurse would instruct the parents to encourage how many minutes of physical activity each day? a. 45 b. 60 c. 15 d. 30

b. 60

A 2-year-old child is receiving digoxin (Lanoxin). The nurse should notify the practitioner and withhold the medication if the apical pulse is less than which rate? a. 60 beats/min b. 90 beats/min c. 100 beats/min d. 120 beats/min

b. 90 beats/min

The nurse is performing an admission assessment of an adolescent with the teen and the parents. During the assessment the nurse suspects that the teen may be pregnant. What is the best way for the nurse to address this situation? a. Ask the teen, with the parents present, if she might be pregnant. b. Ask the parents to wait in the family lounge while finishing the assessment, then ask the teen during the assessment. c. Ask the teen's physician to talk to the parents and the teen about the possibility of pregnancy. d. Ask the parents to step out of the room and tell them the nurse's suspicion.

b. Ask the parents to wait in the family lounge while finishing the assessment, then ask the teen during the assessment.

What drug is an angiotensin-converting enzyme (ACE) inhibitor? a. Furosemide (Lasix) b. Captopril (Capoten) c. Chlorothiazide (Diuril) d. Spironolactone (Aldactone)

b. Captopril (Capoten)

What statement best identifies the cause of heart failure (HF)? a. Disease related to cardiac defects b. Consequence of an underlying cardiac defect c. Inherited disorder associated with a variety of defects d. Result of diminished workload imposed on an abnormal myocardium

b. Consequence of an underlying cardiac defect

A cardiac defect that allows blood to shunt from the (high pressure) left side of the heart to the (lower pressure) right side can result in which condition? a. Cyanosis b. Heart failure c. Decreased pulmonary blood flow d. Bounding pulses in upper extremities

b. Heart failure

A nurse is reviewing blood work for a child with a cyanotic heart defect. What result would most likely be seen in a client experiencing polycythemia? a. Decreased RBC b. Increased RBC c. Increased WBC d. Decreased WBC

b. Increased RBC

What blood flow pattern occurs in a ventricular septal defect? a. Mixed blood flow b. Increased pulmonary blood flow c. Decreased pulmonary blood flow d. Obstruction to blood flow from ventricles

b. Increased pulmonary blood flow

A 6-year-old girl is diagnosed with aortic stenosis. The mother asks the nurse what the likely treatment for this condition will involve. What should the nurse tell the mother? a. No treatment is necessary, as the defect will resolve spontaneously b. Insertion of a catheter with an uninflated balloon tip into the affected area followed by inflation of the balloon to open the narrowing c. Insertion of Dacron-coated stainless-steel coils by interventional cardiac catheterization d. Surgical closure by ductal ligation

b. Insertion of a catheter with an uninflated balloon tip into the affected area followed by inflation of the balloon to open the narrowing

What preparation should the nurse consider when educating a school-age child and the family for heart surgery? a. Unfamiliar equipment should not be shown. b. Let the child hear the sounds of a cardiac monitor, including alarms. c. Explain that an endotracheal tube will not be needed if the surgery goes well. d. Discussion of postoperative discomfort and interventions is not necessary before the procedure.

b. Let the child hear the sounds of a cardiac monitor, including alarms.

A 17-year-old adolescent tells the nurse that he is not having sex because it would make his parents very angry. This response indicates that the adolescent has a developmental lag in which area? a. Cognitive development b. Moral development c. Psychosocial development d. Psychosexual development

b. Moral development

The nurse notices that a child is increasingly apprehensive and has tachycardia after heart surgery. The chest tube drainage is now 8 ml/kg/hr. What should be the nurses initial intervention? a. Apply warming blankets. b. Notify the practitioner of these findings. c. Give additional pain medication per protocol. d. Encourage child to cough, turn, and deep breathe.

b. Notify the practitioner of these findings.

An infant with tetralogy of Fallot becomes cyanotic. Which nursing intervention would be the first priority? a. Start an IV for fluids. b. Place the infant in the knee-chest position. c. Raise the head of the bed. d. Prepare the infant for surgery.

b. Place the infant in the knee-chest position.

What sign/symptom is a major clinical manifestation of rheumatic fever (RF)? a. Fever b. Polyarthritis c. Osler nodes d. Janeway spots

b. Polyarthritis

A 6-year-old child is scheduled for a cardiac catheterization. What consideration is most important in planning preoperative teaching? a. Preoperative teaching should be directed at his parents because he is too young to understand. b. Preoperative teaching should be adapted to his level of development so that he can understand. c. Preoperative teaching should be done several days before the procedure so he will be prepared. d. Preoperative teaching should provide details about the actual procedures so he will know what to expect.

b. Preoperative teaching should be adapted to his level of development so that he can understand.

The nurse is caring for a child with persistent hypoxia secondary to a cardiac defect. The nurse recognizes the risk of cerebrovascular accidents (strokes) occurring. What strategy is an important objective to decrease this risk? a. Minimize seizures. b. Prevent dehydration. c. Promote cardiac output. d. Reduce energy expenditure.

b. Prevent dehydration.

What condition is the leading cause of death after heart transplantation? a. Infection b. Rejection c. Cardiomyopathy d. Heart failure

b. Rejection

Caleb and his mother are visiting the clinic for Caleb to get his sports physical. After the exam without Caleb in the room, his mother mentions that she worries that he is participating in risk behaviors and that his dependence on his peers is growing stronger. "What can I do to keep Caleb safe?" Which response by the nurse would be most appropriate? a. Encourage the family to spend more time together playing games or watching movies. b. Remind her that family connectedness is a strong factor in helping kids to remain resilient. c. Tell her that this is normal behavior and that Caleb will out grow this d. Suggest that he invite his friends over to the house and include them in family activities.

b. Remind her that family connectedness is a strong factor in helping kids to remain resilient.

Which behavior suggests appropriate psychosocial development in the adolescent? a. The adolescent seeks validation for socially acceptable behavior from older adults. b. The adolescent is self-absorbed and self-centered and has sudden mood swings. c. Adolescents move from peers and enjoy spending time with family members. d. Conformity with the peer group increases in late adolescence.

b. The adolescent is self-absorbed and self-centered and has sudden mood swings.

The parents of a 3-year-old child with congenital heart disease are afraid to let their child play with other children because of possible overexertion. How should the nurse reply to this concern? a. The parents should meet all the child's needs. b. The child needs opportunities to play with peers. c. Constant parental supervision is needed to avoid overexertion. d. The child needs to understand that peers activities are too strenuous.

b. The child needs opportunities to play with peers.

A mother is asking for more information about her infant's patent ductus arteriosus (PDA). What would be included in the education? a. Your child may need multiple surgeries to correct this defect. b. This is caused by an opening that usually closes by 1 week of age. c. An IV for fluids will be started immediately. d. This type of defect is caused by having a genetic predisposition for it.

b. This is caused by an opening that usually closes by 1 week of age.

What clinical manifestation is a common sign of digoxin toxicity? a. Seizures b. Vomiting c. Bradypnea d. Tachycardia

b. Vomiting

Which statement is the most appropriate advice to give parents of a 16-year-old teenager who is rebellious? a. You need to be stricter so that your teenager feels more secure. b. You need to allow your teenager to make realistic choices while using consistent and structured discipline. c. Increasing your teens involvement with his peers will improve his self-esteem. d. Allow your teenager to choose the type of discipline that is used in your home.

b. You need to allow your teenager to make realistic choices while using consistent and structured discipline.

The nurse will monitor which adolescent client most closely for the risk of suicide? a. a heterosexual client with a history of cocaine use whose best friend moved hours away last week b. an LGBT client requesting the nurse have the client's necklace and whose parents divorced last month c. a homosexual client who is failing two high school courses and refusing prescribed medication d. a heterosexual client diagnosed with multiple personality disorder requesting no visitor

b. an LGBT client requesting the nurse have the client's necklace and whose parents divorced last month

An adolescent is prescribed retinoic acid cream as therapy for his acne. About which of the following would you caution him? a. not putting the medication on just prior to bedtime b. avoiding staying in the sun for extended periods of time c. applying the cream while his face is wet d. not applying the cream directly on lesions

b. avoiding staying in the sun for extended periods of time

The nurse is performing a health surveillance visit with a 12-year-old boy. Which characteristic suggests the boy has entered adolescence? a. understands that actions have consequences b. experiences frequent mood changes c. shows growing interest in attracting girls' attention d. feels secure with his body image

b. experiences frequent mood changes

After assessing a child, the nurse suspects coarctation of the aorta based on a finding of: a. hepatomegaly. b. femoral pulse weaker than brachial pulse. c. bounding pulse. d. narrow pulse.

b. femoral pulse weaker than brachial pulse.

Which behavior by an 18-year-old is consistent with successful progression through the stages of Piaget's theory of development? a. reflects a strong moral code b. uses critical thought processes to handle a problem c. has a strong sense of understanding of internal identity d. is able to be part of a large group of peers while maintaining a sense of self

b. uses critical thought processes to handle a problem

The nurse is teaching an in-service program to a group of nurses on the topic of children diagnosed with rheumatic fever. The nurses in the group make the following statements. Which statement is most accurate regarding the diagnosis of rheumatic fever? a. "The onset and progression of this disorder is rapid." b. "Being up-to-date on immunizations is the best way to prevent this disorder." c. "Children who have this diagnosis may have had strep throat." d. "This disorder is caused by genetic factors."

c. "Children who have this diagnosis may have had strep throat."

The nurse is providing child and family education prior to discharge following a cardiac catheterization. The nurse is teaching about signs and symptoms of complications. Which statement by the mother indicates a need for further teaching? a. "We need to avoid a tub bath for the next 3 days." b. "We need to watch for changes in skin color or difficulty breathing." c. "The feeling of the heart skipping a beat is common." d. "Strenuous activity should be limited for the next 3 days."

c. "The feeling of the heart skipping a beat is common."

The nurse is caring for an infant with Down syndrome who has been diagnosed with atrioventricular canal defect. The parents asks the nurse, "Why do you not put oxygen on our baby more often when his lips and fingernails are blue?" What is the best response by the nurse? a. "Oxygen isn't always the best treatment for your child's condition. Surgery is necessary." b. "I can only place oxygen on your child if the doctor orders oxygen." c. "While it seems that oxygen would help, it actually worsens this condition. Treating the cause of the disease will help." d. "This is something we should talk with the physician about. Maybe it would help your baby."

c. "While it seems that oxygen would help, it actually worsens this condition. Treating the cause of the disease will help."

After returning from cardiac catheterization, the nurse monitors the child's vital signs. The heart rate should be counted for how many seconds? a. 15 b. 30 c. 60 d. 120

c. 60

A nurse is preparing to administer a prescribed dose of digoxin to an 6-month-old infant. After assessing the infant's apical pulse, the nurse decides to withhold the dose and notify the health care provider. The nurse bases this decision on which apical pulse rate? a. 118 beats/min b. 94 beats/min c. 80 beats/min d. 102 beats/min

c. 80 beats/min

The nurse is caring for a 10-year-old boy following a cardiac catheterization. Four hours after the procedure, the nurse notes some minor bleeding at the site. Which action would be most appropriate? a. Contact the physician. b. Change the dressing. c. Apply pressure 1 inch above the site. d. Ensure that the child's leg is kept straight.

c. Apply pressure 1 inch above the site.

Decreasing the demands on the heart is a priority in care for the infant with heart failure (HF). In evaluating the infants status, which finding is indicative of achieving this goal? a. Irritability when awake b. Capillary refill of more than 5 seconds c. Appropriate weight gain for age d. Positioned in high Fowler position to maintain oxygen saturation at 90%

c. Appropriate weight gain for age

The parents of a 14-year-old girl are concerned that their adolescent spends too much time looking in the mirror. Which statement is the most appropriate for the nurse to make? a. Your teenager needs clearer and stricter limits about her behavior. b. Your teenager needs more responsibility at home. c. During adolescence, this behavior is not unusual. d. The behavior is abnormal and needs further investigation.

c. During adolescence, this behavior is not unusual.

The school nurse is performing health assessments on students in middle school. Of what developmental milestone should the nurse be aware? a. Height in girls increases rapidly after menarche and usually ceases increasing immediately after menarche. b. Boys reach PHV and peak weight velocity (PWV) at about 16 years of age. c. Peak height velocity (PHV) occurs at approximately 12 years of age in girls or about 6 to 12 months after menarche. d. Boys' growth spurts usually begin between the ages of 8 and 14 years and end between the ages of 13½ and 17½ years.

c. Peak height velocity (PHV) occurs at approximately 12 years of age in girls or about 6 to 12 months after menarche.

A nurse is teaching an adolescent about Tanner stages. Which statement best describes Tanner staging? a. Predictable stages of puberty that are based on chronological age b. Staging of puberty based on the initiation of menarche and nocturnal emissions c. Predictable stages of puberty that are based on primary and secondary sexual characteristics d. Staging of puberty based on the initiation of primary sexual characteristics

c. Predictable stages of puberty that are based on primary and secondary sexual characteristics

Which health teaching concept should the nurse emphasize when instructing the parents of a child with polycythemia caused by a congenital heart disorder? a. Prepare for seizures. b. Encourage progressive activity. c. Prevent dehydration. d. Expect the skin to turn yellow.

c. Prevent dehydration.

After returning from cardiac catheterization, the nurse determines that the pulse distal to the catheter insertion site is weaker. How should the nurse respond? a. Elevate the affected extremity. b. Notify the practitioner of the observation. c. Record data on the assessment flow record. d. Apply warm compresses to the insertion site.

c. Record data on the assessment flow record.

What action by the school nurse is important in the prevention of rheumatic fever (RF)? a. Encourage routine cholesterol screenings. b. Conduct routine blood pressure screenings. c. Refer children with sore throats for throat cultures. d. Recommend salicylates instead of acetaminophen for minor discomforts.

c. Refer children with sore throats for throat cultures.

The nurse finds that a 6-month-old infant has an apical pulse of 166 beats/min during sleep. What nursing intervention is most appropriate at this time? a. Administer oxygen. b. Record data on the nurses notes. c. Report data to the practitioner. d. Place the child in the high Fowler position.

c. Report data to the practitioner.

The nurse is assessing the psychosocial development of an adolescent. The nurse determines that the client is in the middle post-conventional phase with which observation? a. The adolescent states, "I am glad my parents instilled such a good work ethic in me." b. The nurse hears the adolescent talking with a friend and states, "I don't understand how some of the rich in our society don't help the poor." c. The adolescent tells the nurse, "I'm starting to think that some of my friends care a lot more about what other people think of them than what I do." d. The nurse hears the adolescent asking the parents, "How does God decide that some people get sick and some people don't?"

c. The adolescent tells the nurse, "I'm starting to think that some of my friends care a lot more about what other people think of them than what I do."

A nurse is obtaining the history from a woman who is in labor. Which of the following if reported by the mother would alert the nurse to the possibility that the newborn has an increased risk for a congenital heart defect? a. The mother states she took acetaminophen while pregnant. b. The mother states she slept all the time while pregnant. c. The mother states she has lupus. d. The mother has a history of seizures.

c. The mother states she has lupus.

Which statement by the nurse is most appropriate to a 15-year-old adolescent whose friend has mentioned suicide? a. Tell your friend to come to the clinic immediately. b. You need to gather details about your friends suicide plan. c. Your friends threat needs to be taken seriously and immediate help for your friend is important. d. If your friend mentions suicide a second time, you will want to get your friend some help.

c. Your friends threat needs to be taken seriously and immediate help for your friend is important.

A nurse is caring for a teenager who is in the end stage of cancer. Which of the following nursing interventions provides self-esteem and self-worth to the teen? a. answering all of the teenager's questions b. listening to the adolescent's fears about death c. allowing the teenager to completely participate in decisions d. encouraging the teenager to talk about feelings

c. allowing the teenager to completely participate in decisions

The teenager with severe edema is reluctant to return to school but avoids discussing the reasons for this. From knowledge of adolescent growth and development and awareness of the manifestations of edema, what does the nurse assume is the main reason for the teen's feelings? a. diet and fluid intake modifications b. impaired mobility due to joint motion restriction c. changes in physical appearance d. need to urinate frequently

c. changes in physical appearance

A nurse is giving a talk to nursing students about women's health. What does the nurse tell the students is the main cause of dysmenorrhea in adolescents? a. amenorrhea b. metrorrhagia c. endometriosis d. premenstrual dysphoric disorder

c. endometriosis

A nurse caring for a client diagnosed with Chlamydia trachomatis can expect which subsequent tests? a. trichomoniasis b. syphilis c. gonorrhea d. candidiasis

c. gonorrhea

A nurse is addressing a group of school teachers on the importance of sex education for children. What should the nurse emphasize as the highest primary source of sex education information for adolescents? a. counselors b. teachers c. parents d. peers

c. parents

An infant is hospitalized with heart failure. The health care provider has prescribed furosemide, enalapril, and carvedilol as part of the plan of care. Based on these medications, when reviewing the infant's laboratory results, which value is most important for the nurse to consider? a. blood urea nitrogen (BUN) b. calcium c. potassium d. glucose

c. potassium

Which factor contributes to early adolescents engaging in risk-taking behaviors? a. Peer pressure b. A desire to master their environment c. Engagement in the process of separation from their parents d. A belief that they are invulnerable

d. A belief that they are invulnerable

The nurse is conducting a presentation for a group of nurses who work with adolescents. The group discusses dysmenorrhea. Which statement is most accurately related to dysmenorrhea? a. Genetic abnormalities are the most common cause of dysmenorrhea. b. Common symptoms of dysmenorrhea are weight gain and mood swings. c. Dysmenorrhea can result from diaphragms or tampons being left in place too long. d. A contributing factor in dysmenorrhea is the increased secretion of prostaglandins.

d. A contributing factor in dysmenorrhea is the increased secretion of prostaglandins.

What nursing consideration is important when suctioning a young child who has had heart surgery? a. Perform suctioning at least every hour. b. Suction for no longer than 30 seconds at a time. c. Expect symptoms of respiratory distress when suctioning. d. Administer supplemental oxygen before and after suctioning.

d. Administer supplemental oxygen before and after suctioning.

A 16-year-old client is admitted to the hospital for acute appendicitis and an appendectomy is performed. Which nursing intervention is most appropriate to facilitate normal growth and development postoperatively? a. Encourage the client to rest and read. b. Encourage the parents to room in with the client. c. Allow the family to bring in the client's favorite computer games. d. Allow the client to interact with others in his or her same age group.

d. Allow the client to interact with others in his or her same age group.

What type of drug reduces hypertension by interfering with the production of angiotensin II? a. Diuretics b. Vasodilators c. Beta-blockers d. Angiotensin-converting enzyme (ACE) inhibitors

d. Angiotensin-converting enzyme (ACE) inhibitors

The nurse is caring for a school-age girl who has had a cardiac catheterization. The child tells the nurse that her bandage is too wet. The nurse finds the bandage and bed soaked with blood. What nursing action is most appropriate to institute initially? a. Notify the physician. b. Place the child in Trendelenburg position. c. Apply a new bandage with more pressure. d. Apply direct pressure above the catheterization site.

d. Apply direct pressure above the catheterization site.

The nurse is performing an assessment of the genitalia of a 15-year-old male. The nurse notes that the pigment of the skin of the scrotum is much lighter than the rest of the client's skin color. What is the nurse's best action? a. There is no need to address this issue since this is a normal finding for an adolescent male. b. Document the findings so there is proof of the assessment findings. c. Talk with the client's parents to see if they were aware of this pigment issue. d. Ask the client if the scrotal skin has always been lighter in pigment than the rest of the patient's skin.

d. Ask the client if the scrotal skin has always been lighter in pigment than the rest of the patient's skin.

The best response a nurse can make to a 15-year-old girl who has verbalized a desire to have a baby is: a. Have you talked with your parents about this? b. Do you have plans to continue school? c. Will you be able to support the baby? d. Can you tell me how your life will change if you have an infant?

d. Can you tell me how your life will change if you have an infant?

What term is defined as the volume of blood ejected by the heart in 1 minute? a. Afterload b. Cardiac cycle c. Stroke volume d. Cardiac output

d. Cardiac output

What nutritional component should be altered in the infant with heart failure (HF)? a. Decrease in fats b. Increase in fluids c. Decrease in protein d. Increase in calories

d. Increase in calories

The diagnosis of hypertension depends on accurate assessment of blood pressure (BP). What is the appropriate technique to measure a childs BP? a. Assess BP while the child is standing. b. Compare left arm with left leg BP readings. c. Use a narrow cuff to ensure that the readings are correct. d. Measure BP with the child in the sitting position on three separate occasions.

d. Measure BP with the child in the sitting position on three separate occasions.

The parents of a young child with heart failure (HF) tell the nurse that they are nervous about giving digoxin. The nurses response should be based on which knowledge? a. It is a safe, frequently used drug. b. Parents lack the expertise necessary to administer digoxin. c. It is difficult to either overmedicate or undermedicate with digoxin. d. Parents need to learn specific, important guidelines for administration of digoxin.

d. Parents need to learn specific, important guidelines for administration of digoxin.

A nurse is caring for a child with Kawasaki disease. Which assessment finding would the nurse expect to see? a. Low blood pressure and decreased heart rate b. Decreased heart rate and impalpable pulse c. Irritability and dry mucous membranes d. Peeling hands and feet; fever

d. Peeling hands and feet; fever

A 3-month-old infant has a hypercyanotic spell. What should be the nurses first action? a. Assess for neurologic defects. b. Prepare the family for imminent death. c. Begin cardiopulmonary resuscitation. d. Place the child in the knee-chest position.

d. Place the child in the knee-chest position.

The physician suggests that surgery be performed for patent ductus arteriosus (PDA) to prevent which complication? a. Hypoxemia b. Right-to-left shunt of blood c. Decreased workload on the left side of the heart d. Pulmonary vascular congestion

d. Pulmonary vascular congestion

When conducting a physical examination of a child with suspected Kawasaki disease, which finding would the nurse expect to assess? a. Malar rash b. Hirsutism or striae c. Café au lait spots d. Strawberry tongue

d. Strawberry tongue

A chest radiography examination is ordered for a child with suspected cardiac problems. The child's parent asks the nurse, What will the x-ray show about the heart? The nurses response should be based on knowledge that the radiograph provides which information? a. Shows bones of the chest but not the heart b. Evaluates the vascular anatomy outside of the heart c. Shows a graphic measure of electrical activity of the heart d. Supplies information on heart size and pulmonary blood flow patterns

d. Supplies information on heart size and pulmonary blood flow patterns

A school nurse finds a 10-year-old's blood pressure is over the 95th percentile. The nurse advises the parent to seek medical attention for the child. What outcome would the nurse expect? a. Advise the child go to the emergency room. b. This is a normal result for a child this age. c. The child will probably need surgery. d. The child will need the blood pressure checked two more times.

d. The child will need the blood pressure checked two more times.

When caring for the child with Kawasaki disease, what should the nurse know to provide safe and effective care? a. Aspirin is contraindicated. b. The principal area of involvement is the joints. c. The child's fever is usually responsive to antibiotics within 48 hours. d. Therapeutic management includes administration of gamma globulin and salicylates.

d. Therapeutic management includes administration of gamma globulin and salicylates.

To prevent infective endocarditis in the child with an artificial heart valve, the nurse teaches parents to: a. avoid raw fruits and vegetables. b. disallow household pets. c. immediately treat unexplained fevers with acetaminophen. d. administer prophylactic antibiotics before dental work.

d. administer prophylactic antibiotics before dental work.

The nurse is planning care for an infant with a nursing diagnosis of decreased cardiac output related to a cardiac defect. What is the most appropriate outcome for this nursing diagnosis? The child will: a. demonstrate electrolyte values within acceptable parameters. b. have stable ABGs, decreased pulmonary secretions, and clear breath sounds. c. demonstrate stable vital signs, capillary refill less than 3 seconds, and a urine output of 1-2 ml/kg/hr. d. exhibit clear breath sounds and no weight gain.

d. exhibit clear breath sounds and no weight gain.

When planning care for adolescents, the nurse should: a. teach parents first, and they, in turn, will teach the teenager. b. provide information for their long-term health needs because teenagers respond best to long-range planning. c. maintain the parents role by providing explanations for treatment and procedures to the parents only. d. give information privately to adolescents about how they can manage the specific problems that they identify.

d. give information privately to adolescents about how they can manage the specific problems that they identify.

In observing a group of young adolescents playing basketball, it is noted that many of the adolescents appear to be uncoordinated and drop the ball often. The most common reason this occurs is because: a. hormone levels affect the motor skills of the adolescent. b. movements are voluntary and the adolescent has trouble focusing. c. fine motor skills have not yet begun to develop. d. large muscles grow before small muscles grow.

d. large muscles grow before small muscles grow.

A client's newborn is diagnosed with Tetralogy of Fallot. When explaining this condition to the client, which of the following defects would the nurse's description include? a. stenosis of the aorta b. atrial septal defect c. left ventricular hypertrophy d. overriding of the aorta

d. overriding of the aorta

The nurse is caring for a pediatric client diagnosed with eczema. Which topical medication order does the nurse anticipate for this client? 1. Corticosteroids 2. Retinoids 3. Antifungals 4. Antibacterials

1. Corticosteroids

An infant of a mother infected with human immunodeficiency virus (HIV) is seen in the clinic each month and is being monitored for symptoms indicative of HIV infection. With knowledge of the most common opportunistic infection of children infected with HIV, the nurse assesses the infant for which sign? 1. Cough 2. Liver failure 3. Watery stool 4. Nuchal rigidity

1. Cough

A pediatric client is hospitalized with a severe case of impetigo contagiosa. Which antibiotic does the nurse anticipate the healthcare provider will order for this client? 1. Dicloxacillin (Pathocil) 2. Rifampin (Rifadin) 3. Sulfamethoxazole and trimethoprim (Bactrim) 4. Metronidazole (Flagyl)

1. Dicloxacillin (Pathocil)

The nurse is closely monitoring the intake and output of an infant with heart failure who is receiving diuretic therapy. The nurse should use which most appropriate method to assess the urine output? 1. Weighing the diapers 2. Inserting a urinary catheter 3. Comparing intake with output 4. Measuring the amount of water added to formula

1. Weighing the diapers

The nurse is examining a 12-month-old who is brought to the clinic for persistent diaper rash. The nurse finds perianal inflammation with bright red scaly plaques and small papules. Satellite lesions are also present. What is the most likely cause of this clients diaper rash? 1. Impetigo (staph) 2. Candida albicans (yeast) 3. Urine and feces 4. Infrequent diapering

2. Candida albicans (yeast)

The nurse reviews the laboratory results for a child with a suspected diagnosis of rheumatic fever, knowing that which laboratory study would assist in confirming the diagnosis? 1. Immunoglobulin 2. Red blood cell count 3. White blood cell count 4. Anti-streptolysin O titer

4. Anti-streptolysin O titer

A 2-month-old client has a candidal diaper rash. Which medication does the nurse anticipate will be prescribed for this client? 1. Bacitracin ointment 2. Hydrocortisone ointment 3. Desitin 4. Nystatin given topically and orally

4. Nystatin given topically and orally

A pediatrician has prescribed oxygen as needed for an infant with heart failure. In which situation should the nurse administer the oxygen to the infant? 1. During sleep 2. When changing the infant's diapers 3. When the mother is holding the infant 4. When drawing blood for electrolyte level testing

4. When drawing blood for electrolyte level testing

The school nurse is conducting pediculosis capitis (head lice) checks. Which findings would indicate a positive head check? 1. White, flaky particles throughout the entire scalp region 2. Maculopapular lesions behind the ears 3. Lesions in the scalp that extend to the hairline or neck 4. White sacs attached to the hair shafts in the occipital area

4. White sacs attached to the hair shafts in the occipital area

A pediatrician prescribes laboratory studies for an infant of a woman positive for human immunodeficiency virus (HIV). The nurse anticipates that which laboratory study will be prescribed for the infant? 1. Chest x-ray 2. Western blot 3. CD4+ cell count 4. p24 antigen assay

4. p24 antigen assay

What is a true statement regarding varicella zoster virus infection? a. It tends to be more severe in children. b. Secondary bacterial infections of the skin can occur. c. It is transmitted by fecal-oral route. d. The incubation period is 7 days.

b. Secondary bacterial infections of the skin can occur.

When providing care for a child with herpes zoster (shingles), the parents ask the nurse how the child contracted this infectious disorder. Which response by the nurse is most appropriate? a. "Herpes zoster is a reactivation of a previous varicella zoster infection." b. "Handwashing is an effective way to prevent the spread of infectious disorders." c. "Children who are immunocompromised are more likely to contract shingles." d. "Your child must have been exposed to someone with herpes zoster."

a. "Herpes zoster is a reactivation of a previous varicella zoster infection."

When describing measles to a local parent group, the nurse explains that which of the following is the hallmark clinical manifestation? a. Koplik spots b. cough c. fever d. conjunctivitis

a. Koplik spots

A nurse in a well-child clinic is teaching parents about their child's immune system. Which statement, made by the nurse, is correct? a. The immune system distinguishes and actively protects the body's own cells from foreign substances. b. The immune system is fully developed by 1 year of age. c. The immune system protects the child against communicable diseases in the first 6 years of life. d. The immune system responds to an offending agent by producing antigens.

a. The immune system distinguishes and actively protects the body's own cells from foreign substances.

The nurse is caring for a child who is taking corticosteroids for systemic lupus erythematosus. The nurse closely monitors the child based on the understanding that corticosteroids exert which major action? a. They can mask signs of infection. b. They decrease renal function. c. They cause bone marrow suppression. d. They increase liver enzymes.

a. They can mask signs of infection.

The nurse is caring for a newborn diagnosed with patent ductus arteriosus. Which finding will the nurse assess that is consistent with this diagnosis? a. absent femoral pulses b. systolic murmur c. slow heart rate d. expiratory grunt

a. absent femoral pulses

The nurse is assigned to care for a 14-year-old child who is hospitalized in traction for serious leg fractures after an automobile accident. The parents ask the nurse to avoid administering analgesics to their child to help prevent him from becoming addicted. Which response by the nurse is indicated? a. "If there is no history of substance use disorder in the family there should be no increased risk for the development of addiction." b. "Administering medications to manage reports of pain is not going to cause addiction." c. "Your child is too young to experience drug addiction." d. "We can talk with the health care provider to see about reducing the amount of medications given to reduce the potential for addiction."

b. "Administering medications to manage reports of pain is not going to cause addiction."

The parent of a child with deep partial-thickness (second-degree) burns on the legs asks the nurse, "One of the staff told me that the dressings being used have silver in them. Why is that?" Which response by the nurse would be most appropriate? a. "Silver is used to help prevent any scarring." b. "Dressings containing silver help prevent infection." c. "Silver has been shown to speed up the healing process." d. "Silver helps repair nerve endings that were damaged."

b. "Dressings containing silver help prevent infection."

The nursing instructor has completed a presentation on normal immune function. Which statement by a student would suggest a need for further education? a. "Phagocytosis is the process in which phagocytes swallow up and break down microorganisms." b. "Humoral immunity is generally functional at birth." c. "Cellular immunity is cell-mediated immunity controlled by T cells." d. "Humoral immunity is immunity mediated by antibodies secreted by B cells."

b. "Humoral immunity is generally functional at birth."

The nurse is providing education to the parents of a child prescribed oral cyclophosphamide. Which statement by the parent indicates additional teaching is needed? a. "My child needs to drink plenty of fluids while taking this medication." b. "I need to give this medication to my child at bedtime." c. "I will monitor my child closely for signs of an infection." d. "I will wear rubber gloves if I need to clean up any of my child's body fluids."

b. "I need to give this medication to my child at bedtime."

Which behavior by an 18-year-old is consistent with successful progression through the stages of Piaget's theory of development? a. has a strong sense of understanding of internal identity b. uses critical thought processes to handle a problem c. is able to be part of a large group of peers while maintaining a sense of self d. reflects a strong moral code

b. uses critical thought processes to handle a problem

During a routine assessment, the nurse determines that a school-age child has head lice. What did the nurse assess in this child? a. red raised rash on the neck b. white flecks on hair shafts c. macular rash on the arms d. pustule formation on the trunk

b. white flecks on hair shafts

A nursing student is learning about developmental disorders. The nursing instructor realizes that further instruction is necessary when the student makes which statement? a. "Families should not be blamed for causing a developmental delay." b. "Families should work to facilitate the child's progress." c. "A definitive cause can be found for every developmental disorder." d. "Families should be helped to accept the child's developmental delay."

c. "A definitive cause can be found for every developmental disorder."

What is the drug of choice the nurse would administer in the acute treatment of anaphylaxis? a. Diphenhydramine (Benadryl) b. Cimetidine (Tagamet) c. Epinephrine (Adrenaline) d. Albuterol (Ventolin)

c. Epinephrine (Adrenaline)

A nurse is reviewing the medical record of an infant whose mother is HIV positive. Which factor in the maternal history would the nurse interpret as helping to decrease the infant's risk for HIV transmission? a. coexistence of another sexually transmitted infection b. high maternal viral load c. use of zidovudine therapy during pregnancy d. low maternal CD4+ lymphocyte count

c. use of zidovudine therapy during pregnancy

The nurse is promoting nutrition to a teen who is going through a growth spurt. Which food should the nurse recommended for its high iron content? a. organic carrots b. fat-free milk c. whole grain bread d. fresh orange juice

c. whole grain bread

The parents of a child with heart failure ask the nurse, "How will the digoxin he is getting help?" Which response by the nurse would be most appropriate? a. "Digoxin helps to open up the blood vessels to improve blood flow." b. "The drug will help to remove the extra fluid in his body." c. "The drug will lower his blood pressure so the heart won't work so hard." d. "Digoxin helps to improve the heart's ability to contract ."

d. "Digoxin helps to improve the heart's ability to contract ."

The nurse is assessing the skin of a 6-year-old child with urticaria. When interviewing the child and parents, which question would be most important for the nurse to ask? a. "When did you first notice the rash?" b. "Is there any itching with the rash?" c. "Did you do anything at home to treat the rash?" d. "Is the child having any trouble breathing?"

d. "Is the child having any trouble breathing?"

A nurse is taking the history of a 4-year-old child who will undergo a cardiac catheterization. Which statement by the parent may necessitate rescheduling of the procedure? a. "My child kept scratching the chest, so I applied hydrocortisone cream to stop the itching." b. "My child tells me about headaches because of being scared and nervous about the procedure." c. "My child is allergic to iodine and shellfish." d. "My child seems listless and slightly warm."

d. "My child seems listless and slightly warm."

The nurse is caring for a 16-year-old adolescent who was arrested for driving while intoxicated. Which teaching method is most effective in changing the adolescent's behavior? a. scolding the client for such irresponsible behavior b. teaching that alcohol eventually will lead to other drug abuse c. reviewing the long-term effects of alcohol on the liver d. stressing that the driver's license can be lost if drinking continues

d. stressing that the driver's license can be lost if drinking continues

The nurse is caring for a child presenting with plaques around the nose and mouth that have a honey-crusted appearance. What treatment does the nurse anticipate for the child? a. one application of permethrin, then repeat application in 7 days b. one application of malathion left on overnight c. acyclovir for 5 to 7 days d. topical mupirocin for 10 to 14 days

d. topical mupirocin for 10 to 14 days

The clinic nurse reviews the record of a child just seen by the pediatrician and diagnosed with suspected aortic stenosis. The nurse expects to note documentation of which clinical manifestation specifically found in this disorder? 1. Pallor 2. Hyperactivity 3. Activity intolerance 4. Gastrointestinal disturbances

3. Activity intolerance

During the recovery-management phase of burn treatment, which is the most common complication seen in children? 1. Shock 2. Metabolic acidosis 3. Burn-wound infection 4. Asphyxia

3. Burn-wound infection

On assessment of a child admitted with a diagnosis of acute-stage Kawasaki disease, the nurse expects to note which clinical manifestation of the acute stage of the disease? 1. Cracked lips 2. Normal appearance 3. Conjunctival hyperemia 4. Desquamation of the skin

3. Conjunctival hyperemia

When teaching a group of new parents about newborn care and development, which immunoglobulin would the nurse explain as being primarily responsible for the passive immunity exhibited by newborns? a. IgG b. IgM c. IgE d. IgA

a. IgG

A nurse is assessing a young child and suspects coarctation of the aorta based on which finding? a. Excessive crying b. Diastolic murmur c. Unequal upper and lower extremity pulses d. Hypotension

c. Unequal upper and lower extremity pulses

The clinic nurse is instructing the parent of a child with human immunodeficiency virus (HIV) infection regarding immunizations. The nurse should provide which instruction to the parent? 1. The hepatitis B vaccine will not be given to the child. 2. The inactivated influenza vaccine will be given yearly. 3. The varicella vaccine will be given before 6 months of age. 4. A Western blot test needs to be performed and the results evaluated before immunizations.

2. The inactivated influenza vaccine will be given yearly.

The nurse has provided home care instructions to the parents of a child who is being discharged after cardiac surgery. Which statement made by the parents indicates a need for further instruction? 1. "A balance of rest and activity is important." 2. "I can apply lotion or powder to the incision if it is itchy." 3. "Activities in which my child could fall need to be avoided for 2 to 4 weeks." 4. "Large crowds of people need to be avoided for at least 2 weeks after surgery."

2. "I can apply lotion or powder to the incision if it is itchy."

The nurse explains to the parents of a child with a severe burn that wearing of an elastic pressure garment (Jobst stocking) during the rehabilitative stage can help with the prevention of which complication? 1. Poor circulation 2. Hypertrophic scarring 3. Pain 4. Formation of thrombus in the burn area

2. Hypertrophic scarring

A nurse is caring for a toddler client who is diagnosed with scabies and prescribed a 5 percent permethrin lotion. How will the nurse apply this lotion when administering it to the toddler? 1. To the scalp only 2. Over the entire body from the chin down, as well as on the scalp and forehead 3. Only on the areas with evidence of scabies activity 4. Only on the hands

2. Over the entire body from the chin down, as well as on the scalp and forehead

A pediatric client sustains a minor burn. When teaching the family the treatment for this burn, the nurse would teach that the clients diet should be high in which substance? 1. Fats 2. Protein 3. Minerals 4. Carbohydrates

2. Protein

The nurse is providing care for a pediatric client who has a third-degree circumferential burn of the right arm. Which nursing diagnosis is the priority for this client? 1. Risk for Infection 2. Risk for Altered Tissue Perfusion 3. Risk for Altered Nutrition: Less than Body Requirements 4. Impaired Physical Mobility

2. Risk for Altered Tissue Perfusion

An infant has a severe case of oral thrush (Candida albicans). Which nursing diagnosis is the priority for this infant? 1. Activity Intolerance Related to Oral Thrush 2. Ineffective Airway Clearance Related to Mucus 3. Ineffective Infant Feeding Pattern Related to Discomfort 4. Ineffective Breathing Pattern Related to Oral Thrush

3. Ineffective Infant Feeding Pattern Related to Discomfort

The nurse is planning care for a 3-month-old infant diagnosed with eczema. Which should be the focus of the nurses care for this infant? 1. Maintaining adequate nutrition 2. Keeping the baby content 3. Preventing infection of lesions 4. Applying antibiotics to lesions

3. Preventing infection of lesions

The nurse is monitoring an infant with congenital heart disease closely for signs of heart failure (HF). The nurse should assess the infant for which early sign of HF? 1. Pallor 2. Cough 3. Tachycardia 4. Slow and shallow breathing

3. Tachycardia

A child with rheumatic fever will be arriving to the nursing unit for admission. On admission assessment, the nurse should ask the parents which question to elicit assessment information specific to the development of rheumatic fever? 1. "Has the child complained of back pain?" 2. "Has the child complained of headaches?" 3. "Has the child had any nausea or vomiting?" 4. "Did the child have a sore throat or fever within the last 2 months?"

4. "Did the child have a sore throat or fever within the last 2 months?"

The nurse provides home care instructions to the parent of a child with acquired immunodeficiency syndrome (AIDS). Which statement by the parent indicates the need for further teaching? 1. "I will wash my hands frequently." 2. "I will keep my child's immunizations up to date." 3. "I will avoid direct unprotected contact with my child's body fluids." 4. "I can send my child to day care if he has a fever, as long as it is a low-grade fever."

4. "I can send my child to day care if he has a fever, as long as it is a low-grade fever."

The nurse provides home care instructions to the parents of a child with heart failure regarding the procedure for administration of digoxin. Which statement made by the parent indicates the need for further instruction? 1. "I will not mix the medication with food." 2. "If more than 1 dose is missed, I will call the pediatrician." 3. "I will take my child's pulse before administering the medication." 4. "If my child vomits after medication administration, I will repeat the dose."

4. "If my child vomits after medication administration, I will repeat the dose."

A parent phones the nurse stating their 5-year-old child has lesions similar to those of varicella. The parent states the child is itchy and uncomfortable. Which statement by the parent will the nurse clarify? a. "I am going to give my child a baby aspirin to decrease their itchiness and so they can rest better." b. "I will keep my child home from school until all of the lesions have completely crusted over." c. "I will try an oatmeal bath or oatmeal cream with an antihistamine to soothe the child's lesions." d. "I have placed gloves on both of my child's hands so they will not scratch and cause an infection."

a. "I am going to give my child a baby aspirin to decrease their itchiness and so they can rest better."

The nurse is caring for a 2-month-old infant who has been diagnosed with acute heart failure. The nurse is providing teaching about nutrition. Which statement by the mother indicates a need for further teaching? a. "I need to feed him every hour to make sure he eats enough." b. "Gavage feedings may be required for now." c. "Small, frequent feedings are best if tolerated." d. "The baby may need as much as 150 calories/kg/day."

a. "I need to feed him every hour to make sure he eats enough."

The nurse is teaching the parents of a 5-year-old child diagnosed with head lice about using permethrin. The nurse determines that the teaching was successful based on which statement by the parents? a. "We need to leave the medication on for about 10 minutes before rinsing it off." b. "One application of the medication should be enough to get rid of the lice." c. "We should apply the medication to our child's hair and scalp when it is dry." d. "If we use the medicine, we will not have to use the special comb for the nits."

a. "We need to leave the medication on for about 10 minutes before rinsing it off."

The nursing is caring for a hospitalized child diagnosed with varicella-zoster virus. The child's parents ask how to prevent the child's siblings from contracting the virus. Which response by the nurse is best? a. "We will place your child on contact and airborne precautions. It is best for the other children not to visit." b. "Vaccinating your other children is the only way to prevent them from contracting the virus." c. "As long as your other children wash their hands, they should not contract the virus." d. "Since this is a virus, there is nothing you can do to prevent your other children from getting it."

a. "We will place your child on contact and airborne precautions. It is best for the other children not to visit."

Which client will the nurse assess first after receiving shift report? a. A client with human immunodeficiency virus (HIV) whose temperature is 102.2°F (39°C) b. A client with serum sickness stating, "I just feel bad all over." c. A client with contact dermatitis who has blisters and mild edema on the lower extremities d. A client newly diagnosed with allergic rhinitis prescribed loratadine 10 mg

a. A client with human immunodeficiency virus (HIV) whose temperature is 102.2°F (39°C)

After assessing a child's blood pressure, the nurse determines the pulse pressure and finds that it is narrowed. What would the nurse identify as associated with this finding? a. Aortic stenosis b. Aortic insufficiency c. Patent ductus arteriosus d. Complete heart block

a. Aortic stenosis

Coarctation of the aorta demonstrates few symptoms in newborns. What is an important assessment to make on all newborns to help reveal this condition? a. Assessing for the presence of femoral pulses b. Recording an upper extremity blood pressure c. Observing for excessive crying d. Auscultating for a cardiac murmur

a. Assessing for the presence of femoral pulses

The school nurse is walking through the lunchroom when one of the children says she started to feel strange after trading lunches with a friend. Which assessment would be most important? a. Determining if her throat itches b. Checking if she has any nausea c. Asking if she has abdominal pain d. Asking if she has a rash anywhere

a. Determining if her throat itches

While assessing a neonate with a ventricular septal defect (VSD), the nurse notes crackles and retractions. The nurse obtains the following vital signs: temp 100.2°F (38°C), pulse 134 bpm, respirations 64 breaths/minute, oxygen saturation 97% on room air. What will the nurse do first? a. Give furosemide intravenously. b. Administer acetaminophen rectally. c. Advise the mother to bottle feed. d. Apply oxygen 10 liters/min (LPM) via oxyhood.

a. Give furosemide intravenously.

The nurse is preparing educational materials for a group of new parents about allergic reactions. Which specific immunoglobulin should the nurse emphasize as being responsible for these types of reactions? a. IgE b. IgA c. IgM d. IgG

a. IgE

What is the primary nursing concern for a hospitalized child with HIV infection? a. Maintaining growth and development b. Eating foods that the family brings to the child c. Consideration of parental limitations and weaknesses d. Resting for 2 to 3 hours twice a day

a. Maintaining growth and development

Which recommendation by the nurse is appropriate for a mother who has a preschool child who refuses to take the medications for HIV infection? a. Mix medications with chocolate syrup or follow with chocolate candy. b. Mix the medications with milk or an essential food. c. Skip the dose of medication if the child protests too much. d. Mix the medication in a syringe, hold the child down firmly, and administer the medication.

a. Mix medications with chocolate syrup or follow with chocolate candy.

A nurse is teaching parents about transmission of human immunodeficiency virus (HIV) in the pediatric population. The nurse should relate that the most common mode of transmission of HIV virus is: a. Perinatal transmission b. Sexual abuse c. Blood transfusions d. Poor hand washing

a. Perinatal transmission

What information should be included in the teaching plan for a child with varicella? a. Remind the child not to scratch the lesions. b. Utilize salt solutions to assist in healing oral lesions. c. Administer aspirin for fever. d. Place the child in a warm bath for skin discomfort.

a. Remind the child not to scratch the lesions.

The nurse observes a red rash that spreads across the childs cheeks and nose. This assessment finding is characteristic of which of the following conditions? a. Systemic lupus erythematosus (SLE) b. Rheumatic fever c. Kawasaki disease d. Anaphylactic reaction

a. Systemic lupus erythematosus (SLE)

The nurse is preparing to take a blood pressure reading for a 5-year-old child with coarctation of the aorta. How will the nurse proceed with the assessment? a. Take a blood pressure reading on all four extremities. b. Have the child lie supine during the assessment. c. Ensure the child is calm for at least 60 seconds prior to taking a blood pressure reading. d. Take a blood pressure reading on the right arm.

a. Take a blood pressure reading on all four extremities.

A newborn has been diagnosed with congenital heart disease. Which of the following congenital heart diseases is associated with cyanosis? a. Tetralogy of Fallot b. coarctation of the aorta c. aortic stenosis d. pulmonary stenosis

a. Tetralogy of Fallot

A young girl arrives at the emergency room after being bitten by a neighbor's dog. The mother is concerned her daughter will get rabies. The nurse carefully examines and treats the bite and questions the mother and daughter about the details surrounding the dog biting her. What information would most strongly indicate a risk for rabies infection in this client? a. The dog was unprovoked when he bit the girl b. There have been no other reported instances in the area c. The dog was properly immunized for rabies d. The dog belonged to a neighbor

a. The dog was unprovoked when he bit the girl

Parents are told that their infant has a heart defect with a left-to-right shunt. What is the best way for the nurse to explain this type of shunting to the parents? a. This type of shunting causes an increase of blood to the lungs. b. This type of shunting causes an increase of blood to the systemic circulation. c. This type of shunting causes a decrease of blood to the lungs. d. This type of shunting causes a decrease of blood to the brain.

a. This type of shunting causes an increase of blood to the lungs.

An advance practice mental health nurse is preparing for an individual therapy session with a 7-year-old girl who has been the victim of sexual abuse. The girl has limited proficiency in the dominant language. Which approach will likely engage the girl? a. art therapy with the nurse b. talk therapy with the nurse c. activity therapy with the nurse d. game therapy with the nurse

a. art therapy with the nurse

A nursing student is reviewing information about medications used to treat congestive heart failure in children. The student demonstrates understanding of the information by identifying which drug as prescribed to increase myocardial contractility? a. digoxin b. hydralazine c. nifedipine d. furosemide

a. digoxin

The nurse is assessing a child who is experiencing renal complications as a result of lupus. Which finding is of greatest concern? a. elevated blood pressure b. elevated temperature c. hypotension d. reduced body temperature

a. elevated blood pressure

The nurse is caring for a child with juvenile idiopathic arthritis (JIA). There is involvement of five or more small joints and it is affecting the body symmetrically. This tells the nurse that the child: a. has polyarticular JIA. b. is at risk for anaphylaxis. c. has pauciarticular JIA. d. has systemic JIA.

a. has polyarticular JIA.

The nurse is instructing a group of parents about transmission of infectious diseases in children. Which would the nurse cite as the primary method for prevention? a. immunization b. Handwashing c. isolation d. education

a. immunization

A 5-year-old has allergic rhinitis. It would be most appropriate to collect information regarding the child's exposure to which substances? a. pollens b. foods c. drugs d. metals

a. pollens

The nurse is providing a class for a group of child care providers. When discussing allergic reactions, which statement by a participant indicates the need for further instruction? a. "Allergic reactions can happen hours after eating something." b. "If a child has previously eaten a food and not had a reaction they are not 'truly' allergic to it. c. "In addition to hives some children may also have vomiting and diarrhea when having an allergic reaction to a food." d. "Most allergic reactions will happen within a few minutes of eating a problematic food."

b. "If a child has previously eaten a food and not had a reaction they are not 'truly' allergic to it.

When educating the family of an infant with a small, asymptomatic atrial septal defect (ASD), what information would be included in the education? a. "The medication indomethacin is used to try to close the hole." b. "Most infants do not need surgical repair for this." c. "The medication prostaglandin E1 is used to try to close the hole." d. "Surgery is usually performed in the first two months of life for this."

b. "Most infants do not need surgical repair for this."

A pediatric client is newly diagnosed with a stinging-insect allergy. Which advice is most appropriate for the nurse to provide this client's parent? a. "I recommend you consult a genetic counselor to reveal other susceptible family members." b. "Obtain your child a medical alert ID bracelet so the presence of the allergy can be identified easily." c. "Your child should join a peer support group to help relieve anxiety about this problem." d. "Arrange for your child to receive allergy testing for foods with ingredients similar to those in insect venom."

b. "Obtain your child a medical alert ID bracelet so the presence of the allergy can be identified easily."

The parents of an adolescent boy ask the nurse when they will know that their son has reached puberty. What is the best response by the nurse? a. "A rapid growth spurt occurs during puberty." b. "Puberty occurs when the person becomes able to reproduce sexually." c. "Puberty spans the ages between 11 and 20 years of age." d. "Emotional needs predominate the puberty period."

b. "Puberty occurs when the person becomes able to reproduce sexually."

The nurse is caring for an infant girl with a suspected cardiovascular disorder. Which statement by the mother would warrant further investigation? a. "My baby does not make any grunting noises." b. "The baby seems more comfortable over my shoulder." c. "The baby usually drinks all of her bottle." d. "I don't notice any rapid breathing patterns."

b. "The baby seems more comfortable over my shoulder."

The nurse is teaching the parents of an 8-year-old child diagnosed with folliculitis on both arms about caring for their child. The nurse determines that additional teaching is needed based on which statement by the parents? a. "We need to wash the area with warm soap and water to keep it clean." b. "We can apply a steroid cream to the area to help with the itching." c. "We should apply warm compresses to the area several times a day." d. "We should call our health care provider if the lesions get bigger in size."

b. "We can apply a steroid cream to the area to help with the itching."

A nurse is teaching the parents of a child diagnosed with rheumatic fever about prescribed drug therapy. Which statement would indicate to the nurse that additional teaching is needed? a. "If she needs dental surgery, we might need additional medication." b. "We can stop the penicillin when her symptoms disappear." c. "She needs to take the drug for the full 14 days." d. "To prevent another episode, she'll need preventive antibiotic therapy for at least 5 years."

b. "We can stop the penicillin when her symptoms disappear."

The nurse is caring for a 6-year-old boy with mumps. Which of the following statements by the child would cause the nurse to suspect the boy is experiencing a complication of mumps? a. "My knees are sore and stiff." b. "I keep coughing up mucus." c. "I feel wobbly when I walk." d. "Please talk a little louder."

d. "Please talk a little louder."

A school-aged child is recovering from varicella. The parent calls the school nurse and states, "my child is feeling much better" and asks when the child can return to school. What information does the nurse provide the parent? a. "Your child may return to school when free of any lesions." b. "Your child may return to school when all of the lesions have crusted over." c. "Your child may return to school when there has been no fever for 48 hours." d. "Your child may return to school when a health care provider has given written permission."

b. "Your child may return to school when all of the lesions have crusted over."

The school nurse is teaching a child with stinging-insect allergies how to avoid insects while on the class trip. Which instruction will the nurse provide? a. Limit your time outside in the heat of the day. b. Do not sit by the garbage can. c. Wear perfume but not cologne. d. Wear a hair net to contain hair.

b. Do not sit by the garbage can.

What is the major nursing concern for a child having an anaphylactic reaction? a. Identifying the offending allergen b. Ineffective breathing pattern c. Increased cardiac output d. Positioning to facilitate comfort

b. Ineffective breathing pattern

The nurse is preparing a teaching plan for the parents of a child who has been diagnosed with a congenital heart defect. What would the nurse be least likely to include? a. Signs of complications b. Maintenance of strict bed rest c. Daily weight assessment d. Prevention of infection

b. Maintenance of strict bed rest

When educating the family of an ill infant with an atrioventricular canal defect/septal defect, what information would be included in the education if the doctor is planning on performing palliative care until the infant is healthier? a. Most infants do not need surgical repair for this if palliative procedures are performed. b. Palliative pulmonary artery banding should help the infant grow. c. VSD patching surgery should be performed immediately. d. The medication indomethacin is used to try to close the hole.

b. Palliative pulmonary artery banding should help the infant grow.

The nurse is caring for a child undergoing highly active antiretroviral therapy (HAART) for HIV infection. The nurse is preparing to administer the prescribed medication. In addition to the nucleoside analog reverse transcriptase inhibitors (NRTIs) and the nonnucleoside analog reverse transcriptase inhibitors (NNRTIs), the nurse is cognizant that the child will be taking which additional medication as part of the three-drug regimen? a. Disease-modifying antirheumatic drugs (DMARDs) b. Protease inhibitors c. Cytotoxic drugs d. Corticosteroids

b. Protease inhibitors

A parent brings an infant in for poor feeding and listlessness. Which assessment data would most likely indicate a coarctation of the aorta? a. Pulses weaker in upper extremities compared to lower extremities b. Pulses weaker in lower extremities compared to upper extremities c. Cyanosis with feeding d. Cyanosis with crying

b. Pulses weaker in lower extremities compared to upper extremities

A nurse is preparing to administer routine immunizations to an infant who is HIV positive. What is the American Academy of Pediatrics recommendation for immunizing infants who are HIV positive? a. Follow the routine immunization schedule. b. Routine immunizations are administered. Assess CD4+ counts before administering the MMR and varicella vaccinations. c. Do not give immunizations because of the infants altered immune status. d. Eliminate the pertussis vaccination because of the risk of convulsions.

b. Routine immunizations are administered. Assess CD4+ counts before administering the MMR and varicella vaccinations.

A nurse is promoting vaccine administration. When instructing on the physiological changes, which statement best explains what occurs in the child when vaccines are administered? a. The child becomes a carrier of the disease. b. The child develops an active immunity. c. The child develops a passive immunity. d. The child becomes a host for the disease.

b. The child develops an active immunity.

A 5-year-old is getting a cardiac catheterization. When describing this procedure to the parents, which of the following would the nurse most likely include? a. Acetaminophen will be administered prior to the procedure if the child has a fever. b. The child's temperature will be monitored continuously through the procedure by a rectal probe. c. The child will be encouraged to become mobile after the procedure. d. After the procedure, vitals will be monitored closely every hour.

b. The child's temperature will be monitored continuously through the procedure by a rectal probe.

A parent asks about the risk of a congenital heart defect (CHD) being passed on to another child since they already have one child that has it, but no one else in the family has one. What is the best response by the nurse? a. This was probably caused by environmental factors, not genetics. b. There is less than a 7% chance a sibling would inherit a heart defect. c. These occur related to medication the mother was taking while pregnant. d. There is no chance this will be passed to another child since we do not know what caused it.

b. There is less than a 7% chance a sibling would inherit a heart defect.

A preschool-age child is being seen for a rash that occurred after the mother applied a sunscreen prior to permitting the child to swim at the beach. For which type of allergic reaction should the nurse prepare teaching materials for the mother? a. atopic dermatitis b. contact dermatitis c. delayed hypersensitivity d. autoimmunity

b. contact dermatitis

The nurse is conducting a physical examination of a child with a ventricular septal defect. Which finding would the nurse expect to assess? a. fixed split-second heart sound b. holosystolic harsh murmur along the left sternal border c. systolic ejection murmur d. right ventricular heave

b. holosystolic harsh murmur along the left sternal border

The nurse is explaining to a parent some of the basic aspects of the immune system and its functions. She informs them that B cells, also known as _________ cells, will attack __________ antigens. a. humoral; viral b. humoral; bacterial c. killer; viral d. killer; bacterial

b. humoral; bacterial

A young parent brings the school-aged child to the office for a sports physical examination. During the appointment, the parent informs the nurse about being worried because the child does not like school and does not seem to be reading, writing, or spelling as well as others in the class. The parent adds that the child struggles to get organized and to manage time. What condition does the nurse suspect? a. Asperger syndrome b. learning disorder c. autism spectrum disorder d. Down syndrome

b. learning disorder

The nurse is assessing a school-aged child for clinical manifestations of abuse. Which finding requires further follow up by the nurse? a. bruise on the knee that appears new b. report of genital itchiness c. the child's picky eating habits d. bruise on the elbow, partially healed

b. report of genital itchiness

The parents of a child diagnosed with varicella are concerned about their other children getting it. The nurse instructs the parents that their child is contagious for how much longer now that the rash has appeared? a. for 4 days more now that the rash is present b. until there are no more new lesions and lesions have crusted over c. for up to 8 days more after the rash initially appears d. until the rash disappears, which is about 3 days

b. until there are no more new lesions and lesions have crusted over

A child has been hospitalized with a diagnosis of severe impetigo. The nurse is interviewing the family. Which question will have the greatest impact on the child's care? a. "How long has the child had the infection?" b. "Do you have any concerns about filling the prescriptions?" c. "Does your child have any allergies to medications?" d. "Is there anything else you think we should know about your family?"

c. "Does your child have any allergies to medications?"

To avoid anaphylactic reactions in children, which question would be most important to ask a parent before administering penicillin to her infant? a. "Do you have a telephone to call us immediately if she develops trouble breathing?" b. "What do you give her to alleviate itching?" c. "Has she ever had penicillin before?" d. "Is there any family history of allergy to penicillin?"

c. "Has she ever had penicillin before?"

The parent of a school-age child comments to the nurse, "Every time my child eats enchiladas at our local Mexican restaurant the child gets a rash. It just does not make sense to me." How should the nurse respond? a. "Maybe it is an allergy to something else and you just notice after eating there by coincidence." b. "That is odd. Does anyone else in your family react that way?" c. "Has your child ever been tested for a peanut allergy?" d. "Is your child allergic to milk?"

c. "Has your child ever been tested for a peanut allergy?"

The parents of a 5-year-old child with a cardiovascular disorder tell the nurse they don't understand why their child isn't gaining weight, "We make sure our child has 3 very nutritious meals every day." How should the nurse respond? a. "Are you sure you are making nutrient-dense foods?" b. "It's hard to get your child to eat enough at this age to maintain their weight since they are expending so much energy with the heart condition." c. "It's great you are providing nutritious meals, but small, frequent meals will tire your child less and promote weight gain." d. "Maybe your child doesn't really like the foods your making. This could lead to not gaining sufficient weight."

c. "It's great you are providing nutritious meals, but small, frequent meals will tire your child less and promote weight gain."

A new parent brings the 3-month-old infant to the clinic for a well-baby check up. During the visit, the parent asks the nurse, "I know the rays from the sun can be harmful, so what should I do to protect my infant?" Which suggestion by the nurse would be most appropriate? a. "Invest in clothing that has sun protective factor (SPF) already in the material." b. "As long as you use a sunscreen, your infant will be protected from the sun." c. "The best thing to do is keep any infant under the age of 6 months out of the sun." d. "A wide-brimmed hat and an umbrella for shade should be enough for your infant."

c. "The best thing to do is keep any infant under the age of 6 months out of the sun."

A parent states to the nurse, "I feel that my child picks up every virus and bacteria that is going around. My child has been sick several times ever since being diagnosed with asthma." After listening to the parent's statement and reviewing the asthma treatment, which statement by the nurse indicates the likely reason for the child's virus susceptibility? a. "The child may be having a reaction to the new combination of medications." b. "The child is taking a bronchodilator and may be breathing in more viral particles." c. "The child is on oral medications to suppress the inflammatory response." d. "The child is getting allergy shots, which may increase antibody production."

c. "The child is on oral medications to suppress the inflammatory response."

Which intervention is appropriate for a child receiving high doses of steroids? a. Limit activity and receive home schooling. b. Decrease the amount of potassium in the diet. c. Administer a killed virus vaccine. d. Monitor for seizure activity.

c. Administer a killed virus vaccine.

The nurse is caring for a child brought to the emergency department after an animal bite. Which action will the nurse perform first? a. Assess the child's height, weight, and temperature. b. Administer rabies vaccine and rabies immune globulin. c. Ask if the animal was provoked prior to the bite. d. Question the child about malaise, pain, and hydrophobia.

c. Ask if the animal was provoked prior to the bite.

A 5-year-old is being prepared for diagnostic cardiac catheterization, in which the catheter will be inserted in the right femoral vein. What intervention should the nurse take to prevent infection? a. Keep the child NPO for 2 to 4 hours before the procedure b. Record pedal pulses c. Avoid drawing a blood specimen from the right femoral vein before the procedure d. Apply EMLA cream to the catheter insertion site

c. Avoid drawing a blood specimen from the right femoral vein before the procedure

What information would be included in the care plan of an infant in heart failure? a. Maintain child in the supine position. b. Administer digoxin even if the infant is vomiting. c. Begin formulas with increased calories. d. Encourage larger, less frequent feedings.

c. Begin formulas with increased calories.

A child is hospitalized with a diagnosis of severe cellulitis. The nurse is preparing the family for discharge. Which instruction is most important for the nurse to convey to the family? a. Perform proper hand hygiene. b. Keep follow-up appointments. c. Complete the prescribed antibiotics. d. Monitor for signs of worsening condition.

c. Complete the prescribed antibiotics.

Which statement by the parent of a 5-year-old child with acquired immunodeficiency syndrome (AIDS) regarding prescribed antiretroviral agents indicates that she has a good understanding of disease management? a. When my child's pain increases, I double the recommended dosage of antiretroviral medication. b. Addiction is a risk, so I use the medication only as ordered. c. Doses of the antiretroviral medication are selected on the basis of my child's age and growth. d. By the time my child is an adolescent, she will not need her antiretroviral medications any longer

c. Doses of the antiretroviral medication are selected on the basis of my child's age and growth.

When providing discharge instructions to a child who was admitted to the hospital following stridor, wheezing, and urticaria after taking penicillin, which nursing action is priority? a. Educate the parents about possible side effects of penicillin in children. b. Question the child about the amount of penicillin that was taken. c. Encourage the child to wear a medical alert bracelet for penicillin. d. Advise the parents to have their child evaluated for atopic diseases.

c. Encourage the child to wear a medical alert bracelet for penicillin.

A nurse assesses a child on long-term systemic corticosteroid therapy for which condition? a. Hypotension b. Dilation of blood vessels in the cheeks c. Growth delays d. Decreased appetite and weight loss

c. Growth delays

The nurse is caring for child who present to the emergency department with reports of a fever for 5 days. The nurse notes a diffuse maculopapular rash, reddened cracked lips, erythema of hands, and bilateral conjunctivitis and suspects Kawasaki disease. Which nursing action is priority? a. Administer acetaminophen. b. Place the child on a soft diet. c. Initiate intravenous access. d. Assess cervical lymph nodes.

c. Initiate intravenous access.

A 7-year-old child with an earache comes to the clinic. The child's parent reports that 1 day ago the child had a fever and headache and did not want to play. When the nurse asks where it hurts, the child points to the jawline in front of the earlobe. What does the nurse expect the diagnosis will be for this child? a. Fifth disease b. Measles c. Mumps d. Mononucleosis

c. Mumps

Which nursing action is most appropriate when caring for a child with positive serum IgE antibodies, a white blood cell count of 6,000/mm3, and 10% eosinophils? a. Review current CD4 counts. b. Prepare child for stem cell transplant. c. Obtain a careful health history. d. Percuss abdomen for hepatomegaly.

c. Obtain a careful health history.

What should the nurse include in a teaching plan for a mother of a toddler who will be taking prednisone for several months? a. The medication should be taken between meals. b. The medication needs to be discontinued because of the risks associated with long-term usage. c. The medication should not be stopped abruptly. d. The medication may lower blood glucose so the mother needs to observe the child for signs of hypoglycemia.

c. The medication should not be stopped abruptly.

The nurse is caring for a child with congestive heart failure and is administering the drug digoxin. At the beginning of this drug therapy, the process of digitalization is done for which reason? a. To establish a maintenance dose of the drug b. To decrease the pain to a tolerable level c. To build the blood levels to a therapeutic level d. To increase the heart rate

c. To build the blood levels to a therapeutic level

The nurse is caring for a newborn whose mother is HIV positive. The nurse would expect to administer a 6-week course of which medication? a. Ritonavir b. Lopinavir c. Zidovudine d. Nevirapine

c. Zidovudine

The nurse is administering intravenous immune globulin (IVIG). The nurse assesses vital signs and adverse reactions every 15 minutes for the first hour of administration. After the first hour, the nurse will continue to assess the child at which frequency? a. at the end of the transfusion b. every 60 minutes c. every 30 minutes d. every 45 minutes

c. every 30 minutes

The nurse is assessing a child with pauciarticular-type juvenile idiopathic arthritis. What would the nurse expect to assess? a. rash b. fever c. eye inflammation d. splenomegaly

c. eye inflammation

A parent brings their 4-year-old child to the emergency department. The parent says that their child has frequent vomiting and diarrhea. When the nurse obtains previous medical history from the computer, it shows that this family has had 12 visits in the last 2 months for the same problems with no substantiated symptoms observed by the staff. The child is smiling and interactive with no signs of dehydration. What does the nurse suspect may be occurring? a. parental fear overcaring for the child at home b. emotional abuse c. medical child abuse (formerly Munchausen syndrome by proxy) d. child neglect

c. medical child abuse (formerly Munchausen syndrome by proxy)

A child is diagnosed with rheumatic fever. For which medication will the nurse educate the caregivers? a. insulin b. phenytoin c. nonsterioidal anti-inflammatory drugs (NSAIDs) d. antiviral

c. nonsterioidal anti-inflammatory drugs (NSAIDs)

The nurse is caring for an adolescent diagnosed with anorexia nervosa. Which education will the nurse include in the client's discharge teaching? a. methods for desensitization b. proper administration of phenelzine c. referrals to counseling services d. appropriate exercise routines

c. referrals to counseling services

A nurse is preparing a presentation for a group of parents of toddlers at the local community center. The topic of the presentation is burn prevention. When describing burns in toddlers, which situation would the nurse likely identify as the most common cause of thermal burns? a. touching an open, hot oven door b. playing unsupervised with matches c. scalding from pulling a hot pan off the stove d. playing with a household cleaning agent container

c. scalding from pulling a hot pan off the stove

A nurse is caring for a newborn with congenital heart disease (CHD). Which finding would the nurse interpret as indicating distress? a. feeding lasting for 15-20 minutes b. reduced respiratory rate during feeding c. subcostal retraction at the time of feeding d. perspiration on body after feeding

c. subcostal retraction at the time of feeding

The nurse is teaching the parents of a child diagnosed with erythema multiforme about the condition. The nurse determines that the teaching was successful based on which statement by the parents? a. "After this one episode, our child will not have it again." b. "We need to have our child avoid exposure to nickel." c. "The sulfa drug our child was taking caused this rash." d. "The rash should go away in about 2 weeks."

d. "The rash should go away in about 2 weeks."

The parents of a child with physical and developmental special needs state, "We wish our child could get some kind of educational experience." How should the nurse respond? a. "Since all children can attend school regardless of their special need, I suggest you talk with your local school about enrolling your child." b. "It would be very difficult for your child to attend school with all of his disabilities. It's unfortunate, but it is reality." c. "I am sure it must be difficult to know that your child will never be able to go to school like other children." d. "This must be difficult for you. Let's talk with the social worker to see what programs are available for your child."

d. "This must be difficult for you. Let's talk with the social worker to see what programs are available for your child."

A nurse is teaching parents about the importance of immunizations for infants because of immaturity of the immune system. The parents demonstrate that they understand the teaching if they make which statement? a. The spleen reaches full size by 1 year of age. b. IgM, IgE, and IgD levels are high at birth. c. IgG levels in the newborn infant are low at birth. d. Absolute lymphocyte counts reach a peak during the first year.

d. Absolute lymphocyte counts reach a peak during the first year.

Which nursing diagnosis would best apply to a child experiencing rheumatic fever? a. Disturbed sleep pattern related to hyperexcitability b. Ineffective breathing pattern related to cardiomegaly c. Risk for self-directed violence related to development of cerebral anoxia d. Activity intolerance related to increased cardiac workload

d. Activity intolerance related to increased cardiac workload

The nurse in the emergency department is examining an 18-month-old child who recently received a first dose of penicillin. The nurse notes lip edema, urticaria, stridor, and tachycardia. Which action will the nurse take next? a. Begin cardiopulmonary resuscitation (CPR). b. Obtain intravenous (IV) access. c. Gather tracheal intubation equipment. d. Administer epinephrine.

d. Administer epinephrine.

A nurse is providing care to an infant who is admitted with burns over the face, neck and chest. The nurse identifies which goal as priority for planning the infant's care? a. Pain is at a tolerable level. b. Wounds remain infection-free. c. Fluid balance is maintained. d. Airway remains patent.

d. Airway remains patent.

A school-aged child, who is allergic to bee stings, states, "I think I was stung by a bee outside." Which intervention by the school nurse is most appropriate? a. Determine if the client was stung b. Administer epinephrine c. Apply an ice compress to the site d. Assess the client for signs of anaphylactic shock

d. Assess the client for signs of anaphylactic shock

A mother of a child in the terminal stages of AIDS tells the nurse that her child wants to celebrate his birthday early because he wont be here on his birthday. Which is the best response the nurse can make to this mother? a. What does your husband think about giving the party for the child? b. How does the family feel about your giving in to the child? c. Ill children can be very manipulative. d. Is this the first time he has spoken about death?

d. Is this the first time he has spoken about death?

After teaching a group of students about acute rheumatic fever, the instructor determines that the teaching was successful when the students identify which assessment finding? a. Osler nodes b. Black lines c. Janeway lesions d. Jerky movements of the face and upper extremities

d. Jerky movements of the face and upper extremities

A nurse is administering digoxin to a 3-year-old child. What would be a reason to hold the dose of digoxin? a. Fever and tinnitus b. Ataxia c. Hypertension d. Nausea and vomiting

d. Nausea and vomiting

An infant is seen in the emergency department with several raised red welts over the abdomen and lower extremities. The parent states that the symptoms developed suddenly over the past few hours. The infant is fussy and has a low grade temperature. What assessment is most important for the nurse to perform? a. Question the parent about methods of punishment. b. Examine the lips and oral mucosa for cyanosis. c. Determine whether the child is breastfed or formula fed. d. Observe the infant's respiratory effort.

d. Observe the infant's respiratory effort.

A nurse is providing care to a toddler after surgery for a partial atrioventricular (AV) canal defect. The nurse has set a client care goal of maintaining adequate respiratory function. Which nursing intervention is most applicable to this goal? a. Auscultate lungs for adventitious sounds. b. Administer analgesics as prescribed. c. Show the toddler how to splint the incision with a pillow. d. Provide activities such as blowing bubbles.

d. Provide activities such as blowing bubbles.

The nurse is caring for a preschool-age child who has been seen in the emergency department for an allergic reaction to stinging insects twice in the past month. What teaching should the nurse provide the parents to help reduce the child's exposure to insects? a. Have the child sit next to a railing near steps. b. Use lightly scented powders and lotions. c. Avoid going outdoors during the heat of the day. d. Remove flowering plants from the patio deck.

d. Remove flowering plants from the patio deck.

In caring for the child with rheumatic fever, the nurse recognizes that which nursing diagnosis would be most important to include in this child's plan of care? a. Disturbed body image b. Risk for aspiration c. Delayed growth and development d. Risk for acute pain

d. Risk for acute pain

A group of nursing students are reviewing information about humoral and cellular immunity. The students demonstrate understanding of this material when they identify what as being involved in cellular immunity? a. Antigens b. Antibodies c. B cells d. T cells

d. T cells

The parents of a 10-year-old with HIV have never told their child that he has the virus. The child asks the nurse why he is "on so many medications." What action should the nurse take? a. The nurse should suggest to the child to speak with his doctor. b. The nurse should explain the infection to the child. c. The nurse should tell the parents when they enter the child's room that their child has a question for them. d. The nurse should encourage the child to talk with his parents about his medications.

d. The nurse should encourage the child to talk with his parents about his medications.

The nurse is caring for a newborn in the hospital. Which assessment finding is most concerning? a. high-pitched systolic murmur b. respiratory rate 62 breaths per minute c. cool and bluish tint to hands d. a fixed split-S2 heart sound

d. a fixed split-S2 heart sound

A child with heart failure is receiving supplemental oxygen. The nurse understands that in addition to improving oxygen saturation, this intervention also has what effect? a. increases pulmonary vascular resistance b. promotes diuresis c. mobilizes secretions d. causes vasodilation

d. causes vasodilation

The nurse is collecting data on a child being evaluated for rheumatic fever. The caregiver reports that over the past several weeks the child seems to have lack of coordination, facial grimaces and repetitive involuntary movements. Based on these symptoms the nurse would suspect what condition? a. arthralgia b. polyarthritis c. carditis d. chorea

d. chorea

The nurse is monitoring the labs of a child admitted for an exacerbation of juvenile pauciarticular arthritis. Which lab result does the nurse expect to be elevated? a. lymphocyte immunophenotyping T-cell quantification b. immunoglobulin electrophoresis c. radioallergosorbent test d. erythrocyte sedimentation rate (ESR)

d. erythrocyte sedimentation rate (ESR)

When caring for a child with Kawasaki disease, the nurse would know that: a. antibiotics should be administered every 8 hours by IV. b. steroid creams are used for the hand peeling. c. joint pain is a permanent problem. d. management includes administration of aspirin and IVIG.

d. management includes administration of aspirin and IVIG.

A child is diagnosed with juvenile idiopathic arthritis and is receiving several different medications listed in the medication administration record. Which agent would the nurse identify as being used to prevent disease progression? a. ibuprofen b. prednisone c. aspirin d. methotrexate

d. methotrexate

A nurse is preparing a presentation for a group of nurses about HIV infection. Which of the following would the nurse include as the major means of transmission responsible for almost all new HIV infections in the preadolescent population? a. exposure to contaminated body fluid b. blood transfusions c. clotting factor administration d. mother-to-child transmission

d. mother-to-child transmission

When developing a teaching plan for the parents of a child diagnosed with tricuspid atresia, the nurse would integrate knowledge of which of the following as the major mechanism involved? a. increased pulmonary blood flow b. narrowing of the major vessel c. mixing of well-oxygenated and poorly-oxygenated blood d. obstruction of blood flow to the lungs

d. obstruction of blood flow to the lungs

The most common complication of varicella is: a. encephalitis. b. scarring. c. pneumonia. d. secondary bacterial infections.

d. secondary bacterial infections.

Which of the following is inconsistent with the mode of transmission of HIV? a. sexual contact b. mother-to-infant transmission c. blood d. skin contact

d. skin contact