Pediatric COMPREHENSIVE Practice Exam

34. Parents are told they must start taking their toddler to the dentist. They are concerned their child is too young and that the dentist will be too harsh with the child. The nurse suggests the parents do which of the following before the dental visit? 1. Tell the child it will not hurt. 2. Warn that they will have the dentist give a needle in case of bad behavior. 3. Tell the child they will go along to the dentist so that they can model comfortable, safe behavior. 4. Offer the child a treat for good behavior.

3

3. The posture of a healthy term newborn is described by which word? 1. Hypotonic. 2. Asymmetric. 3. Opisthotonic. 4. Flexion.

4

60. A 7-year-old child in a classroom is disruptive with loud talking, short attention span, difficulty organizing work, unable to finish assigned class work, and moodiness. Which of the following is the most likely diagnosis for this child? 1. Enuresis. 2. Sexual abuse. 3. Learning disability. 4. Attention deficit/hyperactivity disorder.

4

54. A child returns from surgery, having had tonsils and adenoids removed. When the parents are getting ready for discharge, the nurse instructs them to do what to care for their child. Select all that apply. 1. Some secretions may be blood-tinged for a few days. 2. Run a cool mist vaporizer in the bedroom. 3. Pain relief should be provided every 4 hours. 4. The child can resume a normal diet. 5. The child should blow the nose and cough every 4 hours.

1,2, 3

76. A 10-month-old has fallen out of the high chair and is brought to the emergency department. Put the following components of the nurse's assessment into the correct order. 1. Airway____ 2. Bleeding____ 3. Appetite____ 4. Breathing____ 5. Circulation____ 6. Level of consciousness____

1, 4, 5, 6, 2, 3

84. A child arrives at the pediatric emergency department, having had a generalized seizure at home and a recent sore throat and mild fever. During the nurse's assess ment, the child begins to have generalized tonic-clonic seizure activity. The drug of choice and method of administration the nurse expects the physician to order are which of the following? 1. Lorezapam and diazepam, combined in an intravenous solution of D5W. 2. Lorezapam given intravenously or diazepam given directly into a vein. 3. Phenobarbital administered in an intravenous solution of D 5W, 0.45 normal saline. 4. Phenytoin in a dextrose solution given intravenously over 1 hour.

2

86. Which of the following best describes the type of seizure displayed in the figure? 1. Tonic-clonic. 2. Absence. 3. Atonic. 4. Akinetic. 5. Myoclonic. 6. Infantile spasm.

2

35. A 17-month-old is brought into the clinic, and the nurse notes the toddler has tooth decay on the maxillary upper incisors. The toddler is holding a bottle of juice, and the parent says the child cannot seem to be weaned from the bottle. The nurse could suggest which of the following tactics to assist the parent in weaning the toddler? Select all that apply. 1. Hide the bottle, and tell the toddler that it is not needed anymore. 2. Put only tap water in the bottle. 3. Give the bottle only at night. 4. Give the toddler a pacifier and take the bottle away. 5. Do not give any bottles before bed.

1, 2, 5

6. A family is adopting a 3-year-old child from Russia. What suggestions can be given to the parents for incorporating the child? Select all that apply. 1. Learn as much about the child as possible before adoption. 2. Expect conflict and determine how to work through it with the child. 3. Do not discuss the biological parents with the child. 4. Discuss your expectations with the child. 5. Try to maintain a part of the child's original family name.

1, 2, 4, 5

66. The physician orders montelukast (Singulair) for a 10-year-old who has moderate, persistent asthma. The nurse should instruct the child and parents about which characteristic of the medication? Select all that apply. 1. This is an add-on medication to the child's regular medications. 2. The child is too young to be taking this medication. 3. It is not to be used to treat acute episodes.

1, 3

28. The nurse working in the newborn nursery has to draw a heel-stick blood sample be fore an infant's discharge. What can the nurse do to decrease the pain the infant feels from this procedure? Select all that apply. 1. Wrap the heel in a warm, damp cloth. 2. Use EMLA before doing the stick. 3. Swaddling the infant. 4. Have the infant do non-nutritive sucking. 5. Do the stick while the infant is asleep.

1, 3, 4

52. During a 15-month well-child examination, the physician hears an innocent murmur. The nurse knows which of the following about such a murmur? Select all that apply. 1. It is short in duration. 2. It is an S 2 murmur. 3. It is loudest in the pulmonic area. 4. It is fixed and can be heard in many positions. 5. It is grade III or less.

1, 3, 5

9. Match each genetic term with its definition and function. 1. Congenital 2. FISH analysis 3. Genome 4. Malformation 5. Phenotype 6. Syndrome A. Morphogenic defect of an organ B. Recognized pattern of malformation C. Present at birth D. Clinically exhibited characteristic E. Fluorescent in situ hybridization F. Complete genetic information of organism

1, C 2, E 3, F 4, A 5, D 6, B

88. A 14-year-old sustained a grade III concussion while playing football. Which of the following statements made by the parents indicates that further patient education is needed? 1. "Our child will not be able to play football until recovery is complete." 2. "Our child needs to get back to school quickly, as there are midterms next week." 3. "Our child's headaches may continue for the next 6 months; we should call the physician if the headaches get worse." 4. "If our child suffers another concussion before recovery is complete, brain injury will be compounded."

2

20. Parents confide to the nurse that their child, who is 35 months old, does not talk and spends hours sitting on the floor watching the ceiling fan go around. They are concerned their child may have autism. The nurse should ask the parents which question? 1. "Does your child have brothers or sisters?" 2. "Does your child seek you out for comfort and love?" 3. "Do you have trouble getting babysitters for your child?" 4. "Does your child receive speech therapy?"

2

22. A 3-month-old is brought to the public clinic, and the parent tells the nurse that the baby is fussy, spits up constantly, and has a lot of gas, and that there is a family history of allergies. The nurse knows that these symptoms are related to which diagnosis? 1. Failure to thrive. 2. Sensitive to cow's milk. 3. Phenylketonuria. 4. Pancreatic insufficiency.

2

36. Parents are frustrated with toilet training their 2-year-old. Both parents work full time and claim they do not have time to spend on toilet training. What suggestions can the nurse give the parents to decrease their frustration? 1. "You will have to invest some time if the child is to be toilet trained." 2. "A child needs to be both physically and psychologically ready to learn the skills needed to be continent." 3. "Do you think your child is stubborn?" 4. "Have the child sit on the toilet until the child voids."

2

44. The parent of a school-aged child who is a paraplegic and uses a wheelchair states that the child is allergic to latex. The nurse knows that the most important intervention for this child is which of the following? 1. Giving antihistamines and steroids after procedures. 2. Prevention of contact with latex products. 3. Doing a radioallergosorbent test before each procedure. 4. Using only latex-free gloves when doing procedures.

2

49. What are the two organizations in the United States that make and govern the recommendations for immunization policies and procedures? 1. National Advisory Committee on Immunization and American Medical Association. 2. U.S. Public Health Service Centers for Disease Control and American Academy of Pediatrics. 3. National Immunization Program and Pediatric Infectious Disease Association. 4. National Institutes of Health and Minister of National Health and Welfare.

2

5. The parent of a newborn wants to know what the newborn screening test does. What is the nurse's best response? 1. "Not all states do newborn screening." 2. "All states test for phenylketonuria and hypothyroidism." 3. "Babies are screened at 48 hours of age." 4. "The baby who is taken home within 24 hours is not screened."

2

51. The nurse is assisting with a sports physical session at a local grade school. A fixed splitting of the S2 sound is heard in an otherwise healthy child. The nurse knows that this is a diagnostic sign of which cardiac defect? 1. Mitral regurgitation. 2. Atrial septal defect. 3. Functional murmur. 4. Pericardial friction rub.

2

58. Three preschool children and their Middle East-born parents come to a homeless shelter. The family has been homeless for 3 months. The children appear somewhat unkempt but nourished. One of the children has several enlarged cervical lymph nodes and is running a low-grade fever. Which chronic infectious illness should be suspected in the child? 1. Chlamydial pneumonia. 2. Tuberculosis. 3. Pertussis (whooping cough). 4. Asthma.

2

69. Parents of a 2-year-old with Down syndrome are told the child should be screened for atlantoaxial instability. The nurse tells the parents that which of the following are symptoms of this instability? 1. Mental retardation. 2. Neck pain and torticollis. 3. Vision and hearing loss. 4. Delayed secondary sexual development.

2

75. While assisting with a lumbar puncture procedure on an infant or small child, the nurse should do which of the following? 1. Have the patient in a clean diaper to avoid contamination of the site. 2. Monitor the patient's cardiorespiratory status at all times. 3. Position the patient in the prone position with the head to the left. 4. Start an intravenous line to facilitate use of conscious sedation.

2

78. An adolescent Hispanic is complaining of knees swelling and hurting, hands and feet being cold all the time, frequent headaches, and a red rash on the cheeks and nose. The nurse suspects which of the following? 1. Multiple sclerosis. 2. Normal adolescent concerns. 3. Myasthenia gravis. 4. Systemic lupus erythematosus.

4

64. The high-school nurse is setting up a smoking prevention campaign for the students. Which of the following is the nurse's best approach? 1. Discuss health consequences of smoking. 2. Use scare tactics and point out the negative effects of smoking. 3. Offer alternatives to smoking such as chewing gum and doing activities that distract. 4. Have the adolescents talk with their parents about smoking.

3

68. The parents of a 19-year-old ask the nurse what they should do in terms of long term care placement for their severely disabled child. Which of the following is the nurse's best response? 1. "How much care do you want?" 2. "Do you have other children who could take your child into their home?" 3. "Do you have a detailed plan of care?" 4. "Are you working with an agency or social worker about this matter?"

3

72. Which of the following is immediate postoperative care for an infant diagnosed with hydrocephalus who had a shunt placed? 1. Wet-to-dry dressing changes at both the shunt insertion site and the abdominal incision site. 2. Inform the parents they will have to measure the child's head at least once a day. 3. Position the infant's head off the shunt site for the first 2 postoperative days. 4. Complete vital signs and neurological checks every 4 hours.

3

83. A child is admitted to the nurse's unit with a suspected diagnosis of meningitis. The nurse should tell the parent which of the following? 1. Antibiotics are not initiated until the cerebrospinal fluid cultures are definitive for specificity to prevent resistance. 2. Antibiotics are useless against viral infections, so they are not used for meningitis. 3. Antibiotics should be started before the cerebrospinal fluid cultures are definitive because culture results may take up to 3 days. 4. Antibiotic initiation is based on the age, signs, and symptoms of the patient, not on the causative agent.

3

87. Which of the following best describes the type of seizure displayed in the figure? 1. Infantile spasm. 2. Febrile seizure. 3. Simple partial seizure with motor signs. 4. Simple partial seizure with sensory signs. 5. Atonic partial seizure. 6. Absence seizure.

3

81. A parent calls the nurse for dosing information for Pepto-Bismol and aspirin for children who are 8 and 9 years old and are ill. The nurse states which of the following? Select all that apply. 1. 1 tbs of Pepto-Bismol after every diarrhea stool. 2. 81-mg baby aspirin every 4 hours. 3. No medications are necessary. 4. Pepto-Bismol contains aspirin. 5. Diet as tolerated. 6. Reye syndrome is associated with aspirin use.

3, 4, 5, 6

71. A newborn with suspected hydrocephalus is transferred to the intensive care unit for further evaluation and treatment. The baby's nurse knows which of the following? 1. To use sedation as needed to keep the baby from crying or being fussy. 2. To keep the crib in a flat and neutral position. 3. To expect the infant to sleep more than a baby without hydrocephalus. 4. To not use any scalp veins for intravenous infusions.

4

85. Parents of a child with generalized seizures ask the nurse for information to give their child's teachers. Which of the following should be included? 1. A soft-padded spoon should be kept nearby to put between the child's teeth at the onset of a seizure. 2. Roll the child onto the abdomen, with the head to the left, so any contents can flow from the mouth. 3. If a seizure lasts longer than 10 minutes, the parents or an ambulance should be called. 4. As the child grows, medication dosages may need to be adjusted to control seizure activity.

4

99. Which of the following applies to encephalitis? Select all that apply. 1. Usually caused by a bacterial infection. 2. A chronic disease. 3. Most commonly seen after a varicella infection in the newborn population. 4. Newborns diagnosed with encephalitis often have extensive neurological problems. 5. Can be seen with meningitis.

4, 5

96. The term __________________ is commonly defined as stiffness of the neck.

Nuchal rigidity

95. Seizures that originate in one hemisphere are called _________________.

Partial or focal seizures

94. According to Freud, the most significant achievement of toddlers is _______________.

Toilet training

91. The injection site of choice for a 6-month-old receiving immunizations is the _________________.

Vastus lateralis

37. Parents are interested in switching their child from a booster seat to a regular seat belt. The child is 7 years old and weighs 51 lb. What can the nurse tell the parents about switching the child to a seat belt? Select all that apply. 1. The safest place to ride in the car is in the front seat. 2. The child needs to weigh 60 lb and be 8 years old to qualify legally for a seat belt. 3. The seat belt should be worn low on the hips. 4. Use a shoulder belt only if it does not cross the child's neck. 5. Tether straps are optional.

2, 3, 4

7. When the parents of a 5-year-old tell the child they are divorcing, the parents need to be aware of behaviors that the child may demonstrate. Select all that apply. 1. Increased self-esteem, bragging. 2. Changes in sleep and appetite. 3. Feelings of abandonment. 4. Develops dictatorial attitude. 5. Verbalizes feelings about divorce-related changes.

2, 3, 5

8. The mother of a 6-month-old is going back to work. The nurse should make which of the following suggestions for ways to evaluate day care. Select all that apply. 1. Larger day-care centers with more services. 2. High health and safety requirements. 3. Caretakers who are loving and kind. 4. Challenging activities for all the children. 5. Child care ratios that maximize staff use. 6. Small class size.

2, 3, 6

32. Parents are concerned that their toddler refuses to sleep in the new toddler bed and wonder what to do. The nurse explains that the child is using "global organization." What does the nurse mean by this term? 1. "The preoperational phase of developing cognitive thought starts around 3 years old." 2. "The child is self-centered and does not want to learn." 3. "The child sees changing to a toddler bed as changing the whole process of sleeping and going to bed." 4. "The toddler may have a phobia to the bed."

3

4. The nurse is working in the newborn nursery and accidentally bumps the crib of one of the babies. This baby demonstrates an asymmetric tonic neck reflex. The nurse sees this baby in which posture? 1. Extends trunk upward and lifts head. 2. Oscillating movements of the ankles and knees. 3. A "fencing" posture. 4. Extension and abduction of extremities and fanning of fingers.

3

46. A 4-week-old infant has a hip dysplasia and is wearing a Pavlik harness. The nurse notices what when the infant's diapers are changed? 1. Diaper dermatitis. 2. Talipes equinovarus. 3. Leg shortening and limited abduction. 4. Pain.

3

50. A nurse is working in a well-child clinic administering immunizations to preschoolers. The nurse should do which procedure to minimize local reactions to the biological drugs? 1. Apply EMLA cream 1 hour before. 2. Change the needle on the syringe after drawing up the biological drug. 3. Inject into the vastus lateralis or ventrogluteal muscle. 4. Use distraction such as telling the child to hold the breath.

3

57. An 11-month-old was born at 28 weeks' gestation and required 2 weeks of ventilation. The baby is currently well and is being seen in the clinic. The physician recommends that the baby receive preventive therapy for respiratory syncytial virus for the next 5 months. The nurse knows that the physician will order which medication? 1. RespiGam. 2. Ribavirin. 3. Palivizumab (Synagis). 4. Pneumococcal vaccine.

3

42. A 16-year-old comes into the clinic for a physical examination. The teen weighs 180 lb and is 5 feet, 5 inches tall. According to the following figure, the basal metabolic index is ______________.

30

18. The nurse is working in a school health clinic, and a child comes in complaining of "something" in my eye." What should the nurse do first? 1. Have the child wash hands. 2. Refer the child to an ophthalmologist. 3. Wash out the affected eye with tap water. 4. Examine the eye for a foreign body.

4

70. Early signs and symptoms of hydrocephalus in infants include which of the following? 1. Confusion, headache, diplopia. 2. Rapid head growth, poor feeding, confusion. 3. Papilledema, irritability, headache. 4. Full fontanels, poor feeding, rapid head growth.

4

82. In children with meningitis, there is the potential for many complications occurring from damage to the nervous system. Which of the following is/are the most common, nonlethal complication(s)? 1. Cranial nerve deficits. 2. Epilepsy. 3. Bleeding intracranially. 4. Cerebral palsy.

1

59. A teacher has a pupil with head lice (pediculosis capitis). The nurse should see what to diagnose the infestation? Select all that apply. 1. Crawling insects. 2. White flakes in the hair. 3. Nits attached close to scalp. 4. Inflammatory papules. 5. Dark brown hair.

1, 3, 4

92. Infants should ride in a _______________ car seat until they weigh 9 kg and are approximately 1 year old.

Rear-facing

89. The nurse is doing discharge teaching for a 3-month-old with a new shunt that was placed for hydrocephalus. Which of the following are signs and symptoms of hydrocephalus that the parents may see if the shunt malfunctions? Select all that apply. 1. Vomiting. 2. Irritability. 3. Poor feeding. 4. Headache. 5. Sunken fontanel. 6. Seizures. 7. Inability to wake up infant. 8. Hyperactivity.

1, 2, 3, 6, 7

33. Parents express concern about their 5-year-old who has started having more temper tantrums. The parents want to know if this is normal for this age. What should the nurse ask the parents about the tantrums? Select all that apply. 1. "Does the child do anything right in front of you?" 2. "Are the tantrums related to one specific aspect of life?" 3. "Are the tantrums causing any harm to self or others?" 4. "Have you consulted the Internet for any suggestions?" 5. "How do you handle your child during a tantrum?"

1, 2, 3, 5

73. In preparing the patient and family for hospital discharge, which of the following signs and symptoms of shunt malfunction and infection should the nurse include in the teaching plan? Select all that apply. 1. Emesis, lethargy. 2. A change in neurological behavior. 3. Fever, irritability. 4. Diarrhea or constipation. 5. Redness along the shunt system.

1, 2, 3, 5

12. Parents are told by the genetic counselor that they have a 1:4 probability of having a second child with cystic fibrosis (CF). They already have one child who is affected. The parents state their risk is lower now than when they had the previous child. What should the nurse tell the parents about the 1:4 probability? 1. Each pregnancy is an independent event. 2. The probability of having another child with CF is twice as likely as it was when they had the first child. 3. The probability of having a healthy child is twice as likely with this pregnancy. 4. The probability of miscarrying is greater now than with the previous pregnancy.

1

21. The nurse in the emergency department is caring for an 8-month-old who suffered a concussion from an automobile accident. The infant was in the car seat at the time. The nurse should assess the infant for which symptoms? 1. Sweating, irritability, and pallor. 2. Plethora and hyperthermia. 3. Crying with fear. 4. Negative Babinski reflex.

1

41. The nurse is working in a school health clinic, and a teen mentions that her older sister just had a baby born with an open spine (myelomeningocele). The teen is wondering if there is anything she can do to prevent this from happening to her baby when she decides to have children. The best response the nurse can offer this teen is to do what about her daily diet? 1. Take a multivitamin with folic acid daily. 2. Eat more fruits and vegetables daily. 3. Have breakfast every morning. 4. There is nothing that can be done to decrease the risk.

1

45. A 5-month-old with a lumbar myelomeningocele is admitted to the unit with an Arnold-Chiari malformation. The nurse knows this infant has which diagnosis? 1. Hydrocephalus. 2. Anencephaly. 3. Tethering of the spinal cord. 4. Perinatal hemorrhage.

1

55. A 2-year-old is brought to the emergency department for fever and ear pain. The parents note the child has had many ear infections and that polyethylene tubes have been recommended, but the parents cannot afford surgery. The child is diagnosed with bilateral otitis media. The toddler is carrying a baby bottle full of juice, and a parent is carrying a pack of cigarettes. What one preventive measure could be taught the parents to decrease the incidence of ear infections? 1. Wean the toddler from the bottle. 2. Give the toddler a decongestant before bedtime. 3. Encourage the parent to smoke outside the house. 4. Have the child's hearing checked.

1

61. A child is diagnosed with schizophrenia. The child is taking haloperidol (Haldol), and the family has been instructed to watch for extrapyramidal side effects. The nurse knows that extrapyramidal side effects include which symptoms in a child? 1. Abnormal movements and twitches. 2. Inappropriate behaviors. 3. Excessive aggressiveness. 4. Thoughts of suicide.

1

67. The nurse is caring for a child dying from leukemia. The parents want to know how comfortable the nurse is in giving doses of pain medication that are larger than customary to their child. The nurse knows that the parents are asking about which ethical principle of care? 1. Double effect. 2. Cultural influences. 3. Honesty. 4. Withholding pain medication.

1

74. The parents of an infant with hydrocephalus ask about future activities in which their child can participate in school and as an adolescent. The nurse should tell the parents which of the following? 1. A helmet should be worn during any activity that could lead to head injury. 2. Only non-contact sports should be pursued, such as swimming or tennis. 3. Because of the risk of shunt system infection, swimming is not a sports option. 4. The child should wear a life alert bracelet; then there is no need to be aware of the shunt system.

1

98. Which of the following applies to cerebral palsy? Select all that apply. 1. It is the most common chronic disorder of childhood. 2. Hyperbilirubinemia increases the risk of cerebral palsy. 3. It is a progressive chronic disorder. 4. Most children do not experience any learning disabilities. 5. There is a familial tendency seen in children with cerebral palsy.

1, 2

11. A pregnant teen is to have prenatal genetic testing. She is afraid of needles and wants to know the least invasive way she can get the genetic testing done. The nurse should suggest which testing procedure? 1. Triple marker screen. 2. Ultrasound examination. 3. Amniocentesis. 4. Chorionic villus sampling.

2

16. The nurse is working in a clinic, and the next patient is an infant with deaf parents. In addition to providing an interpreter for the deaf, the nurse should incorporate what additional aid in her communication with the family? 1. Talk as done with hearing families. 2. Maintain good eye contact to let them read the nurse's lips. 3. Explain procedures thoroughly. 4. Recommend a trained hearing dog.

2

39. The clinic is doing a lead screening program for children in a low-income Hispanic community. The nurse working in the program wants to tell the parents the reasons to have their children screened for lead poisoning. Select all the following reasons that apply. 1. Young children absorb 10% of the lead to which they are exposed. 2. Homes built between 1900 and 1950 may contain lead-based paint. 3. The blood level of lead should be below 12.8 mcg/dL. 4. Lead can affect any part of the body, but the brain and kidneys are at greatest risk. 5. Foods such as fruit, candy, and antacids contain lead.

2, 4

97. Which of the following applies to brain tumors? Select all that apply. 1. Brain tumors are the most common malignancy in the United States. 2. Although an exact cause is unknown, an association has been linked to paints and radiation. 3. All children with brain tumors present with very similar manifestations. 4. Brain tumors in children usually occur below the cerebellum. 5. Symptoms of brain tumors always appear rapidly.

2, 4

80. A 12-year-old cut a hand while climbing a barb-wired fence. What should the nurse discuss with the parents regarding need for tetanus vaccine? Select all that apply. 1. No tetanus vaccine is necessary; it is too soon. 2. Tetanus is a potentially fatal disease. 3. Puncture wounds are less susceptible to tetanus. 4. There will be mild soreness at the injection site. 5. Tdap should be administered. 6. Td should be administered.

2, 5

17. A teenager is legally blind. The teen is wearing thick glasses and is carrying some school books. What question should the nurse ask the teen? 1. "Just how blind are you?" 2. "Can you see enough to read those books?" 3. "Tell me what you can see in this room." 4. "Is your vision worse than 20/200 in either of your eyes?"

3

27. A baby is brought into the clinic for follow-up review of phenylketonuria. The baby is 9 months old and weighs 22 lb. If the recommendation is to limit the phenylala nine in the diet to 25 mg/kg, this infant should have no more than _________/day.

250 mg

1. Which outcome is expected in a breast-fed newborn? 1. Voids spontaneously within 12 hours of life. 2. Loses 10% of body weight in the first 5 days. 3. Regains birth weight by the 10th day of life. 4. Awakens spontaneously for all feedings.

3

13. A nurse is working in the obstetrics/gynecology clinic, and a young woman tells the nurse she is pregnant. She states she is concerned that her boyfriend may be "slow" mentally. The nurse should do which activity first? 1. Develop a pedigree. 2. Take a family history. 3. Inform the provider about the concern. 4. Refer the client for genetic counseling.

3

56. An 18-month-old, who attends day care, has been having a barking, hoarse-sounding cough that comes in spasms with very noisy respirations for the last 2 nights. The parent is concerned that the child has picked up an infection at day care. The day-care staff indicates the child does not cough during the day, has no fever, and is eating and drinking well. The nurse knows that this description is most likely which condition? 1. Laryngotracheobronchitis. 2. Bacterial tracheitis. 3. Asthma. 4. Acute spasmodic laryngitis.

4

100. Which approach gives the most support to parents grieving over a terminally ill newborn? 1. State "You are both still young and will be able to have more children." 2. Avoid the parents; let them ask you questions. 3. Offer rationalizations for the child's terminal illness. 4. State "You are still feeling all the pain of your child's illness."

4

14. The nurse is caring for a school-aged child with leukemia. The child's complete blood count is very low. The parents are Jehovah's Witness. The nurse should recognize that the family faces which dilemma? 1. Numerous dietary kosher laws exist. 2. A belief that only Allah cures illness. 3. The parents may want the child to have anointing of the sick. 4. Opposed to transfusions and vaccines.

4

29. The nurse's unit is using the POPS pain scale for measuring pain in infants. The nurse knows this tool is which of the following? 1. Pain Assessment Tool for infants 27 weeks to term gestation. 2. The neonatal Postoperative Pain Measurement Scale for infants 32 to 60 weeks gestation. 3. Premature Infant Pain Profile for infants 28 to 40 weeks gestation. 4. Postoperative Pain Score for infants 1 to 7 months.

4

38. The nurse goes to the kindergarten classroom to evaluate a rash. A 5-year-old has patches of vesicles on the chest and face rather than on the arms and legs. The child says it is very itchy. The teacher tells the nurse the child had a runny nose a couple of days ago. The nurse suspects that the rash is caused by which virus? 1. Fifth disease (erythema infectiosum) 2. Roseola (exanthema subitum) 3. Scarlet fever (group A-B hemolytic streptococcus) 4. Chickenpox (varicella zoster)

4

47. Which of the following is the primary goal for a newborn with a cleft of the soft palate? 1. Prevent ear infections. 2. Help the mother bond with the baby. 3. Repair the cleft palate. 4. Establish feeding and sucking.

4

65. A child with moderate asthma is wheezing and coughing. Before the physician sees the child, the nurse should perform which test? 1. Skin testing for allergens. 2. PCO 2 levels. 3. Metered dose inhaler. 4. Peak flowmeter.

4

2. The average newborn weighs 3400 g. The nurse will tell the parents that the baby weighs_________________ lb.

7.5

40. A 9-year-old boy is brought to the clinic for a physical. The child's weight is 95 lb (95th percentile), and the height is 4 feet, 4 inches (50th percentile). Systolic blood pressure is 118 mm Hg, and diastolic blood pressure is 75 mm Hg. Reading the blood pressure graph in the following figure, the boy is in the __________ percentile for systolic and in the ____________ percentile for diastolic readings for his age.

95th, 90th

90. When introducing solid foods into an infant's diet, it is important to introduce one food at a time in order to rule out __________________.

Allergies

31. Parents tells the nurse that their 18-month-old is always curious about the environment and is learning new words every day. The nurse knows the baby is entering a phase of rapid _________________ development.

Cognitive

93. According to Piaget, the school-age child is in the ____________________________ stage of cognitive development.

Concrete operations

43. A 12-year-old girl with a thoracic myelomeningocele has had numerous urinary tract infections and has difficulty doing her clean intermittent self-catheterization. She and her parents are seeking an alternative way to empty her bladder. The surgeon has offered to do a Mitrofanoff procedure. The nurse knows that the surgeon will use the _________ to create a continent conduit between the bladder and the abdominal wall.

appendix

53. A child is giggling and laughing, and the nurse gently places one hand on the child's front and back of their chest. The sounds can be felt through the skin. This finding is called vocal _______________.

fremitus

48. When an infant is born with a herniation of the abdominal wall with intestine present and the peritoneal sac absent, it is called a _______________.

gastroschisis