Pediatrics

The nurse analyzes the laboratory values of a child with leukemia who is receiving chemotherapy. The nurse notes that the platelet count is 19,500 mm3. On the basis of this laboratory result, which intervention should the nurse include in the plan of care? 1. Initiate bleeding precautions 2. Monitor closely for signs of infection 3. Monitor the temperature every 4 hours 4. Initiate protective isolation precautions

1. Initiate bleeding precautions

A 10-year-old child with asthma is treated for acute exacerbation in the emergency department. The nurse caring for the child should monitor for which sign, knowing that it indicates a worsening of the condition? 1. Warm, dry skin 2. Decreased wheezing 3. Pulse rate of 90 bpm 4. Respirations of 18 breaths/minute

2. Decreased wheezing

A mother brings her 3-week-old infant to a clinic for a phenylketonuria rescreening blood test. The test indicates a serum phenylalanine level of 1mg/dL. The nurse reviews this result and makes which interpretation? 1. It is positive 2. It is negative 3. It is inconclusive 4. It requires rescreening at age 6 weeks

2. It is negative

The nurse is caring for an infant with bronchitis, and diagnostic tests have confirmed respiratory syncytial virus (RSV). on the basis of this finding, which is the most appropriate nursing action? 1. Initiate strict enteric precautions 2. Move the infant to a room with another child with RSV 3. Leave the infant in the present room because RSV is not contagious 4. Inform the staff that they must wear a mask, gloves, and a gown when caring for the child.

2. Move the infant to a room with another child with RSV

An adolescent client with type 1 diabetes mellitus is admitted to the emergency department for treatment of diabetic ketoacidosis. Which assessment findings should the nurse expect to note? 1. Sweating and tremors 2. Hunger and hypertension 3. Cold, clammy skin and irritability 4. Fruity breath odor and decreasing level of consciousness

4. Fruity breath odor and decreasing level of consciousness

A child with laryngotracheobronchitis (croup) is placed in a cool mist tent. The mother becomes concerned because the child is frightened, consistently crying and trying to climb out of the tent. Which is the most appropriate nursing action? 1. Tell the mother that the child must stay in the tent 2. Place a toy in the tent to make the child feel more comfortable 3. Call the HCP and obtain a prescription for a mild sedative 4. Let the mother hold the child and direct the cool mist over the child's face

4. Let the mother hold the child and direct the cool mist over the child's face

The school nurse is performing pediculosis capitis (head lice) assessments. Which assessment finding indicates that a child has a "positive" head check" 1. Maculopapular lesions behind the ears 2. Lesions in the scalp that extend to the hairline or neck 3. White flaky particles throughout the entire scalp region 4. White sacs attached to the hair shafts in the occipital area

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

The nurse reviews the laboratory results for child with a suspected diagnosis of rheumatic fever, knowing 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

I healthcare provider has prescribed oxygen as needed for an infant with heart failure. In which situation should the nurse administer the oxygen of infant? 1. During sleep 2. when changing the infant 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

Antibiotics are prescribed for a child with otitis media who underwent a myringotomy with insertion of tympanostomy tubes. The nurse provides discharge instructions to the parents regarding the administration of the antibiotics. Which statement, if made by the parents, indicates understanding of the instructions provided? 1. "Administer the antibiotics until they are gone" 2. "Administer the antibiotics if the child has a fever" 3. "Administer the antibiotic until the child feels better" 4. "Begin to taper the antibiotics after 3 days of a full course"

1. "Administer the antibiotics until they are gone"

The nurse is caring for a child after a tonsillectomy. The nurse monitors the child, knowing that which finding indicates the child is bleeding? 1. Frequent swallowing 2. A decreased pulse rate 3. Complaints of discomfort 4. An elevation in blood pressure

1. Frequent swallowing

The home care nurse provides instructions regarding basic infection control to the parent of an infant with human immunodeficiency virus infection. Which statement, if made by the parent, indicates the need for further instruction? 1. "I will clean up any spills from the diaper with diluted alcohol" 2. "I will wash baby bottles, nipples, and pacifiers in the dishwasher" 3. "I will be sure to prepare foods that are high in calories and high in protein" 4. "I will be sure to wash my hands carefully before and after caring for my infant"

1. "I will clean up any spills from the diaper with diluted alcohol"

The parents of a child recently diagnosed with cerebral palsy ask the nurse about the limitations of the disorder. The nurse responds by explaining that the limitations occur as a result of which pathophysiological process? 1. An infectious disease of the central nervous system 2. An inflammation of the brain as a result of a viral illness 3. A chronic disability characterized by impaired muscle movement and posture 4. A congenital condition that results in moderate to severe intellectual disabilities

1. An infectious disease of the central nervous system

Atropine sulfate, 0.6 mg intramuscularly, is prescribed for a child preoperatively, the nurse has determined that the dose prescribed is safe and prepares to administer how many milliliters to the child? Fill in the blank (refer to figure) 1. Answer - 1.5 mL

1. Answer - 1.5 mL

An infant of a mother infected with human immunodeficiency virus 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

The mother of a 3-year-old child arrives at a clinic and tells the nurse that the child has been scratching the skin continuously and has developed a rash. The nurse assesses the child and suspects the presence of scabies. The nurse bases this suspicion on which finding noted on assessment of the child's skin? 1. Fine grayish red lines 2. Purple-colored lesions 3. Thick, honey colored crusts 4. Cluster of fluid-filled vesicles

1. Fine grayish red lines

A 1-month-old infant is seen in a clinic and is diagnosed with developmental dysplasia of the hip. On assessment, the nurse understands that which finding should be noted in this condition? 1. Limited range of motion in the affected hip 2. An apparent lengthened femur on the affected side 3. Asymmetrical adduction of the affected hip when the infant is placed supine with the knees and hips flexed 4. Symmetry of the gluteal skinfolds when the infant is placed prone and the legs are extended against the examining table

1. Limited range of motion in the affected hip

The nurse notes documentation that a child is exhibiting an inability to flex the leg when the thigh is flexed anteriorly at the hip. Which condition does the nurse suspect? 1. Meningitis 2. Spinal cord injury 3. Intracranial bleeding 4. Decreased cerebral blood flow

1. Meningitis

The mother of a 4-year-old child tells the pediatric nurse that the child's abdomen seems to be swollen. During further assessment, the mother tells the nurse that the child is eating well and that the activity level of the child is unchanged. The nurse, suspecting the possibility of Wilm's tumor, should avoid which during the physical assessment? 1. Palpating the abdomen for a mass 2. Assessing the urine for the presence of hematuria 3. Monitoring the temperature for the presence of fever 4. Monitoring the blood pressure for the presence of hypertension

1. Palpating the abdomen for a mass

The clinic nurse reads the results of the tuberculin skin test (TST) on a 3-year-old child. The results indicate an area of induration measuring 10mm. The nurse should interpret these results as which finding? 1. Positive 2. Negative 3. Inconclusive 4. Definitive and requiring a repeat test

1. Positive

The nurse is planning care for a child with hemolytic uremic syndrome who has been anuric and will be receiving peritoneal dialysis treatment. The nurse should plan to implement which measure? 1. Restrict fluids as prescribed. 2. Care for the arteriovenous fistula. 3. Encourage foods high in potassium. 4. Administer analgesics as prescribed.

1. Restrict fluids as prescribed.

The nurse provides home care instructions to the parents of a child with celiac disease. The nurse should teach the parents to include which food item in the child's diet? 1. Rice 2. Oatmeal 3. Rye toast 4. Wheat bread

1. Rice

The clinic nurse is reviewing the health care provider's prescription for a child who has been diagnosed with scabies. Lindane has been prescribed for the child. The nurse questions the prescription if which is noted in the child's record? 1. The child is 18 months old 2. The child is being bottle fed 3. A sibling is using lindane for the treatment of scabies 4. The child has a history of frequent respiratory infections

1. The child is 18 months old

After a tonsillectomy, a child begins to vomit bright red blood. The nurse should take which initial action? 1. Turn the child to the side 2. Administer the prescribed antiemetic 3. Notify the health care provider (HCP) 4. Maintain NPO (nothing by mouth) status

1. Turn the child to the side

The nurse is monitoring a 3-year-old child for signs and symptoms of increased intracranial pressure after a craniotomy. The nurse plans to monitor for which early sign of symptom of increased ICP? 1. Vomiting 2. Bulging anterior fontanel 3. Increasing head circumference 4. Complaints of a frontal headache

1. Vomiting

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 the formula

1. Weighing the diapers

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 exercise 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 two weeks after surgery."

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

A 4-year-old child sustains a fall at home. After an x-ray examination, the child is determined to have a fractured arm and a plaster cast is applied. The nurse provides instructions to the parents regarding care for the child's cast. Which statement by the parents indicates a need for further instruction? 1. "the cast may feel warm as the cast dries" 2. "I can use lotion or powder around the cast edges to relieve itching" 3. "a small amount of white shoe polish can touch up a soiled white cast" 4. "if the cast becomes wet, a blow drier set on the cool setting may be used to dry the cast"

2. "I can use lotion or powder around the cast edges to relieve itching"

The nurse is caring for a 4-year-old child with human immunodeficiency virus infection. The nurse should expect which statement that is aligned with the psychosocial expectations of this age? 1. "being sick is scary" 2. "I know it hurts to die" 3. "I know I will be healthy soon" 4. "I know I am different than other kids"

2. "I know it hurts to die"

The nurse reviews the record of a child who is suspected to have glomerulonephritis. Which statement by the client's parent should the nurse expect that is associated with this diagnosis? 1. "I'm so glad they didn't find any protein in his urine" 2. "I noticed his urine was the color of coca-cola lately" 3. "His health care provider said his kidneys are working well" 4. "The nurse who admitted my child said his blood pressure was low"

2. "I noticed his urine was the color of coca-cola lately"

The nurse provides a teaching session to the nursing staff regarding osteosarcoma. Which statement by a member of the nursing staff indicates a need for information? 1. "The femur is the most common site of this sarcoma" 2. "The child does not experience pain at the primary tumor site" 3. "Limping, if a weight-bearing limb is affected, is a clinical manifestation" 4. "The symptoms of the disease in the early stage are almost always attributed to normal growing pains"

2. "The child does not experience pain at the primary tumor site"

The nursing student is presenting a clinical conference and discusses the cause of B-thalassemia. The nursing student informs the group that a child at greatest risk of developing this disorder is which of these? 1. A child of Mexican descent 2. A child of Mediterranean descent 3. A child whose intake of iron is extremely poor 4. A breast-fed child of a mother with chronic anemia

2. A child of Mediterranean descent

The nurse is instructing the parents of a child with iron deficiency anemia regarding the administration of a liquid oral iron supplement. Which instruction should the nurse tell the parents? 1. Administer the iron at mealtimes 2. Administer the iron through a straw 3. Mix the iron with cereal to administer 4. Add the iron to formula for easy administration

2. Administer the iron through a straw

A 4-year-old child is admitted to the hospital for abdominal pain. The mother reports that the child has been pale and excessively tired and is bruising easily. On physical examination, lymphadenopathy and hepatosplenomegaly are noted. Diagnostic studies are being performed because acute lymphocytic leukemia is suspected. The nurse determines that which laboratory results confirms the diagnosis? 1. Lumbar puncture showing no blast cells 2. Bone marrow biopsy showing blast cells 3. Platelet count of 350,000 mm3 4. White blood cell count 4500 mm3

2. Bone marrow biopsy showing blast cells

The nurse is caring for an infant with a diagnosis of bladder exstrophy. To protect the expose bladder tissue, the nurse should plan which intervention? 1. Cover the bladder with petroleum jelly gauze. 2. Cover the bladder with a non adhering plastic wrap. 3. Apply sterile distilled water dressings over the bladder mucosa. 4. Keep the bladder tissue drive by covering with dry sterile gauze.

2. Cover the bladder with a non adhering plastic wrap.

A child undergoes surgical removal of a brain tumor. During the postoperative period, the nurse notes that the child is restless, the pulse rate is elevated, and the blood pressure has decreased significantly from the baseline value. The nurse suspects that the child is in shock. Which is the most appropriate nursing action? 1. Place the child in a supine position 2. Notify the HCP 3. Place the child in Trendelenburg position 4. Increase the flow rate of the intravenous fluids

2. Notify the HCP

The nurse is monitoring a child for bleeding after surgery for removal of a brain tumor. The nurse checks the head dressing for the presence of blood and notes a colorless drainage on the back of the dressing. Which intervention should the nurse perform immediately? 1. Reinforce the dressing 2. Notify the HCP 3. Document the findings and continue to monitor 4. Circle the area of drainage and continue to monitor

2. Notify the HCP

The mother of a 6-year-old child arrives at a clinic because the child has been experiencing itchy, red, and swollen eyes. The nurse notes a discharge from the eyes and send a culture to the laboratory for analysis. Chlamydial conjunctivitis is diagnosed. On the basis of this diagnosis, the nurse determines that which requires further investigation. 1. Possible trauma 2. Possible sexual abuse 3. Presence of allergy 4. Presence of a respiratory infection

2. Possible sexual abuse

The nurse admits a child to the hospital with a diagnosis of pyloric stenosis. On assessment, which data would the nurse expect to obtain when asking the parent about the child's symptoms? 1. Watery diarrhea 2. Projectile vomiting 3. Increased urine output 4. Vomiting large amounts of bile

2. Projectile vomiting

The nurse is reviewing that lab results for a child scheduled for a tonsillectomy. The nurse determines that which lab value is most significant to review? 1. Creatinine level 2. Prothrombin time 3. Sedimentation rate 4. Blood urea nitrogen

2. Prothrombin time

An infant with a diagnosis of hydrocephalus is scheduled for surgery. Which is the priority nursing intervention in the preoperative period? 1. Test the urine for protein 2. Reposition the infant frequently 3. Provide a stimulating environment 4. Assess blood pressure every 15 minutes

2. Reposition the infant frequently

The nurse is preparing to care for a child after a tonsillectomy. The nurse documents on the plan of care to place that child in which position? 1. Supine 2. Side-lying 3. High Fowler's 4. Trendelenburg

2. Side-lying

After a tonsillectomy the nurse reviews the health care provider's postoperative prescriptions. Which prescription should that nurse question? 1. Monitor for bleeding 2. Suction every 2 hours 3. Give no milk or milk products 4. Give clear, cool liquids when awake and alert

2. Suction every 2 hours

The day care nurse is observing a 2-year-old child and suspects that the child may have strabismus. Which observation made by the nurse indicates the presence of this condition? 1. The child has difficulty hearing 2. The child consistently tilts the head to see 3. The child does not respond when spoken to. 4. The child consistently turns the head to hear.

2. The child consistently tilts the head to see

The emergency department nurse is caring for a child diagnosed with epiglottitis. In assessing the child, the nurse should monitor for which indication that the child may be experiencing airway obstruction? 1. The child exhibits nasal flaring and bradycardia 2. The child is leaning forward, with the chin thrust out. 3. The child has a low-grade fever and complains of a sore throat 4. The child is leaning backward, supporting himself of herself with the hands and arms

2. The child is leaning forward, with the chin thrust out.

The clinic nurse is instructing the parent of a child with human immunodeficiency virus 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 performing in admission assessment on a 2-year-old child who has been diagnosed with nephrotic syndrome notes that which most common characteristic is associated with this syndrome? 1. Hypertension 2. generalized edema 3. increase urinary output 4. frank, bright red blood in the urine

2. generalized edema

The nurse is preparing to care for a child with a diagnosis of intussusception. The nurse reviews the child's record and expects to note which sign of this disorder documented? 1. Watery diarrhea 2. Ribbon-like stools 3. Profuse projectile vomiting 4. Bright red blood and mucus in the stools

4. Bright red blood and mucus in the stools

the health care provider did not prescribe antibiotics. Which response should the nurse make? 1. "The child may be allergic to antibiotics" 2. "The child is too young to receive antibiotics" 3. "Antibiotics are not indicated unless a bacterial infection is present" 4. "The child still has the maternal antibodies from birth and does not need antibiotics"

3. "Antibiotics are not indicated unless a bacterial infection is present"

A 6-year-old child with human immunodeficiency virus infection has been admitted to the hospital for pain management. The child ask the nurse if the pain will ever go away. The nurse should make which best response to the child? 1. "the pain will go away if you lie still and let the medicine work" 2. "try not to think about it. The more you think it hurts, the more it will hurt" 3. "I know it must hurt, but if you tell me when it does, I will try to make it hurt a little less" 4. "I will give you something to make the pain go all away"

3. "I know it must hurt, but if you tell me when it does, I will try to make it hurt a little less"

Which question should the nurse asked the parents of a child suspected of having glomerulonephritis? 1. "Did your child fall off a bike onto the handlebars?" 2. "Has the child had persistent nausea and vomiting?" 3. "Has the child been itchy or had a rash anytime In the last week?" 4. "Has a child had a sore throat or throat infection in the last few weeks?"

4. "Has a child had a sore throat or throat infection in the last few weeks?"

Parents bring their 2-week-old infant to a clinic for treatment after a diagnosis of clubfoot made at birth. Which statement by the parents indicates a need for further teaching regarding this disorder? 1. "treatment needs to be started as soon as possible" 2. "I realize my infant will reuire follow-up care until fully grown" 3. "I need to bring my infant back to the clinic in 1 month for a new cast" 4. "I need to come to the clinic every week with my infant for the casting"

3. "I need to bring my infant back to the clinic in 1 month for a new cast"

The nurse is providing instructions to the parents of a child with scoliosis regarding the use of a brace. Which statement by the parents indicates a need for further instructions? 1. "I will encourage my child to perform prescribed exercises" 2. "I will have my child wear soft fabric clothing under the brace" 3. "I should apply lotion under the brace to prevent skin breakdown" 4. "I should avoid the use of powder because it will cake under the brace"

3. "I should apply lotion under the brace to prevent skin breakdown"

The nurse is providing medication instructions to a parent. Which statement by the parent indicates a need for further instruction? 1. "I should cuddle my child after giving the medication" 2. "I can give my child a frozen juice bar after he swallows the medication" 3. "I should mix the medication in the baby food and give it when I feed my child" 4. "if my child does not like the taste of the medicine, I should encourage him to pinch his nose and drink the medication through a straw"

3. "I should mix the medication in the baby food and give it when I feed my child"

The nurse prepares a teaching plan for the mother of a child diagnosed with bacterial conjunctivitis . which, if stated by the mother, indicates a need for further teaching? 1. "I need to wash my hands frequently" 2. "I need to clean the eye as prescribed" 3. "It is okay to share towels and washcloths" 4. "I need to give the eye drops as prescribed"

3. "It is okay to share towels and washcloths"

The school nurse has provided an instructional session about impetigo to the parents of the children attending school. Which statement, if made by a parent, indicates a need for further instruction? 1. "it is extremely contagious" 2. "It is most common in humid weather" 3. "Lesions most often are located on the arms and chest" 4. "It might show up in areas of broken skin such as an insect bite"

3. "Lesions most often are located on the arms and chest"

A 6-year-old child with leukemia is hospitalized and is receiving combination chemotherapy. Laboratory results indicate that the child is neutropenic, and protective isolation procedures are initiated. The grandmother of the child visits and brings a fresh bouquet of flowers picked from her garden, and asks the nurse for a vase for the flowers. Which response should the nurse provide to the grandmother? 1. "I have a vase in the utility room, and I will get it for you" 2. "I will get the vase and wash it well before you put flowers in it" 3. "The flowers from your garden are beautiful, but should not be placed in the child's room at this time" 4. "When you bring the flowers into the room, place them on the bedside stand as far away form the child as possible"

3. "The flowers from your garden are beautiful, but should not be placed in the child's room at this time"

The parents of a child with juvenile idiopathic arthritis call the clinic nurse because the child is experiencing a painful exacerbation of the disease. The parents ask the nurse if the child can perform range-of-motion exercises at this time. The nurse should make which response? 1. "avoid all exercise during painful periods" 2. "range-of-motion exercises must be performed every day" 3. "have the child perform simple isometric exercises during this time" 4. "admister additional pain medication before performing range-of-motion exercises"

3. "have the child perform simple isometric exercises during this time"

Sulfisoxazole, 1 g orally twice daily, is prescribed for an adolescent with a urinary tract infection. The medication label reads 500-mg tablets." The nurse has determined that the dosage prescribed is safe. The nurse administers how many tables per dose to the adolescent? 1. ½ tablet 2. 1 tablet 3. 2 tablets 4. 3 tablets

3. 2 tablets

A pediatric client with ventricular septal defect repair is placed on a maintenance dosage of digoxin. The dosage of 8mcg/kg/day, and the client's weight is 7.2 kg. the health care provider prescribes the digoxin to be given twice daily. The nurse prepares how many mcg of digoxin to administer to the client at each dose 1. 12.6 mcg 2. 21.4 mcg 3. 28.8 mcg 4. 32.2 mcg

3. 28.8 mcg

The nurse is monitoring a child with burns during treatment for burn shock. Which assessment provides the most accurate guide to determine the adequacy of fluid resuscitation? 1. Skin turgor 2. Level of edema at burn site 3. Adequacy of capillary filling 4. Amount of fluid tolerated in 24 hours

3. Adequacy of capillary filling

A child has fluid volume deficit. The nurse performs an assessment and determines that the child is improving and the deficit is resolving if which finding is noted? 1. The child has no tears 2. Urine specific gravity is 1.035 3. Capillary refill is less than 2 seconds 4. Urine output is less than 1mL/kg/hr

3. Capillary refill is less than 2 seconds

The nurse reviews the record of a newborn infant and notes that a diagnosis of esophageal atresia with tracheoesophageal fistula is suspected. The nurse expects to note which most likely sign of this condition documented in the record? 1. Incessant crying 2. Coughing at nighttime 3. Choking with feedings 4. Severe projectile vomiting

3. Choking with feedings

The nurse is assisting a health care provider examining a 3-week-old infant with developmental dysplasia of the hip. What test or sign should the nurse expect the HCP to assess? 1. Babinski's sign 2. The moro reflex 3. Ortolani's maneuver 4. The palmar-plantar grasp

3. Ortolani's maneuver

A lumbar puncture is performed on a child suspected to have bacterial meningitis, and cerebrospinal fluid is obtained for analysis. The nurse reviews the results of the CSF analysis and determines that which results would verify the diagnosis? 1. Clear CSF, decreased pressure, and elevated protein level 2. Clear CSF, elevated protein, and decreased glucose levels 3. Cloudy CSF, elevated protein, and decreased glucose levels 4. Cloudy CSF, decreased protein, and decreased glucose levels

3. Cloudy CSF, elevated protein, and decreased glucose levels

The mother of a 6-year-old who has type 1 diabetes mellitus calls a clinic nurse and tells the nurse that the child has been sick. The mother reports that she checked the child's urine and it was positive for ketones. The nurse should instruct the mother to take which action? 1. Hold the next dose of insulin 2. Come to the clinic immediately 3. Encourage the child to drink liquids 4. Administer an additional dose of regular insulin

3. Encourage the child to drink liquids

The clinic nurse reviews the record of a child just seen by a healthcare provider and diagnosed with suspected aortic stenosis. The nurse expects to no documentation of which clinical manifestation specifically found in this disorder? 1. Pallor 2. Hyperactivity 3. Exercise intolerance 4. gastrointestinal disturbances

3. Exercise intolerance

The nurse is caring for a newborn with suspected diagnosis of imperforate anus. The nurse monitors the infant, knowing that which is a clinical manifestation associated with this disorder? 1. Bile-stained fecal emesis 2. The passage of currant jelly-like stools 3. Failure to pass meconium stool in the first 24 hours of birth 4. Sausage-shaped mass palpated in the upper right abdominal quadrant

3. Failure to pass meconium stool in the first 24 hours of birth

A ten-year-old child with hemophilia A has slipped on the ice and bumped his knee. The nurse should prepare to administer which prescription? 1. Injection of factor X 2. Intravenous infusion of iron 3. Intravenous infusion of factor VII 4. Intramuscular injection of iron using the Z-track method

3. Intravenous infusion of factor VII

An infant has just returned to the nursing unit after surgical repair of a cleft lip on the right side. The nurse should place the infant in which best position at this time? 1. Prone position 2. On the stomach 3. Left lateral position 4. Right lateral position

3. Left lateral position

A child is hospitalized because of persistent vomiting. The nurse should monitor the child closely for which problem? 1. Diarrhea 2. Metabolic acidosis 3. Metabolic alkalosis 4. Hyperactive bowel sounds

3. Metabolic alkalosis

The nurse is assigned to care for an 8-year-old child with a diagnosis of a basilar skull fracture. The nurse reviews the health care providers prescriptions and should contact the HCP to question which prescription? 1. Obtain daily weight 2. Provide clear liquid intake 3. Nasotracheal suction as needed 4. Maintain a patent intravenous line

3. Nasotracheal suction as needed

The nurse is reviewing the record of a child with increased intracranial pressure and notes that the child has exhibited signs of decerebrate posturing. On assessment of the child, the nurse expects to note which characteristic of this type of posturing? 1. Flaccid paralysis of all extremities 2. Adduction of the arms at the shoulders 3. Rigid extension and pronation of the arms and legs 4. Abnormal flexion of the upper extremities and extension and adduction of the lower extremities

3. Rigid extension and pronation of the arms and legs

The nurse is providing home care instructions to the parents of a 10-year-old with hemophilia. Which sport activity should the nurse suggest for the child? 1. Soccer 2. Basketball 3. Swimming 4. Field hockey

3. Swimming

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

3. Tachycardia

The nurse collect the urine specimen preoperatively from a child with epispadias who is scheduled for surgical repair. When analyzing the results of the urinalysis, what should the nurse most likely expect to note? 1. Hematuria 2. proteinuria 3. bacteriuria 4. glucosuria

3. bacteriuria

On assessment of a child admitted with a diagnosis of acute stage Kawasaki disease, the nurse expects to know 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

Assessment findings of an infant admitted to the hospital reveal machinery like murmur on auscultation of the heart and signs of heart failure. The nurse reviews congenital cardiac anomalies and identifies the infant's condition as which disorder? Refer to the figure (the circled area) to determine the condition. 1. Aortic stenosis 2. atrial septal defect 3. patent ductus arteriosus 4. ventricular septal defect

3. patent ductus arteriosus

The nurse provides home care instructions to the parents of a child with acquired immunodeficiency syndrome. 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 provide 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 make the medication with food." 2. " I will take my child's pose before minister in the medication." 3. " If more than one dose is missed, I will call the healthcare provider." 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."

The nurse is reviewing a treatment plan with the parents of a newborn with hypospadias. Which statement by the parents indicated their understanding of the plan? 1. "Caution should be used when straddling the infant on the hip." 2. "Vital signs should be taken daily to check for bother infection." 3. "Catheterization will be necessary when the infant does not void." 4. "Circumcision has been delayed to save tissue for surgical repair."

4. "Circumcision has been delayed to save tissue for surgical repair."

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. "How's the child complained of back pain?" 2. "Has a child complained of headaches? " 3. "Has a child had any nausea or vomiting? " 4. "Did the child have a sore throat or fever with in the last two months?"

4. "Did the child have a sore throat or fever with in the last two months?"

The nurse provided discharge instructions to the parents of a 2 year old child who had an orchiopexy to correct cryptorchidism. Which statement by the parents indicates a need for further instruction? 1. "I'll check his temperature." 2. "I'll give him medication so he'll be comfortable." 3. "I'll check his voiding to be sure there's no problem." 4. "I'll let him decide when to return to his play activities."

4. "I'll let him decide when to return to his play activities."

The clinic nurse is providing instructions to a parent of a child with cystic fibrosis regarding the immunization schedule for the child. Which statement should the nurse make to the parent? 1. "The immunization schedule will need to be altered" 2. "The child should not receive any hepatitis vaccines" 3. "The child will receive all of the immunizations except for the poli series" 4. "The child will receive the recommended basic series of immunizations along with a yearly influenza vaccination"

4. "The child will receive the recommended basic series of immunizations along with a yearly influenza vaccination"

The mother with human immunodeficiency virus infection brings her 10-month old infant to the clinic for a routine checkup. The health care provider has documented that the infant is asymptomatic for HIV infection. After the checkup, the mother tells the nurse that she is so pleased that the infant will not get HIV infection. The nurse should make which most appropriate response to the mother? 1. "I am so pleased also that everything has turned out fine" 2. "because symptoms have not developed, it is unlikely that your infant will develop HIV infection" 3. "everything looks great, but be sure to return with your infant next month for the scheduled visit" 4. "most children infected with HIV develop symptoms within the first 9 month of life, and some become symptomatic sometime before they are 3 years old"

4. "most children infected with HIV develop symptoms within the first 9 month of life, and some become symptomatic sometime before they are 3 years old"

The nurse provides home care instructions to the parents of a child hospitalized with pertussis who is in the convalescent stage and is being prepared for discharge. Which statement by a parent indicates a need for further instruction? 1. "we need to encourage our child to drink fluids" 2. "coughing spells may be triggered by dust or smoke" 3. "vomiting may occur when our child has coughing episodes" 4. "we need to maintain droplet precautions and a quiet environment for at least 2 weeks"

4. "we need to maintain droplet precautions and a quiet environment for at least 2 weeks"

A health care provider's prescription reads "ampicillin sodium 125 mg IV every 6 hours." The medication label reads "when reconstituted with 7.4 mL of bacteriostatic water, the final concentration is 1 g/7.4 mL." the nurse prepares to draw up how many milliliters to administer 1 dose? 1. 1.1 mL 2. 0.54 mL 3. 7.425 mL 4. 0.925 mL

4. 0.925 mL

Penicillin G procaine, 1,000,000 units IM, is prescribed for a child with an infection. The medication label reads "1,200,000 units per 2 mL." the nurse has determined that the dose prescribed is safe. The nurse administers how many milliliters per dose to the child? 1. 0.8 mL 2. 1.2 mL 3. 1.4 mL 4. 1.7 mL

4. 1.7 mL

A child is receiving a series of hepatitis B vaccine and arrives at the clinic with his parent for the second dose. Before administering the vaccine, the nurse should ask the child and parent about a history of a severe allergy to which substance? 1. Eggs 2. Penicillin 3. Sulfonamides 4. A previous dose of hepatitis B vaccine or component

4. A previous dose of hepatitis B vaccine or component

An infant receives a diphtheria, tetanus, and acellular pertussis immunization at a well-baby clinic. The parent returns home and calls the clinic to report that the infant has developed swelling and redness at the site of injection. Which intervention should the nurse suggest to the parent? 1. Monitor the infant for a fever 2. Bring the infant back to the clinic 3. Apply a hot pack to the injection site 4. Apply a cold pack to the injection site

4. Apply a cold pack to the injection site

A topical corticosteroid is prescribed by the health care provider for a child with atopic dermatitis (eczema). Which instruction should the nurse give the parent about applying the cream? 1. Apply the cream over the entire body 2. Apply a thick layer of cream to affected areas only 3. Avoid cleansing the area before application of the cream 4. Apply a thin layer of cream and rub it into the area thoroughly

4. Apply a thin layer of cream and rub it into the area thoroughly

Permethrin is prescribed for a child with a diagnosis of scabies. The nurse should give which instructions to the parents regarding the use of this treatment? 1. Apply the lotion to areas of the rash only 2. Apply the lotion and leave it on for 6 hours 3. Avoid putting clothes on the child over the lotion 4. Apply the lotion to cool, dry skin at least 30 min after bathing

4. Apply the lotion to cool, dry skin at least 30 min after bathing

A new parent expresses concern to the nurse regarding sudden infant death syndrome (SIDS). She asks the nurse how to position her new infant for sleep. In which position should the nurse tell the parent to place the infant? 1. Side or prone 2. Back or prone 3. Stomach with the face turned 4. Back rather than on the stomach

4. Back rather than on the stomach

A mother arrives at the emergency department with her 5-year-old child and states that the child fell off a bunk bed. A head injury is suspected. The nurse checks the child's airway status and assesses the child for early and late signs of increased intracranial pressure. Which is a late sign of increased ICP? 1. Nausea 2. Irritability 3. Headache 4. Bradycardia

4. Bradycardia

A child is placed in skeletal traction for treatment of a fractured femur. The nurse creates a plan of care and should include which intervention? 1. Ensure that all ropes are outside the pulleys 2. Ensure that the weights are resting lightly on the flood 3. Restrict diversional and play activities until the child is out of traction 4. Check the health care provider's prescriptions for the amount of weight to be applied

4. Check the health care provider's prescriptions for the amount of weight to be applied

A health care provider prescribes an intravenous solution of 5% dextrose and half-normal saline with 40 mEq of potassium chloride for a child with hypotonic dehydration. The nurse performs which priority assessment before administering this IV prescription? 1. Obtains a weight 2. Takes the temperature 3. Takes the blood pressure 4. Checks the amount of urine output

4. Checks the amount of urine output

A parent brings her 4-month-old infant to a well-baby clinic for immunizations. The child is up to date with immunization schedule. The nurse should prepare to administer which immunizations to this infant? 1. Varicella, hepatitis B vaccine 2. Diphtheria, tetanus, acellular pertussis; measles , mumps, rubella; inactivated poliovirus vaccine 3. MMR, haemophilus influenzae type b, DTap 4. DTapP, hib, IPV, pneumococcal vaccine, rotavirus vaccine

4. DTapP, hib, IPV, pneumococcal vaccine, rotavirus vaccine

A child with B-thalassemia is receiving long-term blood transfusion therapy for the treatment of the disorder. Chelation therapy is prescribed as a result of too much iron from the transfusion. Which medication should the nurse anticipate to be prescribed? 1. Fragmin 2. Meropenem 3. Metoprolol 4. Deferoxamine

4. Deferoxamine

A school-age child with type 1 diabetes mellitus has soccer practice and the school nurse provides instructions regarding how to prevent hypoglycemia during practice. Which should the school nurse tell the child to do? 1. Eat twice amount normally eaten at lunch time 2. Take half the amount of prescribed insulin on practice days 3. Take the prescribed insulin at noontime rather than in the morning 4. Eat a small box of raisins or drink a cup of orange juice before soccer practice

4. Eat a small box of raisins or drink a cup of orange juice before soccer practice

The mother of an 8-year-old child being treated for right lower lobe pneumonia at home calls the clinic nurse. The mother tells the nurse that the child complains of discomfort on the right side and that ibuprofen is not effective. Which instruction should the nurse provide to the mother? 1. Increase the dose of ibuprofen 2. Increase the frequency of ibuprofen 3. Encourage the child to lie on the left side 4. Encourage the child to lie on the right side

4. Encourage the child to lie on the right side

The clinic nurse instructs parents of a child with sickle cell anemia about the precipitating factors related to sickle cell crisis. Which, if identified by the parents as a precipitating factor, indicates the need for further instruction? 1. Stress 2. Trauma 3. Infection 4. Fluid overload

4. Fluid overload

The clinic nurse reviews the record of an infant and notes that the health care provider has documented a diagnosis of suspected Hirschsprung's disease. The nurse reviews the assessment findings documented in the record, knowing that which sign most likely led the mother to seek health care for the infant? 1. Diarrhea 2. Projectile vomiting 3. Regurgitation of feedings 4. Foul-smelling-ribbon-like stools

4. Foul-smelling-ribbon-like stools

The nurse is planning care for a child with acute bacterial meningitis. Based on the mode of transmission of this infection, which precautionary intervention should be included in the plan of care? 1. Maintain enteric precautions 2. Maintain neutropenic precautions 3. No precautions are required as long as antibiotics have been started 4. Maintain respiratory isolation precautions for at least 24 hours after the initiation of antibiotics

4. Maintain respiratory isolation precautions for at least 24 hours after the initiation of antibiotics

A child with type 1 diabetes mellitus is brought to the emergency department by the mother, who states that the child has been complaining of abdominal pain and has been lethargic. Diabetic ketoacidosis is diagnosed. Anticipating the plan of care, the nurse prepares to administer which type of IV infusion? 1. Potassium infusion 2. NPH insulin infusion 3. 5% dextrose infusion 4. Normal saline infusion

4. Normal saline infusion

A child has the a right femur fracture caused by a motor vehicle crash and is placed in skin traction temporarily until surgery can be performed. During assessment, the nurse notes that the dorsalis pedis pulse is absent on the right foot. Which action should the nurse take? 1. Administer an analgesic 2. Release the skin traction 3. Apply ice to the extremity 4. Notify the health care provider

4. Notify the health care provider

A child who has undergone spinal fusion for scoliosis complains of abdominal discomfort and begins to have episodes of vomiting. On further assessment, the nurse notes abdominal distention. On the basis of these findings, the nurse should take which action? 1. Administer an antiemetic 2. Increase the intravenous fluids 3. Place the child in a sims' position 4. Notify the health care provider

4. Notify the health care provider

A health care provider prescribes laboratory studies for an infant of a woman positiove for human immunodeficiency virus. 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

The nurse analyzes the laboratory results of a child with hemophilia. The nurse understands that which result will most likely be abnormal in this child? 1. Platelet count 2. Hematocrit level 3. Hemoglobin level 4. Partial thromboplastin time

4. Partial thromboplastin time

A 7-year-old child is seen in a clinic, and the healthcare provider documents a diagnosis of primary nocturnal enuresis. The nurse should provide which information to the parents? 1. Primary nocturnal enuresis does not respond to treatment. 2. Primary nocturnal enuresis is caused by psychiatric problem. 3. Primary nocturnal enuresis require surgical intervention to improve the problem. 4. Primary nocturnal enuresis is usually outgrow without therapeutic intervention.

4. Primary nocturnal enuresis is usually outgrow without therapeutic intervention.

A child is diagnosed with Reye's syndrome. The nurse creates a nursing care plan for the child and should include which intervention in the plan? 1. Assessing hearing loss 2. Monitoring urine output 3. Changing body position every 2 hours 4. Providing a quiet atmosphere with dimmed lighting

4. Providing a quiet atmosphere with dimmed lighting

Laboratory studies are performed for a child suspected to have iron deficiency anemia. The nurse reviews the laboratory results, knowing that which result indicates this type of anemia? 1. Elevated hemoglobin level 2. Decreased reticulocyte count 3. Elevated red blood cell count 4. Red blood cells that are microcytic and hypochromic

4. Red blood cells that are microcytic and hypochromic

The nurse has just administered ibuprofen to a child with a temperature of 102F. The nurse should also take which action? 1. Withhold oral fluids for 8 hours 2. Sponge the child with cold water 3. Plant to administer salicylate in 4 hours 4. Remove excess clothing and blankets from the child

4. Remove excess clothing and blankets from the child

The nurse creates a plan of care for a child at risk for tonic-clonic seizures. In the plan of care, the nurse identifies seizure precautions and documents that which item need to be placed at the child's bedside? 1. Emergency cart 2. Tracheotomy set 3. Padded tongue blade 4. Suctioning equipment and oxygen

4. Suctioning equipment and oxygen

A diagnosis of Hodgkin's disease is suspected in a 12-year-old child. Several diagnostic studies are performed to determine the presence of this disease. Which diagnostic test result will confirm the diagnosis of Hodgkin's disease? 1. Elevated vanillylmandelic acid urinary levels 2. The presence of blast cells in the bone marrow 3. The presence of Epstein-Barr virus in the blood 4. The presence of Reed-Sternberg cells in the lymph nodes

4. The presence of Reed-Sternberg cells in the lymph nodes

The nurse provides feeding instructions to a parent of an infant diagnosed with gastroesophageal reflux disease. Which instruction should the nurse give to the parents to assist in reducing the episodes of emesis? 1. Provide less frequent, larger feedings 2. Burp the infant less frequently during feedings 3. Thin the feedings by adding water to the formula 4. Thicken the feedings by adding rice cereal to the formula

4. Thicken the feedings by adding rice cereal to the formula

The nurse prepares to administer an intramuscular injection to a 4-month-old infant. The nurse selects which best site to administer the injection? 1. Ventrogluteal 2. Lateral deltoid 3. Rectus femoris 4. Vastus lateralis

4. Vastus lateralis