Peds Exam 2

A 10-year-old child is found to have hemophilia. The nurse is explaining how hemophilia is inherited. What is the best explanation of the genetic factor that is involved? 1 It follows the Mendelian law of inherited disorders. 2 The mother is a carrier of the disorder but usually is not affected by it. 3 It is an autosomal dominant disorder in which the woman carries the trait. 4 A carrier may be male or female, but the disease occurs in the sex opposite that of the carrier

2 The mother is a carrier of the disorder but usually is not affected by it.

A nurse is preparing to discharge a school-aged child who has undergone splenectomy for β-thalassemia (Cooley anemia). What information should the discharge teaching include? 1 The child should avoid participation in contact sports. 2 The hematologic problems have been cured by the splenectomy. 3 A high fever should be reported to the child's healthcare provider. 4 Blood transfusions will be needed more frequently than before the splenectomy

3 A high fever should be reported to the child's healthcare provider.

What is the cause of milk anemia in toddlers? 1 Drinking skim milk 2 Drinking whole milk 3 Increased milk intake 4 Increased intake of fruits

Increased milk intake

A 12-year-old child with sickle cell anemia is admitted during a vaso-occlusive crisis. What is the priority of care for this child? 1 Relieving pain 2 Exercising joints 3 Increasing urine output 4 Improving respirations

Relieving pain

Which condition is caused by a virus that primarily infects a specific subset of T lymphocytes, the CD4+ T-cells? a. Wiskott-Aldrich syndrome b. Acquired immunodeficiency syndrome (AIDS) c. Severe combined immunodeficiency disease d. Idiopathic thrombocytopenic purpura (ITP)

b. Acquired immunodeficiency syndrome (AIDS)

Glucocorticoids, mineralocorticoids, and sex steroids are secreted by which organ? Select one: a. Anterior pituitary b. Adrenal cortex c. Parathyroid glands d. Thyroid gland

b. Adrenal cortex

What is the characteristic of the immune-mediated type 1 diabetes mellitus? Select one: a. Oral agents are often effective for treatment b. Age at onset is usually younger than 18 years c. Ketoacidosis is infrequent d. Onset is gradual

b. Age at onset is usually younger than 18 years

Which term is used to describe a type of fracture that does not produce a break in the skin? Select one: a. Compound b. Simple c. Comminuted d. Complicated

b. Simple

The nurse is admitting a toddler with the diagnosis of juvenile hypothyroidism. Which is a common clinical manifestation of this disorder? Select one: a. Insomnia b. Accelerated growth c. Dry skin d. Diarrhea

c. Dry skin

The nurse is providing teaching to the parents of a preschool-age client who is prescribed iron supplements for iron-deficiency anemia. Which parental statements indicate the need for further education? Select all that apply. 1 "We will mix the iron with milk to enhance absorption." 2 "We will mix the iron with black tea to enhance absorption." 3 "We will mix the iron with orange juice to enhance absorption." 4 "We will avoid giving our child green tea because it can decrease absorption." 5 "We will avoid feeding our child tomatoes because it can decrease absorption."

"We will mix the iron with milk to enhance absorption." "We will mix the iron with black tea to enhance absorption."

A nurse in the pediatric clinic is evaluating a 6-year-old child with sickle cell anemia whose spleen autoinfarcted by age 4. What is the priority nursing care at this time? 1 Monitoring for signs of jaundice 2 Assessing the abdomen frequently 3 Monitoring serial hematocrit readings 4 Determining parental knowledge about infection

Determining parental knowledge about infection

The school nurse is assessing a 10-year-old boy with hemophilia who has fallen while playing in the schoolyard. At which site does the nurse expect to find internal bleeding? 1 Joints 2 Abdomen 3 Cerebrum 4 Epiphyses

Joints

What should the plan of care include to minimize the potential for a sickling episode in a child with sickle cell anemia? 1 Providing an iron-rich diet 2 Ensuring hemoconcentration 3 Enforcing periods of quiet play 4 Promoting adequate oxygenation

Promoting adequate oxygenation

A 2-year-old child with previously diagnosed hemophilia is admitted to the pediatric unit for observation after a motor vehicle collision. The toddler has several bruises but no other apparent injuries. What is the nurse's specific concern regarding this child? 1 Risk for falls 2 Undetected injury 3 Deficient fluid volume 4 Development of infection

Undetected injury

Common clinical manifestations of vaccine reactions include: a. Intussusception b. Laryngeal edema c. Encephalopathy d. Urticaria

Urticaria

The nurse concludes that a parent of an otherwise healthy child with varicella chickenpox) has an accurate understanding of the disease when the parent states: a. "I will send my child back to school when all of the lesions are dry and crusted over." b. "I will apply calamine lotion every hour to decrease itching." c. "I will give my child 80 mg of aspirin three times a day until the fever is gone." d. "I will take my child to our primary care provide to request antibiotics."

a. "I will send my child back to school when all of the lesions are dry and crusted over."

At what age do most children have an adult concept of death as being inevitable, universal, and irreversible? Select one: a. 9 to 11 years b. 2 to 3 years c. 4 to 5years d. 6 to 8 years

a. 9 to 11 years

What is the most appropriate nursing diagnosis for a child diagnosed with moderate anemia? a. Activity intolerance related to generalized weakness b. Risk for injury related to depressed sensorium c. Risk for Injury related to dehydration and abnormal hemoglobin d. Decreased cardiac output related to abnormal hemoglobin

a. Activity intolerance related to generalized weakness

José is 4 year old. Preoperative teaching for a 4-year-old child scheduled for a cardiac catheterization should be done with what primary consideration in mind? Select one: a. Adapted to his level of development so that he can understand. b. Done several days before the procedure so that he will be prepared. c. Directed at his parents because he is too young to understand. d. Detailed in regard to the actual procedures so he will know what to expect.

a. Adapted to his level of development so that he can understand.

A young child has just injured an ankle at school. In addition to calling the child's parents, what is the most appropriate immediate action by the school nurse? Select one: a. Apply ice b. Obtain parental permission for administration of acetaminophen or aspirin c. Encourage child to assume a comfortable position d. Observe for edema and discoloration

a. Apply ice

A young child with human immunodeficiency virus is receiving several antiretroviral drugs. What is the expected outcome of these drug therapies? a. Delay disease progression b. Cure the disease c. Treat Pneumocystis jiroveci pneumonia d. Prevent spread of disease

a. Delay disease progression

Which interaction is part of the discharge plan for a school-age child with osteomyelitis who is receiving home antibiotic therapy? Select one: a. Arrangements for tutoring and schoolwork b. Instructions for a low-calorie diet c. Instructions for the parent to return the child to team sports immediately d. Instructions for a high-fat, low-protein diet

a. Arrangements for tutoring and schoolwork

Which clinical manifestations would suggest hydrocephalus in a neonate? Select one: a. Bulging fontanel and dilated scalp veins b. Constant low-pitched cry and restlessness c. Depressed fontanel and decreased blood pressure d. Closed fontanel and high-pitched cry

a. Bulging fontanel and dilated scalp veins

What is a common, serious complication of rheumatic fever? Select one: a. Cardiac valve damage b. Cardiac arrhythmias c. Seizures d. Pulmonary hypertension

a. Cardiac valve damage

This disease has an incubation period of 14 to 21 days. Infected individuals are highly contagious. The disease presents with flu-like symptoms followed by an eruption of lesions that change from macules to papules to vesicles. a. Chickenpox b. Roseola c. Measles d. Mumps

a. Chickenpox

What is the primary nursing intervention necessary to prevent bacterial endocarditis? Select one: a. Counsel parents of high risk children about prophylactic antibiotics. b. Encourage restricted mobility in susceptible children. c. Institute measures to prevent dental procedures. d. Observe children for complications such as embolism and heart failure.

a. Counsel parents of high risk children about prophylactic antibiotics.

What is the primary result of anemia? a. Decreased oxygen-carrying capacity of blood. b. Increased blood viscosity. c. Depressed hematopoietic system. d. Presence of abnormal hemoglobin.

a. Decreased oxygen-carrying capacity of blood.

Which nursing intervention is appropriate when caring for a child who has experienced a seizure? a. Describe and record the seizure activity observed. b. Place a tongue blade between the teeth if they become clenched. c. Restrain the child when seizure occurs to prevent bodily harm. d. Suction the child during a seizure to prevent aspiration.

a. Describe and record the seizure activity observed.

A mother asks a nurse why it is necessary to have her baby immunized if she disinfects her house daily. The nurse's best response is: a. Even if you clean every day, your baby is susceptible to infections because a baby's immune system is immature b. Why don't you discuss your concerns with your baby's doctor c. Is is a state law that your child received immunizations d. You don't have to immunize your child if you are sure you disinfect everything in your house

a. Even if you clean every day, your baby is susceptible to infections because a baby's immune system is immature

What is the most appropriate intervention for the parents of a 6-year-old girl with precocious puberty? Select one: a. Explain the importance of having the child foster relationships with same-age peers. b. Counsel parents that there is no treatment currently available for this disorder. c. Assure the child's parents that there is no increased risk for sexual abuse because of her appearance. d. Advise the parents to consider birth control for their daughter.

a. Explain the importance of having the child foster relationships with same-age peers.

Which topic should be a priority to teach to daycare facility staff to help control the spread of infections? a. Hand washing procedures b. Immunization schedules for infants and children c. Immune system development in childhood d. Etiology of common infectious diseases

a. Hand washing procedures

The nurse is caring for an 11-year-old boy who has recently been diagnosed with diabetes. What should be included in the teaching plan for daily injections? Select one: a. He is old enough to give most of his own injections. b. Self-injections will be possible when he is closer to adolescence. c. The parents do not need to learn the procedure. d. He can learn about self-injections when he is able to reach all injection sites.

a. He is old enough to give most of his own injections.

What immunizations are due at a 2-month-old well child visit? [select all that apply] a. IPV b. HBV c. Hib d. MMR e. Rota

a. IPV b. HBV c. Hib e. Rota

What name is given to identify an acquired hemorrhagic disorder that is characterized by excessive destruction of platelets? a. Immune thrombocytopenia b. Aplastic anemia c. Thalassemia major d. Disseminated intravascular coagulation

a. Immune thrombocytopenia

Which statement most accurately describes the pathologic changes of sickle cell anemia? a. Increased red blood cell destruction occurs b. Sickle-shaped cells decrease blood viscosity c. Sickle-shaped cells carry excess oxygen d. Decreased red blood cell destruction occurs

a. Increased red blood cell destruction occurs

Which of the followng statements is true regarding care of the child with Kawasaki disease? Select one: a. Management includes administration of intravenous immune globulin and aspirin. b. The principal area of involvement is the joints. c. The child's fever is usually responsive to antibiotics within 48 hours. d. Aspirin is contraindicated.

a. Management includes administration of intravenous immune globulin and aspirin.

What is the most common problem for children born with a myelomeningocele? a. Neurogenic bladder b. Intellectual impairment c. Cranioschisis d. Respiratory compromise

a. Neurogenic bladder

The nurse, talking with the tearful parent of a child newly diagnosed with a chronic illness, asks, "Who do you talk with when something is worrying you?" What is the purpose of this statement? Select one: a. Part of assessing parent's available support system. b. Inappropriate, because parent is so upset. c. A diversion of the present crisis to similar situations with which parent has dealt. d. An intervention to find someone to help parent.

a. Part of assessing parent's available support system.

A child is admitted to the hospital with a diagnosis of "rule out pertussis". The physician's orders include: nasopharyngeal (NP) culture, Erythromycin 250 mg po q 6 hours, and respiratory isolation. The nurse would institute these orders in what sequence? a. Place in isolation, culture NP, administer Erythromycin b. Place in isolation, administer Erythromycin, culture NP c. Culture NP, place in isolation, administer Erythromycin d. Culture NP, administer Erythromycin, place in isolation

a. Place in isolation, culture NP, administer Erythromycin

Which is often administered to prevent or control hemorrhage in a child diagnosed with cancer? Select one: a. Platelets b. Corticosteroids c. Nitrosoureas d. Whole blood

a. Platelets

Type 1 diabetes mellitus is suspected in an adolescent. Which clinical manifestation may be present? Select one: a. Poor wound healing b. Fluid overload c. Moist skin d. Weight gain

a. Poor wound healing

The feeling of guilt that the child "caused" the disability or illness is especially critical in which child? Select one: a. Preschooler b. Adolescent c. School-age child d. Toddler

a. Preschooler

This disease present with a high fever, and malaise followed by a maculopapular rash that starts on the face and moves downward. Affected children are often congested. Complications include blindness, encephalitis, otits media, seizures, and death a. Rubeola b. Varicella c. Roseola d. Erythema infectiousum

a. Rubeola

When developing a plan of care for a 1-month-old infant with sepsis, which of the following instructions would the nurse expect to include? a. Strictly monitor input and output b. Weigh the infant every other day c. Use the intravenous line for antibiotics only d. Monitor vital signs every 6 hours

a. Strictly monitor input and output

A nurse is teaching nursing students the physiology of congenital heart defects. Which defect results in decreased pulmonary blood flow? Select one: a. Tetralogy of Fallot b. Patent ductus arteriosus c. Atrial septal defect d. Ventricular septal defect

a. Tetralogy of Fallot

Which immunization should be given with caution to children infected with human immunodeficiency virus? a. Varicella b. Inactivated poliovirus c. Influenza d. Pneumococcus

a. Varicella

What immunizations are due at a 4-year-old well child check-up? [Select all that apply] a. Varicella b. MMR c. Tdap d. DTaP e. HPV

a. Varicella b. MMR d. DTaP

What is the priority nursing goal for a 14 year old diagnosed with Graves' disease? Select one: a. Verbalizing the importance of monitoring for medication side effects b. Developing alternative educational goals c. Allowing the adolescent to make decisions about whether or not to take medication d. Relieving constipation

a. Verbalizing the importance of monitoring for medication side effects

Which intervention should be included in the plan of care for an infant with the nursing diagnosis of Excess Fluid Volume related to congestive heart failure? Select one: a. Weigh the infant every day on the same scale at the same time. b. Administer digoxin as ordered by the physician. c. Put the infant in a car seat to minimize movement. d. Notify the physician when weight gain exceeds more than 20 g/day.

a. Weigh the infant every day on the same scale at the same time.

As related to inherited disorders, which statement is descriptive of most cases of hemophilia? a. X-linked recessive inherited disorder in which a blood-clotting factor is deficient b. Autosomal dominant disorder causing deficiency in a factor involved in the blood-clotting reaction c. Y-linked recessive inherited disorder in which the red blood cells become moon shaped d. X-linked recessive inherited disorder causing deficiency of platelets and prolonged bleeding

a. X-linked recessive inherited disorder in which a blood-clotting factor is deficient

An adolescent with osteosarcoma is scheduled for a leg amputation in 2 days. The nurse's approach should include which action? Select one: a. Explaining that, although the amputation is difficult, it will cure the cancer b. Answering questions with straightforward honesty c. Avoiding discussing the seriousness of the condition d. Assisting the adolescent in accepting the amputation as better than a long course of chemotherapy

b. Answering questions with straightforward honesty

Which interventions should the nurse include in the plan of care for the infant awaiting surgical closure of a myelomeningocele sac? Select one: a. Reinforcement of the original dressing if drainage noted b. Covered with a sterile, moist, nonadherent dressing c. A diaper secured over the dressing d. Open to air

b. Covered with a sterile, moist, nonadherent dressing

What is an expected assessment finding in a child with coarctation of the aorta? Select one: a. Orthostatic hypotension b. Disparity in blood pressure between the upper and lower extremities c. Systolic hypertension in the lower extremities d. Blood pressure higher on the left side of the body

b. Disparity in blood pressure between the upper and lower extremities

The nurse is teaching the parents of a 7-year-old child who has just had a cast applied for a fractured arm with the wrist and elbow immobilized. Which instructions should be included in the teaching? Select one: a. Swelling of the fingers is to be expected for the next 48 hours. b. Elevate casted arm when resting and when sitting up. c. Allow the affected limb to hang down for 1 hour each day. d. Immobilize the shoulder to decrease pain in the arm.

b. Elevate casted arm when resting and when sitting up.

Which is a common clinical manifestation of Hodgkin disease? Select one: a. Bone and joint pain b. Enlarged, firm, nontender lymph nodes c. Painful, enlarged lymph nodes d. Petechiae

b. Enlarged, firm, nontender lymph nodes

The parents of a child who has just been diagnosed with type 1 diabetes ask about exercise. The nurse should provide the parents with what information to address the child's safety needs? Select one: a. Exercise will increase blood glucose. b. Extra snacks are needed before exercise. c. Extra insulin is required during exercise. d. Exercise should be restricted.

b. Extra snacks are needed before exercise.

The Glasgow Coma Scale consists of an assessment of what functions? a. Level of consciousness and verbal response. b. Eye opening and verbal and motor responses. c. Intracranial pressure (ICP) and level of consciousness. d. Pupil reactivity and motor response.

b. Eye opening and verbal and motor responses.

The nurse assesses a 4-year-old who has a fine, pink, maculopapular rash that started on the face and then spread downward. Over the last three days, the rash has disappeared from the face, and is now on the extremities. Cervical and occipital lymph nodes are tender and enlarged. Which communicable disease would the nurse suspect? a. Roseola b. German measles (Rubella) c. Erythema infectiousum d. Varicella (chickenpox)

b. German measles (Rubella)

The parents of a child who has just died ask to be left alone so that they can rock their child one more time. In response to their request, what intervention should the nurse implement? Select one: a. Kindly explain that they need to say good-bye to their child now and leave. b. Grant their request. c. Discourage this because it will only prolong their grief. d. Assess why they feel that this is necessary.

b. Grant their request.

A 10 year old sustained a fracture in the epiphyseal plate of the right fibula when falling from a tree. When discussing this injury with the child's parents, the nurse should consider which statement? Select one: a. This type of fracture is inconsistent with a fall. b. Growth can be affected by this type of fracture. c. Healing is usually delayed in this type of fracture. d. This is an unusual fracture site in young children.

b. Growth can be affected by this type of fracture.

Which statement correctly describes β-thalassemia major (Cooley's anemia)? a. All formed elements of the blood are depressed. b. Increased incidence occurs in families of Mediterranean extraction. c. Increased incidence occurs in persons of West African descent. d. Inadequate numbers of red blood cells are present.

b. Increased incidence occurs in families of Mediterranean extraction.

A child is unconscious after a motor vehicle accident. The watery discharge from the nose tests positive for glucose. The nurse should recognize that this suggests what complication? Select one: a. Brainstem injury b. Leaking of cerebrospinal fluid (CSF) c. Upper respiratory tract infection d. Diabetic coma

b. Leaking of cerebrospinal fluid (CSF)

A child will start treatment for precocious puberty. This involves injections of which synthetic medication? Select one: a. Gonadotropins b. Luteinizing hormone-releasing hormone c. Somatotropic hormone d. Thyrotropin

b. Luteinizing hormone-releasing hormone

Surgical closure of the ductus arteriosus would bring about what desired effect? Select one: a. Decrease the edema in legs and feet. b. Prevent the return of oxygenated blood to the lungs. c. Stop the loss of unoxygenated blood to the systemic circulation. d. Increase the oxygenation of blood.

b. Prevent the return of oxygenated blood to the lungs.

What nursing consideration is especially important when caring for a child diagnosed with juvenile idiopathic arthritis (JIA)? Select one: a. Encourage range-of-motion exercises during periods of inflammation. b. Teach child and family the correct administration of medications. c. Administer acetaminophen to reduce inflammation. d. Apply ice packs to relieve stiffness and pain.

b. Teach child and family the correct administration of medications.

A 5-month-old has a white patches on the tongue and buccal mucosa. He was recently treated with an antibiotic for a strep infection. He has decreased oral intake and cries when the lesions are touched. a. Corona virus b. Thrush c. Coxsackievirus d. Lyme disease

b. Thrush

When infants are seen for fractures, which nursing intervention is a priority? Select one: a. No intervention is necessary. It is not uncommon for infants to fracture bones. b. Assess for genetic factors. c. Assess for child abuse. Fractures in infants are often nonaccidental. d. Assess the family's safety practices. Fractures in infants usually result from falls.

c. Assess for child abuse. Fractures in infants are often nonaccidental.

The nurse is talking to a parent of an infant with heart failure about feeding the infant. Which statement about feeding the child is correct? Select one: a. "You should feed your baby every 2 hours." b. "You should place a nasal oxygen cannula on your infant during and after each feeding." c. "You may need to increase the caloric density of your infant's formula." d. "You may need to increase the amount of formula your infant eats with each feeding."

c. "You may need to increase the caloric density of your infant's formula."

Which information should the nurse give to a child who is to have magnetic resonance imaging (MRI) of the brain? Select one: a. "You will have to lie flat after the test is finished." b. "You will have to drink a special fluid before the test." c. "Your head will be kept from moving during the procedure." d. "You will have electrodes placed on your head with glue."

c. "Your head will be kept from moving during the procedure."

A school-age child diagnosed with leukemia experienced severe nausea and vomiting when receiving chemotherapy for the first time. Which is the most appropriate nursing action to prevent or minimize these reactions with subsequent treatments? Select one: a. Administer an antiemetic as soon as child has nausea. b. Encourage drinking large amounts of favorite fluids. c. Administer an antiemetic at least 30 minutes before chemotherapy begins. d. Encourage child to take nothing by mouth (remain NPO) until nausea and vomiting subside.

c. Administer an antiemetic at least 30 minutes before chemotherapy begins.

A child with a rhinorrhea and a low-grade fever presents at an immunization clinic to receive vaccinations. The nurse should: a. Ask the mother to reschedule with appointment for a time when the child is symptom free b. Hold the immunization and ask the mother to return when the child is well c. Administer the vaccines the child is scheduled to receive d. Administer inactivated vaccines and hold live vaccines for another date

c. Administer the vaccines the child is scheduled to receive

In which condition are all the formed elements of the blood simultaneously depressed? a. Thalassemia major b. Sickle cell anemia c. Aplastic anemia d. Iron deficiency anemia

c. Aplastic anemia

The nurse uses the palms of the hands when handling a wet cast to achieve what outcome? Select one: a. Keep the patient's limb balanced b. Facilitate easy turning c. Avoid indenting the cast d. Assess dryness of the cast

c. Avoid indenting the cast

An adolescent boy is brought to the emergency department after a motorcycle accident. His respirations are deep, periodic, and gasping. There are extreme fluctuations in blood pressure. Pupils are dilated and fixed. What type of head injury should the nurse suspect? a. Subdural hemorrhage b. Skull fracture c. Brainstem d. Epidural hemorrhage

c. Brainstem

What should the nurse consider when preparing a school-age child and the family for heart surgery? Select one: a. Not showing unfamiliar equipment b. Explaining that an endotracheal tube will not be needed if the surgery goes well c. Avoiding mentioning postoperative discomfort and interventions d. Letting child hear the sounds of an electrocardiograph monitor

d. Letting child hear the sounds of an electrocardiograph monitor

What is a common clinical manifestation of juvenile hypothyroidism? Select one: a. Accelerated growth b. Diarrhea c. Dry skin d. Insomnia

c. Dry skin

Chelation therapy is begun on a child with β-thalassemia major with what expected result? a. Decreasing the risk of hypoxia. b. Managing nausea and vomiting. c. Elimination of excess iron. d. Treatment of the disease.

c. Elimination of excess iron.

A neonate is born with mild clubfeet. When the parents ask the nurse how this will be corrected, the nurse should base the explanation on what fact? Select one: a. Traction is tried first. b. Surgical intervention is needed. c. Frequent, serial casting is tried first. d. Children outgrow this condition when they learn to walk.

c. Frequent, serial casting is tried first.

What is best described as the inability of the heart to pump an adequate amount of blood to the systemic circulation at normal filling pressures? Select one: a. Systemic venous congestion b. Congenital heart defect c. Heart failure d. Pulmonary congestion

c. Heart failure

Which complication should the nurse asses for when caring for a child post cardiac catheterization? Select one: a. Pneumonia b. Rapidly increasing blood pressure c. Hemorrhage d. Congestive heart failure

c. Hemorrhage

What is the priority nursing intervention for a child hospitalized with hemarthrosis resulting from hemophilia? a. Administration of acetaminophen for pain relief b. Assessment of the impact of hospitalization on the family system c. Immobilization and elevation of the affected joint d. Assessment of the child's response to hospitalization

c. Immobilization and elevation of the affected joint

Which drug would be used to treat a child who has increased intracranial pressure (ICP) resulting from cerebral edema? a. Atropine sulfate b. Sodium bicarbonate c. Epinephrine hydrochloride d. Mannitol

d. Mannitol

Which is the most descriptive of a school-age child's reaction to death? Select one: a. Imagines the deceased person to be still alive b. Has little understanding of words such as forever c. Is very interested in funerals and burials d. Has an idealistic view of the world and criticizes funerals as barbaric

c. Is very interested in funerals and burials

The nurse is assessing a child who was just admitted to the hospital for observation after a head injury. What is the most essential part of the nursing assessment to detect early signs of a worsening condition? Select one: a. Vital signs b. Posturing c. Level of consciousness d. Focal neurologic signs

c. Level of consciousness

Which statement best explains why iron deficiency anemia is common during toddlerhood? a. Fetal iron stores are depleted by age 1 month. b. Dietary iron cannot be started until age 12 months. c. Milk is a poor source of iron. d. Iron cannot be stored during fetal development.

c. Milk is a poor source of iron.

To help the adolescent deal with diabetes, the nurse must consider which characteristic of adolescence? Select one: a. Need to make peers aware of the seriousness of hypoglycemic reactions b. Preoccupation with the future c. Need to be perfect and similar to peers d. Desire to be unique

c. Need to be perfect and similar to peers

Four year old, placed in Buck's extension traction for Legg-Calvé-Perthes disease, is crying with pain as the nurse assesses that the skin of the right foot is pale with an absence of pulse. What should the nurse do first? Select one: a. Give the child medication to relieve the pain. b. Reposition the child and notify the physician. c. Notify the practitioner of the changes noted. d. Chart the observations and check the extremity again in 15 minutes.

c. Notify the practitioner of the changes noted.

What is the most common mode of transmission of human immunodeficiency virus (HIV) in the pediatric population? a. Sexual abuse b. Blood transfusions c. Perinatal transmission d. Poor hand washing

c. Perinatal transmission

What term is used to identify the condition in which the normal adult hemoglobin is partly or completely replaced by abnormal hemoglobin? a. Aplastic anemia b. Thalassemia major c. Sickle cell anemia d. Iron deficiency anemia

c. Sickle cell anemia

The nurse is administering an IV chemotherapeutic agent to a child diagnosed with leukemia. The child suddenly begins to wheeze and have severe urticaria. Which is the most appropriate nursing action? Select one: a. Explain to child that this is an expected side effect. b. Observe child closely for next 10 minutes. c. Stop drug infusion immediately. d. Recheck rate of drug infusion.

c. Stop drug infusion immediately.

A child eats some sugar cubes after experiencing symptoms of hypoglycemia. This rapid-releasing sugar should be followed by: Select one: a. fruit juice. b. saturated and unsaturated fat. c. complex carbohydrate and protein. d. several glasses of water.

c. complex carbohydrate and protein.

The nurse is assessing a child with herpetic (HSV - Type I) gingivostomatitis. The nurse wears gloves when examining the lesions. This action is: a. unnecessary because the virus is sexually transmitted. b. unnecessary because the virus is not easily spread. c. necessary because the virus can easily enter breaks in the skin. d. necessary only if the nurse touches his/her own mouth.

c. necessary because the virus can easily enter breaks in the skin.

The nurse, closely monitoring a child who is unconscious after a fall, notices that the child suddenly has a fixed and dilated pupil. The nurse should interpret this as the indication of what occurrence? Select one: a. Eye trauma b. Indication of brain death c. Severe brainstem damage d. Neurosurgical emergency

d. Neurosurgical emergency

The nurse has received report on four children. Which child should the nurse assess first? a. An adolescent admitted after a motor vehicle accident who is oriented to person and place. b. A toddler in a persistent vegetative state with a low-grade fever. c. A school-age child in a coma with stable vital signs. d. A preschool child with a head injury and decreasing level of consciousness.

d. A preschool child with a head injury and decreasing level of consciousness.

What is the nurse's first action when planning to teach the parents of an infant with a congenital heart defect (CHD)? Select one: a. Discuss the plan with the nursing team b. Gather literature for the parents c. Secure a quiet place for teaching d. Assess the parents' anxiety level and readiness to learn

d. Assess the parents' anxiety level and readiness to learn

Which defect results in increased pulmonary blood flow? Select one: a. Tricuspid atresia b. Pulmonic stenosis c. Transposition of the great arteries d. Atrial septal defect

d. Atrial septal defect

Exophthalmos may occur in children with what diagnosis? Select one: a. Hyperparathyroidism b. Hypoparathyroidism c. Hypothyroidism d. Hyperthyroidism

d. Hyperthyroidism

Which statement is most descriptive of a concussion? a. A slight lesion develops remote from the site of trauma. b. Petechial hemorrhages cause amnesia. c. Visible bruising and tearing of cerebral tissue occur. d. It is a transient, reversible neuronal dysfunction.

d. It is a transient, reversible neuronal dysfunction.

The nurse is caring for an infant diagnosed with congestive heart disease (CHD). The nurse should plan which intervention to decrease cardiac demands? Select one: a. Discourage parents from rocking the infant b. Allow the infant to sleep through feedings during the night c. Wait for the infant to cry to show definite signs of hunger d. Organize nursing activities to allow for uninterrupted sleep

d. Organize nursing activities to allow for uninterrupted sleep

An 8-month-old infant becomes hypercyanotic while blood is being drawn. What should be the nurse's first action? Select one: 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

A child with pulmonary atresia exhibits cyanosis with feeding. On reviewing this child's laboratory values, the nurse is not surprised to notice which abnormality? Select one: a. Dehydration b. Infection c. Anemia d. Polycythemia

d. Polycythemia

As part of the treatment for congestive heart failure, the child takes the diuretic furosemide. As part of teaching home care, the nurse encourages the family to give the child foods such as bananas, oranges, and leafy vegetables. These foods are recommended because they are high in what electrolyte? Select one: a. Chlorides b. Sodium c. Zinc d. Potassium

d. Potassium

The nurse is planning activity for a 4-year-old child with anemia. Which activity should the nurse plan for this child? a. Game of "hide and seek" in the children's outdoor play area b. A walk down to the hospital lobby c. Participation in dance activities in the playroom d. Puppet play in the child's room

d. Puppet play in the child's room

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

d. Refer children with sore throats for throat cultures.

Which term is used when a patient remains in a deep sleep, responsive only to vigorous and repeated stimulation? a. Obtundation b. Persistent vegetative state c. Coma d. Stupor

d. Stupor

Which nursing intervention is appropriate to assess for neurovascular competency in a child suspected of experiencing compartment syndrome? Select one: a. The degree of motion and ability to position the extremity. b. The amount of swelling noted in the extremity and pain intensity. c. The length, diameter, and shape of the extremity. d. The skin color, temperature, movement, sensation, and capillary refill of the extremity.

d. The skin color, temperature, movement, sensation, and capillary refill of the extremity.

The mother of a 1-month-old infant tells the nurse that she worries that her baby will get meningitis like her oldest son did when he was an infant. On what information should the nurse's response be based upon? a. Meningitis rarely occurs during infancy. b. Vaccination to prevent all types of meningitis is now available. c. Often a genetic predisposition to meningitis is found. d. Vaccination to prevent Haemophilus influenzae type B meningitis has decreased the frequency of this disease in children.

d. Vaccination to prevent Haemophilus influenzae type B meningitis has decreased the frequency of this disease in children.

Which statement best describes a myelomeningocele? a. Herniation of the brain and meninges through a defect in the skull. b. Fissure in the spinal column that leaves the meninges and the spinal cord exposed. c. Hernial protrusion of a sac-like cyst of meninges with spinal fluid but no neural elements. d. Visible defect with an external sac-like protrusion containing meninges, spinal fluid, and nerves.

d. Visible defect with an external sac-like protrusion containing meninges, spinal fluid, and nerves.

What is a common sign of digoxin toxicity? Select one: a. Bradypnea b. Seizures c. Tachycardia d. Vomiting

d. Vomiting