Peds test 2

Prevention of hearing impairment in children is a major goal for the nurse. How can this be best achieved?

Being involved in immunization clinics for children.

The nurse is preparing a 12-year-old girl for a bone marrow aspiration. She tells the nurse she wants her mother with her "like before." The most appropriate nursing action is which of the following?

Grant her request.

An 8-month-old infant is restrained to prevent interference with the IV infusion. The nurse should do which of the following?

Remove restraints whenever possible.

The nurse encourages the mother of a toddler with acute LTB to stay at the bedside as much as possible. The nurse's rationale for this action is primarily which of the following?

The mother's presence will reduce anxiety and ease child's respiratory efforts

The nurse is caring for a 5-year-old child who is scheduled for a tonsillectomy in 2 hours. Which of the following actions should the nurse include in the child's postoperative care plan? (Select all that apply.)

Notify the surgeon if the child swallows frequently. Place the child on the abdomen until fully wake. Allow the child to have diluted juice after the procedure.

An 18-month-old child is seen in the clinic with AOM. Trimethoprim- sulfamethoxazole (Bactrim) is prescribed. Which of the following statements made by the parent indicates a correct understanding of the instructions?

"I should administer all of the prescribed medication."

Which statement by a parent about a child's conjunctivitis indicates that further teaching is needed?

"When the eye drainage improves, we'll stop giving the antibiotic ointment."

A venipuncture will be performed on a 7-year-old girl. She wants her mother to hold her during the procedure. The nurse should recognize that this:

May help the child relax.

The nurse is talking to a parent of an infant with congestive heart failure about feeding the infant. Which of the following statements about feeding the child is correct?

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

Which of the following is a complication that may occur after a cardiac catheterization?

Cardiac arrhythmia

Which of the following is the most common clinical manifestation of retinoblastoma?

Cat's eye reflex

Which of the following terms refers to opacity of the crystalline lens that prevents light rays from entering the eye and refracting on the retina?

Cataract

Which of the following is the most important consideration in managing TB in children?

Chemotherapy

A nurse is preparing a teaching session for parents on the prevention of childhood hearing loss. The nurse identify what as being the most common cause of hearing impairment in children?

Chronic otitis media

Which of the following statements best describes iron deficiency anemia in infants?

Clinical manifestations are similar regardless of the cause of the anemia.

Which of the following clinical manifestations would the nurse expect to see as shock progresses in a child and becomes decompensated shock?

Confusion and somnolence

A nurse would suspect possible visual impairment in a child who displays which of the following?

Excessive rubbing of the eyes

In preparing to give "enemas until clear" to a young child, the nurse should select which of the following?

Normal saline

A child is brought to the emergency department experiencing an anaphylactic reaction to a bee sting. Once the airway is established, the nurse should do which of the following actions? Place in correct sequence.

Obtain vascular access. Administer epinephrine. Keep child warm and calm.

What painful, tender, pea-sized nodules may appear on the pads of the fingers or toes in bacterial endocarditis?

Osler nodes

Which of the following clinical manifestations should the nurse expect when a child with sickle cell anemia experiences an acute vaso-occlusive crisis?

Painful swelling of hands and feet; painful joints

The parents of a young child with congestive heart failure tell the nurse that they are "nervous" about giving digoxin. The nurse's response should be based on which of the following?

Parents must learn specific, important guidelines for administration of digoxin

Which of the following is often administered to prevent or control hemorrhage in a child with cancer?

Platelets

Which of the following structural defects constitute tetralogy of Fallot?

Pulmonic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy

Which of the following is the leading cause of death after heart transplantation?

Rejection

Distortion of sound and problems in discrimination are characteristic of what type of hearing loss?

Sensorineural

Which of the following explanations regarding cardiac catheterization is appropriate for a preschool child?

When the procedure is done, you will have to keep your leg straight for at least 4 hours.

Which of the following should the nurse include when teaching the mother of a 9- month-old infant about administering liquid iron preparations?

Adequate dosage will turn the stools a tarry green color.

In which of the following conditions are all the formed elements of the blood simultaneously depressed?

Aplastic anemia

One of the supervisors for a home health agency asks the nurse to give the family a survey evaluating the nurses and other service providers. The nurse should recognize this as which of the following?

Appropriate to improve quality of care

The child diagnosed with Down syndrome should be evaluated for which of the following before participating in some sports?

Atlantoaxial instability

A child with leukemia is receiving triple intrathecal chemotherapy consisting of methotrexate, cytarabine, and hydrocortisone. The purpose of this is to prevent:

central nervous system (CNS) disease

The nurse is teaching a mother how to perform chest physiotherapy and postural drainage on her 3-year-old child, who has cystic fibrosis. To perform percussion, the nurse should instruct her to

cover the skin with a shirt or gown before percussing

The parents of a child hospitalized with sickle cell anemia tell the nurse that they are concerned about narcotic analgesics causing addiction. The nurse should explain that narcotic analgesics:

rarely cause addiction because they are medically indicated.

Several blood tests are ordered for a preschool child with severe anemia. She is crying and upset because she remembers the venipuncture done at the clinic 2 days ago. The nurse should explain that:

topical application of local anesthetic can eliminate venipuncture pain

When caring for a child with an intravenous infusion, the nurse should do which of the following?

Observe the insertion site frequently for signs of infiltration

Effective CPR on a 5-year-old child should include which of the following?

One breath to every five chest compressions

The parent of an infant with nasopharyngitis should be instructed to notify the health professional if the infant:

Shows signs of an earache.

Which of the following is the preferred site for intramuscular injections in infants?

Vastus lateralis

The nurse is assessing a child with croup. Examining the child's throat by using a tongue depressor might precipitate which of the following?

Complete obstruction

Labored breathing is referred to as:

dyspnea

A child with CF is receiving recombinant human deoxyribonuclease (rhDNase). This drug:

may cause voice alterations

A school-age child had an upper respiratory tract infection for several days and then began having a persistent dry, hacking cough that was worse at night. The cough has become productive in the past 24 hours. This is most suggestive of which of the following?

Bronchitis

Which action best facilitates lipreading by the hearing-impaired child?

Speaking at an even rate

Hearing is expressed in decibels (dB), or units of loudness. Which of the following is, in decibels, the softest sound a normal ear can hear?

0

The nurse is talking to the parent of a 13-month-old child. The mother states, "My child does not make noises like 'da' or 'na' like my sister's baby, who is only 9 months old." Which of the following statements by the nurse would be most appropriate to make?

"I am going to request a referral to a hearing specialist."

The nurse is preparing an active adolescent for discharge after a cardiac catheterization. Which of the following statements by the adolescent would indicate a need for further teaching?

"I have to stay on strict bed rest for 3 days."

A mother calls the outpatient clinic requesting information on appropriate dosing for over-the-counter medications for her 13-month-old who has symptoms of an upper respiratory tract infection and fever. The box of acetaminophen says to give 120 mg q4h when needed. At his 12-month visit, the nurse practitioner prescribed 150 mg. The nurse's best response is which of the following?

"The nurse practitioner ordered the drug based on weight, which is a more accurate way of determining a therapeutic dose.

The school nurse is caring for a child with a penetrating eye injury. Emergency treatment includes which of the following?

Apply a Fox shield to affected eye and any type of patch to the other eye

The nurse is caring for a school-age girl who has had a cardiac catheterization. The child tells the nurse that her bandage is "too wet." The nurse finds the bandage and bed soaked with blood. The most appropriate initial nursing action is which of the following?

Apply direct pressure above catheterization site.

Nursing interventions for the child after a cardiac catheterization would include which of the following? (Select all that apply.)

Assess the affected extremity for temperature and color. Maintain a patent peripheral intravenous catheter until discharge.

A child has a chronic, nonproductive cough and diffuse wheezing during the expiratory phase of respiration. This suggests which of the following?

Asthma

Which of the following defects results in increased pulmonary blood flow

Atrial septal defect

A boy with leukemia screams whenever he needs to be turned or moved. What is the most probable cause of this pain?

Bone involvement

It is important to make certain that sensory connectors and oximeters are compatible, since wiring that is incompatible can cause which of the following?

Burns under sensors

A school-age child is admitted in vaso-occlusive sickle cell crisis. The child's care should include which of the following?

Adequate hydration and pain management

A school-age child with leukemia experienced severe nausea and vomiting when receiving chemotherapy for the first time. Which of the following is the most appropriate nursing action to prevent or minimize these reactions with subsequent treatments?

Administer an antiemetic before chemotherapy begins

A possible cause of acquired aplastic anemia in children is which of the following?

Drugs

The nurse must suction a child with a tracheostomy. Interventions should include which of the following?

Each pass of the suction catheter should take no longer than 5 seconds.

Chelation therapy is begun on a child with β-thalassemia major. The purpose of this therapy is to do which of the following?

Eliminate excess iron.

A child is brought to the emergency department experiencing an anaphylactic reaction to a bee sting. While an airway is being established, the nurse should prepare which of the following medications for immediate administration?

Epinephrine

Clinical manifestations of toxic shock syndrome include which of the following?

Erythematous macular rash

The nurse is preparing a child for possible alopecia from chemotherapy. Which of the following should be included?

Explain to child that when hair regrows, it may have a slightly different color or texture.

A parent asks the nurse why a developmental assessment is being conducted for a child during a routine well-child visit. The nurse answers based on what knowledge about such routine developmental assessments?

The best method for early detection of cognitive disorders.

José is a 4-year-old child scheduled for a cardiac catheterization. Preoperative teaching should be:

adapted to his level of development so that he can understand.

Therapeutic management of the child with rheumatic fever includes:

administering penicillin.

The home health nurse is caring for a child who requires complex care. The family expresses frustration related to obtaining accurate information about their child's illness and its management. Which of the following is the best action for the nurse?

Clarify family's request, and provide information they want.

Which of the following is an implanted ear prosthesis for children with sensorineural hearing loss?

Cochlear implant

The most common type of hearing loss, which results from interference of transmission of sound to the middle ear, is called:

conductive.

A beneficial effect of administering digoxin (Lanoxin) is that it:

decreases edema.

A young child with HIV is receiving several antiretroviral drugs. The purpose of these drugs is to:

delay disease progression.

Chronic otitis media with effusion (OME) is differentiated from acute otitis media (AOM) because it is usually characterized by which of the following?

A feeling of fullness in the ear

Asthma in infants is usually triggered by:

A viral infection

When liquid medication is given to a crying 10-month-old infant, which approach minimizes the possibility of aspiration?

Administering the medication with a syringe (without needle) placed along the side of the infant's tongue

It is generally recommended that a child with acute streptococcal pharyngitis can return to school:

After taking antibiotics for 24 hours.

Katie, 4 years old, is admitted to outpatient surgery for removal of a cyst on her foot. Her mother puts the hospital gown on her, but Katie is crying because she wants to leave on her underpants. The most appropriate nursing action is which of the following?

Allow her to wear her underpants

A nurse is preparing to perform a dressing change on a 6-year-old child with mild cognitive impairment (CI) who sustained a minor burn. Which strategy should the nurse use to prepare the child for this procedure?

Demonstrate a dressing change on a doll.

Using knowledge of child development, which of the following is the best approach when preparing a toddler for a procedure?

Demonstrate the procedure on a doll.

Which of the following types of croup is always considered a medical emergency

Epiglottitis

The Heimlich maneuver is recommended for airway obstruction in children older than:

1 year

A child is receiving total parenteral nutrition (TPN; hyperalimentation). At the end of 8 hours, the nurse observes the solution and notes that 200 ml/8 hr is being infused rather than the ordered amount of 300 ml/8 hr. The nurse should adjust the rate so that how much will infuse during the next 8 hours?

300 mL

An 8-year-old child is receiving digoxin (Lanoxin). The nurse should notify the practitioner and withhold the medication if the apical pulse is less than which of the following?

70 beats/min

When communicating with other professionals, it is important for home care nurses to:

Restrict communication to clinically relevant information

A parent whose two school-age children have asthma asks the nurse in what sports, if any, they can participate. The nurse should recommend which of the following?

Swimming

When both parents have sickle cell trait, what is the chance their children will have sickle cell anemia?

25%

The nurse should suspect a hearing impairment in an infant who demonstrates which of the following behaviors?

Absence of babbling by age 7 months

When a child with mild mental retardation reaches the end of adolescence, which of the following characteristics would be expected?

Achieves a mental age of 8 to 12 years

A family wants to begin oral feeding of their 4-year-old son, who is ventilator dependent and currently tube-fed. They ask the home health nurse to feed him the baby food orally. The nurse recognizes a high risk of aspiration and an already compromised respiratory status. The most appropriate nursing action is which of the following?

Acknowledge their request, explain the risks, and explore with the family the available options.

Which of the following is caused by a virus that primarily infects a specific subset of T lymphocytes, the CD4+ T cells?

Acquired immunodeficiency syndrome (AIDS)

Which of the following is the most appropriate nursing diagnosis for a child with anemia?

Activity Intolerance related to generalized weakness

Which of the following is an important nursing consideration when chest tubes will be removed from a child?

Administer analgesics before procedure.

Which of the following is an important nursing consideration when suctioning a young child who has had heart surgery?

Administer supplemental oxygen before and after suctioning

A young boy will receive a bone marrow transplant (BMT). This is possible because one of his older siblings is a histocompatible donor. What is this type of BMT called?

Allogeneic

Which of the following types of shock is characterized by a hypersensitivity reaction causing massive vasodilation and capillary leaks, which may occur with drug or latex allergy?

Anaphylactic shock

When should children with cognitive impairment be referred for stimulation and educational programs?

As young as possible

The home health nurse outlines short- and long-term goals for a 10-year-old child with many complex health problems. Who should agree on these goals?

Child, family, and all professionals involved

The most common cause of hearing impairment in children is which of the following?

Chronic otitis media

An 8-year-old girl is receiving a blood transfusion when the nurse notes that she has developed precordial pain, dyspnea, distended neck veins, slight cyanosis, and a dry cough. These manifestations are most suggestive of which of the following complications?

Circulatory overload

Several types of long-term central venous access devices are used. Which of the following is considered an advantage of a Hickman-Broviac catheter?

Easy to use for self-administered infusions

The home health nurse is planning care for a 3-year-old boy who has Down syndrome and is receiving continuous oxygen. He recently began walking around furniture. He is spoon-fed by his parents and eats some finger foods. Which of the following is the most appropriate goal to promote normal development?

Encourage mobility.

Which action is contraindicated when a child diagnosed with Down syndrome is hospitalized?

Encourage parents to leave the child alone at night.

The nurse is caring for a 10-month-old infant with respiratory syncytial virus (RSV) bronchiolitis. Which of the following interventions should be included in the child's care? (Select all that apply.)

Encourage to drink 8 ounces of formula every 4 hours. Cluster care to encourage adequate rest. Place on noninvasive oxygen monitoring.

Nursing considerations related to the administration of oxygen in an infant include which of the following?

Ensure uninterrupted delivery of the appropriate oxygen concentration

Which of the following drugs is considered the most useful in treating cardiac arrest?

Epinephrine hydrochloride

The home health nurse asks a child's mother many questions as part of the assessment. The mother answers many questions, then stops and says, "I don't know why you ask me all this. Who gets to know this information?" The nurse should do which of the following?

Explain who will have access to the information

Kimberly, age 3 years, has a fever associated with a viral illness. Her mother calls the nurse, reporting a fever of 102° F even though she had acetaminophen 2 hours ago. The nurse's action should be based on which of the following?

Fevers such as this are common with viral illnesses.

The parents of a child with cancer tell the nurse that a bone marrow transplant (BMT) may be necessary. Which of the following should the nurse recognize as important when discussing this with the family?

Finding a suitable donor involves matching antigens from the human leukocyte antigen (HLA) system.

What is an appropriate nursing intervention when caring for an infant with an upper respiratory tract infection and elevated temperature?

Give small amounts of favorite fluids frequently to prevent dehydration.

Which statement expresses accurately the genetic implications of cystic fibrosis (CF)?

If it is present in a child, both parents are carriers of this defective gene.

The mother of a toddler yells to the nurse, "Help! He is choking to death on his food." The nurse determines that lifesaving measures are necessary based on which of the following?

Inability to speak

Which of the following is an important nursing consideration when performing a bladder catheterization on a young boy?

Insert 2% lidocaine lubricant into the urethra.

A parent whose child has been diagnosed with a cognitive deficit should be counseled about what fact related to intellectual impairment?

Is likely caused by a variety of factors.

Which statement accurately describes fragile X syndrome?

It is the second most common genetic cause of cognitive impairment.

Which of the following statements is characteristic of AOM?

It is treated with a broad range of antibiotics

The nurse has just collected blood by venipuncture in the antecubital fossa. Which of the following should the nurse do next?

Keep arm extended, and apply pressure to the site for a few minutes.

Which interventions should the nurse plan when caring for a child with a visual impairment? (Select all that apply.)

Keep items in the room in the same location. Describe the placement of the eating utensils on the meal tray. Identify noises for the child.

The home care nurse has been visiting an adolescent with recently acquired quadriplegia. The teen's mother tells the nurse, "I'm sick of providing all the care while my husband does whatever he wants to, whenever he wants to do it." Which of the following should be the initial action of the nurse?

Listen and reflect mother's feelings.

A child with autism spectrum disorder (ASD) is admitted to the hospital with pneumonia. The nurse should plan which priority intervention when caring for the child?

Maintain a structured routine and keep stimulation to a minimum.

What is the earliest recognizable clinical manifestation(s) of CF?

Meconium ileus

Which of the following explains why iron deficiency anemia is common during toddlerhood?

Milk is a poor source of iron.

The nurse is caring for a child with carbon monoxide poisoning associated with smoke inhalation. Which of the following is essential in this child's care?

Monitor arterial blood gases.

The nurse is caring for a child with acute respiratory distress syndrome (ARDS) associated with sepsis. Nursing actions should include which of the following?

Monitor pulse oximetry.

In some genetically susceptible children, anesthetic agents can trigger malignant hyperthermia. The nurse should be alert in observing that, in addition to an increased temperature, an early sign of this disorder is which of the following?

Muscle rigidity

An adolescent male visits his primary care provider complaining of difficulty with his vision. When the nurse asks the adolescent to explain what visual deficits he/she is experiencing, the adolescent states, "I am having difficulty seeing distant objects; they are less clear than things that are close." What disorder does the nurse suspect the adolescent has?

Myopia

Which of the following terms refers to the ability to see objects clearly at close range but not at a distance?

Myopia

Pancreatic enzymes are administered to the child with CF. Nursing considerations should include which of the following?

Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal.

The nurse enters a room and finds a 6-year-old child who is unconscious. After calling for help and before being able to use an automatic external defibrillator, what steps should the nurse take? Place in correct order.

Place on a hard surface. Use the head tilt-chin lift maneuver and check for breathing. Give two rescue breaths Feel carotid pulse while maintaining head tilt with the other hand. Place heel of one hand on lower half of sternum with other hand on top. Administer 30 chest compressions with two breaths.

A 2-year-old child is being admitted to the hospital for possible bacterial meningitis. When preparing for a lumbar puncture, the nurse should do which of the following?

Prepare child for conscious sedation during the test.

A 2-year-old child comes to the emergency department with dehydration and hypovolemic shock. Which of the following best explains why an intraosseous infusion is started?

Rapid venous access is not possible.

Seventy-two hours after cardiac surgery, a young child has a temperature of 101° F. The nurse should do which of the following?

Report findings to physician

Mark, age 6 years, is hospitalized for intravenous (IV) antibiotic therapy. He eats little on his "regular diet" trays. He tells the nurse that all he wants to eat is pizza, tacos, and ice cream. Which of the following is the best nursing action?

Request these favorite foods for him.

A nurse must do a venipuncture on a 6-year-old child. Which of the following is an important consideration in providing atraumatic care?

Restrain child only as needed to perform venipuncture safely.

Which of the following should be the major consideration when selecting toys for a child who is mentally retarded?

Safety

Fragile X syndrome is which of the following?

Second most common genetic cause of mental retardation

Which is the most common congenital anomaly associated with Down syndrome?

Septal defects

Which of the following is an inherited immunodeficiency disorder characterized by absence of both humoral and cell-mediated immunity?

Severe combined immunodeficiency syndrome

Which of the following facilitates lip reading by the hearing-impaired child?

Speak at an even rate.

The nurse is administering an IV chemotherapeutic agent to a child with leukemia. The child suddenly begins to wheeze and have severe urticaria. Which of the following is the most appropriate nursing action?

Stop drug infusion immediately.

Tepid water or sponge baths are indicated for hyperthermia in children. The nurse should do which of the following?

Stop the bath if the child begins to chill.

What is the most common causative agent of bacterial endocarditis?

Streptococcus viridans

Several complications can occur when a child receives a blood transfusion. Which of the following is an immediate sign or symptom of an air embolus?

Sudden difficulty in breathing

The nurse is talking with a 10-year-old boy who wears bilateral hearing aids. The left hearing aid is making an annoying whistling sound that the child cannot hear. Which of the following is the most appropriate nursing action?

Suggest he reinsert the hearing aid

CF is suspected in a toddler. Which of the following tests is essential in establishing this diagnosis?

Sweat chloride test

Which of the following tests aid in the diagnosis of CF?

Sweat chloride test, stool for fat, chest radiograph films

Which of the following defects results in decreased pulmonary blood flow?

Tetralogy of Fallot

What should the nurse keep in mind when planning to communicate with a child who is diagnosed with an autism spectrum disorder (ASD)?

The child may exhibit monotone speech and echolalia.

Which of the following statements is the most descriptive of bronchial asthma?

There is heightened airway reactivity.

Skin testing for tuberculosis (TB) (the Mantoux test) is recommended:

periodically for children who reside in high-prevalence regions.

Which of the following should the nurse consider when having consent forms signed for surgery and procedures on children?

The risks and benefits of a procedure are part of the consent process.

When caring for the child with Kawasaki disease, the nurse should know which of the following?

Therapeutic management includes administration of gamma globulin and aspirin

Why are cool-mist vaporizers rather than steam vaporizers recommended in home treatment of respiratory tract infections?

They are safer

Which of the following is most descriptive of the pathophysiology of leukemia?

Unrestricted proliferation of immature white blood cells (WBCs) occurs.

Many of the physical characteristics of Down syndrome present nursing problems. Care of the child should include which of the following?

Use a cool-mist vaporizer to keep mucous membranes moist

The nurse is caring for an unconscious child. Skin care should include which of the following?

Use draw sheet to move child in bed to reduce friction and shearing injuries.

Which of the following immunizations should be given with caution to children infected with HIV?

Varicella

The nurse must do a heel stick on an ill neonate to obtain a blood sample. Which of the following is recommended to facilitate this?

Wrap foot in a warm washcloth.

Which of the following is a common clinical manifestation of Hodgkin disease?

Enlarged, firm, nontender lymph nodes

An appropriate intervention to encourage food and fluid intake in a hospitalized child is which of the following?

Give high-quality foods and snacks whenever child expresses hunger.

The nurse assesses a toddler for excessive tearing and corneal haziness to confirm which medical diagnosis?

Infantile glaucoma

An implanted ear prosthesis for children with sensorineural hearing loss is a(n):

cochlear implant.

Meperidine (Demerol) is not recommended for children in sickle cell crisis because it:

may induce seizures

An adolescent gets hit in the eye during a fight. The school nurse, using a flashlight, notes the presence of gross hyphema (hemorrhage into anterior chamber). The nurse should:

notify parents that adolescent needs to see an ophthalmologist.

Which of the following is a common sign of digoxin toxicity?

vomiting

A nurse is providing a parent information regarding autism spectrum disorder (ASD). Which statement made by the parent indicates understanding of the teaching?

"The onset of autism usually occurs before toddler stage."

Decongestant nose drops are recommended for a 10-month-old infant with an upper respiratory tract infection. Instructions for nose drops should include which of the following?

Avoid using for more than 3 days.

An infant has developed staphylococcal pneumonia. Nursing care of the child with pneumonia includes which of the following? (Select all that apply.)

Cluster care to conserve energy. Administration of antibiotics.

What term is used to identify the most common type of hearing loss, which results from interference of transmission of sound to the middle ear?

Conductive

An infant's parents ask the nurse about preventing OM. Which of the following should be recommended?

Avoid tobacco smoke

The Allen test is performed as a precautionary measure before which one of the following procedures?

Arterial puncture

When caring for a newborn with Down syndrome, the nurse should be aware that the most common congenital anomaly associated with Down syndrome is which of the following?

Congenital heart disease

Which of the following is best described as the inability of the heart to pump an adequate amount of blood to the systemic circulation at normal filling pressures?

Congestive heart failure

Which of the following is the most effective pain-management approach for a child who is having a bone marrow aspiration?

Conscious or unconscious sedation

Which of the following clinical manifestations would the nurse expect to see as shock progresses in a child and becomes decompensated shock? (Select all that apply.)

Cool extremities and decreased skin turgor Confusion and somnolence Tachypnea and poor capillary refill time

Which of the following is a major clinical manifestation of rheumatic fever?

Polyarthritis

The advantages of the ventrogluteal muscle as an injection site in young children include which of the following? (Select all that apply.)

Less painful than vastus lateralis Free of important nerves and vascular structures Easily identified by major landmarks

Which of the following should the nurse consider when preparing a school-age child and the family for heart surgery?

Let child hear the sounds of an ECG monitor.

The nurse is reviewing first aid with a group of school nurses. Which of the following statements made by a participant indicates a correct understanding of the information?

"If a child has a nosebleed, I should have the child sit up and lean forward."

A 6-month-old infant is receiving digoxin (Lanoxin). The nurse should notify the practitioner and withhold the medication if the apical pulse is less than which of the following?

90 to 110 beats/min

Prevention of hearing impairment in children is a major goal for the nurse. This can be achieved through which of the following?

Being involved in immunization clinics for children

One of the most frequent causes of hypovolemic shock in children is which of the following?

Blood loss

Myelosuppression, associated with chemotherapeutic agents or some malignancies such as leukemia, can cause bleeding tendencies because of what?

Decrease in blood platelets

Which of the following is an accurate description of anemia?

Decreased oxygen-carrying capacity of blood

In providing nourishment for a child with CF, which of the following factors should the nurse keep in mind?

Diet should be high in carbohydrates and protein.

A newborn assessment shows separated sagittal suture, oblique palpebral fissures, depressed nasal bridge, protruding tongue, and transverse palmar creases. These findings are most suggestive of which of the following?

Down syndrome

What is one of the major physical characteristics of the child with Down syndrome?

Hypotonic musculature

An adolescent will receive a BMT. The nurse should explain that the bone marrow will be administered by which of the following?

IV infusion

Which of the following is an acquired hemorrhagic disorder that is characterized by excessive destruction of platelets?

Idiopathic thrombocytopenic purpura

The nurse is caring for a child after heart surgery. Which of the following should the nurse do if evidence is found of cardiac tamponade?

Immediately report this to physician.

Which of the following occurs in septic shock?

Increased cardiac output

Which of the following statements best describes β-thalassemia major (Cooley anemia)?

Increased incidence occurs in families of Mediterranean extraction.

Which of the following describes the pathologic changes of sickle cell anemia?

Increased red blood cell destruction occurs.

The nurse is discussing sexuality with the parents of an adolescent girl with moderate cognitive impairment. Which of the following should the nurse consider when dealing with this issue?

Individuals with cognitive impairment need a well-defined, concrete code of sexual conduct.

Which of the following best describes why children have fewer respiratory tract infections as they grow older?

Repeated exposure to organisms causes increased immunity.

The teaching plan for the parents of a 3-year-old child with amblyopia should include which instruction?

Cover the "good" eye completely with a patch.

The nurse wore gloves during a dressing change. When the gloves are removed, the nurse should do which of the following?

Wash hands thoroughly

Which teaching guideline helps prevent eye injuries during sports and play activities?

Wear eye protection when participating in high risk sports such as paintball.

The nurse is recommending how to prevent iron deficiency anemia in a healthy, term, breast-fed infant. Which of the following should be suggested?

Iron-fortified infant cereal by age 4 to 6 months

A father calls the emergency department nurse saying that his daughter's eyes burn after getting some dishwasher detergent in them. The nurse recommends that the child be seen in the emergency department or by an ophthalmologist. The nurse also should recommend which of the following before the child is transported?

Irrigate eyes copiously with tap water for 20 minutes.

Autism is a complex developmental disorder. The diagnostic criteria for autism include delayed or abnormal functioning in which of the following areas with onset before age 3 years? (Select all that apply.)

Language as used in social communication Symbolic or imaginative play Social interaction

Which of the following immunizations should not be given to a child receiving chemotherapy for cancer?

Measles, rubella, mumps

A young child who has an intelligence quotient (IQ) of 45 would be described as which of the following?

Moderately retarded but trainable

The nurse is caring for a child with persistent hypoxia secondary to a cardiac defect. The nurse recognizes that a risk exists of cerebrovascular accidents (strokes). Which of the following is an important objective to decrease this risk?

Prevent dehydration.

The nurse is planning care for an adolescent with AIDS. Which of the following is the priority nursing goal?

Prevent infection.

Surgical closure of the ductus arteriosus would do which of the following?

Prevent the return of oxygenated blood to the lungs.

Appropriate interventions to facilitate socialization of the cognitively impaired child include which of the following?

Provide peer experiences, such as scouting, when older

A chest radiograph film is ordered for a child with suspected cardiac problems. The child's parent asks the nurse, "What will the radiograph show about the heart?" The nurse's response should be based on knowledge that the x-ray film will do which of the following?

Provide permanent record of heart size and configuration

The emergency department nurse is cleaning multiple facial abrasions on 9-year-old Mike. His mother is present. He is crying and screaming loudly. The nurse should do which of the following?

Tell him it is okay to cry and scream.

The nurse is planning how to prepare a 4-year-old child for some diagnostic procedures. Guidelines for preparing this preschooler should include which of the following?

Tell the child that procedures are never a form of punishment.

Mark, a 9 year old with Down syndrome, is mainstreamed into a regular third grade for part of the school day. His mother asks the school nurse about programs, such as Cub Scouts, that he might join. The nurse's recommendation should be based on which of the following?

Children with Down syndrome have the same need for socialization as other children.

Which of the following drugs is an angiotensin-converting enzyme (ACE) inhibitor?

Captopril (Capoten)

Which of the following is a common, serious complication of rheumatic fever?

Cardiac valve damage

The school nurse is informed that a child with HIV will be attending school soon. Which of the following is an important nursing intervention?

Carefully follow universal precautions

Cardiopulmonary resuscitation (CPR) is begun on a toddler. Which of the following pulses is usually palpated because it is the most central and accessible?

Carotid

When assessing the eyes of a neonate, the nurse observes opacity of the lens. This represents which of the following?

Cataracts

The nurse approaches a group of school-age patients to administer medication to Sam Hart. To identify the correct child, the nurse should do which of the following?

Check the patient's identification name band.

Parents of a 3-year-old child with congenital heart disease are afraid to let their child play with other children because of possible overexertion. The nurse's reply should be based on which of the following?

Child needs opportunities to play with peers.

A 9 year old diagnosed with Down syndrome is mainstreamed into a regular third-grade class for part of the school day. His mother asks the school nurse about programs such as Cub Scouts that he might join. The nurse's recommendation should be based on what knowledge?

Children with Down syndrome have the same need for socialization as other children.

The primary nursing intervention to prevent bacterial endocarditis is which of the following?

Counsel parents of high-risk children about prophylactic antibiotics

Which assessment findings help confirm a diagnosis of Down syndrome? (Select all that apply.)

High-arched, narrow palate Protruding tongue Transverse palmar crease

When discussing hyperlipidemia with a group of adolescents, the nurse should explain that high levels of what are thought to protect against cardiovascular disease?

High-density lipoproteins (HDLs)

Iron dextran is ordered for a young child with severe iron deficiency anemia. Nursing considerations include which of the following?

Inject deeply into a large muscle

Which of the following is a clinical manifestation of the systemic venous congestion that can occur with congestive heart failure?

Peripheral edema

An 8-month-old infant has a hypercyanotic spell while blood is being drawn. The nurse's first action should be which of the following?

Place the child in the knee-chest position

The nurse is preparing to insert a nasogastric tube into a 4-year-old child for intermittent suctioning after abdominal surgery. Place in correct sequence the steps for inserting a nasogastric tube.

Place the child in the supine position with head slightly hyperflexed Measure the tube from the tip of the nose to the ear lobe to midpoint between the xiphoid process and the umbilicus. Lubricate the nasogastric tube with water-soluble lubricant. Insert the nasogastric tube through the nares. Check the placement of the tube by aspirating stomach contents. Tape the nasogastric tube securely to the child's face.

When administering a gavage feeding to a school-age child, the nurse should do which of the following?

Position on right side after administering feeding

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 which of the following?

Potassium

Home care is being considered for a young child who is ventilator dependent. Which of the following factors is most important in deciding whether home care is appropriate?

Preparation and training of family

Which of the following actions by the school nurse is important in the prevention of rheumatic fever?

Refer children with sore throats for throat cultures.

A young child with leukemia has anorexia and severe stomatitis. The nurse should suggest that the parents try which of the following?

Relax any eating pressures.

Which of the following is a condition in which the normal adult hemoglobin is partly or completely replaced by abnormal hemoglobin?

Sickle cell anemia

Which of the following is descriptive of most cases of hemophilia?

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

Guidelines for intramuscular administration of medication in school-age children include which of the following?

Insert needle quickly, using a dartlike motion.

When teaching a mother how to administer eye drops, where should the nurse tell her to place them?

In the conjunctival sac that is formed when the lower lid is pulled down

Which of the following drugs is usually given first in the emergency treatment of an acute, severe asthma episode in a young child?

Short-acting â2 agonists

It is now recommended that children with asthma who are taking long-term inhaled steroids should be assessed frequently because which of the following may develop?

Slowed growth

An appropriate method for administering oral medications that are bitter to an infant or small child would be to mix them with which of the following?

Small amount (1 teaspoon) of a sweet-tasting substance such as jam or ice cream

A nurse is instructing a nursing assistant on techniques to facilitate lipreading with a hearing-impaired child who lip-reads. Which techniques should the nurse include? (Select all that apply.)

Speak at eye level. Use facial expressions while speaking. Keep sentences short.

A child is diagnosed with influenza, probably type A disease. Management includes which of the following?

Amantadine hydrochloride to reduce symptoms

The school nurse is caring. What emergency treatment is appropriate for a child with a penetrating eye injury?

Applying a Fox shield to the affected eye and any type of patch to the other eye.

Frequent urine testing for specific gravity and glucose are required on a 6-month-old infant. Which of the following is the most appropriate way to collect small amounts of urine for these tests?

Aspirate urine from cotton balls inside diaper with a syringe.

The nurse gives an injection in a patient's room. The nurse should do which of the following with the needle for disposal?

Dispose of syringe and needle in a rigid, puncture-resistant container in patient's room.

A critically ill child has hyperthermia. The parents ask the nurse to give an antipyretic such as acetaminophen (Tylenol). The nurse should explain that antipyretics:

Are of no value in treating hyperthermia.

A child with CF receives aerosolized bronchodilator medication. This medication should be administered:

before chest physiotherapy (CPT).

β-Adrenergic agonists and methylxanthines are often prescribed for a child with an asthma attack. What is their action?

Dilate the bronchioles