Peds Test questions

The nurse teaches parents how to care for their child who has tympanostomy tubes inserted. Which actions by the parents indicate appropriate understanding of the teaching session? Select all that apply. 1. Encouraging the child to drink generous amounts of fluids 2. Administering a decongestant for one to two weeks following surgery 3. Restricting the child to quiet activities after surgery 4. Limiting diet to soft, bland foods 5. Avoiding getting water in ears during bath time

1. Encouraging the child to drink generous amounts of fluids 3. Restricting the child to quiet activities after surgery 5. Avoiding getting water in ears during bath time

A child is admitted with a diagnosis of early localized Lyme disease. Which clinical manifestations would the nurse expect to find on the initial assessment of this client? Select all that apply. 1. Erythema 515 cm in diameter 2. Hyperactivity 3. Cranial nerve palsies 4. Fever 5. Headache

1. Erythema 515 cm in diameter 4. Fever 5. Headache

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.

A parent asks the nurse, "Why should I have my child immunized for human papillomavirus (HPV) when my child is only 11 years old? Isn't it a sexually transmitted infection?" Which of the following responses by the nurse is appropriate? 1. "I agree with you. I will ask your child's pediatrician if the HPV vaccine could be delayed until she becomes sexually active." 2. "It is recommended that children begin the vaccine series when they are preteen so that they have time to develop full immunity." 3. "Although HPV is de ned as a sexually transmitted disease, it can also be transmitted if a person with upper respiratory warts coughs or sneezes." 4. "I understand. It is important to realize though that the majority of people in this country are infected with the virus by the time they are in high school."

2. "It is recommended that children begin the vaccine series when they are preteen so that they have time to develop full immunity."

The nurse advises a pregnant woman, 30 weeks' gestation, that she should receive a vaccine to protect the baby from a serious infectious disease. Which of the following explanations should the nurse provide the woman? 1. "Receiving the Hemophilus influenzae type B (Hib) vaccine will help to protect the baby from developing meningitis." 2. "You should receive the tetanus, diphtheria, and pertussis (Tdap) vaccine because babies are very susceptible to Bordetella pertussis bacteria that cause whooping cough." 3. "You will receive the rotavirus (RV) vaccine because diarrheal illnesses are so life threatening to babies." 4. "If you receive the meningococcal conjugate vaccine (MCV) today you will be preventing your baby from developing bacterial sepsis after delivery."

2. "You should receive the tetanus, diphtheria, and pertussis (Tdap) vaccine because babies are very susceptible to Bordetella pertussis bacteria that cause whooping cough."

A nurse is assessing infants for visually related developmental milestones. Which infant is showing a delay in meeting an expected milestone? 1. 4-month-old who has a social smile 2. 8-month-old who has just begun to inspect her own hand 3. 12-month-old who stacks blocks 4. 7-month-old who picks up a raisin by raking

2. 8-month-old who has just begun to inspect her own hand

**An infant is diagnosed with acute otitis media. Which intervention is most appropriate for the nurse to teach the infants parents? 1. Keep the baby in a flat lying position during sleep. 2. Administer acetaminophen (Tylenol) to relieve discomfort. 3. Administer a decongestant. 4. Place baby to sleep with a pacifier.

2. Administer acetaminophen (Tylenol) to relieve discomfort.

The nurse reviewing the record of a woman who is planning to become pregnant notes that the woman is not immune to rubella. In addition to recommending that the client have the MMR (measles, mumps, rubella) vaccine, which of the following actions should the nurse take? 1. Educate the client that she will be fully immune to rubella one year after receiving the injection. 2. Advise the client that she should use birth control for 4 weeks after receiving the vaccine. 3. Inform the client that a baby born after she receives the vaccine will be immune to rubella. 4. Remind the client that she will need to receive 2 more injections of the vaccine during the next few months.

2. Advise the client that she should use birth control for 4 weeks after receiving the vaccine.

A child is admitted to the hospital with pneumonia. The childs oximetry reading is 88 percent upon admission to the pediatric floor. Which is the priority nursing intervention for this child? 1. Obtain a blood sample to send to the lab for electrolyte analysis. 2. Begin oxygen per nasal cannula. 3. Medicate for pain. 4. Begin administration of intravenous fluids.

2. Begin oxygen per nasal cannula.

**The nurse is providing care to an infant in the emergency department. Upon assessment, the infant is noted to have to be experiencing tachypnea, wheezing, retractions, and nasal flaring. The infant is irritability and the parents state the infant has had poor fluid intake for two days. Pulse ox reading is currently at 85% on room air. The infants blood gas is pending. Which diagnosis does the nurse anticipate for this infant? 1. Bronchitis 2. Bronchiolitis 3. Pneumonia 4. Active pulmonary tuberculosis

2. Bronchiolitis

The nurse is teaching a prenatal class about infant care. Under which circumstances should the nurse emphasize that parents should call their healthcare provider immediately? Select all that apply. 1. Child 4 months old, received a DTaP immunization yesterday, and has a temperature of 38.0 degrees C (100.4 degrees F) 2. Child under 3 months old and has a temperature over 40.1 degrees C (104.2 degrees F) 3. Child difficult to awaken and has a pulsing fontanel 4. Child has purple spots on the skin and is lethargic. 5. Child has a stiff neck and has been irritable for three days.

2. Child under 3 months old and has a temperature over 40.1 degrees C (104.2 degrees F) 3. Child difficult to awaken and has a pulsing fontanel 4. Child has purple spots on the skin and is lethargic. 5. Child has a stiff neck and has been irritable for three days.

The mother of a hospitalized 2-year-old child with viral laryngotracheobronchitis (croup) asks the nurse why 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."

During an admission assessment, the nurse notes that the child has impaired oral mucous membranes. Which intervention is most appropriate for the nurse to implement for this child? 1. Administering topical analgesics 2. Promoting an adequate intake of nutrients 3. Administering antibiotics as ordered 4. Using lemon and glycerin for oral hygiene

2. Promoting an adequate intake of nutrients

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

2. Prothrombin time

An unimmunized child with a serious puncture wound has been diagnosed with tetanus. Which of the following actions is critical for the unit charge nurse to perform? 1. Check that the child is maintained on contact isolation. 2. Reinforce the need to pad the side rails and headboard of the child's hospital bed. 3. Assign only fully immunized nurses to care for the child. 4. Order a hypothermia mattress and prescribed antiviral medications for the child.

2. Reinforce the need to pad the side rails and headboard of the child's hospital bed.

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

2. Side-lying

A nurse working in a pediatric clinic is responsible for monitoring and maintaining the vaccinations on site. Which actions are appropriate for this nurse to implement? Select all that apply. 1. Fluctuate refrigerator and freezer temperatures each day. 2. Store vaccines in the center of the unit. 3. Check and record the temperature of the unit twice each day. 4. Have a plan for power outages. 5. Place bottles of water in each unit to help keep temperatures consistent.

2. Store vaccines in the center of the unit. 3. Check and record the temperature of the unit twice each day. 4. Have a plan for power outages. 5. Place bottles of water in each unit to help keep temperatures consistent.

After a tonsillectomy, the nurse reviews the health care provider's (HCP's) postoperative prescriptions. Which prescription should the 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.

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 int eh tent to make the child feel more comfortable. 3. Call the health care provider 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.

A child has had tympanostomy tubes inserted. Before discharging the child from the hospital, which of the following should be included in the nurse's discharge teaching? 1. Elevate the head of the child's bed 30 degrees for the next week. 2. Bright-red bleeding may drain from the ears for remainder of the day. 3. Administer narcotic analgesic every 4 hours for the next two days. 4. Not to allow the child's head to be submerged in bath or pool water.

4. Not to allow the child's head to be submerged in bath or pool water.

A child with asthma will be receiving an oral dose of prednisone. The order reads prednisone 2 mg/kg per day. The child weighs 50 lbs. The child will receive ____ milligrams daily. Round the answer to the nearest whole number.

46 mg/day

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 antibiotics 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."

A school-age child, whose parents are accompanying him, has been admitted to the pediatric unit on droplet isolation. Which of the following should the nurse include in the admission information for the child? 1. "It is important that you wear a face mask whenever you leave your room." 2. "I know that it will be hard for you, but your parents can only stay in your room for fifteen minutes out of every hour." 3. "You will hear a funny whooshing sound whenever the door to your room opens because the air is kept from going into the hallway." 4. "Everyone who comes into your room will be wearing a cap, gown, and mask."

1. "It is important that you wear a face mask whenever you leave your room."

A 1-year-old child is being seen in the pediatrician's office. The child is up to date on all immunizations. The mother asks, "Will my child need to receive any shots today?" Which of the following responses by the nurse is appropriate? 1. "The measles, mumps, and rubella (MMR); varicella (VAR); and hepatitis A (HepA) vaccines are all given once children reach one year of age." 2. "The last hepatitis B (HepB) vaccine is due to be administered." 3. "Children's first influenza vaccination (IIV) is administered at one year of age, and it will be given again every year at this same time." 4. "The rotavirus (RV) vaccine will be given today to prevent severe diarrhea."

1. "The measles, mumps, and rubella (MMR); varicella (VAR); and hepatitis A (HepA) vaccines are all given once children reach one year of age."

**The nurse prepares a DTaP (diphtheria, tetanus toxoid, and acellular pertussis) immunization for a 6-month-old infant. To administer this injection safely, the nurse chooses which needle, size and length, injection type, and injection site? 1. 25-gauge, 5/8-inch needle; IM (intramuscular); anterolateral thigh. 2. 22-gauge, 1/2-inch needle; IM (intramuscular); ventrogluteal. 3. 25-gauge, 5/8-inch needle; ID (intradermal); deltoid. 4. 25-gauge, 3/4-inch needle; SQ (subcutaneous); anterolateral thigh.

1. 25-gauge, 5/8-inch needle; IM (intramuscular); anterolateral thigh.

The nurse suspects that an infant has a visual disorder caused by abnormal musculature. Which test will the nurse perform to detect this disorder? 1. A cover/uncover test 2. An ophthalmologic exam 3. A vision-acuity exam 4. A pupil-reaction-to-light test

1. A cover/uncover test

Which nursing diagnosis is most appropriate for an infant with acute bronchiolitis due to respiratory syncytial virus (RSV)? 1. Activity Intolerance 2. Decreased Cardiac Output 3. Pain, Acute 4. Tissue Perfusion, Ineffective (peripheral)

1. Activity Intolerance

**A child is admitted to the hospital with the diagnosis of laryngotracheobronchitis (LTB). Which nursing intervention is the priority for this child? 1. Administer nebulized epinephrine and oral or IM dexamethasone. 2. Administer antibiotics and assist with possible intubation. 3. Swab the throat for a throat culture. 4. Obtain a sputum specimen.

1. Administer nebulized epinephrine and oral or IM dexamethasone.

While suctioning a child with a tracheostomy tube in place, a nurse discovers that the suction catheter will not advance inside the tracheostomy tube and the child is becoming pale and anxious, with noticeable suprasternal retractions. What should be the nurse's priority action? 1. Change the tracheostomy tube at once. 2. Instill normal saline into the tracheostomy tube and attempt suctioning again. 3. Obtain a pulse oximetry reading. 4. Auscultate lung sounds.

1. Change the tracheostomy tube at once.

**A child is diagnosed with group A beta-hemolytic streptococcus (GABHS) infection of the throat. Which item will the nurse include in the teaching plan for the parents? 1. Complete the entire course of antibiotics. 2. Keep the child NPO (nothing by mouth). 3. Continue normal activities. 4. Do not allow the child to gargle with saltwater.

1. Complete the entire course of antibiotics.

A nurse is caring for a visually impaired 20-month-old who has not begun to walk. Which nursing diagnosis is the most appropriate for this client? 1. Delayed growth and development 2. Impaired physical mobility 3. Self-care deficit 4. Impaired home maintenance

1. Delayed growth and development

A child, who has been diagnosed with rubeola, is being cared for at home. Which of the following actions should the nurse educate the parents to perform? 1. Keep the lights in the child's room dimmed. 2. Give the child oatmeal baths every 3 to 4 hours. 3. Administer calcium supplements every 12 hours. 4. Maintain the child on contact isolation for one week.

1. Keep the lights in the child's room dimmed.

**A school nurse is planning care for a school-age child recently diagnosed with asthma. Which items will the school nurse include in the plan of care at the school? Select all that apply. 1. Maintain a log of quick-relief medication administration. 2. Call the parents if quick-relief medications work appropriately. 3. Assess for symptoms of exercise-induced bronchospasm. 4. Coordinate education of the childs teachers. 5. Conduct a support group for all children with asthma.

1. Maintain a log of quick-relief medication administration. 3. Assess for symptoms of exercise-induced bronchospasm. 4. Coordinate education of the childs teachers. 5. Conduct a support group for all children with asthma.

The nurse is assessing a school-age client who experienced blunt force trauma to the chest when an airbag deployed following a motor vehicle crash. Which areas of assessment are essential for this client? Standard Text: Select all that apply. 1. Monitor responsiveness and behavior. 2. Monitor SpO2. 3. Auscultate the lungs for crackles, wheezes, decreased breath sounds. 4. Document input and output. 5. Note changes in voice quality or coughing.

1. Monitor responsiveness and behavior. 2. Monitor SpO2. 3. Auscultate the lungs for crackles, wheezes, decreased breath sounds. 5. Note changes in voice quality or coughing.

**Following parental teaching, the nurse is evaluating the parents understanding of environmental control for their child's asthma management. Which statement by the parents indicates appropriate understanding of the teaching? 1. We will replace the carpet in our child's bedroom with tile. 2. Were glad the dog can continue to sleep in our childs room. 3. Well be sure to use the fireplace often to keep the house warm in the winter. 4. Well keep the plants in our child's room dusted.

1. We will replace the carpet in our child's bedroom with tile.

The parents of a boy who is diagnosed with mumps ask the nurse whether there is any special care that they should provide their child. Which of the following responses would be appropriate for the nurse to provide? Select all that apply. 1. Offer soft foods for the child to eat. 2. Encourage the child to drink citrus fruit juices each day. 3. Monitor the child carefully for signs of testicular discomfort. 4. Place an ice collar or warm compresses around the child's neck. 5. Administer ordered antihistamines for the full course of the disease.

1. Offer soft foods for the child to eat. 3. Monitor the child carefully for signs of testicular discomfort. 4. Place an ice collar or warm compresses around the child's neck.

The nurse is preparing for the admission of an infant with a diagnosis of bronchiolitis caused by respiratory syncytial virus (RSV). Which interventions should the nurse include in the plan of care? Select all that apply. 1. Place the infant in a private room. 2. Ensure that the infant's head is in a flexed position. 3. Wear a mask at all times when in contact with the infant. 4. Place the infant in a tent that delivers warm humidified air. 5. Position the infant on the side, with the head lower than the chest. 6. Ensure that nurses caring for the infant with RSV do not care for other high-risk children.

1. Place the infant in a private room. 6. Ensure that nurses caring for the infant with RSV do not care for other high-risk children.

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

1. Positive

A child has been diagnosed with acute otitis media of the right ear. Which interventions should the nurse include in the plan of care? Select all that apply. 1. Provide a soft diet. 2. Position the child on the left side. 3. Administer an antihistamine twice daily. 4. Irrigate the right ear with normal saline every 8 hours. 5. Administer ibuprofen for fever every 4 hours as prescribed and as needed. 6. Instruct the parents about the need to administer the prescribed antibiotics for the full course of therapy.

1. Provide a soft diet. 5. Administer ibuprofen for fever every 4 hours as prescribed and as needed. 6. Instruct the parents about the need to administer the prescribed antibiotics for the full course of therapy.

The nurse educator is teaching a group of nursing students how to perform a respiratory assessment for a newborn in the newborn intensive care unit (NICU) diagnosed with respiratory distress syndrome (RDS). Which normal characteristics of the newborns respiratory system increase the risk for obstruction? Select all that apply. 1. Shorter and narrower airway 2. Higher trachea 3. Bronchial branching at different angles 4. Inadequate smooth muscle bundles 5. Diaphragmatic breather

1. Shorter and narrower airway 2. Higher trachea 3. Bronchial branching at different angles

The nurse is providing care to an infant who is diagnosed with bronchiolitis. Which breath sounds indicate the infant is experiencing respiratory distress? Select all that apply. 1. Tachypnea 2. Wheezing 3. Grunting 4. Retractions 5. Eupnea

1. Tachypnea 2. Wheezing 3. Grunting

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.

**A child is showing signs of acute respiratory distress. Which position will the nurse place this child? 1. Upright 2. Side-lying 3. Flat 4. In semi-Fowlers

1. Upright

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 beats/minute 4. Respirations of 18 breaths/minute

2. Decreased wheezing

A mother brings her 4-month-old infant in for a routine checkup and vaccinations. The mother reports that the infant was exposed to a brother who has the flu. Which action by the nurse is most appropriate based on these assessment findings? 1. Withhold the vaccinations. 2. Give the vaccinations as scheduled. 3. Withhold the DTaP vaccination but give the others as scheduled. 4. Give the infant the flu vaccination but withhold the others.

2. Give the vaccinations as scheduled.

**The nurse is teaching a group of mothers of infants about the benefits of immunization. Which immunization will the nurse teach to the mothers that can assist in preventing the life-threatening disease epiglottitis? 1. Measles, mumps, and rubella (MMR) 2. Haemophilus influenzae type B (HIB) 3. Hepatitis B 4. Polio

2. Haemophilus influenzae type B (HIB)

A 5-year-old child who has received no vaccinations is admitted to the pediatric unit with a diagnosis of diphtheria. Which of the following signs/symptoms would the nurse expect to see? 1. Macular papular rash 2. Markedly edematous neck 3. Strawberry-red tongue 4. Conjunctival hemorrhages

2. Markedly edematous neck

The nurse is caring for an infant with bronchiolitis, 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.

The mother of an 11-month-old remarks to a nurse at the pediatric clinic, "We are so lucky. Our daughter has never had an ear infection!" Which of the following factors can the nurse tell the mother have protected her daughter from the disease? Select all that apply. 1. The family owns no pets. 2. No one in the family smokes. 3. The mother breastfeeds her daughter. 4. Child attends day care only two mornings a week. 5. The family lives in the southern part of the country.

2. No one in the family smokes. 3. The mother breastfeeds her daughter. 4. Child attends day care only two mornings a week.

A nurse is caring for a child who is receiving a bronchodilator medication by nebulized aerosol therapy. Which of the following are appropriate actions for the nurse to take? (Select all that apply) 1. Instruct the child that the treatment will last 30 mins 2. Obtain vital signs prior to administration 3. Tell the child to take deep, slow breaths 4. Determine if the child should use a mask 5. Attach the device to an air source

2. Obtain vital signs prior to administration 3. Tell the child to take deep, slow breaths 4. Determine if the child should use a mask 5. Attach the device to an air source

A nurse is caring for a visually impaired school-age child. Which nursing intervention is the highest priority for this child during the admission process? 1. Explaining playroom policies 2. Orienting the child to where furniture is placed in the room 3. Letting the child touch equipment that will be used during the hospitalization 4. Taking the child on a tour of the unit

2. Orienting the child to where furniture is placed in the room

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 sends 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 an allergy 4. Presence of a respiratory infection

2. Possible sexual abuse

The clinic nurse is assessing a child who is scheduled to receive a live virus vaccine (immunization). What are the general contraindications associated with receiving a live virus vaccine? Select all that apply. 1. The child has symptoms of a cold. 2. The child has a previous anaphylactic creation to the vaccine. 3. The mother reports that the child is having intermittent episodes of diarrhea. 4. The mother reports that the child has not had an appetite and has been fussy. 5. The child has a disorder that caused a severely deficient immune system. 6. The mother reports that the child has recently been exposed to an infectious disease.

2. The child has a previous anaphylactic creation to the vaccine. 5. The child has a disorder that caused a severely deficient immune system.

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 or herself with the hands and arms.

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

A 7-year-old child has been prescribed penicillin V for streptococcal pharyngitis. Which of the following information should the nurse teach the parents regarding the medication? 1. Once the child starts the medication, he will no longer be contagious. 2. The child must take all of the medication. 3. The child's fever may persist until all of the medicine has been taken. 4. If given with food, the medicine will be ineffective.

2. The child must take all of the medication.

A parent brings her school-age child to the clinic because the child has a temperature of 100.2F. The child remains active without other symptoms. Which statement by the nurse to the parents is most appropriate? 1. Take the child's temperature every 2 hours and call the clinic if it reaches 102F or above. 2. Unless the fever bothers the child, it is best to let the natural body defenses respond to the infection. 3. Keep the child warm, because shivering often occurs with fever. 4. Alternate acetaminophen and ibuprofen to help keep the fever down and keep the child comfortable.

2. Unless the fever bothers the child, it is best to let the natural body defenses respond to the infection.

**The nurse completes postoperative discharge teaching to the parents of a child who had a tonsillectomy. Which statement by the parents indicates correct understanding of the teaching session? 1. We will call the physician for any indication of ear pain. 2. We will plan on administering acetaminophen (Tylenol) for pain. 3. We will be sure to give our child adequate amounts of citrus juices. 4. We will keep our child on bed rest for 10 days after the surgery.

2. We will plan on administering acetaminophen (Tylenol) for pain.

**The nurse is teaching the parents of a newly diagnosed cystic fibrosis patient how to administer the pancreatic enzymes. How often will the nurse teach the parents to administer the enzymes? 1. Two times per day 2. With meals and snacks 3. Every 6 hours around the clock 4. Four times per day

2. With meals and snacks

The nurse prepares a teaching plan for the mother of a child diagnosed with bacterial conjunctivitis. Which, if stated but he 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 parent of an infant who is to receive an injection of the polio vaccine asks, "Why can't my child have the oral vaccine like I did as a child? I really don't want the baby to receive any more injections than are necessary." Which of the following responses would be appropriate for the nurse to give? 1. "The oral vaccine has been found to be less effective than the injectable vaccine." 2. "The baby will be protected from getting polio in a shorter period of time with the injectable vaccine." 3. "The oral form of the vaccine is no longer being administered to children in our country." 4. "It was discovered that many babies were being poorly immunized because they often spit out the bad tasting oral vaccine."

3. "The oral form of the vaccine is no longer being administered to children in our country."

The nurse is caring for four clients. Which client has the highest risk of developing retinopathy of prematurity? 1. 30-week-gestation infant who was in an Oxy-Hood for 12 hours and weighed 1800 grams. 2. 32-week-gestation infant who needed no oxygen and weighed 1850 grams. 3. 28-week-gestation infant who has been on long-term oxygen and weighed 1400 grams. 4. 28-week-gestation infant who was on short-term oxygen and weighed 1420 grams.

3. 28-week-gestation infant who has been on long-term oxygen and weighed 1400 grams.

A child is prescribed rifampicin for treatment of tuberculosis. For which length of time will the nurse tell the parents that this child must remain on the medication? 1. 2 months 2. 4 months 3. 6 months 4. 8 months

3. 6 months

A toddler client with a fever is prescribed amoxicillin clavulanate 250 mg/5 cc three times daily by mouth 10 days for otitis media. Which teaching point will guard against antibiotic resistance to the disease process? 1. Administer a loading dose for the first dose. 2. Measure the prescribed dose in a household teaspoon. 3. Give the antibiotic for the full 10 days. 4. Stop the antibiotic if the child is afebrile.

3. Give the antibiotic for the full 10 days.

The hospital has just provided its nurses with information about biologic threats and terrorism. After completing the course, a group of nurses is discussing its responsibility in relation to bioterrorism. Which statement by the nurse indicates a correct understanding of the concepts presented? 1. It is important to separate clients according to age and illness to prevent the spread of disease. 2. It is important to dispose blood-contaminated needles in the lead-lined container. 3. I will notify the Centers for Disease Control (CDC) if a large number of persons with the same life-threatening infection present to the emergency room. 4. I will initiate isolation precautions for a hospitalized client with methicillin-resistant staphylococcus aureus (MRSA).

3. I will notify the Centers for Disease Control (CDC) if a large number of persons with the same life-threatening infection present to the emergency room.

**A newborn is suspected of having cystic fibrosis. As the child is being prepared for transfer to a pediatric hospital, the mother asks the nurse which symptoms made the practitioner suspect cystic fibrosis. Which response by the nurse is the most appropriate? 1. Steatorrheic stools 2. Constipation 3. Meconium ileus 4. Rectal prolapse

3. Meconium ileus

**A nurse is planning to teach school-age children about the common cold. Which information should the nurse include in the teaching session? 1. Vaccinations can prevent contraction of a nasopharyngitis virus. 2. Antibiotics will eliminate the nasopharyngitis virus. 3. Proper handwashing can prevent the spread of the infection. 4. Aspirin should be taken for alleviation of fever if the common cold is contracted.

3. Proper handwashing can prevent the spread of the infection.

The nurse is discussing ways to treat fever in the home environment to a group of parents in the community. Which statement is appropriate for the nurse to include in the presentation? 1. Ibuprofen is the only effective means to reduce fever. 2. If the child requires more than one dose of acetaminophen antibiotics are needed. 3. Purchase a new bottle of acetaminophen for your newborn because it will have recommended medication concentration. 4. It is not necessary to follow the recommendations on the bottle of ibuprofen as this will not prevent an overdose for your child.

3. Purchase a new bottle of acetaminophen for your newborn because it will have recommended medication concentration.

The school nurse is trying to prevent the spread of a flu virus through the school. Which infection-control strategies can be employed to prevent the spread of the flu virus? Select all that apply. 1. Teaching parents safe food preparation and storage 2. Withholding immunizations for children with compromised immune systems 3. Sanitizing toys, telephones, and door knobs to kill pathogens 4. Separating children with infections from children who are well 5. Teaching children to wash their hands after using the bathroom

3. Sanitizing toys, telephones, and door knobs to kill pathogens 4. Separating children with infections from children who are well 5. Teaching children to wash their hands after using the bathroom

A nurse is providing information to a group of new mothers. Which statement best explains why newborns and young infants are more susceptible to infection? 1. They have high levels of maternal antibodies to diseases to which the mother has been exposed. 2. They have passive transplacental immunity from maternal immunoglobulin G. 3. They have immune systems that are not fully mature at birth. 4. They have been exposed to microorganisms during the birth process.

3. They have immune systems that are not fully mature at birth.

Parents of a child admitted with respiratory distress are concerned because the child wont lie down and wants to sit in a chair leaning forward. Which response by the nurse is the most appropriate? 1. This helps the child feel in control of his situation. 2. The child needs to be encouraged to lie flat in bed. 3. This position helps keep the airway open. 4. This confirms the child has asthma.

3. This position helps keep the airway open.

An infant receives a diphtheria, tetanus, and acellular pertussis (DTaP) immunization at a well-baby clinic. The parent returns home and calls the clinic to report that the infant has develop swelling and redness at the site of the injection. Which intervention should the nurse suggest to the parent? 1. Monitor the infant for 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.

The mother of a child who has been prescribed antibiotics for a diagnosis of scarlet fever telephones the pediatrician's office and states, "My child's temperature is normal, and the rash is disappearing, but my child has enough antibiotics for another 5 days. Do I really have to give my child all of the antibiotics?" Which of the following responses by the nurse is appropriate? 1. "I will ask the doctor if you can stop because we are trying to keep from giving children too many antibiotics." 2. "Scarlet fever is actually caused by a virus, so you can stop administering your child's antibiotics right away." 3. "As long as your child's temperature remains normal for a full day, you can stop administering the antibiotics." 4. "It is important that you finish giving your child the antibiotics in order to prevent your child from developing a serious complication."

4. "It is important that you finish giving your child the antibiotics in order to prevent your child from developing a serious complication."

The mother of a 3-year-old child who has been diagnosed with an ear infection states, "I can't understand why you won't give my child antibiotics. Can't you see that she is sick?" Which of the following responses by the nurse is appropriate at this time? 1. "I know how you feel, but the best medicine for your daughter right now is acetaminophen." 2. "Your child will get better on her own in a few days." 3. "I am also very surprised that the pediatrician didn't order antibiotics." 4. "It is likely that the ear infection is caused by a virus, and antibiotics do not kill viruses."

4. "It is likely that the ear infection is caused by a virus, and antibiotics do not kill viruses."

The clinic nurse is providing instructions to a parent of a child with CF regarding the immunization schedule for the child. Which statement should the nurse make to the parent? 1. "The immunization schedule will not be altered." 2. "The child should not receive any hepatitis vaccines." 3. "The child will receive all of the immunizations except for the polio 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."

A child is receiving a series of the 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

**The child who had a tonsillectomy earlier today is now awake and tolerating fluids. The child asks for something to eat. Which food choice is most appropriate for this client? 1. Orange slices 2. Lemonade 3. Grapefruit juice 4. Applesauce

4. Applesauce

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

An 8-year-old, African immigrant is admitted to the pediatric unit with elevated viral titers for the poliovirus. For which of the following signs/ symptoms should the nurse carefully monitor the child? 1. Tinnitus 2. Petechial rash 3. Flank pain 4. Bradypnea

4. Bradypnea

A nurse is educating a group of parents regarding ways to prevent disease in their home. Which of the following information should the nurse include regarding preventing the transmission of hepatitis A? 1. Cover mouths and noses when coughing or sneezing. 2. Protect family members from blood of affected individuals. 3. Wash all clothing and bedding and dry in a hot dryer. 4. Carefully wash all fresh fruits and vegetables before eating.

4. Carefully wash all fresh fruits and vegetables before eating.

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

4. DTaP, Hib, IPV, pneumococcal vaccine (PCV), rotavirus vaccine (RV)

Reducing the number of preventable childhood illnesses is a major national goal in Healthy People 2020. What will the school nurse teach families regarding immunizations in order to reach this goal? 1. A minor illness with a low-grade fever is a contraindication to receiving an immunization according to Healthy People 2020. 2. Vaccines should be given one at a time for optimum active immunity in the prevention of illness and disease. 3. Premature infants and low-birth-weight infants should receive half doses of vaccines for protection from communicable diseases. 4. It is important to maintain vaccination coverage for recommended vaccines in early childhood and to maintain them through kindergarten.

4. It is important to maintain vaccination coverage for recommended vaccines in early childhood and to maintain them through kindergarten.

The practitioner changes the medications for the child with asthma to salmeterol (Serevent). The mother asks the nurse what this drug will do. The nurse explains that salmeterol (Serevent) is used to treat asthma because the drug produces which characteristic? 1. Decreases inflammation 2. Decreases mucous production 3. Controls allergic rhinitis 4. Dilates the bronchioles

4. Dilates the bronchioles.

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 the ibuprofen. 2. Increase the frequency of the 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.

**A mother refuses to have her child be immunized with measles, mumps, and rubella (MMR) vaccine because she believes that letting her infant get these diseases will help him fight off other diseases later in life. Which response by the nurse is most appropriate? 1. Honor her request because she is the parent. 2. Explain that antibodies can fight many diseases. 3. Tell her that not immunizing her infant may protect pregnant women. 4. Explain that if her child contracts measles, mumps, or rubella, there could be very serious and permanent complications from these diseases.

4. Explain that if her child contracts measles, mumps, or rubella, there could be very serious and permanent complications from these diseases.

A parent reports that her school-age child, who has had all recommended immunizations, had a mild fever one week ago and now has bright red cheeks and a lacy red maculopapular rash on the trunk and arms. Which disease process does the nurse suspect based on the parents description? 1. Chicken pox (varicella) 2. German measles (rubella) 3. Roseola (exanthem subitum) 4. Fifth disease (erythema infectiosum)

4. Fifth disease (erythema infectiosum)

**A nurse is assessing a neonate. Which assessment finding indicates that the neonate's respiratory status is worsening? 1. Acrocyanosis 2. Arterial CO2 of 40 3. Periorbital edema 4. Grunting respirations with nasal flaring

4. Grunting respirations with nasal flaring

**The nurse prepares the second diphtheria, tetanus toxoid, and acellular pertussis (DTaP) and second inactivated polio vaccine (IPV) immunization injections for an infant who is 4 months old. The nurse may also give which of immunizations during the same well-child-care appointment? 1. Var (varicella) 2. TIV (influenza) 3. MMR (measles, mumps, rubella) 4. Haemophilus influenza type B (HIB)

4. Haemophilus influenza type B (HIB)

A school-age child has epistaxis. Which intervention by the school nurse is the most appropriate? 1. Tilting the child's head forward, squeezing the nares below the nasal bone, and applying ice to the nose 2. Tilting the child's head back, squeezing the bridge of the nose, and applying a warm, moist pack to the nose 3. Lying the child down and applying no pressure, ice, or warm pack 4. Immediately packing the nares with a cotton ball soaked with Neo-Synephrine

4. Immediately packing the nares with a cotton ball soaked with Neo-Synephrine

The hospital admitting nurse is taking a history of a child's illness from the parents. The nurse concludes that the parents treated their 6-year-old child appropriately for a fever related to otitis media. Which action by the parents brought the nurse to this conclusion? 1. Used aspirin every four hours to reduce the fever 2. Alternated acetaminophen with ibuprofen every two hours 3. Put the child in a tub of cold water to reduce the fever 4. Offered generous amounts of fluids frequently

4. Offered generous amounts of fluids frequently

A 10-year-old child, who has been positively diagnosed with influenza, is to be cared for at home by the child's parents. Which of the following client-care information should the nurse include in the teaching? 1. The child should be isolated from all susceptible contacts for 2 full weeks. 2. The entire 10-day course of antibiotics must be administered to the child. 3. If the child complains of a sore throat, the child should be seen in an emergency department. 4. Only acetaminophen should be administered to the child for pain or for febrile episodes.

4. Only acetaminophen should be administered to the child for pain or for febrile episodes.

A neonate has been diagnosed with a herpes simplex viral infection of the eye. Which medication will the nurse prepare to administer? 1. Fluoroquinolone eye drops or ointment 2. Intravenous penicillin 3. Oral erythromycin 4. Parenteral acyclovir (Zovirax) and vidarabine (VIRA-A) ophthalmic ointment

4. Parenteral acyclovir (Zovirax) and vidarabine (VIRA-A) ophthalmic ointment

**A nurse delegates the task of neonatal vital-sign assessment to a nurse technician. Which instruction will the nurse give to the technician prior to assign care? 1. Report any neonate using abdominal muscles to breathe. 2. Report any neonate with apnea for 10 seconds. 3. Count respirations for 15 seconds and multiply by 4 to get the rate for 1 minute. 4. Report any neonate with a breathing pause that lasts 20 seconds or longer.

4. Report any neonate with a breathing pause that lasts 20 seconds or longer.

Which action by the nurse can assist a child who has a mild hearing loss and reads lips to adapt to hospitalization? 1. Speaking directly to the parents for communication 2. Speaking in a loud voice while facing the child 3. Using a picture board as the main means of communication 4. Touching the child lightly before speaking

4. Touching the child lightly before speaking