Practice Questions
A nurse is caring for a child who is experiencing neuropathy due to chemotherapy. Which of the following are manifestations of neuropathy? (Select all that apply.) A. Constipation B. Skin breakdown C. Foot drop D. Jaw pain E. Hemorrhage cystitis
A, C, D
A nurse is assessing an infant who has heart failure. Which of the following findings should the nurse expect? (Select all that apply.) A. Bradycardia B. Cool extremities C. Peripheral edema D. Increased urinary output E. Nasal flaring
B, C, E
A 14-year-old with thalassemia asks for your assistance in choosing her afternoon snack. Which choice is the most appropriate? a. Peanut butter with rice cake b. Small spinach salad c. Apple slices with cheddar cheese d. Small burger on wheat bun
C
A child with cancer is receiving chemotherapy, and his mother is concerned that the nausea and vomiting associated with chemotherapy are reducing his ability to eat and gain weight appropriately. What is the most appropriate nursing action? a. Administer an antiemetic at the first hint of nausea. b. Offer the child's favorite foods to encourage him to eat. c. Start antiemetic drugs prior to the chemotherapy infusion. d. Maintain IV fluid infusion to avoid dehydration.
C
A child with hemophilia fell while riding his bicycle. He was wearing a helmet and did not lose consciousness. He has a mild abrasion on his knee that is not oozing. He is complaining of abdominal pain. What is the priority nursing assessment? a. Perform neurologic checks. b. Assess ability to void frequently. c. Carefully assess his abdomen. d. Examine his knee frequently.
C
A nurse is planning care for an infant who is scheduled to have a lumbar puncture. Which of the following actions should the nurse include in the plan of care? A. Cleanse the thoracic area of the infant's back with an antiseptic solution. B. Apply a eutectic mixture of local anesthetic cream just before the procedure begins. C. Restrain the infant during the procedure to prevent movement. D. Position the infant with his head extended and chin raised.
C
The nurse is caring for a child after a cardiac catheterization. What is the nursing priority? a. Allow early ambulation to encourage activity participation. b. Check pulses above the catheter insertion site for strength and quality. c. Assess extremity distal to the insertion site for temperature and color. d. Change the dressing to evaluate the site for infection.
C
A nurse is caring for a child who has oral mucositis. Which of the following actions should the nurse take? (Select all that apply.) A. Swab the mucosa with lemon glycerin swabs. B. Apply viscous lidocaine. C. Offer soft foods. D. Use a soft, disposable toothbrush for oral care. E. Encourage gargling with a warm saline mouthwash.
C, D, E
A nurse is providing teaching about the management of epistaxis to an adolescent. Which of the following positions should the nurse instruct the adolescent to take when experiencing a nosebleed? A. Sit up and lean forward. B. Sit up and tilt the head up. C. Lie in a supine position. D. Lie in a prone position.
A
Sam, age 11, has a diagnosis of rheumatic fever and has missed school for a week. What is the most likely cause of this problem? a. previous streptococcal throat infection b. history of open-heart surgery at 5 years of age c. playing too much soccer and not getting enough rest d. exposure to a sibling with pneumonia
A
The nurse is caring for a 5-year-old child with a congenital heart anomaly causing chronic cyanosis. When performing the history and physical examination, what is the nurse least likely to assess? a. obesity from overeating b. clubbing of the nail beds c. squatting during play activities d. exercise intolerance
A
The nurse is caring for a child who has just been admitted to the pediatric unit with sickle cell crisis. He is complaining that his right arm and leg hurt. What is the priority nursing intervention? a. Administer pain medication every 3 hours intravenously until pain is controlled. b. Perform passive range of motion of the arm and leg to maintain function. c. Try acetaminophen for pain first, moving up to opioids only if needed. d. Use narcotic analgesics and warm compresses as needed to control the pain.
A
The parents of a child with a developmental disability ask the nurse for advice about disciplining their child. What is the best response by the nurse? a. "You should choose methods that are most congruent with your values about discipline." b. "Children like this really can't follow directions, so they may be very hard to discipline." c. "Punish your child only for socially unacceptable or offending behaviors." d. "Spanking works well for this type of child, as they really don't like pain."
A
A nurse is providing teaching about epistaxis to the parent of a school-age child. Which of the following should the nurse include as an action to take when managing an episode of epistaxis? (Select all that apply.) A. Press the nares together for at least 10 min. B. Breathe through the nose until bleeding stops. C. Pack cotton or tissue into the naris that is bleeding. D. Apply a warm cloth across the bridge of the nose. E. Insert petroleum into the naris after the bleeding stops.
A, C
A nurse is assessing a child who has rhabdomyosarcoma of the upper arm. Which of the following findings should the nurse expect? (Select all that apply.) A. Pain B. Discoloration of the skin C. Lymph node enlargement D. Easy bruising E. Palpable mass
A, C, E
A nurse is caring for a child who has thrombocytopenia. Which of the following actions should the nurse take? (Select all that apply.) A. Monitor for manifestations of bleeding. B. Administer routine immunizations. C. Obtain rectal temperatures. D. Avoid peripheral venipunctures. E. Limit visitors.
A, D
A nurse is caring for a child who is suspected of having rheumatic fever. Which of the following findings should the nurse expect? (Select all that apply.) A. Erythema marginatum (rash) B. Continuous joint pain of the digits C. Tender, subcutaneous nodules D. Decreased erythrocyte sedimentation rate E. Elevated C-reactive protein
A, E
A nurse is caring for a toddler who has a Wilms' tumor. Which of the following actions should the nurse take? A. Palpate the child's abdomen to identify the size of the tumor. B. Prepare the child for surgery. C. Teach the parents about dialysis. D. Obtain a 24-hr urine specimen from the child.
B
A nurse is caring for an infant whose screening test reveals a potential diagnosis of sickle cell disease. Which of the following tests should be performed to distinguish if the infant has the trait or the disease? A. Sickle solubility test B. Hemoglobin electrophoresis C. Complete blood count D. Transcranial Doppler
B
A nurse is preparing to administer iron dextran IM to a school-age child who has iron deficiency anemia. Which of the following actions by the nurse is appropriate? A. Administer the dose in the deltoid muscle. B. Use the Z-track method when administering the dose. C. Avoid injecting more than 2 mL with each dose. D. Massage the injection site for 1 min after administering the dose.
B
A nurse is teaching a caregiver of a preschool child about factors that affect the child's perception of death. Which of the following factors should the nurse include in the teaching? A. Preschool children have no concept of death. B. Preschool children perceive death as temporary. C. Preschool children often regress to an earlier stage of behavior. D. Preschool children experience fear related to the disease process.
B
The nurse is caring for a 3-year-old with a gastrostomy tube and tracheostomy who is on supplemental oxygen and multiple medications. The mother is rooming in during this hospitalization. What is the priority nursing action? a. Incorporate the mother's assistance in care when convenient. b. Recognize the mother as the expert on her child's needs and care. c. Recommend that the mother go home to get some rest. d. Provide family-centered care since the mother is there.
B
A 5-year-old has been diagnosed with Wilms tumor. What is the priority nursing intervention for this child? a. Educate the parents about dialysis, as the kidney will be removed. b. Measure abdominal girth every shift. c. Avoid palpating the child's abdomen. d. Monitor BUN and creatinine every 4 hours.
C
A child on the pediatric unit has morning laboratory results of Hgb 10.0, Hct 30.2, WBC 24,000, and platelets 20,000. What is the priority nursing assessment? a. Assess for pallor, fatigue, and tachycardia. b. Monitor for fever. c. Assess for bruising or bleeding. d. Determine intake and output.
C
A nurse is caring for a child following an above-the-knee amputation. Which of the following actions should the nurse take? A. Avoid discussing the amputation. B. Administer aspirin for phantom pain. C. Prepare the child for a prosthesis fitting. D. Maintain the affected limb in the dependent position.
C
A nurse is caring for a child who is postoperative following surgical removal of a Wilms' tumor. Which of the following assessments is an indication to continue NPO status? A. Abdominal girth 1 cm larger than yesterday B. Report of pain at the operative site C. Absent bowel sounds D. Passing of flatus every 30 min
C
A nurse is caring for an adolescent who has a new diagnosis of osteosarcoma. Which of the following actions should the nurse take first? A. Ensure that the adolescent has a referral for a psychiatrist visit. B. Prepare a teaching plan to educate the adolescent in detail about the diagnosis and treatment. C. Spend time with the adolescent to answer any questions. D. Perform a mental status examination to assess the adolescent's thought patterns.
C
A nurse is providing teaching to the caregiver of an infant who has a prescription for digoxin. Which of the following instructions should the nurse include? A. "Do not offer your baby fluids after giving the medication." B. "Digoxin increases your baby's heart rate." C. "Give the correct dose of medication at regularly scheduled times." D. "If your baby vomits a dose, you should repeat the dose to ensure that the correct amount is received."
C
The nurse is caring for a child who has received all possible medical care for cancer yet continues to experience relapse and metastasis. It is time to make the transition from curative care attempts to palliative care. What is the most important nursing consideration at this time? a. The health care professionals should make the decision about the child's care. b. The family may lose a sense of hope, so cancer treatments should continue. c. Involve the family in the decision-making process about the shift to palliative care. d. Palliative care can take place only at home, so the child should be discharged.
C
The parents of a 5-year-old with special health care needs talk to the parents of a 10-year-old with a similar condition for quite a while each day. What is the nurse's interpretation of this behavior? a. The nurse has not provided enough emotional support for the parents. b. This relationship between the children's parents is potentially unhealthy. c. Support between parents of special children is extremely valuable. d. Confidentiality is a pressing issue in this particular situation.
C
A nurse is teaching the parent of a child who has a Wilms' tumor. Which of the following statements should the nurse include in the teaching? (Select all that apply.) A. "Your child will need to have chemotherapy for 12 months." B. "Wilms' tumors are typically genetic in nature." C. "Surgery is done usually within 48 hours of diagnosis." D. "Palpating the tumor could cause spread of the cancer." E. "Further treatments will start immediately after surgery."
C, D, E
A nurse is caring for a child who is dying. Which of the following are findings of impending death? (Select all that apply.) A. Heightened sense of hearing B. Tachycardia C. Difficulty swallowing D. Sensation of being cold E. Cheyne-Stokes respirations
C, E
A 2-day-old infant was just diagnosed with aortic stenosis. What is the most likely nursing assessment finding? a. gallop and rales b. blood pressure discrepancies in the extremities c. right ventricular hypertrophy on ECG d. heart murmur
D
A child with leukemia has the following am laboratory results: Hgb 8.0, Hct 24.2, WBC 8,000, platelets 150,000. What is the priority nursing assessment? a. Monitor for fever. b. Assess for bruising or bleeding. c. Determine intake and output. d. Assess for pallor, fatigue, and tachycardia.
D
A nurse is caring for a child who has a terminal illness and reviews palliative care with an assistive personnel (AP). Which of the following statements by the AP indicates understanding of this review? A. "I'm sure the family is hopeful that the new medication will stop the illness." B. "I'll miss working with this client now that only nurses will be caring for the child." C. "I will get all the client's personal objects out of the room." D. "I will listen and respond as the family talks about their child's life."
D
A nurse is providing teaching to the parent of a child who has a new prescription for liquid oral iron supplements. Which of the following statements by the parent indicates an understanding of the teaching? A. "I should take my child to the emergency department if his stools become dark." B. "My child should avoid eating citrus fruits while taking the supplements." C. "I should give the iron with milk to help prevent an upset stomach." D. "My child should take the supplement through a straw."
D
A nurse is teaching a guardian about complicated grief. Which of the following statements should the nurse make? A. "Complicated grief occurs when little time is spent thinking about the loss." B. "Personal activities are rarely affected when experiencing complicated grief." C. "Guardians will experience complicated grief together." D. "Counseling can be helpful in resolving complicated grief."
D
The nurse is caring for a child with a developmental disability who is starting kindergarten this year. The mother is tearful and doesn't want the child to go to school. What is the best response by the nurse? a. "Do you need some time alone to collect yourself?" b. "You've known for a while this time would come." c. "Can I call your husband or a friend for you?" d. "It is normal to feel stressed or sad at this time."
D
While assessing a 4-month-old infant, the nurse notes that the baby experiences a hypercyanotic spell. What is the priority nursing action? a. Provide supplemental oxygen by face mask. b. Administer a dose of IV morphine sulfate. c. Begin cardiopulmonary resuscitation. d. Place the infant in a knee-to-chest position.
D
A child with leukemia received chemotherapy about 10 days ago. She presents today with a temperature of 100.4°F, an absolute neutrophil count of 500, and mild bleeding of the gums. What is the priority nursing intervention? a. Administer IV antibiotics as ordered. b. Provide vigorous oral care frequently with a firm toothbrush. c. Monitor pulse and blood pressure for changes. d. Administer packed red blood cell transfusion.
A
A nurse is assessing a child who has neuroblastoma of the adrenal gland. Which of the following are manifestations of metastasis from the primary site? (Select all that apply.) A. Weight gain B. Bone pain C. Periorbital ecchymoses D. Proptosis E. Weight loss
B, C, D, E
A nurse is assessing a child who has leukemia. Which of the following are early manifestations of leukemia? (Select all that apply.) A. Hematuria B. Anorexia C. Petechiae D. Ulcerations in the mouth E. Unsteady gait
B, C, E
A nurse is providing home care instructions to a parent of a child who is receiving chemotherapy. Which of the following instructions should the nurse include in the teaching? (Select all that apply.) A. Manifestations of infection B. Bleeding precautions C. Hand hygiene D. Homeschooling E. Airborne precautions
A, B, C
A nurse often cares for children who are dying. Which of the following are actions for the nurse to take to maintain professional effectiveness? (Select all that apply.) A. Remain in contact with the family after their loss. B. Develop a professional support system. C. Take time off from work. D. Suggest that a hospital representative attend the funeral. E. Demonstrate feelings of sympathy toward the family.
A, B, C
A nurse is assessing a child who has rhabdomyosarcoma of the nasopharynx. Which of the following are manifestations of rhabdomyosarcoma? (Select all that apply.) A. Enlarged neck lymph nodes B. Pain C. Vomiting D. Epistaxis E. Diplopia
A, B, D
A nurse is assessing an infant who has coarctation of the aorta. Which of the following findings should the nurse expect? (Select all that apply.) A. Weak femoral pulses B. Cool skin of lower extremities C. Severe cyanosis D. Clubbing of the fingers E. Low blood pressure
A, B, E
A nurse is providing teaching to the parent of a child who has a neuroblastoma. Which of the following statements should the nurse include in the teaching? (Select all that apply.) A. "Chemotherapy and radiotherapy may be necessary for treatment." B. "Your child will need a bone marrow biopsy." C. "Your child will be paralyzed because of this tumor." D. "Most children are diagnosed around age 12." E. "Your child will need surgery for resection of the tumor."
A, B, E
A nurse is caring for a 2-year-old child who has a heart defect and is scheduled for cardiac catheterization. Which of the following actions should the nurse take? A. Place on NPO status for 12-hr prior to the procedure. B. Check for iodine or shellfish allergies prior to the procedure. C. Elevate the affected extremity following the procedure. D. Limit fluid intake following the procedure
B