RN pediatrics chapter 12, 13, 21, 22

6. A 7-year-old with a myelomeningocele is paralyzed from the waist to her feet. She is either in bed or in a chair day and night. A physical evaluation is performed regularly to check skin integrity. While conducting a skin assessment, the nurse finds a partial-thickness skin loss with exposed dermis on the sacrum. How does the nurse classify this pressure ulcer on the assessment form? 1. First-degree pressure ulcer 2. Second-degree pressure ulcer 3. Deep tissue pressure ulcer 4. Unstageable ulcer

2. Second-degree pressure ulcer

11. Parents bring a toddler who is 2-1/2 years old to the hospital because of observed difficulty with breathing. In addition, they share that at bedtime the toddler has a barky cough. The toddler is diagnosed with laryngotracheobronchitis, commonly referred to as croup. Which assessment finding does the nurse expect related to the diagnosis? 1.Fever accompanied by a congested cough 2.Inspiratory stridor heard in the upper airway 3.Elevated temperature and diaphoresis 4.Snoring sounds throughout respirations

2.Inspiratory stridor heard in the upper airway

10. The parent of a 3-month-old returns for a visit with the health-care provider who is caring for the infant's hip dysplasia. However, the nurse notes that on arrival, the infant is not wearing the prescribed Pavlick harness. The parent indicates they removed the harness, believing the infant was uncomfortable. Which is the best response by the nurse? 1. Inform the parent how to check for capillary refill in the toes. 2. Assess the infant for trauma or swelling to the lower extremities. 3. Report the findings to the health-care provider before entering the examination room. 4. Ask the parent to demonstrate how to place the Pavlick harness.

1. Inform the parent how to check for capillary refill in the toes.

19. The nurse works in a pediatric clinic with patients who have heart disease or who have undergone treatment for heart disease. The nurse is frequently asked about the need for prophylactic antibiotics for these patients during invasive dental care. Which patients does the nurse identify as being at risk for endocarditis and being in need of antibiotic therapy? Select all that apply. 1. A child with a prosthetic heart valve 2. A child with a congenital defect scheduled for surgical repair 3. A child who was previously diagnosed with endocarditis 4. A child with a confirmed diagnosis of rheumatic heart disease 5. A child who had a congenital heart defect repaired 9 months ago

1. A child with a prosthetic heart valve 2. A child with a congenital defect scheduled for surgical repair 3. A child who was previously diagnosed with endocarditis 4. A child with a confirmed diagnosis of rheumatic heart disease

18. The pediatric nurse is providing care for a school-age patient diagnosed with rheumatic heart disease. When developing a plan of care for the patient's hospital stay, which interventions does the nurse include? Select all that apply. 1. Administer inflammatory and antibiotic medications as prescribed. 2. Assess for the presence of strep throat or other throat infections. 3. Include chest pain and heart palpation assessment with vital signs. 4. Begin patient/family teaching about the possibility of surgery. 5. Organize daily care and treatments to provide for joint pain relief.

1. Administer inflammatory and antibiotic medications as prescribed. 3. Include chest pain and heart palpation assessment with vital signs. 5. Organize daily care and treatments to provide for joint pain relief.

1. The clinical nursing instructor gives a lecture regarding maintenance of skin integrity while caring for a hospitalized child. Later, one of the nursing students is caring for a hospitalized child. Which action by the nursing student demonstrates that the teaching was effective? 1. Changes the location of the pulse oximeter every 2 hours 2. Trims the infant's fingernails and toenails 3. Scrubs the infant vigorously with every diaper change 4. Holds the infant in a rocking chair for an hour

1. Changes the location of the pulse oximeter every 2 hours

10. The parents are preparing to take their newborn, who was diagnosed with tetralogy of Fallot with pulmonary atresia, home. The nurse is developing a teaching sheet regarding care of the newborn for the parents. Which information does the nurse need to include in the teaching plan? 1.There is no need to limit activities. 2.It is important to maintain caloric intake. 3.No secondary complications are expected. 4.The neonate has natural immunity to infections.

2.It is important to maintain caloric intake.

20. The nurse is preparing a home-care plan for a child whose leg wound cultured positive for methicillin-resistant Staphylococcus aureus (MRSA). Which information should the nurse include? Select all that apply. 1. Do not share towels or any personal care items. 2. Wash hands with soap, rubbing for 30 seconds before rinsing. 3. Line dry clothes after washing. 4. Disinfect surfaces with bleach effective for MRSA. 5. Leave the wound open to air.

1. Do not share towels or any personal care items. 2. Wash hands with soap, rubbing for 30 seconds before rinsing. 4. Disinfect surfaces with bleach effective for MRSA.

15. The nurse educator of a burn unit is developing a counseling module for an adolescent who was burned in a house fire. Which of the following should be included in the discharge counseling for the adolescent and the adolescent's parents? Select all that apply. 1. Feelings of anxiety, guilt, and depression may be experienced. 2. Post-traumatic stress declines over the first 2 to 3 months. 3. Post-traumatic stress is often at its worse immediately after the incident. 4. There may be a lack of support groups in which to participate. 5. Patients may have body image disturbance 2 years after the injury.

1. Feelings of anxiety, guilt, and depression may be experienced. 3. Post-traumatic stress is often at its worse immediately after the incident. 5. Patients may have body image disturbance 2 years after the injury.

15. The nurse is caring for a 13-year-old patient diagnosed with adolescent idiopathic scoliosis. The curve in her back was treated by spinal fusion with rod insertion. Which is the priority nursing intervention in the postoperative period? 1.Promote adequate oral fluid intake. 2.Keep oxygen saturation within normal limits. 3.Ensure placement of indwelling urinary catheter. 4. Maintain a straight back, no bending.

2.Keep oxygen saturation within normal limits.

14. Parents of a toddler with eczema are concerned about alleviating discomfort from itching and preventing infection, since constant scratching has been an issue. They ask the nurse what measures they can take to care for their child. The nurse creates a teaching sheet to provide information regarding the care of a patient with eczema. Which concept should the nurse include on the teaching? 1. Maintain hydration of the skin. 2. Bathe frequently with warm to hot water using mild soaps. 3. Apply cool, wet compresses four times daily. 4. Avoid use of fabric softeners.

1. Maintain hydration of the skin.

18. A teenaged patient arrives in the emergency department where the health-care provider diagnoses a dislocated shoulder. It is the patient's first dislocation. Which should the nurse prepare for treatment of the dislocation? 1. Make sedative medication available. 2. Prepare a minimally invasive surgery room. 3. Anticipate a physical therapist consultation. 4. Get portable radiology equipment.

1. Make sedative medication available.

19. A first-year high-school student visits the school nurse to ask how she can get rid of the warts on her hands. She is embarrassed what her friends will think if they notice them, and she fears spreading them to others. Which of the following should the nurse include in the plan of care? Select all that apply. 1. Plantar or palmar warts are caused by human papillomavirus (HPV). 2. Hand hygiene should be performed after touching warts. 3. Old warts can be picked or scraped off as they become dry. 4. Cryosurgery is an option once she reaches age 18. 5. A patch with salicylic acid (Duofilm) is helpful to dissolve warts.

1. Plantar or palmar warts are caused by human papillomavirus (HPV). 2. Hand hygiene should be performed after touching warts. 5. A patch with salicylic acid (Duofilm) is helpful to dissolve warts.

9. An adolescent is brought to the health-care provider's office for evaluation of scaly rashes and erythema on the scalp. The patient also has some patches of hair loss. The nurse should anticipate which test will most likely be ordered? 1. Potassium hydroxide (KOH) stain 2. Blood cultures 3. Comprehensive metabolic panel (CMP) 4. Skin biopsy

1. Potassium hydroxide (KOH) stain

2. An 11-year-old child who had been treated for a broken leg is having a cast removed. After removal, the child asks the nurse about playing basketball for the local league. Which should be included in the response to the child? 1. The child should avoid playing basketball for up to 4 weeks but can then resume playing. 2. The child can play basketball as soon as the stiffness in this leg subsides, which is typically within 3 to 5 days. 3. The child should avoid playing basketball until she has stopped growing due to risk of reinjury. 4. The child may play basketball immediately, but should stop if the extremity develops swelling and pain.

1. The child should avoid playing basketball for up to 4 weeks but can then resume playing.

11. The nurse is providing care to a 7-year-old child who has been diagnosed with avascular necrosis. The patient's guardians ask the nurse what to expect due to this diagnosis. Which would be appropriate information to provide to the parents? 1. The child will be hospitalized and placed in traction. 2. The child will be treated by surgically placing a femoral screw. 3. The child will be placed in a Pavlik harness for several weeks. 4. The child will be given medication while on bedrest.

1. The child will be hospitalized and placed in traction.

16. The nurse is providing teaching to the parent of a toddler 2 years of age diagnosed with otitis media. The toddler presented with a fever of 100.9°F (38.3°C) and does not indicate symptoms related to pain. Which information does the nurse give the parent when the physician orders 48 to 72 hours of supportive care? Select all that apply. 1.Provide age-appropriate antipyretics/analgesics as needed. 2.Administer all of the prescribed antibiotic. 3.Support hydration with fluid increases. 4.Monitor temperature and report increases. 5.Apply topical steroid preparations as instructed.

1.Provide age-appropriate antipyretics/analgesics as needed. 3.Support hydration with fluid increases. 4.Monitor temperature and report increases.

20. The nurse in a pediatric clinic is assessing a toddler brought in by a parent who states, "I have noticed some increasing incidents of coughing and wheezing over the last few weeks." Auscultation by the nurse reveals some adventitious breath sounds in the upper right lobe. Which questions does the nurse ask the parent? Select all that apply. 1."Have you noticed any missing small toys?" 2."How often is the child allowed to self-feed?" 3."Is there an older child who gives this child food?" 4."Can you recall a specific time of gagging or cyanosis?" 5."Have you noticed any foreign objects in the child's stool?"

1."Have you noticed any missing small toys?" 3."Is there an older child who gives this child food?" 4."Can you recall a specific time of gagging or cyanosis?"

8. The nurse is providing care for an infant with an inner ear infection. The nurse is aware that the condition has occurred multiple times in a 3-month period. Which comment by the parent indicates to the nurse that specific teaching is needed regarding the incidences of infection? 1."I now put her to bed with a bottle." 2."I clean her ears with cotton swabs." 3."She likes her ears submerged while bathing." 4."Her older brother brings colds home from school."

1."I now put her to bed with a bottle."

19. The nurse is conducting a class for parents of children with asthma. After covering the topic of asthma triggers, the nurse asks for feedback on the information. Which statements indicate the parents understand actions to reduce asthma triggers? Select all that apply. 1."I think that we will need to stop using the fireplace." 2."We will be rethinking the possibility of a family pet." 3."Now may be the time for relocating to a warmer climate." 4."No more going outside without a mask from now on." 5."Reorganizing our schedules will definitely reduce stress."

1."I think that we will need to stop using the fireplace." 2."We will be rethinking the possibility of a family pet." 5."Reorganizing our schedules will definitely reduce stress."

14. A new mother brings her 2-week-old neonate to the pediatrician's office, stating, "I think something is wrong with my baby." When the infant is undressed, the nurse notices signs of possible cardiac problems. Which assessment findings support the nurse's suspicions? Select all that apply. 1.Prolonged capillary refill time 2.Bluish tinge to oral structures 3.Peripheral cyanosis of left leg 4.Amount of urinary output 5.Mottled appearance of skin

1.Prolonged capillary refill time 2.Bluish tinge to oral structures 5.Mottled appearance of skin

2. The nurse in the newborn unit of a pediatric hospital is providing care for a neonate born at 34 weeks' gestation. The nurse is aware that the immediate risk to the neonate is which condition? 1.A lack of a phospholipid in the alveoli 2.Inability to maintain body temperature 3.Delay in closure of cardiac foramen 4.A decrease in renal function

1.A lack of a phospholipid in the alveoli

19. The family of an infant is present in the hospital when the diagnosis of osteomyelitis is given to the infant. Which treatment order does the nurse anticipate? Select all that apply. 1. Emergency surgery for incision and drainage 2. Oral nystatin 3. Pavlik harness 4. Systemic IV antibiotics 5. Physical therapy

1.Emergency surgery for incision and drainage 5.Physical therapy

15. The nurse is interviewing an adolescent patient 17 years of age who was diagnosed with cystic fibrosis (CF) as an infant. The patient shares feelings of frustration about needing to always live with parents. Which information provided by the nurse is likely to be most important to the patient? 1.How chest physiotherapy (CPT) can be performed independently 2.The availability of home meal delivery to those needing a therapeutic diet 3.Organizations that will provide transportation for persons with chronic illness 4.A list of social organizations available for young persons who have special needs

1.How chest physiotherapy (CPT) can be performed independently

12. The nurse is providing care for a neonate diagnosed with tetralogy of Fallot. Prostaglandin E1 therapy is prescribed to keep the foramen ovale and the ductus arteriosus open. Which is the most important intervention for the nurse to include in the neonate's plan of care? 1.Maintain a separate IV access for continuous administration of the medication. 2.Watch for respiratory distress or apnea after adding medication to the breathing tube. 3.Monitor for and document evidence of flushing, bradycardia, and irritability as expected. 4.Monitor weight and adjust the dosage using a scale of 0.05 to 0.1 μg/kg/min IV infusion.

1.Maintain a separate IV access for continuous administration of the medication.

16. The nurse is providing care for a 9-year-old patient who was recently diagnosed with cardiomyopathy after a viral infection. Which teaching does the nurse provide to the patient's parents about the diagnosed condition? Select all that apply. 1.Need for intensive care of the patient 2.Preparation for anticipatory grieving 3.The necessity for physical activity 4.Importance of allowing patient to discuss feelings 5.Reasons for frequent medical visits

1.Need for intensive care of the patient 2.Preparation for anticipatory grieving 4.Importance of allowing patient to discuss feelings 5.Reasons for frequent medical visits

5. The nurse is assisting with high school sports physicals. The nurse performs a physical assessment on a 17-year-old male student who is tall and thin, with disproportionately long arms. Which additional finding will prompt the nurse to recommend a cardiac evaluation? 1.Notable laxity of joints 2.Sparsity of body hair 3.Deep tone to the voice 4.Slow, rhythmic gait

1.Notable laxity of joints

9. A 3-month-old infant is diagnosed with pulmonary stenosis. Which parent teaching does the nurse provide? 1.Options for treatment include a repair of the artery or the valve. 2.Balloon angioplasty is performed as an outpatient procedure. 3.Pulmonary stenosis repair can be delayed until 1 year of age. 4.After repair, the child is no longer at risk for cardiac problems.

1.Options for treatment include a repair of the artery or the valve.

3. The nurse is aware the neonate's blood circulation is different before birth than after birth. Which circulation pattern does the nurse recognize as occurring prior to birth? 1.Oxygenated blood flows from the right atrium to the left atrium through the foramen ovale. 2.Oxygenated blood flows from the right ventricle to the lungs and then to the left ventricle. 3.For a short time after birth, the neonate continues to depend on the mother for oxygen supply. 4.Once the neonate takes a first breath, the ductus venosus closes and blood goes to the lungs.

1.Oxygenated blood flows from the right atrium to the left atrium through the foramen ovale.

15. A neonate became dusky and developed respiratory distress at the age of 4 days and is diagnosed with a hypoplastic left heart. The surgeon obtains an informed consent from the parents to perform emergency surgery. Which information will the nurse provide to promote parental understanding? Select all that apply. 1.The left side of the neonate's heart did not develop correctly. 2.The function of left side of the heart is to pump blood to the body. 3.Provide reassurance to the parents that surgery will fix the problem. 4.Share that medical management of the condition is needed for 1 year. 5.A normally existing hole in the wall of the heart at birth will be enlarged.

1.The left side of the neonate's heart did not develop correctly. 2.The function of left side of the heart is to pump blood to the body. 5.A normally existing hole in the wall of the heart at birth will be enlarged.

7. A child is being treated with a hip Spica cast and preparing to be discharged home. Which statement by the parents demonstrates effective education and readiness to care for the child? 1. "We will turn our daughter every day and watch for skin irritation." 2. "Placing the absorbent part of the diaper toward the skin is best." 3. "We will limit our daughter's snacks to avoid obesity." 4. "If our daughter is in pain, we will use only oxycodone to treat pain."

2. "Placing the absorbent part of the diaper toward the skin is best."

9. A 2-year-old child is being evaluated for a musculoskeletal disorder. The child's laboratory results indicate hypophosphatemia, a normal erythrocyte sedimentation rate, and negative rheumatoid factor. Which disorder is the child likely experiencing? 1. Juvenile arthritis 2. Genu varum (bowlegs) 3. Septic arthritis 4. Avascular necrosis

2. Genu varum (bowlegs)

13. A 6-year-old patient is being assessed by the pediatrician for breathing difficulties. The pediatrician expresses a need for diagnostic tests to identify or rule out asthma. Which tests does the nurse anticipate ordering? 1.Throat culture 2.Pulmonary function tests 3.Electrocardiogram 4.Peak flow meter

2.Pulmonary function tests

16. A 15-year-old male has been diagnosed with a slipped capital femoral epiphysis and is scheduled for surgery. The nurse expects this patient to exhibit which clinical presentation? 1. Waddling gait 2. Anterior knee and thigh pain 3. Internally rotated lower leg 4. Increased hip flexibility

2. Anterior knee and thigh pain

1. The nurse is providing care for a father and son who were injured in an all-terrain vehicle (ATV; off-roading) accident. The 5-year-old child has a torus fracture in the forearm. The father has a fractured clavicle. The parent asks about healing time. Which information should the nurse share with the parent? 1. The healing time for both will be about the same. 2. Children require a shorter immobilization time and will heal faster. 3. Adults require a shorter immobilization time and will heal faster. 4. Clavicle fractures heal faster than arm fractures.

2. Children require a shorter immobilization time and will heal faster.

6. The nurse is assessing a newborn and observes that the newborn flexes the arm to the chest and cries with some movement. Which fracture does the newborn most likely have? 1. Torus fracture 2. Clavicle fracture 3. Greenstick fracture 4. Medial condyle fracture

2. Clavicle fracture

14. The nurse is providing care for a 14-year-old patient who is within the first 24 hours postoperative for scoliosis treatment. Which intervention, if performed, would demonstrate appropriate care measures? 1. Removing the indwelling urinary catheter immediately on arrival to the care unit 2. Repositioning the patient every 2 to 4 hours while in bed during the recovery period 3. Encouraging the patient to walk postoperatively once daily during pain-free periods 4. Monitoring oxygen levels and bowel sounds once daily until patient is discharged to home

2. Repositioning the patient every 2 to 4 hours while in bed during the recovery period

18. During an outside gym class, a high-school student was stung on the lip by a bee. After determining that the student was not allergic to bee stings, which treatment should the school nurse recommend to soothe the sting? Select all that apply. 1. Apply vinegar and oil drops to the site of the sting. 2. Create a paste of baking soda and water and apply to the lip. 3. Wash the lip with cool water and apply ice to the sting. 4. Take an over-the-counter antihistamine. 5. Apply a hot pack to the lip.

2. Create a paste of baking soda and water and apply to the lip. 3. Wash the lip with cool water and apply ice to the sting. 4. Take an over-the-counter antihistamine.

20. A 14-year-old student reports to the school nurse that he has a persistent pain and soreness in his legs. The student is part of the football team. There is no evidence of injury to the student. Which information should the nurse provide to the student? Select all that apply. 1. Continue to practice despite tiredness and pain. 2. Do stretching exercises before playing or being active. 3. Ask the coach to sit out of practice for a week. 4. Ensure shoes and equipment fit properly and are stable. 5. Learn proper body mechanics for the activities.

2. Do stretching exercises before playing or being active. 4. Ensure shoes and equipment fit properly and are stable. 5. Learn proper body mechanics for the activities.

8. The nurse is providing care to a preschool-aged child who has been placed in a hip Spica cast for treatment of a femur fracture. The child is given narcotic pain medication for the first 48 hours before being sent home. When providing discharge instructions to the child's parents, which is the most important? 1. Assist the child to find ways to play while in the cast. 2. Ensure the cast is not too tight around the abdomen. 3. Keep the cast clean by using absorbent pads when toileting. 4. Avoid giving the child sugary snacks while being treated.

2. Ensure the cast is not too tight around the abdomen.

16. The nurse is providing care for an 8-year-old child who was treated for a dog bite. Before discharging the child home, the nurse plans a play session, with the parents included, that focuses on safety around animals and pets in the home. What points would the nurse present during the session? Select all that apply. 1. Avoidance of animals while the wound is healing 2. Importance of not disturbing animals while they are sleeping or eating 3. Diseases that pets can transmit to humans, such as tetanus 4. Supervision of young children and pets 5. Stopping antibiotics when the redness and swelling go down

2. Importance of not disturbing animals while they are sleeping or eating 3. Diseases that pets can transmit to humans, such as tetanus 4. Supervision of young children and pets

13. A junior high-school student is cooking in the home economics room when some oil splashes on his fingers and hand. He immediately rinses his hand with cool tap water. The skin is not broken, but soon, a blister begins to form. The teacher sends the student to the school nurse for evaluation and treatment. Which nursing intervention is most appropriate? 1. Apply ice to the burned area for 20 minutes. 2. Soak the burn in cool water. 3. Puncture the blister with a sterile needle. 4. Apply baby oil and wrap with a sterile dressing.

2. Soak the burn in cool water.

17. The school nurse is educating preschool parents about the management of lice infestation, which has currently become a problem among the students. Which recommendations should the nurse include in the caregiver education? Select all that apply. 1. Use a pediculicide shampoo every day and let the hair air dry. 2. Use a fine-toothed comb to remove nits from wet hair. 3. Apply mayonnaise to the hair and cover with a plastic cap. 4. Wash clothing and bedding in hot soapy water and dry on hot cycle. 5. Wash hair with a regular shampoo daily and blow dry with a cool setting.

2. Use a fine-toothed comb to remove nits from wet hair. 3. Apply mayonnaise to the hair and cover with a plastic cap. 4. Wash clothing and bedding in hot soapy water and dry on hot cycle.

11. A nurse is caring for a 12-year-old child who fell off a bicycle and sustained a laceration to the leg. What is the nurse's priority intervention? 1. Clean the laceration with normal saline. 2. Use gauze to apply pressure to the laceration. 3. Ascertain whether the child's tetanus immunization is up to date. 4. Apply antibiotic ointment such as bacitracin to the laceration.

2. Use gauze to apply pressure to the laceration.

20. A parent brings a 2-year-old child with a fever and a rash to the pediatric clinic. The health-care provider suggests the child may have one of several conditions that present with similar symptoms, but wants to rule out Kawasaki disease. Which tests does the nurse expect to be performed? Select all that apply. 1. Chest x-ray 2. White blood cell count 3. Allergy testing 4. Baseline echocardiograms 5. Magnetic resonance imaging (MRI) of the chest

2. White blood cell count 4. Baseline echocardiograms

4. The nurse is providing care for a neonate diagnosed with a cardiovascular disorder immediately after birth. When gathering assessment information from the mother, which comment will the nurse recognize as the most likely contributing factor for the defect? 1."We live in the country, and we get all our water from a well." 2."I quit my preschool job when a child was diagnosed with measles." 3."The baby was born a week early; I hope that is not the cause." 4."We were in a European country before pregnancy was confirmed."

2."I quit my preschool job when a child was diagnosed with measles."

7. The nurse is caring for a newborn born at 36 weeks' gestation and observes an apneic episode of 15 seconds. Which action does the nurse take first? 1.Administer oxygen. 2.Apply pulse oximetry on right hand. 3.Suction secretions with the bulb suction. 4.Hold the newborn in an upright position.

2.Apply pulse oximetry on right hand.

14. The parents of three children aged 4, 6, and 9 years are preparing to travel abroad as missionaries. The children are in good health and up to date for immunizations; however, the parents are concerned about the high level of tuberculosis (TB) in the area to which they are assigned. Which recommendation does the nurse make for the protection of the children? 1.Protect the children with good nutrition. 2.Have the children receive the bacillus Calmette-Guerin (BCG) vaccine. 3.Arrange for monthly TB testing for the family. 4.Start the children on preventive medication.

2.Have the children receive the bacillus Calmette-Guerin (BCG) vaccine.

6. A toddler who is 2 years old is playing in the playroom at the hospital and suddenly begins to choke and cough. The nurse attending to the toddler understands airway physiology and places the child in which position to dislodge a possibly inhaled object? 1.Head down and on the left side 2.Head down and on the right side 3.Head horizontal to the floor and supine 4.Head in a neutral position and prone

2.Head down and on the right side

17. The nurse is providing postoperative teaching to the parents of a preschool child after a tonsillectomy. For which events does the nurse prompt the parents to contact the physician? Select all that apply. 1.The child keeps an emesis basin close by. 2.The child is frequently swallowing without food or fluids. 3.Bright red blood is noticed in the child's mouth. 4.The child is asking for ice chips and popsicles. 5.The child refuses oral analgesics because it hurts to swallow.

2.The child is frequently swallowing without food or fluids. 3.Bright red blood is noticed in the child's mouth. 5.The child refuses oral analgesics because it hurts to swallow.

12. The nurse on a pediatric acute care unit is providing care for an infant who is 11 months of age. The infant is diagnosed with a lower respiratory infection that produces large amounts of thick secretions the infant cannot cough up. When planning to suction the infant, which factor is important to remember? 1.The parents are likely to become angry about the procedure. 2.The infant will respond negatively to a temporary loss of breath. 3.The nurse should apologize after the procedure for stress related to the procedure. 4.The nurse should have assistance to immobilize the infant during the procedure.

2.The infant will respond negatively to a temporary loss of breath.

18. The nurse is caring for a newborn diagnosed with esophageal atresia and tracheoesophageal fistula. Which information does the nurse provide to the parents? Select all that apply. 1.Prenatal conditions that contribute to the problem 2.The manifestation supporting the diagnosis 3.Diagnostic tests performed since the birth 4.Methods of treating the condition 5.Actions for promoting recovery

2.The manifestation supporting the diagnosis 3.Diagnostic tests performed since the birth 4.Methods of treating the condition 5.Actions for promoting recovery

3. A nurse is teaching a group of parents about melanoma and sunburn prevention. Which statement by a parent indicates that more teaching is needed? 1. "My children wear hats and ultraviolet (UV)-blocking clothing regularly." 2. "I apply sunscreen to my children 30 minutes before going to the pool." 3. "At the pool, we stay close to the water to stay cool." 4. "I try to schedule outdoor activities for later in the afternoon."

3. "At the pool, we stay close to the water to stay cool."

17. The nurse on a pediatric unit is providing care for a 5-year-old child diagnosed with congestive heart failure. The physician prescribes digoxin therapy. Which medication-focused interventions does the nurse include when creating a plan of care for the patient? Select all that apply. 1. Hold medication if an antibiotic is prescribed. 2. Evaluate parent's ability to obtain radial pulse. 3. Administer medication at the same time every day. 4. Administer 1 hour before or 2 hours after meals. 5. Replace medication if a dose is vomited within 1 hour.

3. Administer medication at the same time every day. 4. Administer 1 hour before or 2 hours after meals.

7. A 6-month-old infant presents to the clinic with a diaper rash. The nurse observes a well-demarcated rash and satellite lesions on buttocks and legs. Based on the assessment, which treatment will the nurse recommend? 1. An antiviral medication 2. Baby powder application at each diaper change 3. An ointment containing nystatin (Mycostatin) 4. A hydrocortisone ointment

3. An ointment containing nystatin (Mycostatin)

4. The nurse is preparing to complete assessments on children in a shelter for those who are homeless. Which assessment will assist the nurse to identify possible musculoskeletal conditions in each child? 1. Eating and sleeping patterns 2. Height and weight growth patterns 3. Motor development patterns 4. Sensory development patterns

3. Motor development patterns

3. The nurse is caring for a child who reports having pain in the ankle after "twisting" it during play. Which would be the most appropriate follow-up assessment to this report? 1. Color and temperature of the skin around the ankle 2. The patient's gait and range-of-motion of all extremities 3. Swelling and deformity of the ankle joint 4. Palpation of the joints proximal to the ankle

3. Swelling and deformity of the ankle joint

17. A 3-year-old, well-known to the nursing staff, is admitted to the hospital frequently for fracture treatment secondary to osteogenesis imperfecta (OI). It is known by staff and parents that the child is fragile. The nurse develops a long-term care plan to review with the parents. Which is the priority intervention for this child's plan of care? 1. Observe the child's height and weight growth. 2. Monitor for bluish colored sclera development. 3. Teach methods to prevent falls and injury. 4. Inform parents about the OI foundation.

3. Teach methods to prevent falls and injury.

4. An eighth-grade student appears in the school infirmary with a skin manifestation that itches. He states that it began on the way to school after he took a shortcut through a field. The nurse performs a skin assessment and finds areas of erythema with streaks and patches on both legs. The nurse determines that the child is exhibiting signs of contact dermatitis. What is the first action that the nurse should take? 1. Alert the child's parents. 2. Apply cool, wet compresses. 3. Wash the area thoroughly with soap and water. 4. Contact medical help by notifying the child's health-care provider.

3. Wash the area thoroughly with soap and water.

11. The nurse is reviewing medications for the treatment of a heart rhythm disorder in a patient who is 8 years of age. The parent of the patient states that the physician recently prescribed medication to treat the patient's attention deficit-hyperactivity disorder (ADHD). Using knowledge of recent professional recommendations, which statement by the nurse is correct? 1."We need to remind the physician there is a heart condition." 2."Do not start the medication until I can check for safety warnings." 3."Children with heart disorders have a higher incidence of ADHD." 4."Giving the medication can cause death if there is a cardiac issue."

3."Children with heart disorders have a higher incidence of ADHD."

5. The nurse is caring for a child who has been diagnosed with epiglottitis. Which statement by the parents demonstrates effective patient education? 1."I will stop giving the antibiotics when my daughter feels better." 2."I will look into her mouth and throat to see it is red and swollen." 3."I will comfort her as much as possible to prevent her from crying." 4."I will expect the doctor to order a polymerase chain reaction (PCR) test to confirm the diagnosis."

3."I will comfort her as much as possible to prevent her from crying."

1. A nurse is caring for a 4-month-old child diagnosed with influenza. Which order should the nurse expect to read in the electronic health record? 1.Limit oral hydration. 2.Initiate airborne precautions. 3.Administer Tylenol for fever. 4.Administer Motrin for malaise.

3.Administer Tylenol for fever.

8. The nurse is preparing an 8-year-old patient for a cardiac catheterization. Which intervention will the nurse initiate immediately postprocedure? 1.Observe for signs and symptoms of infection. 2.Hold food and fluids until gag reflex returns. 3.Keep the involved extremity straight for 4 to 6 hours. 4.Notify health care provider if green or yellow drainage is noted.

3.Keep the involved extremity straight for 4 to 6 hours.

6. The nurse is providing care for a 12-year-old patient who is hospitalized with generalized weakness and muscle wasting, which began in the hips, pelvic area, thighs, and shoulders. The physician suspects Duchenne's muscular dystrophy. Which action by the physician does the nurse expect? 1.Prescribe physical therapy to improve muscle strength. 2.Suggest homeschooling until the acute stage ends. 3.Perform an echocardiogram to evaluate cardiac functioning. 4.Perform muscle biopsies to identify the stage of the disease.

3.Perform an echocardiogram to evaluate cardiac functioning.

13. The nurse is assessing a 10-year-old patient post-appendectomy postsurgery. Which finding does the nurse recognize as a sign of hypovolemic shock? 1.Heart rate of 60 2.Temperature of 103°F (39.4°C) 3.Urine output 4.Increased blood pressure

3.Urine output

12. The parent of a 6-week-old patient calls the health-care provider's office and reports the infant is irritable, running a fever, holds his hip in an "unusual" position, and was recently given antibiotics for an ear infection. Which response by the nurse is most appropriate? 1. "Administer acetaminophen every 4 hours for the fever and call back if he still has a fever in 24 hours." 2. "This can easily be managed at home and will most likely resolve on its own." 3. "The antibiotics need more time to work. Finish the antibiotics prescribed and call back if the symptoms continue." 4. "You need to take him to the walk-in clinic or emergency room for evaluation."

4. "You need to take him to the walk-in clinic or emergency room for evaluation."

8. A 15-month-old toddler has a strange rash on his nose and mouth. It contains papules and vesicles and has a honeylike, glazed look. The toddler has a history of eczema, but the nurse differentiates the features of the presenting rash and explains that he has developed a secondary infection. What is the treatment of choice for this type of dermatological disease? 1. Bathe the skin daily with hydrogen peroxide. 2. Apply Caladryl lotion to dry the lesions. 3. Use an antiviral lotion as ordered for 7 to 10 days. 4. Administer topical antibiotics as ordered until the skin is clear.

4. Administer topical antibiotics as ordered until the skin is clear.

12. A teenager suffered third-degree burns of the face and hands while at a campfire that burned out of control. Emergency treatment is provided, and the patient is then admitted to a burn treatment center. Which nursing action should the nurse perform first? 1. Place a nasogastric tube for feeding. 2. Monitor intake and output. 3. Check wound for infection. 4. Auscultate lungs for signs of respiratory distress.

4. Auscultate lungs for signs of respiratory distress.

10. A teenager is being cared for in the emergency department after being trapped in a garage fire at her home. Partial-thickness burns are present on the side of the face, as well as on both arms. Which nursing action is the highest priority? 1. Apply cool, sterile compresses to the burns. 2. Remove all clothing from the patient. 3. Give pain medication as ordered. 4. Give 100% humidified oxygen.

4. Give 100% humidified oxygen.

5. A 15-year-old male is very distressed about the skin problems on his face, neck, and back. He has whiteheads on his face and some blackheads. The nurse educates him about acne and designs a plan of care to use to treat and prevent skin eruptions. Which statement should the nurse include when teaching about skin care? 1. Chocolate should be eliminated from the diet. 2. It is important to use oil-based lotions. 3. Squeezing whiteheads should be done only after a thorough cleansing. 4. Keep hair clean and off the face.

4. Keep hair clean and off the face.

5. The nurse is caring for a child in the emergency department. The child's arm is abnormally positioned, and the child is holding the arm near that area and is crying with pain. The child's parents explain that the child fell off the bicycle when riding on the streets of the subdivision. Which is the priority care to provide to the child? 1. Apply ice to the painful area. 2. Elevate the child's arm. 3. Encourage the child to rest. 4. Protect the child from further injury.

4. Protect the child from further injury.

13. A 12-year-old girl is noted to have a C-shaped lateral spinal curvature. Which condition is the girl most likely experiencing? 1. Internal femoral torsion 2. Hip dysplasia 3. Clubfoot 4. Scoliosis

4. Scoliosis

2. A school nurse is examining a third-grade student complaining of a small lump on the head. After parting the hair, it is evident that a tick has embedded into the scalp. Which nursing intervention should the school nurse take? 1. Apply mineral oil to the site of attachment and wait for the tick to back out. 2. Squeeze the tick and pull it off with bare fingers. 3. Spray DEET directly on to the child's skin where the tick is embedded. 4. Use tweezers or forceps to remove the tick, pulling up with steady pressure.

4. Use tweezers or forceps to remove the tick, pulling up with steady pressure.

1. The nurse is providing information to the parents of a toddler who is scheduled for surgery for the replacement of the pulmonic valve. The parents have many questions about the function of the valve. Which information from the nurse is correct? 1.The valve must work correctly to get oxygen from the lungs to the body. 2.If the valve does not work correctly, blood is kept from entering the heart. 3.When the valve is defective, the blood leaving the heart is decreased. 4.A defect in the valve causes less blood to get to the lungs for oxygenation.

4.A defect in the valve causes less blood to get to the lungs for oxygenation.

2. The nurse caring for a child who is exhibiting supraventricular tachycardia as revealed on the cardiac monitor. Which nursing intervention would the nurse attempt first? 1.Administer adenosine. 2.Perform nasal suctioning. 3.Apply ice to the forehead. 4.Ask the child to bear down.

4.Ask the child to bear down.

4. The nurse is providing care for a school-age patient who received a head injury while playing sports. Which initial assessment finding causes the nurse greatest concern? 1.Confusion and disorientation 2.Headache with periods of nausea 3.Immediate loss of consciousness 4.Changes in breathing and heart rates

4.Changes in breathing and heart rates

3. The nurse is providing care for a 7-year-old patient who was brought to the emergency department with a persistent dry cough, low fever, and abdominal pain and diarrhea. Testing confirms the child has COVID-19. Which patient characteristic does the nurse recognize as being a risk factor for more severe disease? 1.The child is from a middle-income community. 2.The child is White. 3.The child has not reached puberty. 4.The child has diabetes.

4.The child has diabetes.

10. The nurse in an acute care pediatric facility is preparing to assume care of multiple patients at the change of shift. Which patient will the nurse plan to assess first? 1.The toddler who exhibits clubbing of the fingertips 2.The preschooler with pneumonia who has poor skin turgor 3.The infant who can sleep only with the head of the bed elevated 4.The infant who prefers a tripod position instead of lying down

4.The infant who prefers a tripod position instead of lying down

9. The nurse in a pediatric clinic is performing assessments on multiple infants. Which infant does the nurse recognize as being at greatest risk for a respiratory disorder? 1.The infant born at 36 weeks who exhibited respiratory problems at birth 2.The infant who was born at term and recently adopted from another country 3.The infant who sleeps all night, exhibits eczema, and has a family history of asthma 4.The infant with recurrent sore throats and both pets and smokers in the house

4.The infant with recurrent sore throats and both pets and smokers in the house

7. The nurse is caring for a 36-week gestation newborn who has a heart murmur, poor feeding, fatigue, and bounding pulses. The vital signs are temperature, 97.8°F (36.5°C); respirations, 62 breaths/min; heart rate, 158 beats/min; and blood pressure, 65/25 mm Hg. Which finding does the nurse recognize as being indicative of patent ductus arteriosus (PDA)? 1.Heart rate of 158 beats/min 2.Respiration rate of 62 breaths/min 3.Heart murmur 4.Wide pulse pressure

4.Wide pulse pressure