Test ch. 21, 23, 24
41. What is the drug of choice for the relief of mild to moderate pain in infants and children? A. Acetaminophen B. Ibuprofen C. Fentanyl D. Naloxone
ANS: A Rationale: Acetaminophen is commonly used for the relief of mild to moderate pain in infants and children
19. An 8-year-old child will be hospitalized for several weeks in skeletal traction to treat a fractured femur. What does the nurse realize immobilization in this age-group can generate feelings of in planning care of this child? a. Loss of control b. Altered body image c. Shame and guilt d. Fear of bodily harm
ANS: A Forced dependency in the hospital, such as immobilization, can result in a feeling of loss of control and loss of security.
7. A hospitalized toddler was drinking from a cup at home but now refuses to drink from anything except his favorite bottle. What is the most likely reason for this behavior? a. He is dealing with the anxiety of hospitalization by regressing. b. He is demonstrating attention-seeking behaviors because of an overabundance of attention in the hospital. c. He is attempting to refocus the attention of the adults around him to avoid further painful procedures. d. He is exhibiting normal behavior for his age, as children often stop new behaviors after they believe they have mastered them.
ANS: A Hospitalization is frustrating for toddlers. They show their displeasure when illness restricts satisfaction of their desires. It is not unusual for a toddler who was drinking from a cup to refuse it in the hospital.
23. The nurse is preparing to start an IV on an infant admitted to the pediatric unit. What intervention is appropriate for the nurse to implement? a. Involve the parents. b. Provide a simple explanation to the child. c. Let the child examine the equipment. d. Suggest coping techniques.
ANS: A It is appropriate to involve the parents when performing a procedure on an infant. Providng a simple explanation, letting the child examine the equipment, and suggesting coping techniques are not appropriate interventions for an infant.
9. What is the best suggestion by the nurse when parents ask, "When is the best time to begin to prepare a 5-year-old for surgery and hospitalization?" a. "As soon as the surgery is scheduled" b. "About 2 weeks before surgery" c. "About 4 days before surgery" d. "On the night before admission to the hospital"
ANS: C Parents should prepare children for procedures and hospitalization a few days in advance.
A child diagnosed with epilepsy had a generalized tonic-clonic seizure that lasted 90 seconds. What would the nurse expect to assess after a generalized tonic-clonic seizure? a. Restlessness b. Sleepiness c. Nausea d. Anxiety
b
What is the best way for the nurse to communicate with a 10-year-old child who has a hearing impairment? a. Use gestures and signs as much as possible. b. Let the childs parents communicate for her. c. Face the child and speak clearly in short sentences. d. Recognize that the childs ability to communicate will be on a 6-year-old childs level
c
What symptom leads the nurse caring for a 5-month-old with viral influenza to suspect the development of Reyes syndrome? a. Respirations drop from 18 to 14 breaths/min b. Falling asleep after feeding c. Sudden vomiting without effort d. Development of a macular rash
c
What will the nurse include when caring for a child in Bucks extension? a. Positioning the child with hips flexed 90 degrees at all times b. Keeping the weights in contact with the floor c. Checking for skin irritation from traction equipment d. Releasing the weights on a schedule
c
What will the nurse teach parents when giving instructions for acute conjunctivitis? a. Apply cool compresses to the affected eye several times a day. b. Instill topical steroid eye drops for 1 week. c. Clear drainage from the inner to the outer aspect of the eye. d. Keep the eye patched until the inflammation resolves.
c
What would the nurse include in planning teaching to parents of a child with Legg-Calv-Perthes disease about the long-term effects of this disease? a. There are no long-term effects. b. The disease is self-limited and requires no long-term treatment. c. Degenerative arthritis may develop later in life. d. There is risk of osteogenic sarcoma in adulthood
c
31. What are the stages of separation anxiety in the toddler? A. Protest, despair, and denial B. Denial, dependence, and submission C. Protest, sadness, and despair D. Despair, anxiety, and regression
ANS: A Rationale: The major tasks of adolescence include establishing an identity, separating from family, initiating intimacy, and developing career choices for economic independence. Erikson identifies the major task of this group as identity versus role confusion. Emancipation is a critical element in the establishment of identity.
18. What statement by the parent of a hospitalized toddler leads the nurse to determine the parent understands a hospitalized toddler's need for transitional objects? a. "This stuffed animal makes him feel secure." b. "He insisted on bringing this dirty old blanket with him." c. "I'm going to buy him a big stuffed animal from the gift shop." d. "I'd like to get him some toys from the playroom."
ANS: A The use of a transitional object such as a blanket or a favorite toy promotes security.
21. The nurse shares the information and timelines recorded on the interdisciplinary outline of care for a child. What is this document? a. Clinical pathway b. Comprehensive nursing care plan c. Holistic care approach d. Incorporated cost analysis
ANS: A This document is the clinical pathway, which is a broad outline of interdisciplinary plan of care with specific timelines.
2. A 2-year-old child has been crying constantly for his mother since he was hospitalized 3 days ago. What does this behavior suggest? a. The toddler feels abandoned by his mother. b. The child still has not adjusted to his hospitalization. c. The child is not separated from his mother often. d. There is a poor mother-child bond.
ANS: A Unless toddlers are extremely ill, their grief and sense of abandonment during hospitalization are obvious.
25. What will the nurse include when documenting the discharge of a pediatric patient? (Select all that apply.) a. Time of discharge b. Adult(s) accompanying the child and the relationship to the child c. Condition of the child d. Method of transportation e. Instructions that were given to physician
ANS: A, B, C, D Information that should be included in the discharge note include time of discharge, adults accompanying the child and relationship to child, condition of the child, and method of transportation. It should also be documented that instructions were given to parents.
26. The nurse suggests to parents that they use the outpatient surgical center for their child's upcoming surgery. What advantage(s) does this type of facility have to offer? (Select all that apply.) a. Lower cost b. Less incidence of health care-associated infections c. Reduction of parent-child separation d. Ample time for recuperation at the facility e. Decreased emotional impact of illness
ANS: A, B, C, E All options listed are advantages of outpatient services with the exception of recuperating at the facility.
39. Which are appropriate interventions to improve a child's hospitalization, regardless of age? Select all that apply. A. Provide recuperation at home when possible. B. Provide a cheerful, casual atmosphere. C. Provide a flexible schedule. D. Provide a roommate who is age-appropriate. E. Provide for rooming in for parents. F. Provide activities that are developmentally appropriate.
ANS: A, B, C, E, F Rationale: It is not best practice to provide a roommate for hospitalized children. The other interventions listed provide benefit to the hospitalized child.REF: Page 475
28. What information will the nurse include when taking a developmental history? (Select all that apply.) a. Previous experience with hospitalization b. Cultural needs c. History of illness d. Allergies e. Child's nickname
ANS: A, B, E The developmental history has information about the child and the child's developmental and cultural needs and personal preferences. The information relative to history of illness or allergies would be covered in the medical history.
29. The nurse is preparing to obtain a throat culture on a toddler patient. What interventions are appropriate for the nurse to implement? (Select all that apply.) a. Model desired behavior. b. Instruct patient not to yell. c. Use distractions. d. Explain the procedure in detail. e. Encourage the child to ask questions.
ANS: A, C Whenever possible the parent should be involved in the preparation for and initiation of a treatment or procedure, and the child should be prepared according to his or her developmental level. For a toddler, model the behavior desired (i.e., opening the mouth), tell the child it is okay to yell if the treatment or procedure is uncomfortable, and use distractions. Explaining the procedure in detail and encouraging questions are appropriate interventions for an older child.
27. What are the basic fears of a young child being hospitalized? (Select all that apply.) a. Separation b. Permanent scarring c. Pain d. Cost e. Body intrusion
ANS: A, C, E Small children all share the same basic fears relative to hospitalization, which are separation from family, pain, and body intrusion or mutilation.
8. A nurse encourages a school-age child to draw a picture after a painful procedure. What is the best rationale for this nursing intervention? a. Attempting to re-establish rapport b. Providing a way for the child to express his feelings c. Encouraging quiet play d. Distracting the child from thinking about the pain
ANS: B After treatments, the nurse should encourage children to draw and talk about their drawings or to act out their feelings through puppet play.
16. When a 2-year-old returns to her hospital room following a diagnostic procedure, her parents are not available, and the child is crying loudly. Which technique is most appropriate to alleviate the child's distress? a. Rock the child gently to sleep. b. Play with the child using pop-up toys. c. Role play with the child to act out her feelings. d. Ask the child to draw a picture about her feelings.
ANS: B Distractions such as blowing bubbles, looking through a kaleidoscope, and playing with pop-up toys may help reduce anxiety and pain.
13. The mother of a hospitalized toddler states, "He cries when I visit. Maybe I should just stay away." What is the nurse's best response? a. "Perhaps you are right. He only gets upset when you have to leave." b. "It is important that you are here. This is a common reaction in children when they are separated from their parents." c. "It might be easier for your child if you would stay with him, but this decision is up to you." d. "We take good care of him and he seems fine when you are not here."
ANS: B During the second stage of separation anxiety (despair), the child is quiet, is not crying, and is sad and depressed. The child will revert to protest when the parent arrives for a visit.
20. The nurse explains to the parents of a hospitalized child that their child will receive fentanyl for an upcoming procedure. What advantage of fentanyl will the nurse explain? a. It is specifically designed for children. b. It has a rapid onset. c. It is nonaddicting. d. It has a long duration.
ANS: B Fentanyl is a drug useful for all ages because of its rapid onset and brief duration.
42. What statement about discharge planning for the pediatric patient is true? A. Continues after discharge B. Begins upon admission C. Is initiated by the pediatrician's office D. Begins when the parents are ready
ANS: B Rationale: Preparation for the patient's discharge ideally begins on admission, because the goal of hospitalization is to return a healthier and happier child to the parents
40. A hospitalized toddler requests a bottle for his juice, although he has been drinking from a cup at home. What instructions should the nurse provide to the parents? A. Encourage the child to use a straw. B. Praise appropriate behavior and ignore regressions. C. Redirect him and remind him he is a big boy who drinks from a cup. D. Distract him and provide the juice in a cup.
ANS: B Rationale: Regression should not be punished. Nurses can guide parents to praise appropriate behavior and ignore regressions. When the child is free of the stress that caused the regression, praise will motivate the achievement of appropriate behavior.
33. The best way to minimize separation anxiety in the hospital infant is to A. Explain routines carefully B. Encourage parents to room-in C. Provide age-appropriate roommate D. Provide an age appropriate toy
ANS: B Rationale: Rooming-in is highly desirable. When rooming-in is impossible, consistent caregivers should be assigned to care for the child and the parents.
34. Which statement by the parent of a hospitalized 4 year-old child indicated an understanding of the child's needs? A. "I am going to buy him a box of new toys to keep him busy while in the hospital." B. "I am going to bring some of his favorite toys from home for him to play with while he's in the hospital." C. "I'm glad there is a television in the room for him to watch all day." D. "I will stay every day and till he falls asleep and then I will go home."
ANS: B Rationale: The use of a transitional object, such as a blanket or a favorite toy from home, promotes security.
1. Which child would have the most difficulty in coping with separation from parents because of hospitalization? a. 3-month-old child b. 16-month-old child c. 4-year-old child d. 7-year-old child
ANS: B Separation anxiety occurs after age 6 months and is most pronounced in the toddler.
15. Which nursing action would facilitate rapport with a child and the child's parents during the admission process? a. Direct the parents to undress the child. b. Answer questions in a calm and matter-of-fact way. c. Perform assessments and ask questions as quickly as possible. d. Express concern about the seriousness of the child's condition.
ANS: B The nurse tries not to appear rushed. A matter-of-fact attitude must be maintained regardless of the child's condition.
3. Which statement best corresponds to a preschooler's understanding of hospitalization? a. "A germ made me get sick." b. "I got sick because I was mad at my brother." c. "My tonsils are sick and they have to come out." d. "I have a cast because I broke my leg."
ANS: B The preschooler may feel guilty, particularly if an accident happens as a result of mischief on his or her part.
10. The mother of a 3-year-old tells the nurse that she will be in to visit tomorrow around 12:00 PM. The next morning, the child asks the nurse, "When is my mommy coming?" What is the nurse's best response? a. "Your mommy will be here around noon." b. "Your mommy will be here when you have lunch." c. "Mommy will be here very soon." d. "Your mommy is coming in 4 hours."
ANS: B The toddler and preschooler do not understand time yet. They understand time relationships through activities in their experience, such as naptime and mealtimes.
24. The pediatric nurse is caring for child that weighs 15 kilograms and calls the physician for an order for Acetaminophen for pain control. What is the maximum amount of medication per dose the nurse anticipates ordering? a. 100 mg b. 150 mg c. 225 mg d. 250 mg
ANS: C Acetaminophen is commonly used for the relief of mild to moderate pain in infants and children. The maximum dose is 15 mg/kg/dose for infants and children, with a maximum of 5 doses in 24 hours.
22. The anxious parent asks if there is a danger of her 2-year-old child becoming addicted to the opioid pain reliever. What is the nurse's most helpful response? a. "Although this drug is addictive, the doctor monitors the dose very carefully." b. "Don't worry. Addicted children are very easy to wean off the drug." c. "Addiction is rare in children when opiates are given for pain." d. "Addictive behaviors are easy to assess. The drug will be stopped if that happens."
ANS: C Addiction is rare in children.
5. The nurse must make a room assignment for a 16-year-old with cystic fibrosis. Which roommate would be the most appropriate for this patient? a. A 4-year-old child who had an appendectomy b. A 10-year-old child with sickle cell disease in vaso-occlusive crisis c. A 15-year-old with type 1 diabetes mellitus d. To assign the adolescent to a private room
ANS: C Adolescents usually do better in rooms with one or more roommates than in single rooms. The adolescent would do best with a roommate who is closest to his or her age and also lives with a chronic illness.
11. A 13-year-old girl has been hospitalized for the past week. When discussing the girl's feelings about her illness, what would the nurse expect the girl to express as her biggest concern? a. Invasive procedures b. Loss of control c. Appearance d. Separation from her boyfriend
ANS: C Illness during early adolescence (12 to 15 years) is seen mainly as a threat to body image.
14. What should the nurse, preparing to collect an admission history from parents who have recently emigrated from Russia, keep in mind? a. Eye-to-eye contact is considered disrespectful. b. Touching the child's head means the nurse is superior. c. Smiling is inappropriate in a serious situation. d. Staring is a sign of the nurse's rudeness.
ANS: C In Russia, a smile indicates happiness and is inappropriate in a serious or sad situation.
4. The parents of a hospitalized toddler are upset because she seems more interested in her toys when they come to visit her. In which stage of separation anxiety is the toddler? a. Protest b. Despair c. Denial d. Attachment
ANS: C In the stage of denial or detachment, the child appears to deny the need for the parents and becomes uninterested in their visits.
32. Assessment of pain is considered a fifth vital sign to be documented by the nurse. The nurse understands that pain in infants? A. Cannot be reliably assessable B. Will not be remembered by the infant C. Can be assessed by observation of behavior D. Is usually caused by fear and anxiety
ANS: C Rationale: In infants, pain may be assessed according to a behavior scale that includes tightly closed eyes, clenched fists, and a furrowed brow.
35. A 4 year-old hospitalized child wets his bed. The parents tell the nurse and the child was completely toilet trained. What should the nurse understand? A. The parents are denying a problem exists. B. The child may be developmentally delays. C. The child may be experiencing regression. D. The child is probably "punishing" the parents.
ANS: C Rationale: Regression is the loss of an achieved level of functioning that previously had been successful to a past level of behavior.
30. Parents are preparing their child for admission to the pediatric unit for minor surgery. What should they expect to see when visiting the pediatric unit? (Select all that apply.) a. Nurses wearing all white b. Formal atmosphere c. Availability of a playroom d. Dim lighting e. Colored bedding
ANS: C, E The children's hospital unit differs in many respects from adult divisions. The pediatric unit or hospital is designed to meet the needs of children and their parents. A cheerful, casual atmosphere helps to bridge the gap between home and hospital and is in keeping with the child's emotional, developmental, and physical needs. Nurses wear colorful uniforms, and colored bedspreads and wagons or strollers for transportation provide a more homelike atmosphere. The physical structure of the unit includes furniture of the proper height for the child, soundproof ceilings, and color schemes with eye appeal. Most pediatric departments include a playroom.
36. Which of the following can be a result of acetaminophen toxicity? A. Gastrointestinal distress B. Cerebral impairment C. Decreased urinary output D. Liver failure
ANS: D Rationale: Acetaminophen toxicity involves liver failure.
38. What pain indicator rated on a 1-to-10 scale can be used with nonverbal children? A. PICIC B. Wong-Baker scale C. Nomogram D. FLACC
ANS: D Rationale: The FLACC scale is a pain indicator that can be used with nonverbal children and is rated on a scale of 0 to 2 for each observation, with 10 being the highest level of pain.
37. The pediatric nurse is discharging a 3-year-old patient of Asian descent. When explaining the discharge instructions to the patient's parents, the nurse notices they are not making eye contact. What factor should be considered by the nurse to be accurate about this situation? A. The parents are not paying attention. B. The parents have a language barrier. C. The parents do not understand the information. D. The parents may consider eye contact to be disrespectful.
ANS: D Rationale: The parents may consider eye contact to be disrespectful. In the United States, eye-to-eye contact with the person with whom one is communicating is considered a show of respect and attention. In some Asian cultures, however, eye-to-eye contact is seen as disrespect
6. The parents of a hospitalized 9-month-old infant ask if their preschool child may visit his younger sibling. What understanding would assist the nurse most in formulating a response? a. Preschool children can be disruptive in the hospital environment. b. Seeing his younger sibling would probably frighten the preschooler and thus should be avoided. c. The sibling could view the infant from the doorway but not enter the room to prevent the spread of microorganisms. d. The preschooler needs to visit his infant sister to reassure himself that she is all right.
ANS: D Siblings are affected by a child's hospitalization. Their ability to cope is influenced by their age, experience, and intactness of the family.
12. The nurse notices that the mother of a child with cerebral palsy corrects and redoes many of the things the nurse does for her child. What is the nurse's most appropriate response to this mother? a. "Would you like to do all of your child's care?" b. "I'm doing the very best job that I can with your child." c. "Why don't you go have a cup of coffee? You are going to be exhausted if you don't take a break." d. "I'd love for you to share with me some of the special things you do for your child."
ANS: D The person who cares daily for the child with a chronic illness can provide information that will best guarantee continuity of care between the home and the hospital.
17. A 4-year-old begins to cry when his mother tells him it is time for his operation. The nurse understands this is an expected reaction. On which particular fear of the preschooler does the nurse base this understanding? a. Loss of control b. Restricted mobility c. Unfamiliar routines d. Invasive procedures
ANS: D The preschool-age child is afraid of bodily harm, particularly invasive procedures.
A child hospitalized for treatment of osteomyelitis complains that he is tired of being sick and wants to know when the antibiotic protocol will end. How long will the nurse indicate that antibiotic therapy will probably last? a. 2 weeks b. 6 weeks c. 2 months d. 3 months
b
A child is diagnosed with nonparalytic strabismus. How will this disorder most likely be corrected? a. Patching the unaffected eye b. Corrective lenses c. Laser treatment d. Surgery
b
A 6-year-old sustained a fractured femur and was put in Russell traction 2 days ago. She screams in pain when she raises herself onto the bedpan. Which nursing diagnosis takes highest priority for this child? a. Pain resulting from tissue trauma b. High risk for impaired skin integrity resulting from immobility c. Altered growth and development related to separation from family d. Altered urinary elimination related to immobility and traction
a
A parent reports that her child has begun to do poorly at school and experiences episodes where he appears to be staring into space. Of which type of seizure is this behavior a characteristic? a. Absence b. Akinetic c. Myoclonic d. Complex partial
a
An adolescent has just had a generalized seizure and collapsed in the school nurses office. When should the nurse should call 911? a. The seizure lasts more than 5 minutes. b. The child is sleepy and lethargic after the seizure. c. The child fell at the onset of the seizure. d. The child is confused and has slurred speech after the seizure.
a
On entering the room of a child in Bucks traction, the nurse makes all of the following observations. Which observation requires a nursing intervention? a. Childs heels are placed firmly against the foot of the bed. b. Head of bed is elevated 20 degrees. c. Weights are hanging freely. d. Ropes are on pulleys.
a
Parents of a 10-year-old child diagnosed with an intellectual deficit are sharing multiple approaches they implement in dealing with various challenges. Which of the following a statements by the parents alerts the nurse that they need further instruction? a. We dress our son every morning for school. b. Our son participates in the Special Olympics every year. c. Our son attends play therapy at a center close to home. d. We attend a support group once a week.
a
The nurse is checking for capillary refill on a child in Bryants traction. How long does it take for the toe to regain color if adequate perfusion is assessed? a. 3 seconds b. 4 seconds c. 5 seconds d. 6 seconds
a
The nurse is providing instructions about how to treat a sprained ankle. What statement by the mother does the nurse recognize as indicative of a need for additional teaching? a. Apply warm compresses to the ankle for the first 24 hours. b. Put an ice pack on the ankle, alternating 30 minutes on with 30 minutes off. c. Wrap the ankle in an Ace bandage for support. d. Keep the leg elevated when sitting.
a
What intervention is appropriate for a nurse assessing a preadolescent child for scoliosis? a. Ask the child to bend forward at the waist and observe the childs back for asymmetry. b. Observe the gait while the child is walking forward heel to toe. c. Have the child flex the knees and look for uneven knee height. d. Look at the childs shoulders and hips while fully clothed.
a
What might the nurse explain as a common treatment for amblyopia? a. Patching the good eye to force the brain to use the affected eye b. Patching the affected eye to allow the refractory muscles to rest c. Using glasses that will slightly blur the image for the good eye d. Using corticosteroids to treat inflammation of the optic nerve
a
What nursing action will significantly decrease the risk of serious complications for a child in Bryants traction? a. Neurovascular checks are done frequently. b. Bandages are wrapped tightly. c. The child is restrained from rolling over. d. The childs buttocks are resting on the bed
a
Which assessment finding in a child with meningitis should be reported immediately? a. Irregular respirations b. Tachycardia c. Slight drop in blood pressure d. Elevated temperature
a
Which observation may cause the nurse to consider the possibility of child abuse when a mother says that her young child fell down the basement stairs? a. Red, green, and yellow bruises on his body b. Bruises are dispersed on his head, arms, and legs c. A broken arm last year, and the child being described as accident-prone d. The mother is very anxious for her son to get medical attention
a
Which aspect(s) of a childs development does the nurse caution parents that hearing impairment can affect? (Select all that apply.) a. Speech clarity b. Language development c. Immunity to disease d. Personality development e. Academic achievement
a, b, d, e
The nurse is educating parents on prevention of eyestrain in their 5-year-old child. What information will the nurse include? (Select all that apply.) a. Encourage books with large type. b. Words in books should be closely spaced. c. Provide adequate lighting without glare. d. Be sure desks and chairs are adequate height. e. Instruct child to squint when reading.
a, c, d
What intervention(s) would the nurse caring for a child with infectious meningitis include? (Select all that apply.) a. Isolation precautions b. Provision of brightly lit room c. Observation for increasing intracranial pressure d. Preparation for spinal tap e. Seizure precautions
a, c, d, e
What will the nurse include then documenting a grand mal seizure? (Select all that apply.) a. Presence of incontinence b. Current dose of antispasmodic medication c. Activity level prior to and following seizure d. Level of consciousness following seizure e. Length of seizure
a, c, d, e
A 13-year-old girl is diagnosed with functional scoliosis. What does the nurse explain as the cause of this spinal curvature defect? a. Juvenile rheumatoid arthritis b. Poor posture c. Heredity d. Myelomeningocele
b
The nurse is caring for a 3-year-old with a head injury. Which assessment would lead the nurse to report the probability of increasing intracranial pressure (ICP)? a. Temperature increase from 37.2 C (99 F) to 37.7 C (100 F) b. Increase in blood pressure with an attendant decrease in pulse c. Increase in respirations d. Equilateral pupils
b
The nurse is reviewing the characteristics of Ewings sarcoma. Which statement if made by the nurse indicates correct understanding of this disease? a. Amputation is the accepted treatment. b. The disease is sensitive to radiation and chemotherapy. c. Metastasis is rare. d. The disease is more prevalent among toddlers and preschoolers.
b
The parent of a child with osteomyelitis asks why his child is in so much pain. What will the nurse respond causes the pain experienced with osteomyelitis? a. Pressure of inelastic bone b. Purulent drainage in the bone marrow c. The cast applied on the extremity d. Circulatory congestion of the skin
b
What assessment made by the school nurse would lead to the suspicion of strabismus? a. Reddened sclera in one eye b. Child covers one eye to read the chalkboard c. Child complains of a headache d. Copious tears while watching TV
b
What intervention will the nurse caring for a child in Bucks skin traction implement? a. Position in high Fowlers position. b. Assist the child to be pulled up in bed. c. Keep childs heel on the bed surface. d. Maintain childs feet against the foot of the bed.
b
What is an appropriate nursing action when a child is experiencing a generalized tonic-clonic seizure? a. Guide the child to the floor if the child is standing, and then go for help. b. Move objects out of the childs immediate area. c. Stick a padded tongue blade between the childs teeth. d. Manually restrain the child.
b
What would the nurse consider an abnormal finding on a musculoskeletal assessment of a 4-year-old child? a. Has inward-turned knees while standing b. Walks on the toes c. Appears to have flat feet d. Swings his arms when walking
b
Which intervention would be helpful in relieving morning discomfort associated with juvenile rheumatoid arthritis? a. Wearing splints at night to prevent extension contractures b. Applying moist heat packs upon awakening c. Taking a warm tub bath the evening before d. Sleeping with two pillows under the head
b
An 8-year-old near-drowning victim is rushed into the ED. What priorities of care will be implemented? (Select all that apply.) a. Parental education regarding prevention b. Respiratory support c. Cardiovascular support d. Controlled rewarming e. Adequate cerebral oxygenation
b, c, d, e
Which assessments would cause the pediatric nurse to suspect the probability of an ear infection in a 6-month-old child? (Select all that apply.) a. Hypersensitivity to noise b. Irritability c. Reddened ear canal d. Rolls head from side to side e. Temperature of 39.4 C (103 F)
b, d, e
A child is admitted to the hospital because she had a seizure. Her parents report that for the past few weeks she has had headaches, with vomiting, that are worse in the morning. What does the nurse suspect? a. Meningitis b. Reyes syndrome c. Brain tumor d. Encephalitis
c
A child is brought to the emergency department after he fell and hit his head on the ground. Which nursing assessment suggests the child has a concussion? a. Sleepy but easily arousable b. Complaining of a stiff neck c. Cannot remember what happened to him d. Pupils react sluggishly to light
c
A pediatric nurse is assisting with the care of a child diagnosed with a fractured femur. What type of fracture would be the most likely to alert the nurse to the possibility of physical abuse? a. Stress fracture b. Compound fracture c. Spiral fracture d. Greenstick fracture
c
Approximately how old does the nurse assess a large green bruise on the thigh of a 4-year-old to be? a. 2 days b. 4 days c. 6 days d. 8 days
c
The nurse assessing a child with juvenile rheumatoid arthritis notes the childs right knee and ankle are swollen, warm, and tender. The child has a temperature of 38.8 C (102 F) and abdominal pain. What type of juvenile rheumatoid arthritis do these findings suggest? a. Psoriatic b. Enthesitis c. Systemic d. Acute febrile
c
The nurse is planning to teach parents about prevention of Reyes syndrome. What information would the nurse include in this teaching? a. Use aspirin instead of acetaminophen for children with viral illness. b. Advise parents to have their children immunized against Reyes syndrome. c. Avoid giving salicylate-containing medications to a child who has viral symptoms. d. Get the child tested for Reyes syndrome if the child exhibits fever, vomiting, and lethargy.
c
The nurse observes a childs position is supine with his arms and legs rigidly extended and the hands pronated. How does the nurse identify this posture? a. Correct anatomical position b. Decorticate c. Decerebrate d. Opisthotonos
c
The nurse observes that the legs of a child with cerebral palsy cross involuntarily, and the child exhibits jerky movements with his arms as he tries to eat. The nurse recognizes that he has which type of cerebral palsy? a. Athetoid b. Ataxic c. Spastic d. Mixed
c
The nurse urges the mother of a 6-month-old to get her child inoculated with Haemophilus influenzae type B. What does this immunization protect against? a. Encephalitis b. Influenza c. Bacterial meningitis d. Otitis media
c
What assessment does the school nurse recognize as the cardinal sign of a hyphema? a. Opacity of the lens b. A yellow-white reflex on the pupil c. A dark-red spot in front of the iris d. Inflamed mucous membranes of the eyelids
c
What characteristic manifestation does the nurse caring for a child with Duchennes muscular dystrophy document? a. Ambulates by holding onto furniture b. Exhibits atrophy of the calf muscles c. Falls frequently and is clumsy d. Has delayed fine-motor development
c
What instruction would the nurse provide to an adolescent who has been fitted with a Milwaukee brace? a. Wear the brace directly against the skin. b. Wear the brace over regular clothing. c. Wear the brace over a T-shirt 23 hours a day. d. Remove the brace before sleeping
c
What would the nurse include in teaching when preparing to teach parents about air travel instructions to prevent barotrauma in infants? a. Using ear plugs during takeoff b. Omitting the meal just before takeoff c. Letting the infant nurse during descent d. Applying ear drops before takeoff
c
What would the nurse include when creating a teaching plan that includes the long-term administration of phenytoin (Dilantin)? a. The medication should be given on an empty stomach. b. Insomnia can be a significant side effect. c. Gums should be massaged regularly to prevent hyperplasia. d. Blood pressure should be closely monitored.
c
What would the nurse include when planning postoperative teaching for a child who has had a tympanostomy with insertion of tubes? a. Keeping the infant flat after feeding b. Giving over-the-counter decongestants c. Avoiding getting water in the ears d. Cleaning the ear canal with cotton-tipped applicators
c
A parent comments that her infant has had several ear infections in the past few months. Why are infants more susceptible to otitis media? a. Infants are in a supine or prone position most of the time. b. Sucking on a nipple creates middle ear pressure. c. They have increased susceptibility to upper respiratory tract infections. d. The eustachian tube is short, straight, and wide.
d
How does Russell traction provide adequate skin traction? a. Subluxates the tibia b. Does not interfere with range of motion c. Prevents the knee from flexing d. Supplies continuous pull in two directions
d
The nurse is performing a neurological assessment on a 10-month-old infant using a modified Glasgow Coma Scale. What score will the nurse give if the child is babbling? a. 1 b. 2 c. 3 d. 4
d
What does the nurse explains to parents of a child with febrile seizures? a. They occur when the body temperature exceeds 38.3 C (101 F). b. They can be prevented by anticonvulsant medication. c. They usually lead to the development of epilepsy. d. They occur when the temperature rises quickly.
d
What finding would the nurse assessing the neurovascular status of a child in Russell traction report immediately? a. Skin thats warm to the touch b. Capillary refill less than 3 seconds c. Ability to wiggle toes d. Bluish coloration of skin
d
What statement by a patients mother leads the nurse to determine she understands instructions about administering an oral antibiotic for otitis media? a. I will continue using the medication until symptoms are relieved. b. I will share the medicine with siblings if their symptoms are the same. c. I will give the medication with a glass of milk. d. I will administer prescribed doses until all the medication is used
d
Which situation would cause the nurse to suspect a hearing impairment? a. 3-month-old infant with a positive Moro reflex b. 15-month-old toddler who is babbling c. 18-month-old toddler who is speaking one-syllable words d. 24-month-old toddler who communicates by pointing
d
Why does a childs fracture heal more rapidly than the adults? a. A childs bones are less porous than adult bone. b. A childs bones are covered by a thicker periosteum. c. A childs bones are not affected by bone overgrowth. d. A childs bones have faster callus formation.
d
