Exam 2 PrepU Questions

A group of students are reviewing information about acute rheumatic fever. The students demonstrate a need for additional review when they identify what as a major Jones criterion? a. arthralgia b. carditis c. erythema marginatum d. subcutaneous nodules

a. arthralgia

The nurse will select which meal as the best choice for a child with iron-deficiency anemia? a. cheeseburger, broccoli, and fresh strawberries b. chicken breast, French fries, and sweetened tea c. peanut butter sandwich, cheese stick, and applesauce d. two slices of pepperoni pizza and a glass of skim milk

a. cheeseburger, broccoli, and fresh strawberries

A child is diagnosed with rheumatic fever. For which medication will the nurse educate the caregivers? a. nonsterioidal anti-inflammatory drugs (NSAIDs) b. antiviral c. insulin d. phenytoin

a. nonsterioidal anti-inflammatory drugs (NSAIDs)

The nurse has been asked to participate in a community health teaching session. Which interventions would the nurse include to help achieve the 2030 National Health Goals to reduce the incidence of anemias? Select all that apply. A. Explain the importance of healthy eating for adolescent participants. B. Instruct pregnant women to take iron supplementation as prescribed. C. Emphasize ways to reduce unintentional injuries at home, work, and play. D. Review foods that are rich in iron that should be a part of a school-age child's diet. E. Examine strategies for elderly community members to improve the quality of life.

A. Explain the importance of healthy eating for adolescent participants. B. Instruct pregnant women to take iron supplementation as prescribed. D. Review foods that are rich in iron that should be a part of a school-age child's diet.

A child with hemophilia A has had repeated episodes of hemarthrosis. Which assessment finding is most important to consider? a. Increased muscle strength b. Decreased range of motion c. Enlargement of the joint space d. Increased cartilage formation

b. Decreased range of motion

A nurse is instructing the parents of a child who is suspected of having pinworms on how to check their child. Which instruction is appropriate? a. Look on the child's bed linens for evidence of black dots. b. Inspect the child's anus with a flashlight 2 to 3 hours after the child is asleep. d. Check the washcloth after having the child wipe themselves during bathing. d. Observe the characteristics of the child's stool, which will be watery.

b. Inspect the child's anus with a flashlight 2 to 3 hours after the child is asleep.

A nurse is providing care to a child with idiopathic thrombocytopenic purpura with a platelet count of 18,000/mm3 μl (18,000 x 109/L). Which medication would the nurse most likely expect to be ordered? a. Folic acid b. Intravenous immune globulin c. Dimercaprol d. Deferoxamine

b. Intravenous immune globulin

After teaching a group of students about acute rheumatic fever, the instructor determines that the teaching was successful when the students identify which assessment finding? a. Janeway lesions b. Jerky movements of the face and upper extremities c. Black lines d. Osler nodes

b. Jerky movements of the face and upper extremities

A 3-year-old child is hospitalized with a diagnosis of sickle cell anemia and is experiencing a pain crisis. Using the FACES scale, the nurse assesses the child's pain to be a 10 on a scale of 1 to 10. The child is receiving intravenous fluids and oxygen at 2 L/min via nasal cannula. The parent is at the bedside holding the child's hand and has a concerned look. What is the nurse's priority in caring for the child? a. Ask the parent if he or she has questions about the plan of care. b. Provide diversional activities for the child. c. Implement strategies to address the child's pain. d. Contact the health care provider to meet with the parent.

c. Implement strategies to address the child's pain.

The nurse is providing teaching to the parents of a child with varicella. Which statement indicates that the parents have understood the instructions? a. "We should apply alcohol to the lesions every four hours." b. "If he has a fever, we can give him some aspirin." c. "The lesions should eventually form soft crusts that drain." d. "We need to make sure that he washes his hands frequently."

d. "We need to make sure that he washes his hands frequently."

After teaching the parents of a child with chickenpox (varicella zoster), the nurse determines that the parents have understood the teaching when they state that their child can return to school at which time? a. After day 5 of the rash b. When the rash is completely healed c. Once the rash appears d. After the lesions have crusted

d. After the lesions have crusted

The nurse is caring for a child who has been admitted for a sickle cell crisis. What would the nurse do first to provide adequate pain management? a. Administer a nonsteroidal anti-inflammatory drug (NSAID) as ordered. b. Use guided imagery and therapeutic touch. c. Administer meperidine as ordered. d. Initiate pain assessment with a standardized pain scale.

d. Initiate pain assessment with a standardized pain scale.

A child in the clinic has a fever and reports a sore neck. Upon assessment the nurse finds a swollen parotid gland. The nurse suspects which infectious disease? a. Measles b. Mumps c. Whooping cough d. Scabies

b. Mumps

It is determined that a preschooler developed anemia after exposure to an insecticide. What should the nurse teach the parents before the child is discharged from the hospital? A. Schedule weekly chelating treatments. B. Provide the child with a high-protein diet. C. Schedule hospital visits to desensitize the child to the insecticide. D. Ensure that the child has no further exposure to the insecticide.

D. Ensure that the child has no further exposure to the insecticide.

When conducting a physical examination of a child with suspected Kawasaki disease, which finding would the nurse expect to assess? a. Hirsutism or striae b. Strawberry tongue c. Malar rash d. Café au lait spots

b. Strawberry tongue

A 6-year-old child is diagnosed with pulmonary stenosis. Upon entering the room, the nurse finds the parent crying. The parent states, "I do not have any idea of the treatment for this condition and I am scared." Which nursing response is most accurate? a. "Having your child in the hospital is scary. Treatment includes the insertion of a catheter with an uninflated balloon into the affected valve, followed by inflation of the balloon to restore blood flow." b. "You are being very brave. I know this is hard. Luckily, no treatment for this condition is necessary, because the defect will resolve itself spontaneously." c. "I agree. It is hard to be in the hospital. Treatment will include the insertion of dacron-coated, stainless-steel coils by interventional cardiac catheterization." d. "I am happy to tell you about the treatment. Your child will need surgical closure by ductal ligation. I can have you complete the surgical consent now if you like."

a. "Having your child in the hospital is scary. Treatment includes the insertion of a catheter with an uninflated balloon into the affected valve, followed by inflation of the balloon to restore blood flow."

The parents of a 10-year-old boy bring the child to the clinic for an evaluation. Which statement by the parents would alert the nurse to the possibility of rheumatic fever? a. "He had a pretty bad sore throat about 10 days ago." b. "His fever has been running around 100°F (37.8°C) the past 2 days." c. "We noticed a white, thick coating on his tongue yesterday." d. "He's been tired the last several days."

a. "He had a pretty bad sore throat about 10 days ago."

The nurse is providing child and family education prior to discharge following a cardiac catheterization. The nurse is teaching about signs and symptoms of complications. Which statement by the mother indicates a need for further teaching? a. "The feeling of the heart skipping a beat is common." b. "We need to avoid a tub bath for the next 3 days." c. "Strenuous activity should be limited for the next 3 days." d. "We need to watch for changes in skin color or difficulty breathing."

a. "The feeling of the heart skipping a beat is common."

A nurse is explaining the immunotherapy regimen to the mother of a child with multiple allergies. During the teaching session, the mother asks, "Why do we need to stay in the clinic for a half-hour after the shot?" Which response by the nurse would be best? a. "We can act quickly if your child has a reaction to the injection." b. "Staying in the clinic for that time is required by our clinic policy and protocols." c. "It's standard operating procedure whenever any medicine is given by injection." d. "The primary health care provider wants to make sure that the medicine is effective."

a. "We can act quickly if your child has a reaction to the injection."

A nurse is teaching the parents of a child diagnosed with rheumatic fever about prescribed drug therapy. Which statement would indicate to the nurse that additional teaching is needed? a. "We can stop the penicillin when her symptoms disappear." b. "If she needs dental surgery, we might need additional medication." c. "She needs to take the drug for the full 14 days." d. "To prevent another episode, she'll need preventive antibiotic therapy for at least 5 years."

a. "We can stop the penicillin when her symptoms disappear."

The nurse is caring for a 13-year-old girl with von Willebrand disease. After teaching the adolescent and her parents about this disorder and care, which response by the parents indicates a need for additional teaching? a. "We need to administer Stimate (desmopressin) prior to dental work." b. "We should be aware that she may suffer from menorrhagia." c. "We should administer desmopressin as often as needed." d. "We understand that she may have frequent nosebleeds."

a. "We need to administer Stimate (desmopressin) prior to dental work."

A 5-year-old is being prepared for diagnostic cardiac catheterization, in which the catheter will be inserted in the right femoral vein. What intervention should the nurse take to prevent infection? a. Avoid drawing a blood specimen from the right femoral vein before the procedure b. Keep the child NPO for 2 to 4 hours before the procedure c. Record pedal pulses d. Apply EMLA cream to the catheter insertion site

a. Avoid drawing a blood specimen from the right femoral vein before the procedure

The nurse is caring for a 10-year-old boy with hemophilia. He asks the nurse for suggestions about appropriate physical activities. Which activity would the nurse most likely recommend? a. Baseball b. Football c. Wrestling d. Soccer

a. Baseball

A 6-year-old girl had a cardiac catheterization at 9 a.m. At 11 a.m. the nurse notes hypotension as compared to baseline. Based on this assessment finding, which of the following would the nurse do first? a. Check the insertion site. b. Recheck the blood pressure every 15 minutes. c. Assess the child's temperature. d. Check the toes' capillary refill.

a. Check the insertion site.

Individuals with hemophilia B have a deficiency in factor IX, which can cause excessive blood loss. What is another name for this clotting factor? a. Christmas factor b. Stuart factor c. Antihemophilic factor d. Proconvertin

a. Christmas factor

The nurse is caring for an infant who exhibits characteristics of allergies. Which suggestion(s) for the parents are helpful in minimizing allergy development? Select all that apply. a. Discontinue cigarette smoking. b. Open the house windows for air circulation. c. Keep the room dust-free. d. Use laundry detergent that has as few chemicals as possible. e. Avoid perfumes and room fresheners.

a. Discontinue cigarette smoking. c. Keep the room dust-free. d. Use laundry detergent that has as few chemicals as possible. e. Avoid perfumes and room fresheners.

A nurse is teaching a school-aged child with iron-deficiency anemia and her parents about dietary measures to increase iron intake. The nurse determines that the teaching was successful when they state which food is high in iron? Select all that apply. a. Eggs b. Fortified cereal c. Green leafy vegetables d. Citrus fruits e. Milk

a. Eggs b. Fortified cereal c. Green leafy vegetables

A nurse is preparing a presentation for a group of new parents and is planning to discuss nutrition during the first year. As part of the presentation, the nurse is planning to address foods that should be avoided to reduce the risk of possible food allergies. Which foods would the nurse most likely include? Select all that apply. a. Eggs b. Shrimp c. Peanuts d. Carrots e. Potatoes f. Bananas

a. Eggs b. Shrimp c. Peanuts

The nurse is performing echocardiography on a newborn who is suspected of having a congenital heart defect. The child's mother is concerned about the safety of using this on a newborn and wants to know how this technology works. The nurse assures her that this technology is very safe and may be repeated frequently without added risk. What should the nurse mention in explaining how this diagnostic test works? a. High-frequency sound waves are directed toward the heart b. X-rays are directed toward the heart c. A radioactive substance is injected intravenously into the bloodstream and is traced and recorded on video d. A microphone is placed on the child's chest to record heart sounds and translate them into electrical energy

a. High-frequency sound waves are directed toward the heart

When describing anaphylaxis to a group of parents whose children have experienced anaphylaxis from insect stings, the nurse integrates knowledge that this response is related to which immunoglobulin? a. IgE b. IgG c. IgA d. IgM

a. IgE

A 15-year-old boy visits his primary care physician's office with fever, headache, and malaise, along with complaints of pain on chewing and pain in the jawline just in front of the ear lobe. The boy asks his mother to leave the exam room for a minute and then tells the nurse that he is also experiencing testicular pain and swelling. The nurse recognizes that this client most likely has which condition? a. Mumps b. Infectious mononucleosis c. Poliomyelitis d. Herpes zoster

a. Mumps

The nurse is assessing a child who presents with a history of fever, malaise, fatigue, and headache. The nurse notes a bulls-eye rash on the child's right leg. Which action will the nurse take? a. Notify the primary health care provider. b. Place the child on contact precautions. c. Obtain an electrocardiography (ECG). d. Clean the rash with rubbing alcohol.

a. Notify the primary health care provider.

A 1-year-old with tetralogy of Fallot turns blue during a temper tantrum. What will the nurse do first? a. Place child in the knee-to-chest position. b. Assess for an irregular heart rate. c. Listen for an increased respiratory rate. d. Explain to the child the need to calm down.

a. Place child in the knee-to-chest position.

An infant with tetralogy of Fallot becomes cyanotic. Which nursing intervention would be the first priority? a. Place the infant in the knee-chest position. b. Start an IV for fluids. c. Prepare the infant for surgery. d. Raise the head of the bed.

a. Place the infant in the knee-chest position.

A mother brings her 8-year-old son for evaluation because of a rash on his lower leg. Which finding would support the suspicion that the child has Lyme disease? a. Playing in the woods about a week ago b. Rash is papular and vesicular c. High fever occurring about 4 days before the rash d. Reports of extreme pruritus with visible nits

a. Playing in the woods about a week ago

When developing the postoperative plan of care for a child with sickle cell anemia who has undergone a splenectomy, which would the nurse identify as the priority? a. Risk for infection b. Impaired skin integrity c. Deficient fluid volume d. Risk for delayed growth and development

a. Risk for infection

What is a true statement regarding varicella zoster virus infection? a. Secondary bacterial infections of the skin can occur. b. The incubation period is 7 days. c. It is transmitted by fecal-oral route. d. It tends to be more severe in children.

a. Secondary bacterial infections of the skin can occur.

The mother of a 5-year-old girl brings the child to the clinic for an evaluation. The mother tells the nurse, "She seems to be so tired and irritable lately. And she looks so pale." Further assessment reveals pale conjunctiva and oral mucous membranes. The nurse suspects iron-deficiency anemia. Which additional finding would help provide additional evidence for this suspicion? a. Spooned nails b. Negative splenomegaly c. Oxygen saturation: 99% d. Bradycardia

a. Spooned nails

An adolescent comes to the clinic reporting a sore throat and chills. The nurse suspects that the adolescent has infectious mononucleosis. Which instruction(s) will the nurse provide to this adolescent? Select all that apply. a. Take acetaminophen for fever and pain. b. Rest and sleep when possible. c. Sleep in a high Fowler position. d. Increase acidic fluid intake. e. Eat soft, nonirritating foods.

a. Take acetaminophen for fever and pain. b. Rest and sleep when possible. e. Eat soft, nonirritating foods.

A cardiac nurse is examining a 10-year-old child with a documented heart murmur. On auscultation, the nurse assesses that the murmur occurs only during systole, is short, and sounds soft and musical. When the child is standing, the nurse can no longer hear the murmur upon auscultation. Upon completion of the assessment, which nursing action is appropriate? a. The nurse would document the findings and state, "Your child has an innocent heart murmur, which is not a cause for concern." b. The nurse would express concern for the child and stress to limit physical activity until further treatment is completed. c. The nurse would notify the health care provider of the continued presence of a murmur and begin referral paperwork to a cardiologist. d. The nurse would have another nurse evaluate the murmur but not discuss the findings with the parent as there is no reason for alarm.

a. The nurse would document the findings and state, "Your child has an innocent heart murmur, which is not a cause for concern."

A nurse is caring for an infant who just had open-heart surgery and the parents are asking why there are wires coming out of the infant's chest. What is the best response by the nurse? a. These wires are connected to the heart and will detect if your infant's heart gets out of rhythm. b. The wires are measuring the fluid level in the heart. c. The wires are left in the heart for 1 month after surgery in case of potential arrhythmias. d. The wires will administer ongoing electrical shocks to the heart to maintain rhythm.

a. These wires are connected to the heart and will detect if your infant's heart gets out of rhythm.

A child with a congenital heart defect is getting an echocardiogram. How would the nurse describe this test to the parent? a. This test will check how blood is flowing through the heart. b. This noninvasive test will check the electrical impulses in the heart. c. This test will only determine the size of the heart. d. This invasive test will measure the blockage in the heart.

a. This test will check how blood is flowing through the heart.

Parents bring their 9-year-old child to the clinic for a well-child visit. They are concerned because several children in the neighborhood have developed Lyme disease and ask for suggestions on what to do to reduce their child's risk. What would be appropriate for the nurse to suggest? Select all that apply. a. Wearing protective clothing when playing in wooded areas. b. Dressing the child in dark clothing when going outdoors. c. Inspecting the skin closely for ticks after the child plays in wooded areas. d. Removing ticks by rubbing them away from the skin with a credit card. e. Contacting the health care provider if there is any area of inflammation that might be a bite.

a. Wearing protective clothing when playing in wooded areas. c. Inspecting the skin closely for ticks after the child plays in wooded areas. e. Contacting the health care provider if there is any area of inflammation that might be a bite.

A 10-week-old infant continues to have a small ventricular septal defect (VSD) and is prescribed digoxin. When evaluating the infant's response to drug therapy, which assessment finding is related to the therapeutic action of the medication? a. a reduced fluid accumulation in the lungs b. a resolving infection of the heart c. the dilation (dilatation) of the coronary vessels d. the closing of the septal defect

a. a reduced fluid accumulation in the lungs

The nurse is providing care for a 13-year-old child diagnosed with iron-deficiency anemia. The client's current hemoglobin level is 11 g/dL (110 g/L). Which intervention will the nurse anticipate including in the client's care? a. giving ferrous sulfate with orange juice between meals b. packed red blood cell transfusions c. providing a high dose of intravenous immunoglobulin weekly d. increasing the daily intake of fresh fruits and vegetables

a. giving ferrous sulfate with orange juice between meals

The nurse is caring for a child with severe allergies to mold, dust, and feathers. Therapeutic management for this child would include which of the following? Select all that apply. a. hyposensitizing the child to mold, dust, and feathers b. IM injection of epinephrine c. Reducing the child's exposure to mold, dust, and feathers d. Modifying the child's response to the allergens with cetirizine

a. hyposensitizing the child to mold, dust, and feathers c. Reducing the child's exposure to mold, dust, and feathers d. Modifying the child's response to the allergens with cetirizine

When caring for a child with Kawasaki disease, the nurse would know that: a. management includes administration of aspirin and IVIG. b. joint pain is a permanent problem. c. antibiotics should be administered every 8 hours by IV. d. steroid creams are used for the hand peeling.

a. management includes administration of aspirin and IVIG.

The nurse develops a meal plan for a child with iron-deficiency anemia. Which meal would the nurse teach the parent has the highest amount of iron? a. red meat, eggs, oatmeal, and dried fruit b. chicken, corn, brown rice, and oranges c. pork, broccoli, white rice, and strawberries d. tuna salad with eggs, whole wheat crackers, and blueberries

a. red meat, eggs, oatmeal, and dried fruit

The nurse is providing care to a 8-year-old child who has had open-heart surgery. The nurse is concerned that the child has developed postcardiac surgery syndrome. Which assessment finding(s) prompts the nurse to notify the surgeon? Select all that apply. a. temperature of 102.6°F (39.2°C) b. ultrasound of the heart revealing heart lining inflammation c. the ability to identify the spleen by palpation d. a maculopapular rash on the chest e. blood pressure of 106/50 mm Hg

a. temperature of 102.6°F (39.2°C) b. ultrasound of the heart revealing heart lining inflammation

The nurse is caring for a 12-year-old boy with idiopathic thrombocytopenia. The nurse is providing discharge instructions about home care and safety recommendations to the boy and his parents. Which response indicates a need for further teaching? a. "We should avoid aspirin and drugs like ibuprofen." b. "He can resume participation in football in 2 weeks." c. "Swimming would be a great activity." d. "Our son cannot take any antihistamines."

b. "He can resume participation in football in 2 weeks."

The nurse will administer what medication to children with Kawasaki disease both in the acute and later stages of the illness? a. penicillin b. aspirin c. intravenous immune globulin d. iron

b. aspirin

A parent phones the nurse stating their 5-year-old child has lesions similar to those of varicella. The parent states the child is itchy and uncomfortable. Which statement by the parent will the nurse clarify? a. "I have placed gloves on both of my child's hands so they will not scratch and cause an infection." b. "I am going to give my child a baby aspirin to decrease their itchiness and so they can rest better." c. "I will try an oatmeal bath or oatmeal cream with an antihistamine to soothe the child's lesions." d. "I will keep my child home from school until all of the lesions have completely crusted over."

b. "I am going to give my child a baby aspirin to decrease their itchiness and so they can rest better."

In discussing the causes of iron-deficiency anemia in children with a group of nurses, the following statements are made. Which of these statements is a misconception related to iron-deficiency anemia? a. "A family's economic problems are often a cause of malnutrition." b. "Milk is a perfect food, and babies should be able to have all the milk they want." c. "Caregivers sometimes don't understand the importance of iron and proper nutrition." d. "Children have a hard time getting enough iron from food during their first few years."

b. "Milk is a perfect food, and babies should be able to have all the milk they want."

A nurse is providing teaching to the parents of a child diagnosed with sickle cell anemia. The discussion is focused on precipitating factors for sickle cell crisis. Which statement by the parents requires the nurse to reinforce the teaching? a. "I make sure my child wears a good warm coat and gloves during winter." b. "Our family is taking a fun hiking trip up in the mountains next week." c. "We always take water along when we are on an outing." d. "I make sure our child is up to date on all immunizations."

b. "Our family is taking a fun hiking trip up in the mountains next week."

A mother asks the nurse why her infant who was born at 34 weeks' gestation is being prescribed ferrous sulfate. Which response by the nurse is most appropriate? a. "Infants with pyloric stenosis require ferrous sulfate." b. "Preterm infants are at risk for iron-deficiency anemia." c. "Your infant may have been having excessive diarrhea." d. "Ferrous sulfate helps improve red blood cell formation."

b. "Preterm infants are at risk for iron-deficiency anemia."

A couple is expecting a child. The fetus undergoes genetic testing and the couple discover the fetus has sickle cell disease. The couple ask the nurse how most commonly happens. Which statement is accurate for the nurse to provide? a. "Sickle cell disease occurs from a random genetic mutation." b. "Sickle cell disease is passed to a fetus when both parents have the gene." c. "Sickle cell disease is passed to a fetus when one of the parents has the gene." d. "Sickle cell diseas can be passed to the fetus in many ways. We will know more at birth."

b. "Sickle cell disease is passed to a fetus when both parents have the gene."

The child is prescribed liquid ferrous sulfate. The nurse should encourage the child to take which action immediately after each dose to best eliminate possible side effects? a. Drink a glass of milk b. Brush his or her teeth c. Remain in an upright position for at least 15 minutes d. Not eat or drink for one hour

b. Brush his or her teeth

a high school football player presents to the school nurse with malaise, fever, headache, and anorexia that have been present for the last few days. Upon physical examination, the nurse notes the cervical lymph nodes are firm and tender, and the tonsils are red and enlarged and appear to have a white covering. After advising the client to see their primary health care provider, what other information is a priority? a. Gargle with warm salt water four times daily. b. Discontinue all contact sports. c. Rest when fatigued. d. Use acetaminophen for discomfort.

b. Discontinue all contact sports.

Infectious mononucleosis ("mono") is caused by which of the following? a. Treponema pallidum b. Epstein-Barr virus c. Microsporum canis d. Streptococcal bacterium

b. Epstein-Barr virus

A toddler who is beginning to walk has fallen and hit his head on the corner of a low table. The caregiver has been unable to stop the bleeding and brings the child to the pediatric clinic. The nurse is gathering data during the admission process and notes several bruises and swollen joints. A diagnosis of hemophilia is confirmed. This child most likely has a deficiency of which blood factor? a. Factor V b. Factor VIII c. Factor X d. Factor XIII

b. Factor VIII

While assessing a neonate with a ventricular septal defect (VSD), the nurse notes crackles and retractions. The nurse obtains the following vital signs: temp 100.2°F (38°C), pulse 134 bpm, respirations 64 breaths/minute, oxygen saturation 97% on room air. What will the nurse do first? a. Advise the mother to bottle feed. b. Give furosemide intravenously. c. Administer acetaminophen rectally. d. Apply oxygen 10 liters/min (LPM) via oxyhood.

b. Give furosemide intravenously.

When teaching a group of new parents about newborn care and development, which immunoglobulin would the nurse explain as being primarily responsible for the passive immunity exhibited by newborns? a. IgA b. IgG c. IgM d. IgE

b. IgG

Which immunoglobin occurs most frequently in plasma and is the major immunoglobulin synthesized during secondary response? a. IgM b. IgG c. IgA d. IgD

b. IgG

A nurse is teaching the parents of a child with sickle cell disease about factors that predispose the child to a sickle cell crisis. The nurse determines that the teaching was successful when the parents identify what as a factor? a. Fluid overload b. Infection c. Respiratory distress d. Pallor

b. Infection

The nurse is caring for child who present to the emergency department with reports of a fever for 5 days. The nurse notes a diffuse maculopapular rash, reddened cracked lips, erythema of hands, and bilateral conjunctivitis and suspects Kawasaki disease. Which nursing action is priority? a. Place the child on a soft diet. b. Initiate intravenous access. c. Administer acetaminophen. d. Assess cervical lymph nodes.

b. Initiate intravenous access.

A 7-year-old child with an earache comes to the clinic. The child's parent reports that 1 day ago the child had a fever and headache and did not want to play. When the nurse asks where it hurts, the child points to the jawline in front of the earlobe. What does the nurse expect the diagnosis will be for this child? a. Measles b. Mumps c. Mononucleosis d. Fifth disease

b. Mumps

A nurse is preparing a teaching plan about environmental control measures for the parents of a child with an allergy. Which recommendation(s) will the nurse include? Select all that apply. a. replacing wooden chairs with more comfortable upholstered furniture b. removing any fur or woolen items from the child's wardrobe c. encasing the mattress and pillow in sturdy plastic d. installing air conditioning in the home e. opening the windows when there is a breeze

b. removing any fur or woolen items from the child's wardrobe c. encasing the mattress and pillow in sturdy plastic d. installing air conditioning in the home

A child with a suspected cardiovascular disorder is to undergo diagnostic testing and is scheduled for an echocardiogram. When explaining this test to the child, what would the nurse most likely include? a. "This test will check the pattern of how your heart is beating." b. "They'll take a picture of your chest to look at the heart's size." c. "A special wand that picks up sound is used to check your heart." d. "Small patches are attached to your chest to check the heart rhythm."

c. "A special wand that picks up sound is used to check your heart."

The nurse is caring for a 9-month-old infant newly diagnosed with atopic dermatitis. The parents are concerned about the dry skin patches and abrasions caused by the infant scratching. The nurse instructs the parent regarding the use of hydrocortisone cream. Which parent statement demonstrates the priority information? a. "We will continue using the hydrocortisone cream until the rash goes away." b. "I can use the hydrocortisone cream as many times a day as necessary." c. "I know I have to follow all the directions while using the hydrocortisone cream." d. "If the cream does not seem to be helping, I will stop using it."

c. "I know I have to follow all the directions while using the hydrocortisone cream."

The nurse is caring for a toddler taking ferrous sulfate for severe iron-deficiency anemia. Which report by the parent is mostconcerning? a. "I brush my child's teeth once every day." b. "My child's stools are darker than usual." c. "I mix ferrous sulfate with milk in a bottle." d. "My child takes ferrous sulfate after meals."

c. "I mix ferrous sulfate with milk in a bottle."

The parents of a 5-month-old infant diagnosed with humoral IgA deficiency question the nurse about why the infant was not diagnosed sooner. Which response by the nurse most appropriate? a. "There is no treatment or cure specific for IgA deficiency in children." b. "IgA deficiency is usually found when evaluating for another illness." c. "Maternal antibodies crossed the placenta and that prevented infections until now." d. "This is associated with allergies, which may not be noted prior to 5 months."

c. "Maternal antibodies crossed the placenta and that prevented infections until now."

The nurse is reinforcing teaching with a group of caregivers of children diagnosed with iron-deficiency anemia. One of the caregivers tells the group, "I give my child ferrous sulfate." Which statement made by the caregivers is correct regarding giving ferrous sulfate? a. "When I give my son ferrous sulfate I know he also needs potassium supplements." b. "I always give the ferrous sulfate with meals." c. "My husband gives our daughter orange juice when she takes her ferrous sulfate, so she gets Vitamin C." d. "We watch closely for any diarrhea since that usually happens when he takes ferrous sulfate."

c. "My husband gives our daughter orange juice when she takes her ferrous sulfate, so she gets Vitamin C."

The nurse is reinforcing teaching with the caregivers of a child with rheumatic fever. Which statement made by the caregivers best indicates an understanding of the treatment regimen? a. "She will be on a high sodium diet until the symptoms go away." b. "Keeping her involved in her regular sports activities will be important." c. "She'll be so happy about watching a movie while on bed rest." d. "If she cuts herself, we know to keep that part of her body elevated above the heart."

c. "She'll be so happy about watching a movie while on bed rest."

A nurse is conducting a class to a group of parents on sickle cell anemia. Which statement by a parent indicates teaching has been effective? a. "This is a hereditary disease that is transmitted by one affected gene." b. "Sickle cell anemia is common in people of Asian descent." c. "The sickle shape of red blood cells decreases oxygen to tissues." d. "Fluid restriction is necessary to control sickle cell anemia."

c. "The sickle shape of red blood cells decreases oxygen to tissues."

The nursing is caring for a hospitalized child diagnosed with varicella-zoster virus. The child's parents ask how to prevent the child's siblings from contracting the virus. Which response by the nurse is best? a. "Vaccinating your other children is the only way to prevent them from contracting the virus." b. "Since this is a virus, there is nothing you can do to prevent your other children from getting it." c. "We will place your child on contact and airborne precautions. It is best for the other children not to visit." d. "As long as your other children wash their hands, they should not contract the virus."

c. "We will place your child on contact and airborne precautions. It is best for the other children not to visit."

The caregiver of a child with sickle cell disease asks the nurse how much fluid her child should have each day after the child goes home. In response to the caregiver's question, the nurse would explain that for the child with sickle cell disease, it is best that the child have: a. 300 to 800 ml of fluid per day. b. 1,000 to 1,200 ml of fluid per day. c. 1,500 to 2,000 ml of fluid per day. d. 2,500 to 3,200 ml of fluid per day.

c. 1,500 to 2,000 ml of fluid per day.

The parents of a 3-month-old infant report concerns the infant is irritable, feeds poorly, and has a rash. The nurse notes weeping, crusty lesions on the infant's cheeks and neck. Which action by the nurse is most appropriate? a. Advise the parents to change the infant's formula. b. Instruct the parents to soak the lesions in mineral oil. c. Contact the health care provider to request treatment. d. Encourage parents to avoid feeding the infant peanuts.

c. Contact the health care provider to request treatment.

The nurse is caring for a child who is receiving a skin test to determine the presence of allergies. A positive skin test for one particular allergen shows the mediation of which type of immune globulin? a. IgG b. IgM c. IgE d. IgA

c. IgE

The nurse is developing a plan of care for a child who is to have a transfusion. Which would the nurse expect to administer because it is the most common form of transfusion? a. Washed red blood cells b. Whole blood c. Packed red blood cells d. Plasma factors

c. Packed red blood cells

In caring for the child with rheumatic fever, the nurse recognizes that which nursing diagnosis would be most important to include in this child's plan of care? a. Delayed growth and development b. Risk for aspiration c. Risk for acute pain d. Disturbed body image

c. Risk for acute pain

A nurse is promoting vaccine administration. When instructing on the physiological changes, which statement best explains what occurs in the child when vaccines are administered? a. The child develops a passive immunity. b. The child becomes a carrier of the disease. c. The child develops an active immunity. d. The child becomes a host for the disease.

c. The child develops an active immunity.

The nurse is caring for a child admitted to the hospital for an open fracture of the femur following a motor vehicle accident. The nurse notes the following lab values: white blood cells 10,000/mm3, hemoglobin 7.9 g/dl (79 g/L), hematocrit 28%, platelets 151,000/mm3. Which nursing action is priority? a. Ask the child to rate pain on a scale 0 to 10. b. Administer antibiotics intravenously stat. c. Transfuse 1 unit of packed red blood cells. d. Provide the family with preoperative instructions.

c. Transfuse 1 unit of packed red blood cells.

The nurse is caring for a child with rheumatic fever who has polyarthritis. Which lab result would the nurse most anticipate with this child's diagnosis and symptoms? a. increased clotting time b. decreased white blood cell count (WBC) c. increased erythrocyte sedimentation rate (ESR) d. decreased leukocyte count

c. increased erythrocyte sedimentation rate (ESR)

A client's newborn is diagnosed with Tetralogy of Fallot. When explaining this condition to the client, which of the following defects would the nurse's description include? a. atrial septal defect b. stenosis of the aorta c. overriding of the aorta d. left ventricular hypertrophy

c. overriding of the aorta

A child diagnosed with hemophilia presents with warm, swollen, painful joints. Which action will the nurse take first? a. Document the presence of hemarthrosis in the client's chart b. Notify the client's primary health care provider c. Assess the client's urine and stool for blood d. Prepare to administer factor replacement medication

d. Prepare to administer factor replacement medication

What information should be included in the teaching plan for a child with varicella? a. Administer aspirin for fever. b. Place the child in a warm bath for skin discomfort. c. Utilize salt solutions to assist in healing oral lesions. d. Remind the child not to scratch the lesions.

d. Remind the child not to scratch the lesions.

Which problem-based nursing care plan will the nurse indicate as priority for the child following cardiac surgery for tetralogy of Fallot? a. surgical site infection risk b. acute parental anxiety c. fluid overload risk d. altered cardiopulmonary tissue perfusion risk

d. altered cardiopulmonary tissue perfusion risk

The nurse is educating a child with a peanut allergy about the signs and symptoms of an anaphylactic reaction. The nurse realizes additional teaching is needed when the child identifies which sign/symptom? a. nausea b. anxiety c. itchy mouth d. constipation

d. constipation

After teaching a group of students about hemophilia, the instructor determines that the students have understood the information when they identify hemophilia A as involving a problem with: a. platelets. b. factor IX. c. plasmin. d. factor VIII.

d. factor VIII.

A 17-year-old is diagnosed with infectious mononucleosis. The nurse should discuss which intervention with the teenager's caregiver to best assure an uncomplicated recovery? a. admission to the hospital for about 7 days b. a 10-day course of antibiotics c. a high-protein, high-fiber, low-fat diet d. precautions to avoid secondary infections

d. precautions to avoid secondary infections

When the nurse is instructing on disease transmission, which is noted as the smallest infectious agent known? a. fungus b. bacteria c. yeast d. virus

d. virus