NUR 113 Exam 5 Practice Questions

To prevent meningococcal infections, the nurse would administer: Vaccine Toxoid Immune globulin Antivenin

Vaccine

The nurse knows the medication methylphenidate is used to treat attention deficit hyperactivity disorder(ADHD). What type of medication is methylphenidate? a selective serotonin reuptake inhibitor (SSRI) a central CNS stimulant a respiratory stimulant an anorectic agent

a central CNS stimulant

The parents of a 9-year-old child ask the nurse for information about quadrivalent human papillomavirus recombinant vaccine. Which information is appropriate for the nurse to provide? Select all that apply. It is ideally given before the child is sexually active. It prevents a common cause of cervical cancer. It prevents sexually transmitted infections. It produces short-term immunity. It can be given to boys and girls.

It is ideally given before the child is sexually active. It prevents a common cause of cervical cancer. It can be given to boys and girls.

The parents of a 4-year-old boy tell the nurse, "We're really worried that our child doesn't have 20/20 vision. It seems that he doesn't always see clearly at a distance." What is the best response by the nurse? "20/20 vision isn't usually achieved until the age of 6 or 7 years but I will let the physician know your concerns." "We don't check a child's vision until they are 6 to 7 years old because their visual acuity hasn't peaked until then." "Until your child can read we can't check the visual acuity." "Vision continues to improve as the child ages. Hopefully you will notice improvement in your child's vision."

"20/20 vision isn't usually achieved until the age of 6 or 7 years but I will let the physician know your concerns."

An older adult tells the nurse, "My friend just developed shingles and has a lot of pain. Is there a way for me to protect myself from it?" How should the nurse respond? "Avoid children and people with shingles." "Ask your healthcare provider about a herpes zoster vaccine." "Use antiviral drugs as soon as you are exposed." "Apply a topical anesthetic agent."

"Ask your healthcare provider about a herpes zoster vaccine."

A nurse is administering a mumps vaccine to an adolescent. Which medication should be available when administering an immunization? Diphenhydramine Hydroxyzine Physostigmine Epinephrine

Epinephrine

The mental health nurse assesses for the most common mental health disorder found in children when asking which question? "Do you ever get scolded at school for not sitting still? "Are you sad often?" "Do you ever hear voices in your head telling you what to do?" "What makes you afraid or nervous?"

"Do you ever get scolded at school for not sitting still?

The mother of a 13-year-old child with special needs reports concerns with her child's requests to eat lunch in the cafeteria at school with the rest of the children as opposed to eating in the nurse's office. What information should be contained in the nurse's response? "There are problems monitoring your child's intake if she eats in the cafeteria so this practice should be discouraged." "Efforts should be made to accommodate your child's request." "Perhaps the school will allow your child to have a few friends to eat in the nurses' office with her." "Maybe you or another family member could go to the school and eat with your child so she is not forced to eat alone."

"Efforts should be made to accommodate your child's request."

The parents of a 7-year-old tell the nurse that they are concerned that their child has attention deficit hyperactivity disorder (ADHD) because he can't seem to stay focused when playing in a baseball game. What questions/comments by the nurse are appropriate? Select all that apply. "Many boys of this age have ADHD. He may need to have medication prescribed." "How is his attention span during school?" "Do you notice him getting distracted in other activities, like bicycling?" "Young boys get easily distracted during baseball." "He is rather young developmentally to be playing a sport like baseball."

"How is his attention span during school?" "Do you notice him getting distracted in other activities, like bicycling?"

The nurse manager is orienting a new nurse. Which statement by the new nurse would indicate that the nurse manager should intervene? "I will document the date and time the vaccine was given in the child's permanent record." "I do not need to document the vaccine manufacturer's name in the child's permanent record." "If a child receives a vaccine at another facility, we will need to document it in the child's permanent record." "If a child has a fever after a vaccine, I do not have to report it to the Vaccine Adverse Event Reporting System."

"I do not need to document the vaccine manufacturer's name in the child's permanent record."

The parents of a 17-year-old adolescent diagnosed with bacterial meningitis tell the nurse, "We just do not understand how this could have happened. Our adolescent has always been healthy and just received a booster vaccine last year." How should the nurse respond? "I understand your frustration. Unfortunately, immunizations are not 100% effective in preventing the infection." "Meningococcal conjugate vaccine covers only two types of bacterial meningitis." "Your child may have been exposed to the type of meningitis that is not covered by the vaccine received." "Maybe your child's immune system is not strong enough to fight off the infection, even with having received the vaccine."

"I understand your frustration. Unfortunately, immunizations are not 100% effective in preventing the infection."

Methylphenidate hydrochloride has been prescribed for a child with attention deficit hyperactivity disorder. The nurse should make which statements to the child's parents? Select all that apply. "You will see a positive response to methylphenidate hydrochloride in approximately 8 weeks." "You should give the dose to your child right before evening bedtime." "Extended-release tablets may be crushed or chewed." "If discontinued, methylphenidate hydrochloride must be tapered off slowly." "If the symptoms do not improve, the medication may need to be adjusted."

"If discontinued, methylphenidate hydrochloride must be tapered off slowly." "If the symptoms do not improve, the medication may need to be adjusted."

A 9-year-old child with attention deficit hyperactivity disorder (ADHD) has been placed on the stimulant methylphenidate. The nurse knows that the teaching has been effective when the parents make which statement? "This drug will have an effect on our child in about 2 weeks." "We'll bring our child in every week to get blood levels drawn." "Our child knows to take this medication once every 12 hours." "Our child may have some side effects, like insomnia, headache, or stomach ache."

"Our child may have some side effects, like insomnia, headache, or stomach ache."

Which statement by parents of a teenager with special needs causes the nurse to believe additional teaching would be helpful? "Our daughter wants to get her ears pierced. We've told her she can't. She'd have too much trouble with the earrings." "Our daughter is embarrassed about needing help with her menstrual periods, but we're troubleshooting ways for her to manage." "Our daughter has friends in her special needs club and also in the youth group at church." "Our daughter has decided not to participate in hippotherapy this year. We think it helped her balance. She disagrees, so we will go with her decision."

"Our daughter wants to get her ears pierced. We've told her she can't. She'd have too much trouble with the earrings."

A pregnant woman reports she is interested in breastfeeding to promote improved health for her child. Which statement by the nurse is most appropriate? "Breastfeeding will improve your child's health." "Breastfeeding provides what is called active immunity." "Passive immunity can be transmitted to your child providing him with some temporary immunity against illness." "Lifelong immunity is provided against some bacterial illnesses from breasting."

"Passive immunity can be transmitted to your child providing him with some temporary immunity against illness."

The nurse is educating a 13-year-old paintball enthusiast about sports-related injuries. Which comment is most likely to be accepted by the child? "Play tough, but wear protective gear." "Most sports injuries happen to guys your age." "Paintball eye injuries have doubled in the past two years." "56% of paintball eye injuries have poor outcomes."

"Play tough, but wear protective gear."

The mother of a 10-day-old infant reports her baby has been having "lots of eye discharge." What is the best initial response by the nurse? "This is normal in infants of this age." "Tell me more about this drainage." "Do you think this looks like an infection?" "Your baby will need to be seen by a neonatal ophthalmologist."

"Tell me more about this drainage."

The nurse is caring for a family of premature infant boy. The parents asks the nurse, "Why do we need to bring in the car seat we bought for him? He isn't going home for another week." What is the best response by the nurse? "We need to assure it is a safe car seat." "We document the brand and size of the car seat." "The baby is not permitted to go home in an unapproved car seat." "The baby will be tested for oxygen desaturation while seated in the car seat"

"The baby will be tested for oxygen desaturation while seated in the car seat"

The parent of a child having tympanoplasty tubes placed asks, "Will my child lose hearing while the tubes are in place?" What is the nurse's best answer? "The tubes are inserted into a section of eardrum in which the hearing is not affected." "There is some risk of permanent deafness, but the benefit of decreasing the infection is worth it." "Your child's hearing will decrease while the tubes are in place." "Have you asked your child's surgeon about that?"

"The tubes are inserted into a section of eardrum in which the hearing is not affected."

The nurse is discussing measles, mumps, and rubella vaccination with a mother who is concerned about using the combined vaccine for her 12-month-old. Which statement by the nurse will be most helpful to the mother in accepting the vaccine? "The vaccine is shown to be effective and safe and will reduce the number of injections your child will need." "It is one of the most commonly used childhood vaccines." "This vaccine is approved by the American Academy of Pediatrics." "This vaccine is recommended by the Centers for Disease Control and Prevention."

"The vaccine is shown to be effective and safe and will reduce the number of injections your child will need."

The nurse is educating the parents of a 7-year-old boy who has hearing loss due to otitis media with effusion. Which statement by the parents indicates that further education is needed? "We need to raise the volume of our voices significantly so he can hear us." "We need to make sure we are speaking clearly." "We need to face our son when we are speaking." "Using hand gestures as visual cues should help our child understand a little better."

"We need to raise the volume of our voices significantly so he can hear us."

The nurse is working with the parents of an infant and has initiated a dialogue about immunizations. The infant's parent states, "We're not comfortable with immunizations because of the safety issue." What is the nurse's best response? "What are some of the safety risks that most concern you?" "Did you read about the risks of immunizations on the internet?" "The benefits of immunizations far outweigh any of the potential risks." "Immunizations have been proven to be safe and effective and are in your child's best interests."

"What are some of the safety risks that most concern you?"

A 13-year-old adolescent is being treated for scoliosis with a brace. During the first follow-up appointment after the brace was initiated, which statement by the adolescent indicates the need for further instruction? "I check my brace daily to make sure there is no damage or change to it." "I leave my brace on for gym at school." "When I get home from school, I look forward to taking off my brace for a few hours before I go to bed." "I wear a t-shirt under my brace."

"When I get home from school, I look forward to taking off my brace for a few hours before I go to bed."

Using the recommended immunization schedule for infants, the nurse administers vaccines in what order from first to last? Click an option, hold and drag it to the desired position, or click an option to highlight it and move it up or down in the order using the arrows to the left. measles, mumps, rubella (MMR) hepatitis B (HepB) influenza rotavirus (RV)

1hepatitis B (HepB) 2rotavirus (RV) 3influenza 4measles, mumps, rubella (MMR)

A nurse has been asked to identify children with attention deficit hyperactivity disorder (ADHD) in a school. Which children should the nurse identify as having ADHD? Select all that apply. A child who has limited facial expressions and poor eye contact A child who is not able to dress himself or herself independently A child who makes excessive noise by tapping the desk A child who verbally abuses other children in the class A child who does not follow instructions in class

A child who makes excessive noise by tapping the desk A child who does not follow instructions in class

The nurse is teaching a group of parents about eyes and eye concerns. The nurse tells these caregivers about a condition that occurs when unequal curvatures in the cornea bend the light rays in different directions and this causes images to be blurred. The condition the nurse is referring to is: Refraction Myopia Astigmatism Hyperopia

Astigmatism

The nurse is caring for an infant who has undergone surgery for infantile glaucoma. What is the priority nursing intervention? A. Place the child prone postoperatively for comfort. B. Teach the family use of the contact lens. C. Place elbow restraints on the infant. D. Provide a mobile for optical stimulation.

C. Place elbow restraints on the infant.

A young child in the clinic has watery eyes and reddened conjunctiva. The child keeps the eyes closed a lot, because it hurts to have them open. Which problem does the nurse suspect for this client? Chalazion Stye Conjunctivitis Blepharitis marginalis

Conjunctivitis

The nurse is teaching the parents of a child who is receiving a vaccine about possible adverse effects. Which would the nurse include as necessitating an immediate call to the health care provider? Pain at the injection site Moderate fever Difficulty breathing Nodule formation at the site

Difficulty breathing

The nurse is educating the parents of an 18-month-old child being prepared to receive cochlear implants. Which statement by the parents requires further teaching? After the implant surgery our child will have normal hearing. We have arranged for speech-language therapy after the implant is activated. Our child will have hearing tests to assess how the implant is working. The cochlear implant must heal and will be activated 2 to 3 weeks after surgery.

After the implant surgery our child will have normal hearing.

Which of the following is accurate regarding acquired immunity? Select all that apply. An immunologic response acquired during life but not present at birth Usually develops as a result of exposure to an antigen through immunization Can develop by contracting a disease A nonspecific immunity present at birth Also know as innate immunity

An immunologic response acquired during life but not present at birth Usually develops as a result of exposure to an antigen through immunization Can develop by contracting a disease

The 12-year-old child has developed a stye. Which may be included in the child's care? Apply hot, moist compresses to the affected area. Manually express the lesion when a head forms. Apply petroleum jelly to reduce irritation. Apply cool, dry compresses to the affected area.

Apply hot, moist compresses to the affected area.

A client will be receiving a hepatitis B vaccination series prior to employment in a dialysis center. What type of immunity will this provide? Forced immunity Naturally acquired active immunity Passive immunity Artificially acquired active immunity

Artificially acquired active immunity

The nurse is preparing a nursing care plan for a 2-year-old child with hearing impairment. Which intervention will be part of the plan? Assess vision to determine functional capability. Explain botulinum injection procedure and risks. Teach parents to make vinegar and alcohol eardrops. Assess the child's ability to convey information.

Assess the child's ability to convey information.

Which is an antidepressant used to treat attention deficit hyperactivity disorder (ADHD)? Atomoxetine Amphetamine Pemoline Dextreamphetamine

Atomoxetine

An adult client being treated for breast cancer inquired about required vaccinations. What information should the nurse provide to this client? Avoid all live vaccines. Be immunized against pneumococcal disease promptly. Receive a tetanus-diphtheria-pertussis booster. Avoid all immunizations for the next 24 months.

Avoid all live vaccines.

The nurse is caring for a child with cerebral palsy who requires a wheelchair to attain mobility. Which intervention would help the child achieve a sense of normality? A. Encourage follow-through with physical therapy exercises. B. Restrict the child to a special needs classroom. C. Encourage after-school activities within the limits of the child's abilities. D. Ensure the school is aware of the child's capabilities.

C. Encourage after-school activities within the limits of the child's abilities.

A 7-year-old child with cerebral palsy has been admitted to the hospital. Which information is most important for the nurse to obtain in the history? A. Age that the child learned to walk B. Parents' expectations of the child's development C. Functional status related to eating and mobility D. Birth history to identify cause of cerebral palsy

C. Functional status related to eating and mobility

Which situation would cause the nurse to become concerned about possible hearing loss? A. A 12-month-old who babbles incessantly, making no sense B. An 8-month-old who says only "da" C. A 3-month-old who startles easily to sound D. A 3-year-old who drops the letter "s"

B. An 8-month-old who says only "da"

A 2-year-old has been prescribed eye patching for strabismus 6 hr/day. What teaching does the nurse provide for the mother? A. Try to patch 6 hr/day, but if you miss some, it is OK. B. Patching is necessary to strengthen vision in the weaker eye. C. Patching will keep the eye from turning in. D. Since the child is so young, patching can be delayed until school age.

B. Patching is necessary to strengthen vision in the weaker eye.

A 4-year-old child is having a vision screening performed. Which screening chart would be best for determining the child's visual acuity? A. Snellen B. Ishihara C. Allen figures D. CVTME

C. Allen figures

The parents of a 5-year-old with special health care needs talk to the parents of a 10-year-old with a similar condition for quite a while each day. What is the nurse's interpretation of this behavior? A. The nurse has not provided enough emotional support for the parents. B. This relationship between the children's parents is potentially unhealthy. C. Support between parents of special children is extremely valuable. D. Confidentiality is a pressing issue in this particular situation.

C. Support between parents of special children is extremely valuable.

The nurse educator is teaching a class of community leaders about immunologic agents. To minimize the concern regarding adverse effects of vaccinations, the nurse should include which mild reactions in the teaching plan? Chills and fever Insomnia and hyperactivity Nausea and vomiting Rash and itching

Chills and fever

The nurse is caring for a child with a developmental disability who is starting kindergarten this year. The mother is tearful and doesn't want the child to go to school. What is the best response by the nurse? A. "Do you need some time alone to collect yourself?" B. "You've known for a while this time would come." C. "Can I call your husband or a friend for you?" D. "It is normal to feel stressed or sad at this time."

D. "It is normal to feel stressed or sad at this time."

A 15-month-old girl is having her first health supervision visit at your facility. Her mother has not brought a copy of the child's immunization record but believes she is fully immunized: "She had immunizations 3 months ago at the local health department." Which would be the best action by the nurse? A. Ask the mother to bring the records to the 18-month health supervision visit. B. Start the "catch-up" schedule because there are no immunization records. C. Keep the child at the facil

D. Call the local health department and verify the child's immunization status.

A 4-year-old complains of extreme pain when the tragus is touched. Though not diagnostic, this sign is most indicative of which disorder? A. Acute otitis media B. Acute tympanic effusion C. Otitis interna D. Otitis externa

D. Otitis externa

The nurse is preparing to administer a diphtheria, tetanus and pertussis vaccine to a 3-year-old child. Which version of the formulation of the vaccine should be administered? DTaP DPT TdaP DT

DTaP

Dexmethylphenidate has been prescribed to Scott, a 7-year-old boy who was diagnosed with ADHD. The mother asks how this medication will help her son. Which would be the most accurate description of the purpose of this medication? Dexmethylphenidate will increase Scott's ability to understand information better. Dexmethylphenidate will stabilize Scott's mood so that he can concentrate. Dexmethylphenidate will improve Scott's attention span so that he will be able to complete a task. Dexmethylphenidate will improve Scott's memory.

Dexmethylphenidate will improve Scott's attention span so that he will be able to complete a task.

During a developmental screening, the nurse notes the toddler is not meeting expected developmental milestones. What is the best action by the nurse? Encourage the family to provide specific developmental tasks to correct the delay. Ask the family if they have a preference of hospitals for an overnight stay for further evaluation. Discuss the delay in milestones with the primary care provider and family. Tell the parents they should monitor the child closely for changes over the next year.

Discuss the delay in milestones with the primary care provider and family.

In children with otitis media, a procedure known as a myringotomy may be performed. Which statement is most accurate regarding this procedure? During this procedure, small tubes are inserted into the tympanic membrane. This procedure is performed as soon as otitis media is diagnosed. A small incision is made in the earlobe during this procedure. The purpose of this procedure is to decrease or stop the drainage.

During this procedure, small tubes are inserted into the tympanic membrane.

The nurse is planning the care of a 5-year-old child with developmental disabilities whose weight is at the 12th percentile for her age. The care team and the child's parents have agreed that interventions are necessary. Which intervention should be added to the plan of care? Encourage the parents to maintain a detailed log of the child's food and fluid intake. Facilitate the insertion of a peripherally inserted central catheter for parenteral nutrition. Allow the child to choose which foods to eat and which foods to reject. Encourage the family to provide a low-fat, high-carbohydrate diet.

Encourage the parents to maintain a detailed log of the child's food and fluid intake.

The nurse is caring for a family with a chronically ill adolescent. The parents are frustrated that the adolescent will not complete the treatment plan during the school day. Which approach by the nurse will be most appropriate? Instructing the adolescent to do the treatment plan during the school day. Encouraging the parents to let go and not be frustrated with the child. Explaining to the parents that the adolescent may be struggling to fit in with his peers. Telling the adolescent that he is still a child and should do as his parents say.

Explaining to the parents that the adolescent may be struggling to fit in with his peers.

The nurse is caring for a 12-month-old with autism spectrum disorder (ASD). What description would you expect to elicit from his mother on history-taking? He responds warmly to his father but not to his mother. He sleeps at least 12 out of every 24 hours. He stares at a rotating wheel on his crib mobile. He already speaks in complete sentences.

He stares at a rotating wheel on his crib mobile.

The nurse is instructing an adolescent who is not sexually active on potential vaccinations available. Which vaccination would the nurse state that decreases the risk of cervical cancer? Hepatitis B Human papilloma viral (HPV) Herpes zoster Meningococcal

Human papilloma viral (HPV)

Which is considered a hyperactive/impulsive behavior seen in attention deficit hyperactivity disorder (ADHD)? Inability to play quietly Avoiding tasks requiring mental effort Making careless mistakes Frequent forgetfulness in daily activities

Inability to play quietly

Which behavior typical of children with autism spectrum disorder (ASD) requires the nurse to maintain special care to keep them safe? A fascination with bright colors Insensitivity to pain A craving for salt Loss of hearing for high frequencies

Insensitivity to pain

The nurse is caring for a child who has conductive hearing loss. What is true regarding this type of hearing loss? It is caused by chronic otitis media or another infection. It is caused by maternal rubella. It is generally severe and unresponsive to medical treatment. It is often undetected until the child goes to school.

It is caused by chronic otitis media or another infection

Which medication is effective in 70% to 80% of children with attention deficit hyperactivity disorder (ADHD)? Methylphenidate Dextroamphetamine Pemoline Amphetamine

Methylphenidate

A client develops fever and arthralgia 4 days after the administration of tetanus toxoid. What reaction to the vaccine is this? Infectious process Anaphylaxis Serum sickness Distress syndrome

Serum sickness

The nurse is developing a care plan for a client diagnosed with attention deficit hyperactivity disorder (ADHD). The nurse teaches the client to take the last dose of dextroamphetamine when? Midnight Noon At 6 p.m. At 9 p.m.

Noon

A nurse is assessing a child with attention deficit hyperactivity disorder. Which assessment finding is the nurse likely to see in this child? Select all that apply. Stuttering Overactivity Attentiveness Impulsiveness Stereotypical movements

Overactivity Impulsiveness

A client is being prescribed dextroamphetamine for the treatment of attention deficit hyperactivity disorder (ADHD). During health education, the nurse should make the client aware of the black box warning relating to what potential risk issue? Kidney failure Potential for abuse Stroke with excessive doses Unstable blood glucose levels

Potential for abuse

What would be the priority goal for the nurse caring for an infant diagnosed with nonorganic failure to thrive? Teach the parent not to spoil the infant. Provide adequate nutrition for growth. Praise positive parenting. Keep the skin dry and intact.

Provide adequate nutrition for growth.

A 5-year-old child is diagnosed with acute otitis media. Which nursing intervention would be priority? Relieving the child's pain Administering a mydriatic Cautioning the child not to pull on the ear Cautioning the child not to blow the nose

Relieving the child's pain

The nurse is conducting a class for pregnant women on problems associated with infections seen in women during gestation. One mother tells the nurse that she has never had chickenpox (varicella) and is worried she will contract it before she delivers. What would the nurse explain to this mother to ease her anxiety? She can receive her varicella vaccine immediately after delivery, followed by a second dose at her 6-week postpartum visit. The likelihood of her catching varicella is very slim, so tell her not to worry. She needs to let her physician know that she has not had varicella so she can get immunized at her next visit. Even if she does get varicella, her baby will be fine since varicella is not passed on to the fetus.

She can receive her varicella vaccine immediately after delivery, followed by a second dose at her 6-week postpartum visit.

Before administering an immunization to their child, the nurse asks parents to take which priority action? Reassure the child. Sign a consent form. Provide the child's immunization record. Assist in restraining the child.

Sign a consent form.

An elementary school nurse is conducting a program for parents on attention deficit hyperactivity disorder (ADHD). What is the most important information for the nurse to include in the program? Boys with ADHD show more aggression than girls with ADHD. Diagnosis usually occurs before the child reaches school age. Sleep disturbances are common for children with ADHD. The child will have fatigue from the increased activity level.

Sleep disturbances are common for children with ADHD.

A group of students are reviewing the various causes of bacterial conjunctivitis in children. The students demonstrate understanding of this condition when they identify what as the most common cause? Staphylococcus aureus Streptococcus pneumoniae Haemophilus influenzae Chlamydia trachomatis

Staphylococcus aureus

What would the nurse identify as a vaccine that is a toxoid? Haemophilus influenza B Pneumococcal polyvalent Tetanus Hepatitis A

Tetanus

A nurse is working with a child undergoing behavioral modification therapy for attention deficit hyperactivity disorder (ADHD). The nurse finds that the child is thin. What could be the most likely reason for this observation? The child finds food distasteful. The child cannot sit through meals. The child has decreased appetite. The child is genetically predisposed to being thin.

The child cannot sit through meals.

The nurse is performing a physical assessment for an 8-year-old child with an earache. Which sign or symptom indicates external otitis (acute otitis externa or swimmer's ear)? The tympanic membrane reacts to a puff of air. Symptoms of upper respiratory infection are present. The ear canal is devoid of cerumen. The child cries out when the ear is grasped.

The child cries out when the ear is grasped.

A nurse is speaking to the peers of a child with attention deficit hyperactivity disorder (ADHD). The nurse finds that these children do not like the child and do not want to include the child during play. What are the likely reasons for the children feeling this way? Select all that apply. The child cannot move or play as quickly as the other children. The child abuses other children. The child is not cooperative while playing. The child constantly interrupts while playing. The child doesn't follow the rules of the game.

The child is not cooperative while playing. The child constantly interrupts while playing. The child doesn't follow the rules of the game.

A nurse is assessing a child with attention deficit hyperactivity disorder (ADHD). For every question asked by the nurse, the child answers, "I don't know." What is the most likely reason for the child to respond in this way? The child does not like talking to the nurse. The child is not willing to answer the nurse. The child is not paying attention to the nurse's questions. The child is not able to understand what the nurse is asking.

The child is not paying attention to the nurse's questions.

A parent of a newborn asks the nurse if there is any way to prevent acute otitis media. What would the nurse state to the parent? Prophylactic acetic acid instillations may be helpful. The frequency of otitis media is reduced in breastfed infants. Prophylactic myringotomy tubes can be inserted at birth. Starting immunizations at birth rather than age 2 months might help.

The frequency of otitis media is reduced in breastfed infants.

What indicator will alert the nurse that the family of the child with special needs is not ready to assume home care? The family is anxious but demonstrates accurately the physical care the child requires. The home environment includes the essentials but is crowded, which compromises ease and efficiency. The parents are new to the community, lack knowledge of its resources, and have no friend/family support. Financial stress is significant owing to loss of the caregiver income.

The parents are new to the community, lack knowledge of its resources, and have no friend/family support.

The nurse is discussing the treatment for a child with attention deficit hyperactivity disorder (ADHD) with a group of school nurses. What would be an appropriate learning setting for a child with ADHD? a classroom with a plan of study that is followed each day a classroom with windows facing a playground a classroom in which children self-select their activities a classroom with tables and chairs rather than individual desks

a classroom with a plan of study that is followed each day

After teaching a parent about common adverse effects associated with routine immunizations, which of the following, if stated by the parent, would indicate the need for additional teaching? a. Difficulty breathing and fainting b. Fever and rash c. Drowsiness and fretfulness d. Swelling and nodule formation at the site of injection

a. Difficulty breathing and fainting

A child with ADHD is placed on methylphenidate therapy. What symptom may children on methylphenidate develop? rapid increase in height hypotension anorexia sleepiness

anorexia

Curious parents ask what type of immunity is provided to their child through immunization with various vaccines. What will be the nurse's answer? naturally acquired active immunity artificially acquired active immunity naturally acquired passive immunity artificially acquired passive immunity

artificially acquired active immunity

During the health history of a 2-week-old neonate, the nurse discovers the child has not yet had a hearing screening. What test should the nurse schedule? auditory brain stem response test Rinne test Weber test tympanometry

auditory brain stem response test

When preparing a presentation for a local parent group about vaccines, the nurse would describe vaccines as being used to stimulate a. passive immunity to a foreign protein. b. active immunity to a foreign protein. c. serum sickness. d. a mild disease in healthy people.

b. active immunity to a foreign protein.

A teaching plan for the parents of a child with ADHD should include a.allowing as much time as needed to complete any task. b.allowing the child to decide when to do homework. c.giving instructions in short simple steps. d.keeping track of positive comments that the child is given. e.providing a reward system for completion of daily tasks. f.spending time at the end of the day reviewing the child's behavior.

c.giving instructions in short simple steps. d.keeping track of positive comments that the child is given. e.providing a reward system for completion of daily tasks.

Attention-deficit/hyperactivity disorder (the inability to concentrate or focus on an activity) and narcolepsy (sudden episodes of sleep) are both most effectively treated with the use of a. neuroinhibitors. b. dopamine receptor blockers. c. major tranquilizers. d. CNS stimulants.

d. CNS stimulants.

Which vaccine would the nurse be least likely to recommend for a 6-month-old child? a. Diphtheria, tetanus, pertussis vaccine b. Haemophilus influenzae b vaccine c. Poliovirus vaccine d. Chickenpox vaccine

d. Chickenpox vaccine

The nurse reviews a patient's record to make sure that tetanus booster shots have been given a. only with exposure to anaerobic bacteria. b. every 2 years. c. every 5 years. d. every 10 years.

d. every 10 years.

A child is taking pemoline (Cylert) for ADHD. The nurse must be aware of which side effect? a.Decreased thyroid-stimulating hormone b.Decreased red blood cell count c.Elevated white blood cell count d.Elevated liver function tests

d.Elevated liver function tests

Parents report that their neonate received intravenous antibiotics while in the newborn nursery. The nurse recognizes this as a potential risk factor for which health problem? hearing impairment visual disorder articulation difficulties difficulty with fine motor skills

hearing impairment

A pediatric nurse will state that the priority reason to have a thorough grasp of the growth and development of children is to: identify developmental risks or delays promptly. thoroughly enjoy working with the different age groups. give parents anticipatory guidance as their children grow and change. interact with children in age-appropriate, nonthreatening ways.

identify developmental risks or delays promptly.

The nurse is educating the parents of a 4-year-old boy with strabismus. Teaching for the parents would include the: need for ultraviolet-protective glasses postoperatively. importance of completing the full course of oral antibiotics. possibility that multiple operations may be necessary. importance of patching as prescribed.

importance of patching as prescribed.

A parent brings a child to the pediatric clinic, stating that the child was diagnosed with attention deficit hyperactivity disorder (ADHD). Which symptoms does the nurse anticipate finding with this child? inattention, impulsive, and hyperactivity hyperactivity, defiant, and disruptive excess motor activity, learning disability, and depression visual impairment, hyperactivity, oppositional defiant

inattention, impulsive, and hyperactivity

The nurse is teaching about prevention of hepatitis A. Which group does the nurse suggest will benefit from this vaccine? people who have recently been exposed to hepatitis A all children as part of childhood immunization people who live in or travel to areas with high rates of hepatitis A infections people with liver disease or who are immunocompromised

people who live in or travel to areas with high rates of hepatitis A infections

The nurse is participating in a family meeting with the parents of a child diagnosed with attention deficit hyperactivity disorder (ADHD) and prescribed dextroamphetamine. The nurse should discuss what black box warning associated with this medication? potential for abuse risk of hemorrhagic stroke anticholinergic effects hyperglycemic crisis

potential for abuse

A nurse is preparing a presentation for a group of parents who have children with significant visual impairment. Which action would the nurse be least likely to include as an example of a self-stimulatory action? shouting head banging rocking spinning

shouting

A nurse is providing care for a client diagnosed with attention deficit hyperactivity disorder (ADHD) who has been taking methylphenidate for several months. When monitoring for potential adverse effects, the nurse should include what assessments? sleep patterns sexual function pupillary response orientation to person, place, and time

sleep patterns

The nurse is caring for a premature infant who is demonstrating poor weight gain secondary to difficulty with feedings and sucking. What referral would the nurse consider for the infant? physical therapy speech therapy discharge planning respiratory therapy

speech therapy

A 9-year-old child is brought to the urgent care center by the parent. Based on assessment findings, the nurse suspects external otitis (acute otitis externa or swimmer's ear). Which finding on otoscopic examination supports this suspicion? bulging, red tympanic membrane swollen, inflamed ear canal copious, soft, yellow cerumen reddish-brown discharge

swollen, inflamed ear canal

The nurse is caring for a special needs child who is preparing for hippotherapy. The nurse is aware that this is what type of therapy? therapeutic horseback riding relaxation therapy therapeutic bicycle riding pet therapy

therapeutic horseback riding

The nurse is admitting a medically fragile child. When planning care for the child and the family, what is the priority for the nurse? to develop a trusting relationship with the family to provide information about the child's educational needs to ensure the family has contact information for resources available in the community to assist the family in defining the role each member will have in caring for the child after discharge

to develop a trusting relationship with the family

The nurse is educating the parents of a 5-year-old girl with infectious conjunctivitis about the disorder. Which information is most important to provide to prevent the spread of the disorder? properly applying the prescribed antibiotic staying home from school washing hands frequently keeping hands away from eyes

washing hands frequently

The nurse is discussing treatment for a child diagnosed with scoliosis. Which statement indicates the parents understand the nurse's education? "Because our child has scoliosis, treatment will include halo traction." "The treatment for our child's scoliosis is anticipated to last between 3 to 4 months." "Because our child is being treated by using braces, the braces will have to be worn almost all the time." "The most successful treatment for scoliosis is surgery before reaching adult age."

"Because our child is being treated by using braces, the braces will have to be worn almost all the time."

A child diagnosed with acute otitis media has been given a prescription for benzocaine. The nurse is correct when she makes which statement? "Benzocaine drops should be placed in your eye to numb it and reduce pain." "Benzocaine is an antibiotic for your eye infection."

"Benzocaine drops should be placed in your eye to numb it and reduce pain."

The nurse is counseling a pregnant adolescent about the health benefits associated with breastfeeding. Which statement by the client indicates understanding? "Breastfeeding my baby will pass on a type of active immunity." "Breastfeeding my baby will pass on passive immunity." "Breastfeeding my baby will provide lifelong immunity against certain diseases." "Breastfeeding my baby will help to stimulate my baby's immune system to activate."

"Breastfeeding my baby will pass on passive immunity."

During a routine sports physical examination, the nurse practitioner recommends HPV vaccination for an 11-year-old girl. Which statements by the client's mother demonstrates understanding of HPV vaccinations? "This vaccination is not indicated for my son, since boys cannot receive the HPV vaccine." "If my daughter is immunized against HPV, she can delay her first scheduled Pap test." "I will track follow-up appointments in my smartphone so she receives all three injections." "It's nice that she can take this vaccination intranasally, to avoid repeated injections."

"I will track follow-up appointments in my smartphone so she receives all three injections."

The nurse is obtaining the history from the parents of an infant who is suspected of having infantile glaucoma. Which statement by the parents would help to confirm this suspicion? "It seems like bright lights really bother him." "He opens his eyes quite frequently when he's awake." "His eye looks about the same size as his other eye." "His eye doesn't seem to tear much."

"It seems like bright lights really bother him."

How would the nurse respond when the parent asks the nurse why she is using pictures with high-contrast patterns to assess a 4-month-old's vision? "Children respond emotionally better to black and white patterns and pictures." "This allows us to assess for color blindness in infants younger than 6 months." "A child's color vision isn't well developed until 12 to 18 months of age or later." "The child's eyes are more attune to high-contrast patterns than to specific colors."

"The child's eyes are more attune to high-contrast patterns than to specific colors."

The mother of a 10-year-old boy with attention deficit hyperactivity disorder (ADHD) contacts the school nurse. She is upset because her son has been made to feel different by his peers because he has to visit the nurse's office for a lunchtime dose of medication. The boy is threatening to stop taking his medication. How should the nurse respond? "He will need to learn to ignore the children; he needs this medication." "I can have the teacher speak with the other children." "You may want to talk to your physician about an extended-release medication." "Remind him that his schoolwork may deteriorate."

"You may want to talk to your physician about an extended-release medication."

The parents of a newborn state, "We are so excited that our baby was born with blue eyes! We were hoping the baby would take after our other child." How should the nurse respond? "It's not uncommon for babies to be born with blue eyes." "You probably won't know for sure the color of your baby's eyes until your baby is 6 to 12 months old." "You can hope they stay that color. There is no guarantee." "The baby's iris will likely become more pigmented, so it's unlikely the eyes will not be blue."

"You probably won't know for sure the color of your baby's eyes until your baby is 6 to 12 months old."

A nurse is speaking to the parents of a child with attention deficit hyperactivity disorder (ADHD). The parents ask the nurse about the reason for the child's underachievement in academics. What explanation given by the nurse is most appropriate? "Your child does not attend classes." "Your child has impaired cognitive abilities." "Your child has difficulty with reading and writing." "Your child has trouble following the teacher's directions."

"Your child has trouble following the teacher's directions."

A 10-month-old child with acute otitis media is prescribed amoxicillin suspension 80 mg/kg/day to be administered in two divided doses. The child weighs 8480 g (18 lb 11 oz). The amoxicillin suspension is available as 250 mg/5 ml. What volume of amoxicillin suspension should the parents be instructed to administer for each dose? Provide the answer in milliliters, rounded to the nearest whole number.

7 mL

The nurse is preparing to administer the measles, mumps and rubella (MMR) vaccine to a child. Which would be a contraindication to administering the vaccine at that time? The child is allergic to eggs. The child's mother is currently pregnant. The child is to receive the varicella vaccine on the same day. The child received the intranasal flu vaccine 2 weeks ago.

The child received the intranasal flu vaccine 2 weeks ago.

A 16-year-old girl is brought to the emergency department after a fight. Her sclera is red. Scleral hemorrhage is suspected. Which findings are in support of this potential diagnosis? Select all that apply. Peripheral vision is mildly impaired. Central vision is moderately impaired. The child reports eye pain. The child's vision is unaffected. The sclera is red.

The child's vision is unaffected. The sclera is red.

The nurse is providing education to an adolescent client who has been prescribed an amphetamine for attention deficit hyperactivity disorder. How does the nurse explain the purpose of a "drug holiday?" To minimize weight loss To prevent hyperthyroidism To allow electrolyte imbalances to resolve To slow bone resorption

To minimize weight loss

A patient is to receive immune globulin after exposure to hepatitis A. The patient has a previous history of allergies to various drugs. Before giving the immune globulin, the nurse should a. have emergency equipment readily available. b. premedicate the patient with aspirin. c. make sure all of the patient's vaccinations are up to date. d. make sure the patient has a ride home.

a. have emergency equipment readily available.

The nurse is assessing an adult client with ADHD. The nurse expects which to be present? a.Difficulty remembering appointments b.Falling asleep at work c.Problems getting started on a project d.Lack of motivation to do tasks

a.Difficulty remembering appointments

The nurse is caring for a 10-year-old girl with acute periorbital cellulitis. Which nursing intervention (therapy) is primary for this disorder? applying heated Aqua pad to site administering antibiotics IV as ordered administering morphine sulfate as ordered monitoring for increased intracranial pressure

administering antibiotics IV as ordered

When assessing the medical record of an older adult to evaluate the status of his immunizations, the nurse would be looking for evidence of which immunizations? a. Yearly pneumococcal vaccination b. Yearly flu vaccination c. Tetanus booster every 10 years d. Tetanus booster every 5 years e. Measles, mumps, rubella vaccine if the patient was born after 1957 f. Varicella vaccine only if there is evidence that the patient had chickenpox as a child

b. Yearly flu vaccination c. Tetanus booster every 10 years

A nurse suffers a needlestick after injecting a patient with suspected hepatitis B. The nurse should? a. have repeated titers to determine whether she was exposed to hepatitis B and if she had hepatitis immune globulin. b. immediately receive hepatitis immune globulin and begin hepatitis B vaccines if she has not already received them. c. start antibiotic therapy immediately. d. go on sick leave until all screening tests are negative.

b. immediately receive hepatitis immune globulin and begin hepatitis B vaccines if she has not already received them.

It is now recommended that all people over the age of 6 months should receive a flu vaccine every fall based on the understanding that the vaccine is repeated because a. the immunity wears off after a year. b. the strains of virus predicted to cause the flu change every year. c. a booster shot will activate the immune system. d. flu shots do not produce good antibodies.

b. the strains of virus predicted to cause the flu change every year.

A 7-year-old child with ADHD is taking clonidine (Kapvay). Common side effects include a.appetite suppression. b.dizziness. c.dry mouth. d.hypotension. e.insomnia. f.nausea.

b.dizziness. c.dry mouth. d.hypotension.

In working with middle to older adolescents with special needs, the nurse teaches the teens when to seek help from a health professional and about the medical insurance process. This nurse is: beginning to prepare the teen for transition to adult care. attempting to relieve stressed parents of some responsibility. promoting improved use of the current health care resources. working to reduce the financial burden for the family.

beginning to prepare the teen for transition to adult care.

The nurse is assessing an adolescent client diagnosed with attention deficit hyperactivity disorder (ADHD) for therapeutic effects of methylphenidate. The nurse should focus on improvement associated with what client functions? Select all that apply. stamina behavior endurance motor task performance cognitive task performance

behavior motor task performance cognitive task performance

A mother brings her child to his 18-month well-baby visit. The nurse would not give the child his routine immunizations in which situations? a. He cried at his last immunization. b. He developed a fever or rash after his last immunization. c. He currently has a fever and symptoms of a cold. d. He is allergic to aspirin. e. He is currently taking oral corticosteroids. f. His siblings are all currently being treated for a viral infection.

c. He currently has a fever and symptoms of a cold. e. He is currently taking oral corticosteroids. f. His siblings are all currently being treated for a viral infection.

A nurse is assessing whether a 6-year-old child has received all required immunizations. Which immunizations does the nurse expect to be documented? hepatitis A; measles, mumps, and rubella (MMR); and inactivated polio virus (IPV) measles, mumps, and rubella (MMR); hepatitis A; and human papilloma virus (HPV) human papilloma virus vaccine (HPV); diphtheria, tetanus, and acellular pertussis (DTaP); and inactivated polio virus (IPV) diphtheria, tetanus, and acellular pertussis (DTaP); measles, mumps, and rubella (MMR); and inactivated polio virus (IPV)

diphtheria, tetanus, and acellular pertussis (DTaP); measles, mumps, and rubella (MMR); and inactivated polio virus (IPV) Between ages 4 and 6, the child should receive DTaP, MMR, and IPV. Hepatitis A isn't a required immunization. HPV is not recommended until age 9.

A nurse is obtaining baseline physical data from a 7-year-old patient who is to be started on dextroamphetamine for ADHD. After obtaining vital signs, height, and weight, the nurse will prepare the patient for an electrocardiogram (ECG). electromyelogram (EMG). electroencephalogram (EEG). electrophysiologic study (EPS).

electrocardiogram (ECG).

The nurse is discussing varicella immunization with a parent of a 13-month-old infant. The parent is reluctant to vaccinate because "it is not necessary." Which comment by the nurse will be most persuasive for immunization? "Mild reactions occur in 5% to 10% of children." "Varicella is a highly contagious herpes virus." "Children not immunized are at risk if exposed to the disease." "The rate of herpes zoster has been declining since the vaccination program began."

"Children not immunized are at risk if exposed to the disease."

The parents of an adolescent with special needs express to the nurse that they feel guilty for considering respite care for a week to attend their older child's destination wedding. What would be the best response by the nurse? "Respite care is often used by families who cannot handle the care of their adolescent every day." "Let's explore several choices for care so you can feel comfortable and trust the care provider." "Have you discussed maybe changing the time or location of the wedding with your older child?" "I would encourage you to embrace respite care as it is a great opportunity for you to be away from the stress of caring for your adolescent."

"Let's explore several choices for care so you can feel comfortable and trust the care provider."

The parents of an 8-year-old child report that the child's teachers noted the child is having problems seeing the board in school but state they do not understand this since the child is able to read from the computer with no difficulty. Which response from the nurse is most appropriate? "This may signal your child is having difficulty paying attention rather than a visual disorder." "Your child will need to be evaluated for an accommodation disorder." "What you are describing may be what is called myopia." "These reports are consistent with hyperopia."

"What you are describing may be what is called myopia."

While administering influenza vaccines for the general public, the nurse will advise which clients to avoid taking the influenza shot? Select all that apply. Client who has a fever with possible strep throat Client with anaphylactic hypersensitivity to eggs Client with Guillain-Barré syndrome Client who has pain at the injection site Client who is HIV positive

Client who has a fever with possible strep throat Client with anaphylactic hypersensitivity to eggs Client with Guillain-Barré syndrome

The nurse is assessing a child diagnosed with autism spectrum disorder (ASD). Which finding will the nurse expect to assess? Slow motor actions Frequently losing things Engaging in dangerous activities Indifferent attachment to a parent

Indifferent attachment to a parent

The nurse is aware that medication dosage for a child with ADHD is stopped occasionally for what reason? Onset of puberty Evaluation of treatment regimen Brain growth Musculoskeletal growth

Evaluation of treatment regimen

What intervention should the nurse choose to assist the family with a special needs child to function in as healthy a manner as possible? Involve both mother and father in explanations and teaching with special attention to keeping the father connected and informed. Focus on preventing denial of the child's condition by the mother and father. Encourage care of the child in a setting outside the family's home. Explain that the situation will become less confusing and easier to handle with time.

Involve both mother and father in explanations and teaching with special attention to keeping the father connected and informed.

An adolescent client has been taking methylphenidate for the treatment of attention deficit hyperactivity disorder (ADHD) for 3 years, achieving significant improvements in behavior and mood. When assessing the child during a scheduled follow-up appointment, the nurse should prioritize what physical assessment to monitor for a potential adverse reaction to the therapy? Abdominal girth and assessment for peripheral edema Measurement of height and body weight Visual acuity and hearing ability Assessment of deep tendon reflexes and peripheral pulses

Measurement of height and body weight

A student accepted into a nursing program must begin receiving the hepatitis B series of injections. The student asks when the next two injections should be administered. What is the best response by the instructor? "You must have the second one in 2 weeks and the third in 1 month." "You must have the second one in 1 month and the third in 6 months." "You must have the second one in 6 months and the third in 1 year." "You must have the second one in 1 year and the third the following year."

"You must have the second one in 1 month and the third in 6 months."

The nurse is working with a 12 year-old client who has been diagnosed with attention-deficit hyperactivity disorder and prescribed methylphenidate (Ritalin). What statement by the client would suggest the presence of adverse drug effects? "I just don't feel hungry very much these days." "Sometimes I just feel so mad at my teacher or my coach." "I fell asleep on the bus last week and missed my stop." "I banged my shin last week and the bruise is still there."

"I just don't feel hungry very much these days."

A female client reports that her mother-in-law was just diagnosed with cervical cancer and asks the nurse about her own risk. Which response by the nurse is correct? "If you have annual Papanicolaou (Pap) tests you have a low risk." "If you had the human papillomavirus (HPV) vaccine, your risk is greatly reduced." "Your risk is higher if you did not use oral contraception." "Your family history indicates you should have genetic testing."

"If you had the human papillomavirus (HPV) vaccine, your risk is greatly reduced."

A 10-year-old girl with attention deficit hyperactivity disorder (ADHD) has been on methylphenidate for 6 months. The girl's mother calls and tells the nurse that the medication is ineffective and requests an immediate increase in the child's dosage. Which response by the nurse would be most appropriate? "Let me talk to the doctor about this." "Let's wait a few more weeks before we do anything." "What does the teacher say?" "Let's set up an appointment for you to come in as soon as possible."

"Let's set up an appointment for you to come in as soon as possible."

A child having tympanostomy tubes placed asks, "How and when will the tubes be removed?" What is the nurse's best response? "You will have them replaced every 2 months until you reach age 18." "The tubes remain in place for 6 months and then are dissolved by vinegar." "The tubes remain in place for 6 to 12 months until they come out by themselves." "The tubes are not removed; they grow permanently into place."

"The tubes remain in place for 6 to 12 months until they come out by themselves."

A nurse is conducting an immunization clinic when a 14-year-old client asks, "Does this vaccine make me immune to the disease?" What is the nurse's best response? "The vaccine imitates a disease without causing illness, resulting in the creation of antibodies to the disease." "The vaccine introduces substances that replicate and can kill the microorganisms if you are exposed." "The vaccine contains medicines that are designed to combat the microorganisms that cause this disease." "The vaccine will not make you immune but will improve your chances of surviving an infection."

"The vaccine imitates a disease without causing illness, resulting in the creation of antibodies to the disease."

The nurse is discussing childhood immunization recommendations with a pediatric patient's parent. Where would the nurse find the most current information on this topic? The World Health Organization The Joint Commission CDC The Occupational Safety Health Administration

CDC

The nurse is preparing a psychosocial assessment for use with clients with various mental health conditions. For which group of clients should the nurse include mostly closed-ended questions? Clients with depression Clients with post-traumatic stress disorder Clients with antisocial personality disorder Clients with adult attention deficit hyperactivity disorder

Clients with adult attention deficit hyperactivity disorder

A child, diagnosed with attention deficit hyperactivity disorder (ADHD), has been prescribed methylphenidate. The child's mother tells the nurse that she does not understand why a stimulant would help since, "my child is completely overstimulated, not understimulated!" What should the nurse explain to the mother about the therapeutic use of methylphenidate? Methylphenidate helps with the symptoms of ADHD, but the reasons for this are not fully understood. Methylphenidate stimulates the parasympathetic nervous system, resulting in increased control of behavior. Methylphenidate stimulates the limbic system, which regulates control over behavior and affect. Methylphenidate enhances the function of dopamine, which regulates cognition.

Methylphenidate helps with the symptoms of ADHD, but the reasons for this are not fully understood.

The nurse is preparing to administer an intramuscular immunization to a 1-month-old infant. What action will the nurse take? Locate and clean the deltoid muscle with alcohol prior to administering the injection. Ask the parent to remove the infant's diaper to allow access to the dorsogluteal muscle. Request the parent to remove the infant's pants so the vastus lateralis muscle is accessible. Swab the fatty tissue on the infant's upper leg with alcohol prior to administering the injection.

Request the parent to remove the infant's pants so the vastus lateralis muscle is accessible.

The parents of a male child with attention deficit-hyperactivity disorder (ADHD) bring the child to the health care provider's office for a follow-up visit. During the visit, the parents tell the nurse that the child receives his first dose of Ritalin at 7:30 every morning. The child's teacher and school nurse have reported that his ADHD symptoms return just before his second daily dose, which coincides with the lunch period at noon. Which might the nurse suggest to help better control the child's symptoms during school hours? Delaying the first dose until the child arrives at school Talking to the health care provider about switching to a longer acting preparation Splitting the first dose so that half is taken before leaving for school and half is taken upon arriving at school Asking the teacher to allow the child to attend a different lunch period so that he can take his second dose earlier in the day

Talking to the health care provider about switching to a longer acting preparation

A public education campaign to stress the importance of childhood immunizations should include which points? a. Prevention of potentially devastating diseases outweighs the discomfort and risks of immunization. b. Routine immunization is standard practice in the United States. c. The practice of routine immunizations has virtually wiped out many previously deadly or debilitating diseases. d. The risk of severe adverse reactions is on the rise and is not being addressed. e. If ther

a. Prevention of potentially devastating diseases outweighs the discomfort and risks of immunization. b. Routine immunization is standard practice in the United States. c. The practice of routine immunizations has virtually wiped out many previously deadly or debilitating diseases. f. The temporary discomfort associated with the immunization can be treated with over-the-counter drugs.

The child is diagnosed with attention deficit hyperactivity disorder (ADHD). Which medication will most likely be administered in conjunction with treatment? ACE inhibitors selective serotonin reuptake inhibitors (SSRIs) central nervous system (CNS) stimulants monoamine oxidase inhibitors (MAOIs)

central nervous system (CNS) stimulants

The nurse is teaching a 12-year-old child with intellectual disability about medications. Which action is essential? a.Speak slowly and distinctly. b.Teach the information to the parents only. c.Use pictures rather than printed words. d.Validate client understanding of teaching.

d.Validate client understanding of teaching.

Knowing that caregivers of a special needs child usually give of themselves in almost unending ways, the nurse will assist the parents by: helping them develop workable health-promoting activities for themselves. stepping in and providing additional direct care. modifying the care plan to focus on only the basic essentials. arranging to have the child spend more time in school.

helping them develop workable health-promoting activities for themselves.

The mother of an 8-year-old boy is concerned that her son has attention deficit hyperactivity disorder. She describes the symptoms he demonstrates. Which behavior should the nurse recognize as an example of impulsiveness? Jumping out of his seat in the middle of class and running to the bathroom without the teacher's permission Inability to answer a question posed by his teacher because he was daydreaming Constantly fidgeting in his chair and shaking his foot Repeating words or phrases spoken by others

Jumping out of his seat in the middle of class and running to the bathroom without the teacher's permission

A client calls the clinic reporting only being able to get a 1-month supply of pills for the client's son, who takes a CNS stimulant for ADHD. The nurse understands that these medications are given in limited numbers for what reason? The cost is prohibitive when prescribed in a large number. It reduces the likelihood of drug dependence or diversion. Changes in dosages are common. HMOs will not reimburse the cost for larger numbers.

It reduces the likelihood of drug dependence or diversion.

A 16-year-old adolescent has a corneal abrasion from a contact lens injury in the right eye. What will the nurse include in discharge teaching for this adolescent? patching of the left eye to strengthen the vision in the right eye wearing glasses while the abrasion heals wearing gauze over the right eye to absorb exudate administering mydriatic tropicamide drops

wearing glasses while the abrasion heals

A pregnant client has tested positive for hepatitis B virus. When discussing the situation with the client, the nurse explains that her newborn will be vaccinated with an initial HBV vaccine dose at which time? within 12 hours of birth within 24 hours of birth within 36 hours of birth within 48 hours of birth

within 12 hours of birth

The nurse is providing education about the recommended pediatric immunization schedule to the parents of an infant. The nurse's recommendation should be based on what function of the immune system? The ongoing ability of B memory cells to create specific immunoglobulins The fact that cytotoxic T cells produce and retain antibodies after stimulation by a vaccine The ability of helper T cells to preserve IgG until it is needed to fight a specific pathogen The fact that antibodies injected during an immunization are retained to fight future infections

The ongoing ability of B memory cells to create specific immunoglobulins

A mother tells the nurse that she is newly pregnant and asks about her 15-month-old's need for the chicken pox immunization because her two older children did "fine" when they had the disease. What is the nurse's best response? "When chicken pox can be avoided, why not do so?" "I realize that the vaccine is somewhat costly, but it is likely to be more economical than dealing with chicken pox." "When your child avoids chicken pox, it protects other children from being exposed to the disease. Some cannot be immunized because of their health conditions." "Your toddler should not receive this live-virus immunization today. It may present a risk to your pregnancy."

"When your child avoids chicken pox, it protects other children from being exposed to the disease. Some cannot be immunized because of their health conditions."

The nurse is preparing to administer a flu shot to an adult client. How would the nurse proceed? Place the steps in sequential order. All options must be used. Click an option, hold and drag it to the desired position, or click an option to highlight it and move it up or down in the order using the arrows to the left. 5Inject it into the muscle at a 90-degree angle. 6Wait 10 seconds before removing needle. 1Put gloves on. 2Locate the deltoid muscle. 3Clean the injection site with an alcohol pad. 4Gently stretch the skin taut at the site.

1Put gloves on. 2Locate the deltoid muscle. 3Clean the injection site with an alcohol pad. 4Gently stretch the skin taut at the site. 5Inject it into the muscle at a 90-degree angle. 6Wait 10 seconds before removing needle.

The epidemiology nurse finds a lower occurrence of influenza cases in a section of a large metropolitan city. Further research reveals higher influenza immunization rates in that section of the city. The nurse determines which probable cause for this occurrence? Immunizations are given at no cost in the area. Persons living in the area are better educated. Immunization has become a community norm. There are fewer tobacco users in this section of town.

Immunization has become a community norm.

A child with attention deficit hyperactivity disorder (ADHD) has been prescribed dextroamphetamine. For what effects should the nurse tell the parents to monitor the child? Select all that apply. Insomnia Hypotension Weight gain Weight loss Appetite suppression

Insomnia Weight loss Appetite suppression

An infant is being administered an immunization. Which statement provides an accurate description of an immunization? It should be administered to a pregnant woman prior to the infant's birth. It is the administration of an antigen for an antibody response. It produces many adverse reactions, particularly autism, in the infant. It protects the infant from exposure to infectious antibodies.

It is the administration of an antigen for an antibody response.

The student nurse is working on a program to address barriers to immunizations. Which would be an example of an intervention that the student nurse should include? Providing combination vaccines to reduce the number of shots the child is to receive. Schedule separate appointments for families with multiple children so the focus will be on one child at a time during the visit. Providing a modified vaccine schedule to allow for more time between vaccines. Providing education that free vaccines are only given by the local public health agencies.

Providing combination vaccines to reduce the number of shots the child is to receive.

The caregivers of a child who is recovering from chickenpox tell the nurse the child was given aspirin for a fever. The nurse would prioritize the assessment for indications of which adverse reaction? Lymphoma Angioneurotic edema Acute renal failure Reye's syndrome

Reye's syndrome

Hearing impairment, blindness, and adverse neurodevelopment in newborns can be prevented by immunization against which childhood disease? Rubella Herpes simplex virus type 2 Epstein-Barr virus Toxoplasmosis

Rubella

The nurse is providing teaching about medication management of attention deficit hyperactivity disorder (ADHD). Which response indicates a need for further teaching? "We should give it to him after he eats breakfast." "This may cause him to have difficulty sleeping." "If he takes this medicine he will no longer have ADHD." "We should see an improvement in his schoolwork."

"If he takes this medicine he will no longer have ADHD."

A client is scheduled to receive an immunization. In which client may the administration of a live vaccine be contraindicated? Client with renal impairment Client with hepatic failure Client with active HIV infection Client over the age of 65

Client with active HIV infection

Your patient, a 6-year-old boy, is starting a regimen of methylphenidate (Ritalin) to control an attention deficit disorder. Family teaching should include which of the following? a. This drug can be shared with other family members who might seem to need it. b. This drug may cause insomnia, weight loss, and GI upset. c. Do not alert the school nurse to the fact that this drug is being taken because the child could have problems later. d. This drug should not be stopped for any reaso

b. This drug may cause insomnia, weight loss, and GI upset.

A nurse is working at a free vaccination clinic today and expects to give vaccinations to more than one hundred children. Which item is most important to have available? Crash cart Epinephrine pen Oxygen cylinder Cold packs

Epinephrine pen

A child returns to the clinic after an episode of external otitis (acute otitis externa or swimmer's ear) that has resolved. What would the nurse emphasize as the priority for preventing future episodes? Keeping ear canals dry Performing handwashing Avoiding upper respiratory tract infections Adhering to regular follow-up to assess for hearing loss

Keeping ear canals dry

A nurse is studying the brain images of children with attention deficit hyperactivity disorder (ADHD). In these images, the nurse would find abnormalities related to which area of the brain? Frontal lobe Parietal lobe Occipital lobe Temporal lobe

Frontal lobe

The nurse is educating the parents of a 6-year-old child about preventing hearing loss. Which topic will be included in the discussion? suddenly doing poorly in school tendency to act silly in the classroom playing the radio loudly prevention and treatment of otitis media

prevention and treatment of otitis media

The nurse has just finished administering the DTaP vaccine to a 2-month-old and is educating the parent about immunization. Which statement is accurate? "Bring her back for the second dose when she is 4 months old." "You need to renew this immunization every 10 years." "The 'T' stands for tuberculosis." "There are no side effects from this vaccine."

"Bring her back for the second dose when she is 4 months old."

What immunizations are recommended for older adults? (Select all that apply.) A tetanus-diphtheria (Td) booster every 10 years An MMR every 7 to 10 years An annual influenza vaccine A one-time administration of pneumococcal vaccine at 65 years of age Rotavirus vaccine

A tetanus-diphtheria (Td) booster every 10 years An annual influenza vaccine A one-time administration of pneumococcal vaccine at 65 years of age

A teenage client, treated with dextroamphetamine for attention deficit hyperactivity disorder (ADHD) for the last 10 years, is now diagnosed with hyperthyroidism. What intervention should be implemented with this client to provide safe management of all conditions? Discontinue the high-calorie diet. Assess the client for pulmonary edema. Discontinue the dextroamphetamine. Administer a proton pump inhibitor.

Discontinue the dextroamphetamine.

A nurse who is providing care on a pediatric client has conducted a medication reconciliation. In light of the fact that the client takes methylphenidate, the nurse is justified in considering a history of what health problem? Anxiety Respiratory depression Obesity Hyperactivity

Hyperactivity

The nurse is aware that CNS stimulants are prescribed for clients with ADHD because these medications have what effect on behavior and attention? Restoring Deteriorating Improving Contravening

Improving

A physician specialist is on a tight time schedule and wishes to share information about a child with special needs with the child's mother, who is the only parent currently available. What will be the nurse's next action? Find a private conference room where the two can sit down together. Soothe the child while the mother and the physician talk in another part of the child's room. Indicate to the physician when the father will be available, and make plans for the three to talk then. Provide the father's phone number so the physician may speak with the father immediately after talking with the mother.

Indicate to the physician when the father will be available, and make plans for the three to talk then.

A pregnant client gets immunized for influenza while in the second trimester. What response occurs in the newborn after birth with regard to protection from the flu? Only the mother will receive the benefits of immunization. The newborn will have to receive immunization against influenza to have any immunity. Maternal vaccination may offer fetal and neonatal passive immunity against the flu. The newborn will not require further immunization against the flu for at least 12 months.

Maternal vaccination may offer fetal and neonatal passive immunity against the flu.

A nurse caring for a client with attention deficit hyperactivity disorder (ADHD) may administer which CNS stimulants? (Select all that apply.) Methylphenidate (Concerta) Phentermine (Adipex-P) Modafinil (Provigil) Doxapram (Dopram) Dextroamphetamine (Dexedrine)

Methylphenidate (Concerta) Dextroamphetamine (Dexedrine)

Which type of immunity is achieved by an infant from its mother through antibodies transferred in utero or in breast milk? Naturally acquired passive immunity Artificially acquired active immunity Artificially acquired passive immunity Naturally acquired active immunity

Naturally acquired passive immunity

The nursing staff at the clinic are discussing the best way to encourage cooperation from young pediatric clients during screenings. Which suggestion would be appropriate? Encourage the children to play with the dressings, syringes, and medication before using them. Allow the children to choose whether to get the screening completed that day or another day. Make a coloring page and allow the child to color it completely before beginning the screening. Purchase stickers or make coloring pages to be given to the children after the screening is completed.

Purchase stickers or make coloring pages to be given to the children after the screening is completed.

A nurse is caring for a child with attention deficit hyperactivity disorder. The nurse asks the child to draw pictures of the child and family members. What is the most likely rationale for this intervention? To release excessive energy To reduce hyperactivity in the child To reward the child for adaptive behavior To help the child self-express

To help the child self-express

The nurse is caring for a 20-month-old girl with equivocal bacterial otitis media, a severe earache, and a temperature of 39°C (102.2°F). Which intervention would the nurse expect to implement? administering antibiotics as soon as they're available obtaining a culture of fluid from the middle ear determining if the girl's balance is shaky when walking administering antivirals to ensure broad coverage of all organisms

administering antibiotics as soon as they're available

A 15-year-old boy who has been taking dextroamphetamine for the treatment of ADHD has been experiencing a depressed mood and a sense of hopelessness. He confides in the school nurse that he has begun taking his stepfather's antidepressant to improve his mood. After immediately phoning the boy's stepfather, the nurse learns that the drug in question is phenelzine (Nardil), a monoamine oxidase inhibitor (MAOI). The nurse should recognize that this combination of drugs creates a serious risk of what health problem? Cardiac arrhythmia Hypertension Nephrotoxicity Hypokalemia

Hypertension

The nurse in the emergency department is caring for a child who has a simple contusion of the right eye following a motor vehicle accident. Upon discharge to home, which response by the parents requires further clarification? "I will need to apply heat to the eye four times a day." "For the first 24 hours I will apply ice for 20 minutes, then leave it off for 20 minutes." "The blood in the white part of the eye is normal with this type of injury." "Our child will probably have a black eye for at least a couple of weeks."

"I will need to apply heat to the eye four times a day."

The nurse is working closely with a premature infant who will be discharged home soon on oxygen and cardiac/respiratory monitoring. Which comments by the parents indicate that discharge instructions were understood? Select all that apply. "It's important that we continue to bathe and dress our baby like you taught us." "We feel like we know how to respond to the alarms on the equipment." "We will only let our baby's grandpa smoke in the house if we have the oxygen turned off." "We need to follow our planned feeding schedule as closely as possible." "We will refer back to our discharge instructions if we are trying to determine if we need to notify the doctor about a change in our baby."

"It's important that we continue to bathe and dress our baby like you taught us." "We feel like we know how to respond to the alarms on the equipment." "We need to follow our planned feeding schedule as closely as possible." "We will refer back to our discharge instructions if we are trying to determine if we need to notify the doctor about a change in our baby."

The parents of a toddler have just learned that their child has profound hearing loss. The parents are very upset and state to the nurse, "It just isn't fair. We did everything right during our pregnancy all the way to this point." How should the nurse respond? "I can't imagine how difficult this must be. When you're ready I would be happy to arrange a meeting with a support group of other parents with children who have hearing loss." "Even when we do the right thing, it doesn't always ensure that our child will be healthy. It's important to think positively." "There could be much worse things to happen to your child. At least your child is healthy in all other aspects." "Many children who have a profound hearing loss function very well. There are lots of treatments available."

"I can't imagine how difficult this must be. When you're ready I would be happy to arrange a meeting with a support group of other parents with children who have hearing loss."