Pedi Nclex Questions

The parent of a 4-month-old with cystic fibrosis (CF) asks the nurse what time to begin the child's first chest physiotherapy (CPT) each day. Which is the nurse's best response? 1. "Thirty minutes before feeding the child breakfast." 2. "After deep-suctioning the child each morning." 3. "Thirty minutes after feeding the child breakfast." 4. "Only when the child has congestion or coughing."

1. "Thirty minutes before feeding the child breakfast."

The parents of a child with glomerulonephritis ask how they will know their child is improving after they go home. Which is the nurse's best response? 1. "Your child's urine output will increase, and the urine will become less tea-colored." 2. "Your child will rest more comfortably as lab tests become more normal." 3. "Your child's appetite will decrease as urine output increases." 4. "Your child's laboratory values will become more normal."

1. "Your child's urine output will increase, and the urine will become less tea-colored."

21. Which child with asthma should the nurse see first? 1. A 12-month-old who has a mild cry, is pale in color, has diminished breath sounds, and has an oxygen saturation of 93%. 2. A 5-year-old who is speaking in complete sentences, is pink in color, is wheezing bilaterally, and has an oxygen saturation of 93%. 3. A 9-year-old who is quiet, is pale in color, and is wheezing bilaterally with an oxygen saturation of 92%. 4. A 16-year-old who is speaking in short sentences, is wheezing, is sitting upright, and has an oxygen saturation of 93%.

1. A 12-month-old who has a mild cry, is pale in color, has diminished breath sounds, and has an oxygen saturation of 93%.

Which child would likely have experienced a delay in the diagnosis of a brain tumor? 1. A 3mo old because signs and symptoms would not have been readily apparent 2. A 5mo old because signs and symptoms would not have been readily suspected 3. School-age child because signs and symptoms would not have been readily suspected 4. Adolescent, because signs and symptoms could have been ignored and denied

1. A 3mo old because signs and symptoms would not have been readily apparent

A child with a seizure disorder has been having episodes during which she drops her pencil and simply appears to be daydreaming. This is most likely a/an 1. Absence seizure 2. Akinetic seizure 3. Non-epileptic seizure 4. Simple spasm seizure

1. Absence seizure

A child diagnosed with meningitis is having a generalized tonic-clonic seizure. Which should the nurse do first? 1. Administer blow-by oxygen and call for additional help 2. Reassure the parents that seizures are common in children with meningitis 3. Call a code and ask the parents to leave the room 4. Assess the child's temperature and blood pressure

1. Administer blow-by oxygen and call for additional help

Which should be included in the plan of care for a child who has a neuroblastoma with metastasis to the bone marrow and pancytopenia? 1. Administer red blood cells 2. Limit school attendance to less than 4 hours daily 3. Administer warfarin (Coumadin) 4. Encourage a diet high in fresh fruits and vegetables

1. Administer red blood cells

Which is the nurse's best response to the parents of a neonate with a meningocele who ask what can they expect 1. After initial surgery to close the defect, most children experience no neurological dysfunction 2. Surgery to close the sac will be postponed until the infant has grown and has enough skin to form a graft 3. After the initial surgery to close the defect, the child will likely have motor and sensory deficits 4. After the initial surgery to close the defect, the child will likely have future problems with urinary and bowel incontinence

1. After initial surgery to close the defect, most children experience no neurological dysfunction

The parent of a 4-year-old brings the child to the clinic and tells the nurse the child's abdomen is distended. After a complete examination, a diagnosis of Wilms tumor is suspected. Which of the following is most important when doing a physical examination on this child? 1. Avoid palpation of the abdomen. 2. Assess the urine for the presence of blood. 3. Monitor vital signs, especially the blood pressure. 4. Obtain an accurate height and weight.

1. Avoid palpation of the abdomen.

The nurse is caring for an unconscious 6yo who has had a severe closed-head injury and notes the following changes: HR has dropped from 120 to 55, BP has increased from 110/44 to 195/62, and respirations are becoming more irregular. Which should the nurse do first after calling the physician? 1. Call for additional help and prepare to administer mannitol 2. Continue to monitor the patient's vital signs and prepare to administer a bolus of isotonic fluids 3. Call for additional help and prepare to administer an antihypertensive 4. Continue to monitor the patient and administer supplemental oxygen

1. Call for additional help and prepare to administer mannitol

Exposure to which illness should be a cause to discontinue therapy and substitute dipyridamole (Persantine) in a child receiving aspirin therapy for Kawasaki disease (KD)? 1. Chickenpox or influenza. 2. E. coli or staphylococcus. 3. Mumps or streptococcus A. 4. Streptococcus A or staphylococcus.

1. Chickenpox or influenza.

A nursing action that promotes ideal nutrition in an infant with congestive heart failure (CHF) is: 1. Feeding formula that is supplemented with additional calories. 2. Allowing the infant to nurse at each breast for 20 minutes. 3. Providing large feedings every 5 hours. 4. Using firm nipples with small openings to slow feedings

1. Feeding formula that is supplemented with additional calories.

A preschooler has been having periods during which he suddenly falls and appears to be weak for a short time after the event. The preschool teacher asks what she should do. Select the nurse's best response. 1. Have the parents follow up with his health-care provider because this is likely an atonic seizure 2. Find out if there have been any new stressors in his life because it could be attention-seeking behavior 3. Have the parents follow-up with his healthcare provider because this is likely an absence seizure 4. The preschool years are a time of rapid growth, and many children appear clumsy. It would be best to watch him and see if it continues

1. Have the parents follow up with his health-care provider because this is likely an atonic seizure

The diet that produces anticonvulsant effects from ketosis consist of: 1. High-fat and low-CHO foods 2. High-fat and high-CHO foods 3. Low-fat and low-CHO foods 4. Low fat and high-CHO foods

1. High-fat and low-CHO foods

Which of the following activities should a nurse suggest for a client diagnosed with hemophilia? Select all that apply. 1. Hiking. 2. Fishing. 3. Soccer. 4. Swimming. 5. Golf.

1. Hiking 2. Fishing 4. Swimming 5. Golf

A child diagnosed with congestive heart failure (CHF) is receiving maintenance doses of digoxin and furosemide. She is rubbing her eyes when she is looking at the lights in the room, and her HR is 70 beats per minute. The nurse expects which laboratory finding? 1. Hypokalemia. 2. Hypomagnesemia. 3. Hypocalcemia. 4. Hypophosphatemia.

1. Hypokalemia (low K+ increases dig toxicity)

The following are examples of acquired heart disease. Select all that apply. 1. Infective endocarditis. 2. Hypoplastic left heart syndrome. 3. Rheumatic fever (RF). 4. Cardiomyopathy. 5. Kawasaki disease (KD). 6. Transposition of the great vessels.

1. Infective endocarditis. 3. Rheumatic fever (RF). 4. Cardiomyopathy. 5. Kawasaki disease (KD).

The nurse is caring for a child with a skull fracture who is unconscious and has severely increased ICP. The nurse notes the child's temp to be 104. Which should the nurse do first? 1. Place a cooling blanket on the child 2. Administer acetaminophen (Tylenol) via NG tube 3. Administer acetaminophen (Tylenol) rectally 4. Place ice packs in the child's axillary areas

1. Place a cooling blanket on the child

Which physiological changes occur as a result of hypoxemia in congestive heart failure (CHF)? 1. Polycythemia and clubbing. 2. Anemia and barrel chest. 3. Increased white blood cells and low platelets. 4. Elevated erythrocyte sedimentation rate and peripheral edema.

1. Polycythemia and clubbing.

The parent of a child with glomerulonephritis asks the nurse why the urine is such a funny color. Which is the nurse's best response? 1. "It is not uncommon for the urine to be discolored when children are receiving steroids and blood pressure medications." 2. "There is blood in your child's urine that causes it to be tea-colored." 3. "Your child's urine is very concentrated, so it appears to be discolored." 4. "A ketogenic diet often causes the urine to be tea-colored."

2. "There is blood in your child's urine that causes it to be tea-colored."

The parents of a 3-month-old ask why their baby will not have an operation to correct a ventricular septal defect (VSD). The nurse's best response is: 1. "It is always helpful to get a second opinion about any serious condition like this." 2. "Your baby's defect is small and will likely close on its own by 1 year of age." 3. "It is common for physicians to wait until an infant develops respiratory distress before they do the surgery." 4. "With a small defect like this, they wait until the child is 10 years old to do the surgery."

2. "Your baby's defect is small and will likely close on its own by 1 year of age."

Treatment for congestive heart failure (CHF) in an infant began 3 days ago and has included digoxin and furosemide. The child no longer has retractions, lungs are clear , and HR is 96 beats per minute while the child sleeps. The nurse is confident that the child has diuresed successfully and has good renal perfusion when the nurse notes the child's urine output is: 1. 0.5 cc/kg/hr. 2. 1 cc/kg/hr. 3. 30 cc/hr. 4. 1 oz/hr.

2. 1 cc/kg/hr.

The nurse is caring for a newborn who has just been diagnosed with tracheo- esophageal fistula and is scheduled for surgery. Which should the nurse expect to do in the pre-operative period? 1. Keep the child in a monitored crib, obtain frequent vital signs, and allow the parents to visit but not hold their infant. 2. Administer intravenous fluids and antibiotics. 3. Place the infant on 100% oxygen via a non-rebreather mask. 4. Have the mother feed the infant slowly in a monitored area, stopping all feedings 4 to 6 hours before surgery..

2. Administer intravenous fluids and antibiotics.

Which medication should the nurse anticipate administering first to a child in status epilepticus? 1. Establish an intravenous line and administer intravenous lorazepam (Ativan) 2. Administer rectal diazepam (Valium) 3. Administer an oral glucose gel to the side of the child's mouth 4. Administer oral diazepam (Valium)

2. Administer rectal diazepam (Valium)

A 10yo with severe factor VIII deficiency falls, injures an elbow, and is brought to the ED. The nurse should prepare which of the following? 1. An IM injection of factor VIII 2. An IV infusion of factor VIII 3. An Injection of desmopressin 4. and IV infusion of platelets

2. An IV infusion of factor VIII

A child has been seen by the school nurse for dizziness since the start of the school term. It happens when standing in line for recess and homeroom. The child now reports that she would rather sit and watch her friends play hopscotch because she cannot count out loud and jump at the same time. When the nurse asks her if her chest ever hurts, she says yes. Based on this history, the nurse suspects that she has: 1. Ventricular septal defect (VSD). 2. Aortic stenosis (AS). 3. Mitral valve prolapse. 4. Tricuspid atresia.

2. Aortic stenosis (AS).

The nurse is taking care of a child with sickle cell disease. The nurse is aware that which of the following problems is (are) associated with sickle cell disease? Select all that apply. 1. Hemarthrosis. 2. Aplastic crisis. 3. Thrombocytopenia 4. Splenic sequestration 5. Vaso-occlusive crisis. 6. Polycythemia

2. Aplastic crisis 4. Splenic Sequestration 5. Vaso-Occlusive Crisis

The nurse is caring for an infant with a myelomeningocele. The parents ask the nurse why the nurse keeps measuring the baby's head circumference. Select the nurse's best response 1. Babies' heads are measure to ensure growth is on track 2. Babies with a myelomeningocele are at risk for hydrocephalus, which shows up as an increase in head size. 3. Because your baby has an opening on the spinal cord, your infant is at risk for meningitis, which can show up as an increase in head size 4. Many infants with myelomeningocele have microcephaly, which can show up as a decrease in head size

2. Babies with a myelomeningocele are at risk for hydrocephalus, which shows up as an increase in head size.

The nurse is aware that cloudy CSF most likely indicates 1. Viral meningitis 2. Bacterial meningitis 3. No infection, b/c CSF is usually cloudy 4. Sepsis

2. Bacterial meningitis

Which activity should an adolescent just diagnosed w/ epilepsy avoid? 1. Swimming, even with a friend 2. Being in a car at night 3. Participating in any strenuous activities 4. Returning to school right away

2. Being in a car at night

The school nurse has been following a child who comes to the office frequently for vague complaints of dizziness and headache. Today, she is brought in after fainting in the cafeteria following a nosebleed. Her BP is 122/85, and her radial pulses are bounding. The nurse suspects she has: 1. Transposition of the great vessels. 2. Coarctation of the aorta (COA). 3. Aortic stenosis (AS). 4. Pulmonic stenosis (PS).

2. Coarctation of the aorta (COA).

What are the clinical manifestations of non-Hodgkin lymphoma? 1. Basically the same as those in Hodgkin disease. 2. Depends on the anatomical site and extent of involvement. 3. Those that affect the abdomen, as non-Hodgkin lymphoma is a fast-growing cancer in very young children. 4. Changes that occur in the lower extremities.

2. Depends on the anatomical site and extent of involvement.

A 16-year-old male is hospitalized for cystic fibrosis. He will be an inpatient for 2 weeks while he receives IV antibiotics. Which action taken by the nurse will most enhance his psychosocial development? 1. Fax the teen's teacher, and have her send in his homework. 2. Encourage the teen's friends to visit him in the hospital. 3. Encourage the teen's grandparents to visit frequently. 4. Tell the teen he is free to use his phone to call or text friends.

2. Encourage the teen's friends to visit him in the hospital.

The parent of an infant diagnosed with a neuroblastoma asks the nurse what the prognosis is. The nurse's best response is 1. Excellent, because a neuroblastoma is always cured 2. Excellent, because infants with a neuroblastoma have the best prognosis 3. Poor, because infants with a neuroblastoma rarely survive 4. Variable, depending on the site of origin

2. Excellent, because infants with a neuroblastoma have the best prognosis

Which position initially is most beneficial for an infant who has just returned from having a VP shunt placed? 1. Semi-Fowler's in an infant seat 2. Flat in the crib 3. Trendelenburg 4. In the crib with the head elevated to 90 degrees

2. Flat in the crib

Which of the following is the best method to prevent the spread of infection to an immunosuppressed child? 1. Administer antibiotics prophylactically to the child. 2. Have people wash their hands prior to contact with the child. 3. Assign the same nurses to care for the child each day. 4. Limit visitors to family members only.

2. Have people wash their hands prior to contact with the child.

What associated manifestation might the nurse occasionally find in a child diagnosed with Wilms tumor? 1. Atrial fibrillation. 2. Hypertension. 3. Endocarditis. 4. Hyperlipidemia.

2. Hypertension.

The nurse i scaring for a 3yo with an altered state of consciousness. The nurse determines that the child is oriented by asking the child to: 1. Name the president of the US 2. Identify her parents and state her own name 3. State her full name and phone number 4. Identify the current month but not the date

2. Identify her parents and state her name

The parent of a child with hemophilia is asking the nurse what caused the hemophilia. Which is the nurse's best response? 1. It is an X-linked dominant disorder. 2. It is an X-linked recessive disorder. 3. It is an autosomal dominant disorder. 4. It is an autosomal recessive disorder.

2. It is an X-linked recessive disorder.

An 18-month-old with a myelomeningocele is undergoing a cardiac catheterization. The mother expresses concern about the use of dye in the procedure. The child does not have any allergies. In addition to the concern for an iodine allergy, what other allergy should the nurse bring to the attention of the catheterization staff? 1. Soy. 2. Latex. 3. Penicillin. 4. Dairy.

2. Latex.

Which is the best action for the nurse to take during a child's seizure? 1. Administer the child's rescue dose of oral diazepam (Valium) 2. Loosen the child's clothing, and call for help 3. Place a tongue blade in the child's mouth to prevent aspiration 4. Carry the child to the infirmary to call 911 and start an intravenous line

2. Loosen the child's clothing, and call for help

The parents of a child with altered consciousness ask if they can stay during the morning assessment. Select the. nurse's best response: 1. Your child is more likely to answer questions and cooperate with any procedures if you are not present 2. Most children feel more at ease when parents are present, so you are more than welcome to stay at the beside 3. It is our policy to ask parents to leave during the first assessment of the shift 4. Many children fear that their parents will be disappointed if they do not do well with procedures, so we recommend that no parents be present at this time

2. Most children feel more at ease when parents are present, so you are more than welcome to stay at bedside

The nurse is providing discharge teaching to the parents of a toddler who experienced a febrile seizure. The nurse knows clarification is needed when the mother says 1. My child will likely have another seizure 2. My child's 7yo brother is also at high risk for a febrile seizure 3. I'll give my child acetaminophen (Tylenol) when ill to prevent the fever from rising too high too rapidly 4. Most children with febrile seizures do not require seizure medications

2. My child's 7yo brother is also at high risk for a febrile seizure

An infant is born with a sac protruding through the spine, containing CSF, a portion of the meninges, and nerve roots. This condition is referred to as 1. Meningocele 2. Myelomeningocele 3. Spina bifida occulta 4. Ancephaly

2. Myelomeningocele

How does the nurse interpret the laboratory analysis of a stool sample containing excessive amounts of azotorrhea and steatorrhea in a child with cystic fibrosis (CF)? The values indicate the child is 1. Not compliant with taking her vitamins. 2. Not compliant with taking her enzymes. 3. Eating too many foods high in fat.4. Eating too many foods high in fiber.

2. Not compliant with taking her enzymes.

A nurse instructs the parent of a child with sickle cell anemia about factors that might precipitate a pain crisis in the child. Which of the following factors identified by the parent as being able to cause a pain crisis indicates a need for further instruction? 1. Infection. 2. Overhydration. 3. Stress at school. 4. Cold environment.

2. Overhydration.

While looking through the chart of an infant with a congenital heart defect (CHD) of decreased pulmonary blood flow, the nurse would expect which laboratory finding? 1. Decreased platelet count. 2. Polycythemia. 3. Decreased ferritin level. 4. Shift to the left.

2. Polycythemia.

A 10-year-old has undergone a cardiac catheterization. At the end of the procedure, the nurse should first assess: 1. Pain. 2. Pulses. 3. Hemoglobin and hematocrit levels. 4. Catheterization report.

2. Pulses.

A 5-year-old is brought to the ER with a temperature of 99.5°F (37.5°C), a barky cough, stridor, and hoarseness. Which nursing intervention should the nurse prepare for? 1. Immediate IV placement. 2. Respiratory treatment of racemic epinephrine. 3. A tracheostomy set at the bedside. 4. Informing the child's parents about a tonsillectomy.

2. Respiratory treatment of racemic epinephrine.

When caring for a child with lymphoma, the nurse needs to be aware of which of the following? 1. The same staging system is used for lymphoma and Hodgkin disease. 2. The aggressive chemotherapy with central nervous system prophylaxis will give the child a good prognosis. 3. All children with lymphoma need a bone marrow transplant for a good prognosis. 4. Despite high-dose chemotherapy, the prognosis is very poor for most children with a diagnosis of lymphoma.

2. The aggressive chemotherapy with central nervous system prophylaxis will give the child a good prognosis.

The parent of a child with cystic fibrosis (CF) is excited about the possibility of the child receiving a double lung transplant. What should the parent understand? 1. The transplant will cure the child of CF and allow the child to lead a long and healthy life. 2. The transplant will not cure the child of CF but will allow the child to have a longer life. 3. The transplant will help to reverse the multisystem damage that has been caused by CF. 4. The transplant will be the child's only chance at surviving long enough to graduate college.

2. The transplant will not cure the child of CF but will allow the child to have a longer life.

The nurse is caring for a child with sickle cell disease who is scheduled to have a splenectomy. What information should the nurse explain to the parents regarding the reason for a splenectomy? 1. To decrease potential for infection. 2. To prevent splenic sequestration. 3. To prevent sickling of red blood cells. 4. To prevent sickle cell crisis.

2. To prevent splenic sequestration.

A parent of a newborn diagnosed with myelomeningocele asks what is/are common long-term complication(s)? The nurse's best response is which of the following? Select all that apply 1. Learning disabilities 2. Urinary tract infections 3. Hydrocephalus 4. Decubitus ulcers and skin breakdown 5. Nutrition issues 6. Attention deficit disorders

2. Urinary tract infections 3. Hydrocephalus

A child has been diagnosed with a midline brain tumor. In addition to showing signs of increased ICP, she has been voiding large amounts of very dilute urine. Which medication does the nurse expect to administer? 1. Mannitol 2. Vasopressin 3. Furosemide 4. Dopamine

2. Vasopressin

Which of the following would be included in the plan of care for a hospitalized newborn following surgical repair of a myelomeningocele? Select all that apply 1. Skull x-rays 2. Daily head circumference measurements 3. MRI scan 4. Vital signs q 6 h 5. Holding to breastfeed

2. daily head circumference measurements 3. MRI scans

Family discharge teaching has been effective when the parent of a toddler diagnosed with Kawasaki disease (KD) states: 1. "The arthritis in her knees is permanent. She will need knee replacements." 2. "I will give her diphenhydramine (Benadryl) for her peeling palms and soles of her feet." 3. "I know she will be irritable for 2 months after her symptoms started." 4. "I will continue with high doses of Tylenol for her inflammation."

3. "I know she will be irritable for 2 months after her symptoms started."

A parent asks the nurse what will need to be done to relieve the constipation of her child who also has cystic fibrosis (CF). Which is the nurse's best response? 1. "Your child likely has an obstruction and will require surgery." 2. "Your child will likely be given IV fluids." 3. "Your child will likely be given MiraLAX." 4. "Your child will be placed on a clear liquid diet."

3. "Your child will likely be given MiraLAX."

Which assessment indicates that the parent of a 7-year-old is following the prescribed treatment for congestive heart failure (CHF)? 1. HR of 56 beats per minute. 2. Elevated red blood cell count. 3. 50th percentile height and weight for age. 4. Urine output of 0.5 cc/kg/hr.

3. 50th percentile height and weight for age.

Which drug should not be used to control secondary hypertension in a sexually active adolescent female who uses intermittent birth control? 1. Beta blockers. 2. Calcium channel blockers. 3. ACE inhibitors. 4. Diuretics.

3. ACE inhibitors.

Which does the nurse include in the post op plan of care for a child with myelomeningocele following ligament release? 1. Encourage the child to resume a regular diet, beginning slowly with bland foods that are easily digested, such as bananas 2. Encourage the child to blow balloons to increase deep breathing and avoid post op pneumonia 3. Assist the child to change positions to avoid skin breakdown 4. Provide education on dietary requirements to prevent obesity and skin breakdown

3. Assist the child to change positions to avoid skin breakdown

In which congenital heart defect (CHD) would the nurse need to take upper and lower extremity BPs? 1. Transposition of the great vessels. 2. Aortic stenosis (AS). 3. Coarctation of the aorta (COA). 4. Tetralogy of Fallot (TOF).

3. Coarctation of the aorta (COA).

A child fell off his bike and sustained a closed-head injury. The child is currently awake and alert, but his mother states that he "passed out" for approximately 2 minutes. The mother appears highly anxious and is very tearful. The child was not wearing a helmet. Which is a priority for the triage nurse to say at this time? 1. Was anyone else injured in the accident? 2. Tell me more about the accident 3. Did he vomit, have a seizure, or display any other behavior that was unusual when he woke up? 4. Why was he not wearing a helmet?

3. Did he vomit, have a seizure, or display any other behavior that was unusual when he woke up?

Which sign best indicate increased ICP in an infant? Select all that apply 1. Sunken anterior fontanelle 2. Complains of blurred vision 3. High-pitch cry 4. Increased appetite 5. Sleeping more than usual

3. High-pitch cry 4. Increased appetite

46. Which would the nurse assess in a 4-week-old infant who has developmental dysplasia of the hip and is wearing a Pavlik harness? 1. Diaper dermatitis. 2. Talipes equinovarus. 3. Leg shortening and limited abduction. 4. Pain.

3. Leg shortening and limited abduction.

A child in the PICU with a head injury is comatose and unresponsive. The parent asks if he needs pain medication. Select the nurse's best response 1. Pain medication is not necessary b/c he is unresponsive and cannot feel pain 2. Pain medication may interfere with his ability to respond and may mask any signs of improvement 3. Pain medication is necessary to make him comfortable 4. Pain medication is necessary for comfort, but we use it cautiously because it increases the demand for oxygen

3. Pain medication is necessary to make him comfortable

The nurse is caring for a child who is receiving extensive radiation as part of the treatment for Hodgkin disease. Which intervention should be implemented? 1. Administer pain medication prior to the child's going to radiation therapy. 2. Assess the child for neuropathy since this is a common side effect. 3. Provide adequate rest, as the child may experience excessive malaise and lack of energy. 4. Encourage the child to eat a low-protein diet while on radiation therapy.

3. Provide adequate rest, as the child may experience excessive malaise and lack of energy.

The nurse is caring for a child receiving radiation therapy for a brain tumor. The parent asks if their child will likely have any learning disabilities. Select the nurse's best answer 1. All children who receive radiation have some amount of learning disability. As long as they receive extra tutoring, they usually do well in school 2. Because your child is so young, she will likely do well and have no problems in the future 3. Response varies with each child, but the younger children who receive radiation tend to have some amount of learning disability later in life 4. Response varies with each child, but younger children who receive radiation tend to have fewer problems later in life than older children

3. Response varies with each child, but the younger children who receive radiation tend to have some amount of learning disability later in life

The parent of a child diagnosed with Wilms tumor asks the nurse what the treatment plan will be. The nurse explains the usual protocol for this condition. Which information should the. nurse give to the parents? 1. The child will have chemotherapy and, after that has been completed, radiation. 2. The child will need to have surgery to remove the tumor 3. The child will go to surgery for removal of the tumor and the kidney will then start chemotherapy 4. The child will need radiation and later surgery to remove the tumor

3. The child will go to surgery for removal of the tumor and the kidney will then start chemotherapy

The parent of.a child with neuroblastoma asks the nurse what the typical signs and symptoms are at first. Select the nurse's best response 1. Most child complain of abdominal fullness and difficulty urinating 2. Many children in the early stages of a neuroblastoma have joint pain and walk with a limp 3. The signs and symptoms vary depending on where the tumor is located, but typical signs include weight loss, abdominal distention, and fatigue 4. The signs and symptoms are fairly consistent regardless of the location of the tumor. They include fatigue, hunger, weight gain, and abdominal fullness

3. The signs and symptoms vary depending on where the tumor is located, but typical signs include weight loss, abdominal distention, and fatigue

Which is included in the plan of care for a newborn who has a myelomeningocele? 1. Place the infant in the prone position with a sterile dry dressing over the defect. Slowly begin oral gastric feeds to prevent the development of necrotizing enterocolitis 2. Place the infant in the prone position with a sterile dry dressing over the defect. Begin intravenous fluids to prevent dehydration 3. Place the infant in the prone position with sterile moist dressing over the defect. Slowly begin oral gastric feeds to prevent the development of necrotizing enterocolitis 4, Place the child in prone position with a sterile moist dressing over the defect. Begin intravenous fluids to prevent dehydration

4, Place the child in prone position with a sterile moist dressing over the defect. Begin intravenous fluids to prevent dehydration

23. The parents of a 6-year-old who has a new diagnosis of asthma ask the nurse what to do to make their home a more allergy-free environment. Which is the nurse's best response? 1. "Use a humidifier in your child's room." 2. "Have your carpet cleaned chemically once a month." 3. "Wash household pets weekly." 4. "Avoid purchasing upholstered furniture."

4. "Avoid purchasing upholstered furniture."

Which statement by a parent of an infant with congestive heart failure (CHF) who is being sent home on digoxin indicates the need for further education? 1. "I will give the medication at regular 12-hour intervals." 2. "If he vomits, I will not give a make-up dose." 3. "If I miss a dose, I will not give an extra dose" 4. "I will mix the digoxin in some formula to make it taste better."

4. "I will mix the digoxin in some formula to make it taste better."

The nurse is discharging a child who has just received chemotherapy for neuroblastoma. Which of the following statements made by the child's parent indicates a need for additional teaching? 1. "I will inspect the skin often for any lesions." 2. "I will do mouth care daily and monitor for any mouth sores." 3. "I will wash my hands before caring for my child." 4. "I will take a rectal temperature daily and report a temperature greater than 101°F (38.3°C) immediately to the physician."

4. "I will take a rectal temperature daily and report a temperature greater than 101°F (38.3°C) immediately to the physician."

The nurse is caring for an adolescent who remains unconscious 24 hours after sustaining a closed-head injury in a motor vehicle accident (MVA). She responds to deep, painful stimulation with decorticate posturing and has an intracranial monitor that shows periodic increased ICP. All other VS remain stable. Select the most appropriate nursing action 1. Encourage the teen's peers to visit and talk to her about school and other pertinent events 2. Encourage the teen's parents to hold her hand and speak loudly to her in an attempt to help her regain consciousness 3. Attempt to keep a normal day/night pattern by keeping the teen in a bright, lively environment during the day and dark quiet environment at night 4. Attempt to keep the environment dark and quiet and encourage minimal stimulation

4. Attempt to keep the environment dark and quiet and encourage minimal stimulation

Brain damage in a child who sustained a closed-head injury can be caused by which factor? 1. Increased perfusion to the brain and increased metabolic needs of the brain 2. Decreased perfusion to the brain and decreased metabolic needs to the brain 3. Increased perfusion to the brain and decreased metabolic needs. of the brain 4. Decreased perfusion of the brain and increased metabolic needs of the brain

4. Decreased perfusion of the brain and increased metabolic needs of the brain

Which of the following will be abnormal in a child with the diagnosis of hemophilia? 1. Platelet count 2. Hemoglobin level 3. White blood cell count 4. Partial thromboplastin time (PTT)

4. Partial thromboplastin time (PTT)

A toddler who has been hospitalized for vomiting due to gastroenteritis is sleeping and difficult to wake up. Assessment reveals vital signs of a regular HR of 220 beats per minute, respiratory rate of 30 per minute, BP of 84/52, and capillary refill of 3 seconds. Which dysrhythmia does the nurse suspect in this child? 1. Rapid pulmonary flutter. 2. Sinus bradycardia. 3. Rapid atrial fibrillation. 4. Supraventricular tachycardia.

4. Supraventricular tachycardia.

The mother of an unconscious child has been calling her name repeatedly and gently shaking her shoulders in an attempt to wake her up. The nurse notes that the child is flexing her arms and wrists while bringing her arms closer to the midline of her body. The child's mother asks, "What is going on?" Select the nurse's best response 1. I think your daughter hears you, and she is attempting to reach out to you 2. Your child is responding to you; please continue trying to stimulate her 3. It appears that your child is having a seizure. 4. Your child is demonstrating a reflex that indicates she is overwhelmed with stimulation she is receiving

4. your child is demonstrating a reflex that she is overwhelmed with stimulation she is receiving

What can a nurse do to reinforce a 5yo's intellectual initiative when he asks about his upcoming surgery? A. Answer the child's questions about his upcoming surgery in simple terms B. Provide the child with a book that has vivid illustrations about his surgery C. Tell the child he should wait and ask the doctor his questions D. Tell the child that she will answer his questions at a later time

A. Answer the child's questions about his upcoming surgery in simple terms

A 5yo has been dx with pseudohypertrophic muscular dystrophy. Which nursing intervention(s) would be appropriate? Select all that apply A. Discuss with the parents the potential need for respiratory support B. Explain that this disease is easily treated with medications C. Suggest exercises that will limit the use of muscles and prevent fatigue D. Assist the parents in finding a nursing facility for future care E. Encourage the parents to contact the school to develop an IEP

A. Discuss with the parents the potential need for respiratory support C. Suggest exercises that will limit the use of muscles and prevent fatigue E. Encourage the parents to contact the school to develop an IEP

The nurse is interviewing the parents of a 6yo who has been experiencing constipation. Which could be a causative factor? Select all that apply: A. Hypothyroidism B. Muscular dystrophy C. Myelomeningocele D. Drinks a lot of milk E. Active in sports

A. Hypothyroidism B. Muscular dystrophy D. Drinks a lot of milk

Which fo the following is most important for educating a patient's family prior to discharge of OM? A. Keep ears dry and clean after swimming B. Refrain from swimming for the next several weeks C. Don't allow patient to bottle feed lying down D. Return to the clinic if discharge is observed in the outer ear

A. Keep ears dry and clean after swimming

Which of the following is NOT a major accomplishment within the first 12 months of a child's life according to Piaget's Cognitive Theory of Development? A. Magical thinking B. Mental representation C. Object permanence D. Separation

A. Magical thinking

The nurse is caring for a newborn with esophageal atresia. When reviewing the mother's history, which would the nurse expect to find? A. Maternal polyhydramnios B. Pregnancy lasting more than 38 weeks C. Poor nutrition during pregnancy D. Alcohol consumption during pregnancy

A. Maternal polyhydramnios

Which statement by the parent is most consistent with minimal change nephrotic syndrome? A. My child missed 2 days of school last week because of a really bad cold B. After camping last week, my child's legs were covered in bug bites C. My child came home from school a week ago because of vomiting and stomach cramps D. We have a pet turtle, but no one washes their hands after playing with the turtle

A. My child missed 2 days of school last week because of a really bad cold

The parents of a child with GN ask how they will know their child is improving when they go home. Which are the nurse's best responses? Select all that apply A. Your child's urine output will increase, and the urine will become less tea colored B. Your child will have more energy as lab tests become more normal C. Your child's appetite will decrease as urine output increases D. Your childs lab values will become more normal E. Your child's weight will increase as the urine becomes less tea colored

A. Your child's urine output will increase, and the urine will become less tea colored E. Your child's weight will increase as the urine becomes less tea colored

A patient has been diagnosed with acute OM in the right ear. Which intervention(s) should the nurse include in his plan of care? A. Lay patient on the left side to promote drainage B. Administer abx C. Irrigate the right ear with saline D. Administer ibuprofen for pain E. Give patient albuterol PRN

B. Administer abx D. Administer ibuprofen for pain

The nurse is caring for a newborn who has just been diagnosed with tracheoesophageal fistula and is scheduled for surgery. Which should the nurse expect to do preop? A. Keep the child in a monitored crib, obtain frequent VS, and allow the parents to visit but not hold their infant B. Administer intravenous fluids and antibiotics C. Place the infant on 100% O2 via a non-rebreather mask D. have the mother feed the infant slowly in a monitored area, stopping all feedings 4-6 hours post surgery

B. Administer intravenous fluids and antibiotics

To obtain an adolescent's health info, the nurse should: A. Interview the adolescent using direct questions B. Gather information during a casual conversation C. Interview the adolescent only in the presence of the parents D. Gather information only from the parents

B. Gather information during a casual conversation

A 9yo girl builds a club house in her backyard. She hangs a sign outside her clubhouse that has "No boys allowed" printed on it. The child's parents are concerned that she is excluding her neighbor's son, and they are upset. What should the school nurse tell the child's parents? A. Her behavior is cause for concern and should be addressed B. Her behavior is common among school-age children C. Her feelings about boys will subside within the. next year D. They should have their daughter speak with the school counselor

B. Her behavior is common among school-age children

Which foods should the nurse recommend to the mother of 2 year old with iron-deficiency anemia? A. 32 oz of whole cow's milk per day B. Meat, eggs, and green vegetables C. Fruits, whole grains, and rice D. 8 oz of juice, three times a day

B. Meat, eggs, and green vegetables

A 6-month-old infant presents to the ER. He is crying, appears thirsty and his mouth is dry. His HR is 176 and his RR is 66. Given the findings above, what level of dehydration is the patient experiencing? A. Mild B. Moderate C. Severe D. Preshock

B. Moderate

Which activity can the nurse provide for a 9yo to encourage a sense of industry A. Allow the child to choose what time to take his medicine B. Provide the child with the homework his teacher has sent C. Allow the child to assist with his bath D. Allow the child to help with his dressing change

B. Provide the child with the homework his teacher has sent

After a tonsillectomy, the nurse reviews the care plan prescribed to the child. Which part(s) of the care plan should the nurse question? (Select all that apply) A. Monitor for bleeding B. Suction q2h C. Give clear liquids when alert and oriented D. Give ice cream to patient to help reduce inflammation

B. Suction q2h D. Give ice cream to patient to help reduce inflammation

A 12-month-old patient comes in post-op tonsillectomy with a HR 156, RR 54, 38 C. The nurse observes that the patient is breathing mostly by mouth, is agitated, and is frequently swallowing. What can the nurse most likely conclude? A. The patient may have an aspiration on foreign object B. The patient may have a post-op hemorrhage C. The patient may have acute streptococcal pharyngitis and may need a throat culture D. The patient shows no abnormalities

B. The patient may have a post-op hemorrhage

The parent of a child with glomerulonephritis asks the nurse why the urine is such a funny color. Which is the nurse's best response? A. It is not uncommon for the urine to be discolored when children are receiving steroids and BP meds B. There is blood in your child's urine that causes it to be tea-colored C. Your child's urine is very concentrated, so it appears to be discolored D. A ketogenic diet often causes the urine to be tea-colored

B. There is blood in your child's urine that causes it to be tea-colored

The clinical manifestations of minimal change nephrotic syndrome are due to which of the following? A. chemical changes in the composition of albumin B. increased permeability of the glomeruli C. Obstruction of the capillaries of the glomeruli D. loss of the kidneys' ability to excrete waste and concentrate urine

B. increased permeability of the glomeruli

A child with minimal change nephrotic syndrome has generalized edema. The skin appears stretched, and areas of breakdown are noted over the bony prominences. The child has been receiving lasix twice daily for several days. What does the nurse expect to be included in the treatment plan tor educe edema? A. An increase in the amount and frequency of lasix B. Addition of a second diuretic, such as mannitol C. Administration of albumin IV D. Elimination fo all fluids and sodium from the child's diet

C. Administration of albumin IV

Which nursing action would help foster a hospitalized 3yo's sense of autonomy?A. Let the child choose what time to take the oral abx B. Allow the child to have a doll for medical play C. Allow the child to administer her own dose of cephalexin (Keflex) via oral syringe D. Le the child watch age-appropriate videos

C. Allow the child to administer her own dose of cephalexin (Keflex) via oral syringe

Which action is a developmentally appropriate method for eliciting a 4yo's cooperation in obtaining the BP? A. Have the child's parents help put on the blood pressure cuff B. Tell the child that if he sits still, the blood pressure machine will go quickly C. Ask the child if he feels a squeezing of his arm D. Tell the child that measuring the BP will not hurt

C. Ask the child if he feels a squeezing of his arm

The parents of a child hospitalized with minimal change nephrotic syndrome ask why the last blood test revealed elevated lipids. Which is the nurse's best response? A. If your child had just eaten a fatty meal, the lipids may have been falsely elevated B. It is not unusual to see elevated lipids in children b/c of the dietary habits of today C. Because your child is losing so much protein, the liver is stimulated and makes more lipids D. Your child's blood is very concentrated b/c of the edema, so the lipids are falsely elevated

C. Because your child is losing so much protein, the liver is stimulated and makes more lipids

WHich findings requires immediate attention in a child with GN? A. Sleeping most of the day and being very cranky when awake; BP is 170/90 B. Urine output is 190mL in an 8hour period and is the color of coca-cola C. Complaining of a severe headache and photophobia D. Refusing breakfast and lunch and stating he is just not hungry

C. Complaining of a severe headache and photophobia

The nurse should tell the parents of a child with DMD that some of the progressive complications include: Select all that apply A. Dry skin and hair, hirsutism, protruding tongue, and mental retardation B. Anorexia, gingival hyperplasia, dry skin and hair C. Contractures, obesity, and pulmonary infections D. Trembling, frequent loss of consciousness, and slurred speech E. Increasing difficulty swallowing and shallow breathing

C. Contractures, obesity, and pulmonary infections E. Increasing difficulty swallowing and shallow breathing

The best method to explain a procedure to a hospitalized pre-school age is to: A. Show the child a pamphlet with pictures showing the procedure B. Have the 5 yo next door tell the 4yo about the procedure C. Demonstrate the procedure on a doll D. Show the child a video of the procedure

C. Demonstrate the procedure on a doll

The nurse is giving discharge instructions to the parent of a 1 month old infant with tracheoesophageal fistula and a gastrostomy tube (GT). The nurse knows the mother understands the discharge teaching when she states: A. I will give my baby feedings through the GT but place liquid medications in the corner of the mouth to be absorbed B. I will flush the GT with 2 oz of water after each feeding to prevent the GT from clogging C. I will clean the area around the GT every day D. I will place petroleum jelly around the GT if any redness develops

C. I will clean the area around the GT every day

Which combination of signs is commonly associated with glomerulonephritis? A. Massive proteinuria, hematuria, decreased urinary output, and lethargy B. Mild proteinuria, increased urinary output, and lethargy C. Mild proteinuria, hematuria, decreased urinary output, and lethargy D. Massive proteinuria, decreased urinary output, and hypotension

C. Mild proteinuria, hematuria, decreased urinary output, and lethargy

The mother of a child who is 2 years 6 months in age has arranged a play date with the neighbor and her child who is 2 years 9 months old. During the play date the two mothers should expect that the children will do which of the following? A. Share and trade their toys while playing B. Play with one another with little or no conflict C. Play alongside one another but not actively with one another D. Only play with one or two items, ignoring most of the other toys

C. Play alongside one another but not actively with one another

All of the following are nursing responsibilities for the post-op patient who just received a tonsillectomy except: A. Maintaining adequate fluid intake B. Watching for signs of bleeding and hemorrhage C. Suctioning the patient's mouth TID D. Positioning the patient upright

C. Suctioning the patient's mouth TID

Which statements would indicate to the nurse that a school-age child is not developmentally on track for her age? Select all that apply A. The child is able to follow a 4-5 step command B. The child started wetting the bed on admission to the hospital C. The child has an imaginary friend name Kelly D. The child enjoys playing board games with her sister E. The child is not able to follow rules

C. The child has an imaginary friend name Kelly E. The child is not able to follow rules

The nurse is caring for a 5 month old infant with a diagnosis of intussusception. The infant has periods of irritability during which the knees are brought to the chest and the infant cries, alternating with periods of lethargy. Vital signs are stable and within age-appropriate limits. The healthcare provider elects to give an enema. The parents ask the purpose of the enema. Which is the nurse's most appropriate response? A. The enema will confirm the diagnosis. If the test result is positive, your child will need to have surgery to correct the intussusception. B. The enema will confirm the diagnosis. Although very unlikely, the enema may also help fix the intussusception so that your child will not immediately need surgery C. The enema will help confirm the diagnosis and has a good chance of fixing the intussusception D. The enema will help confirm the diagnosis and may temporarily fix the intussusception. If the bowel returns to normal, there is a strong likelihood that the intussusception will recur.

C. The enema will help confirm the diagnosis and has a good chance of fixing the intussusception

Which statement accurately describes how the nurse should approach and 11yo to do a physical assessment? A. Ask the child's parents to remain in the room during the physical exam B. Auscultate the heart, lungs, and abdomen first C. Explain hat the physical exam will not hurt D. Explain what the nurse will be doing in basic understandable terms

D. Explain what the nurse will be doing in basic understandable terms

Which foods would be best for a child with DMD. Select all that apply A. High CHO, High protein B. No special food combinations C. extra protein to help strengthen muscles D. Low calorie foods to prevent weight gain E. Thickened liquids and smaller portions that are cut up

D. Low calorie foods to prevent weight gain E. Thickened liquids and smaller portions that are cut up

The nurse will soon receive a 4 month old who has been diagnosed with intussusception. The infant is described as very lethargic with the following VS: T 101.8, HR 181, BP 68/38. The reporting nurse states the infant's abdomen is very rigid. Which is the most appropriate action for the receiving nurse? A. Prepare to accompany the infant to a computed tomography scan to confirm the dx B. Prepare to accompany the infant to the radiology department for a reducing enema C. Prepare to start a second IV line to administer fluids and abx D. Prepare to get the infant ready for immediate surgical correction

D. Prepare to get the infant ready for immediate surgical correction

Which should be the nurse's immediate action when a newborn begins to cough and choke and becomes cyanotic while feeding? A. Inform the healthcare provider of the situation B. Have the mother stop feeding the infant, and observe to see if the choking episode resolves on its own C. immediately determine the infant's oxygen saturation and have the mother stop feeding the infant D. Take the infant from the mother and administer blow-by oxygen while obtaining the infant's oxygen saturation

D. Take the infant from the mother and administer blow-by oxygen while obtaining the infant's oxygen saturation

Which statement accurately describes the best method for assessing a 12-month-old? A. The nurse should assess the child on the examining table B. The nurse should assess the child in a head-to-toe sequence C. The nurse should have the child's parent assist in holding her down D. The nurse should assess the child while she is in her parent's lap

D. The nurse should assess the child while she is in her parent's lap

Which can elicit the Gower sign? Have the child: A. Close the eyes and touch the nose with alternating index fingers B. Hop on one foot and then the other C. Bend from the waist to touch the toes D. Walk like a duck and rise from a squatting position

D. Walk like a duck and rise from a squatting position

A parent asks the nurse how to prevent the child from having minimal change nephrotic syndrome again. which is the nurse's best response? A. It is very rare for a child to have a relapse after having fully recovered B. unfortunately many children have cycles of relapse, and there is very little that can be done to prevent it. C. your child is much less likely to get sick again if sodium is decreased in the diet D. try to keep your child away from sick children because relapses have been associated with infectious diseases

D. try to keep your child away from sick children because relapses have been associated with infectious diseases

The parents of a preschooler dx with muscular dystrophy are asking questions about the course of their child's disease. Which should the nurse tell them? Select all that apply A. Muscular dystrophies usually result in progressive weakness B. The weakness that your child is having will probably not increase C. Your child will be able to function normally and not need any special accommodations D. The extent of weakness depends on doing daily physical therapy E. Your child may have pain in his legs with muscle weakness

E. Your child may have pain in his legs with muscle weakness

A newborn is diagnosed with a congenital heart defect (CHD). The test results reveal that the lumen of the duct between the aorta and pulmonary artery remains open. This defect is known as.

Patent ductus arteriosis

Patent ductus arteriosus causes what type of shunt

left to right

A child who has reddened eyes with no discharge; red, swollen, and peeling palms and soles of the feet; dry, cracked lips; and a "strawberry tongue" most likely has:

Kawasaki's Disease

A 3 mo old has been dix with a ventricular septal defect (VSD). The flow of blood through the heart is

Left to right

The flow of blood through the heart with an atrial septal defect is

Left to right

The nurse is caring for a child who has been in a MVA. The child falls asleep unless her name is called or she is gently shaken. This state of consciousness is referred to as: 1. Coma 2. Delirium 3. Obtunded 4. Confusion

3. Obtunded

Which of the following confirms a diagnosis of Hodgkin disease in a 15-year-old? 1. Reed-Sternberg cells in the lymph nodes. 2. Blast cells in the blood. 3. Lymphocytes in the bone marrow. 4. VMA in the urine.

1. Reed-Sternberg cells in the lymph nodes.

Which vaccines must be delayed for 11 months after the administration of gamma globulin? Select all that apply. 1. Diphtheria, tetanus, and pertussis. 2. Hepatitis B. 3. Inactivated polio virus. 4. Measles, mumps, and rubella. 5. Varicella.

4. Measles, mumps, and rubella. 5. Varicella.

The nurse is caring for a child with leukemia. The nurse should be aware that children being treated for leukemia may experience which of the following complications? Select all that apply. 1. Anemia. 2. Infection. 3. Bleeding tendencies. 4. Bone deformities. 5. Polycythemia.

1. Anemia. 2. Infection.

A child born with Down syndrome should be evaluated for which associated cardiac manifestation? 1. Congenital Heart Defect (CHD) 2. Systemic hypertension 3. Hyperlipidemia 4. Cardiomyopathy

1. CHD

Which laboratory result will provide the most important information regarding the respiratory status of a child with an acute asthma exacerbation? 1. CBC. 2. ABG. 3. BUN. 4. PTT.

2. ABG.

What should the nurse assess prior to administering digoxin? Select all that apply. 1. Sclera. 2. Apical pulse rate. 3. Cough. 4. Liver function test.

2. Apical pulse rate.

Which finding might delay a cardiac catheterization procedure on a 1-year-old? 1. 30th percentile for weight. 2. Severe diaper rash. 3. Allergy to soy. 4. Oxygen saturation of 91% on room air.

2. Severe diaper rash.

31. Which plan would be appropriate in helping to control congestive heart failure (CHF) in an infant? 1. Promoting fluid restriction. 2. Feeding a low-salt formula. 3. Feeding in semi-Fowler position. 4. Encouraging breast milk.

3. Feeding in semi-Fowler position

During play, a toddler with a history of tetralogy of Fallot (TOF) might assume which position? 1. Sitting. 2. Supine. 3. Squatting. 4. Standing.

3. Squatting.

A school-age child is admitted to the hospital for a tonsillectomy. During the nurse's post-operative assessment, the child's parent tells the nurse that the child is in pain. Which of the following observations would be of most concern to the nurse? 1. The child's heart rate and blood pressure are elevated. 2. The child complains of having a sore throat. 3. The child is refusing to eat solid foods. 4. The child is swallowing excessively.

4. The child is swallowing excessively.

A child with a ventriculoperitoneal (VP) shunt complains of a HA and blurry vision and now experiences irritability and sleeping more than usual. The parents ask the nurse what they should do. Select the nurse's best response 1. Give her some acetaminophen (Tylenol), and see if her symptoms improve. If they do not improve, bring her to the health-care providers office 2. It is common for girls to have these sxs, esp prior to beginning their menstrual cycle. Give her a few days, and see if she improves 3. You are probably worried that she is having a problem with her shunt. This is very unlikely because it has been working well for 9 years 4. You should immediately take her to the ED because these may be sxs of a shunt malfunction

4. You should immediately take her to the ED because these may be sxs of a shunt malfunction

Which child is at a risk for developing glomerulonephritis? A. A 3 yo who has impetigo 1 week ago B. A 5yo with a hx of 5 UTIs in the previous year C. A 6yo with new onset T1DM D. A 10yo recovering from viral PNA

A. A 3 yo who has impetigo 1 week ago

Which of the following is the best indicator of dehydration in pediatric patients? A. Change in weight from pre-illness weight to current weight B. Color and amount of urine C. Change in vital signs D. Quality of the mucous membranes

A. Change in weight from pre-illness weight to current weight

Which has the potential to alter a child's level of consciousness? Select all that apply 1. Metabolic disorders 2. Trauma 3. Hypoxic episode 4. Dehydration 5. Endocrine disorders

All of the above

A 10-month-old infant is diagnosed with otitis media for the third time. The mother is frustrated and asks what she can do to prevent her child from getting this again. You tell the mother that: A. She should be sure to dry her child's ear thoroughly after swimming as water near the entrance to the ear can cause OM B. She should stop breastfeeding because breastfeeding can lead to frequent ear infections C. She should put alcohol in her baby's ear regularly to dry out the ear canal D. She should hold her child upright while feeding her a bottle

D. She should hold her child upright while feeding her a bottle

A 6mo who has episodes of cyanosis after crying could have the CHD of decreased pulmonary blood flow called

TOF

Congenital heart defects (CHDs) are classified by which of the following? Select all that apply. 1. Cyanotic defect. 2. Acyanotic defect. 3. Defects with increased pulmonary blood flow. 4. Defects with decreased pulmonary blood flow. 5. Mixed defects. 6. Obstructive defects. 7. Pansystolic murmurs.

3. Defects with increased pulmonary blood flow. 4. Defects with decreased pulmonary blood flow. 5. Mixed defects. 6. Obstructive defects.

A teen is seen in clinic for a possible diagnosis of Hodgkin disease. The nurse is aware that which of the following symptoms should make the physicians suspect Hodgkin disease? 1. Fever, fatigue, and pain in the joints. 2. Anorexia with weight loss. 3. Enlarged, painless, and movable lymph nodes in the cervical area. 4. Enlarged liver with jaundice.

3. Enlarged, painless, and movable lymph nodes in the cervical area.

A nurse is caring for a 5-year-old with sickle cell vaso-occlusive crisis. Which of the following orders should the nurse question? Select all that apply. 1. Position the child for comfort. 2. Apply hot packs to painful areas. 3. Give Demerol 25 mg intravenously every 4 hours as needed for pain. 4. Restrict oral fluids. 5. Apply oxygen per nasal cannula to keep oxygen saturations above 94%.

3. Give Demerol 25 mg intravenously every 4 hours as needed for pain. 4. Restrict oral fluids.

Which of the following should be done to protect the central nervous system from the invasion of malignant cells in a child newly diagnosed with leukemia? 1. Cranial and spinal radiation. 2. Intravenous steroid therapy. 3. Intrathecal chemotherapy. 4. High-dose intravenous chemotherapy.

3. Intrathecal chemotherapy.

Which of the following analgesics is most effective for a child with sickle cell pain crisis? 1. Demerol. 2. Aspirin. 3. Morphine. 4. Excedrin.

3. Morphine.

The nurse is caring for a child who has undergone a cardiac catheterization. During recovery, the nurse notices the dressing is saturated with bright red blood. The nurse's first action is to: 1. Call the interventional cardiologist. 2. Notify the cardiac catheterization laboratory that the child will be returning. 3. Apply a bulky pressure dressing over the present dressing. 4. Apply direct pressure 1 inch above the puncture site.

4. Apply direct pressure 1 inch above the puncture site.

2. Which should the nurse stress to the parents of an infant in a Pavlik harness for treatment of developmental dysplasia of the hip (DDH)? 1. Put socks on over the foot pieces of the harness to help stabilize the harness. 2. Use lotions or powder on the skin to prevent rubbing of straps. 3. Remove harness during diaper changes for ease of cleaning diaper area. 4. Check under the straps at least two to three times daily for red areas.

4. Check under the straps at least two to three times daily for red areas.

Prednisone is given to children who are being treated for leukemia. Why is this medication given as part of the treatment plan? 1. Enhances protein metabolism. 2. Enhances sodium excretion. 3. Increases absorption of the chemotherapy. 4. Destroys abnormal lymphocytes.

4. Destroys abnormal lymphocytes.

During a well-child checkup for an infant with tetralogy of Fallot (TOF), the child develops severe respiratory distress and becomes cyanotic. The nurse's first action should be to: 1. Lay the child flat to promote hemostasis. 2. Lay the child flat with legs elevated to increase blood flow to the heart. 3. Sit the child on the parent's lap, with legs dangling, to promote venous pooling. 4. Hold the child in knee-chest position to decrease venous blood return.

4. Hold the child in knee-chest position to decrease venous blood return.

Which foods would be best for a child with Duchenne muscular dystrophy? 1. High-carbohydrate, high-protein foods. 2. No special food combinations. 3. Extra protein to help strengthen muscles. 4. Low-calorie foods to prevent weight gain.

4. Low-calorie foods to prevent weight gain.

The nurse is caring for a newborn with esophageal atresia. When reviewing the mother's history, which would the nurse expect to find? 1. Maternal polyhydramnios. 2. Pregnancy lasting more than 38 weeks. 3. Poor nutrition during pregnancy. 4. Alcohol consumption during pregnancy

1. Maternal polyhydramnios.

Which will help a school-aged child with muscular dystrophy stay active longer? 1. Normal activities, such as swimming. 2. Using a treadmill every day. 3. Several periods of rest every day. 4. Using a wheelchair upon getting tired.

1. Normal activities, such as swimming.

Expected nursing assessments of a newborn with suspected cystic fibrosis would include: 1. Observe frequency and nature of stools. 2. Provide chest physical therapy. 3. Observe for weight gain. 4. Assess parent's compliance with fluid restrictions.

1. Observe frequency and nature of stools.

Which can elicit the Gower sign? Have the patient: 1. Close the eyes and touch the nose with alternating index fingers. 2. Hop on one foot and then the other. 3. Bend from the waist to touch the toes. 4. Walk like a duck and rise from a squatting position.

4. Walk like a duck and rise from a squatting position.

The nurse is caring for a child with a diagnosis of ALL who is receiving chemotherapy. The nurse notes that the child's platelet count is 20,000/mm3. Based on this laboratory finding, what information should the nurse provide to the child and parents? 1. A soft toothbrush should be used for mouth care. 2. Isolation precautions should be started immediately. 3. The child's vital signs, including blood pressure, should be monitored every 4 hours. 4. All visitors should be discouraged from coming to see the family.

1. A soft toothbrush should be used for mouth care.

Which child is at risk for developing glomerulonephritis? 1. A 3-year-old who had impetigo 1 week ago. 2. A 5-year-old with a history of five UTIs in the previous year. 3. A 6-year-old with new-onset type 1 diabetes. 4. A 10-year-old recovering from viral pneumonia.

1. A 3-year-old who had impetigo 1 week ago.

4. A 4-month-old is brought to the emergency department with severe dehydration. The heart rate is 198, and her blood pressure is 68/38. The infant's anterior fontanel is sunken. The nurse notes that the infant does not cry when the intravenous line is inserted. The child's parents state that she has not "held anything down" in 18 hours. The nurse obtains a finger-stick blood sugar of 94. Which would the nurse expect to do immediately? 1. Administer a bolus of normal saline. 2. Administer a bolus of D10W. 3. Administer a bolus of normal saline with 5% dextrose added to the solution. 4. Offer the child an oral rehydrating solution such as Pedialyte.

1. Administer a bolus of normal saline.

Which interventions decrease cardiac demands in an infant with congestive heart failure (CHF)? Select all that apply. 1. Allow parents to hold and rock their child. 2. Feed only when the infant is crying. 3. Keep the child uncovered to promote low body temperature. 4. Make frequent position changes. 5. Feed the child when sucking the fists. 6. Change bed linens only when necessary. 7. Organize nursing activities.

1. Allow parents to hold and rock their child. 4. Make frequent position changes. 5. Feed the child when sucking the fists. 6. Change bed linens only when necessary. 7. Organize nursing activities.

Which combination of signs is commonly associated with glomerulonephritis? 1. Massive proteinuria, hematuria, decreased urinary output, and lethargy. 2. Mild proteinuria, increased urinary output, and lethargy. 3. Mild proteinuria, hematuria, decreased urinary output, and lethargy. 4. Massive proteinuria, decreased urinary output, and hypotension.

1. Massive proteinuria, hematuria, decreased urinary output, and lethargy.

The parent of a teen with a diagnosis of Hodgkin disease asks what the child's prognosis will be with treatment. What information should the nurse give to the parent and child? 1. Clinical staging of Hodgkin disease will determine the treatment; long-term survival for all stages of Hodgkin disease is excellent. 2. There is a considerably better prognosis if the client is diagnosed early and is 3. between the ages of 5 and 11 years. 4. The prognosis for Hodgkin disease depends on the type of chemotherapy. 5. The only way to obtain a good prognosis is by chemotherapy and bone marrow transplant.

1. Clinical staging of Hodgkin disease will determine the treatment; long-term survival for all stages of Hodgkin disease is excellent.

Which are the most serious complications for a child with Kawasaki disease (KD)? Select all that apply. 1. Coronary thrombosis. 2. Coronary stenosis. 3. Coronary artery aneurysm. 4. Hypocoagulability. 5. Decreased sedimentation rate. 6. Hypoplastic left heart syndrome.

1. Coronary thrombosis. 2. Coronary stenosis. 3. Coronary artery aneurysm.

A 5-year-old has been diagnosed with pseudohypertrophic muscular dystrophy. Which nursing intervention would be appropriate? 1. Discuss with the parents the potential need for respiratory support. 2. Explain that this disease is easily treated with medication. 3. Suggest exercises that will limit the use of muscles and prevent fatigue. 4. Assist the parents in finding a nursing facility for future care.

1. Discuss with the parents the potential need for respiratory support. (3. Suggest exercises that will limit the use of muscles and prevent fatigue.)

School-age children with cancer often have a body image disturbance related to hair loss, moon face, or debilitation. Which of the following interventions is most appropriate? 1. Encourage them to wear a wig similar to their own hairstyle. 2. Emphasize the benefits of the therapy they are receiving. 3. Have them play only with other children with cancer. 4. Use diversional techniques to avoid discussing changes in the body because of the chemotherapy.

1. Encourage them to wear a wig similar to their own hairstyle.

The nurse is caring for a child who is receiving a transfusion of packed red blood cells. The nurse is aware that if the child had a hemolytic reaction to the blood, the signs and symptoms would include which of the following? Select all that apply. 1. Fever. 2. Rash. 3. Oliguria. 4. Hypotension. 5. Chills.

1. Fever 3. Oliguria 4. Hypotension

Which of the following measures should the nurse implement to help with the nausea and vomiting from chemotherapy? Select all that apply. 1. Give an antiemetic 30 minutes prior to the start of therapy. 2. Continue the antiemetic as ordered until 24 hours after the chemotherapy is complete. 3. Remove food that has a lot of odor. 4. Keep the child on a nothing-by-mouth status. 5. Wait until the nausea begins to start the antiemetic.

1. Give an antiemetic 30 minutes prior to the start of therapy. 2. Continue the antiemetic as ordered until 24 hours after the chemotherapy is complete. 3. Remove food that has a lot of odor.

A child diagnosed with leukemia is receiving allopurinol as part of the treatment plan. The parents ask why their child is receiving this medication. What information about the medication should the nurse provide? 1. Helps reduce the uric acid level caused by cell destruction. 2. Used to make the chemotherapy work better. 3. Given to reduce the nausea and vomiting associated with chemotherapy. 4. Helps decrease pain in the bone marrow.

1. Helps reduce the uric acid level caused by cell destruction.

The nurse is caring for a child with Kawasaki disease (KD). A student nurse who is on the unit asks if there are medications to treat this disease. The nurse's response to the student nurse is: 1. Immunoglobulin G and aspirin. 2. Immunoglobulin G and ACE inhibitors. 3. Immunoglobulin E and heparin. 4. Immunoglobulin E and ibuprofen.

1. Immunoglobulin G and aspirin.

Which of the following can be manifestations of leukemia in a child? Select all that apply. 1. Leg pain. 2. Fever. 3. Excessive weight gain. 4. Bruising. 5. Enlarged lymph nodes.

1. Leg pain. 2. Fever. 4. Bruising. 5. Enlarged lymph nodes.

Hypoxic spells in the infant with a congenital heart defect (CHD) can cause which of the following? Select all that apply. 1. Polycythemia. 2. Blood clots. 3. Cerebrovascular accident. 4. Developmental delays. 5. Viral pericarditis. 6. Brain damage. 7. Alkalosis.

1. Polycythemia. 2. Blood clots. 3. Cerebrovascular accident. 4. Developmental delays. 6. Brain damage.

Which of the following best describes the action of chemotherapeutic agents used in the treatment of cancer in children? Select all that apply 1. Suppress the function of normal lymphocytes in the immune system. 2. Are alkylating agents and are cell-specific. 3. Cause a replication of DNA and are cell-specific. 4. Interrupt cell cycle, thereby causing cell death. 5. Prednisone is a natural hormone

1. Suppress the function of normal lymphocytes in the immune system. 4. Interrupt cell cycle, thereby causing cell death. 5. Prednisone is a natural hormone

The nurse is caring for a child being treated for ALL. Laboratory results indicate that the child has a white blood cell count of 5000/mm3 with 5% polys and 3% bands. Which of the following analyses is most appropriate?1. The absolute neutrophil count is 400/mm3, and the child is neutropenic. 2. The absolute neutrophil count is 800/mm3, and the child is neutropenic.3. The absolute neutrophil count is 4000/mm3, and the child is not neutropenic 4. The absolute neutrophil count is 5800/mm3, and the child is not neutropenic.

1. The absolute neutrophil count is 400/mm3, and the child is neutropenic.

Which of the following factors need(s) to be included in a teaching plan for a child with sickle cell anemia? Select all that apply. 1. The child needs to be taken to a physician when sick. 2. The parent should make sure the child sleeps in an air-conditioned room. 3. Emotional stress should be avoided. 4. It is important to keep the child well hydrated. 5. It is important to make sure the child gets adequate nutrition.

1. The child needs to be taken to a physician when sick. 3. Emotional stress should be avoided. 4. It is important to keep the child well hydrated. 5. It is important to make sure the child gets adequate nutrition.

A child with hemophilia A fell and injured a knee while playing outside. The knee is swollen and painful. Which of the following measures should be taken to stop the bleeding? Select all that apply. 1. The extremity should be immobilized. 2. The extremity should be elevated. 3. Warm moist compresses should be applied to decrease pain. 4. Passive range-of-motion exercises should be administered to the extremity. 5. Factor VIII should be administered.

1. The extremity should be immobilized. 2. The extremity should be elevated. 5. Factor VIII should be administered.

Which of the following is correct regarding prognostic factors for determining survival for a child newly diagnosed with ALL? 1. The initial white blood cell count on diagnosis. 2. The race of the child. 3. The amount of time needed to initiate treatment. 4. The allergy history of the child.

1. The initial white blood cell count on diagnosis.

A nurse is caring for a 15-year-old who has just been diagnosed with non-Hodgkin lymphoma. Which of the following should the nurse include in teaching the parents about this lymphoma? Select all that apply. 1. The malignancy originates in the lymphoid system. 2. The presence of Reed-Sternberg cells in the biopsy is considered diagnostic. 3. Mediastinal involvement is typical. 4. The disease is diffuse rather than nodular. 5. Treatment includes chemotherapy and radiation.

1. The malignancy originates in the lymphoid system. 3. Mediastinal involvement is typical. 4. The disease is diffuse rather than nodular. 5. Treatment includes chemotherapy and radiation.

The nurse is caring for a child with sickle cell anemia who is scheduled to have an exchange transfusion. What information should the nurse teach the family? 1. The procedure is done to prevent further sickling during a vaso-occlusive crisis. 2. The procedure reduces side effects from blood transfusions. 3. The procedure is a routine treatment for sickle cell crisis. 4. Once the child's spleen is removed, it is necessary to do exchange transfusions.

1. The procedure is done to prevent further sickling during a vaso-occlusive crisis.

Tetralogy of Fallot (TOF) involves which defects? Select all that apply. 1. Ventricular septal defect (VSD). 2. Right ventricular hypertrophy. 3. Left ventricular hypertrophy. 4. Pulmonic stenosis (PS). 5. Pulmonic atresia. 6. Overriding aorta. 7. Patent ductus arteriosus (PDA).

1. Ventricular septal defect (VSD). 2. Right ventricular hypertrophy. 4. Pulmonic stenosis (PS) 6. Overriding aorta.

18. Which is the nurse's best response to parents who ask what impact asthma will have on the child's future in sports? 1. "As long as your child takes prescribed asthma medication, the child will be fine." 2. "The earlier a child is diagnosed with asthma, the more significant the symptoms." 3. "The earlier a child is diagnosed with asthma, the better the chance the child has of growing out of the disease." 4. "Your child should avoid playing contact sports and sports that require a lot of running."

2. "The earlier a child is diagnosed with asthma, the more significant the symptoms."

The nurse is caring for a 10-year-old with leukemia who is receiving chemotherapy. The child is on neutropenic precautions. Friends of the child come to the desk and ask for a vase for flowers. Which of the following is the best response? 1. "I will get you a special vase that we use on this unit." 2. "The flowers from your garden are beautiful but should not be placed in the room at this time." 3. "As soon as I can wash a vase, I will put the flowers in it and bring it to the room." 4. "Get rid of the flowers immediately. You could harm the child."

2. "The flowers from your garden are beautiful but should not be placed in the room at this time."

Which of the following is a (are) reason(s) to do a lumbar puncture on a child with a diagnosis of leukemia? Select all that apply. 1. Rule out meningitis. 2. Assess the central nervous system for infiltration. 3. Give intrathecal chemotherapy. 4. Determine increased intracranial pressure. 5. Stage the leukemia.

2. Assess the central nervous system for infiltration. 3. Give intrathecal chemotherapy.

A child has completed treatment for leukemia and comes to the clinic with the parents for a checkup. The parents express to the nurse that they are glad their child has been cured of cancer and is safe from getting cancer later in life. Which of the following should the nurse consider in responding? 1. Childhood cancer usually instills immunity to all other cancers. 2. Children surviving one cancer are at higher risk for a second cancer. 3. The child may have a remission of the leukemia but is immune to all other cancers. 4. As long as the child continues to take steroids, there will be no other cancers.

2. Children surviving one cancer are at higher risk for a second cancer.

While assessing a newborn with respiratory distress, the nurse auscultates a machine-like heart murmur. Other findings are a wide pulse pressure, periods of apnea, increased PaCO2, and decreased PO2. The nurse suspects that the newborn has: 1. Pulmonary hypertension. 2. Patent ductus arteriosus (PDA). 3. Ventricular septal defect (VSD). 4. Bronchopulmonary dysplasia.

2. Patent ductus arteriosus (PDA).

41. The nurse is giving discharge instructions to the parent of a 1-month-old infant with tracheoesophageal fistula and a gastrostomy tube (GT). The nurse knows the mother understands the discharge teaching when she states: 1. "I will give my baby feedings through the GT but place liquid medications in the corner of the mouth to be absorbed." 2. "I will flush the GT with 2 ounces of water after each feeding to prevent the GT from clogging." 3. "I will clean the area around the GT with soap and water every day." 4. "I will place petroleum jelly around the GT if any redness develops."

3. "I will clean the area around the GT with soap and water every day."

31. Which statement by the parents of a toddler with repeated otitis media indicates they need additional teaching? 1. "If I quit smoking, my child may have a decreased chance of getting an ear infection." 2. "As my child gets older, he should have fewer ear infections, because his immune system will be more developed." 3. "My child will have fewer ear infections if he has his tonsils removed." 4. "My child may need a speech evaluation."

3. "My child will have fewer ear infections if he has his tonsils removed."

6. The parent of a 5-year-old states that the child has been having diarrhea for 24 hours, vomited twice 2 hours ago, and now claims to be thirsty. The parent asks what to offer the child because the child is refusing Pedialyte. Select the nurse's most appropriate response. 1. "You can offer clear diet soda such as Sprite and ginger ale." 2. "Pedialyte is really the best thing for your child, who, if thirsty enough, will eventually drink it." 3. "Pedialyte is really the best thing for your child. Allow your child some choice in the way to take it by offering small amounts in a spoon, medicine cup, or syringe." 4. "It really does not matter what your child drinks as long as it is kept down. Try offering small amounts of fluids in medicine cups."

3. "Pedialyte is really the best thing for your child. Allow your child some choice in the way to take it by offering small amounts in a spoon, medicine cup, or syringe."

36. Which is the nurse's best response to the parent of an infant diagnosed with the first otitis media who wonders about long-term effects? 1. "The child could suffer hearing loss." 2. "The child could suffer some speech delays." 3. "The child could suffer recurrent ear infections." 4. "The child could require ear tubes."

3. "The child could suffer recurrent ear infections."

The nurse is caring for a 5-month-old infant with a diagnosis of intussusception. The infant has periods of irritability during which the knees are brought to chest and the infant cries, alternating with periods of lethargy. Vital signs are stable and within age-appropriate limits. The physician elects to give an enema. The parents ask the purpose of the enema. Select the nurse's most appropriate response. 1. "The enema will confirm the diagnosis. If the test result is positive, your child will need to have surgery to correct the intussusception." 2. "The enema will confirm the diagnosis. Although very unlikely, the enema may also help fix the intussusception so that your child will not immediately need surgery." 3. "The enema will help confirm the diagnosis and has a good chance of fixing the intussusception." 4. "The enema will help confirm the diagnosis and may temporarily fix the intussusception. If the bowel returns to normal, there is a strong likelihood that the intussusception will recur."

3. "The enema will help confirm the diagnosis and has a good chance of fixing the intussusception."

On examination, a nurse hears a murmur at the left sternal border (LSB) in a child with diarrhea and fever. The parent asks why the pediatrician never said anything about the murmur. The nurse explains: 1. "The pediatrician is not a cardiologist." 2. "Murmurs are difficult to detect, especially in children." 3. "The fever increased the intensity of the murmur." 4. "We need to refer the child to an interventional cardiologist."

3. "The fever increased the intensity of the murmur."

An 18-month-old male is brought to the clinic by his mother. His height is in the 50th percentile, and weight is in the 80th percentile. The child is pale. The physical examination is normal, but his hematocrit level is 20%. Which of the following questions should assist the nurse in making a diagnosis? Select all that apply. 1. "How many bowel movements a day does your child have?" 2. "How much did your baby weigh at birth?" 3. "What does your child eat every day?" 4. "Has the child been given any new medications?" 5. "How much milk does your child drink per day?"

3. "What does your child eat every day?" 5. "How much milk does your child drink per day?"

The parent of an infant with cystic fibrosis (CF) asks the nurse how to meet the child's increased nutritional needs. Which is the nurse's best suggestion? 1. "You may need to increase the number of fresh fruits and vegetables you give your child." 2. "You may need to advance your child's diet to whole cow's milk because it is higher in fat than formula." 3. "You may need to change your child to a higher-calorie formula." 4. "You may need to increase your child's carbohydrate intake."

3. "You may need to change your child to a higher-calorie formula."

The nurse should tell the parents of a child with Duchenne (pseudohypertrophic) muscular dystrophy that some of the progressive complications include: 1. Dry skin and hair, hirsutism, protruding tongue, and mental retardation. 2. Anorexia, gingival hyperplasia, and dry skin and hair. 3. Contractures, obesity, and pulmonary infections. 4. Trembling, frequent loss of consciousness, and slurred speech.

3. Contractures, obesity, and pulmonary infections.

The nurse receives a call from a parent of a child with leukemia in remission. The parent says the child has been exposed to chickenpox. The child has never had chickenpox. Which of the following responses is most appropriate for the nurse? 1. "You need to monitor the child's temperature frequently and call back if the temperature is greater than 101°F (38.3°C)." 2. "At this time there is no need to be concerned." 3. "You need to bring the child to the clinic for a chickenpox immunoglobulin vaccine." 4. "Your child will need to be isolated for the next 2 weeks."

3. "You need to bring the child to the clinic for a chickenpox immunoglobulin vaccine."

Where is the primary site of origin of the tumor in children who have neuroblastoma? 1. Bone. 2. Kidney. 3. Abdomen. 4. Liver.

3. Abdomen

The nurse is caring for a 2-year-old child who was admitted to the pediatric unit for moderate dehydration due to vomiting and diarrhea. The child is restless, with periods of irritability. The child is afebrile with a heart rate of 148 and a blood pressure of 90/42. Baseline laboratory tests reveal the following: Na 152, Cl 119, and glucose 115. The parents state that the child has not urinated in 12 hours. After establishing a saline lock, the nurse reviews the physician's orders. Which order should the nurse question? 1. Administer a saline bolus of 10 mL/kg, which may be repeated if the child does not urinate. 2. Recheck serum electrolytes in 12 hours. 3. After the saline bolus, begin maintenance fluids of D5 1/4 NS with 10 mEq KCl/L. 4. Give clear liquid diet as tolerated.

3. After the saline bolus, begin maintenance fluids of D5 1/4 NS with 10 mEq KCl/L.

20. Which should the nurse administer to provide quick relief to a child with asthma who is coughing, wheezing, and having difficulty catching her breath? 1. Prednisone. 2. Singulair (montelukast). 3. Albuterol. 4. Flovent (fluticasone).

3. Albuterol.

3. A 4-month-old has had vomiting and diarrhea for 24 hours. The infant is fussy, and the anterior fontanel is sunken. The nurse notes the infant does not produce tears when crying. Which task will help confirm the diagnosis of dehydration? 1. Urinalysis obtained by bagged specimen. 2. Urinalysis obtained by sterile catheterization. 3. Analysis of serum electrolytes. 4. Analysis of cerebrospinal fluid.

3. Analysis of serum electrolytes.

1. Which would the nurse expect to assess on a 3-week-old infant with developmental dysplasia of the hip (DDH)? 1. Excessive hip abduction. 2. Femoral lengthening of an affected leg. 3. Asymmetry of gluteal and thigh folds. 4. Pain when lying prone.

3. Asymmetry of gluteal and thigh folds.

22. Which breathing exercises should the nurse have an asthmatic 3-year-old child do to increase her expiratory phase? 1. Use an incentive spirometer. 2. Breathe into a paper bag. 3. Blow a pinwheel. 4. Take several deep breaths.

3. Blow a pinwheel.

A 5-year-old is admitted to the hospital with complaints of leg pain and fever. On physical examination, the child is pale and has bruising over various areas of the body. The physician suspects that the child has ALL. The nurse informs the parent that the diagnosis will be confirmed by which of the following? 1. Lumbar puncture. 2. White blood cell count. 3. Bone marrow aspirate. 4. Bone scan.

3. Bone marrow aspirate.

Which finding requires immediate attention in a child with glomerulonephritis? 1. Sleeping most of the day and being very "cranky" when awake; blood pressure is 170/90. 2. Urine output is 190 mL in an 8-hour period and is the color of Coca-Cola. 3. Complaining of a severe headache and photophobia. 4. Refusing breakfast and lunch and stating he "just is not hungry."

3. Complaining of a severe headache and photophobia.

7. The nurse is caring for a 9-month-old with diarrhea secondary to rotavirus. The child has not vomited and is mildly dehydrated. Which is likely to be included in the discharge teaching? 1. Administer Imodium as needed. 2. Administer Kaopectate as needed. 3. Continue breastfeeding per routine. 4. The infant may return to day care 24 hours after antibiotics have been started.

3. Continue breastfeeding per routine.

The nurse is reviewing discharge instructions with the parents of a child who had a tonsillectomy 24 hours ago. The parents tell the nurse that the child is a big eater, and they want to know what foods to give the child for the next 24 hours. What is the nurse's best response? 1. "The child's diet should not be restricted at all." 2. "The child's diet should be restricted to clear liquids." 3. "The child's diet should be restricted to ice cream and cold liquids." 4. "The child's diet should be restricted to soft foods."

4. "The child's diet should be restricted to soft foods."

17. What is the most important piece of information that the nurse must ask the parent of a child in status asthmaticus? 1. "What time did your child eat last?" 2. "Has your child been exposed to any of the usual asthma triggers?" 3. "When was your child last admitted to the hospital for asthma?" 4. "When was your child's last dose of medication?"

4. "When was your child's last dose of medication?"

A 2-year-old has just been diagnosed with cystic fibrosis (CF). The parents ask the nurse what early respiratory symptoms they should expect to see in their child. Which is the nurse's best response? 1. "You can expect your child to develop a barrel-shaped chest." 2. "You can expect your child to develop a chronic productive cough." 3. "You can expect your child to develop bronchiectasis." 4. "You can expect your child to develop wheezing respirations."

4. "You can expect your child to develop wheezing respirations."

The nurse is caring for a school-aged child with Duchenne muscular dystrophy in the elementary school. Which would be an appropriate nursing diagnosis? 1. Anticipatory grieving. 2. Anxiety reduction. 3. Increased pain. 4. Activity intolerance.

4. Activity intolerance.

Which intervention should be implemented after a bone marrow aspiration? 1. Ask the child to remain in a supine position. 2. Place the child in an upright position for 4 hours. 3. Keep the child nothing by mouth for 6 hours. 4. Administer analgesics as needed for pain.

4. Administer analgesics as needed for pain.

Which of the following measures should the nurse teach the parent of a child with hemophilia to do first if the child sustains an injury to a joint causing bleeding? 1. Give the child a dose of Tylenol. 2. Immobilize the joint, and elevate the extremity. 3. Apply heat to the area. 4. Administer factor per the home-care protocol.

4. Administer factor per the home-care protocol.

A child with leukemia is receiving chemotherapy and is complaining of nausea. The nurse has been giving the scheduled antiemetic. Which of the following should the nurse do when the child is nauseated? 1. Encourage low-protein foods. 2. Encourage low-caloric foods. 3. Offer the child's favorite foods. 4. Offer cool, clear liquids.

4. Offer cool, clear liquids

Which of the following will be abnormal in a child with the diagnosis of hemophilia? 1. Platelet count. 2. Hemoglobin level. 3. White blood cell count. 4. Partial thromboplastin time.

4. Partial thromboplastin time.

The nurse will soon receive a 4-month-old who has been diagnosed with intussusception. The infant is described as very lethargic with the following vital signs: T 101.8°F (38.7°C), HR 181, BP 68/38. The reporting nurse states the infant's abdomen is very rigid. Which is the most appropriate action for the receiving nurse? 1. Prepare to accompany the infant to a computed tomography scan to confirm the diagnosis. 2. Prepare to accompany the infant to the radiology department for a reducing enema. 3. Prepare to start a second intravenous line to administer fluids and antibiotics. 4. Prepare to get the infant ready for immediate surgical correction.

4. Prepare to get the infant ready for immediate surgical correction.