Pediatric Final: Chapters 25-33, 35, 45-49, 51
A child with hypogammaglobulinemia is to receive intravenous immunoglobulin (IVIG). Which of the following would be least appropriate for the nurse to do? A) Shake the vial after reconstituting it B) Premedicate the child with acetaminophen C) Obtain preinfusion vital signs D) Check serum blood urea nitrogen and creatinine levels
A
A group of students are reviewing information about glucose-6-phosphate dehydrogenase (G6PD) deficiency. The students demonstrate understanding of the material when they identify this disorder as due to which of the following? A) X-linked recessive inheritance B) Deficiency in clotting factors C) An excess supply of iron D) Autosomal recessive inheritance
A
The nurse is caring for a child with widespread itching and has recommended bathing as a relief measure. After teaching the mother about this, which statement from the mother indicates a need for further instruction? A) "After bathing, I need to rub his skin everywhere to make sure he is completely dry." B) "I must make sure I use lukewarm water instead of hot water." C) "Oatmeal baths are helpful; we can add Aveeno skin relief bath treatment." D) "We should leave his skin moist before applying medication or moisturizer."
A
The nurse is preparing to administer insulin to a diabetic child. Which of the following would be the recommended route for this administration? A) Subcutaneous B) Intradermal C) Intramuscular D) Oral
A
The nurse is providing care for a 10-year-old girl who has required multiple venipunctures and a computed tomography (CT) scan in a single day. The girl has expressed no fear or need for comfort. How should the nurse respond? A) "Tell me about your day today." B) "Are you doing okay?" C) "Are you feeling okay?" D) "You have done really well today."
A
The nurse is teaching the student nurse the factors that affect the pharmacodynamics of the drugs they are administering. Which of the following is a factor affecting this property of drugs? A) Immature body systems B) Weight C) Body surface D) Body composition
A
The nurse working in community nursing uses epidemiology as a tool. What information can be obtained using this process? A) Health needs of a population B) Cultural needs of a population C) Income levels of a population D) Mortality rates of a population
A
When evaluating the hemogram of an 8-month-old infant, the nurse would identify which type of hemoglobin as being the predominant type? A) Hemoglobin A B) Hemoglobin F C) Hemoglobin A2 D) Hemoglobin S
A
The nurse is developing a plan of care for a child with thalassemia. Which of the following would the nurse expect to include? Select all that apply. A) Packed RBC transfusions B) Deferoxamine therapy C) Heparin therapy D) Opioid analgesics E) Platelet transfusions F) Intravenous immunoglobulin
A B
The nurse is reviewing the laboratory test results of a child who is suspected of having systemic lupus erythematosus (SLE). Which of the following would the nurse identify as supporting this diagnosis? Select all answers that apply. A) Positive antinuclear antibody (ANA) B) Increased C3 levels C) Thrombocytopenia D) Leukopenia E) Increased hematocrit
A C D
The nurse is preparing to administer medication to a child with a gastrostomy tube in place. Which of the following is a recommended guideline for this procedure? Select all answers that apply. A) Verify proper tube placement prior to instilling medication. B) Mix liquid medications with a small amount of water and add directly into the tube. C) Mix powdered medications well with cold water first. D) Crush tablets and mix with warm water to prevent tube occlusion. E) Open up capsules and mix the contents with warm water. F) Flush the tube with water after administering medications.
A D E F
A nurse is assessing the skin of a child with cellulitis. Which of the following would the nurse expect to find? A) Red raised hair follicles B) Warmth at skin disruption site C) Papules progressing to vesicles D) Honey-colored exudate
B
A nurse is providing care to a child with idiopathic thrombocytopenic purpura with a platelet count of 18,000/mm3. Which medication would the nurse most likely expect to be ordered? A) Folic acid B) Intravenous immune globulin C) Dimercaprol D) Deferoxamine
B
The nurse is preparing to administer a medication to a 5-year-old who weighs 35 pounds. The prescribed single dose is 1 to 2 mg/kg/day. Which of the following is the appropriate dose range for this child? A) 8 to 16 mg B) 16 to 32 mg C) 35 to 70 mg D) 70 to 140 mg
B
The nurse is preparing to administer an intramuscular injection to an 8-month-old infant. Which site would the nurse select? A) Rectus femoris B) Vastus lateralis C) Dorsogluteal muscle D) Deltoid
B
The nurse is providing teaching on how to administer nasal drops. Which of the following responses by the parents indicates a need for further teaching? A) "We need to be careful not to stimulate a sneeze." B) "She needs to remain still for at least 10 minutes after administration." C) "Our daughter should lie on her back with her head hyperextended." D) "We must not let the dropper make contact with the nasal membranes.
B
The nurse is talking to the parents of a child who has been diagnosed with severe combined immune deficiency. Which statement by the parents best indicates that they understand their child's condition? A) "He'll need to receive intravenous immunoglobulin routinely." B) "We'll need to prepare him and ourselves for a bone marrow transplant.' C) "He'll need to receive several different types of antiviral medications." D) "We'll make sure that he has his EpiPen with him at all times.
B
Which of the following would the nurse include when teaching an adolescent about tinea pedis? A) "Keep your feet moist and open to the air as much as possible." B) "Dry the area between your toes really well." C) "Wear nylon or synthetic socks every day." D) "Go barefoot when you are in the locker room at school."
B
As part of a clinical conference with a group of nursing students, the instructor is describing the burn classification. The instructor determines that the teaching has been successful when the group identifies which of the following as characteristic of full thickness burns? A) Skin that is reddened, dry, and slightly swollen B) Skin appearing wet with significant pain C) Skin with blistering and swelling D) Skin that is leathery and dry with some numbness
D
A 5-year-old girl is cyanotic, dusky, and anxious when she arrives in the emergency department. Which of the following would be most appropriate? A) Ventilating the child with a bag-valve-mask B) Estimating the child's weight using a Broselow tape C) Providing therapy using automated external defibrillation D) Using rescue breathing and chest compressions
a
A child is undergoing rapid sequence intubation and is receiving atropine. The nurse understands that this agent is used to accomplish which of the following? A) Lessen the vagal effects of intubation B) Reduce intracranial pressure C) Induce amnesia D) Provide short-term paralysis
a
A group of students are reviewing information about major and minor congenital disorders. The students demonstrate understanding of the information when they identify which of the following as a minor disorder? A) Webbed neck B) Omphalocele C) Cutaneous hemangioma D) Facial asymmetry
a
A mother brings her 6-year-old son in for a check-up because the child is complaining of stomachaches. It is the beginning of the school year. Which of the following might the mother also mention? A) The child cries before going to school. B) The child made friends the first day of school. C) The child fights with siblings more often. D) The child loves the crowds in the lunchroom.
a
A nurse is reviewing an article about genetic disorders and patterns of inheritance. The nurse demonstrates understanding of the information by identifying which of the following as an example of an autosomal dominant genetic disorder? A) Neurofibromatosis B) Cystic fibrosis C) Tay-Sachs disease D) Sickle cell disease
a
During a physical assessment of a 5-month-old child, the nurse observes the first tooth has just erupted and uses the opportunity to advise the mother to schedule a dental examination for her baby. Which of the following is the correct time for the dentist visit? A) By the first birthday B) By the second birthday C) By entry into kindergarten D) By entry into first grade
a
The mother of a hospitalized child reports that her daughter, who is having some difficulty eating, just had a 4-ounce cup of ice chips. The nurse documents this on the child's intake flow sheet as which of the following? A) 2 ounces B) 4 ounces C) 6 ounces D) 8 ounces
a
The nurse contacts a child life specialist (CLS) to work with children on a pediatric ward. What is the primary goal of the CLS? A) Decrease anxiety and fear during hospitalization and painful procedures B) Keep children who are hospitalized distracted from pain C) Perform medical procedures using atraumatic principles D) Act as a liaison between the nurse and the child
a
The nurse explains to parents of school-age children that according to Kohlberg's theory of moral development, their child is at the conventional stage of moral development. What is the motivation for school-age children to follow rules? A) They follow rules out of a sense of being a "good person." B) They follow rules out of fear of being punished. C) They follow rules in order to receive praise from caretakers. D) They follow rules because it is in their nature to do so
a
The nurse is caring for a 14-year-old boy with an osteosarcoma. Which of the following communication techniques would be least effective for him? A) Letting him choose juice or soda to take pills B) Seeking the teenager's input on all decisions C) Discussing the benefits of chemotherapy with him D) Avoiding undue criticism of noncompliance
a
The nurse is caring for a 5-year-old girl posttonsillectomy. The girl looks out the window and tells the nurse that it is raining and says, "The sky is crying because it is sad that my throat hurts." The nurse understands that the girl is demonstrating which mental process? A) Magical thinking B) Centration C) Transduction D) Animism
a
The nurse is caring for a hospitalized 13-year-old girl, who is questioning everything the medical staff is doing and is resistant to treatment. How should the nurse respond? A) "Let's work together to plan your day along with your treatments." B) "The sooner you cooperate, the sooner you are going to leave." C) "If you are more cooperative, perhaps we can arrange a visit from friends." D) "Please don't make me call your parents about this."
a
The nurse is developing a plan of care for a 7-year-old boy with diabetes insipidus. Which of the following would the nurse most likely identify as the priority nursing diagnosis? A) Deficient fluid volume related to dehydration B) Excess fluid volume related to edema C) Deficient knowledge related to fluid intake regimen D) Imbalanced nutrition, more than body requirements related to excess weight
a
The nurse is examining a 15-month-old child who was able to walk at the last visit and now can no longer walk. What would be the nurse's best intervention in this case? A) Schedule a full evaluation since this may indicate a neurologic disorder. B) Note the regression in the child's chart and recheck in another month. C) Document the findings as a developmental delay since this is a normal occurrence. D) Ask the parents if they have changed the child's schedule to a less active one.
a
The nurse is gathering the necessary equipment for tracheal intubation for a child who is 2 years old. Which tracheal tube size would the nurse obtain? A) 4.5 B) 5 C) 5.5 D) 6
a
The nurse is helping the parents and their underweight adolescent collaborate on planning a healthy menu. Of which of the following nutritional requirements of adolescents should the nurse be aware? A) Teenagers have a need for increased calories, zinc, calcium, and iron for growth. B) Teenage girls who are active require about 1,800 calories per day. C) Teenage boys who are active require between 2,000 and 2,500 calories per day. D) Adolescents require about 1,000 to 1,200 mg of calcium each day
a
The nurse is providing care to a child experiencing shock. Which of the following intravenous solutions would the nurse expect to administer? A) Ringer lactate B) Dextrose 5% and water C) Dextrose 5% and normal saline D) Dextrose 10% and water
a
The nurse is providing teaching about accidental poisoning to the family of a 3-year-old. The nurse understands that a child of this age is at increased risk of accidental ingestion due to which sensory alteration? A) A less discriminating sense of taste B) A lack of fully developed hearing C) Visual acuity that has not fully developed D) A less discriminating sense of touch
a
The nurse is teaching a new mother about the drastic growth and developmental changes her infant will experience in the first year of life. Which of the following describes a developmental milestone occurring in infancy? A) By 6 months of age the infant's brain weighs half that of the adult brain; at age 12 months, the brain weighs 2.5 times what it did at birth. B) Most infants triple their birthweight by 4 to 6 months of age and quadruple their birthweight by the time they are 1 year old. C) The head circumference increases rapidly during the first 6 months: the average increase is about 1 inch per month. D) The heart triples in size over the first year of life; the average pulse rate decreases from 120 to 140 in the newborn to about 100 in the 1-year-old.
a
The nurse teaches parents of adolescents that adolescents need the support of parents and nurses to facilitate healthy lifestyles. Which of the following should be a priority focus of this guidance? A) Reducing risk-taking behavior B) Promoting adequate physical growth C) Maximizing learning potential D) Teaching personal hygiene routines
a
The nurse uses family-centered care to care for children in a pediatric office. Upon what concept is family-centered care based? A) The family is the constant in the child's life and the primary source of strength. B) The care provider is the constant in the child's life and the primary source of strength. C) The child must be prepared to be his or her own source of strength during times of crisis. D) The wishes of the family should direct the nursing care plan for the child
a
The nurse working in a community clinic attempts to establish a free vaccination program to refer low-income families. What is the key strategy for success when implementing a health promotion activity? A) Partnership development B) Funding for projects C) Finding an audience D) Adequate staffing
a
The parents of a 1-year-old girl, both of whom have perfect teeth, are concerned about their child getting dental caries. Which is the best advice the nurse can provide? A) Tell the parents to limit the child's eating to meal and snack times. B) Urge the parents to take the child to a dentist for a check-up. C) Advise the parents to reduce carbohydrates in the child's diet. D) Advise the parents to use fluoride toothpaste.
a
Which of the following would be least effective in gaining the cooperation of a toddler during a physical examination? A) Tell the child that another child the same age wasn't afraid. B) Allow the child to touch and hold the equipment when possible. C) Permit the child to sit on the parent's lap during the examination. D) Offer immediate praise for holding still or doing what was asked
a
Which of the following would the nurse do first for a 5-year-old girl with profound bradycardia? A) Provide oxygen at 100% B) Administer epinephrine as ordered C) Use warming blankets D) Perform gastric lavage
a
he nurse is implementing care for a hospitalized toddler. What communication technique would the nurse use with the child to reflect the child's developmental level? A) Allow the child extra time to complete thoughts. B) Communicate solely through play. C) Provide simple but honest and straightforward responses. D) Remain nonjudgmental to avoid alienation
a
he nurse is providing anticipatory guidance to the mother of a 9-month-old girl during a well-baby visit. Which of the following topics would be most appropriate? A) Advising how to create a toddler-safe home B) Warning about small objects left on the floor C) Cautioning about putting the baby in a walker D) Telling about safety procedures during baths
a
he nurse is teaching the student nurse the sequence for performing the assessment techniques during a physical examination. What is the appropriate order? A) Inspection, palpation, percussion, auscultation B) Inspection, percussion, palpation, auscultation C) Palpation, percussion, inspection, auscultation D) Inspection, auscultation, palpation, percussion
a
he school nurse providing school health screenings knows that the 7- to 11-year-old is in Piaget's stage of concrete operational thoughts. Which of the following should this age group accomplish when developing operations? Select all answers that apply. A) Ability to assimilate and coordinate information about the world from different dimensions B) Ability to see things from another person's point of view and think through an action C) Ability to use stored memories of past experiences to evaluate and interpret present situations D) Ability to think about a problem from all points of view, ranking the possible solutions while solving the problem E) Ability to think outside of the present and incorporate into thinking concepts that do exist as well as concepts that might exist F) Ability to understand the principle of conservation—that matter does not change when its form changes
a b c f
The school nurse is helping parents choose books for their preschoolers. What literacy skills present in the preschooler would the nurse consider when making choices? Select all answers that apply. A) Preschoolers enjoy books with pictures that tell stories. B) Preschoolers like stories with repeated phrases as they help keep their attention. C) Preschoolers like stories that describe experiences different from their own. D) Preschoolers demonstrate early literacy skills by reciting stories or portions of books. E) Preschoolers may retell the story from the book, pretend to read books, and ask questions about the story. F) Preschoolers do not have enough focus and expanded attention to notice when a page is skipped during reading
a b d e
The school nurse is teaching parents risk factors for suicide in adolescents. Which of the following would the nurse discuss? Select all answers that apply. A) Mental health changes B) History of previous suicide attempt C) Higher socioeconomic status D) Greatly improved school performance E) Family disorganization F) Substance abuse
a b e f
When assessing adolescents for health risks, the nurse must keep in mind the factors related to the prevalence of adolescent injuries. Which of the following accurately describe these factors? Select all answers that apply. A) Increased physical growth B) Insufficient psychomotor coordination C) Tiredness, lack of energy D) Lack of impulsivity E) Peer pressure F) Inexperience
a b e f
A child has a tracheal tube in place and will be receiving medications via this tube. Which of the following medications would the nurse expect to be administered in this manner? Select all answers that apply. A) Lidocaine B) Adenosine C) Atropine D) Dopamine E) Epinephrine F) Naloxone
a c e f
A 5-year-old child with type 1 diabetes is brought to the clinic by his mother for a follow-up visit after having his hemoglobin A1C level drawn. Which result would indicate to the nurse that the child is achieving long-term glucose control? A) 9.0% B) 8.2% C) 7.3% D) 6.9%
b
A 9-year-old girl who has fallen from a second-story window is brought to the emergency department. Which assessment would be a priority? A) Evaluating pupils for equality and reactivity B) Monitoring oxygen saturation levels C) Asking the child if she knows where she is D) Using the appropriate pain assessment scale
b
After teaching the parents of a daughter with central precocious puberty about medication therapy, which statement by the parents indicates successful teaching? A) "She needs to use the nasal spray once every day." B) "She'll start puberty again when the medication stops." C) "This medication will slow down the changes but not reverse them." D) "Once therapy is done, she'll need surgery."
b
At which age would the nurse expect to find the beginning of object permanence? A) 1 month B) 4 months C) 8 months D) 12 months
b
The mother of a 5-year-old boy calls the nurse and seeks advice on how to assist the child with the recent death of his paternal grandfather. The boy keeps asking when his grandpa is coming back. How should the nurse respond? A) "It is best to just ignore this and to not respond to his questions." B) "This is normal; children his age do not understand the permanence of death." C) "You have to keep repeating that his grandfather is never coming back." D) "He will eventually figure this out on his own.
b
The nurse is caring for a 10-year-old girl who is in an isolation room. Which of the following interventions would be a priority intervention for this child? A) Reduce noise as much as possible. B) Provide age-appropriate toys and games. C) Discourage visits from family members. D) Put on mask prior to entering the room.
b
The nurse is caring for an immunosuppressed 3-year-old girl and is providing teaching to the mother about proper oral hygiene. Which of the following responses from the mother indicates a need for further teaching? A) "I really need to carefully check for skin breakdown." B) "I must really scrub her teeth and gums well." C) "I must use a soft toothbrush." D) "I can use a soft gauze sponge to care for her gums."
b
The nurse is caring for an infant who had hyperbilirubinemia requiring exchange transfusion. Based on this information, this infant is at risk for what type of disorder? A) Vision loss TestBankWorld.org B) Hearing loss C) Hypertension D) Hyperlipidemia
b
The nurse is conducting a health history for a 9-year-old child with stomach pains. Which of the following is a recommended guideline when approaching the child for information? A) Wear a white examination coat when conducting the interview. B) Allow the child to control the pace and order of the health history. C) Use quick deliberate gestures to get your point across. D) Do not make physical contact with the child during the interview
b
The nurse is discussing vaccination for Haemophilus influenzae type B (Hib) with the mother of a 6-month-old child. Which of the following comments provides the most compelling reason to get the vaccination? A) "These bacteria live in every human." B) "Young children are especially susceptible to these bacteria." C) "You have a choice of two excellent vaccines." D) "Your child needs this final dose for protection.
b
The nurse is inspecting the fingernails of an 18-month-old girl. Which of the following findings indicates chronic hypoxemia? A) Nails that curve inward B) Clubbing of the nails C) Nails that curve outward D) Dry, brittle nails
b
The nurse is preparing to take a tympanic temperature reading of a 4-year-old. In order to get an accurate reading, what does the nurse need to do? A) Pull the earlobe back and down B) Direct the infrared sensor at the tympanic membrane C) Pull the earlobe down and forward D) Remove any visible cerumen from inside the ear canal
b
The nurse is providing anticipatory guidance for parents of a preschooler regarding sex education. Which of the following is a recommended guideline when dealing with this issue? A) Be prepared to thoroughly cover a topic before the child asks about it. B) Before answering questions, find out what the child thinks about the subject. C) Expand upon the topic when answering questions to prevent further confusion. D) Provide a less than honest response to shelter the child from knowledge that is too advanced.
b
The nurse is providing care to a 4-year-old boy with a broken arm and an infected laceration from a fall. The nurse notes a significant elevation in the child's heart rate. Which intervention would be least appropriate? A) Administering antipyretics as ordered for fever B) Using a defibrillator to reduce the heart rate C) Administering analgesics to reduce pain D) Allowing the parents to comfort the child
b
The nurse is providing care to a child who is intubated and the child's condition is deteriorating. Which of the following would the nurse do first? A) Check if the tracheal tube is obstructed B) Assess for displacement of the tracheal tube C) Look for signs of a possible pneumothorax D) Check the equipment for malfunction
b
The nurse strives to provide culturally competent care for children in a health clinic that follows the principles of health supervision. Which of the following nursing actions reflects this type of care? A) The nurse treats all children the same regardless of their culture. B) The nurse negotiates a care plan with the child and family. C) The nurse researches the child's culture and provides care based on the findings. D) The nurse provides future-based care for culturally diverse children.
b
The parents of a 5-year-old boy tell the nurse that their son is having frequent episodes of night terrors. Which of the following statements would indicate that the boy is having nightmares instead of night terrors? A) "It usually happens about an hour after he falls asleep." B) "He will tell us about what happened in his dream." C) "He is completely unaware that we are there." D) "When we try to comfort him, he screams even more.
b
When instructing the parents of a toddler about appropriate nutrition, which of the following would the nurse recommend? A) About 12 to 16 ounces of fruit juice per day B) Approximately 16 to 24 ounces of milk per day C) Fat intake of 30% to 40% of total calories D) An average of 10 to 12 grams of fiber per day
b
When performing a physical examination on a small child, the nurse observes approximately 8 to 10 light-brown spots concentrated primarily on the trunk and extremities, two small lumps on the posterior trunk, and axillary freckling. The nurse interprets these findings to suggest which of the following? A) Klinefelter syndrome B) Neurofibromatosis C) Fragile X syndrome D) Sturge-Weber syndrome
b
When preparing to administer the polio vaccine to an infant, the nurse would expect to administer the vaccine by which route? A) Intramuscular B) Subcutaneous C) Oral D) Intradermal
b
When preparing to apply a restraint to a child, which of the following would be most important for the nurse to do? A) Expect to keep the restraint on for at least 8 hours. B) Explain that safety, not punishment, is the reason for the restraint. C) Plan to use a square knot to secure the restraint to the side rails. D) Use a limb restraint rather than a jacket restraint for most issues
b
When providing anticipatory guidance to a group of parents with school-aged children, which of the following would the nurse describe as the most important aspect of social interaction? A) School B) Peer relationships C) Family D) Temperament
b
When teaching the parents of a child with phenylketonuria, the nurse would instruct them to include which of the following foods in the child's diet? A) Milk B) Oranges C) Meat D) Eggs
b
Which of the following would lead the nurse to suspect that a 5-year-old child is experiencing supraventricular tachycardia? A) Heart rate 160 beats per minute B) Flattened P waves C) Normal QRS complex D) History of fever
b
Which of the following would the nurse most likely find in a 10-year-old child in the period of concrete operational thought? A) Participation in abstract thinking B) Ability to classify similar objects C) Problem solving via the scientific method D) Ability to make independent decisions
b
Which reflex, if found in a 4-month-old infant, would cause the nurse to be concerned? A) Plantar grasp B) Step C) Babinski D) Neck righting
b
While auscultating the heart of a 5-year-old child, the nurse notes a murmur that is soft and quiet and heard each time the heart is auscultated. The nurse documents this finding as which of the following? A) Grade 1 B) Grade 2 C) Grade 3 D) Grade 4
b
The nurse is preparing a nursing care plan for a child hospitalized for cardiac surgery. Which of the following are examples of interventions that nurses perform in the "building a trusting relationship" stage? Select all answers that apply. A) Gathering information about the child using the child's own toys B) Preparing the child for a procedure by playing games C) Explaining in simple terms what will happen during surgery D) Allowing the child to devise an exercise plan following surgery E) Praising the child for how well he is doing following instructions F) Giving the child a favorite toy to cuddle following a painful procedure
b c
The nurse observes an infant interacting with his parents. Which of the following are normal social behavioral developments for this age group? Select all answers that apply. A) Around 5 months the infant may develop stranger anxiety. B) Around 2 months the infant exhibits a first real smile. C) Around 3 months the infant smiles widely and gurgles when interacting with the caregiver. D) Around 3 months the infant will mimic the parent's facial movements, such as sticking out the tongue. E) Around 3 to 6 months of age the infant may enjoy socially interactive games such as patty-cake and peek-a-boo. F) Separation anxiety may also start in the last few months of infancy.
b c d f
A nurse is promoting the use of family-centered care in a local community clinic. Which of the following are advantages or disadvantages of this type of care provision? Select all answers that apply. A) Recovery times are longer. B) Anxiety is decreased. C) Communication is improved. D) Health care costs are increased. E) Pain management is enhanced. F) More health care resources are utilized
b c e
A 1-month-old infant admitted to the emergency department in respiratory distress exhibits a regular pattern of breathing followed by brief periods of apnea, then tachypnea for a short time, eventually returning to a normal respiratory rate. The nurse documents this finding as which of the following? A) Hypoventilation B) Hyperventilation C) Periodic breathing D) Stridor
c
The nurse is caring for a 13-year-old girl hospitalized for complications from type 1 diabetes. The girl has a nursing diagnosis of powerlessness related to lack of control of multiple demands associated with hospitalization, procedures, treatments, and changes in usual routine. How can the nurse help promote control? A) Ask the child to identify her areas of concern. B) Encourage participation of parents in care activities. C) Offer the girl as many choices as possible. D) Enlist the family's assistance in creating a time schedule
c
The nurse working in the emergency room monitors the admission of children. Statistically, for which one of the following disorders would children younger than 5 years most commonly be admitted? A) Mental health problems B) Injuries C) Respiratory disorders D) Gastrointestinal disorders
c
The parents of a preschooler express concern to the nurse about their son's new habit of masturbating. Which of the following is an appropriate response to this concern? A) Tell the child in a firm manner that this behavior is not acceptable. B) When the child displays this behavior, place him in a "time-out." C) Treat the action in a matter-of-fact manner emphasizing safety. D) Consult a psychotherapist to determine the reason for this behavior
c
Which of the following would the nurse expect to find in an 18-month-old? A) Standing on tiptoes B) Pedaling a tricycle C) Climbing stairs with assistance D) Carrying a large toy while walking
c
A nurse is preparing a presentation for a group of parents with children diagnosed with diabetes type 1. The children are all adolescents. Which of the following issues would the nurse need to address? Select all that apply. A) Self-monitoring of blood glucose levels B) Feelings of being different C) Deficient decision-making skills D) Body image conflicts E) Struggle for independence
c d e
The nurse suspects that a 4-year-old with type 1 diabetes is experiencing hypoglycemia based on which of the following? Select all that apply. A) Blurred vision B) Dry, flushed skin C) Diaphoresis D) Slurred speech E) Fruity breath odor F) Tachycardia
c d f
A 15-month-old girl is having her first health visit at a clinic. The mother has no immunization record but says the child was immunized 3 months ago at the local health department. Which of the following is the best action for the nurse to take? A) Ask the mother to bring the records to the next health maintenance visit. B) Start the catch-up schedule since there are no immunization records. C) Keep the child at the facility while the mother returns home for the records. D) Call the local health department and verify the child's immunization status
d
The mother of a 15-month-old child is questioning the nurse about the need for the hepatitis B vaccination. Which of the following comments provides the most compelling reason for the vaccine? A) "The most common side effect is injection site soreness." B) "This is a recombinant or genetically engineered vaccine." C) "Immunizations are needed to protect the general population." D) "This protects your child from infection that can cause liver disease."
d
The nurse is caring for a 9-year-old boy with achondroplasia. Which of the following would the nurse expect to assess? A) Narrow passages from the nose to the throat B) Slim stature, hypotonia, and a narrow face C) Craniosynostosis and a small nasopharynx D) Trident hand and persistent otitis media
d
The nurse is caring for a couple who is having a triple screen done. The nurse would least likely expect which of the following to be tested? A) a-Fetoprotein B) Human chorionic gonadotropin C) Unconjugated estriol D) Testosterone
d
The nurse is caring for an 8-year-old boy hospitalized for a bone marrow transplant. His parents are in and out of his room throughout the day. Which of the following behaviors of the child would alert the nurse that he is in the second stage of separation anxiety? A) He ignores his parents when they return to his room. B) He cries uncontrollably whenever they leave. C) He forms superficial relationships with his caregivers. D) He sits quietly and is uninterested in playing and eating
d
The school nurse knows that school-age children are developing metalinguistic awareness. Which of the following is an example of this skill? A) The child enjoys reading books. B) The child enjoys conversations with peers. C) The child enjoys speaking on the phone. D) The child enjoys telling jokes.
d
The nurse is teaching the mother of a toddler about burn prevention. Which response by the mother indicates a need for further teaching? A) "We will leave fireworks displays to the professionals." B) "I will set our water heater at 130 degrees." C) "All sleepwear should be flame retardant." D) "The handles of pots on the stove should face inward."
B
When teaching a group of new parents about newborn care and development, which immunoglobulin would the nurse explain as being primarily responsible for the passive immunity exhibited by newborns? A) IgA B) IgG C) IgM D) IgE
B
A nurse is preparing a class for parents of infants about managing diaper dermatitis. Which of the following would the nurse include in the presentation? Select all answers that apply. A) Applying topical nystatin to the diaper area B) Using a blow dryer on warm to dry the diaper area C) Refraining from using rubber pants over diapers D) Using scented diaper wipes to clean the area E) Washing the diaper area with an antibacterial soap
B C
A nurse is caring for a 12-year-old girl with a severe peanut allergy. The girl's parents are upset because the school does not permit her to carry her EpiPen with her. It must remain in the school's office per school regulations. Which response by the nurse would be most appropriate? A) "She is allowed by law to carry her EpiPen with her; I will talk to school authorities." B) "Let's file an action plan and keep it in the school office in the event of anaphylaxis." C) "Make sure she wears a medical alert bracelet so that school staff know she has allergies." D) "I will be happy to train school authorities and staff to recognize anaphylaxis."
A
The mother of a 5-year-old girl brings the child to the clinic for an evaluation. The mother tells the nurse, "She seems to be so tired and irritable lately. And she looks so pale." Further assessment reveals pale conjunctiva and oral mucous membranes. The nurse suspects iron-deficiency anemia. Which additional finding would help provide additional evidence for this suspicion? A) Spooned nails B) Negative splenomegaly C) Oxygen saturation: 99% D) Bradycardia
A
The nurse is administering a crushed tablet to an 18-month-old infant. Which of the following is a recommended guideline for this intervention? A) Mix the crushed tablet with a small amount of applesauce. B) Place the crushed tablet in the infant's formula. C) Mix the crushed tablet with the infant's cereal. D) Crushed tablets should only be mixed with water.
A
The nurse is caring for a 6-year-old child who has multisystem trauma due to a motor vehicle accident. The child is receiving total parenteral nutrition (TPN). Which of the following is a recommended nursing intervention for children on TPN? A) Initially, check blood glucose levels frequently, such as every 4 to 6 hours, to evaluate for hyperglycemia. B) Be vigilant in monitoring the infusion rate, change the rate as necessary, and report any changes to the physician or nurse practitioner. C) If for any reason the TPN infusion is interrupted or stops, begin an infusion of a 10% saline at the same infusion rate as the TPN. D) Administer TPN continuously over an 8-hour period, or after initiation it may be given on a cyclic basis, such as over a 12-hour period during the night.
A
The nurse is caring for a child undergoing highly active antiretroviral therapy (HAART) for HIV infection. The nurse is preparing to administer the prescribed medication. In addition to the nucleoside analog reverse transcriptase inhibitors (NRTIs) and the nonnucleoside analog reverse transcriptase inhibitors (NNRTIs), the nurse is cognizant that the child will be taking which additional medication as part of the three-drug regimen? A) Protease inhibitors B) Corticosteroids C) Cytotoxic drugs D) Disease-modifying antirheumatic drugs (DMARDs)
A
The nurse is caring for a child with thalassemia who is receiving chelation therapy at home using a battery-operated pump. After teaching the parents about this treatment, which statement by the mother indicates a need for additional teaching? A) "I can have the nurse administer the chelation therapy if I am uncomfortable." B) "I must be very careful to strictly adhere to the chelation regimen." C) "The deferoxamine binds to the iron so it can be removed from the body." D) "The medication can be administered while my child is sleeping.
A
The nurse is conducting a physical examination of a toddler with suspected lead poisoning. Lab results indicate blood lead level 52 g/dL. Which action would the nurse expect to happen next? A) Repeat testing within 2 days and prepare to begin chelation therapy as ordered B) Repeat testing within 1 week with education to decrease lead exposure C) Confirm with repeat testing in 1 month and referral to local health department D) Prepare to admit child to begin chelation therap
A
The nurse is providing care to a child with folliculitis. Which of the following would the nurse expect to administer? A) Topical mupirocin B) Oral cephalosporin C) Intravenous oxacillin D) Topical Eucerin cream
A
The nurse is providing home care instructions for a 13-year-old girl recently diagnosed with systemic lupus erythematosus. Which response by the girl indicates a need for further teaching? A) "I need to wear sunscreen in the summer to prevent rashes." B) "I need to eat a healthy diet, exercise, and get plenty of sleep." C) "I need an eye examination every year." D) "I need to be careful when it is cold; I should always wear gloves."
A
When providing care to a child with aplastic anemia, which nursing diagnosis most likely would be the priority? A) Risk for injury B) Imbalanced nutrition, less than body requirements C) Ineffective tissue perfusion D) Impaired gas exchange
A
When reviewing the history of a child with suspected primary immunodeficiency, which of the following would the nurse be least likely to find? A) Weight appropriate for height B) Antibiotic therapy for the past 3 months without effect C) 10 episodes of otitis media in the last year D) Three bouts of sinusitis within a year's time
A
Which of the following would the nurse expect to find in a male infant with Wiskott-Aldrich syndrome? A) Eczema B) Thrombocytosis C) Lymphadenopathy D) Pneumonia
A
A nurse is assessing a child who may have a latex allergy. The nurse asks the child about allergic reactions with certain foods. Which foods if identified by the child as experiencing an allergic reaction would help support the suspected latex allergy? Select all answers that apply. A) Peaches B) Plums C) Carrots D) Tomatoes E) Apples F) Lettuce
A B C D
The nurse is assessing a child with aplastic anemia. Which of the following would the nurse expect to assess? Select all that apply. A) Ecchymoses B) Tachycardia C) Guaiac-positive stool D) Epistaxis E) Severe pain F) Warm tender joints
A B C D
The nurse is teaching the parents of a child diagnosed with iron-deficiency anemia about ways to increase their child's intake of iron. The parents demonstrate understanding of the teaching when they identify which foods as good choices for the child? Select all that apply. A) Tuna B) Salmon C) Tofu D) Cow's milk E) Dried fruits
A B C E
A group of students are preparing for a class exam on skin disorders. As part of their preparation, they are reviewing information about acne vulgaris and its association with increased sebum production. The students demonstrate understanding of the information when they identify which areas as having the highest sebaceous gland activity? Select all answers that apply. A) Face B) Upper chest C) Neck D) Back E) Shoulders
A B D
A nursing student is reviewing information about primary immunodeficiencies. The student demonstrates understanding of the material by identifying which of the following as affecting only males? Select all answers that apply. A) X-linked agammaglobulinemia B) Wiskott-Aldrich syndrome C) Selective IgA deficiency D) X-linked hyper-IgM syndrome E) IgG subclass deficiency F) Severe combined immune deficiency
A B D
The nurse is choosing a vein to insert a peripheral IV for a 2-year-old child. Which of the following sites would be appropriate? Select all answers that apply. A) Hand veins B) Feet veins C) Jugular vein D) Forearm veins E) Scalp veins F) Vena cava
A B D E
A child is diagnosed with a food allergy to milk. When teaching the parents about this allergy, which of the following would the nurse suggest as possible substitutions? Select all answers that apply. A) Fruit juice B) Rice milk C) Yogurt D) Nondairy creamers E) Soy milk
A B E
The nurse referring a child to home care discusses the advantages and disadvantages with the child's family. Which of the following are disadvantages of this method of health care? Select all answers that apply. A) The nurse is performing care of the child in the family's home. B) The home care nurse is not always equipped to perform technical care. C) The out-of-pocket cost of home care is more expensive. D) The technical procedures may be overwhelming for the family. E) The financial burden may cause more stress for the family. F) The child does not receive continuity of care provided in the hospital setting
A C D E
A child is prescribed monthly injections of vitamin B12. When developing the teaching plan for the family, the nurse would focus on which type of anemia? A) Aplastic anemia B) Pernicious anemia C) Folic acid anemia D) Sickle cell anemia
B
A child with iron-deficiency anemia is prescribed ferrous fumarate, 3 mg/kg/day in two divided doses. The nurse interprets this order as indicating which of the following? A) The child requires a prophylactic dose of iron. B) The child has mild to moderate iron deficiency. C) The child has severe iron deficiency. D) The child is being prepared for packed red blood cell administration.
B
A child with suspected sickle cell disease is scheduled for a hemoglobin electrophoresis. When reviewing the child's history, which of the following would the nurse identify as potentially interfering with the accuracy of the results? A) Use of iron supplementation B) Blood transfusion 1 month ago C) Lack of fasting for 12 hours D) History of recent infection
B
A nurse is inspecting the skin of a child with atopic dermatitis. Which of the following would the nurse expect to observe? A) Erythematous papulovesicular rash B) Dry, red, scaly rash with lichenification C) Pustular vesicles with honey-colored exudates D) Hypopigmented oval scaly lesions
B
A nurse is leading a discussion with a group of new mothers about newborn nutrition and its importance for growth and development. One of the mothers asks, "Doesn't the baby get iron from me before birth?" Which response by the nurse would be most appropriate? A) "You give the baby some iron, but it is not enough to sustain him after birth." B) "Because the baby grows rapidly during the first months, he uses up what you gave him." C) "The iron you give him before birth is different from what he needs once he is born." D) "If the baby didn't use up what you gave him before birth, he excretes it soon after birth."
B
A nurse is performing a primary survey on a child who has sustained partial thickness burns over his upper body areas. Which of the following would the nurse do first? A) Inspect the child's skin color B) Assess for a patent airway C) Observe for symmetric breathing D) Palpate the child's pulse
B
A nurse is preparing a plan of care for a child with a primary immunodeficiency. Which nursing diagnosis would the nurse most likely identify as the priority? A) Imbalanced nutrition, less than body requirements related to poor appetite B) Ineffective protection related to impaired humoral defenses C) Acute pain related to inflammatory processes D) Risk for delayed growth and development related to chronic illness
B
A nurse is preparing a presentation for a local parent group about burn prevention and care in children. Which of the following would the nurse be least likely to include in the presentation when describing how to care for a superficial burn? A) Using cool water over the burned area until the pain lessens B) Applying ice directly to the burned skin area C) Covering the burn with a clean, nonadhesive bandage D) Giving the child acetaminophen for pain relief
B
An instructor is developing a plan for a class of nursing students on the various skin disorders. When describing urticaria, which of the following would the instructor include? A) It is a type IV hypersensitivity reaction. B) Histamine release leads to vasodilation C) Wheals appear first followed by erythema. D) The nonpruritic rash blanches with pressure.
B
The nurse is assessing a child with suspected thalassemia. Which of the following would the nurse expect to assess? A) Dactylitis B) Frontal bossing C) Presence of clubbing D) Presence of spooning
B
The nurse is caring for a 12-year-old boy with idiopathic thrombocytopenia. The nurse is providing discharge instructions about home care and safety recommendations to the boy and his parents. Which response indicates a need for further teaching? A) "We should avoid aspirin and drugs like ibuprofen." B) "He can resume participation in football in 2 weeks." C) "Swimming would be a great activity." D) "Our son cannot take any antihistamines."
B
The nurse is caring for a 15-year-old boy who has sustained burn injuries. The nurse observes the burn developing a violaceous color with discharge and a foul odor. The nurse suspects which of the following infections? A) Burn wound cellulitis B) Invasive burn cellulitis C) Burn impetigo D) Staphylococcal scalded skin syndrome
B
The nurse is caring for a child who is taking corticosteroids for systemic lupus erythematosus. The nurse closely monitors the child based on the understanding that corticosteroids exert which major action? A) They increase liver enzymes. B) They can mask signs of infection. C) They cause bone marrow suppression. D) They decrease renal function.
B
The nurse is caring for an 8-year-old girl who requires medication that is only available in an enteric tablet form. The nurse is teaching the mother how to help the girl swallow the medication. Which of the following statements indicates a need for further teaching? A) "I can encourage her to place it on the back of her tongue." B) "I can pinch her nose to make it easier to swallow." C) "We cannot crush this type of pill as it will affect the delivery of the medication." D) "We can place the tablet in a spoonful of applesauce."
B
The nurse is caring for an infant with candidal diaper rash. Which topical agent would the nurse expect the physician to order? A) Corticosteroids B) Antifungals C) Antibiotics D) Retinoids
B
The nurse is caring for children who are receiving IV therapy in the hospital setting. For which of the following children would a central venous device be indicated? A) A child who is receiving an IV push B) A child who is receiving chemotherapy for leukemia C) A child who is receiving IV fluids for dehydration D) A child who is receiving a one-time dose of a medication
B
The nurse is conducting a physical examination of a 9-month-old baby with a flat, discolored area on the skin. The nurse documents this as which of the following? A) Papule B) Macule C) Vesicle D) Scaling
B
The nurse is evaluating the laboratory test results of a 7-year-old child with a suspected hematologic disorder. Which finding would cause the nurse to be concerned? A) WBC: 5.6 × 103/mm3 B) RBC: 2.8 × 106/mm3 C) Hemoglobin: 11.4 mg/dL D) Hematocrit: 35%
B
The nurse is providing parental teaching about home care for an 8-year-old boy with widespread sunburn on his back and shoulders. Which of the following responses indicates a need for further teaching? A) "Cool compresses may help cool the burn." B) "He should manually peel off any flaking skin." C) "Nonsteroidal anti-inflammatory drugs like ibuprofen are helpful." D) "He should avoid hot showers or baths for a couple of days."
B
The nurse is providing teaching for the mother of an infant who receives all of his nutrition through a tube. The nurse is reviewing interventions to promote growth and development. Which of the following responses from the mother indicates a need for further teaching? A) "I will give him a pacifier during feeding time." B) "We need to keep feeding time very quiet." C) "We need to make sure he doesn't lose the desire to eat by mouth." D) "Sucking produces saliva, which aids in digestion."
B
A 3-year-old child has sustained significant severe burns and is ordered to receive 100% oxygen. Which of the following would the nurse use to administer the oxygen? A) Nasal cannula B) Venturi mask C) Nonrebreather mask D) Oxygen hood
C
A 4-year-old is brought to the emergency department with a burn. Which of the following would alert the nurse to the possibility of child abuse? A) Burn assessment correlates with mother's report of contact with a portable heater. B) Parents state that the injury occurred approximately 15 to 20 minutes ago. C) Clear delineations are noted between burned and nonburned skin areas. D) The burn area appears asymmetric and nonuniform.
C
A 5-year-old girl is diagnosed with iron-deficiency anemia and is to receive iron supplements. The child has difficulty swallowing tablets, so a liquid formulation is prescribed. After teaching the parents about administering the iron supplement, which statement indicates the need for additional teaching? A) "She needs to eat foods that are high in fiber so she doesn't get constipated." B) "We'll try to get her to drink lots of fluids throughout the day." C) "We will place the liquid in the front of her gums, just below her teeth." D) "We need to measure the liquid carefully so that we give her the correct amount."
C
A child with systemic lupus erythematosus is receiving high-dose corticosteroid therapy over the long term. The nurse would instruct the parents and child to report which of the following? A) Difficulty urinating B) Visual changes C) Joint pain D) Rash
C
A nurse has just administered medication via an orogastric tube. What is the priority nursing action following administration? A) Check tube placement. B) Retape the tube. C) Flush the tube. D) Remove the tube.
C
A nurse is caring for a 5-year-old in Buck traction. When conducting a skin examination for signs of pressure ulcers, the nurse pays particular attention to which area? A) Sacral area B) Hip area C) Occiput D) Upper arm
C
A nurse is conducting a physical examination of a 5-year-old with suspected iron-deficiency anemia. How would the nurse evaluate for changes in neurologic functioning? A) "Open your mouth so I can look inside your cheeks and lips." B) "Do you have any bruises on your feet or shins?" C) "Will you show me how you walk across the room?" D) "Let me see the palms of your hands and soles of your feet."
C
After administering eye drops to a child, the nurse applies gentle pressure to the inside corner of the eye at the nose for which reason? A) To promote dispersion over the cornea B) To enhance systemic absorption C) To ensure the medication stays in the eye D) To stabilize the eyelid
C
After teaching a class about humoral and cellular immunity, the nurse recognizes that the additional teaching is needed when the class states which of the following? A) Humoral immunity crosses the placenta. B) Cellular immunity involves the T lymphocytes. C) Cellular immunity recognizes antigens. D) Humoral immunity does not destroy the foreign cell.
C
After teaching a class about the differences in the skin of infants and adults, the nurse determines that additional teaching is necessary when the class states which of the following? A) "An infant's skin is thinner than an adult's, so substances placed on the skin are absorbed more readily." B) "The infant's epidermis is loosely connected to the dermis, increasing the risk for breakdown." C) "The infant has a lower risk for damage from ultraviolet radiation because the skin is more pigmented." D) "An infant has less subcutaneous fat, which places the infant at a higher risk for heat loss."
C
The nurse is administering immunizations to children in a neighborhood clinic. Which of the following is the most frequent route of administration? A) Oral B) Intradermal C) Intramuscular D) Topical
C
The nurse is administering intravenous immune globulin (IVIG). The nurse assesses vital signs and for adverse reactions every 15 minutes for the first hour of administration. After the first hour, the nurse most likely would continue to assess the child at which frequency? A) Every 30 minutes B) Every 45 minutes C) Every 60 minutes D) Every 2 hours
C
The nurse is assessing a child with pauciarticular-type juvenile idiopathic arthritis. Which of the following would the nurse expect to assess? A) Fever B) Rash C) Eye inflammation D) Splenomegaly
C
The nurse is caring for a 13-year-old girl with von Willebrand disease. After teaching the adolescent and her parents about this disorder and care, which response by the parents indicates a need for additional teaching? A) "We need to administer Stimate prior to dental work." B) "We should be aware that she may suffer from menorrhagia." C) "We should administer desmopressin as often as needed." D) "We understand that she may have frequent nosebleeds."
C
The nurse is caring for a child who has undergone stem cell transplantation for severe combined immune deficiency. Which of the following would the nurse interpret as indicative of graft-versus-host disease? A) Presence of wheezing B) Splenomegaly C) Maculopapular rash D) Chronic or recurrent diarrhea
C
The nurse is caring for a child who is having an anaphylactic reaction with bronchospasm. The nurse would expect to administer which of the following for bronchospasm as ordered? A) Epinephrine B) Corticosteroid C) Albuterol D) Diphenhydramine
C
The nurse is explaining to the student nurse the therapeutic effects of total parenteral nutrition (TPN). Which of the following accurately describes the use of TPN? A) It is used short term to supply additional calories and nutrients as needed. B) It is delivered via the peripheral vein to allow rapid dilution of hypertonic solution. C) It is a highly concentrated solution of carbohydrates, electrolytes, vitamins, and minerals. D) It is usually used when the child's nutritional status is within acceptable parameters
C
The nurse is preparing a class for a group of adolescents about reducing the risk of skin cancer. Which of the following would the nurse include? A) Using a sunscreen with para-aminobenzoic acid (PABA) with an SPF of at least 10 B) Applying sunscreen at least 1 hour before going outside in the sun C) Avoiding sun exposure between the hours of 10 a.m. and 2 p.m. D) Using artificial UV tanning beds instead of sun exposure
C
The nurse is preparing to administer oral ampicillin to a child who weighs 40 kg. The safe dose for children is 50 to 100 mg/kg/day divided in doses administered every 6 hours. What would be the low single safe dose and high single safe dose per day for this child? A) 50 to 100 mg per dose B) 100 to 500 mg per dose C) 500 to 1,000 mg per dose D) 1,000 to 5,000 mg per dose
C
The nurse is providing care for a 14-year-old girl with severe acne. The girl expresses sadness and distress about her appearance. Which response by the nurse would be most appropriate? A) "Are you using your medicine every day?" B) "Your condition will most likely improve in a year or two." C) "Many people feel this way; I know someone who can help." D) "If you have any scarring you can undergo dermabrasion."
C
The nurse is reviewing the laboratory test results of a child diagnosed with disseminated intravascular coagulation (DIC). Which of the following would the nurse interpret as indicative of this disorder? A) Shortened prothrombin time B) Increased fibrinogen level C) Positive fibrin split products D) Increased platelets
C
The nurse is reviewing the white blood cell differential of a 4-year-old girl. Which value would lead the nurse to be concerned? A) Bands: 8% B) Segs: 28% C) Eosinophils: 10% D) Basophils: 0%
C
The nurse is teaching the parents of a child with a hematologic disorder about the functions of the various blood cells. The nurse determines that the teaching was successful when the parents state which blood cell as being primarily responsible for blood clotting? A) Granulocytes B) Erythrocytes C) Thrombocytes D) Leukocytes
C
The nurse is testing the sensory development of a toddler brought to the clinic for a well visit. Which of the following might alert the nurse to a potential problem with the child's sensory development? A) The toddler places the nurse's stethoscope in his mouth. B) The toddler's vision tests at 20/50 in both eyes C) The toddler does not respond to commands whispered in his ear. D) The toddler's taste discrimination is not at adult levels yet.
C
The nurse is working as a community health care nurse. What would be the nurse's focus when providing care of the child? A) Providing care to the individual and family in acute care settings B) Providing care to the indigent in family care settings C) Providing care in geographically and culturally diverse settings D) Providing care for particular age groups or particular diagnoses
C
The school nurse is walking through the lunchroom when one of the children says she feels strange after switching her lunch with her friend. Which assessment would be most important? A) Asking if she has a rash anywhere B) Checking if she has any nausea C) Determining if her throat itches D) Asking if she has abdominal pain
C
When describing the differences affecting the pharmacokinetics of drugs administered to children, which of the following would the nurse include? A) Oral drugs are absorbed more quickly in children than adults. B) Absorption of intramuscularly administered drugs is fairly constant. C) Topical drugs are absorbed more quickly in young children than adults. D) Absorption of drugs administered by subcutaneous injection is increased.
C
When developing the plan of care for a child with burns requiring fluid replacement therapy, which of the following would the nurse expect to include? A) Administration of colloid initially followed by a crystalloid B) Determination of fluid replacement based on the type of burn C) Administration of most of the volume during the first 8 hours D) Monitoring of hourly urine output to achieve less than 1 mL/kg/hour
C
When speaking to a group of parents at a local elementary school, the nurse describes school nursing as a specialized practice of nursing based on the fact that a healthy child has a better chance to succeed in school. Which of the following best describes the strategy school nurses use to achieve student success? A) They coordinate all school health programs. B) They link community health services. C) They work to minimize health-related barriers to learning. D) They promote student health and safety.
C
Which exercise would the nurse suggest as most helpful to maintain mobility in a child with juvenile idiopathic arthritis? A) Jogging every other day B) Using a treadmill C) Swimming D) Playing basketball
C
The nurse is administering Tylenol PRN to a 9-year-old child on the pediatric ward of the hospital. Which of the following reflect nursing actions that follow the rules of the "eight rights" of pediatric medication administration? Select all answers that apply. A) The nurse identifies the child by checking the name on the child's chart. B) The nurse makes sure the medication is given within the hour of the ordered time. C) The nurse checks the documented time of the last dosage administered. D) The nurse calculates the dosage according to the child's weight. E) The nurse explains the therapeutic effects of the medication to the child and parents. F) The nurse administers the medication even though the child is adamant about not taking it.
C D E
A 6-year-old boy has been admitted to the hospital with burns. The nurse notes carbonaceous sputum. Which of the following would be the priority? A) Determining the burn depth B) Eliciting a description of the burn C) Estimating burn extent D) Ensuring a patent airway
D
A child is diagnosed with atopic dermatitis. Which laboratory test would the nurse expect the child to undergo to provide additional evidence for this condition? A) Erythrocyte sedimentation rate B) Potassium hydroxide prep C) Wound culture D) Serum immunoglobulin E level
D
A child is diagnosed with juvenile idiopathic arthritis and is receiving several different medications listed in the medication administration record. Which agent would the nurse identify as being used to prevent disease progression? A) Aspirin B) Prednisone C) Ibuprofen D) Methotrexate
D
A group of nursing students are reviewing information about humoral and cellular immunity. The students demonstrate understanding of this material when they identify which of the following as involved in cellular immunity? A) B cells B) Antibodies C) Antigens D) T cells
D
A nurse is caring for a 14-year-old girl who received an electrical burn. The nurse would anticipate preparing the girl for which diagnostic tests as ordered? A) Pulse oximetry B) Fiberoptic bronchoscopy C) Xenon ventilation-perfusion scanning D) Electrocardiographic monitoring
D
A nurse is caring for a 14-year-old with a gastrostomy tube. The girl has skin breakdown and irritation at the insertion site. Which of the following would be the most appropriate method to clean and secure the gastrostomy tube? A) Make sure the tube cannot be moved in and out of the child's stomach. B) Use adhesive tape to tape the tube in place and prevent movement. C) Place a transparent dressing over the site whether there is drainage or not. D) If any drainage is present, use a presplit 2 × 2 and place it loosely around the site.
D
The nurse is caring for a 2-year-old boy with hemophilia. His parents are upset by the possibility that he will become infected with hepatitis or HIV from the clotting factor replacement therapy. Which response by the nurse would be most appropriate? A) "Parents commonly fear the worst; however, the factor will help your child lead a normal life." B) "There are risks with any treatment including using blood products, but these are very minor." C) "Although factor replacement is expensive, there's more financial strain from missing work if he has a bleeding episode." D) "Since dry heat treatment of the factor began in 1986, there have been no reports of virus transmission."
D
The nurse is caring for a child who has been admitted for a sickle cell crisis. Which of the following would the nurse do first to provide adequate pain management? A) Administer a nonsteroidal anti-inflammatory drug as ordered. B) Use guided imagery and therapeutic touch. C) Administer meperidine as ordered. D) Initiate pain assessment with a standardized pain scale.
D
The nurse is caring for a child who is receiving total parenteral nutrition (TPN) for failure to thrive. Which of the following nursing actions might the nurse take to prevent complications from this therapy? A) Adhere to clean technique when caring for the catheter and administering TPN. B) Ensure that the system remains an open system at all times. C) Secure all connections and open the catheter during tubing and cap changes. D) Use occlusive dressings and chlorhexidine-impregnated sponge (Biopatch) dressings
D
The nurse is caring for a newborn whose mother is HIV positive. The nurse would expect to administer a 6-week course of which medication? A) Lopinavir B) Ritonavir C) Nevirapine D) Zidovudine
D
The nurse is determining the amount of IV fluids to administer in a 24-hour period to a child who weighs 40 kg. How many milliliters should the nurse administer? A) 1,000 mL B) 1,500 mL C) 1,750 mL D) 1,900 mL
D
The nurse is preparing a 5-year-old for a radiograph. Which of the following would be the best communication to prepare the child for the procedure? A) "We are going to take some x-rays of your body." B) "We need to look inside at some of your organs." C) "X-rays are not painful; you won't feel a thing." D) "We are going to use a big camera to take pictures inside your body."
D
The nurse is preparing to administer ear drops to a 6-year-old. To ensure that the medication is instilled properly, the nurse does which of the following? A) Pulls the pinna downward B) Pulls the pinna downward and back C) Pulls the pinna upward D) Pulls the pinna upward and back
D
The nurse is supporting an 8-year-old child who is having blood specimens drawn. Which method would be least appropriate to use for distraction? A) "Squeeze my hand as tight as you can." B) "Look at how many dots there are on the ceiling." C) "Count with me slowly from 1 to 20." D) "It's okay to scream if it hurts."
D
While providing care to a 5-month-old girl whose family has a history of food allergies, the nurse instructs the parents about foods to be avoided in the first year of life. Which response by the parents indicates a need for further teaching? A) "She cannot have any cow's milk." B) "I should continue breastfeeding until at least 6 months." C) "Peanuts in any form should be avoided." D) "Any kind of fruit is acceptable."
D
he nurse is administering a liquid medication to a 3-year-old using an oral syringe. Which action would be most appropriate? A) Direct the liquid toward the anterior side of the mouth. B) Keep the child's hand away from the oral syringe when squirting the medication. C) Give all of the drug in the syringe at one time with one squirt. D) Allow the child time to swallow the medication in between amounts.
D
he nurse is caring for a child recently diagnosed with glucose-6-phosphate dehydrogenase (G6PD) deficiency. The nurse is teaching the parents about triggers that may result in oxidative stress. Which of the following responses indicates a need for further teaching? A) "I doubt he will ever eat fava beans, but they could trigger hemolysis." B) "He must avoid exposure to naphthalene, an agent found in mothballs." C) "He must never take methylene blue for a urinary tract infection." D) "My son can never take penicillin for an infection."
D
he nurse is helping a 14-year old boy who has asthma to administer medication via an inhaler. Which of the following describes a developmentally appropriate nursing intervention for this child? A) Involve the adolescent's parents in the administration of the medication. B) Allow the adolescent to handle a demo inhaler prior to administering the medication. C) Offer the adolescent a special treat if he uses his inhaler correctly. D) Treat the adolescent as an adult when explaining the use of the inhaler.
D
he nurse working with children in a hospital setting notes that they are being discharged earlier and earlier. Which of the following is a primary reason for this trend? A) Nursing shortages B) Increased funding for home care C) National health care initiatives D) Cost containmen
D
A child weighing 51 lbs requires defibrillation. How many joules would the nurse expect to give initially? A) 46 B) 92 C) 102 D) 204
a
A child with diabetes insipidus is being treated with vasopressin. The nurse would assess the child closely for signs and symptoms of which of the following? A) Syndrome of inappropriate antidiuretic hormone (SIADH) B) Thyroid storm C) Cushing syndrome D) Vitamin D toxicity
a
A group of nursing students are reviewing information about neurocutaneous syndromes. The students demonstrate an understanding of these disorders when they identify which of the following as an example? A) Sturge-Weber syndrome B) Marfan syndrome C) Apert syndrome D) Achondroplasia
a
A new mother expresses concern to the nurse that her baby is crying and grunting when passing stool. What is the nurse's best response to this observation? A) "This is normal behavior for infants unless the stool passed is hard and dry." B) "This is normal behavior for infants due to the immaturity of the gastrointestinal system." C) "This indicates a blockage in the intestine and must be reported to the physician." D) "This is normal behavior for infants unless the stool passed is black or green."
a
A nursing student is preparing an oral presentation about autosomal recessive inheritance. Which of the following must occur for an offspring to demonstrate signs and symptoms of the disorder with this type of inheritance? A) Both parents must be heterozygous carriers. B) One parent must have the disease. C) The mother must be a carrier. D) The father must be affected by the disease.
a
After teaching a group of parents about language development in toddlers, which of the following if stated by a member of the group indicates successful teaching? A) "When my 3-year-old asks 'why?' all the time, this is completely normal." B) "A 15-month-old should be able to point to his eyes when asked to do so." C) "At age 2 years, my son should be able to understand things like under or on." D) "An 18-month-old would most likely use words and gestures to communicate."
a
After teaching the parents of a 9-year-old girl about safety, which statement indicates the need for additional teaching? A) "She can ride in the front seat of the car once she is 10 years old." B) "We need to buy her a helmet so she can ride her scooter." C) "She should ride her bike with the traffic on the side of the road." D) "We signed her up for swim lesions at the local community center."
a
Community-based nursing provides opportunities that are quite different from acute care nursing. Which of the following job characteristics is unique to home care nursing? A) Experiencing a greater amount of independence B) Building a close relationship with the family C) Coordinating therapy services and reimbursements D) Focusing teaching on child independence
a
During a health check-up without his parents, a 17-year-old tells the nurse he is gay. Which of the following approaches should the nurse take? A) "Tell me what makes you think you are gay." B) "This puts you in an at-risk category." C) "We need to talk about safe sex." D) "You're not gay; you're confused."
a
The mother of a 14-year-old girl complains to the nurse that her daughter is moody, shuts herself in her room, and fights with her younger sister. Which of the following comments is most valuable to the mother? A) "Calmly talk to her about your concerns." B) "This is normal for her age." C) "She may be hanging with a bad crowd." D) "Set some rules for family etiquette.
a
The mother of a 7-year-old girl tells the school nurse that her child is deathly afraid of going to school. What would be the best intervention the nurse could suggest in this situation? A) Return the child to school and investigate the cause of the fear. B) Have the child stay home from school until any issues causing this fear are resolved. C) Investigate a new school for the child to attend that the child will not be afraid of. D) Tell the child that privileges will be taken away if she does not return to school
a
The nurse in a community clinic is caring for a 6-month-old boy and his mother. Which of the following is the priority intervention to promote adequate growth? A) Monitoring the child's weight and height B) Encouraging a more frequent feeding schedule C) Assessing the child's current feeding pattern D) Recommending higher-calorie solid foods
a
The nurse is assessing a 2-day-old newborn and suspects Down syndrome based on which of the following? Select all answers that apply. A) Flat facial profile B) Downward slant to the eyes C) Large tongue compared to mouth D) Simian crease E) Epicanthal folds F) Rigid joints
a
The nurse is assessing heart rate for children on the pediatric ward. Which of the following is a normal finding based on developmental age? A) An infant's rate is 90 bpm. B) A toddler's rate is 150 bpm. C) A preschooler's rate is 130 bpm. D) A school-age child's rate is 50 bpm
a
The nurse is caring for 3-day-old girl with Down syndrome whose mother had no prenatal care. Which of the following will be the priority nursing diagnosis? A) Imbalanced nutrition, less than body requirements related to the effects of hypotonia B) Deficient knowledge related to the presence of a genetic disorder C) Delayed growth and development related to a cognitive impairment D) Impaired physical mobility related to poor muscle tone
a
The nurse is caring for a 7-month-old girl during a well-child visit. Which of the following interventions is most appropriate for this child? A) Discussing the type of sippy cup to use B) Advising about increased caloric needs C) Explaining how to prepare table meats D) Describing the tongue extrusion reflex
a
The nurse is caring for a 7-year-old girl hospitalized in isolation. The nurse notices that she has begun sucking her thumb and changing her speech patterns to those of a toddler. What condition is the girl manifesting? A) Regression B) Suppression C) Repression D) Denial
a
The nurse is caring for a 7-year-old girl who is scheduled for a hernia repair and is very scared. Which of the following fears would she also most likely have at this age? A) Fear of being kidnapped B) Fear of cutting her finger C) Fear of sudden loud noises D) Fear of the neighbor's dog
a
The nurse is caring for a premature baby in the NICU. The mother reports that the infant's normally happy and outgoing 5-year-old sister is acting sad and withdrawn. The nurse understands that due to her developmental stage, the girl is at risk of which of the following? A) Viewing her baby sister's illness as her fault B) Harming the baby C) Experiencing clinical depression D) Creating an imaginary friend to cope with the situation
a
The nurse is conducting a routine health assessment of a 3-month-old boy and notices a flat occiput. The nurse provides teaching and emphasizes the importance of tummy time. Which of the following responses by the mother indicates a need for further teaching? A) "He must be positioned on his tummy as much as possible." B) "I need to watch him during his tummy time." C) "I need to change his head position while he is in an upright chair." D) "His head has flattened due to the pressure of his head position.
a
The nurse is conducting a well-child assessment for a 5-year-old boy in preparation for kindergarten. The boy's grandmother is his primary caregiver because the boy's mother has suffered from depression and substance abuse issues. The nurse understands that the child is at increased risk for which developmental problem? A) Lack of social and emotional readiness for school B) Stuttering C) Speech and language delays D) Fine motor skills delay
a
The nurse is describing the maturation of various organ systems during toddlerhood to the parents. Which would the nurse correctly include in this description? A) Myelinization of the brain and spinal cord is complete at about 24 months. B) Alveoli reach adult numbers by 3 years of age. C) Urine output in a toddler typically averages approximately 30 mL/hour. D) Toddlers typically have strong abdominal muscles by the age of 2
a
The nurse is enlisting the parents' assistance for therapeutic hugging prior to an otoscopic examination. What should the nurse emphasize to the parents? A) "You will need to keep his hands down and his head still." B) "If this does not work, we will have to apply restraints." C) "If you are not capable of this, let me know so I can get some assistance." D) "I may need you to leave the room if your son will not remain still."
a
The nurse is explaining to parents that the preschooler's developmental task is focused on the development of initiative rather than guilt. Which of the following is a priority intervention the nurse might recommend for parents of preschoolers to stimulate initiative? A) Reward the child for initiative in order to build self-esteem. B) Change the routine of the preschooler often to stimulate initiative. C) Do not set limits on the preschooler's behavior as this results in low self-esteem. D) As a parent, decide how and with whom the child will play
a
The nurse is inspecting the genitals of a prepubescent girl. Which of the following are normal signs of the onset of puberty? A) Appearance of pubic hair around 11 to 13 years old B) Swelling or redness of the labia minora C) Presence of a small amount of downy pubic hair D) Lesions on the external genitalia
a
The nurse is interviewing a 3-year-old girl who tells the nurse: "Want go potty." The parents tell the nurse that their daughter often speaks in this type of broken speech. What would be the nurse's appropriate response to this concern? A) "This is a normal, common speech pattern in the 3-year-old and is called telegraphic speech." B) "This is considered a developmental delay in the 3-year-old and we should consult a speech therapist." C) "This is a condition known as echolalia and can be corrected if you work with your daughter on language skills." D) "This is a condition known as stuttering and it is a normal pattern of speech development in the toddler
a
The nurse is obtaining the health history for a 15-month-old boy from the parents. The child is not yet speaking. Which finding would be eliminated as a risk factor for a possible genetic disorder? A) The child is male and Caucasian. B) The grandmother and father have hearing impairments. C) The child was a breech delivery 3 weeks early. D) The mother was 37 when she became pregnant.
a
The nurse is performing an annual check-up for an 8-year-old child. Compared to the previous assessment of this child, which of the following characteristics would most likely be observed? A) Breathing is diaphragmatic. B) Pulse rate is increased. C) Secondary sex characteristics are present. D) Blood pressure has reached adult level
a
The nurse is preparing a class for a group of adolescents about promoting safety. Which of the following would the nurse plan to include as the leading cause of adolescent injuries? A) Car accidents B) Firearms C) Water D) Fires
a
The nurse is preparing a teaching plan for the family and their 6-year-old son who has just been diagnosed with diabetes mellitus. Which of the following would the nurse identify as the initial goal for the teaching plan? A) Developing management and decision-making skills B) Educating the parents about diabetes mellitus type 1 C) Developing a nutritionally sound, 30-day meal plan D) Promoting independence with self-administration of insulin
a
The nurse is preparing to assess the pulse of an 18-month-old child. Which pulse would be most difficult for the nurse to palpate? A) Radial B) Brachial C) Pedal D) Femoral
a
The nurse is teaching the parents of an overweight 18-month-old girl about diet. Which intervention will be most effective for promoting proportionate growth? A) Remove high-calorie, low-nutrient foods from the diet. B) Ensure 30 minutes of unstructured activity per day. C) Avoid sharing your snacks and candy with the child. D) Reduce the amount of high-fat food the child eats.
a
The nurse is watching toddlers at play. Which of the following normal behaviors would the nurse observe? A) Toddlers engage in parallel play. B) Toddlers engage in solitary play. C) Toddlers engage in cooperative play. D) Toddlers do not engage in play outside the home
a
The nurse knows that the school-age child is in Erikson's stage of industry versus inferiority. Which of the following is the best example of a school-ager working toward accomplishing this developmental task? A) The child signs up for after-school activities. B) The child performs his bedtime preparations autonomously. C) The child becomes aware of the opposite sex. D) The child is developing a conscience
a
The nurse observing toddlers in a day care center notes that they may be happy and pleasant one moment and overreact to limit setting the next minute by throwing a tantrum. What is the focus of the toddler's developmental task that is driving this behavior? A) The need for separation and control B) The need for love and belonging C) The need for safety and security D) The need for peer approval
a
The nurse performing a health history on a child asks the parents if their child has experienced increased appetite or thirst. What body system is the nurse assessing with this question? A) Endocrine B) Genitourinary C) Hematologic D) Neurologic
a
The parent of a 6-month old infant asks the nurse for advice about his son's thumb sucking. What would be the nurse's best response to this parent? A) "Thumb sucking is a healthy self-comforting activity." B) "Thumb sucking leads to the need for orthodontic braces." C) "Caregivers should pay special attention to the thumb sucking to stop it." D) "Thumb sucking should be replaced with the use of a pacifier."
a
The parents bring their 3-year-old son to the emergency department after having found that he has ingested some of his mother's medicine. Which assessment would be of critical importance for this child? A) Assessing mental status and skin moisture and color B) Evaluating the effectiveness of the child's breathing C) Noting the child's pulse rate and quality D) Auscultating all lung fields for signs of edema
a
The parents of a 4-year-old who is a picky eater ask the nurse what foods to include in their child's diet to provide adequate iron consumption. Which of the following foods would the nurse recommend? A) Cooked lentils B) Whole milk C) Oranges D) Sweet potatoes
a
When assessing the vision of a 2-month-old, the nurse would use which of the following? A) Black-and-white checkerboard B) Red and blue circles C) Gray and blue animal drawings D) Green and yellow letters
a
When observing a group of preschoolers at play in the clinic waiting room, which type of play would the nurse be least likely to note? A) Parallel play B) Cooperative play C) Dramatic play D) Fantasy play
a
When providing anticipatory guidance to parents about lying during the preschool period, which of the following would the nurse emphasize? A) "You need to determine the reason for lying before punishing the child." B) "Lying typically occurs because the child is afraid of being punished." C) "The misbehavior is usually more serious than the lying itself." D) "It is okay to become angry when dealing with the child's lying
a
When teaching a class about trisomy 21, the instructor would identify this disorder as due to which of the following? A) Nondisjunction B) X-linked recessive inheritance C) Genomic imprinting D) Autosomal dominant inheritance
a
Which of the following would lead the nurse to suspect that a child has Turner syndrome? A) Webbed neck B) Microcephaly C) Gynecomastia D) Cognitive delay
a
The nurse is assessing the psychosocial development of a preschooler. Which of the following are normal activities characteristic of the preschooler? Select all answers that apply. A) Plans activities and makes up games B) Initiates activities with others C) Acts out roles of other people D) Engages in parallel play with peers E) Classifies or groups objects by their common elements F) Understands relationships among objects
a b c
The nurse is conducting a psychosocial assessment of a child with asthma brought to the physician's office for a check-up. Which of the following are psychosocial issues that might be assessed? Select all answers that apply. A) Health insurance coverage B) Transportation to health care facilities C) School's response to the chronic illness D) Past medical history E) Future treatment plans F) Health maintenance needs
a b c
The nurse is caring for preschoolers in a day care center. Of which of the following developmental milestones of this age group should the nurse be aware? Select all answers that apply. A) Counting 10 or more objects B) Correctly naming at least four colors C) Understanding the concept of time D) Knowing everyday objects E) Understanding the differences of others F) Forming concepts as logical as an adult's
a b c d
The nurse is teaching the parents of a 4-year-old boy about the normal maturations of the child's organs during the preschool years and their effect on body functions. Which of the following statements accurately describe these changes? Select all answers that apply. A) Myelination of the spinal cord allows for bowel and bladder control to be complete in most children by age 3 years. B) The respiratory structures are continuing to grow in size, and the number of alveoli continues to increase, reaching the adult number at about 7 years of age. C) Heart rate increases and blood pressure decreases slightly during the preschool years; an innocent heart murmur may be heard upon auscultation. D) The bones continue to increase in length and the muscles continue to strengthen and mature; however, the musculoskeletal system is still not fully mature. E) The small intestine is continuing to grow in length, and stool passage usually occurs once or twice per day in the average preschooler. F) The urethra remains long in both boys and girls, making them more susceptible to urinary tract infections than adults
a b d e
The nurse is providing atraumatic care to children in a hospital setting. Which of the following are principles of this philosophy of care? Select all answers that apply. A) Avoid or reduce painful procedures B) Avoid or reduce physical distress C) Minimize parent-child interactions D) Provide child-centered care E) Minimize child control F) Use core primary nursing
a b f
The nurse is questioning the parents of a 2-year-old child to obtain a functional history. Which of the following topics might the nurse include? Select all answers that apply. A) The child's toileting habits B) Use of car seats and other safety measures C) Problems with growth and development D) Prenatal and perinatal history E) The child's race and ethnicity F) Use of supplements and vitamins
a b f
The school nurse is conducting a seminar for parents of adolescents on how to communicate with teenagers. Which of the following guidelines might the nurse recommend? Select all answers that apply. A) Talk face to face and be aware of body language. B) Ask questions to see why he or she feels that way. C) Do not give praise unless the adolescent deserves it. D) Speak to your child as an authority figure, not an equal. E) Don't admit that you make mistakes. F) Don't pretend you know all the answers
a b f
The nurse is aware that the community affects the health of its members. Which of the following statements accurately reflect a community influence of health care? Select all answers that apply. A) A community can be a contributor to a child's health or be the cause of his or her illnesses. B) The child's health should be separated from the health of the surrounding community. C) Community support and resources are necessary for children with significant problems. D) Poverty has not been linked to an increase in health problems in communities. E) The breakdown of community and family support systems can lead to depression and violence. F) Ideally, the child's medical home is located outside the community
a c e
A group of students are reviewing information about respiratory arrest in children. The students demonstrate understanding of this information when they identify which of the following as a common cause involving the upper airway? Select all answers that apply. A) Croup B) Asthma C) Pertussis D) Epiglottitis E) Pneumothorax
a d
The nurse caring for newborns knows that infants exhibit phenomenal increases in their gross motor skills over the first 12 months of life. Which of the following statements accurately describe the typical infant's achievement of these milestones? Select all answers that apply. A) At 1 month the infant lifts and turns the head to the side in the prone position. B) At 2 months the infant lifts head and looks around. C) At 6 months the infant pulls to stand up. D) At 7 months the infant sits alone with some use of hands for support. E) At 9 months the infant crawls with the abdomen off the floor. F) At 12 months the infant walks independently.
a d e f
The nurse is assessing the respiratory system of a newborn. Which of the following anatomic differences place the infant at risk for respiratory compromise? Select all answers that apply. A) The nasal passages are narrower. B) The trachea and chest wall are less compliant. C) The bronchi and bronchioles are shorter and wider. D) The larynx is more funnel shaped. E) The tongue is smaller. F) There are significantly fewer alveoli.
a d f
The nurse is preparing a hospitalized 7-year-old girl for a lumbar puncture. Which of the following actions would help reduce her stress related to the procedure? Select all answers that apply. A) Pretend to perform the procedure on her doll. B) Explain the procedure to her in medical terms. C) Do not allow her to see or touch the equipment. D) Teach her the steps of the procedure. E) Tell her not to pay attention to any sounds she might hear. F) Introduce her to the health care personnel.
a d f
A 2-week-old child responds to a bell during an initial health supervision examination. The child's records do not show that a newborn hearing screening was done. Which of the following is the best action for the nurse to take? A) Do nothing because responding to the bell proves he does not have a hearing deficit. B) Immediately schedule the infant for a newborn hearing screening. C) Ask the mother to observe for signs that the infant is not hearing well. D) Screen again with the bell at the 2-month-old health supervision visit
b
A child is brought to the emergency department with a suspected poisoning. Which of the following would the nurse least likely expect to be used? A) Gastric lavage B) Syrup of ipecac C) Activated charcoal D) Whole bowel irrigation
b
A child is diagnosed with hyperthyroidism. Which agent would the nurse expect the physician to prescribe? A) Mineralocorticoid B) Methimazole C) Levothyroxine D) Dexamethasone
b
A child with diabetes reports that he is feeling a little shaky. Further assessment reveals that the child is coherent but with some slight tremors and sweating. A fingerstick blood glucose level is 70 mg/dL. Which of the following would the nurse do next? A) Administer a sliding-scale dose of insulin B) Give 10 to 15 grams of a simple carbohydrate C) Offer a complex carbohydrate snack D) Administer glucagon intramuscularly
b
A group of nursing students are reviewing the components of the endocrine system. The students demonstrate understanding of the review when they identify which of the following as the primary function of this system? A) Regulation of water balance B) Hormonal secretion C) Cellular metabolism D) Growth stimulation
b
A large portion of the nurse's efforts is dedicated to health supervision for children who use the facility as their primary medical contact. At which of the following facilities does the nurse work? A) An urgent care center B) A pediatric practice C) A mobile outreach immunization program D) A dermatology practice
b
A new mother shows the nurse that her baby grasps her finger when she touches the baby's palm. How might the nurse respond to this information? A) "This is a primitive reflex known as the plantar grasp." B) "This is a primitive reflex known as the palmar grasp." C) "This is a protective reflex known as rooting." D) "This is a protective reflex known as the Moro reflex.
b
A nursing instructor is preparing a class discussion on the benefits and drawbacks associated with genetic advances and the Human Genome Project. Which of the following would the instructor address as a potential problem? A) Early detection possibilities B) Risk profiling C) Focus on causes D) Rapid diagnosis
b
A pregnant woman is to undergo testing to evaluate for chromosomal abnormalities. Which test would the nurse expect to be done the earliest? A) Amniocentesis B) Chorionic villi sampling C) Triple screen D) Fetal nuchal translucency
b
After assessing a 10-year-old girl, the nurse documents the appearance of breast buds, identifying this as which of the following? A) Menarche B) Thelarche C) Puberty D) Tanner stage 5
b
After teaching a group of students about therapeutic play, the instructor determines that additional teaching is needed when the students identify which of the following as a characteristic? A) Focus on coping B) Use of a highly structured format C) Dramatization of emotions D) Expression of feelings
b
After teaching the mother about follow-up immunizations for her daughter, who received the varicella vaccine at age 14 months, the nurse determines that the teaching was successful when the mother states that a follow-up dose should be given at which time? A) When the child is 20 to 36 months of age B) When the child is 4 to 6 years of age C) When the child is 11 to 12 years of age D) When the child is 13 to 15 years of age
b
An adolescent is scheduled for outpatient arthroscopic surgery on his knee next week. As part of preparing him for the procedure, which action would be most appropriate? A) Discussing the events with the adolescent and his mother upon arrival the morning of the procedure B) Providing detailed explanations of the procedure at least a week in advance of the procedure C) Encouraging the parent to stay with the adolescent as much as possible before the procedure D) Answering the adolescent's questions with simple answers, encouraging him to ask the surgeon
b
Based on Erikson's developmental theory, which of the following is the major developmental task of the adolescent? A) Gaining independence B) Finding an identity C) Coordinating information D) Mastering motor skills
b
During a health history, the nurse explores the sleeping habits of a 3-yearold boy by interviewing his parents. Which of the following statements from the parents reflects a recommended guideline for promoting healthy sleep in this age group? A) "Our son sleeps through the night, and we insist that he takes two naps a day." B) "We keep a strict bedtime ritual for our son, which includes a bath and bedtime story." C) "Our son still sleeps in a crib because we feel it is the safest place for him at night." D) "Our son occasionally experiences night walking so we allow him to stay up later when this happens.
b
For which of the following children would the nurse conduct an immediate comprehensive health history? A) A child who is brought to the emergency room with lacerations B) A child who is a new client in a pediatric office C) A child who is a routine client and presents with signs of a sinus infection D) A child whose condition is improving
b
The child life specialist (CLS) is preparing a 6-year-old child for a magnetic resonance imaging (MRI) scan. Which of the following statements reflects the use of atraumatic principles when explaining the procedure? A) "You will be taken to a magnetic resonance imaging machine for an x-ray of your liver." B) "You may hear some loud noises when you are lying in the machine, but they won't hurt you." C) "You have nothing to worry about; the MRI machine is safe and will not cause you any pain." D) "Let's just get you to the x-ray department for your test and you'll see how simple it is."
b
The mother of a 5-year-old child with eczema is getting a check-up for her child before school starts. Which of the following will the nurse do during the visit? A) Change the bandage on a cut on the child's hand B) Assess the compliance with treatment regimens C) Discuss systemic corticosteroid therapy D) Assess the child's fluid volume
b
The nurse is assessing a 2-year-old boy who has missed some developmental milestones. Which finding will point to the cause of motor skill delays? A) The mother is suffering from depression. B) The child is homeless and has no toys. C) The mother describes an inadequate diet. D) The child is unperturbed by a loud noise
b
The nurse is assessing a 4-month-old boy during a scheduled visit. Which of the following findings might suggest a developmental problem? A) The child does not coo or gurgle. B) The child does not babble or laugh. C) The child never squeals or yells. D) The child does not say dada or mama
b
The nurse is assessing the temperature of a diaphoretic toddler who is crying and being uncooperative. What would be the best method to assess temperature in this child? A) Oral thermometer B) Axillary method C) Temporal scanning D) Rectal route
b
The nurse is caring for a 10-year-old boy who is in traction. The boy has a nursing diagnosis of deficient diversional activity related to confinement in bed that is evidenced by verbalization of boredom and lack of participation in play, reading, and schoolwork. Which of the following would be the best intervention? A) Offer the child reading materials. B) Enlist the aid of a child life specialist. C) Encourage the child to complete his homework. D) Ask for the parents' assistance
b
The nurse is caring for a 4-week-old girl and her mother. Which of the following is the most appropriate subject for anticipatory guidance? A) Promoting the digestibility of breast milk B) Telling how and when to introduce rice cereal C) Describing root reflex and latching on D) Advising how to choose a good formula
b
The nurse is caring for a 7-year-old boy experiencing respiratory distress who is scheduled to have a chest radiograph. Which of the following would be most important for the nurse to include in the child's plan of care? A) Administering a sedative to help calm the child B) Assisting the child to lie still during the chest radiograph C) Accompanying the child to continue observation D) Informing the child that he might hear a loud banging noise
b
The nurse is caring for a 7-year-old boy who needs his left leg immobilized. What is the priority nursing intervention? A) Enlist the assistance of a child life specialist. B) Explain to the boy that he must keep his leg very still. C) Apply a clove-hitch restraint to the boy's left leg. D) Explain that a restraint will be applied if he cannot hold still
b
The nurse is caring for a couple who have just learned that their infant has a genetic disorder. Which of the following would be least appropriate for the nurse to do at this time? A) Actively listening to the parents' concerns B) Teaching the parents about the child's medical needs C) Providing time for the parents to ask questions D) Offering suggestions for support services
b
The nurse is caring for an 11-year-old girl preparing to undergo a magnetic resonance imaging (MRI) scan. Which of the following statements would best help prepare the girl for the test and decrease anxiety? A) "You won't hear a sound if you wear your headphones." B) "The machine makes a very loud rattle; however, headphones will help." C) "There are a variety of loud sounds you will hear." D) "The MRI scanner sounds like a machine gun.
b
The nurse is caring for an 8-year-old girl with an endocrine disorder involving the posterior pituitary gland. Which of the following would the nurse expect to implement? A) Instructing the parents to report adverse reactions to the growth hormone treatment B) Teaching the parents how to administer the desmopressin acetate C) Informing the parents that treatment stops when puberty begins D) Educating the parents to report signs of acute adrenal crisis
b
The nurse is caring for an 8-year-old girl with hyperpituitarism. Which of the following ordered treatments will the nurse expect to perform? A) Give desmopressin acetate intranasally B) Inject octreotide acetate C) Give 1 mg/kg/day of methimazole D) Administer glipizide orally
b
The nurse is conducting a well-child examination of a 5-year-old girl, who was 40 inches tall at her last examination at age 4. Which of the following height measurements would be within the normal range of growth expected for a preschooler? A) 41 inches B) 43 inches C) 45 inches D) 47 inches
b
The nurse is counseling the mother of a newborn who is concerned about her baby's constant crying. What teaching would be appropriate for this mother? A) Carrying the baby may increase the length of crying. B) Reducing stimulation may decrease the length of crying. C) Using vibration, white noise, or swaddling may increase crying. D) Using a swing or car ride may increase the incidence of crying episodes.
b
The nurse is educating a first-time mother who has a 1-week-old boy. Which of the following is the most accurate anticipatory guidance? A) Describing the effect of neonatal teeth on breastfeeding B) Explaining that the stomach holds less than 1 ounce C) Informing that fontanels will close by 6 months D) Telling that the step reflex persists until the child walk
b
The nurse is explaining a discharge plan to the parents of an infant being discharged from the hospital. Which of the following characteristics regarding adult learning should the nurse incorporate into her plan? A) Adults are dependent learners. B) Adults are problem focused. C) Adults are future focused. D) Adults do not value past learning
b
The nurse is explaining the difference between active and passive immunity to the student nurse. Which of the following statements accurately describes a characteristic of the process of immunity? A) Active immunity is produced when the immunoglobulins of one person are transferred to another. B) Passive immunity can be obtained by injection of exogenous immunoglobulins. C) Active immunity can be transferred from mothers to infants via colostrum or the placenta. D) Passive immunity is acquired when a person's own immune system generates the immune response.
b
The nurse is measuring the blood pressure of a 12-year-old boy with an oscillometric device. The boy's reading is greater than the 90th percentile for gender and height. What is the appropriate nursing action? A) Repeat the reading with the oscillometric device. B) Repeat the blood pressure reading using auscultation. C) Measure the blood pressure in all four extremities. D) Measure the blood pressure with a Doppler
b
The nurse is observing a 24-month-old boy in a day care center. Which finding suggests delayed motor development? A) The child has trouble undressing himself. B) The child is unable to push a toy lawnmower. C) The child is unable to unscrew a jar lid. D) The child falls when he bends over.
b
The nurse is performing a physical assessment of a 10-year-old boy. The nurse notes that during last year's check-up the child weighed 80 pounds. According to average growth for this age group, what would be his expected current weight? A) 83 pounds B) 85 pounds C) 87 pounds D) 89 pounds
b
The nurse is performing a physical examination of an 11-year-old girl. Which of the following observations would be expected? A) The child has not gained weight since last year. B) The child has grown 3 inches since last year. C) The child breathes abdominally. D) The child's third molars are about to erupt
b
The nurse is performing a risk assessment of a 5-year-old and determines the child has a risk factor for cystic fibrosis. What type of screening would the nurse perform to confirm or rule out this disease? A) Universal screening B) Selective screening C) Hyperlipidemia screening D) Developmental screening
b
The nurse is preparing a presentation to a local parent group about pediatric health supervision. Which of the following would the nurse emphasize as the focus? A) Injury prevention B) Wellness C) Health maintenance D) Developmental surveillance
b
The nurse is providing anticipatory guidance for parents of a school-age child on teaching the dangers of drugs and alcohol. Which of the following advice might be helpful for these parents? A) School-age children are not ready to absorb information that deals with drugs and alcohol. B) School-age children can think critically to interpret messages seen in advertising, media, and sports. C) Parents must prevent their child from being exposed to messages that are in conflict with their values. D) Discussions with children need to be based on facts and focused on the past and future.
b
The nurse is reviewing the laboratory test results of a child with Addison disease. Which of the following would the nurse expect to find? A) Hypernatremia B) Hyperkalemia C) Hyperglycemia D) Hypercalcemia
b
The nurse is talking with a chatty 7-year-old girl during her regular check-up. Which of the following behaviors would the child also be expected to exhibit? A) Showing no interest in what the nurse sees in her ears B) Explaining what is right and what is wrong C) Demonstrating independence from her mother D) Showing no concern when the nurse hurts her own finger
b
The nurse is teaching a couple about X-linked disorders. They are concerned that they might pass on hemophilia to their children. Which of the following responses indicates the need for further teaching? A) "The father can't be a carrier if he doesn't have hemophilia." B) "If the father doesn't have it, then his kids won't either." C) "If the mother is a carrier, her daughter could be one too." D) "If the mother is a carrier, her sons may have hemophilia."
b
The nurse is teaching a new mother about the development of sensory skills in her newborn. Which of the following would alert the mother to a sensory deficit in her child? A) The newborn's eyes wander and occasionally are crossed. B) The newborn does not respond to a loud noise. C) The newborn's eyes focus on near objects. D) The newborn becomes more alert with stroking when drowsy.
b
The nurse is teaching good sleep habits for toddlers to the mother of a 2-year-old boy. Which response indicates the mother understands sleep requirements for her son? A) "I'll put him to bed at 7 p.m., except Friday and Saturday." B) "He needs 13 hours of sleep per day including his nap." C) "I need to put the side down on the crib so he can get out." D) "His father can give him a horseback ride into his bed."
b
The nurse is teaching the parents of a 1-month-old girl with Down syndrome how to maintain good health for the child. Which instruction would the nurse be least likely to include? A) Getting cervical radiographs between 3 and 5 years of age B) Adhering to the special dietary needs of the child C) Getting an echocardiogram before 3 months of age D) Monitoring for symptoms of respiratory infection
b
The nurse is teaching the parents of a 12-year-old boy about appropriate approaches when raising an adolescent. Which of the following comments should be included in the discussion? A) "Find out if his friends are worthy of him." B) "Try to be open to his views." C) "Maintain a firm set of rules." D) "Remind him that he is still your little boy.
b
The nurse is teaching the parents of a 2-year-old toddler methods of dealing with their child's "negativism." Based on Erokson's theory of development, which of the following would be an appropriate intervention for this child? A) Discourage solitary play; encourage playing with other children. B) Encourage the child to pick out his own clothes. C) Use "time-outs" whenever the child says "no" inappropriately. D) Encourage the child to take turns when playing games
b
The nurse is teaching the parents of a 9-year-old girl about the socialization that is occurring in their child through school contacts. Which of the following information would the nurse include in her teaching plan? A) Teachers are the most influential people in the development of the school-age child's social network. B) Continuous peer relationships provide the most important social interaction for school-age children. C) Parents should establish norms and standards that signify acceptance or rejection. D) A characteristic of school-age children is their formation of groups with no rules and values involved
b
The nurse is teaching the student nurse how to perform a physical assessment based on the child's developmental stage. Which of the following statements accurately describes a recommended guideline for setting the tone of the examination for a school-age child? A) Keep up a running dialogue with the caregiver, explaining each step as you do it. B) Include the child in all parts of the examination; speak to the caregiver before and after the examination. C) Speak to the child using mature language and appeal to his or her desire for self- care. D) Address the child by name; speak to the caregiver and do the most invasive parts last
b
The nurse knows that barriers to the adolescent's health and successful achievement of the tasks of adolescence exist. Which of the following is the major barrier to health for this population? A) Cultural B) Socioeconomic C) Marital status D) Racial
b
The parents of a 2-year-old girl are frustrated by the frequent confrontations they have with their child. Which is the best anticipatory guidance the nurse can offer them? A) "Respond in a calm but firm manner." B) "You need to adhere to various routines." C) "Put her in time-out when she misbehaves." D) "It's important to toddler-proof your home.
b
The parents of a 4-year-old ask the nurse when their child will be able to differentiate right from wrong and develop morals. What would be the best response of the nurse? A) "The preschooler has no sense of right and wrong." B) "The preschooler is developing a conscience." C) "The preschooler sees morality as internal to self." D) "The preschooler's morals are their own, right or wrong."
b
The parents of an 11-year-old child ask the nurse for suggestions to promote good nutrition for their child. Which response by the nurse would be most appropriate? A) "Be sure to limit protein to one meal every day." B) "Use whole-grain or enriched breads and cereals." C) "Have eggs on the average of once a week." D) "Eat dark green leafy vegetables about twice a week."
b
The school nurse is conducting vision screening for a 7-year-old girl and documents the condition "amblyopia." What would the nurse tell the parents about this condition? A) "Amblyopia is an uncorrected refractive error of the eye." B) "Amblyopia is reduced vision in an eye that has not been adequately used during early development." C) "Amblyopia is a malalignment of the eye, which occurs at birth." D) "Amblyopia is a clouding of the lens of the eye caused by trauma to the eye."
b
The school nurse is preparing a program on sexuality and birth control for a class of 14- to 16-year-olds. Which of the following behaviors will have the most influence on how the information is presented? A) Teens are adjusting to new body images. B) Adolescents tend to take risks. C) Teenagers are able to think in the abstract. D) Adolescents understand that actions have consequences.
b
The school nurse knows that dating is a milestone for adolescents. Which of the following statements accurately describes a trend in teen dating? A) Most late adolescents spend more time in activities with mixed-sex groups, such as dances and parties, than they do dating as a couple. B) Most teens have been involved in at least one romantic relationship by middle adolescence. C) Teens that date frequently report slightly lower levels of self-esteem and decreased autonomy. D) Homosexual behavior as a teen usually indicates that the adolescent will maintain a homosexual orientation.
b
When providing support and education to the family of a child who is diagnosed with a serious genetic abnormality, which of the following would be the highest priority? A) Assisting with scheduling follow-up visits B) Establishing a trusting relationship C) Teaching the family what to expect D) Using measures to promote growth and development
b
Which food suggestion would be most appropriate for the mother of a preschooler to ensure an adequate intake of calcium? A) Spinach B) White beans C) Enriched bread D) Fortified cereal
b
he nurse is counseling parents of a picky eater on how to promote healthy eating habits in their child. Which of the following interventions would be appropriate advice? A) Allow the child to pick out his or her own foods for meals. B) Present the food matter-of-factly and allow the child to choose what to eat. C) Offer high-fat snacks if the child does not eat to get him or her to eat something. D) Offer the child a special treat if he or she eats all the food on the plate.
b
he nurse is incorporating nonverbal communication with verbal communication when explaining the treatment plan for a child with juvenile diabetes. Which of the following should the nurse do to communicate effectively with this family? A) Relax; maintain an open posture, with the arms crossed. B) Sit opposite the family and lean forward slightly. C) Use eye contact sparingly to avoid embarrassment. D) Speak a verbal yes or no; do not use head nods.
b
he nurse is providing anticipatory guidance to a mother of a 5-month-old boy about introducing solid foods. Which statement by the mother indicates that effective teaching has occurred? A) "I'll start with baby oatmeal cereal mixed with low-fat milk." B) "The cereal should be a fairly thin consistency at first." C) "I can puree the meat that we are eating to give to my baby." D) "Once he gets used to the cereal, then we'll try giving him a cup.
b
he school nurse is performing a physical examination on a 13-year-old boy who is on the soccer team. Which of the following is a physical quality that develops during these early adolescent years? A) Coordination B) Endurance C) Speed D) Accuracy
b
A child is diagnosed with cri-du-chat syndrome. Which of the following would the nurse expect to assess? Select all answers that apply. A) Hypertonia B) Short stature C) Simian crease D) Wide and flat nasal bridge E) Hydrocephaly
b c d
The nurse assesses the spirituality of an adolescent. Which of the following are normal moral and spiritual milestones in this age group? Select all answers that apply. A) Adolescents will base their actions on the avoidance of punishment and the attainment of pleasure. B) Adolescents develop their own set of morals and values and question the status quo. C) Adolescents undergo the process of developing their own set of morals at different rates. D) Adolescents are more interested in the spiritualism of their religion than in the actual practices of their religion. E) Adolescents can understand the concepts of right and wrong and are developing a conscience. F) Adolescents are able to understand and incorporate into their behavior the concept of the "golden rule.
b c d
The nurse is performing developmental surveillance for children at a medical home. Which of the following infants are most at risk for developmental delays? Select all answers that apply. A) A child whose birthweight was 1,600 g B) A child whose parent has a mental illness C) A child raised by a single parent D) A child with a lead level above 10 mg/dL E) A child with hypertonia or hypotonia F) A child with gestational age more than 33 weeks
b c e
The pediatric nurse is aware of the maturation of organ systems in the school-age child. Which of the following accurately describe these changes? Select all answers that apply. A) The brain grows very slowly during the school-age years and growth is complete by the time the child is 12 years of age. B) Respiratory rates decrease, abdominal breathing disappears, and respirations become diaphragmatic in nature. C) The school-age child's blood pressure increases and the pulse rate decreases, and the heart grows more slowly during the middle years. D) The school-age child experiences more gastrointestinal upsets compared with earlier years since the stomach capacity increases. E) Bladder capacity increases, but varies among individual children, and girls generally have a greater bladder capacity than boys. F) Prepubescence typically occurs in the 2 years before the beginning of puberty and is characterized by the development of secondary sexual characteristics.
b c e f
The nurse is helping parents prepare a healthy meal plan for their toddler. Which of the following guidelines for promoting nutrition should be followed when planning meals? Select all answers that apply. A) The child younger than 2 years of age should have his or her fat intake restricted. B) Extending breastfeeding into toddlerhood is believed to be beneficial to the child. C) Weaning from the bottle should occur by 6 to 12 months of age. D) Adequate calcium intake and appropriate exercise lay the foundation for proper bone mineralization. E) The toddler requires an average intake of 500 mg calcium per day. F) Toddlers tend to have the highest daily iron intake of any age group
b d e
The nurse is performing an admission of a 10-year-old boy. Which of the following actions will help the nurse establish a trusting and caring relationship with the child and his family? Select all answers that apply. A) The nurse should not minimize the child's fears by smiling. B) The nurse should initiate introductions. C) The nurse should not use formal titles at the introduction. D) The nurse should maintain eye contact at the appropriate level. E) The nurse should start communication with the child first and then move on to the family. F) The nurse should use age-appropriate communication with the child
b d f
The parents of a preschooler ask the nurse to help them choose a preschool for their child. Which of the following are recommended guidelines and goals for choosing a preschool? Select all answers that apply. A) The main goal of preschool is to improve reading and writing skills and readiness for entering into grade school. B) When selecting a preschool the parent may want to consider the accreditation of the school and the teachers' qualifications. C) The teachers should decide how focused on curriculum the school should be for each individual student. D) The parent should observe the classroom, evaluating the environment, noise level, and sanitary practices. E) The type of discipline used in the school is also an important factor. Parents should choose a preschool that uses corporal punishment. F) The parent should observe the classroom to determine how the children interact with each other and how the teachers interact with the children.
b d f
A child with growth hormone deficiency is receiving growth hormone. Which of the following would the nurse interpret as indicating effectiveness of this therapy? A) Rapid weight gain B) Complaints of headaches C) Height increase of 4 inches D) Growth plate closure
c
A group of nursing students are reviewing information about the endocrine system in infants and children. The students demonstrate understanding of the information when they state which of the following? A) Endocrine glands begin developing in the third trimester of gestation. B) At birth, the endocrine glands are completely functional. C) Infants have difficulty balancing glucose and electrolytes. D) A child's endocrine system has little effect on growth and development.
c
A group of students are working on a presentation for a local health fair about safety for children. When developing this presentation, the students would address which of the following as the most common cause of pediatric injury? A) Sports B) Firearm use C) Falls D) Automobile accidents
c
A mother brings her 31/2-year-old daughter to the emergency department because the child has been vomiting and having diarrhea for the past 36 hours. When assessing this child's temperature, which method would be least appropriate? A) Oral B) Tympanic C) Rectal D) Axillary
c
A nurse determines that a child is exhibiting compensated supraventricular tachycardia (SVT). Which of the following would be attempted first? A) Adenosine B) Synchronized cardioversion C) Vagal maneuvers D) Amiodarone
c
A nurse is caring for a 4-year-old girl. The mother says that the girl is afraid of cats and dogs and does not like to go to the playground anymore because she wants to avoid the dogs that are often being walked at the park. What should the nurse tell the mother? A) "It is best to avoid the playground until she outgrows the fear." B) "She needs to face her fears head-on; take her to the park as much as possible." C) "Acknowledge her fear and help her develop a strategy for dealing with it." D) "Try to minimize her fears and insist that she go to the park."
c
After teaching a class about inborn errors of metabolism, the instructor determines that additional teaching is needed when the class identifies which of the following as an example of an inborn error of metabolism? A) Galactosemia B) Maple syrup urine disease C) Achondroplasia D) Tay-Sachs disease
c
After teaching a group of nursing students about shock in children, the instructor determines that the teaching was successful when the students identify which type of shock as most common? A) Septic B) Cardiogenic C) Hypovolemic D) Distributive
c
As part of their orientation to their pediatric clinical rotation, an instructor is teaching a group of students how to perform cardiopulmonary resuscitation (CPR) on a child. Two students return demonstrate the skill using an infant manikin. Which of the following indicates the proper technique? A) Compressing 30 times for every 2 breaths B) Placing the heel of the hand on the midsternum C) Giving 2 breaths followed by 15 compressions D) Using two hands to perform chest compressions
c
Assessment reveals that a child weighs 73 lb and is 4 ft 1 in. tall. The nurse calculates this child's body mass index as: A) 19.1 B) 20.7 C) 21.4 D) 24.5
c
During a health maintenance visit, a 15-year-old girl mentions that she is not happy with how overweight she is. Which of the following approaches is best for the nurse to take? A) "Good observation. Let's talk about diet and exercise." B) "Don't worry; you are within the weight and height guidelines." C) "What specifically have you been noticing?" D) "Tell me about your parents. Are they overweight?
c
During the health history, the mother of a 4-month-old child tells the nurse she is concerned that her baby is not doing what he should be at this age. What is the nurse's best response? A) "I'll be able to tell you more after I do his physical." B) "Fill out the questionnaire and then I can let you know." C) "Tell me what concerns you." D) "All mothers worry about their babies. I'm sure he's doing well."
c
The nurse has determined that an 8-year-old girl is at risk for being overweight. Which of the following interventions would be a priority prior to developing the care plan? A) Determining the need for additional caloric intake B) Asking the parents who they want to work with the child C) Interviewing the parents about their eating habits D) Discussing the influence of peers on the child's diet
c
The nurse has seen a 15-year-old girl and a 16-year-old boy during health surveillance visits. Which of the following physical characteristics would be seen in both teenagers? A) Decreased respiratory rates of 15 to 20 breaths per minute B) Eruption of last four molars C) Increased shoulder, chest, and hip widths D) Fully functioning sweat and sebaceous glands
c
The nurse is administering 10 units of NPH insulin to a child at 8 a.m. The nurse would expect this insulin to begin acting at which time? A) By 8:15 a.m. B) Between 8:30 and 9 a.m. C) Between 9 and 11 a.m. D) Around 12 noon
c
The nurse is assessing a 12-month-old boy with an English-speaking father and a Spanish-speaking mother. The boy does not say mama or dada yet. Which of the following is the priority intervention? A) Performing a developmental evaluation of the child B) Encouraging the parents to speak English to the child C) Asking the mother if the child uses Spanish words D) Referring the child to a developmental specialist
c
The nurse is assessing a 13-year-old boy with type 2 diabetes mellitus. Which of the following would the nurse correlate with disorder? A) The parents report that their child had "a cold or flu" recently. B) Blood pressure is decreased when checking vital signs. C) The parents report that their son "can't drink enough water." D) Auscultation reveals Kussmaul breathing.
c
The nurse is assessing a 3-year-old boy's development during a well-child visit. Which response by the child indicates the need for further assessment? A) He says a swear word when he hurts himself playing. B) He says "pew" when his sister has soiled her diaper. C) He laughs when his brother cries getting vaccinated. D) He constantly asks "why?" whenever he is told a fact.
c
The nurse is assessing a 4-year-old boy whose mother was 40 years old when he was born. Which of the following findings suggests this child has a genetic disorder? A) Inquiry determines the child had feeding problems. B) Observation shows nasal congestion and excess mucus. C) Inspection reveals low-set ears with lobe creases. D) Auscultation reveals the presence of wheezing.
c
The nurse is assessing a 9-year-old girl with a history of tuberculosis at age 6 years. She has been losing weight and has no appetite. The nurse suspects Addison disease based on which of the following assessment findings? A) Arrested height and increased weight B) Thin, fragile skin and multiple bruises C) Hyperpigmentation and hypotension D) Blurred vision and enuresis
c
The nurse is assessing an infant and notes that the infant's urine has a musty odor. Which of the following would the nurse suspect? A) Maple syrup urine disease B) Tyrosinemia C) Phenylketonuria D) Trimethylaminuria
c
The nurse is assessing the heart rate of a healthy 13-month-old child. The nurse knows to auscultate which of the following sites to obtain an accurate assessment? A) Radial pulse B) Brachial pulse C) Apical pulse at the third or fourth intercostal space D) Apical pulse at the fourth or fifth intercostal space at the midclavicular line
c
The nurse is assessing the motor skills of a 5-year-old girl. Which finding would cause the nurse to be concerned? A) Can copy a square on another piece of paper B) Can dress and undress herself without help C) Draws a person with three body parts D) Is beginning to tie her own shoelaces
c
The nurse is assessing the neck of an 8-year-old child with Down syndrome. Which of the following findings would the nurse expect during the examination? A) Webbing B) Excessive neck skin C) Lax neck skin D) Shortened neck
c
The nurse is caring for a 1-month-old girl with low-set ears and severe hypotonia who was diagnosed with trisomy 18. Which nursing diagnosis would the nurse identify as most likely? A) Interrupted family process related to the child's diagnosis B) Deficient knowledge deficit related to the genetic disorder C) Grieving related to the child's poor prognosis D) Ineffective coping related to stress of providing care
c
The nurse is caring for a 10-year-old boy with hyperpituitarism due to a tumor on the anterior pituitary gland. Which of the following would be a priority for this child? A) Promoting a healthy body image B) Encouraging effective family coping C) Providing pre- and postoperative care D) Promoting knowledge about treatment options
c
The nurse is caring for a 4-year-old girl who has been hospitalized for over a week with severe burns. Which of the following would be a priority intervention to help satisfy this preschool child's basic needs? A) Encourage friends to visit as often as possible. B) Suggest that a family member be present with her 24 hours a day C)Explain necessary procedures in simple language that she will understand. D) Allow her to make choices about her meals and activities as much as permitted
c
The nurse is conducting a physical examination of a child following a comprehensive health history. What should be the focus of the physical examination? A) The child B) The parents C) Chief complaint D) Developmental age
c
The nurse is counseling the parents of a 10-year-old child who was caught stealing at school. Which of the following topics should the nurse cover? A) Having the child return the property in front of his or her class B) Discussing ways for the child to save face C) Finding out what is currently going on at home D) Reminding the child daily that stealing is wrong
c
The nurse is discussing ways to promote discipline with parents who are becoming increasingly frustrated with their teenager. Which of the following would the nurse identify as most important? A) Establish rules and expectations. B) Collaborate to determine consequence. C) Make your responses consistent. D) Explain the rules to the adolescent.
c
The nurse is educating a 16-year-old girl who has just been diagnosed with acute myelogenous leukemia. Which of the following statements best demonstrates therapeutic communication? A) Discussing the treatment plan in detail for the next few weeks B) Using medical terms when describing the disease C) Assessing the adolescent's emotional status in private D) Talking about clothing and the stores where she shops
c
The nurse is examining a 10-month-old boy who was born 10 weeks early. Which of the following findings is cause for concern? A) The child has doubled his birthweight. B) The child exhibits plantar grasp reflex. C) The child's head circumference is 19.5 inches. D) No primary teeth have erupted yet
c
The nurse is examining the posture of a male toddler and notes the condition "lordosis." What would be the appropriate reaction of the nurse to this finding? A) Explain that the child will need a back brace. B) Refer the toddler to a physical therapist. C) Do nothing; this is a normal condition for toddlers. D) Notify the primary care physician about the condition
c
The nurse is helping a new mother prepare for breastfeeding her infant. During which of the following newborn states of consciousness would the nurse recommended attempting the feeding? A) Light sleep B) Drowsiness C) Quiet alert state TestBankWorld.org D) Active alert state
c
The nurse is performing a health assessment of a 3-month-old Black American boy. For what condition should this infant be monitored based on his race? A) Jaundice B) Iron deficiency C) Lactose intolerance D) Gastroesophageal reflux disease (GERD
c
The nurse is performing a physical assessment of a 3-year-old girl. Which of the following would be a concern for the nurse? A) The toddler gained 4 pounds in weight since last year. B) The toddler gained 3 inches in height since last year. C) The toddler's anterior fontanel is not fully closed. D) The circumference of the child's head increased 1 inch since last year
c
The nurse is performing a vision screening for a 4-year-old child. Which of the following screening charts would be best for determining the child's visual acuity? A) Snellen B) Ishihara C) Allen figures D) Color Vision Testing Made Easy (CVTME)
c
The nurse is performing risk assessments on adolescents in the school setting. Which one of the following teens should the nurse screen for hypertension? A) An Asian female B) A white male C) An African American male D) A Jewish male
c
The nurse is preparing a child and his family for a lumbar puncture. Which of the following would be a primary intervention instituted by the CLS to keep the child safe? A) Distraction methods B) Stimulation methods C) Therapeutic hugging D) Therapeutic touch
c
The nurse is preparing a teaching plan for a 10-year-old girl with hyperthyroidism. Which of the following would the nurse include in the plan? A) Describing surgery to remove an anterior pituitary tumor B) Teaching her parents to give injections of growth hormone C) Explaining about the radioactive iodine procedure D) Showing her parents how to give DDAVP intranasally
c
The nurse is providing anticipatory guidance to a mother to help promote healthy sleep for her 3-week old baby. Which of the following recommended guidelines might be included in the teaching plan? A) Place the baby on a soft mattress with a firm flat pillow for the head. B) Place the head of the bed near the window to provide fresh air, weather permitting. C) Place the baby on his or her back when sleeping. D) If the baby sleeps through the night, wake him or her up for the night feeding
c
The nurse is providing care for children in a pediatric medical home. Which of the following is a characteristic of care in these types of facilities? A) All insurance except Medicaid is accepted. B) Ambulatory care is not provided C) A centralized database contains all child information. D) Continuity of care is provided from infancy through adulthood.
c
The nurse is providing guidance after observing a mother interact with her negative 2- year-old boy. For which interaction will the nurse advise the mother that she is handling the negativism properly? A) Telling the child to stop tearing pages from magazines B) Asking the child if he would please quit throwing toys C) Telling the child firmly that we don't scream in the office D) Saying, "Please come over here and sit in this chair. OK?"
c
The nurse is providing suggestions to a female adolescent about foods to help meet her nutritional requirements for iron. Which food would the nurse suggest as a good source of iron? A) Broccoli B) Yogurt C) Peanut butter D) White beans
c
The nurse is screening a 6-year-old child for mental ability. Which of the following tests would the nurse use to assess intelligence? A) Denver Articulation Screening B) Denver PRQ C) Goodenough-Harris Drawing Test D) Parents' Evaluation of Developmental Status (PEDS.
c
The nurse is supervising lunch time for children on a pediatric ward. Which of the following observations is considered abnormal for this age group? A) The child has a full set of primary teeth. B) The child has no difficulty chewing and swallowing meat. C) The child uses his fingers and refuses to use a fork. D) The child is a picky eater.
c
The nurse is teaching a new mother the proper techniques for breastfeeding her newborn. Which of the following is a recommended guideline that should be implemented? A) Wash the hands and breasts thoroughly prior to breastfeeding. B) Stroke the nipple against the baby's chin to stimulate wide opening of the baby's mouth. C) Bring the baby's wide-open mouth to the breast to form a seal around all of the nipple and areola. D) When finished the mother can break the suction by firmly pulling the baby's mouth away from the nipple.
c
The nurse is teaching parents interventions appropriate to the emotional development of their toddlers. Which of the following is a recommended intervention for this age group? A) Remove children's security blankets at this stage to help them assert their autonomy. B) Distract toddlers from exploring their own body parts, particularly their genitals. C) Do not blame toddlers for aggressive behavior; instead, point out the results of their behavior. D) Offer toddlers many choices to foster control over their environment.
c
The nurse is teaching parents to plan nutritional meals for their son who is overweight. Which of the following guidelines might the nurse include in the teaching plan? A) School-age children with an average body weight of 20 to 35 kg need approximately 90 calories per kilogram daily. B) The average water requirement for a school-age child per 24 hours ranges from 2,000 to 2,500 mL per day. C) The school-age child needs 28 g of protein and 800 mg of calcium for maintenance of growth and good nutrition. D) In the school-age child, calories needed to sustain weight increase, while the appetite decreases
c
The nurse is teaching the student nurse how to communicate effectively with children. Which one of the following methods would the nurse recommend? A) Position self above the child's level to denote authority. B) If possible, communicate with the child apart from the parent. C) Direct questions and explanations to the child. D) Use the medical terms for body parts and medical care
c
The nurse is using the formula for bladder capacity to measure the bladder capacity of a 9-year-old girl. What number would the nurse document for this measurement? A) 9 ounces B) 10 ounces C) 11 ounces D) 12 ounces
c
The nurse knows that effective communication with children and their parents is critical to providing atraumatic quality nursing care. Which of the following statements accurately describes the communication patterns of children? A) Communication patterns are similar from one child to the next. B) Children often use more words than adults to describe their fears. C) Children rely more on nonverbal communication and silence. D) Parents more often require affective communication rather than neutral communication.
c
The pediatric nurse is planning quiet activities for hospitalized 18-month-olds. Which of the following would be an appropriate activity for this age group? A) Painting by number B) Putting shapes into appropriate holes C) Stacking blocks D) Using crayons to color in a coloring book
c
The school nurse is performing health assessments on students in middle school. Of which of the following developmental milestones should the nurse be aware? A) Height in girls increases rapidly after menarche and usually ceases immediately after menarche. B) Boys' growth spurt usually begins between the ages of 8 and 14 years and ends between the ages of 131/2 and 171/2 years. C) Peak height velocity (PHV) occurs at approximately 12 years of age in girls or about 6 to 12 months after menarche. D) Boys reach PHV and peak weight velocity (PWV) at about 16 years of age
c
When caring for an 8-year-old boy injured in an automobile accident, the nurse demonstrates understanding of the principles of Pediatric Advanced Life Support (PALS) by which action? A) Assisting ventilation with a bag-valve-mask (BVM) device B) Treating ventricular fibrillation using a defibrillator C) Managing compensated shock to prevent decompensated shock D) Treating supraventricular tachycardia using cardioversion
c
When describing the various changes that occur in organ systems during adolescence, which of the following would the nurse include? A) Significant increase in brain size B) Ossification completed later in girls C) Decrease in heart rate D) Decrease in activity of sebaceous glands
c
Which measure would be most appropriate for the nurse to do to ensure that a child's endotracheal (ET) tube is correctly positioned? A) Auscultate for abdominal breath sounds B) Mark the tracheal tube at the child's lip C) Watch for a yellow display on a CO2 monitor D) Inspect for water vapor in the tracheal tube
c
he nurse is assessing the gross motor skills of an 8-year-old boy. Which of the following interview questions would facilitate this assessment? A) "Do you like to do puzzles?" B) "Do play any instruments?" C) "Do you participate in any sports?" D) "Do you like to construct models?
c
he nurse is implementing interventions to prevent physical stressors for a 9-year-old child receiving chemotherapy in the hospital. Which of the following is an example of using atraumatic care for this child? A) Use restraint or "holding down" of the child during the procedure to prevent injury. B) Have the parent stand near and/or rub the child's feet during the procedure. C) Insert a saline lock if the child will require multiple doses of parenteral medications. D) Avoid using numbing techniques for multiple blood draws or IV insertion
c
he nurse is promoting learning and school attendance to an 11-year-old girl. Which of the following factors will affect the child's attitude most? A) Her parents' values and desires B) The dramatic changes to her body C) Peer group behaviors and attitudes D) Desire for attention from boy
c
he nurse measures the head circumference of a 6-month-old infant. Which measurement would the nurse interpret as most appropriate? A) 33 cm B) 35 cm C) 43.5 cm D) 47 cm
c
he parents of a 2-day-old girl are concerned because her feet and hands are slightly blue. How should the nurse respond? A) "Your daughter has acrocyanosis; this is causing her blue hands and feet." B) "Let's watch her carefully to make sure she does not have a circulatory problem." C) "This is normal; her circulatory system will take a few days to adjust." D) "This is a vasomotor response caused by cooling or warming.
c
The nurse is consulting with a child life specialist (CLS) to help minimize the stress of hospitalization for a child. Which of the following services would the CLS provide? Select all answers that apply. A) Medical preparation for tests, surgeries, and other medical procedures B) Support before and after, but not during, medical procedures C) Activities to support normal growth and development D) Grief and bereavement support E) Emergency room interventions for children and families F) Only inpatient consultations with families
c d e
The nurse is caring for children in a physician's office where health supervision is practiced. Which of the following is a key focus of health supervision? Select all answers that apply. A) Making referrals for all health care needs B) Monitoring disease incidence C) Optimizing level of functioning D) Monitoring quality of care provided E) Teaching parents to prevent injury F) Providing care developed from national guidelines
c e f
The nurse is providing developmentally appropriate care for a toddler hospitalized for observation following a fall down the steps. Which of the following measures might the nurse consider when caring for this child? Select all answers that apply. A) Use the en face position when holding the toddler. B) Use a bed for toddlers who have an adult present. C) Avoid leaving small objects that can be swallowed in the bed. D) Explain activities in concrete, simple terms. E) Allow the child to select meals and activities. F) Encourage parents to stay to prevent separation anxiety
c f
A 3-year-old child is scheduled for a hearing screening. The nurse would prepare the child for screening by which method? A) Auditory brain stem response B) Evoked otoacoustic emissions C) Visual reinforcement audiometry D) Conditioned play audiometry
d
A 6-month-old girl weighs 14.7 pounds during a scheduled check-up. Her birth weight was 8 pounds. Which of the following is the priority nursing intervention? A) Talking about solid food consumption B) Discouraging daily fruit juice intake C) Increasing the number of breastfeedings D) Discussing the child's feeding patterns
d
A child who weighs 53 lbs is receiving fluid volume replacement as part of the treatment for shock. The nurse is evaluating the child's hourly urinary output to determine if the child's condition is improving. Which output would the nurse interpret as most indicative of improvement? A) 12 mL B) 15 mL C) 22 mL D) 30 mL
d
A group of students are reviewing information about the various types of insulin used to treat type 1 diabetes. The students demonstrate understanding of the information when they identify which insulin listed below as having the longest duration? A) Lispro B) Regular C) NPH D) Glargine
d
A mother and her 4-week-old infant have arrived for a health maintenance visit. Which of the following activities will the nurse perform? A) Assess the child for an upper respiratory infection B) Take a health history for a minor injury C) Administer a varicella injection D) Plot the child's head circumference on a growth chart
d
A mother calls the school nurse and is concerned because her 13-year-old daughter's friends wear heavy makeup and black clothes. Which of the following is the best advice for the mother? A) "This can lead to piercings and tattoos." B) "The teen years are a time for experimenting." C) "Encourage her to socialize with the kids at church." D) "Teen appearance might not accurately reflect their actual values."
d
A mother is concerned about her infant's spitting up. Which suggestion would be most appropriate? A) "Put the infant in an infant seat after eating." B) "Limit burping to once during a feeding." C) "Feed the same amount but space out the feedings." D) "Keep the baby sitting up for about 30 minutes afterward."
d
A nurse is assessing the fontanels of a crying newborn and notes that the posterior fontanel pulsates and briefly bulges. What do these findings indicate? A) Increased intracranial pressure B) Overhydration C) Dehydration D) These are normal findings
d
A nurse is teaching the parents of an infant with congenital adrenal hyperplasia about the signs and symptoms of adrenal crisis. The nurse determines that the teaching was successful when the parents identify which of the following? A) Bradycardia B) Constipation C) Fluid overload D) Persistent vomiting
d
During a well-child check-up, the parents of a 9-year-old boy tell the nurse that their son's friends told him that soccer is a stupid game, and now he wants to play baseball. Which comment by the nurse best explains the effects of peer groups? A) "The child's best friends will continue playing soccer." B) "The children will cheer for each other regardless of the sport being played." C) "Your child will rarely talk to you about his friends." D) "Acceptance by friends, especially of the same sex, is very important at this age.
d
The adolescent continues to develop self-concept and self-esteem. Which of the following is most important to a teen's self-esteem? A) Strong authority figures B) Spirituality C) Morals and values D) Body image
d
The mother of a 4-year-old boy tells the nurse that her son occasionally wets his pants during the day. How should the nurse respond? A) "Is there a family history of diabetes?" B) "Suddenly having accidents can be a sign of diabetes." C) "That's normal; don't worry about it." D) "Tell me about the circumstances when this occurs."
d
The neonatal nurse assesses newborns for iron-deficiency anemia. Which of the following newborns is at highest risk for this disorder? A) A postterm newborn B) A term newborn with jaundice C) A newborn born to a diabetic mother D) A premature newborn
d
The nurse emphasizes that a toddler younger than the age of 18 months should never be spanked primarily for which reason? A) Spanking in a child this age predisposes the child to a pro-violence attitude. B) The child will become resentful and angry, leading to more outbursts. C) Spanking demonstrates a poor model for problem-solving skills. D) There is an increased risk for physical injury in this age group
d
The nurse is administering a hepatitis B vaccine to a child. What is the classification of this type of vaccine? A) Killed vaccines B) Toxoid vaccines C) Conjugate vaccines D) Recombinant vaccines
d
The nurse is assessing the heart rate of a healthy school-age child. The nurse expects that the child's heart rate will be in which of the following ranges? A) 80 to 150 bpm B) 70 to 120 bpm C) 65 to 110 bpm D) 60 to 100 bpm
d
The nurse is caring for a 13-year-old girl with delayed puberty. Based on the nurse's knowledge of this condition, the nurse would include which nursing diagnosis in the child's plan of care? A) Disabled family coping related to the child's disorder B) Imbalanced nutrition, less than body requirements related to the child's short stature C) Noncompliance related to the need for lifelong hormone therapy D) Deficient knowledge related to the administration of estradiol
d
The nurse is caring for a 4-year-old boy with Ewing sarcoma who is scheduled for a computed axial tomography (CAT) scan tomorrow. Which of the following is the best example of therapeutic communication? A) Telling him he will get a shot when he wakes up tomorrow morning B) Telling him how cool he looks in his baseball cap and pajamas C) Using family-familiar words and soft words when possible D) Describing what it is like to get a CAT scan using words he understands
d
The nurse is caring for a 6-year-old girl who was injured in a bicycle accident. Which question would be most important for the nurse to ask during the health history? A) "Has she been diagnosed with any chronic disorders?" B) "Is your daughter currently taking any medications?" C) "Is she allergic to any medications or drugs?" D) "Tell me how the bicycle accident happened."
d
The nurse is caring for an 8-year-old girl who requires numerous venipunctures and injections daily. The nurse understands that the child is exhibiting signs of sensory overload and enlists the assistance of the child life specialist. What should the therapeutic play involve to best deal with the child's stressors? A) Puppets and dolls B) Drawing paper and crayons C) Wooden hammer and pegs D) Sewing puppets with needles
d
The nurse is counseling a couple who suspect that they could bear a child with a genetic abnormality. Which of the following would be most important for the nurse to incorporate into the plan of care when working with this family? A) Gathering information from at least three generations B) Informing the family of the need for a wide range of information C) Maintaining the confidentiality of the information D) Presenting the information in a nondirective manner
d
The nurse is designing a nursing care plan for a toddler with lymphoma, who is hospitalized for treatment. Which of the following is a priority intervention that the nurse should include in this child's nursing plan? A) Limiting visitors to scheduled visiting hours B) Planning physical therapy for the child C) Introducing the toddler to other toddlers in the unit D) Monitoring the toddler for developmental delays
d
The nurse is developing a nursing care plan for a hospitalized 6-year-old. Which of the following behaviors would warrant nursing intervention? A) The child pretends he is talking to an imaginary friend when the nurse addresses the child. B) The child states that her fairy godmother is going to come and take her home. C) The child starts talking about his grandmother and then quickly changes the subject to a new toy he received. D) The child does not want to play games with other children on the hospital ward
d
The nurse is developing a teaching plan for toddler safety to present at a parenting seminar. Which of the following are safety interventions that the nurse should address? A) Encourage parents to enroll toddlers in swimming classes to avoid the need for constant supervision around water. B) Advise parents to keep pot handles on stoves turned outward to avoid accidental burns. C) Encourage parents to smoke only in designated rooms in the house or outside the house. D) Advise parents to use a forward-facing car seat with harness straps and a clip, placed in the backseat of the car
d
The nurse is examining a 2-year-old child who was adopted from Guatemala. Which of the following would be a priority screening for this child? A) Screening for congenital defects B) Screening for abuse C) Screening for childhood illnesses D) Screening for infectious diseases
d
The nurse is obtaining a health history from parents whose 4-month-old boy has congenital hypothyroidism. Which of the following would the nurse most likely assess? A) The child has above-normal growth for his age. B) The child is active and playful. C) The skin is pink and healthy looking. D) It is difficult to keep the child awake.
d
The nurse is performing a cognitive assessment of a 2-year-old. Which of the following behaviors would alert the nurse to a developmental delay in this area? A) The child cannot say name, age, and gender. B) The child cannot follow a series of two independent commands. C) The child has a vocabulary of 40 to 50 words. D) The child does not point to named body parts
d
The nurse is performing a health history on a 6-year-old boy who is having trouble adjusting to school. Which of the following questions would be most likely to elicit valuable information? A) "Do you like your new school?" B) "Are you happy with your teacher?" C) "Do you enjoy reading a book?" D) "What are your new classmates like?"
d
The nurse is performing a physical examination on a sleeping newborn. Which of the following body systems should the nurse examine last? A) Heart B) Abdomen C) Lungs D) Throat
d
The nurse is performing an assessment of the reproductive system of a 17-year-old girl. Which of the following would alert the nurse to a developmental delay in this girl? A) Areola and papilla separate from the contour of the breast B) Mature distribution and coarseness of pubic hair C) Developed breast tissue D) Occurrence of first menstrual period
d
The nurse is preparing a presentation for a local parent-teacher organization about the growth and development of school-age children. Which of the following would the nurse include? A) Boys mature much more quickly than girls of the same age during this time. B) From 6 to 12 years of age, children grow an average of 4 inches per year. C) The child's body size is in direct correlation with his or her maturity level. D) Secondary sex characteristics are often embarrassing for both sexes
d
The nurse is preparing a presentation to a local community group about genetic disorders and the types of congenital anomalies that can occur. Which of the following would the nurse include as a major congenital anomaly? A) Overlapping digits B) Polydactyly C) Umbilical hernia D) Cleft palate
d
The nurse is preparing the plan of care for a child experiencing respiratory distress. Which of the following would be the priority? A) Providing supplemental oxygen B) Monitoring for changes in status C) Assisting ventilation D) Maintaining a patent airway
d
The nurse is promoting a healthy diet to guide a mother when feeding her 2-week-old girl. Which of the following is the most effective anticipatory guidance? A) Encouraging breastfeeding until the sixth month B) Advocating iron supplements with bottle-feeding C) Advising fluid intake per feeding of 5 or 6 ounces D) Discouraging the addition of fruit juice to the die
d
The nurse is promoting nutrition to a 13-year-old boy who is overweight. Which of the following comments should the nurse expect to include in the discussion? A) "You need to go on a low-fat diet." B) "Eat what your parents eat." C) "Go out for a sport at school." D) "Keep a food diary.
d
The nurse is providing anticipatory guidance to an obese teenager. Which of the following interventions would be most likely to promote healthy weight in teenagers? A) Make the focus of the program weight centered. B) Begin directly advising children about their weight at age 6. C) Focus physical activity on competitive sports and activities. D) Obtain nutritional histories directly from the school-age child and adolescent
d
The nurse is providing anticipatory guidance to the parents of an 18-month-old girl. Which guidance will be most helpful for toilet teaching? A) Telling them either one may demonstrate toilet use B) Assuring them that bladder control occurs first C) Telling them that curiosity is a sure sign of readiness D) Advising them to use praise, not scolding
d
The nurse is providing discharge planning for a 12-year-old boy with multiple medical conditions. Which of the following would be the best teaching method for this child and his family? A) Demonstrate the care and ask for a return demonstration. B) Provide and review educational booklets and materials. C) Provide a written schedule for the child's care. D) Provide a trial period of home care
d
The nurse is providing discharge teaching regarding formula preparation for a new mother. Which of the following guidelines would the nurse include in the teaching plan? A) Always wash bottles and nipples in hot soapy water and rinse well; do not wash them in the dishwasher. B) Store tightly covered ready-to-feed formula can after opening in refrigerator for up to 24 hours. C) Warm bottle of formula by placing bottle in a container of hot water, or microwaving formula. D) Do not add cereal to the formula in the bottle or sweeten the formula with honey
d
The nurse is providing teaching about car safety to the parents of a 5-year-old girl who weighs 45 pounds. What should the nurse instruct the parents to do? A) "Place her in a booster seat with lap and shoulder belts in the front seat." B) "Place her in the back seat with the lap and shoulder belts in place." C) "Place her in a forward-facing car seat with a harness and top tether." D) "Place her in a booster seat with lap and shoulder belts in the back seat.
d
The nurse is teaching a couple about the pros and cons of genetic testing. Which of the following statements best describes the capabilities of genetic testing? A) "Various genetic tests help the physician choose appropriate treatments." B) "Genetic testing helps couples avoid having children with fatal diseases." C) "Genetic tests identify people at high risk for preventable conditions." D) "Some genetic tests can give a probability for developing a disorder."
d
The nurse is teaching the parents of a 2-year-old girl how to deal with common toddler situations. Which is the best advice? A) Discipline the child for regressive behavior. B) Scold the child for public thumb sucking. C) Tell the older sibling to not act like a baby. D) Have the child help clean up a bowel accident.
d
The nurse is teaching the student nurse about abnormal findings when assessing the breasts of children. Which of the following may be associated with renal disorders? A) Swollen nipples upon inspection of a newborn's breasts B) Tender nodule palpated under the nipple of a 10-year-old C) Observation of enlarged breast tissue in a male adolescent D) Observation of a supernumerary nipple along the mammary ridge
d
The nurse is transporting a 6-month-old with a suspected blood disorder to the nursery. What is the most appropriate method of transporting the child by the nurse? A) A wagon with rails B) Cradle hold C) Football hold D) Over the shoulder
d
The nurse is using verbal skills to explain the nursing care plan to parents of a 10-year- old child with cancer. Which of the following describes a guideline the nurse should follow to provide appropriate verbal communication? A) Use closed-ended questions that do not restrict the child's or parent's answers. B) Allow the focus to change without redirecting the conversation. C) Restate the child's and parents comments in your own words. D) Paraphrase the child's or parent's feelings to demonstrate empathy
d
The nurse of a preschool child is helping parents develop a healthy meal plan for their child. Which of the following nutritional requirements for this age group should the nurse consider? A) The 3- to 5-year-old requires 300 to 500 mg calcium and 10 mg iron daily. B) The 3-year-old should consume 10 mg dietary fiber daily. C) The 4- to 8-year-old requires 15 mg dietary fiber per day. D) The typical preschooler requires about 85 kcal/kg of body weight
d
The nurse teaching safety to teens knows that which of the following is the leading cause of death among adolescents? A) Drowning B) Poisoning C) Diseases D) Unintentional injuries
d
The parents of a child with congenital adrenal hyperplasia bring the child to the emergency department for evaluation because the child has had persistent vomiting. Which of the following would lead the nurse to suspect that the child is experiencing an acute adrenal crisis? A) Hypernatremia B) Bradycardia C) Hypertension D) Hyperkalemia
d
The parents of an 8-year-old boy are interested in promoting learning through reading to their son. Which of the following suggestions by the nurse would best promote this goal? A) Have the parents choose what he should read initially. B) Tell the child to read instead of watching TV with his parents. C) Tell the parents that reading is for the child to do by himself. D) Take the child to the library to check out some books
d
The school nurse is planning to teach a segment on smoking during the freshman health classes. The nurse is aware that this needs to be a forum rather than a lecture. Which of the following techniques will also help deliver a "don't smoke" message? A) Showing a command of the facts on smoking B) Speaking with a tone of authority C) Keeping your personal experiences out of it D) Listening to all comments nonjudgmentally
d
The school nurse is preparing a talk on the influence of the media on school-age children to present at the next PTO meeting. Which of the following facts might the nurse include in the introduction? A) Children in the United States spend about 6 hours a day either watching TV or playing video games. B) A child will see 2,000 murders by the end of grade school and 20,000 commercials a year. C) A school-age child cannot determine what is real from what is fantasy; therefore, TV and video games can lead to aggressive behavior. D) Parents should limit television watching and video-game playing to 2 hours per day.
d
The school nurse is teaching parents about the effects of bullying on school children. Which of the following accurately describes this developmental concern? A) Children who bully are those who report themselves as being lonely and having difficulty in forming friendships. B) Children who are bullied are reported to have low self-esteem, poor grades, and poor interpersonal skills. C) In general, about 20% of all children attending school are frightened and afraid most of the day. D) Both boys and girls are bullied; boys usually bully boys and use force more often
d
Two working parents are discussing with the school nurse the possibility of their 12- year-old girl going home alone after school. Which of the following suggestions should the nurse make? A) Provide entertainment until the parents come home B) Allow the child to go to a friend's house. C) Teach her how to take a message if someone calls. D) Purchase caller ID for the phone.
d
When describing Prader-Willi syndrome to a group of nursing students, the instructor would describe this condition as one affecting which chromosome? A) 4 B) 5 C) 11 D) 15
d
When providing guidance to the parents of a child with Down syndrome, which of the following would be most appropriate? A) Encourage the parents to home-school the child. B) Advise the parents that the child will need monthly thyroid testing. C) Instruct them on the need for yearly dental visits. D) Teach the parents about the need for a high-fiber diet.
d
Which activity would the nurse least likely include as exemplifying the preconceptual phase of Piaget's preoperational stage? A) Displays of animism B) Use of active imaginations C) Understanding of opposites D) Beginning questioning of parents' values
d
Which intervention would be most helpful in preventing barotrauma when ventilating a 3-year-old girl with a bag-valve-mask? A) Choosing the correct size bag and face mask B) Setting the flow rate at exactly 10 L/minute C) Maintaining the airway in the open position D) Delivering one breath every 3 to 5 seconds
d
Which of the following would be most appropriate to use to help maintain a patent airway in an infant experiencing a respiratory emergency? A) Neck hyperextension B) Head tilt-chin lift technique C) Jaw-thrust maneuver D) Small towel under shoulders
d
Which of the following would the nurse expect to assess in a child with hypothyroidism? A) Nervousness B) Heat intolerance C) Smooth velvety skin D) Weight gain
d
he nurse is caring for a toddler who is in Piaget's sensorimotor stage of cognitive development. Which of the following tasks would the nurse expect the toddler to be able to perform? A) Completing puzzles with four pieces B) Winding up a mechanical toy C) Playing make-believe with dolls D) Knowing which are his or her toys
d
he nurse is using pulse oximetry to measure oxygen saturation in a 3-year-old girl. The nurse understands that falsely high readings may be associated with which situation or condition? A) A nonsecure connection B) Cold extremities C) Hypovolemia D) Anemia
d
The nurse is choosing foods for a toddler's diet that are high in vitamin A. Which of the following could be added to the menu? Select all answers that apply. A) Applesauce B) Avocados C) Broccoli D) Sweet potatoes E) Spinach F) Carrot
d e f
The nurse is ordered to apply restraints to a toddler who keeps pulling at the tubes in his arm. Which of the following criteria must occur to ensure proper use of these restraints? Select all answers that apply. A) The nurse must check the restraints every 15 minutes while they are in place. B) Secure the restraints with ties to the side rails, not the bed or crib frame. C) Assess the temperature of the affected extremities, pulses, and capillary refill every 15 minutes after placement. D) Use a clove-hitch type of knot to secure the restraints with ties. E) Remove the restraint every 2 hours to allow for range of motion and repositioning. F) Encourage parent participation, providing continuous explanations about the reasons and time frame for restraints
d e f