Pediatric Nursing Exam III

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When communicating with dying children, what should the nurse remember? A.) Adolescent children tend to be concrete thinkers B.) Games, art, and play provide a good means of expression C.) When children can recite facts, they understand the implications of those facts D.) If children's questions direct the conversation, the assessment will be incomplete

Which type of family should the nurse recognize when a mother, her children, and a stepfather live together? A.) Traditional nuclear B.) Blended C.) Extended D.) Binuclear

What are core principles of patient- and family-centered care (select all that apply): A.) Collaboration B.) Empowering families C.) Providing formal and informal support D.) Maintaining strict policy and procedure routines E.) Withholding information that is likely to cause anxiety

B, C

After spinal fusion surgery the nurse should check for signs of what? A.) Seizure activity B.) Increased intracranial pressure C.) Impaired color, sensitivity, and movement to the lower extremities D.) Impaired pupillary response during neurologic checks

What needs to be included as essential teaching for adolescents with systemic lupus erythematosus (SLE)? A.) High calorie diet because of increased metabolic needs B.) Home schooling to decrease the risk of infections C.) Protection from sun and fluorescent lights to minimize rash D.) Intensive exercise regimen to build up muscle strength and endurance

What nursing intervention is appropriate when caring for an unconscious child? A.) Avoid using narcotics or sedatives to provide comfort and pain relief B.) Change the child's position infrequently to minimize the chance of increased intracranial pressure (ICP) C.) Monitor fluid intake and output carefully to avoid fluid overload and cerebral edema D.) Give tepid sponge baths to reduce fevers above 38.3 C (101 F) because antipyretics are contraindicated

What nursing intervention is most appropriate when caring for the child with osteomyelitis? A.) Encourage frequent ambulation B.) Administer antibiotics with meals C.) Move and turn the child carefully and gently to minimize pain D.) Provide active range of motion exercises for the affected extremity

What parents should have the most difficult time coping with their child's hospitalization? A.) Parents of a child hospitalized for juvenile arthritis B.) Parents of a child hospitalized with a recent diagnosis of bronchiolitis C.) Parents of a child hospitalized for sepsis resulting from an untreated injury D.) Parents of a child hospitalized for surgical correction of undescended testicles

How might the quality of life for a terminally ill child and his family be enhanced by nurses? A.) Tell the family what is best B.) Leave the family alone to deal with their tragedy C.) Remain objective and uninvolved with family grieving D.) Advocate for and implement pain and symptom relief measures

Neuropathic bladder disorders are common among children with which disorder? A.) Plagiocephaly B.) Meningocele C.) Craniosynostosis D.) Myelomeningocele

Daily toothbrushing and flossing can be encouraged for the child on chemotherapy when the platelet count is above which? A.) 10,000/mm3 B.) 20,000/mm3 C.) 30,000/mm3 D.) 40,000/mm3

What side effect commonly occurs with corticosteroid (prednisone) therapy? A.) Alopecia B.) Anorexia C.) Nausea and vomiting D.) Susceptibility to infection

A hospitalized school-age child with phenylketonuria (PKU) is choosing foods from the hospitals menu. Which food choice should the nurse discourage the child from choosing? A.) Banana B.) Milkshake C.) Fruit juice D.) Corn on the cob

A 10-year-old child, without a history of previous seizures, experiences a tonic-clonic seizure at school that lasts more than 5 minutes. Breathing is not impaired. Some postictal confusion occurs. What is the most appropriate initial action by the school nurse? A.) Stay with child and have someone else call emergency medical services (EMS) B.) Notify the parent and regular practitioner C.) Notify the parent that the child should go home D.) Stay with the child, offering calm reassurance

The nurse is planning care for a school-age child with bacterial meningitis. What intervention should be included? A.) Keep environmental stimuli to a minimum B.) Have the child move her head from side to side at least every 2 hours C.) Avoid giving pain medications that could dull sensorium D.) Measure head circumference to assess developing complications

A 12-year-old child has failed several courses of chemotherapy. An experimental drug is available that his parents want him to receive. He has told his parents and the oncologists that he is ready to die and does not want any more chemotherapy. The nurse recognizes what to be true? A.) Parents and child both need support in the decision making B.) Twelve-year-olds are minors and cannot give consent or refuse treatments C.) The oncologists needs to make the decision because the parents and child disagree D.) The parents have the right and responsibility to make decisions for their children younger than age 18 years

A 12-year-old child with Guillain-Barr syndrome (GBS) is admitted to the pediatric intensive care unit. She tells you that yesterday her legs were weak and that this morning she was unable to walk. After the nurse determines the current level of paralysis, which should the next priority assessment be? A.) Swallowing ability B.) Parental involvement C.) Level of consciousness D.) Antecedent viral infections

A 12-year-old girl is newly diagnosed with diabetes when she develops ketoacidosis. How should the nurse structure a successful education program? A.) Essential information is presented initially B.) Teaching should take place in the child's semiprivate room C.) Education is focused toward the parents because the child is too young D.) All information needed for self-management of diabetes is taught at once

A 17-year-old patient is returning to the surgical unit after Luque instrumentation for scoliosis repair. In addition to the usual postoperative care, what additional intervention will be needed? A.) Position changes are made by log rolling B.) Assistance is needed to use the bathroom C.) The head of the bed is elevated to minimize spinal headache D.) Passive range of motion is instituted to prevent neurologic injury

A 4-month-old with significant head lag meets the criteria for floppy infant syndrome. A diagnosis of progressive infantile spinal muscular atrophy (Werdnig-Hoffmann disease) is made. What should be included in the nursing care for this child? A.) Infant stimulation program B.) Stretching exercises to decrease contractures C.) Limited physical contact to minimize seizures D.) Encouraging parents to have additional children

A breastfed infant has just been diagnosed with galactosemia. The therapeutic management of this includes which? A.) Stop breastfeeding the infant B.) Add amino acids to breast milk C.) Substitute a lactose-containing formula for breast milk D.) Give the appropriate enzyme along with breast milk

A child develops syndrome of inappropriate antidiuretic hormone secretion (SIADH) as a complication to meningitis. What action should be verified before implementing? A.) Forcing fluids B.) Daily weights with strict input and output (I and O) C.) Strict monitoring of urine volume and specific gravity D.) Close observation for signs of increasing cerebral edema

A child has been admitted with status epilepticus. An emergency medication has been ordered. What medication should the nurse expect to be prescribed? A.) Lorazepam (Ativan) B.) Phenytoin (Dilantin) C.) Topiramate (Topamax) D.) Ethosuximide (Zarontin)

A child has been diagnosed with a Wilms tumor. What should preoperative nursing care include? A.) Careful bathing and handling B.) Monitoring of behavioral status C.) Maintenance of strict isolation D.) Administration of packed red blood cells

A child is receiving vincristine (Oncovin). The nurse should monitor for which side effect of this medication? A.) Diarrhea B.) Photosensitivity C.) Constipation D.) Ototoxicity

A child is upset because, when the cast is removed from her leg, the skin surface is caked with desquamated skin and sebaceous secretions. What technique should the nurse suggest to remove this material? A.) Soak in a bathtub B.) Vigorously scrub the leg C.) Carefully pick material off the leg D.) Apply powder to absorb the material

A child with cancer being treated with chemotherapy is receiving a platelet transfusion. The nurse understands that the transfused platelets should survive the body for how many days? A.) 1 to 3 days B.) 4 to 6 days C.) 7 to 9 days D.) 10 to 12 days

A lumbar puncture (LP) is being done on an infant with suspected meningitis. The nurse expects which results for the cerebrospinal fluid that can confirm the diagnosis of meningitis? A.) WBCs; glucose B.) RBCs; normal WBCs C.) Glucose; normal RBCs D.) Normal RBCs; normal glucose

A parent of a hospitalized child on chemotherapy asks the nurse if a sibling of the hospitalized child should receive the varicella vaccination. The nurse should give which response? A.) The sibling can get a varicella vaccination B.) The sibling should not get a varicella vaccination C.) The sibling should wait until the child is finished with chemotherapy D.) The sibling should get varicella-zoster immune globulin if exposed to chickenpox

A school-age child with diabetes gets 30 units of NPH insulin at 0800. According to when this insulin peaks, the child should be at greatest risk for a hypoglycemic episode between when? A.) Lunch and dinner B.) Breakfast and lunch C.) 0830 to his midmorning snack D.) Bedtime and breakfast the next morning

A student athlete was injured during a basketball game. The nurse observes significant swelling. The player states he thought he heard a pop, that the pain is pretty bad, and that the ankle feels as if it is coming apart. Based on this description, the nurse suspects what injury? A.) Sprain B.) Fracture C.) Dislocation D.) Stress fracture

A young child with leukemia has anorexia and severe stomatitis. What approach should the nurse suggest that the parents try? A.) Relax any eating pressures B.) Firmly insist that the child eat normally C.) Serve foods that are either hot or cold D.) Provide only liquids because chewing is painful

A young girl has just injured her ankle at school. In addition to notifying the child's parents, what is the most appropriate, immediate action by the school nurse? A.) Apply ice B.) Observe for edema and discoloration C.) Encourage child to assume a position of comfort D.) Obtain parental permission for administration of acetaminophen or aspirin

After chemotherapy is begun for a child with acute leukemia, prophylaxis to prevent acute tumor lysis syndrome includes which therapeutic intervention? A.) Hydration B.) Oxygenation C.) Corticosteroids D.) Pain management

The nurse is assessing a family's use of complementary medicine practices. What practices are classified as mindbody control therapies (select all that apply): A.) Relaxation B.) Acupuncture C.) Prayer therapy D.) Guided imagery E.) Herbal medicine

A, C, D

An adolescent is scheduled for a leg amputation in 2 days for treatment of osteosarcoma. What approach should the nurse implement? A.) Answer questions with straightforward honesty B.) Avoid discussing the seriousness of the condition C.) Explain that although the amputation is difficult, it will cure the cancer D.) Help the adolescent accept the amputation as better than a long course of chemotherapy

An adolescent whose leg was crushed when she fell off a horse is admitted to the emergency department. She has completed the tetanus immunization series, receiving the last tetanus toxoid booster 8 years ago. What care is necessary for therapeutic management of this adolescent to prevent tetanus? A.) Tetanus toxoid booster is needed because of the type of injury B.) Human tetanus immunoglobulin is indicated for immediate prophylaxis C.) Concurrent administration of both tetanus immunoglobulin and tetanus antitoxin is needed D.) No additional tetanus prophylaxis is indicated. The tetanus toxoid booster is protective for 10 years

As part of the diagnostic evaluation of a child with cancer, biopsies are important for staging. What statement explains what staging means? A.) Extent of the disease at the time of diagnosis B.) Rate normal cells are being replaced by cancer cells C.) Biologic characteristics of the tumor or lymph nodes D.) Abnormal, unrestricted growth of cancer cells producing organ damage

During the summer many children are more physically active. What changes in the management of the child with diabetes should be expected as a result of more exercise? A.) Food intake B.) Food intake C.) Risk of hyperglycemia D.) Risk of insulin reaction

In teaching parents how to minimize or prevent bleeding episodes when the child is myelosuppressed, the nurse includes what information? A.) Meticulous mouth care is essential to avoid mucositis B.) Rectal temperatures are necessary to monitor for infection C.) Intramuscular injections are preferred to intravenous ones D.) Platelet transfusions are given to maintain a count greater than 50,000/mm3

One pediatric oncologic emergency is acute tumor lysis syndrome. Symptoms that this may be occurring include what? A.) Muscle cramps and tetany B.) Respiratory distress and cyanosis C.) Thrombocytopenia and sepsis D.) Upper extremity edema and neck vein distension

Parents of a hospitalized child often question the skill of staff. The nurse interprets this behavior by the parents as what? A.) Normal B.) Paranoid C.) Indifferent D.) Wanting attention

The clinic nurse is assessing infant reflexes. What assessment indicates a persistence of primitive reflexes? A.) Tonic neck reflex at 8 months of age B.) Palmar grasp at 4 months of age C.) Plantar grasp at 9 months of age D.) Rooting reflex at 3 months of age

The family and child have decided that hospice care best meets their needs during the terminal phase of illness. The nurse recognizes that the parents understand the principles of this care when they make which statement? A.) It will be good to be at home and care for our child B.) What a relief it will be not to need any more medicines C.) We are going to miss the support of the hospice team when our child dies D.) We know that once hospice care starts, we will not be able to return to the hospital if the care is difficult

The nurse is caring for a neonate born with a myelomeningocele. Surgery to repair the defect is scheduled the next day. What is the most appropriate way to position and feed this neonate? A.) Prone with the head turned to the side B.) On the side C.) Supine in an infant carrier D.) Supine, with defect supported with rolled blankets

The nurse is planning care for a child recently diagnosed with diabetes insipidus (DI). What intervention should be included? A.) Encourage the child to wear medical identification B.) Discuss with the child and family ways to limit fluid intake C.) Teach the child and family how to do required urine testing. D.) Reassure the child and family that this is usually not a chronic or life-threatening illness

The nurse is providing support to parents adapting to the hospitalization of their child to the pediatric intensive care unit. The nurse notices that the parents keep asking the same questions. What should the nurse do? A.) Patiently continue to answer questions, trying different approaches B.) Kindly refer them to someone else for answering their questions C.) Recognize that some parents cannot understand explanations D.) Suggest that they ask their questions when they are not upset

The nurse is teaching the family of an infant with cerebral palsy how to administer a diazepam (Valium) pill by gastrostomy tube. What should the nurse include in the teaching session? A.) The pill should be crushed and mixed with a small amount of water B.) The pill should be crushed and mixed with the infant's formula C.) After administering the medication, flush the tube with air D.) Before administering the medication, check the placement of the tube

The nurse is teaching the parents of a 1-month-old infant with developmental dysplasia of the hip about preventing skin breakdown under the Pavlik harness. What statement by the parent would indicate a correct understanding of the teaching? A.) I should gently massage the skin under the straps once a day to stimulate circulation B.) I will apply a lotion for sensitive skin under the straps after my baby has been given a bath to prevent skin irritation C.) I should remove the harness several times a day to prevent contractures D.) I will place the diaper over the harness, preferably using a super absorbent disposable diaper that is relatively thin

The nurse should expect to care for which age of child if the admitting diagnosis is retinoblastoma? A.) Infant or toddler B.) Preschool- or school-age child C.) School-age or adolescent child D.) Adolescent

What are the most common clinical manifestations of brain tumors in children? A.) Headaches and vomiting B.) Blurred vision and ataxia C.) Hydrocephalus and clumsy gait D.) Fever and poor fine motor control

What condition can result from the bone demineralization associated with immobility? A.) Osteoporosis B.) Pooling of blood C.) Urinary retention D.) Susceptibility to infection

What form of diabetes is characterized by destruction of pancreatic beta cells, resulting in insulin deficiency? A.) Type 1 diabetes B.) Type 2 diabetes C.) Gestational diabetes D.) Maturity-onset diabetes of the young (MODY)

What is a major goal for the therapeutic management of juvenile idiopathic arthritis (JIA)? A.) Control pain and preserve joint function B.) Minimize use of joint and achieve cure C.) Prevent skin breakdown and relieve symptoms D.) Reduce joint discomfort and regain proper alignment

What is appropriate mouth care for a toddler with mucosal ulceration related to chemotherapy? A.) Mouthwashes with plain saline B.) Lemon glycerin swabs for cleansing C.) Mouthwashes with hydrogen peroxide D.) Swish and swallow with viscous lidocaine

What is important to incorporate in the plan of care for a child who is experiencing a seizure? A.) Describe and record the seizure activity observed B.) Suction the child during a seizure to prevent aspiration C.) Place a tongue blade between the teeth if they become clenched D.) Restrain the child when seizures occur to prevent bodily harm

What measure is important in managing hypercalcemia in a child who is immobilized? A.) Provide adequate hydration B.) Change position frequently C.) Encourage a diet high in calcium D.) Provide a diet high in calories for healing

What nursing intervention is most appropriate when providing comfort and support for a child when death is imminent? A.) Limit care to essentials B.) Avoid playing music near the child C.) Whisper to the child instead of using a normal voice D.) Explain to the child the need for constant measurement of vital signs

What statement is most descriptive of a school-age child's reaction to death? A.) Very interested in funerals and burials B.) Little understanding of words such as forever C.) Imagine the deceased person to be still alive D.) Can explain death from a religious or spiritual point of view

What type of seizure may be difficult to detect? A.) Absence B.) Generalized C.) Simple partial D.) Complex partial

When a preschool-age child is hospitalized without adequate preparation, the nurse should recognize that the child may likely see hospitalization as what? A.) Punishment B.) Loss of parental love C.) Threat to the child's self-image D.) Loss of companionship with friends

When is an autopsy required? A.) In the case of a suspected suicide B.) When a person has a known terminal illness C.) With a hospice patient who dies at home D.) With the victim of a motor vehicle collision

The mother of an infant tells the nurse that sometimes there is a whitish glow in the pupil of his eye. The nurse should suspect which condition? A.) Brain tumor B.) Retinoblastoma C.) Neuroblastoma D.) Rhabdomyosarcoma

Which intervention by the nurse can help ease negative feelings and fear in a 5-year old child being admitted to the hospital? A.) Preparing the child for the hospital experience B.) Not intervention because children this age cannot be prepared C.) No intervention because preparation will increase the child's stress D.) Preparing the child for the potential negative effects of hospitalization

Which parenting style would the nurse document in a family where the parents have little to no control over the children? A.) Permissive B.) Democratic C.) Authoritarian D.) Authoritative

While interacting with a hospitalized child, the nurse learns that the child lives with foster parents and a fost brother. Which type of family is this? A.) Nuclear B.) Blended C.) Extended D.) Binuclear

The nurse is teaching the family with a child with cerebral palsy (CP) strategies to prevent constipation. What should the nurse include in the teaching session (select all that apply): A.) Increase fluid intake B.) Increase fiber in the diet C.) Administer stool softeners daily as prescribed D.) Increase the amount of dairy products in the diet E.) Allow the child to decide when to try to have a bowel movement

A, B, C

What functional goal should the nurse expect for a child who has a T1 to T10 spinal cord injury (select all that apply): A.) May be braced for standing B.) Able to drive automobile with hand controls C.) Can manage adapted public transportation D.) Some able to use regular public transportation E.) Ambulates well, often with short leg braces with or without cane

A, B, C

What are signs and symptoms of the stage of detachment in relation to separation anxiety in young children (select all that apply): A.) Appears happy B.) Lacks interest in the environment C.) Regresses to an earlier behavior D.) Forms new but superficial relationships E.) Interacts with strangers or familiar caregivers

A, D, E

What strategies should the nurse implement to increase nutritional intake for the child receiving chemotherapy (select all that apply): A.) Allow the child any food tolerated B.) Fortify foods with nutritious supplements C.) Allow the child to be involved in food selection D.) Encourage the parents to place pressure on the importance of eating E.) Encourage the child to eat favorite foods during infusion of chemotherapy medications

A, B, C

The nurse is conducting preoperative teaching to parents and their child about an external fixation device. What should the nurse include in the teaching session (select all that apply): A.) Pin care B.) Crutch walking C.) Modifications in activity D.) Observing pin sites for infection E.) Full weight bearing will be allowed after 24 hours

A, B, C, D

The nurse is preparing to admit a 2-year-old child with spina bifida occulta. What clinical manifestations of spina bifida occulta should the nurse expect to observe (select all that apply): A.) Dark tufts of hair B.) Skin depression or dimple C.) Port-wine angiomatous nevi D.) Soft, subcutaneous lipomas E.) Bladder and sphincter paralysis

A, B, C, D

What are some of the associated disabilities seen with cerebral palsy (select all that apply): A.) Visual impairment B.) Hearing impairment C.) Speech difficulties D.) Intellectual impairment E.) Associated heart defects

A, B, C, D

A child on chemotherapy has developed rectal ulcers. What interventions should the nurse teach to the child and parents to relieve the discomfort of rectal ulcers (select all that apply): A.) Warm sitz baths B.) Use of stool softeners C.) Record bowel movements D.) Use of an opioid for discomfort E.) Occlusive ointment applied to the area

A, B, C, E

The nurse is preparing to admit a 6-month-old infant with increased intracranial pressure (ICP). What clinical manifestations should the nurse expect to observe in this infant (select all that apply): A.) High-pitched cry B.) Poor feeding C.) Setting-sun sign D.) Sunken fontanel E.) Distended scalp veins F.) Decreased head circumference

A, B, C, E

The nurse is preparing to admit a neonate with bacterial meningitis. What clinical manifestations should the nurse expect to observe (select all that apply): A.) Jaundice B.) Cyanosis C.) Poor tone D.) Nuchal rigidity E.) Poor sucking ability

A, B, C, E

The nurse is preparing to admit an adolescent with bacterial meningitis. What clinical manifestations should the nurse expect to observe? (select all that apply): A.) Fever B.) Chills C.) Headache D.) Poor tone E.) Drowsiness

A, B, C, E

The nurse relates to parents that there are some beneficial effects of hospitalization for their child. What are beneficial effects of hospitalization (select all that apply): A.) Recovery from illness B.) Improve coping abilities C.) Opportunity to master stress D.) Provide a break from school E.) Provide new socialization experiences

A, B, C, E

The nurse is assisting with application of a synthetic cast on a child with a fractured humerus. What are the advantages of a synthetic cast over a plaster of Paris cast (select all that apply): A.) Less bulky B.) Drying time is faster C.) Molds readily to body part D.) Permits regular clothing to be word E.) Can be cleaned with small amount of soap and water

A, B, D, E

The nurse is preparing to admit a 7-year-old child with ataxic cerebral palsy. What clinical manifestations of ataxic cerebral palsy should the nurse expect to observe (select all that apply): A.) Wide-based gait B.) Rapid, repetitive movements performed poorly C.) Slow, twisting movements of the trunk or extremities D.) Hypertonicity with poor control of posture, balance, and coordinated motion E.) Disintegration of movements of the upper extremities when the child reaches for objects

A, B, E

In teaching a 16-year-old adolescent who was recently diagnosed with systemic lupus erythematosus (SLE), what statements should the nurse include (select all that apply): A.) You should use a moisturizer with a sun protection factor (SPF) of 30 B.) You should avoid pregnancy because this can cause a flare-up C.) You should not receive any immunizations in the future D.) You may need to be on a low-protein, high-carbohydrate diet E.) You should expect to lose weight while taking steroids F.) You may need to modify your daily recreational activities

A, B, F

What are signs and symptoms of the stage of despair in relation to separation anxiety in young children (select all that apply): A.) Withdrawn from others B.) Uncommunicative C.) Clings to parents D.) Physically attacks strangers E.) Forms new but superficial relationships F.) Regresses to early behaviors

A, B, F

The nurse is preparing to admit a 5-year-old child with a lower motor neuron syndrome. What clinical manifestations of a lower motor neuron syndrome should the nurse expect to observe (select all that apply): A.) Loss of hair B.) Babinski reflex present C.) Skin and tissue changes D.) Marked atrophy of atonic muscle E.) Hyperreflexia with tendon reflexes exaggerated

A, C, D

The nurse is preparing to admit a 7-year-old child with type 2 diabetes. What clinical features of type 2 diabetes should the nurse recognize (select all that apply): A.) Oral agents are effective B.) Insulin is usually needed C.) Ketoacidosis is infrequent D.) Diet only is often effective E.) Chronic complications frequently occur

A, C, D

What are common respiratory symptoms dying children experience (select all that apply): A.) Cough B.) Eupnea C.) Wheezing D.) Shortness of breath E.) Decrease in secretions

A, C, D

What factors can negatively affect parents reactions to their child's illness (select all that apply): A.) Additional stresses B.) Previous coping abilities C.) Lack of support systems D.) Seriousness of the threat to the child E.) Previous experience with hospitalization

A, C, D

Parents tell the nurse that siblings of their hospitalized child are feeling left out. What suggestions should the nurse make to the parents to assist the siblings to adjust to the hospitalization of their brother or sister (select all that apply): A.) Arrange for visits to the hospital B.) Limit information given to the siblings C.) Encourage phone calls to the hospitalized child D.) Make or buy inexpensive toys or trinkets for the siblings E.) Identify an extended family member to be their support system

A, C, D, E

The nurse is preparing to admit a 10-year-old child with Duchenne muscular dystrophy. What clinical features of Duchenne muscular dystrophy should the nurse recognize (select all that apply): A.) Calf muscle hypertrophy B.) Late onset, usually between 6 and 8 years of age C.) Progressive muscular weakness, wasting, and contractures D.) Loss of independent ambulation by 9 to 12 years of age E.) Slowly progressive, generalized weakness during adolescence

A, C, D, E

The nurse should teach the family that which residual disabilities can occur for a child being treated for a brain tumor (select all that apply): A.) Ataxia B.) Anorexia C.) Dysphagia D.) Sensory deficits E.) Crania nerve palsies

A, C, D, E

What characterizes a preschoolers concept of death (select all that apply): A.) Belief their thoughts can cause death B.) They have a concrete understanding of death C.) Death is seen as temporary and gradual D.) Death is seen as a departure, a kind of sleep E.) They usually have some sense of the meaning of death

A, C, D, E

The nurse is caring for a child with meningitis. What acute complications of meningitis should the nurse continuously assess the child for (select all that apply): A.) Seizures B.) Cerebral palsy C.) Cerebral edema D.) Hydrocephalus E.) Cognitive impairments

A, C, E

What does the nurse recognize as physical signs of approaching death (select all that apply): A.) Mottling of skin B.) Decreased sleeping C.) Cheyne-Stokes respirations D.) Loss of the sense of hearing E.) Decreased appetite and thirst

A, C, E

The nurse is preparing a community outreach program for adolescents about the characteristic differences between type 1 and type 2 diabetes mellitus (DM). What concepts should the nurse include (select all that apply): A.) Type 1 DM has an abrupt onset B.) Type 1 DM is often controlled with oral glucose agents C.) Type 1 DM occurs primarily in whites D.) Type 2 DM always requires insulin therapy E.) Type 2 DM frequently has a familial history F.) Type 2 DM occurs in people who are overweight

A, C, E, F

The nurse is precepting a new graduate nurse at an ambulatory pediatric hematology and oncology clinic. What cardinal signs of cancer in children should the nurse make the new nurse aware of (select all that apply): A.) Sudden tendency to bruise easily B.) Transitory, generalized pain C.) Frequent headaches D.) Excessive, rapid weight gain E.) Gradual, steady fever F.) Unexplained loss of energy

A, C, F

The nurse is caring for a 14-year-old child with systemic lupus erythematous (SLE). What clinical manifestations should the nurse expect to observe (select all that apply): A.) Arthralgia B.) Weight gain C.) Polycythemia D.) Abdominal pain E.) Glomerulonephritis

A, D, E

The nurse is caring for a child immobilized because of Russel traction. What interventions should the nurse implement to prevent renal calculi (select all that apply): A.) Monitor output B.) Encourage the patient to drink apple juice C.) Encourage milk intake D.) Ensure adequate fluids E.) Encourage the patient to drink cranberry juice

A, D, E

The nurse is caring for a child with increased intracranial pressure (ICP). What interventions should the nurse plan for this child (select all that apply): A.) Avoid jarring the bed B.) Keep the room brightly lit C.) Keep the bed in a flat position D.) Administer prescribed stool softeners E.) Administer a prescribed antiemetic for nausea

A, D, E

The nurse is preparing to admit a 10-year-old child with absence seizures. What clinical features of absence seizures should the nurse recognize (select all that apply): A.) There is no aura B.) There is a postictal state C.) They usually last longer than 30 seconds D.) There is a brief loss of consciousness E.) There is an occasional clonic movement

A, D, E

The parents tell a nurse our child is having some short-term negative outcomes since the hospitalization. The nurse recognizes that what can negatively affect short-term negative outcomes (select all that apply): A.) Parent's anxiety B.) Consistent nurses C.) Number of visitors D.) Length of hospitalization E.) Multiple invasive procedures

A, D, E

The school nurse recognizes that the adverse effects of performance-enhancing substances can include what (select all that apply): A.) Depression B.) Dehydration C.) Hypotension D.) Aggressiveness E.) Changes in libido

A, D, E

What characterizes a toddlers concept of death (select all that apply): A.) They are unable to comprehend an absence of life B.) They may recognize the fact of physical death C.) They understand the universality and inevitability of death D.) The are affected more by the change in lifestyle than the concept of death E.) They can only think about events in terms of their own frame of reference-living

A, D, E

A 2-year-old child starts to have a tonic-clonic seizure. The child's jaws are clamped. What is the most important nursing action at this time? A.) Place a padded tongue blade between the child's jaws B.) Stay with the child and observe his respiratory status C.) Prepare the suction equipment D.) Restrain the child to prevent injury

A 3-year-old child has a femoral shaft fracture. The nurse recognizes that the approximate healing time for this child is how long? A.) 2 weeks B.) 4 weeks C.) 6 weeks D.) 8 weeks

A 4-year-old child is placed in Buck extension traction for Legg-Calv-Perthes disease. He is crying with pain as the nurse assesses the skin of his right foot and sees that it is pale with an absence of pulse. What should the nurse do first? A.) Reposition the child and notify the practitioner B.) Notify the practitioner of the changes noted C.) Give the child medication to relieve the pain D.) Chart the observations and check the extremity again in 15 minutes

A 5-year-old child is being prepared for surgery to remove a brain tumor. Preparation for surgery should be based on which information? A.) Removal of the tumor will stop the various signs and symptoms B.) Usually the postoperative dressing covers the entire scalp C.) He is not old enough to be concerned about his head being shaved D.) He is not old enough to understand the significance of the brain

A 7-year-old child has just had a cast applied for a fractured arm with the wrist and elbow immobilized. What information should be included in the home care instructions? A.) No restrictions of activity are indicated B.) Elevate casted arm when both upright and resting C.) The shoulder should be kept as immobile as possible to avoid pain D.) Swelling of the fingers is to be expected. Notify a health professional if it persists more than 48 hour

A child has just returned from surgery for repair of a fractured femur. The child has a long-leg cast on. The toes on the leg with the cast are edematous, but they have color, sensitivity, and movement. What action should the nurse take? A.) Call the health care provider to report the edema B.) Elevate the foot and leg on pillows C.) Apply a warm moist pack to the foot D.) Encourage movement of toe

A child in the terminal stage of cancer has frequent breakthrough pain. Nonpharmacologic methods are not helpful, and the child is exceeding the maximum safe dose for opiate administration. What approach should the nurse implement? A.) Add acetaminophen for the breakthrough pain B.) Titrate the opioid medications to control the child's pain as specified in the protocol C.) Notify the practitioner that immediate hospitalization is indicated for pain management D.) Help the parents and child understand that no additional medication can be given because of the risk of respiratory depression

A child is on phenytoin (Dilantin). What should the nurse encourage? A.) Fluid restriction B.) Good dental hygiene C.) A decrease in vitamin D intake D.) Taking the medication with milk

A child with a hip spica cast is being prepared for discharge. Recognizing that caring for a child at home is complex, the nurse should include what instructions for the parents discharge teaching? A.) Turn every 8 hours B.) Specially designed car restraints are necessary C.) Diapers should be avoided to reduce soiling of the cast D.) Use an abduction bar between the legs to aid in turning

A child with osteosarcoma is experiencing phantom limb pain after an amputation. What prescribed medication is effective for short-term phantom pain relief? A.) Phenytoin (Dilantin) B.) Gabapentin (Neurontin) C.) Valproic Acid (Depakote) D.) Phenobarbital (Phenobarbital)

A child, age 3 years, has cerebral palsy (CP) and is hospitalized for orthopedic surgery. His mother says he has difficulty swallowing and cannot hold a utensil to feed himself. He is slightly underweight for his height. What is the most appropriate nursing action related to feeding this child? A.) Bottle or tube feed him a specialized formula until he gains sufficient weight B.) Stabilize his jaw with caregivers hand (either from a front or side position) to facilitate swallowing C.) Place him in a well-supported, semi-reclining position D.) Place him in a sitting position with his neck hyperextended to make use of gravity flow

A goal for children with spina bifida is to reduce the chance of allergy development. What is a priority nursing intervention? A.) Recommend allergy testing B.) Provide a latex-free environment C.) Use only powder-free latex gloves D.) Limit use of latex products as much as possible

A parent tells the nurse that 80% of children with the same type of leukemia as his sons have a 5-year survival. He believes that because another child on the same protocol as his son has just died, his son now has a better chance of success. What is the best response by the nurse? A.) It is sad for the other family but good news for your child B.) Each child has an 80% likelihood of 5-year survival C.) The data suggest that 20% of the children in the clinic will die. There are still many hurdles for your son D.) You should avoid the grieving family because you will be benefiting from their loss

A preadolescent has maintained good glycemic control of his type 1 diabetes through the school year. During summer vacation, he has had repeated episodes of hypoglycemia. What additional teaching is needed? A.) Carbohydrates in the diet need to be replaced with protein B.) Additional snacks are needed to compensate for increased activity C.) The child needs to decrease his activity level to minimize episodes of hypoglycemia D.) Insulin dosage should be increased to compensate for a change in activity level

A recommendation to prevent neural tube defects (NTDs) is the supplementation of what? A.) Vitamin A throughout pregnancy B.) Folic acid for all women of childbearing age C.) Folic acid during the first and second trimesters of pregnancy D.) Multivitamin preparations as soon as pregnancy is suspected

A school-age child with leukemia experienced severe nausea and vomiting when receiving chemotherapy for the first time. What is the most appropriate nursing action to prevent or minimize these reactions with subsequent treatments? A.) Administer the chemotherapy between meals B.) Give an antiemetic before chemotherapy begins C.) Have the child bring favorite foods for snacks D.) Keep the child NPO (nothing by mouth) until nausea and vomiting subside

A toddler is admitted to the pediatric unit with presumptive bacterial meningitis. The initial orders include isolation, intravenous access, cultures, and antimicrobial agents. The nurse knows that antibiotic therapy will begin when? A.) After the diagnosis is confirmed B.) When the medication is received from the pharmacy C.) After the child's fluid and electrolyte balance is stabilized D.) As soon as the practitioner is notified of the culture results

An 8-year-old girl has been uncooperative and angry since the diagnosis of cancer was made. Her parents tell the nurse that they do not know what to do because she is always so mad at us. What nursing action is most appropriate at this time? A.) Explain to child that anger is not helpful B.) Help the parents deal with her anger constructively C.) Ask the parents to find out what she is angry about D.) Encourage the parents to ignore the anger at this time

An adolescent comes to the school nurse after experiencing shin splints during a track meet. What reassurance should the nurse offer? A.) Shin splints are expected in runners B.) Ice, rest, and nonsteroidal antiinflammatory drugs (NSAIDs) usually relieve pain C.) It is generally best to run around and work the pain out D.) Moist heat and acetaminophen are indicated for this type of injury

An adolescent will receive a bone marrow transplant (BMT). The nurse should explain that the bone marrow will be administered by which method? A.) Bone grafting B.) Intravenous infusion C.) Bone marrow injection D.) Intraabdominal infusion

An infant is born with one lower limb deficiency. When is the optimum time for the child to be fitted with a functional prosthetic device? A.) As soon as possible after birth B.) When the infant is developmentally ready to stand up C.) At about ages 12 to 15 months, when most children are walking D.) At about 4 years, when the healthy limb is not growing so rapidly

Essential postoperative nursing management of a child after removal of a brain tumor includes which nursing care? A.) Turning and positioning every 2 hours B.) Measuring all fluid intake and output C.) Changing the dressing when it becomes soiled D.) Using maximum lighting to ensure accurate observations

Gingivitis is a common problem in children with cerebral palsy (CP). What preventive measure should be included in the plan of care? A.) High-carbohydrate diet B.) Meticulous dental hygiene C.) Minimum use of fluoride D.) Avoidance of medications that contribute to gingivitis

Immobilization causes what effect on metabolism? A.) Hypocalcemia B.) Decreased metabolic rate C.) Positive nitrogen balance D.) Increased levels of stress hormones

Intranasal administration of desmopressin acetate (DDAVP) is used to treat which condition? A.) Hypopituitarism B.) Diabetes insipidus (DI) C.) Syndrome of inappropriate antidiuretic hormone (SIADH) D.) Acute adrenocortical insufficiency

The middle school nurse is speaking to parents about prevention of injuries as a goal of the physical education program. How should the goal be achieved? A.) Use of protective equipment at the family's discretion B.) Education of adults to recognize signs that indicate a risk for injury C.) Sports medicine program to help student athletes work through overuse injuries D.) Arrangements for multiple sports to use same athletic fields to accommodate more children

The most important nursing intervention when caring for an infant with myelomeningocele in the preoperative stage is which? A.) Take vital signs every hour B.) Place the infant on the side to decrease pressure on the spinal sac C.) Watch for signs that might indicate developing hydrocephalus D.) Apply a heat lamp to facilitate drying and toughening of the sac

The nurse has attended a professional development program about palliative care for the pediatric population. What statement by the nurse should indicate a correct understanding of the program? A.) Palliative care provides interventions that hasten death B.) Palliative care promotes the optimal functioning and quality of life C.) Palliative care does not provide pain and symptom management like hospice care D.) Palliative care is not well received in hospitals that provide end-of-life care for children

The nurse is administering an intravenous chemotherapeutic agent to a child with leukemia. The child suddenly begins to wheeze and have severe urticaria. What nursing action is most appropriate to initiate? A.) Recheck the rate of drug infusion B.) Stop the drug infusion immediately C.) Observe the child closely for next 10 minutes D.) Explain to the child that this is an expected side effect

The nurse is caring for a 6-year-old child with acute lymphoblastic leukemia (ALL). The parent states, My child has a low platelet count, and we are being discharged this afternoon. What do I need to do at home? What statement is most appropriate for the nurse to make? A.) You should give your child aspirin instead of acetaminophen for fever or pain B.) Your child should avoid contact sports or activities that could cause bleeding C.) You should feed your child a bland, soft, moist diet for the next week D.) Your child should avoid large groups of people for the next week

The nurse is caring for a child receiving chemotherapy for leukemia. The child's granulocyte count is 600/mm3 and platelet count is 45,000/mm3. What oral care should the nurse recommend for this child? A.) Rinsing mouth with water B.) Daily toothbrushing and flossing C.) Lemon glycerin swabs for cleansing D.) Wiping teeth with moistened gauze or Toothettes

The nurse is caring for a family whose infant was just born with anencephaly. What is the most important nursing intervention? A.) Implement measures to facilitate the attachment process B.) Help the family cope with the birth of an infant with a fatal defect C.) Prepare the family for extensive surgical procedures that will be needed D.) Provide emotional support so the family can adjust to the birth of an infant with problems

The nurse is collecting a 24-hour urine sample on a child with suspected diagnosis of neuroblastoma. What finding in the urine is expected with neuroblastomas? A.) Ketones B.) Catecholamines C.) Red blood cells D.) Excessive white blood cells

The nurse is making a home visit 48 hours after the death of an infant from sudden infant death syndrome (SIDS). What intervention is an appropriate objective for this visit? A.) Give contraceptive information B.) Provide information on the grief process C.) Reassure parents that SIDS is not likely to occur again D.) Thoroughly investigate the home situation to verify SIDS as the cause of death

The nurse is preparing a staff education in-service session for a group of new graduate nurses who will be working in a long-term care facility for children; many of the children have cerebral palsy (CP). What statement should the nurse include in the training? A.) Children with dyskinetic CP have a wide-based gait and repetitive movements B.) Children with spastic pyramidal CP have a positive Babinski sign and ankle clonus C.) Children with hemiplegia CP have mouth muscles and one lower limb affected D.) Children with ataxic CP have involvement of pharyngeal and oral muscles with dysarthria

The nurse is providing support to a family that is experiencing anticipatory grief related to their child's imminent death. What statement by the nurse is therapeutic? A.) Your other children need you to be strong B.) You have been through a very tough time C.) His suffering is over; you should be happy D.) God never gives us more than we can handle

A toddler with spastic cerebral palsy needs to be transported to the radiology department. What transportation method should the nurse use to take the toddler to the radiology department? A.) A stretcher B.) A wheelchair C.) A wagon with pillows D.) Carried in the nurse's arms

The nurse is teaching the parent of a 4-year-old child with a cast on the arm about care at home. What statement by the parent indicates a correct understanding of the teaching? A.) I should have the affected limb hang in a dependent position B.) I will use an ice pack to relieve the itching C.) I should avoid keeping the injured arm elevated D.) I will expect the fingers to be swollen for the next 3 days

The nurse is teaching the parent of a preschool child how to administer the child's insulin injection. The child will be receiving 2 units of regular insulin and 12 units of NPH insulin every morning. What should the parent be taught? A.) Draw the insulin in separate syringes B.) Draw the regular insulin first and then the NPH into the same syringe C.) Draw the NPH insulin first and then the regular into the same syringe D.) Check blood sugar first, and if below 120, hold the regular insulin and give the NPH

The nurse knows that parents need further teaching with regard to the treatment of congenital clubfoot when they state what? A.) We'll keep the cast dry B.) Were happy this is the only cast our baby will need C.) We'll watch for any swelling of the foot while the cast is on D.) We're getting a special car seat to accommodate the cas

The nurse should suspect a child has cerebral palsy (CP) if the parent says what? A.) My 6-month-old baby is rolling from back to prone now B.) My 4-month-old doesn't lift his head when on his tummy C.) My 8-month-old can sit without support D.) My 10-month-old is not walking

The nurse stops to assist an adolescent who has experienced severe trauma when hit by a motorcycle. The emergency medical system (EMS) has been activated. The first person who provided assistance applied a tourniquet to the child's leg because of arterial bleeding. What should the nurse do related to the tourniquet? A.) Loosen the tourniquet B.) Leave the tourniquet in place C.) Remove the tourniquet and apply direct pressure if bleeding is still present D.) Remove the tourniquet every 5 minutes, leaving it off for 30 seconds each time

The parents of a child with spastic cerebral palsy (CP) state that their child seems to have significant pain. In addition to systemic pharmacologic management, the nurse includes which teaching? A.) Patterning B.) Positions to reduce spasticity C.) Stretching exercises after meals D.) Topical analgesics for muscle spasms

What childhood cancer may demonstrate patterns of inheritance that suggest a familial basis? A.) Leukemia B.) Retinoblastoma C.) Rhabdomyosarcoma D.) Osteogenic sarcoma

What clinical manifestations suggest hydrocephalus in an infant? A.) Closed fontanel and high-pitched cry B.) Bulging fontanel and dilated scalp veins C.) Constant low-pitched cry and restlessness D.) Depressed fontanel and decreased blood pressure

What finding is characteristic of fractures in children? A.) Fractures rarely occur at the growth plate site because it absorbs shock well B.) Rapidity of healing is inversely related to the child's age C.) Pliable bones of growing children are less porous than those of adults D.) The periosteum of a child's bone is thinner, is weaker, and has less osteogenic potential compared to that of an adult

What is a principle of palliative care that can be included in the care of children? A.) Maintenance of curative therapy B.) Child and family as the unit of care C.) Exclusive focus on the spiritual issues the family faces D.) Extensive use of opiates to ensure total pain control

What is an appropriate nursing intervention when caring for a child in traction? A.) Removing adhesive traction straps daily to prevent skin breakdown B.) Assessing for tightness, weakness, or contractures in uninvolved joints and muscles C.) Providing active range of motion exercises to affected extremity three times a day D.) Keeping child prone to maintain good alignment

What is the rationale for orthopedic surgery for a child with cerebral palsy? A.) To cure spasticity B.) To improve function C.) For cosmetic purposes D.) To prevent the need of physical therapy

What is the recommended drink for athletes during practice and competition? A.) Sports drinks to replace carbohydrates B.) Cold water for gastrointestinal tract rapid absorption C.) Carbonated beverages to help with acid-base balance C.) Enhanced performance carbohydrate-electrolyte drinks

What specific gravity of the urine is desired so that hemorrhagic cystitis is prevented? A.) 1.035 B.) 1.030 C.) 1.025 D.) 1.005

What statement is true concerning osteogenesis imperfecta (OI)? A.) It is easily treated B.) It is an inherited disorder C.) Braces and exercises are of no therapeutic value D.) Later onset disease usually runs a more difficult course

What type of cerebral palsy (CP) is the most common type? A.) Ataxic B.) Spastic C.) Dyskinetic D.) Mixed type

After a tonic-clonic seizure, what symptoms should the nurse expect the child to experience? A.) Diarrhea and abdominal discomfort B.) Irritability and hunger C.) Lethargy and confusion D.) Nervousness and excitability

What nursing interventions should the nurse plan for a hospitalized toddler to minimize fear of bodily injury (select all that apply): A.) Perform procedures slowly B.) Maintain parent-child contact C.) Use progressively smaller dressings on surgical incisions D.) Tell the child bleeding will stop after the needle is removed E.) Remove a dressing as quickly as possible from surgical incisions

B, C

The nurse is assessing a family's use of complementary medicine practices. What practices are classified as nutrition, diet, and lifestyle or behavioral health changes (select all that apply): A.) Reflexology B.) Macrobiotics C.) Megavitamins D.) Health risk reduction E.) Chiropractic medicine

B, C, D

What are favorable prognostic criteria for acute lymphoblastic leukemia (select all that apply): A.) Male gender B.) CALLA positive C.) Early preB cell D.) 2 to 10 years of age E.) Leukocyte count ?7?50,000/mm3

B, C, D

What findings should the nurse expect to observe in a 7-month-old infant with Werdnig-Hoffman disease (select all that apply): A.) Noticeable scoliosis B.) Absent deep tendon reflexes C.) Abnormal tongue movements D.) Failure to thrive E.) Prominent pectus excavatum F.) Significant leg involvement

B, C, D

What functional goal should the nurse expect for a child who has a C7 spinal cord injury (select all that apply): A.) Able to drive automobile with hand controls B.) Complete independence within limitations of a wheelchair C.) Can roll over in bed, sit up in bed, and eat independently D.) Requires some assistance in transfer and lower extremity dressing E.) Ambulation with bilateral long braces using four-point or swing-through crutch gait

B, C, D

A child has had a short-arm synthetic cast applied. What should the nurse teach to the child and parents about cast care (select all that apply): A.) Relieve itching with heat B.) Elevate the arm when resting C.) Observe the fingers for any evidence of discoloration D.) Do not allow the child to put anything inside the cast E.) Examine the skin at the cast edges for any breakdown

B, C, D, E

The nurse is caring for a 14-year-old child with juvenile idiopathic arthritis (JIA). What clinical manifestations should the nurse expect to observe (select all that apply): A.) Erythema over joints B.) Soft tissue contractures C.) Swelling in multiple joints D.) Morning stiffness of the joints E.) Loss of motion in the affected joints

B, C, D, E

What characterizes a school-aged child's concept of death (select all that apply): A.) Have a mature understanding of death B.) Can respond to logical explanations of death C.) Personify death as the devil or the bogeyman D.) Have a deeper understanding of death in a concrete sense E.) Fear the mutilation and punishment associated with death

B, C, D, E

What effects of an altered pituitary secretion in a child with meningitis indicates syndrome of inappropriate antidiuretic hormone (SIADH) (select all that apply): A.) Hypotension B.) Serum sodium is decreased C.) Urinary output is decreased D.) Evidence of overhydrationE E.) Urine specific gravity is increased

B, C, D, E

What guidelines should the nurse follow when handling chemotherapeutic agents (select all that apply): A.) Use clean technique B.) Prepare medications in a safety cabinet C.) Wear gloves designed for handling chemotherapy D.) Wear face and eye protection when splashing is possible E.) Discard gloves and protective clothing in a special container

B, C, D, E

What influences a child's reaction to the stressors of hospitalization (select all that apply): A.) Gender B.) Separation C.) Support systems D.) Developmental age E.) Previous experience with illness

B, C, D, E

The nurse is preparing to admit a 7-year-old child with an upper motor neuron syndrome. What clinical manifestations of an upper motor neuron syndrome should the nurse expect to observe (select all that apply): A.) No flexor spasms B.) Babinski reflex present C.) No wasting of muscle mass D.) Marked atrophy of atonic muscle E.) Hyperreflexia with tendon reflexes exaggerated

B, C, E

The nurse is caring for a child with retinoblastoma that was treated with an enucleation. What interventions should the nurse plan for care of an eye socket after enucleation (select all that apply): A.) Clean the prosthesis B.) Change the eye pad daily C.) Keep the opposite eye covered initially D.) Irrigate the socket daily with a prescribed solution E.) Apply a prescribed antibiotic ointment after irrigation

B, D, E

The nurse is preparing to admit a 5-year-old with spina bifida cystica that was below the second lumbar vertebra. What clinical manifestations of spina bifida cystica below the second lumbar vertebra should the nurse expect to observe (select all that apply): A.) No motor impairment B.) Lack of bowel control C.) Soft, subcutaneous lipomas D.) Flaccid, partial paralysis of lower extremities E.) Overflow incontinence with constant dribbling of urine

B, D, E

The nurse is teaching the family of a child with type 1 diabetes about insulin. What should the nurse include in the teaching session (select all that apply): A.) Unopened vials are good for 60 days B.) Diabetic supplies should not be left in a hot environment C.) Insulin can be placed in the freezer if not used every day D.) After it has been opened, insulin is good for up to 28 to 30 days E.) Insulin bottles that have been opened should be stored at room temperature or refrigerated

B, D, E

What are characteristics of diabetic ketoacidosis (select all that apply): A.) Pallor B.) Acidosis C.) Bradypnea D.) Dehydration E.) Electrolyte imbalance

B, D, E

What cerebrospinal fluid (CSF) analysis should the nurse expect with viral meningitis (select all that apply): A.) Color is turbid B.) Protein count is normal C.) Glucose is decreased D.) Gram stain findings are negative E.) White blood cell (WBC) count is slightly elevated

B, D, E

A 14-year-old girl is in the intensive care unit after a spinal cord injury 2 days ago. What nursing intervention is a priority for this child? A.) Minimizing environmental stimuli B.) Administering immunoglobulin C.) Monitoring and maintaining systemic blood pressure D.) Discussing long-term care issues with the family

A 14-year-old is admitted to the emergency department with a fracture of the right humerus epiphyseal plate through the joint surface. What information does the nurse know regarding this type of fracture? A.) It will create difficulty because the child is left handed B.) It will heal slowly because this is the weakest part of the bone C.) This type of fracture requires different management to prevent bone growth complications D.) This type of fracture necessitates complete immobilization of the shoulder for 4 to 6 weeks

A 20-kg (44-lb) child in ketoacidosis is admitted to the pediatric intensive care unit. What order should the nurse not implement until clarified with the physician? A.) Weigh on admission and daily B.) Replace fluid volume deficit over 48 hours C.) Begin intravenous line with D5 0.45% normal saline with 20 mEq of potassium chloride D.) Give intravenous regular insulin 2 units/kg/hr after initial rehydration bolus

A child has been seizure free for 2 years. A father asks the nurse how much longer the child will need to take the antiseizure medications. How should the nurse respond? A.) Medications can be discontinued at this time B.) The child will need to take the drugs for 5 years after the last seizure C.) A step-wise approach will be used to reduce the dosage gradually D.) Seizure disorders are a lifelong problem. Medications cannot be discontinued

A child with juvenile idiopathic arthritis (JIA) is started on a nonsteroidal antiinflammatory drug (NSAID). What nursing consideration should be included? A.) Monitor heart rate B.) Administer NSAIDs between meals C.) Check for abdominal pain and bloody stools D.) Expect inflammation to be gone in 3 or 4 days

A child with leukemia is receiving intrathecal chemotherapy to prevent which condition? A.) Infection B.) Brain tumor C.) Central nervous system (CNS) disease D.) Drug side effects

A critically injured child has died and is being removed from a ventilator in the pediatric intensive care unit. What is a priority nursing intervention for the family at this time? A.) Ensure that parents are in the waiting room while the ventilator is removed B.) Help the parents understand that the child is already dead and no further interventions are necessary C.) Control the environment around the child and family to provide privacy D.) Encourage them to wait to see their child until the funeral home has prepared the body

A feeding technique the nurse can teach to parents of a child with cerebral palsy to improve use of the lips and the tongue to facilitate speech is which? A.) Feeding pureed foods B.) Placing food on the tongue C.) Placing food at the side of the tongue D.) Placing food directly into the mouth with a spoon

A mother tells the clinic nurse that she often puts honey on her infants pacifier to soothe the infant. What response should the nurse make to the mother? A.) That is a good way to soothe your baby B.) Honey does not have any soothing effects C.) There is still a risk for infant botulism from honey D.) Honey is OK, but it should not be put on the pacifier

A neonate is born with mild clubfeet. When the parents ask the nurse how this will be corrected, what should the nurse explain? A.) Traction is tried first B.) Surgical intervention is needed C.) Frequent, serial casting is tried first D.) Children outgrow this condition when they learn to walk

A preadolescent has been diagnosed with scoliosis. The planned therapy is the use of a thoracolumbosacral orthotic. The preadolescent asks how long she will have to wear the brace. What is the appropriate response by the nurse? A.) For as long as you have been told B.) Most preadolescents use the brace for 6 months C.) Until your vertebral column has reached skeletal maturity D.) It will be necessary to wear the brace for the rest of your life

A pregnant woman asks about prenatal diagnosis of hydrocephalus. The nurses response should be based on which knowledge? A.) It can be diagnosed only after birth B.) It can be diagnosed by chromosome studies C.) It can be diagnosed with fetal ultrasonography D.) It can be diagnosed by measuring the lecithin-to-sphingomyelin ratio

A preschooler is found digging up a pet bird that was recently buried after it died. What is the best explanation for this behavior? A.) He has a morbid preoccupation with death B.) He is looking to see if a ghost took it away C.) He needs reassurance that the pet has not gone somewhere else D.) The loss is not yet resolved, and professional counseling is needed

A school-age child is diagnosed with a life-threatening illness. The parents want to protect their child from knowing the seriousness of the illness. The nurse should provide which explanation? A.) This attitude is helpful to give parents time to cope B.) This will help the child cope effectively by denial C.) Terminally ill children know when they are seriously ill D.) Terminally ill children usually choose not to discuss the seriousness of their illness

An 8-year-old child is hit by a motor vehicle in the school parking lot. The school nurse notes that the child is responding to verbal stimulation but is not moving his extremities when requested. What is the first action the nurse should take? A.) Wait for the child's parents to arrive B.) Move the child out of the parking lot C.) Have someone notify the emergency medical services (EMS) system D.) Help the child stand to return to play

An adolescent diabetic is admitted to the emergency department for treatment of hyperglycemia and pneumonia. What are characteristics of diabetic hyperglycemia? A.) Cold, clammy skin and lethargy B.) Hunger and hypertension C.) Thirst, being flushed, and fruity breath D.) Disorientation and pallor

An adolescent has just been brought to the emergency department with a spinal cord injury and paralysis from a diving accident. The parents keep asking the nurse, How bad is it? The nurses response should be based on which knowledge? A.) Families adjust better to life-threatening injuries when information is given over time B.) Immediate loss of function is indicative of the long-term consequences of the injury C.) Extent and severity of damage cannot be determined for several weeks or even months D.) Numerous diagnostic tests will be done immediately to determine extent and severity of damage

An adolescent with a spinal cord injury is admitted to a rehabilitation center. Her parents describe her as being angry, hostile, and uncooperative. The nurse should recognize that this is suggestive of which psychosocial state? A.) Normal phase of adolescent development B.) Severe depression that will require long-term counseling C.) Normal response to her situation that can be redirected in a healthy way D.) Denial response to her situation that makes rehabilitative efforts more difficult

At which age do most children have an adult concept of death as being inevitable, universal, and irreversible? A.) 4 to 5 years B.) 6 to 8 years C.) 9 to 11 years D.) 12 to 16 years

Chemotherapeutic agents are classified according to what feature? A.) Side effects B.) Effectiveness C.) Mechanism of action D.) Route of administration

During a well-child visit, the mother tells the nurse that her 4-month-old infant is constipated, is less active than usual, and has a weak-sounding cry. The nurse suspects botulism and questions the mother about the child's diet. What factor should support this diagnosis? A.) Breastfeeding B.) Commercial formula C.) Infant cereal with honey D.) Improperly sterilized bottles

Early diagnosis of congenital hypothyroidism (CH) and phenylketonuria (PKU) is essential to prevent which? A.) Obesity B.) Diabetes C.) Cognitive impairment D.) Respiratory distress

Nursing care of the child with myelosuppression from leukemia or chemotherapeutic agents should include which therapeutic intervention? A.) Restrict oral fluids B.) Institute strict isolation C.) Use good hand-washing technique D.) Give immunizations appropriate for age

Parents ask the nurse, When should palliative care be initiated? What is the best response by the nurse? A.) When curative care is not feasible B.) When the child's prognosis is uncertain C.) It should be included along the continuum of care D.) It should begin when curative treatments are no longer appropriate

Parents bring a 7-year-old child to the clinic for evaluation of an injured wrist after a bicycle accident. The parents and child are upset, and the child will not allow an examination of the injured arm. What priority nursing intervention should occur at this time? A.) Send the child to radiology so radiography can be performed B.) Initiate an intravenous line and administer morphine for the pain C.) Calmly ask the child to point to where the pain is worst and to wiggle fingers D.) Have the parents hold the child so that the nurse can examine the arm thoroughly

Parents tell the nurse they do not want to let their school-age child know his illness is terminal. What response should the nurse make to the parents? A.) Have you discussed this with your health care provider? B.) I would do the same thing in your position; it is better the child doesn't know C.) I understand you want to protect your child, but often children realize the seriousness of their illness D.) I praise you for that decision; it can be so difficult to be truthful about the seriousness of your sons illness

Phenylketonuria is a genetic disease that results in the body's inability to correctly metabolize which? A.) Glucose B.) Thyroxine C.) Phenylalanine D.) Phenylketones

Spastic cerebral palsy (CP) is characterized by which clinical manifestations? A.) Athetosis, dystonic movements B.) Tremors, lack of active movement C.) Hypertonicity; poor control of posture, balance, and coordinated motion D.) Wide-based gait; poor performance of rapid, repetitive movements

The nurse at a summer camp recognizes the signs of heatstroke in an adolescent girl. Her temperature is 40 C (104 F). She is slightly confused but able to drink water. Nursing care while waiting for transport to the hospital should include what intervention? A.) Administer antipyretics B.) Administer salt tablets C.) Apply towels wet with cool water D.) Sponge with solution of rubbing alcohol and water

The nurse is assessing a child's functional self-care level for feeding, bathing and hygiene, dressing, and grooming and toileting. The child requires assistance or supervision from another person and equipment or device. What code does the nurse assign for this child? A.) I B.) II C.) III D.) IV

The nurse is caring for a 4-year-old child with cerebral palsy (CP). The child, developmentally, is at an infant stage. Appropriate developmental stimulation for this child should be what? A.) Playing pat-a-cake with the child B.) None so the child does not become overstimulated C.) Putting a colorful mobile with music on the bed D.) Giving the child a coloring book and crayons

The nurse is caring for a hospitalized adolescent whose femur was fractured 18 hours ago. The adolescent suddenly develops chest pain and dyspnea. The nurse should suspect what complication? A.) Sepsis B.) Osteomyelitis C.) Pulmonary embolism D.) Acute respiratory tract infection

The nurse is often the individual who is in the optimum position to suggest tissue donation to a family (after consultation with the practitioner). What will occur if a family chooses organ or tissue donation? A.) The funeral will be delayed B.) Cremation is the preferred method of burial C.) Written consent is required for tissue or organ donation D.) An open casket cannot be used subsequent to this procedure

The nurse is preparing a child for possible alopecia from chemotherapy. What information should the nurse include? A.) Wearing hats or scarves is preferable to a wig B.) Expose head to sunlight to stimulate hair regrowth C.) Hair may have a slightly different color or texture when it regrows D.) Regrowth of hair usually begins 12 months after chemotherapy ends

The nurse is teaching a child with a cast about cast removal. What should the nurse teach the child about cast removal? A.) The cast cutter will be a quiet machine B.) You will feel cold as the cast is removed C.) You will feel a tickly sensation as the cast is removed D.) The cast cutter cuts through the cast like a circular saw

The nurse is teaching infant care to parents with an infant who has been diagnosed with osteogenesis imperfecta (OI). What should the nurse include in the teaching session? A.) Bisphosphonate therapy is not beneficial for OI B.) Physical therapy should be avoided as it may cause damage to bones C.) Lift the infant by the buttocks, not the ankles, when changing diapers D.) The infant should meet expected gross motor development without assistive devices

The nurse is teaching the girls varsity sports teams about the female athlete triad. What is essential information to include? A.) They should take low to moderate calcium to avoid hypercalcemia B.) They have strong bones because of the athletic training C.) Pregnancy can occur in the absence of menstruation D.) A diet high in carbohydrates accommodates increased training

The nurse is teaching the parents of a 3-year-old child who has been diagnosed with tonic-clonic seizures. What statement by the parent should indicate a correct understanding of the teaching? A.) I should attempt to restrain my child during a seizure B.) My child will need to avoid contact sports until adulthood C.) I should place a pillow under my child's head during a seizure D.) My child will need to be taken to the emergency department [ED] after each seizure

The nurse understands that a school-age child may react to death with what reaction? A.) Joking B.) Having no reaction C.) Fearing the unknown D.) Seeing it as a distant event

The nurse uses the five Ps to assess ischemia in a child with a fracture. What finding is considered a late and ominous sign? A.) Petaling B.) Posturing C.) Paresthesia D.) Positioning

The parents of a child who has just been diagnosed with type 1 diabetes ask about exercise. What effect does exercise have on a type 1 diabetic? A.) Exercise increases blood glucose B.) Extra insulin is required during exercise C.) Additional snacks are needed before exercise D.) Excessive physical activity should be restricted

The parents of an infant with cerebral palsy (CP) ask the nurse if their child will have cognitive impairment. The nurses response should be based on which knowledge? A.) Affected children have some degree of cognitive impairment B.) Around 20% of affected children have normal intelligence C.) About 45% of affected children have normal intelligence D.) Cognitive impairment is expected if motor and sensory deficits are severe

The sibling of a 4-year-old girl dies from sudden infant death syndrome. The parents are concerned because the 4-year-old girl showed more outward grief when her cat died than now. How should the nurse explain this reaction to the parents? A.) The child is not old enough to have a concept of death B.) This suggests maladaptive coping, and referral is needed for counseling C.) The death may be so painful and threatening that the child must deny it for now D.) The child is not old enough to have formed a significant attachment to her sibling

To help an adolescent deal with diabetes, the nurse needs to consider which characteristic of adolescence? A.) Desire to be unique B.) Preoccupation with the future C.) Need to be perfect and similar to peers D.) Awareness of peers that diabetes is a severe disease

What are quick, jerky, grossly uncoordinated, irregular movements that may disappear on relaxation called? A.) Twitching B.) Spasticity C.) Choreiform movements D.) Associated movements

What chemotherapeutic agent can cause an anaphylactic reaction? A.) Prednisone (Deltasone) B.) Vincristine (Oncovin) C.) L-Asparaginase (Elspar) D.) Methotrexate (Trexall)

What description identifies the pathophysiology of leukemia? A.) Increased blood viscosity B.) Abnormal stimulation of the first stage of coagulation process C.) Unrestricted proliferation of immature white blood cells (WBCs) D.) Thrombocytopenia from an excessive destruction of platelets

What explanation best describes how preschoolers react to the death of a loved one? A.) Grief is acute but does not last long at this age B.) Children this age are too young to have a concept of death C.) Preschoolers may feel guilty and responsible for the death D.) They express grief in the same way that the adults in the preschoolers life are expressing grief

What finding is a clinical manifestation of increased intracranial pressure (ICP) in children? A.) Low-pitched cry B.) Sunken fontanel C.) Diplopia, blurred vision D.) Increased blood pressure

What is a physiologic effect of immobilization on children? A.) Metabolic rate increases B.) Venous return improves because the child is in the supine position C.) Circulatory stasis can lead to thrombus and embolus formation D.) Bone calcium increases, releasing excess calcium into the body (hypercalcemia)

What is a priority of care when a child has an external ventricular drain (EVD)? A.) Irrigation of drain to maintain flow B.) As-needed dressing changes if dressing becomes wet C.) Frequent assessment of amount and color of drainage D.) Maintaining the EVD below the level of the child's head

What is an important nursing consideration when caring for a child with juvenile idiopathic arthritis (JIA)? A.) Apply ice packs to relieve acute swelling and pain B.) Administer acetaminophen to reduce inflammation C.) Teach the child and family correct administration of medications D.) Encourage range of motion exercises during periods of inflammation

What is an important priority in dealing with the child suspected of having Wilms tumor? A.) Intervening to minimize bleeding B.) Monitoring temperature for infection C.) Ensuring the abdomen is protected from palpation D.) Teaching parents how to manage the parenteral nutrition

What is the initial clinical manifestation of generalized seizures? A.) Confusion B.) Feeling frightened C.) Loss of consciousness D.) Seeing flashing lights

What is the primary method of treating osteomyelitis? A.) Joint replacement B.) Bracing and casting C.) Intravenous antibiotic therapy D.) Long-term corticosteroid therapy

What most accurately describes bowel function in children born with a myelomeningocele? A.) Incontinence cannot be prevented B.) Enemas and laxatives are contraindicated C.) Some degree of fecal continence can usually be achieved D.) Colostomy is usually required by the time the child reaches adolescence

What statement best describes Duchenne (pseudohypertrophic) muscular dystrophy (DMD)? A.) It has an autosomal dominant inheritance pattern B.) Onset occurs in later childhood and adolescence C.) It is characterized by presence of Gower sign, a waddling gait, and lordosis D.) Disease stabilizes during adolescence, allowing for life expectancy to approximately age 40 years

What statement is characteristic of type 1 diabetes mellitus? A.) Onset is usually gradual B.) Ketoacidosis is infrequent. C.) Peak age incidence is 10 to 15 years D.) Oral agents are available for treatment

What statement is most accurate in describing tetanus? A.) Inflammatory disease that causes extreme, localized muscle spasm B.) Disease affecting the salivary gland with resultant stiffness of the jaw C.) Acute infectious disease caused by an exotoxin produced by an anaerobic spore-forming, gram-positive bacillus D.) Acute infection that causes meningeal inflammation resulting in symptoms of generalized muscle spasm

What statement related to clinical trials developed for pediatric cancers is most accurate? A.) Are accessible only in major pediatric centers B.) Do not require consent for standard therapy C.) Provide the best available therapy compared with an expected improvement D.) Are standardized to provide the same treatment to all children with the disease

What term is used to describe an abnormally increased convex angulation in the curvature of the thoracic spine? A.) Scoliosis B.) Lordosis C.) Kyphosis D.) Ankylosis

What term refers to seizures that involve both hemispheres of the brain? A.) Absence B.) Acquired C.) Generalized D.) Complex partial

What type of chemotherapeutic agent alters the function of cells by replacing a hydrogen atom of a molecule? A.) Plant alkaloids B.) Antimetabolites C.) Alkylating agents D.) Antitumor antibiotics

When does idiopathic scoliosis become most noticeable? A.) In the newborn period B.) When the child starts to walk C.) During the preadolescent growth spurt D.) During adolescence

The nurse is preparing to admit a 7-year-old child with complex partial seizures. What clinical features of complex partial seizures should the nurse recognize (select all that apply): A.) They last less than 10 seconds B.) There is usually no aura C.) Mental disorientation is common D.) There is frequently a postictal state E.) There is usually an impaired consciousness

C, D, E

The nurse is teaching the parents of a child with a seizure disorder about the triggers that can cause a seizure. What should the nurse include in the teaching session (select all that apply): A.) Cold B.) Sugared drinks C.) Emotional stress D.) Flickering lights E.) Hyperventilation

C, D, E

What factors influence the effects of a child's hospitalization on siblings (select all that apply): A.) Older siblings B.) Experiencing minimal changes C.) Receiving little information about their ill brother or sister D.) Being cared for outside the home by care providers who are not relatives E.) Perceiving that their parents treat them differently compared with before their siblings hospitalization

C, D, E

What characterizes an infant's concept of death (select all that apply): A.) Death is seen as temporary B.) Death is seen as a departure, a kind of sleep C.) Death has no significance before 6 months of age D.) They believe that death is a consequence of their thoughts E.) Anxiety is not created by death but by loss, even temporary, of the paren

C, E

A 12-year-old boy is in the final phase of dying from leukemia. He tells the nurse who is giving him opiates for pain that his grandfather is waiting for him. How should the nurse interpret this situation? A.) The boy is experiencing side effects of the opiates B.) The boy is making an attempt to comfort his parents C.) He is experiencing hallucinations resulting from brain anoxia D.) He is demonstrating readiness and acceptance that death is near

A 23-month-old child is admitted to the hospital with a diagnosis of meningitis. She is lethargic and very irritable with a temperature of 102 F. What should the nurses care plan include? A.) Observing the child's voluntary movement B.) Checking the Babinski reflex every 4 hours C.) Checking the Brudzinski reflex every 1 hour D.) Assessing the level of consciousness (LOC) and vital signs every 2 hours

A 6-year-old child is admitted for revision of a ventriculoperitoneal shunt for noncommunicating hydrocephalus. What sign or symptom does the child have that indicates a revision is necessary? A.) Tachycardia B.) Gastrointestinal upset C.) Hypotension D.) Alteration in level of consciousness

A 7-year-old child is in the end stages of cancer. The parents ask you how they will know when death is imminent. What physical sign is indicative of approaching death? A.) Hunger B.) Tachycardia C.) Increased thirst D.) Difficulty swallowing

A child eats some sugar cubes after experiencing symptoms of hypoglycemia. This rapid-releasing sugar should be followed by which dietary intervention? A.) Sports drink and fruit B.) Glucose tabs and protein C.) Glass of water and crackers D.) Milk and peanut butter on bread

A child has a seizure disorder. What test should be done to gather the most specific information about the type of seizure the child is having? A.) Sleep study B.) Skull radiography C.) Serum electrolytes D.) Electroencephalogram (EEG)

A child has an absolute neutrophil count (ANC) of 500/mm3. The nurse should expect to be administering which prescribed treatment? A.) Platelets B.) Packed red blood cells C.) Zofran (ondansetron) D.) G-CSF (Neupogen) daily

A child is admitted for revision of a ventriculoperitoneal shunt for noncommunicating hydrocephalus. What is a common reason for elective revision of this shunt? A.) Meningitis B.) Gastrointestinal upset C.) Hydrocephalus resolution D.) Growth of the child since the initial shunting

A parent needs to leave a hospitalized toddler for a short period of time. What action should the nurse suggest to the parent to ease the separation for the toddler? A.) Bring a new toy when returning B.) Leave when the child is distracted C.) Tell the child when they will return D.) Leave a favorite article from home with the child

A woman who is 6 weeks pregnant tells the nurse that she is worried that, even though she is taking folic acid supplements, the baby might have spina bifida because of a family history. The nurses response should be based on what? A.) Prenatal detection is not possible yet B.) There is no genetic basis for the defect C.) Chromosome studies done on amniotic fluid can diagnose the defect prenatally D.) Open neural tube defects (NTDs) result in elevated concentrations of a-fetoprotein in amniotic fluid

An 8-year-old child is hospitalized with infectious polyneuritis (Guillain-Barr syndrome [GBS]). When explaining this disease process to the parents, what should the nurse consider? A.) Paralysis is progressive with little hope for recovery B.) Disease is inherited as an autosomal, sex-linked, recessive gene C.) Disease results from an apparently toxic reaction to certain medications D.) Muscle strength slowly returns, and most children recover

An 8-year-old girl with moderate cerebral palsy (CP) recently began joining a regular classroom for part of the day. Her mother asks the school nurse about joining the after-school Girl Scout troop. The nurses response should be based on which knowledge? A.) Most activities such as Girl Scouts cannot be adapted for children with CP B.) After-school activities usually result in extreme fatigue for children with CP C.) Trying to participate in activities such as Girl Scouts leads to lowered self-esteem in children with CP D.) Recreational activities often provide children with CP with opportunities for socialization and recreation

At which developmental period do children have the most difficulty coping with death, particularly if it is their own? A.) Toddlerhood B.) Preschool C.) School age D.) Adolescence

Parents are considering treatment options for their 5-year-old child with Legg-Calv-Perthes disease. Both surgical and conservative therapies are appropriate. They are able to verbalize the differences between the therapies when they make what statement? A.) All therapies require extended periods of bed rest B.) Conservative therapy will be required until puberty C.) Our child cannot attend school during the treatment phase D.) Surgical correction requires a 3- to 4-month recovery period

Postoperative positioning for a child who has had a medulloblastoma brain tumor (infratentorial) removed should be which? A.) Trendelenburg B.) Head of bed elevated above heart level C.) Flat on operative side with pillows behind the head D.) Flat, on either side with pillows behind the back

Several nurses tell their nursing supervisor that they want to attend the funeral of a child for whom they had cared. They say they felt especially close to both the child and the family. The supervisor should recognize that attending the funeral serves what purpose? A.) It is improper because it increases burnout B.) It is inappropriate because it is unprofessional C.) It is proper because families expect this expression of concern D.) It is appropriate because it can assist in the resolution of personal grief

The mother of a 1-month-old infant tells the nurse she worries that her baby will get meningitis like the child's younger brother had when he was an infant. The nurse should base a response on which information? A.) Meningitis rarely occurs during infancy B.) Often a genetic predisposition to meningitis is found C.) Vaccination to prevent all types of meningitis is now available D.) Vaccinations to prevent pneumococcal and Haemophilus influenzae type B meningitis are available

The nurse is assessing a child who was just admitted to the hospital for observation after a head injury. What clinical manifestation is the most essential part of the nursing assessment to detect early signs of a worsening condition? A.) Posturing B.) Vital signs C.) Focal neurologic signs D.) Level of consciousness

The nurse is caring for a child with myasthenia gravis (MG). What health care prescription should the nurse verify before administering? A.) Ceftizoxime (Cefizox) B.) Cefotaxime (Claforan) C.) Ceftriaxone (Rocephin) D.) Garamycin (gentamicin)

The nurse is caring for a child with tetanus during the acute phase. What should the nurse plan in the care for this child? A.) Playing music on a radio B.) Giving frequent back rubs C.) Providing bright lighting in the room D.) Clustering nursing care to limit distractions

The nurse is caring for an immobilized preschool child. What intervention is helpful during this period of immobilization? A.) Encourage wearing pajamas B.) Let the child have few behavioral limitations C.) Keep the child away from other immobilized children if possible D.) Take the child for a walk by wagon outside the room

The nurse is closely monitoring a child who is unconscious after a fall and notices that the child suddenly has a fixed and dilated pupil. How should the nurse interpret this? A.) Eye trauma B.) Brain death C.) Severe brainstem damage D.) Neurosurgical emergency

The nurse is discussing long-term care with the parents of a child who has a ventriculoperitoneal shunt. What issues should be addressed? A.) Most childhood activities must be restricted B.) Cognitive impairment is to be expected with hydrocephalus C.) Wearing head protection is essential until the child reaches adulthood D.) Shunt malfunction or infection requires immediate treatment

The nurse is discussing with a child and family the various sites used for insulin injections. What site usually has the fastest rate of absorption? A.) Arm B.) Leg C.) Buttock D.) Abdomen

The nurse is instructing student nurses about the stress of hospitalization for children from middle infancy throughout the preschool years. What major stress should the nurse relate to the students? A.) Pain B.) Bodily injury C.) Loss of control D.) Separation anxiety

The nurse is teaching an adolescent about giving insulin injections. The adolescent asks if the disposable needles and syringes can be used more than once. The nurses response should be based on which knowledge? A.) It is unsafe B.) It is acceptable for up to 24 hours C.) It is acceptable for families with very limited resources D.) It is suitable for up to 3 days if stored in the refrigerator

The nurse is teaching parents the proper use of a hip-knee-ankle-foot orthosis (HKAFO) for their 4-year-old child. The parents demonstrate basic essential knowledge by making what statement? A.) Alcohol will be used twice a day to clean the skin around the brace B.) Weekly visits to the orthotist are scheduled to check screws for tightness C.) Initially, a burning sensation is expected and the brace should remain in place D.) Condition of the skin in contact with the brace should be checked every 4 hours

The nurse needs to assess a 15-month-old child who is sitting quietly on his father's lap. What initial action by the nurse would be most appropriate? A.) Ask the father to place the child on the exam table B.) Undress the child while he is still sitting on his father's lap C.) Talk softly to the child while taking him from his father D.) Begin the assessment while the child is in his father's lap

The parents of a child with cancer tell the nurse that a bone marrow transplant (BMT) may be necessary. What information should the nurse recognize as important when discussing this with the family? A.) BMT should be done at the time of diagnosis B.) Parents and siblings of the child have a 25% chance of being a suitable donor C.) If BMT fails, chemotherapy or radiotherapy will need to be continued D.) Finding a suitable donor involves matching antigens from the human leukocyte antigen (HLA) system

Total-body irradiation is indicated for what reason? A.) Palliative care B.) Lymphoma therapy C.) Definitive therapy for leukemia D.) Preparation for bone marrow transplant

What blood glucose measurement is most likely associated with diabetic ketoacidosis? A.) 185 mg/dl B.) 220 mg/dl C.) 280 mg/dl D.) 330 mg/dl

What chemotherapeutic agent is classified as an antitumor antibiotic? A.) Cisplatin (Platinol AQ) B.) Vincristine (Oncovin) C.) Methotrexate (Texall) D.) Daunorubicin (Cerubidine)

What choice of words or phrases would be inappropriate to use with a child? A.) Rolling bed for stretcher B.) Special medicine for dye C.) Make sleepy for deaden D.) Catheter for intravenous

What clinical manifestation is considered a cardinal sign of diabetes mellitus? A.) Nausea B.) Seizures C.) Impaired vision D.) Frequent urination

What clinical manifestation occurs with hypoglycemia? A.) Lethargy B.) Confusion C.) Nausea and vomiting D.) Weakness and dizziness

What factor is most important for parents implementing do not resuscitate (DNR) orders? A.) Parents beliefs about euthanasia B.) Presence of other children in the home C.) Experiences of the health care team with other children in this situation D.) Acknowledgment by health care team that child has no realistic chance for cure

What functional ability should the nurse expect in a child with a spinal cord lesion at C7? A.) Complete respiratory paralysis B.) No voluntary function of upper extremities C.) Inability to roll over or attain sitting position D.) Almost complete independence within limitations of wheelchair

What immunization should not be given to a child receiving chemotherapy for cancer? A.) Tetanus vaccine B.) Inactivated poliovirus vaccine C.) Diphtheria, pertussis, tetanus (DPT) D.) Measles, mumps, rubella (MMR)

What is a common clinical manifestation of Hodgkin disease? A.) Petechiae B.) Bone and joint pain C.) Painful, enlarged lymph nodes D.) Nontender enlargement of lymph nodes

What is a major goal of therapy for children with cerebral palsy (CP)? A.) Cure the underlying defect causing the disorder B.) Reverse the degenerative processes that have occurred C.) Prevent the spread to individuals in close contact with the child D.) Recognize the disorder early and promote optimum development

What is a nursing intervention to reduce the risk of increasing intracranial pressure (ICP) in an unconscious child? A.) Suction the child frequently B.) Turn the child's head side to side every hour C.) Provide environmental stimulation D.) Avoid activities that cause pain or crying

What is the antiepileptic medication that requires monitoring of vitamin D and folic acid? A.) Topiramate (Topamax) B.) Valproic acid (Depakene) C.) Gabapentin (Neurontin) D.) Phenobarbital (Luminal)

What is the most common cause of cerebral palsy (CP)? A.) Central nervous system (CNS) diseases B.) Birth asphyxia C.) Cerebral trauma D.) Neonatal encephalopathy

What pain management approach is most effective for a child who is having a bone marrow test? A.) Relaxation techniques B.) Administration of an opioid C.) EMLA cream applied over site D.) Conscious or unconscious sedation

What refers to a hernial protrusion of a saclike cyst of meninges, spinal fluid, and a portion of the spinal cord with its nerves through a defect in the vertebral column? A.) Rachischisis B.) Meningocele C.) Encephalocele D.) Myelomeningocele

What should the nurse plan for an immobilized child in cervical traction to prevent deep vein thrombosis (DVT)? A.) Elevate the child's legs B.) Place a foot cradle on the bed C.) Place a pillow under the child's knees D.) Assist the child to dorsiflex the feet and rotate the ankles

What statement applies to the current focus of the dietary management of children with diabetes? A.) Measurement of all servings of food is vital for control B.) Daily calculate specific amounts of carbohydrates, fats, and proteins C.) The number of calories for carbohydrates remains constant on a daily basis; protein and fat calories are liberal D.) The intake ensures day-to-day consistency in total calories, protein, carbohydrates, and moderate fat while allowing for a wide variety of foods

What statement is correct regarding sports injuries during adolescence? A.) Conditioning does not help prevent many sports injuries B.) The increase in strength and vigor during adolescence helps prevent injuries related to fatigue C.) More injuries occur during organized athletic competition than during recreational sports participation D.) Adolescents may not possess insight and judgment to recognize when a sports activity is beyond their capabilities

When a child develops latex allergy, which food may also cause an allergic reaction? A.) Yeast B.) Wheat C.) Peanuts D.) Bananas

Which is a consequence of the physical punishment of children, such as spanking? A.) The psychologic impact is usually minimal B.) The child's development of reasoning increases C.) Children rarely become accustomed to spanking D.) Misbehavior is likely to occur when parents are not present

Which is an accurate description of homosexual (or gay-lesbian) families? A.) A nurturing environment is lacking B.) The children become homosexual like their parents C.) The stability needed to raise healthy children is lacking D.) The quality of parenting is equivalent to that of non-gay parents

Which statement accurately describes family system theory? A.) Family is viewed as the sum of the individual members within the family B.) Change in one family member cannot cause a change in other members C.) Individual family members are readily identified as the source of a problem D.) when the family system is disrupted, change may occur at any point in the system

Which symptom indicates unhealthy coping in a child whose parents are divorcing? A.) Body rash B.) Body aches C.) Increased sleep D.) Loss of appetite

A spinal tap must be done on a 9-year-old boy. While he is waiting in the treatment room, the nurse observes that he seems composed. When the nurse asks him if he wants his mother to stay with him, he says, I am fine. How should the nurse interpret this situation? A.) This child is unusually brave B.) He has learned that support does not help C.) Nine-year-old boys do not usually want a parent present during the procedure D.) Children in this age group often do not request support even though they need and want it

At what age will the child best adapt to adoption? A.) One year B.) Seven years C.) Fifteen years D.) Five months

Because of their striving for independence and productivity, which age group of children is particularly vulnerable to events that may lessen their feeling of control and power? A.) Infants B.) Toddlers C.) Preschoolers D.) School-age children

Cognitive development influences response to pain. What age group is most concerned with the fear of losing control during a painful experience? A.) Toddlers B.) Preschoolers C.) School-age children D.) Adolescents

How is family systems theory best described? A.) The family is viewed as the sum of individual members B.) A change in one family member cannot create a change in other members C.) Individual family members are readily identified as the source of a problem D.) When the family system is disrupted, change can occur at any point in the system

Parents of a preschool child ask the nurse, Should we set rules for our child as part of a discipline plan? Which is an accurate response by the nurse? A.) It is best to delay the punishment if a rule is broken B.) The child is too young for rules. At this age, unrestricted freedom is best C.) It is best to set the rules and reason with the child when the rules are broken D.) Set clear and reasonable rules and expect the same behavior regardless of the circumstances

The home care nurse visits a family and notes a very strict parenting style, including rigid rule setting and frequent use of time-out when rules are broken. Which type of parental control is being practices? A.) Reasoning B.) Permissive C.) Authorative D.) Authoritarian

The nurse is caring for a 3-year-old child during a long hospitalization. The parent is concerned about how to support the child's siblings during the hospitalization. What statement is appropriate for the nurse to make? A.) You should choose one parent to spend every night in the hospital while the other parent stays at home with the other children B.) You could leave your hospitalized child for periods at night to be at home with the other children C.) You should discourage the siblings from visiting because this could upset everyone in the family D.) You could encourage a nightly phone call between the siblings as part of the bedtime routine

The nurse is doing a prehospitalization orientation for a girl, age 7 years, who is scheduled for cardiac surgery. As part of the preparation, the nurse explains that after the surgery, the child will be in the intensive care unit. How might the explanation by the nurse be viewed? A.) Unnecessary B.) The surgeon's responsibility C.) Too stressful for a young child d.) An appropriate part of the child's preparation

The psychosexual conflicts of preschool children make them extremely vulnerable to which threat? A.) Loss of control B.) Loss of identity C.) Separation anxiety D.) Bodily injury and pain

What change does the nurse teach the parents to expect in their child after prolonged hospitalization? A.) Anger toward parents B.) Jealousy toward siblings C.) Repressed feeling of resentment D.) Regression in newly learned skills

What is a characteristic of a family with invisible poverty? A.) Poor nutrition B.) Poor sanitation C.) Insufficient clothing D.) Lack of healthcare facilities

What is the primary goal of care coordination? A.) Providing timely care B.) Ensuring access to a variety of services C.) Reducing the financial cost of health care D.) Ensuring continuity across various settings

Which term is defined as the emotional attitude that one's own ethnic group is superior to others? A.) Culture B.) Ethnicity C.) Socialization D.) Ethnocentrism

A child, age 4 years, tells the nurse that she needs a Band-Aid where she had an injection. What nursing action should the nurse implement? A.) Apply a Band-Aid B.) Ask her why she wants a Band-Aid C.) Explain why a Band-Aid is not needed D.) Show her that the bleeding has already stopped

An 8-year-old girl is being admitted to the hospital from the emergency department with an injury from falling off her bicycle. What intervention will help her most in her adjustment to the hospital? A.) Explain hospital schedules to her, such as mealtimes B.) Use terms such as honey and dear to show a caring attitude C.) Explain when parents can visit and why siblings cannot come to see her D.) Orient her parents, because she is too young, to her room and hospital facility

During which phase of separation anxiety is a toddler most likely to cling to the parent? A.) Protest B.) Inactivity C.) Depression D.) Regression to earlier behavior

The mother of a 7-month-old infant newly diagnosed with cystic fibrosis is rooming in with her infant. She is breastfeeding and provides all the care except for the medication administration. What should the nurse include in the plan of care? A.) Ensuring that the mother has time away from the infant B.) Making sure the mother is providing all of the infants care C.) Determining whether other family members can provide the necessary care so the mother can rest D.) Contacting the social worker because of the mothers interference with the nursing care

The nurse is caring for a child whose parents are unable to stay with the child for long hours. Which action by the nurse helps to ease the feelings of separation from home? A.) Surround the child with familiar items B.) Move the child's bed towards the window C.) Provide musical, visual or tactile activities D.) Allow the child to continue school lessons

The nurse is caring for an adolescent hospitalized for asthma. The adolescent belongs to a large family. The nurse recognizes that the adolescent is likely to relate to which group? A.) Peers B.) Parents C.) Siblings D.) Teachers

The nurse is planning care for a patient with a different ethnic background. Which should be an appropriate goal? A.) Adapt, as necessary, ethnic practices to health needs B.) Attempt, in a nonjudgmental way, to change ethnic beliefs C.) Encourage continuation of ethnic practices in the hospital setting D.) Strive to keep ethnic background from influencing health needs

The nurse should expect a toddler to cope with the stress of a short period of separation from parents by displaying what? A.) Regression B.) Happiness C.) Detachment D.) Indifference

The parent of a hospitalized child tells the nurse, "We do not eat meat. We are practicing Buddhists and strict vegetarians." The most appropriate intervention by the nurse is to: A) Order the child a meatless tray B) Tell the parent to take any meat off the child's meal tray C) Ask the parent if they would like to have a Buddhist priest visit D) Explain to the parent that meat provides protein needed to heal their child

What is a common experience of a sibling during a sister's or brother's illness or hospitalization? A.) Anger B.) Support C.) Detachment D.) Positive adaptation

When assessing a family, the nurse determines that the parents exert little or no control over their children. This style of parenting is called which? A.) Permissive B.) Dictatorial C.) Democratic D.) Authoritarian

When discussing discipline with the mother of a 4-year-old child, which should the nurse include? A.) Parental control should be consistent B.) Withdrawal of love and approval is effective at this age C.) Children as young as 4 years rarely need to be disciplined D.) One should expect rules to be followed rigidly and unquestioningly

Which role should nurses play in ensuring that spiritual health care practices do not negatively affect the therapeutic relationship between the nurse and the patient? A.) Maintain open communication between the family and health care team B.) Assume the patient will freely communicate personal religious needs C.) Provide a traditional western diet and allow the patient to choose what to eat D.) Assume the patient adheres to all of the common practices of the documented religion

The nurse is teaching parents about the effects of media on childhood obesity. The nurse realizes the parents understand the teaching if they make which statements (select all that apply): A.) Advertising of unhealthy food can increase snacking B.) Increased screen time may be related to unhealthy sleep C.) There is a link between the amount of screen time and obesity D.) Increased screen time can lead to better knowledge of nutrition E.) Physical activity increases when children increase the amount of screen time

A, B, C

The nurse teaches the parents of a preschool child techniques to minimize misbehavior. Which actions taken by the parents show an understanding of the instructions given (select all that apply): A.) Recognizing when the child is tired to prevent conflicts B.) Setting limits for the child with some friendly reminders C.) Reprimanding the child in a firm but normal tone of voice D.) Not allowing the child to have any kind of power or control E.) Waiting 30 minutes to punish the child after an incident of misbehavior

A, B, C

What behavior does the nurse expect when caring for a preschool-age child admitted to the hospital (select all that apply): A.) Develops trust in adults B.) Cries quietly for the parents C.) Tolerates brief periods of separation D.) Refuses to comply with the usual routines E.) Attempts to physically keep the parents near

A, B, C

Which describe the feelings and behaviors of adolescents related to divorce (select all that apply): A.) Disturbed concept of sexuality B.) May withdraw from family and friends C.) Worry about themselves, parents, or siblings D.) Expression of anger, sadness, shame, or embarrassment E.) Engage in fantasy to seek understanding of the divorce

A, B, C, D

The parents of a 5-year-old child ask the nurse how they can minimize misbehavior. Which responses should the nurse give (select all that apply): A.) Set clear and reasonable goals. B.) Praise your child for desirable behavior C.) Don't call attention to unacceptable behavior D.) Teach desirable behavior through your own example E.) Don't provide an opportunity for your child to have any control

A, B, D

Which describe the feelings and behaviors of early preschool children related to divorce (select all that apply): A.) Regressive behavior B.) Fear of abandonment C.) Fear regarding the future D.) Blame themselves for the divorce E.) Intense desire for reconciliation of parents

A, B, D

Which factors will influence self-care in the chronically ill hospitalized child (select all that apply): A.) Child's level of interest B.) Child's physical ability C.) The parent doing all care D.) Child's developmental age E.) Child's interest in spirituality

A, B, D

The nurse is providing care to a school-age-child in an ambulatory setting. What are the benefits of ambulatory care (select all that apply): A.) Increased cost savings B.) Reduces chances of infection C.) Reduced time for preparation D.) No separation anxiety in the child E.) Minimized stressors compared to hospitalization

A, B, D, E

What are the different stages of separation anxiety in children (select all that apply): A.) Protest B.) Despair C.) Approval D.) Regression E.) Detachment

A, B, E

The nurse is presenting a staff development program about understanding culture in the health care encounter. Which components should the nurse include in the program (select all that apply): A.) Cultural humility B.) Cultural research C.) Cultural sensitivity D.) Cultural competency

A, C, D

A 10-year-old girl needs to have another intravenous (IV) line started. She keeps telling the nurse, "Wait a minute," and, "I'm not ready." How should the nurse interpret this behavior? A.) IV insertions are viewed as punishment B.) This is expected behavior for a school-age child C.) Protesting like this is usually not seen past the preschool years D.) The child has successfully manipulated the nurse in the past

A 13-year-old child with cystic fibrosis (CF) is a frequent patient on the pediatric unit. This admission, she is sleeping during the daytime and unable to sleep at night. What should be a beneficial strategy for this child? A.) Administer prescribed sedative at night to aid in sleep B.) Negotiate a daily schedule that incorporates hospital routine, therapy, and free time C.) Have the practitioner speak with the child about the need for rest when receiving therapy for CF D.) Arrange a consult with the social worker to determine whether issues at home are interfering with her care

A foster parent is talking to the nurse about the health care needs for the child who has been placed in the parents care. Which statement best describes the health care needs of foster children? A.) Foster children always come from abusive households and are emotionally fragile B.) Foster children tend to have a higher than normal incidence of acute and chronic health problems C.) Foster children are usually born prematurely and require technologically advanced health care D.) Foster children will not stay in the home for an extended period, so health care needs are not as important as emotional fulfillment

A parent of a school-age child tells the school nurse that the parents are going through a divorce. The child has not been doing well in school and sometimes has trouble sleeping. The nurse should recognize this as what? A.) Indicative of maladjustment B.) A common reaction to divorce C.) Suggestive of a lack of adequate parenting D.) An unusual response that indicates a need for referral

After the family, which has the greatest influence on providing continuity between generations? A.) Race B.) School C.) Social class D.) Government

Children may believe that they are responsible for their parents divorce and interpret the separation as punishment. At which age is this most likely to occur? A.) 1 year B.) 4 years C.) 8 years D.) 13 years

The nurse asks a child of Jewish ancestry about a blister noted on the wrist. The child tells the nurse, "My grandmother rubbed garlic there." Which condition is the grandmother treating? A.) Poor eyesight B.) A skin infection C.) Digestive problems D.) A respiratory illness

The nurse discovers welts on the back of a Vietnamese child during a home health visit. The child's mother says she has rubbed the edge of a coin on her childs oiled skin. The nurse should recognize this as what? A.) Child abuse B.) Cultural practice to rid the body of disease C.) Cultural practice to treat enuresis or temper tantrums D.) Child discipline measure common in the Vietnamese culture

The nurse is aware that if patients different cultures are implied to be inferior, the emotional attitude the nurse is displaying is what? A.) Acculturation B.) Ethnocentrism C.) Cultural shock D.) Cultural sensitivity

The nurse is caring for a 10-year-old child during a long hospitalization. What intervention should the nurse include in the care plan to minimize loss of control and autonomy during the hospitalization? A.) Allow the child to skip morning self-care activities to watch a favorite television program B.) Create a calendar with special events such as a visit from a friend to maintain a routine C.) Allow the child to sleep later in the morning and go to bed later at night to promote control D.) Create a restrictive environment so the child feels in control of sensory stimulation

The nurse is discussing issues that are important with parents considering a cross-racial adoption. Which statement made by the parents indicates further teaching is needed? A.) We will try to preserve the adopted childs racial heritage B.) We are glad we will be getting full medical information when we adopt our child C.) We will make sure to have everyone realize this is our child and a member of the family D.) We understand strangers may make thoughtless comments about our child being different from us

The nurse is explaining different parenting styles to a group of parents. The nurse explains that an authoritative parenting style can lead to which child behavior? A.) Shyness B.) Self-reliance C.) Submissiveness D.) Self-consciousness

The nurse is notified that a 9-year-old boy with nephrotic syndrome is being admitted. Only semi-private rooms are available. What roommate should be best to select? A.) A 10-year-old girl with pneumonia B.) An 8-year-old boy with a fractured femur C.) A 10-year-old boy with a ruptured appendix D.) A 9-year-old girl with congenital heart disease

The nurse is reviewing the importance of role learning for children. The nurse understands that children's roles are primarily shaped by which members? A.) Peers B.) Parents C.) Siblings D.) Grandparents

The nurse is teaching a group of new nursing graduates about identifiable qualities of strong families that help them function effectively. Which quality should be included in the teaching? A.) Lack of congruence among family members B.) Clear set of family values, rules, and beliefs C.) Adoption of one coping strategy that always promotes positive functioning in dealing with life events D.) Sense of commitment toward growth of individual family members as opposed to that of the family unit

The parents of a 4-month-old infant cannot visit except on weekends. What action by the nurse indicates an understanding of the emotional needs of a young infant? A.) Place her in a room away from other children B.) Assign her to the same nurse as much as possible C.) Tell the parents that frequent visiting is unnecessary D.) Assign her to different nurses so she will have varied contacts

What is the common fear of hospitalized adolescents? A.) Pain B.) Altered body image C.) Restricted motor activity D.) Separation from material things

What is the primary nursing goal for a hospitalized toddler? A.) Providing privacy B.) Encouraging parents to room in C.) Explaining procedures and routines D.) Encouraging contact with children of the same age

Which family theory explains how families react to stressful events and suggests factors that promote adaptation to these events? A.) Interactional theory B.) Family stress theory C.) Erikson's psychosocial theory D.) Developmental systems theory

Which family theory is described as a series of tasks for the family throughout its life span? A.) Exchange theory B.) Developmental theory C.) Structural-functional theory D.) Symbolic interactional theory

Which statement by the nurse may result in a poor outcome in a child who has behavioral problems? A.) "Please put that book down" B.) "Let's talk about it and see what we can decide" C.) "I am sorry, but I can't read you a story right now" D.) "When the television show is over, it will be time for dinner"

Parents of a 12 year old report to the nurse that the child watches 6 hours of television per day. Which conditions is the child at risk for (select all that apply): A.) Depression B.) Drug abuse C.) Alcoholism D.) Eating disorder E.) Attention-deficit disorder

B, C, D

A 6-year-old is being discharged home, which is 90 miles from the hospital, after an outpatient hernia repair. In addition to explicit discharge instructions, what should the nurse provide? A.) An ambulance for transport home B.) Verbal information about follow-up care C.) Prescribed pain medication before discharge D.) Driving instructions for a route with less traffic

A Hispanic toddler has pneumonia. The nurse notices that the parent consistently feeds the child only the broth that comes on the clear liquid tray. Food items, such as Jell-O, Popsicles, and juices, are left. Which statement best explains this? A.) The parent is trying to feed the child only what the child likes most B.) Hispanics believe the evil eye enters when a person gets cold C.) The parent is trying to restore normal balance through appropriate hot remedies D.) Hispanics believe an innate energy called chi is strengthened by eating soup

A couple with a seven year old child get divorces. Which factor is considered when determining who gets custody of the child? A.) Financial resources B.) The preference of the child C.) Ability to best provide for the child's welfare D.) Familiarity with the existing care of the child

A mother brings 6-month-old Eric to the clinic for a well-baby checkup. She comments, I want to go back to work, but I don't want Eric to suffer because I'll have less time with him. Which is the nurses most appropriate answer? A.) I'm sure he'll be fine if you get a good babysitter B.) You will need to stay home until Eric starts school C.) Let's talk about the child care options that will be best for Eric D.) You should go back to work so Eric will get used to being with others

A parent brings a child to the clinic for a regular checkup and is questioned about the family's medical history. The parent privately explains that the child is adopted, and does not want the child to know. Which guidance would the nurse give to this parent? A.) Instruct the parent to never reveal the information to the child B.) Divulge the information to the child in a very sensitive manner C.) Advise the parent to speak openly to the child and tell the truth D.) Ask the parent to withhold the information until the child is an adult

Children are taught the values of their culture through observation and feedback relative to their own behavior. In teaching a class on cultural competence, the nurse should be aware that which factor may be culturally determined? A.) Ethnicity B.) Racial variation C.) Status D.) Geographic boundaries

The nurse is admitting a 7-year-old child to the pediatric unit for abdominal pain. To determine what the child understands about the reason for hospitalization, what should the nurse do? A.) Find out what the parents have told the child B.) Review the note from the admitting practitioner C.) Ask the child why he came to the hospital today D.) Question the parents about why they brought the child to the hospital

The nurse is caring for a child belonging to the Asian culture. The child is unwilling to eat the food provided in the hospital. Which action would the nurse take? A.) Explain to the child the benefits of having the food provided by the hospital B.) Ask the family members to bring food from a restaurant based on the diet plan C.) Ask the family member to bring homemade food based on the child's diet plan D.) Ask the patient food services of the hospital to prepare the child's favorite food

The nurse is discussing parenting in reconstituted families with a new stepparent. The nurse is aware that the new stepparent understands the teaching when which statement is made? A.) I am glad there will be no disruption in my lifestyle B.) I don't think children really want to live in a two-parent home C.) I realize there may be power conflicts bringing two households together D.) I understand contact between grandparents should be kept to a minimum

The nurse is planning to counsel family members as a group to assess the familys group dynamics. Which theoretic family model is the nurse using as a framework? A.) Feminist theory B.) Family stress theory C.) Family systems theory D.) Developmental theory

The nurse removes an intravenous (IV) needle from a toddler's hand and quickly covers the area with a bandage. Why is a bandage particularly important in this age group? A.) Because the bandage promotes independence B.) Because the bandage promotes freedom of movement C.) Because toddlers have poorly defined body boundaries D.) Because the bandage demonstrates respect to the child

The nurse working in an outpatient surgery center for children understands which concept? A.) Children's anxiety is minimal in such a center B.) Waiting is not stressful for parents in such a center C.) Families need to be prepared for what to expect after discharge D.) Accurate and complete discharge teaching is the responsibility of the surgeon

The parents of a 3-year-old admitted for recurrent diarrhea are upset that the practitioner has not told them what is going on with their child. What is the priority intervention for this family? A.) Answer all of the parents questions about the child's illness B.) Immediately page the practitioner to come to the unit to speak with the family C.) Help the family develop a written list of specific questions to ask the practitioner D.) Inform the family of the time that hospital rounds are made so that they can be present

The parents of a toddler ask the nurse for suggestions about discipline. When discussing the use of time-outs, which suggestions would the nurse include? A.) Send the child to the child's room B.) The general rule is one hour of time-out per year of age C.) Select an area that is safe and non stimulating, such as a hallway D.) If the child cries, refuses, or is more disruptive, try another method of discipline

The parents of a young child ask the nurse for suggestions about discipline. When discussing the use of time-outs, which should the nurse include? A.) Send the child to his or her room if the child has one B.) A general rule for length of time is 1 hour per year of age C.) Select an area that is safe and non-stimulating, such as a hallway D.) If the child cries, refuses, or is more disruptive, try another approach

The primary nursing goal for the hospitalized child younger than 5 years is to prevent which concern? A.) Discomfort B.) Sleep problems C.) Separation from parents D.) Changes in normal routine

The school nurse understands that children are impacted by divorce. Which has the most impact on the positive outcome of a divorce? A.) Age of the child B.) Gender of the child C.) Family characteristics D.) Ongoing family conflict

Two hospitalized adolescents are playing pool in the activity room. Neither of them seems enthusiastic about the game. How should the nurse interpret this situation? A.) Playing pool requires too much concentration for this age group B.) Pool is an activity better suited for younger children C.) The adolescents may be enjoying themselves but have lower energy levels than healthy children D.) The adolescents lack of enthusiasm is one of the signs of depression

What behavior should most likely be manifested in an infant experiencing the protest phase of separation anxiety? A.) Inactivity B.) Depression and sadness C.) Inconsolable and crying D.) Regression to earlier behavior

What is the major stressor of hospitalization for children from middle infancy throughout the preschool years? A.) Fear of pain B.) Loss of control C.) Separation anxiety D.) Fear of bodily injury

What is the most common reaction of many parents to their child's hospitalization? A.) Relief B.) Anger C.) Helplessness D.) Depression

Which condition in children is associated with increased levels of entertainment media use? A.) Considerate behavior B.) Delayed sexual activity C.) Unhealthy eating habits D.) Awareness of substance abuse issues

Which description of foster care is accurate? A.) Living permanently with an adoptive family B.) An institutional setting where many children live together C.) An approved living situation away from the family of origin D.) Living with grandparents but away from the biologic parents

Which instruction is appropriate for parents who are preparing to tell their children about their decision to divorce? A.) Avoid crying in front of children B.) Avoid discussing the reason for the divorce C.) Give reassurance that the divorce is not the children's fault D.) Give reassurance that the divorce will not affect most aspects of the children's lives

Which statement made by the student nurse about the guidelines for integrating spiritual care into pediatric nursing practice indicates a need for further education? A.) "Each patient should be treated as an individual" B.) "The nurse should listen to what a family says about specific rituals" C.) "Refrain from allowing children to tell you about the specifics of their religious beliefs" D.) "The institution's chaplaincy department should be contacted to request specific rituals"

Which term best describes the sharing of common characteristics that differentiates one group from other groups in a society? A.) Race B.) Culture C.) Ethnicity D.) Superiority

Which term refers to a shared culture, social, and linguistic heritage? A.) Beliefs B.) Culture C.) Ethnicity D.) Socialization

Which type of family should the nurse recognize when the paternal grandmother, the parents, and two minor children live together? A.) Blended B.) Nuclear C.) Extended D.) Binuclear

The nurse is educating parents about behavior modification techniques. Which instruction would the nurse provide to help with disciplining their children (select all that apply): A.) Use a moderate amount of spanking B.) Use corporal punishment whenever needed C.) Use rewards to encourage positive behavior D.) Promise a visit to the zoo for good behavior E.) Use time-outs to help the child become calm

C, D, E

What are some environmental stressors for the child and family in the pediatric intensive care unit (select all that apply): A.) Pain B.) Immobility C.) Constant lights D.) Sleep deprivation E.) Unfamiliar sounds

C, E

A 3-year-old child was adopted immediately after birth. The parents have just asked the nurse how they should tell the child that she is adopted. Which guideline concerning adoption should the nurse use in planning a response? A.) It is best to wait until the child asks about it B.) The best time to tell the child is between the ages of 7 and 10 years C.) It is not necessary to tell a child who was adopted so young D.) Telling the child is an important aspect of their parental responsibilities

A 6-year-old child is admitted to the pediatric unit and requires bed rest. Having art supplies available meets which purpose? A.) Allows the child to create gifts for parents B.) Provides developmentally appropriate activities C.) Is essential for play therapy so the child can work on past problems D.) Let the child express thoughts and feelings through pictures rather than words

A 9-year-old boy has an unplanned admission to the intensive care unit (ICU) after abdominal surgery. The nursing staff has completed the admission process, and his condition is beginning to stabilize. When speaking with the parents, the nurse should expect what additional stressor to be evident? A.) Usual day-night routine B.) Calming influence of staff C.) Adequate privacy and support D.) Insufficient remembering of his condition and routine

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