PEDIATRICS: EXAM 3
A 10-year-old diagnosed with chronic renal failure is seen at the dialysis center for dialysis treatment three times a week. The child weighs 35 pounds after dialysis. Physician's order: Epogen 50 U/kg three times weekly after dialysis. Medication on hand: Epogen 2000 U/mL Calculate how many ml of Epogen the child should receive three times a week.
Answer: 0.38 mL
A 3-day-old preterm infant is diagnosed with necrotizing enterocolitis. The nurse plans care around the frequent radiographs. How frequently should the nurse anticipate that the radiology staff will bring the portable machine to the nursery? 1. Every 6 hours 2. Every 12 hours 3. Every 24 hours 4. Every 48 hours
Answer: 1
A 5-year-old sibling of a 9-year-old child with cystic fibrosis tells the nurse, "I wish I had a breathing disease, too." The nurse knows the parents strive to spend quality time with each child and with both children together. What is the sibling currently experiencing? 1. Jealousy 2. Isolation 3. Loneliness 4. Anger
Answer: 1
A child experienced a lacerated spleen in a motor vehicle accident. Which is the highest priority nursing intervention on admission to the pediatric intensive care unit (PICU) following surgery? 1. Observing for signs of hypovolemic shock 2. Maintaining IV fluids 3. Implementing strict bedrest 4. Administering blood products as ordered
Answer: 1
A child is admitted with infective endocarditis. Which nursing intervention is most appropriate for this child? 1. Start an intravenous line. 2. Place the child in contact isolation. 3. Place the child on seizure precautions. 4. Assist with a lumbar puncture.
Answer: 1
A child is scheduled for a kidney transplant. The nurse completes the preoperative teaching to prepare the child and parents for the surgery and postoperative considerations. Which statement by the parents indicates understanding of the teaching session? 1. "We know it's important to see that our child takes prescribed medications after the transplant." 2. "We'll be glad we won't have to bring our child in to see the doctor again." 3. "We're happy our child won't have to take any more medicine after the transplant." 4. "We understand our child won't be at risk anymore for catching colds from other children at school."
Answer: 1
A child, in renal failure, is diagnosed with hyperkalemia. Which food choices will the nurse teach the parents and child to avoid? 1. Carrots and green, leafy vegetables 2. Chips, cold cuts, and canned foods 3. Spaghetti and meat sauce, breadsticks 4. Hamburger on a bun, cherry gelatin
Answer: 1
A neonate is fed 20 mL of formula every three hours by orogastric lavage. At the beginning of this feeding, the nurse aspirates 15 mL of gastric residual. Which action by the nurse is the most appropriate? 1. Withhold the feeding and notify the healthcare provider. 2. Replace the residual and continue with the full feeding. 3. Replace the residual but only give 5 mL of the feeding. 4. Withhold the feeding and check the residual in three hours.
Answer: 1
A nurse is preparing for the delivery of a newborn with a known diaphragmatic hernia defect. Which equipment does the nurse ensure is prepared at the bedside? 1. Intubation setup 2. Appropriate bag and mask 3. Sterile gauze and saline 4. Soft arm restraints
Answer: 1
A pediatric client is hospitalized with a severe case of impetigo contagiosa. Which antibiotic does the nurse anticipate the healthcare provider will order for this client? 1. Dicloxacillin (Pathocil) 2. Rifampin (Rifadin) 3. Sulfamethoxazole and trimethoprim (Bactrim) 4. Metronidazole (Flagyl)
Answer: 1
A preschool-age client diagnosed with nephrotic syndrome is placed on prednisone for several weeks. Which teaching point is appropriate for the nurse to include in the teaching plan for this client? 1. Never stop the medication suddenly. 2. This drug is taken once a week on Sunday. 3. The child should always take the medication at night before bed. 4. This drug should be taken with meals.
Answer: 1
A school-age child has been seen in the pediatric clinic three times in the last two months for complaints of abdominal pain. Physical exam and all ordered lab work have been normal. Which question by the nurse would most likely help determine the etiology of the child's abdominal pain? 1. "Have there been any changes in your child's school or home life recently?" 2. "How many meals does your child eat each day?" 3. "Are your child's immunizations up to date?" 4. "Has your child had any fevers or viral illnesses in the last three months?"
Answer: 1
A school-age client diagnosed with nephrotic syndrome is severely edematous. The primary healthcare provider has placed the child on bed rest. Which nursing intervention is a priority for this client? 1. Reposition the child every 2 hours. 2. Monitor BP every 30 minutes. 3. Encourage fluids. 4. Limit visitors.
Answer: 1
A school-age client is admitted to the pediatric intensive care unit (PICU) in critical condition after a motor vehicle accident. Which intervention should be implemented at this time? 1. Maintain consistent caregivers. 2. Turn the lights off at night. 3. Keep alarm levels low. 4. Consult the hospital play therapist.
Answer: 1
A toddler-age client is in end-stage renal failure. Which nursing intervention will assist this child most? 1. Maintain the child's normal routines. 2. Explain body changes that will take place. 3. Encourage friends to visit. 4. Allow the child to talk about the illness.
Answer: 1
An adolescent client must wear a brace for the correction of scoliosis. Which nursing diagnosis is most appropriate for this client? 1. Risk for Impaired Skin Integrity 2. Risk for Altered Growth and Development 3. Risk for Impaired Mobility 4. Risk for Impaired Gas Exchange
Answer: 1
An adolescent client who is diagnosed with Duchenne muscular dystrophy is seen in the clinic for a routine health visit. Which nursing diagnosis is the priority for this client? 1. Risk for Impaired Mobility Related to Hypertrophy of Muscles 2. Risk for Infection Related to Altered Immune System 3. Risk for Impaired Skin Integrity Related to Paresthesia 4. Risk for Altered Comfort Related to Effects of the Illness
Answer: 1
An infant born with an omphalocele defect is admitted to the intensive-care nursery. Which instruction from the nurse manager to the unlicensed assistive personnel is most appropriate? 1. Prepare a warmer. 2. Prepare a crib. 3. Prepare a feeding of formula. 4. Prepare the bilirubin light.
Answer: 1
An infant is born with an esophageal atresia and tracheoesophageal fistula. Which preoperative nursing diagnosis is the priority for this infant? 1. Risk for Aspiration Related to Regurgitation 2. Acute Pain Related to Esophageal Defect 3. Ineffective Infant Feeding Pattern Related to Uncoordinated Suck and Swallow 4. Ineffective Tissue Perfusion: Gastrointestinal, Related to Decreased Circulation
Answer: 1
During a 4-month-old's well-child check, the nurse discusses introduction of solid foods into the infant's diet and concerns for foods commonly associated with food allergies. Due to allergies, which foods will the nurse instruction the parents to avoid until after 1 year of age? 1. Strawberries, eggs, and wheat 2. Peas, tomatoes, and spinach 3. Carrots, beets, and spinach 4. Squash, pork, and tomatoes
Answer: 1
During a well-child exam, the parents of a preschool-age child inform the nurse that they are thinking of buying a television for their child's bedroom and ask for advice as to whether this is appropriate. Which response by the nurse is the most appropriate? 1. "Research has shown that children with a television in their bedroom spend significantly less time playing outside than other children, and physical inactivity in children has been linked to many chronic diseases such as obesity and type 2 diabetes." 2. "Research has shown that watching educational television shows improves a child's performance in school." 3. "Don't buy a television for your child's room; he is much too young for that." 4. "It is okay for children to have a television in their room as long as you limit the amount of time they watch it to less than two hours per day."
Answer: 1
Parents of a child in the pediatric intensive care unit (PICU) have been experiencing shock and disbelief regarding their situation. Which statement by the parents indicates they are moving forward into the next stage of coping? 1. "Why not me instead of my child?" 2. "It is hard for me to have others take care of my child." 3. "I feel like life is suspended in time." 4. "I am glad I can help with his care."
Answer: 1
The mother of a child with a heart defect is questioning the nurse about the child's diuretic. When teaching the mother about the medication, what should the emphasis from the nurse? 1. Close monitoring of output 2. The digitalization process 3. The possibility that pulses in the child might be weak 4. The child's increased appetite
Answer: 1
The nurse admits a child with a ventricular septal defect (VSD) to the unit. Which nursing diagnosis for this child is the most appropriate? 1. Impaired Gas Exchange Related to Pulmonary Congestion Secondary to the Increased Pulmonary Blood Flow 2. Deficient Fluid Volume Related to Hyperthermia Secondary to the Congenital Heart Defect 3. Acute Pain Related to the Effects of a Congenital Heart Defect 4. Hypothermia Related to Decreased Metabolic State
Answer: 1
The nurse completes parent education related to treatment for a pediatric client with congenital clubfoot. Which statement by the parents indicates the need for further education? 1. "We're happy this is the only cast our baby will need." 2. "We'll watch for any swelling of the feet while the casts are on." 3. "We'll keep the casts dry." 4. "We're getting a special car seat to accommodate the casts."
Answer: 1
The nurse has admitted a child with tricuspid atresia. The nurse would expect which initial lab result? 1. A high hemoglobin 2. A low hematocrit 3. A high WBC count 4. A low platelet count
Answer: 1
The nurse has completed discharge teaching for the family of a child diagnosed with Legg- Calve-Perthes disease. Which statement by the family indicates the need for further education? 1. "We're glad this will only take about 6 weeks to correct." 2. "We understand swimming is a good sport for Legg-Calve Perthes." 3. "We know to watch for areas on the skin the brace may rub." 4. "We understand that abduction of the affected leg is important."
Answer: 1
The nurse in the newborn nursery is performing the admission assessment on a neonate. Which assessment finding indicates the neonate may have congenital hip dysplasia? 1. Asymmetry of the gluteal and thigh fat folds 2. Trendelenburg sign 3. Telescoping of the affected limb 4. Lordosis
Answer: 1
The nurse is administering several medications to an infant with neurologic impairment and delay. Which medication is a proton pump inhibitor that is administered for gastroesophageal reflux? 1. Omeprazole 2. Ranitidine 3. Phenytoin 4. Glycopyrrolate
Answer: 1
The nurse is admitting an infant diagnosed with supraventricular tachycardia. Which intervention is the priority for this infant? 1. Apply ice to the face. 2. Perform Valsalva's maneuver. 3. Administer a beta blocker. 4. Prepare for cardioversion.
Answer: 1
The nurse is caring for a 5-month-old with biliary atresia. The mother asks why the healthcare provider wants her child to take the medication, cholestyramine. What would the nurse's response be? 1. Decrease itching 2. Increase WBCs 3. Decrease use of antibiotics 4. Increase appetite
Answer: 1
The nurse is caring for a pediatric client diagnosed with eczema. Which topical medication order does the nurse anticipate for this client? 1. Corticosteroid 2. Retinoid 3. Antifungal 4. Antibacterial
Answer: 1
The nurse is performing the initial assessment of a child newly diagnosed Kawasaki disease. Which symptoms would the nurse expect to assess with this child? 1. Dry, swollen, fissured lips 2. Nonpalpable lymph nodes 3. Conjunctivitis with exudates 4. Cyanosis of the hands and feet
Answer: 1
The nurse is planning activities for a toddler with a birth injury of a torn brachial plexus that resulted in muscle atrophy and weakness of his right arm. Which nursing intervention is most appropriate for this client? 1. Offering the toddler a choice of clothing 2. Asking the toddler if he would like to take his medicine 3. Dressing the toddler 4. Feeding the toddler
Answer: 1
The nurse is providing care to a male infant who is diagnosed with hypospadias. Which clinical manifestation does the nurse anticipate when assessing this infant? 1. A urethral meatus that is located on the ventral surface of the penis 2. The presence of foreskin 3. A small opening or a fissure that extends the entire length of the penis 4. An opening on the dorsal surface of the penis
Answer: 1
The nurse is providing care to a toddler client who is diagnosed with osteogenesis imperfecta. Which nursing intervention is appropriate for this client? 1. Support of the trunk and extremities when moving 2. Traction care 3. Cast care 4. Postop spinal surgery care
Answer: 1
The nurse is teaching the parents of a 4-month-old infant about good feeding habits. The nurse emphasizes the importance of holding the baby during feeding and not letting the infant go to sleep with the bottle. Which disorder is associated with propped feedings and going to sleep with the bottle? 1. Otitis media 2. Aspiration 3. Malocclusion problems 4. Sleeping disorders
Answer: 1
The nurse is working with a child with a chronic condition. The nurse observes that over time, the parents have experienced a pattern of periodic grieving alternating with denial. What are the parents currently experiencing based on this assessment finding? 1. Chronic sorrow 2. Compassion fatigue 3. Dysfunctional parenting 4. Pathological grieving
Answer: 1
The nurse prepares a DTaP (diphtheria, tetanus toxoid, and acellular pertussis) immunization for a 6-month-old infant. To administer this injection safely, the nurse chooses which needle, size and length, injection type, and injection site? 1. 25-gauge, 5/8-inch needle; IM (intramuscular); anterolateral thigh. 2. 22-gauge, 1/2-inch needle; IM (intramuscular); ventrogluteal. 3. 25-gauge, 5/8-inch needle; ID (intradermal); deltoid. 4. 25-gauge, 3/4-inch needle; SQ (subcutaneous); anterolateral thigh.
Answer: 1
The school nurse completes an assessment of a school-age client to determine the services this child will need in the classroom. The client is a newly diagnosed with type I diabetes mellitus. Based on this information, which special healthcare need category is the most appropriate? 1. Dependent on medication or special diet 2. Dependent on medical technology 3. Increase use of healthcare services 4. Functional limitations
Answer: 1
The school nurse is planning a smoking-prevention program for middle school students. Which intervention is most likely to be effective in preventing middle school children from smoking? 1. Having a local high school basketball star come to talk to the students about the importance of not smoking 2. Having the school's biology teacher demonstrate the pathophysiology of the effects of smoking tobacco on the body 3. Developing colorful posters with catchy slogans and placing them all over the school 4. Having a pledge campaign with prizes awarded, during which students sign contracts saying that they will not use tobacco products
Answer: 1
The school nurse is providing care to a school-age client who experienced a sprain of the right ankle on the playground. Which intervention is appropriate for the nurse to implement for this client? 1. Apply ice to the extremity 2. Apply a warm, moist pack to the extremity 3. Perform passive range of motion to the extremity 4. Lower the extremity to below the level of the heart
Answer: 1
There are many healthcare needs of children with chronic conditions. What nursing strategy would best help parents with continuity of care? 1. Include the family and older child in decision making. 2. Assist the family in gaining transportation to healthcare appointments. 3. Provide the family with resources such as social services. 4. Recognize and respect the cultural needs of the family.
Answer: 1
While teaching the parents of a newborn about infant care and feeding, which instruction by the nurse is the most appropriate? 1. Delay supplemental foods until the infant is 4 to 6 months old. 2. Delay supplemental foods until the infant reaches 15 pounds or greater. 3. Begin diluted fruit juice at 2 months of age, but wait 3 to 5 days before trying a new food. 4. Add rice cereal to the nighttime feeding if the infant is having difficulty sleeping after 2 months of age.
Answer: 1
The nurse is teaching a group of students about wound healing. Which items will the nurse include as occurring during the hemostasis and inflammation stage of wound healing? Select all that apply. 1. Clot formation to seal the wound 2. Production of collagen and granulation tissue 3. Scar formation and strengthening 4. Release of inflammatory mediators by platelets 5. Swelling as a result of increased capillary permeability
Answer: 1, 2, 5
The child is diagnosed with an upper urinary tract infection (UTI). The family asks the nurse what is the difference in the symptoms of an upper versus a lower urinary tract infection? Match each symptom (1- 8 below) with the appropriate infection. A. Lower UTI B. Upper UTI 1. High fever 2. Diarrhea 3. Chills 4. Hematuria 5. Costovertebral angle tenderness 6. Cloudy urine 7. Suprapubic or flank pain 8. Moderate/severe dehydration
Answer: 1 - B, 2 - A, 3 - B, 4 - A, 5 - B, 6 - A, 7 - A, 8 - B 1. Upper UTI 2. Lower UTI 3. Upper UTI 4. Lower UTI 5. Upper UTI 6. Lower UTI 7. Lower UTI 8. Upper UTI
Match the child's concept of death with their behavioral response. A. Infant B. Toddler C. Preschool-age child D. School-age child E. Adolescent 1. Understands difference between temporary separation and death. 2. Senses emotions of caregivers and altered routines. 3. Capable of understanding death, recognizes all people and self will die. 4. No understanding of true concept of death. 5. Believes death is temporary and the person will return.
Answer: 1 - D, 2 - A, 3 - E, 4 - B, 5 - C 1. School-age child 2. Infant 3. Adolescent 4. Toddler 5. Preschool-age child
Match the formalized plan for the child with a chronic condition with its description. A. Individualized family service plan (IFSP) B. Individualized education plan (IEP) C. Individualized health plan (IHP) D. Individualized transition plan (ITP) 1. Helps individuals receive vocational training and move successfully from the home into other community settings. 2. Developed for a child with cognitive, motor, social, and communication impairment who needs special education services. 3. Developed for the early intervention process for infants with special healthcare needs and their families. 4. Developed for the child with medical conditions that need to be managed within the school setting
Answer: 1 - D, 2 - B, 3 - A, 4 - C 1. Individualized transition plan (ITP) 2. Individualized education plan (IEP) 3. Individualized family service plan (IFSP) 4. Individualized health plan (IHP)
The nurse is providing care to an adolescent client who is dying. Which assessment findings indicate the client is experiencing a decrease in peripheral circulation? Select all that apply. 1. Cool skin 2. Mottled appearance 3. Cheyne-Stokes respirations 4. Increased agitation 5. Increased urine output
Answer: 1, 2
The nurse teaches a group of parents' strategies to reduce the risk of lead exposure for their children. Which statements indicate an appropriate understanding of the content presented? Select all that apply. 1. "We will provide our child with frequent snacks high in iron and calcium." 2. "We will wash any surfaces that have peeling paint." 3. "We will store leftovers in a ceramic pot." 4. "We can continue to use our traditional-medicine treatment, Azarcon, for any GI upset." 5. "We will sand the windowsills to remove the lead-based paint."
Answer: 1, 2
A child is prescribed hemodialysis for the treatment of kidney failure. When providing care for this child, what will the nurse monitor for during the assessment? Select all that apply. 1. Shock 2. Hypotension 3. Infections 4. Migraines 5. Fluid overload
Answer: 1, 2, 3
A novice nurse in the newborn intensive care unit (NICU) has just performed postmortem care on a premature infant who passed away. The novice nurse asks to be excused near the end of the shift. Which interventions can be implemented to support this nurse. Select all that apply. 1. Schedule additional education on bereavement care 2. Ask a seasoned nurse to talk with the novice nurse 3. Tell the nurse it is OK to grieve with the family 4. Recommend that the nurse transfer to another unit 5. Assign the nurse to stable clients only
Answer: 1, 2, 3
A school health nurse is screening school-age students for scoliosis. Which assessment findings indicate the need for further evaluation for scoliosis? Select all that apply. 1. Uneven shoulders and hips 2. A one-sided rib hump 3. Prominent scapula 4. Lordosis 5. Pain
Answer: 1, 2, 3
The nurse is conducting an admission assessment for a preschool age client in the emergency department. When using the resiliency theory, which findings place this client at risk? Select all that apply. 1. Loss of health insurance 2. No primary care provider 3. Incomplete immunizations 4. A grandmother who is able to room-in 5. High level language skills from the child
Answer: 1, 2, 3
The parents of a child with Duchenne muscular dystrophy are in the clinic after diagnosis and ask the nurse if the family should have genetic testing completed. Who should the nurse suggest to have genetic testing? Select all that apply. 1. Female cousins 2. Aunts 3. Sisters 4. Brothers 5. Uncles and male cousins
Answer: 1, 2, 3
The school nurse is implementing a program to decrease bullying. Which interventions are appropriate for the school nurse to implement? Select all that apply. 1. Train teachers about the behaviors 2. Ensure adult supervision in the hallways 3. Teach children to report behaviors 4. Ensure that immunizations are up-to-date 5. Set up anti-hazing policies
Answer: 1, 2, 3
The nurse is preparing an educational session for sexually active adolescents. Which statements are appropriate for the nurse to include when educating about sexually transmitted infections (STIs)? Select all that apply. 1. "Frequently diagnosed STIs include chlamydia, genital herpes, gonorrhea, human papillomavirus, trichomoniasis, and syphilis." 2. "Your risk for contracting an STI can be decreased by using a condom when having sex." 3. "Birth control pills are useful in decreasing your risk of contracting an STI." 4. "Risk factors for pelvic inflammatory disease (PID) include multiple sexual partners, lack of barrier protection during intercourse, and history of an STI." 5. "Pelvic inflammatory disease (PID) is an infection of the lower genital tract."
Answer: 1, 2, 4
Parents of a child who will begin enteral feedings ask the nurse what advantage this type of feeding has over other methods. Which responses by the nurse are the most appropriate? Select all that apply. 1. "Enteral feeding is the closest to natural feeding methods." 2. "The child must be able to absorb nutrients." 3. "Enteral feeding is complex to administer." 4. "Enteral feeding requires a central venous catheter." 5. "Enteral feeding has a high success rate."
Answer: 1, 2, 5
The nurse is providing care to a pediatric client who is diagnosed with psoriasis. Which clinical manifestations does the nurse anticipate upon assessment of this client? Select all that apply. 1. Thick, silvery, scaly erythematous plaque 2. Pruritus 3. Dry skin, likely to crack and fissure 4. Fragile skin and blisters 5. Irregular border surrounded by normal skin
Answer: 1, 2, 5
An infant with tetralogy of Fallot is having a hypercyanotic episode ("tet" spell). Which nursing interventions are appropriate for the nurse to implement for this infant? Select all that apply. 1. Place the child in knee-chest position. 2. Draw blood for a serum hemoglobin. 3. Administer oxygen. 4. Administer morphine and propranolol intravenously as ordered. 5. Administer Benadryl as ordered.
Answer: 1, 3, 4
The nurse educator is preparing an in-service on the basic functions of the gastrointestinal (GI) system. Which statements will the nurse educator include in the in-service? Select all that apply. 1. "The GI system is responsible for the ingestion of fluids and nutrients." 2. "The GI system is responsible for the excretion of fluids and nutrients." 3. "The GI system is responsible for the metabolism of nutrients." 4. "As infants grow, their stomach capacity increases, decreasing the frequency with which they need to be fed." 5. "By the second year of life, digestive processes are still developing."
Answer: 1, 3, 4
Which stressor is common in the hospitalized toddler with a chronic disorder? Select all that apply. 1. Fear of painful procedures 2. Self-concept 3. Interruption of normal routines 4. Unfamiliarity of caregivers 5. Isolation
Answer: 1, 3, 4
While the nurse is conducting the history of a school-age child, the parents admit to owning firearms. Which safety measures are appropriate to include in the teaching plan for this family? Select all that apply. 1. Using a gun lock on all firearms in the house 2. Taking the child to a shooting range for lessons on how to use a gun properly 3. Storing the guns and ammunition in separate places 4. Keeping all the guns in a locked cabinet 5. Explaining the dangers of a gun to the child and telling her explicitly to never touch it
Answer: 1, 3, 4
The nurse is caring for the newborn with bilateral clubfoot. What nursing diagnoses would the nurse address? Select all that apply. 1. Activity intolerance 2. Impaired physical mobility 3. Risk for impaired skin integrity 4. Ineffective breathing pattern 5. Impaired parenting
Answer: 2, 3, 5
The nurse is caring for the newborn with hyperbilirubinemia. What nursing diagnoses would the nurse address? Select all that apply. 1. Activity intolerance 2. Deficient fluid volume 3. Risk for impaired attachment 4. Ineffective breathing pattern 5. Risk for imbalanced body temperature
Answer: 2, 3, 5
The hospital has just provided its nurses with information about biologic threats and terrorism. After completing the course, a group of nurses is discussing its responsibility in relation to bioterrorism. Which statement by the nurse indicates a correct understanding of the concepts presented? 1. "It is important to separate clients according to age and illness to prevent the spread of disease." 2. "It is important to dispose blood-contaminated needles in the lead-lined container." 3. "I will notify the Centers for Disease Control (CDC) if a large number of persons with the same life-threatening infection present to the emergency room." 4. "I will initiate isolation precautions for a hospitalized client with methicillin-resistant staphylococcus aureus (MRSA)."
Answer: 3
The mother of a toddler is concerned because her child does not seem interested in eating. The child is drinking 5 to 6 cups of whole milk per day and one cup of fruit juice. When the weight-to-height percentile is calculated, the child is in the 90th to 95th percentile. What is the best advice the nurse can provide to the mother? 1. Eliminate the fruit juice from the child's diet. 2. Offer healthy snacks, presented in a creative manner, and let the child choose what he wants to eat without pressure from the parents. 3. Change from whole milk to 2 percent milk and decrease milk consumption to three to four cups per day and the fruit juice to a half cup per day, offering water if the child is still thirsty in between. 4. Make sure that the child is getting adequate opportunities for exercise, as this will increase his appetite and help lower the child's weight-to-height percentile.
Answer: 3
The nurse can instruct parents to expect children in which age group to begin to assume more independent responsibility for their own management of a chronic condition, such as blood glucose monitoring, insulin administration, intermittent self-catheterization, and appropriate inhaler use? 1. Toddlers 2. Preschool-age 3. School-age 4. Adolescents
Answer: 3
The nurse is conducting a health promotion class for adolescents. In counseling an adolescent about lifestyle choices, what should the adolescent eliminate in order to decrease the risk of the most preventable cause of adult death? 1. Alcohol use 2. Obesity 3. Tobacco use 4. Cocaine use
Answer: 3
The nurse is discussing ways to treat fever in the home environment to a group of parents in the community. Which statement is appropriate for the nurse to include in the presentation? 1. "Ibuprofen is the only effective means to reduce fever." 2. "If the child requires more than one dose of acetaminophen antibiotics are needed." 3. "Purchase a new bottle of acetaminophen for your newborn because it will have recommended medication concentration." 4. "It is not necessary to follow the recommendations on the bottle of ibuprofen as this will not prevent an overdose for your child."
Answer: 3
The nurse is instructing a parent of a newborn on the foods that are to be started based on age. The nurse instructs the parent that the first food given to a newborn is rice cereal. What statement by the parent suggests appropriate understanding of the next food that can be introduced? 1. "Chicken can be given next." 2. "Eggs can be given next." 3. "Fruits should be given next." 4. "Whole milk should be started."
Answer: 3
The nurse is planning a class for school-age children on prevention of obesity through exercise. It is important to encourage the children to exercise a minimum of how many minutes a day to meet current recommendations? 1. 20 minutes 2. 30 minutes 3. 60 minutes 4. 90 minutes
Answer: 3
The nurse is planning care for a 3-month-old infant diagnosed with eczema. Which should be the focus of the nurse's care for this infant? 1. Maintaining adequate nutrition 2. Keeping the baby content 3. Preventing infection of lesions 4. Applying antibiotics to lesions
Answer: 3
The nurse is planning postoperative care for an infant after a cleft-lip repair. Which nursing intervention is most appropriate for this infant? 1. Prone positioning 2. Suctioning with a Yankauer device 3. Supine or side-lying positioning 4. Avoidance of soft elbow restraints
Answer: 3
The nurse is preparing to ambulate a school-age client who had an appendectomy. In addition to pharmacological pain management, the nurse can use which nonpharmacological pain-management strategy for this client? 1. A heating pad 2. A warm, moist pack 3. A pillow on the abdomen 4. An ice pack
Answer: 3
The nurse is preparing to discharge a toddler-age client who just had an orchiopexy. Which discharge instruction is appropriate for this client? 1. Information to the parents about the child's resuming normal vigorous activities 2. Discussion with the parents about the low incidence of testicular malignancy and no further need for any follow-up 3. Explanation to the parents about the need for loose, nonrestrictive clothing 4. Reassurance to the parents that infertility is not a future risk
Answer: 3
The nurse is providing instruction to the parents of an infant with a colostomy. Which statement by the parents indicates appropriate understanding of the teaching session? 1. "We will change the colostomy bag with each wet diaper." 2. "We will use adhesive enhancers when we change the bag." 3. "We will watch for skin irritation around the stoma." 4. "We will expect a moderate amount of bleeding after cleansing the area around the stoma."
Answer: 3
The nurse is teaching family members how to care for their infant in a Pavlik harness to treat congenital developmental dysplasia of the hip. Which statement will the nurse include in the teaching session? 1. "Apply lotion or powder to minimize skin irritation." 2. "Put clothing over the harness for maximum effectiveness of the device." 3. "Check at least 2 or 3 times a day for red areas under the straps." 4. "Place a diaper over the harness, preferably using a thin, superabsorbent, disposable diaper."
Answer: 3
The nurse is working in an adolescent medical clinic. What can the nurse anticipate when comparing adolescents in the clinic with chronic conditions to their peers? 1. A high level self-esteem 2. A concern for their parents 3. An altered body image 4. A decreased concern about their appearance
Answer: 3
When examining a toddler-age child during a well-child physical, which assessment is the priority? 1. Visual acuity 2. Helmet use 3. Risk of lead exposure 4. Whether household drinking water contains fluorine
Answer: 3
Which athletic activity can the nurse recommend for a school-age client with pulmonary-artery hypertension? 1. Cross-country running 2. Soccer 3. Golf 4. Basketball
Answer: 3
Which client in the pediatric intensive care unit (PICU) would most benefit from palliative care? 1. A child with end-stage leukemia 2. A child with a broken arm after a motor vehicle accident 3. A child with burn injuries to the legs 4. A child with recurrent asthma
Answer: 3
The nurse is assessing a 14-year-old and notes signs and symptoms of bulimia nervosa. Which assessments led the nurse to this conclusion? Select all that apply. 1. Pale skin 2. Dry, splitting hair 3. Erosion of tooth enamel 4. Calluses on back of hand 5. Gum recession
Answer: 3, 4, 5
The school nurse is trying to prevent the spread of a flu virus through the school. Which infection-control strategies can be employed to prevent the spread of the flu virus? Select all that apply. 1. Teaching parents safe food preparation and storage 2. Withholding immunizations for children with compromised immune systems 3. Sanitizing toys, telephones, and door knobs to kill pathogens 4. Separating children with infections from children who are well 5. Teaching children to wash their hands after using the bathroom
Answer: 3, 4, 5
The student nurse is learning a lesson about communicable diseases and how they are spread. On a quiz the next day the nurse uses the information learned in this lesson and demonstrates learning. For a communicable disease to occur what factors must be in place? Select all that apply. 1. Antibodies 2. Toxoid 3. Pathogen 4. Transmission 5. Host
Answer: 3, 4, 5
Reducing the number of preventable childhood illnesses is a major national goal in Healthy People 2020. What will the school nurse teach families regarding immunizations in order to reach this goal? 1. A minor illness with a low-grade fever is a contraindication to receiving an immunization according to Healthy People 2020. 2. Vaccines should be given one at a time for optimum active immunity in the prevention of illness and disease. 3. Premature infants and low-birth-weight infants should receive half doses of vaccines for protection from communicable diseases. 4. It is important to maintain vaccination coverage for recommended vaccines in early childhood and to maintain them through kindergarten.
Answer: 4
Siblings of a client in pediatric intensive care unit (PICU) are preparing to visit their brother, who was hit by a car while riding his bike. Which intervention by the nurse will assist the siblings in preparing for the visit? 1. Spend time developing a relationship with the siblings. 2. Have the parents go with the siblings when they visit. 3. Encourage the siblings to talk to a social worker before seeing their brother. 4. Explain what the siblings will hear and see when they visit.
Answer: 4
The clinic nurse is working with a child with multiple disabilities. The parents have asked the nurse to help them in meeting with the school board to develop an Individualized Education Plan (IEP) and an Individualized Health Plan (IHP). Which nursing intervention is most appropriate? 1. Providing a written list of the child's medical diagnoses for the IEP meeting. 2. Offering to wait with the child while the parents attend the IEP meeting. 3. Listening to the parents' concerns and complaints about the school district. 4. Presenting verbally the child's cognitive, physical, and social skills to school officials at the IEP meeting.
Answer: 4
The hospital admitting nurse is taking a history of a child's illness from the parents. The nurse concludes that the parents treated their 6 year-old child appropriately for a fever related to otitis media. Which action by the parents brought the nurse to this conclusion? 1. Used aspirin every four hours to reduce the fever 2. Alternated acetaminophen with ibuprofen every two hours 3. Put the child in a tub of cold water to reduce the fever 4. Offered generous amounts of fluids frequently
Answer: 4
The mother of an infant born prematurely at 32 weeks expresses the desire to breastfeed her child. The nurse correctly responds with which statement when the mother asks how long she should breastfeed her baby? 1. "Until the child begins solid foods." 2. "Many breastfeed for 2 years." 3. "It is recommended that mothers of preterm infants breastfeed at least a month." 4. "Breast milk should be the only food for the first 6 months."
Answer: 4
The nurse finds that an infant has stronger pulses in the upper extremities than in the lower extremities, and higher blood pressure readings in the arms than in the legs. Which assessment will the nurse perform next on this infant? 1. Pedal pulses 2. Pulse oximetry level 3. Hemoglobin and hematocrit values 4. Blood pressure of the four extremities
Answer: 4
The nurse is checking peripheral perfusion to a child's extremity following a cardiac catheterization. Which assessment finding indicates adequate peripheral circulation to the affected extremity? 1. A capillary refill of greater than three seconds 2. A palpable dorsalis pedis pulse but a weak posterior tibial pulse 3. A decrease in sensation with a weakened dorsalis pedis pulse 4. A capillary refill of less than three seconds with palpable warmth
Answer: 4
The nurse is evaluating an infant's tolerance of feedings after a pyloromyotomy. Which finding indicates that the infant is not tolerating the feeding? 1. Need for frequent burping 2. Irritability during feeding 3. The passing of gas 4. Emesis after two feedings
Answer: 4
The nurse is providing care to a pediatric client recently diagnosed with celiac disease. Which food choice indicates appropriate understanding of the material presented? 1. Pizza with milk 2. Spaghetti and meat sauce with juice 3. Hot dog on a bun with a shake 4. Fruit plate with Gatorade
Answer: 4
The nurse is providing education to the parents of a pediatric client who is diagnosed with tinea capitis (ringworm of the scalp). Which statement made the parents indicates an appropriate understanding of the teaching session? 1. "We will give the griseofulvin on an empty stomach." 2. "We're glad ringworm isn't transmitted from person to person." 3. "Once the lesion is gone, we can stop the griseofulvin." 4. "We will give the griseofulvin with milk or peanut butter."
Answer: 4
The nurse is working with a group of parents who have children with chronic conditions. Which statement by a parent would indicate a risk for a caregiver burden that could become overwhelming? 1. "My mother moved in and helped us take our quadruplets home." 2. "Our health insurance sent us a rejection letter for my child's brand name medication, and we must fill out forms to get the generic." 3. "I chose to quit my job to be home with my child, and my husband helps in the evening when he can." 4. "I have to care for my child day and night, which leaves little time for me."
Answer: 4
The nurse must prepare parents to see their adolescent daughter in the pediatric intensive-care unit (PICU). The child arrived by life flight after experiencing multiple traumas in a car accident involving a suspected drunk driver. At this time, which statement by the nurse to the family is the most appropriate? 1. "Don't worry; everything will be okay. We will take excellent care of your child." 2. "You should press charges against the drunk driver." 3. "Your child's leg was crushed and may have to be amputated." 4. "Your child's condition is very critical; her face is swollen, and she may not look like herself."
Answer: 4
The nurse prepares the second diphtheria, tetanus toxoid, and acellular pertussis (DTaP) and second inactivated polio vaccine (IPV) immunization injections for an infant who is 4 months old. The nurse may also give which of immunizations during the same well-child care appointment? 1. Var (varicella) 2. TIV (influenza) 3. MMR (measles, mumps, rubella) 4. Haemophilus influenza type B (HIB)
Answer: 4
The parents of a toddler-age child who sustained severe head trauma from falling out a second-story window are arguing in the pediatric intensive-care unit (PICU) and blaming each other for the child's accident. Which nursing diagnosis is most appropriate for this family? 1. Parental Role Conflict Related to Protecting the Child 2. Hopelessness Related to the Child's Deteriorating Condition 3. Anxiety Related to the Critical-Care-Unit Environment 4. Family Coping: Compromised, Related to the Child's Critical Injury
Answer: 4
The school nurse is conducting pediculosis capitis (head lice) checks. Which findings would indicate a "positive" head check? 1. White, flaky particles throughout the entire scalp region 2. Maculopapular lesions behind the ears 3. Lesions in the scalp that extend to the hairline or neck 4. White sacs attached to the hair shafts in the occipital area
Answer: 4
Which symptoms are characteristic of a preschool-age client who is diagnosed with a urinary tract infection? 1. Foul-smelling urine, elevated blood pressure, and hematuria 2. Severe flank pain, nausea, headache 3. Headache, hematuria, vertigo 4. Urgency, dysuria, fever
Answer: 4
A child recently had a kidney transplant and is prescribed cyclosporine. The parents ask the nurse about the reason for the cyclosporine. Which reason will the nurse include in the response for why this medication is prescribed? 1. To boost immunity 2. To suppress rejection 3. To decrease pain 4. To improve circulation
Answer: 2
A family actively participates in school functions. One of the children is paraplegic and requires a wheelchair for mobility. Which process does the nurse determine the family is working on based on these assessment findings? 1. Stagnation 2. Normalization 3. Isolation 4. Interaction
Answer: 2
The nurse is providing care for a pediatric client who has a third degree circumferential burn of the right arm. Which nursing diagnosis is the priority for this client? 1. Risk for Infection 2. Risk for Altered Tissue Perfusion 3. Risk for Altered Nutrition: Less than Body Requirements 4. Impaired Physical Mobility
Answer: 2
The nurse is providing care to a toddler-age child. Which assessment finding is indicative of abuse? 1. Parents indicating that they did not see the event occur 2. Inconsistency of stories between caregivers 3. Bruising noted on the knees and shins 4. Acting out behavior of the child
Answer: 2
The nurse is providing nutritional guidance to the parents of a toddler. Which comment by the parent would prompt the nurse to provide additional education? 1. "I should not give my child raw oysters." 2. "It is safe to leave my meat red in the center as long as there are no juices running." 3. "We always wash our hands well before any food preparation." 4. "We use separate utensils for preparing raw meat and preparing fruits, vegetables, and other foods."
Answer: 2
The nurse is teaching the parents of a group of cardiac patients. Which teaching guideline will the nurse include for any child who has undergone cardiac surgery? 1. The child should be restricted from most play activities. 2. The child should be evaluated to determine if prophylactic antibiotics for dental, oral, or upper-respiratory-tract procedures are necessary. 3. The child should not receive routine immunizations. 4. The child can be expected to have a fever for several weeks following the surgery.
Answer: 2
The nurse teaches parents that the anticholinergic drug oxybutynin is used to treat enuresis. The parents ask the nurse why the medication is being prescribed. Which response by the nurse is the most appropriate? 1. "It's an antidepressant that is used to help the child relax." 2. "It will help decrease the spasms sometimes associated with enuresis." 3. "It has an antidiuretic effect, so your child can attend sleepovers." 4. "It will slow the production of urine, so your child does not have to urinate as frequently."
Answer: 2
The pediatric nurse is working with a parent who is suspected of Münchausen Syndrome by Proxy. Which action by the nurse is the priority? 1. Confront the parent with concerns of possible abuse. 2. Carefully document parent-child interactions. 3. Try to keep the parent separated from the child as much as possible. 4. Explain to the child that the parent is causing the illness and that the health team will prevent the child from being harmed.
Answer: 2
Which intervention is considered supportive care for a family whose infant has died from sudden infant death syndrome (SIDS)? 1. Interviewing parents to determine the cause of the SIDS incident 2. Allowing parents to hold, touch, and rock the infant 3. Sheltering parents from the grief by not giving them any personal items of the infant, such as footprints 4. Advising parents that an autopsy is not necessary
Answer: 2
While teaching a health promotion class to a group of parents of children in a Head Start class, which information should the nurse include to help decrease the risk of dental caries? 1. Delay introducing cow's milk until at least 1 year of age. 2. Offer drinking cups only at meal and snack times. 3. Encourage use of homemade baby food without preservatives. 4. Offer juices diluted 50 percent with water.
Answer: 2
While working at a weekend "free clinic," the nurse is assessing a toddler when the mother of the child confides that it has been very difficult providing for her family of four children on her limited budget. She is not sure that she has enough money to buy food for the rest of the month and the antibiotic that is needed for the child's ear infection. Which intervention would be the most beneficial for this family? 1. Giving the mother enough free samples of the antibiotic for the recommended course of treatment 2. Putting the mother in contact with a local agency that provides food on a regular basis to needy families and helps them access other resources in the community 3. Talking with the mother about the factors that increase a child's risk of acquiring an ear infection 4. Talking with the mother about the importance of a balanced diet in the growth and development of children and providing her with a list of inexpensive, nutritious foods
Answer: 2
In counseling an adolescent female about safe sex practices, which question is the most appropriate for the nurse to ask? 1. "Do you and your boyfriend use a condom every time you have sex?" 2. "Do you have a boyfriend, and if so, are you sexually active?" 3. "Do you have one or more sexual partners?" 4. "Have you and your boyfriend ever had unprotected sex?"
Answer: 3
A mother brings her 4-month-old infant in for a routine checkup and vaccinations. The mother reports that the infant was exposed to a brother who has the flu. Which action by the nurse is most appropriate based on these assessment findings? 1. Withhold the vaccinations. 2. Give the vaccinations as scheduled. 3. Withhold the DTaP vaccination but give the others as scheduled. 4. Give the infant the flu vaccination but withhold the others.
Answer: 2
A newborn is diagnosed with Hirschsprung disease. Which clinical manifestations found on assessment support this newborn's diagnosis? 1. Acute diarrhea; dehydration 2. Failure to pass meconium; abdominal distension 3. Currant jelly; gelatinous stools; pain 4. Projectile vomiting; altered electrolytes
Answer: 2
A nurse is caring for a toddler client who is diagnosed with scabies and prescribed a 5 percent permethrin lotion. How will the nurse apply this lotion when administering it to the toddler? 1. To the scalp only 2. Over the entire body from the chin down, as well as on the scalp and forehead 3. Only on the areas with evidence of scabies activity 4. Only on the hands
Answer: 2
A nurse is preparing to admit a child with possible obstructive uropathy. Which laboratory test should the nurse expect to draw on this child? 1. Platelet count 2. Blood urea nitrogen (BUN) and creatinine 3. Partial thromboplastin time (PTT) 4. Blood culture
Answer: 2
A nurse is talking to the mother of an exclusively breastfed African American 3-month-old infant who was born in late fall. Which supplement will the nurse recommend for this infant? 1. Iron 2. Vitamin D 3. Fluoride 4. Calcium
Answer: 2
The nurse is caring for a pediatric client who sustained a severe burn. Determine the order of what would be done for this child when the medical team arrives on the scene: Response 1. Start intravenous fluids. Response 2. Provide for relief of pain. Response 3. Establish an airway. Response 4. Place a Foley catheter.
Answer: 3, 1, 2, 4 Establish an airway. Start intravenous fluids. Provide for relief of pain. Place a Foley catheter.
A parent brings her school-age child to the clinic because the child has a temperature of 100.2°F. The child remains active without other symptoms. Which statement by the nurse to the parents is most appropriate? 1. "Take the child's temperature every 2 hours and call the clinic if it reaches 102°F or above." 2. "Unless the fever bothers the child, it is best to let the natural body defenses respond to the infection." 3. "Keep the child warm, because shivering often occurs with fever." 4. "Alternate acetaminophen and ibuprofen to help keep the fever down and keep the child comfortable."
Answer: 2
A pediatric client sustains a minor burn. When teaching the family the treatment for this burn, the nurse would teach that the client's diet should be high in which substance? 1. Fats 2. Protein 3. Minerals 4. Carbohydrates
Answer: 2
A preschool-age client is diagnosed with acute glomerulonephritis and is admitted to the hospital. Which nursing diagnosis is most appropriate for this client? 1. Risk for Injury Related to Loss of Blood in Urine 2. Fluid-Volume Excess Related to Decreased Plasma Filtration 3. Risk for Infection Related to Hypertension 4. Altered Growth and Development Related to a Chronic Disease
Answer: 2
A recently divorced mother who must return to work is concerned about the effects of placing her child in day care full time. In counseling the mother, which factor does the nurse share as the most influential in determining whether or not day care has a positive or negative effect on the child? 1. The ratio of day-care workers to children 2. The closeness of the parent-child relationship 3. The amount of time that the children spend playing outside 4. The cleanliness of the facility
Answer: 2
An adolescent client has a stiff neck, a headache, a fever of 103 degrees Fahrenheit, and purpuric lesions noted on the legs. Although the adolescent's physical needs take priority at the present time, the nurse can expect which to be the most significant psychological stressor for this adolescent? 1. Separation from parents and home 2. Separation from friends and permanent changes in appearance 3. Fear of painful procedures and bodily mutilation 4. Fear of getting behind in schoolwork
Answer: 2
An infant returns from surgery for correction of bilateral congenital clubfeet. The infant has bilateral long-leg casts. The toes on both feet are edematous, but there is color, sensitivity, and movement to them. Which action by the nurse is the most appropriate? 1. Call the healthcare provider to report the edema. 2. Elevate the legs on pillows. 3. Apply a warm, moist pack to the feet. 4. Encourage movement of toes.
Answer: 2
Celiac disease presents many challenges for a family. What should the nurse emphasize when educating the parents of a newly diagnosed child? 1. Ice cream is a safe dessert on a gluten-free diet. 2. The child's weight and height should reach normal levels in about 1 year. 3. Processed foods are usually gluten-free. 4. Insurance pays only a small amount of the cost of celiac diets.
Answer: 2
The adolescent is seen in the clinic for a consultation to treat severe acne. The adolescent has tried other medications, but the acne has not been responsive. The nurse knows that what medication is the most effective for this client with severe acne? 1. Oral contraceptives 2. Isotretinoin 3. Antibiotics 4. Benzoyl peroxide
Answer: 2
The nurse explains to the parents of a child with a severe burn that wearing of an elastic pressure garment (Jobst stocking) during the rehabilitative stage can help with the prevention of which complication? 1. Poor circulation 2. Hypertrophic scarring 3. Pain 4. Formation of thrombus in the burn area
Answer: 2
The nurse has set up a group discussion for several families with chronically ill children. The nurse informs these parents that they may face which ethical issue? 1. Normalization 2. Withholding and refusal of treatment 3. Repeated hospital admissions 4. Lack of proper dietary needs
Answer: 2
The nurse is caring for a pediatric client in Bryant skin traction. Which nursing intervention is most appropriate for this client? 1. Remove the adhesive traction straps daily to prevent skin breakdown. 2. Check the traction frequently to ensure that proper alignment is maintained. 3. Place the child in a prone position to maintain good alignment. 4. Move the child as infrequently as possible to maintain traction.
Answer: 2
The nurse is conducting a nutritional assessment for a toddler client who is diagnosed with failure to thrive (FTT). Which parameters will the nurse include in the assessment process for this toddler and family? Select all that apply. 1. Height 2. Weight 3. Hemoglobin and hematocrit 4. Twenty-four-hour food diary 5. Maternal dietary intake during pregnancy
Answer: 1, 2, 3, 4
A young school-age child is in the pediatric intensive-care unit (PICU) with a fractured femur and head trauma. The child was not wearing a helmet while riding his new bicycle on the highway and collided with a car. Which nursing diagnoses may be appropriate for this family? Select all that apply. 1. Guilt Related to Lack of Child Supervision and Safety Precautions 2. Family Coping: Compromised, Related to the Critical Injury of the Child 3. Parental Role Conflict Related to Child's Injuries and PICU Policies 4. Knowledge Deficit Related to Home Care of Fractured Femur 5. Anger Related to Feelings of Helplessness
Answer: 1, 2, 3, 5
The nurse is assessing an adolescent and notes signs and symptoms of anorexia nervosa. Which signs and symptoms led the nurse to believe the adolescent has this condition? Select all that apply. 1. Extreme weight loss 2. Depression 3. Irregular menses 4. Sedentary lifestyle 5. Bradycardia
Answer: 1, 2, 3, 5
The nurse is planning care for a preschool-age client who has cerebral palsy (CP). Which interventions are appropriate for this client? Select all that apply. 1. Providing heath supervision 2. Collaborating with physical therapy 3. Assisting with planning educational services 4. Prescribing medication for spasticity 5. Promoting growth and development
Answer: 1, 2, 3, 5
The nurse is examining a 12-month-old who is brought to the clinic for persistent diaper rash. The nurse finds perianal inflammation with bright red scaly plaques and small papules. Satellite lesions are also present. What is the most likely cause of this client's diaper rash? 1. Impetigo (staph) 2. Candida albicans (yeast) 3. Urine and feces 4. Infrequent diapering
Answer: 2
It is important that parents of adolescents with special needs transition care of the adolescent so they can learn to make good decisions on their own. Which items are considered transitional needs? Select all that apply. 1. Attending school 2. Discussing sexual matters 3. Letting most friends know of the medical condition 4. Socialization beyond the family 5. To write his or her own individualized healthcare plan
Answer: 1, 2, 4
The nurse in the long-term care clinic is reviewing the charts of a group of children with chronic physical, psychological, functional, and social limitations. Which conditions are most likely to lead to chronic limitations? Select all that apply. 1. Near drowning 2. Congenital heart defect 3. Sinusitis 4. Fetal insult when the mother contracted rubella in the first trimester of pregnancy 5. Sepsis contracted as a neonate
Answer: 1, 2, 4, 5
The emergency-room nurse receives a preschool-age child who was hit by a car. Which nursing interventions are a priority for this child? Select all that apply. 1. Performing a rapid head-to-toe assessment 2. Recording the parents' insurance information 3. Assessing airway, breathing, and circulation 4. Asking the parents about organ donation 5. Asking the parents if anyone witnessed the accident
Answer: 1, 3
The family has just been informed by the healthcare provider that their newborn is diagnosed with a congenital heart defect, Tetralogy of Fallot (TOF). The family tells the nurse that the healthcare provider told them that TOF is comprised of several defects, and they ask the nurse what the defects are. What will the nurse tell the family? Select all that apply. 1. Pulmonary stenosis 2. Coarctation of the aorta 3. Right ventricular hypertrophy 4. Ventral septal defect 5. Overriding aorta
Answer: 1, 3, 4, 5
The nurse is caring for a school-age client who had an appendectomy after a ruptured appendix. Which orders does the nurse anticipate for this client? Select all that apply. 1. Antibiotics 2. A clear liquid diet 3. NG tube 4. Vital signs every 4 hours 5. Frequent monitoring of bowel sounds
Answer: 1, 3, 4, 5
The nurse educator is teaching a group of nursing students the pathophysiologic reasons related to genitourinary (GU) disorders in the pediatric population. Which statements are appropriate for the nurse educator to include in the teaching session? Select all that apply. 1. "Incomplete organ development during fetal development is the cause of many GU disorders." 2. "Improper placement of the urethra in vagina is one cause of GU disorders." 3. "GU disorders in the pediatric population can be caused by hydronephrosis." 4. "GU disorders in the pediatric population are not caused by infections." 5. "Anatomic obstruction or incomplete nerve innervation can cause GU disorders."
Answer: 1, 3, 5
The nurse is providing care to a school-age client admitted to the emergency department following a motor vehicle crash. The client is exhibiting symptoms of hypovolemic shock. Which nursing interventions are appropriate for this client? Select all that apply. 1. Monitor hemoglobin and hematocrit. 2. Monitor liver enzymes. 3. Administer oxygen, as needed. 4. Administer a dextrose solution. 5. Monitor blood glucose.
Answer: 1, 3, 5
The nurse is teaching a group of adolescents about care for acne vulgaris. Which interventions will the nurse include in the teaching session? Select all that apply. 1. Wash skin with mild soap and water twice a day. 2. Use astringents and vigorous scrubbing. 3. Avoid picking or squeezing the lesions. 4. Apply tretinoin (Retin-A) liberally. 5. Avoid sun exposure if on tetracycline.
Answer: 1, 3, 5
The parents of a toddler are concerned about their child's finicky eating habits. While counseling the parents, which statements by the nurse are the most appropriate? Select all that apply. 1. "The child is experiencing physiologic anorexia, which is normal for this age group." 2. "A general guideline for food quantity at a meal is one-quarter cup of each food per year of age." 3. "It is more appropriate to assess a toddler's nutritional demands over a 1-week period rather than a 24-hour one." 4. "Nutritious foods should be made available at all times of the day so that she is able to 'graze' whenever she is hungry." 5. "The toddler should drink 16 to 24 ounces of milk daily."
Answer: 1, 3, 5
A child is on a ventilator in the pediatric intensive care unit (PICU). Which nursing intervention would best meet the psychosocial needs of this child? 1. Allow the parents to remain at the bedside. 2. Touch and talk to the child often. 3. Provide the child with a blanket from home. 4. Provide consistent caregivers.
Answer: 2
A child is admitted with a diagnosis of early localized Lyme disease. Which clinical manifestations would the nurse expect to find on the initial assessment of this client? Select all that apply. 1. Erythema 5 to 15 cm in diameter 2. Hyperactivity 3. Cranial nerve palsies 4. Fever 5. Headache
Answer: 1, 4, 5
A child recently had a heart transplant and the nurse teaches the parents the importance of administering cyclosporine A. Which statement by the parents indicates an appropriate understanding of the teaching session? 1. "Cyclosporin A reduces serum-cholesterol level." 2. "Cyclosporin A prevents rejection." 3. "Cyclosporin A treats hypertension." 4. "Cyclosporin A treats infections."
Answer: 2
The family and school-age child are at the healthcare clinic for immunizations. The nurse takes the time to talk with the child and family about reducing the transmission of infection. What practices should the nurse suggest for the family? Select all that apply. 1. Do not share dishes, utensils, and cups. 2. Sanitize toys every week with Lysol. 3. Use alcohol-based hand sanitizer with the child after eating and toileting. 4. Cough or sneeze into cloth tissue 5. Dispose of diapers in a closed container.
Answer: 1, 5
A school-aged child is admitted with pneumococcal meningitis. The child weighs 44 pounds. The physician orders: ceftriaxone (Rocephin) 50 mg/kg/dose IV every 12 hours three times and then every 24 hours. Calculate how many mg/dose of ceftriaxone the child will receive and then calculate mL/hr to infuse via pump. Supply on hand is: a premix of ceftriaxone 1 g/50 mL, administer over 30 minutes.
Answer: 1000 mg/dose; 100 mL/hr
A child diagnosed with acute glomerulonephritis is in the playroom and experiences blurred vision and headache. Which action by the nurse is the most appropriate? 1. Check the urine to see if hematuria has increased. 2. Obtain a blood pressure on the child; notify the healthcare provider. 3. Reassure the child, and encourage bed rest until the headache improves. 4. Obtain serum electrolytes, and send a urinalysis to the lab.
Answer: 2
A child is admitted to the hospital unit with physical injuries. The nurse is taking the child's history. Which statement by the parent would arouse suspicion of abuse? 1. "I did not realize that my baby was able to roll over yet, and I was just gone a minute to check on dinner when the baby rolled off of the couch and onto our tile floor." 2. "The baby's 18-month-old brother was trying to pull the baby out of the crib and dropped the baby on the floor." 3. "I placed the baby in the infant swing. His 6-year-old brother was running through the house and tripped over the swing, causing it to fall." 4. "I was walking up the steps and slipped on the ice, falling while carrying my baby."
Answer: 2
A child is admitted to the neonatal intensive care unit (NICU). The parents are concerned because they cannot stay for long hours to visit. Which statement made by the nurse is most appropriate? 1. "One of you might take a leave of absence to be here more." 2. "Parents often feel this way; would you be interested in talking with others who have experienced having a child in the NICU?" 3. "Perhaps the grandparents can make the visits for you." 4. "Why can't you visit after work every day?"
Answer: 2
The nurse is providing care to an adolescent child who is at risk for developing adult-onset cardiovascular disease. Which teaching points will decrease the adolescent's risk? Select all that apply. 1. Encourage a decrease in smoking. 2. Limit fat intake to 20 to 35 percent of intake. 3. Encourage participation in vigorous exercise for at least 30 minutes. 4. Maintain a normal weight. 5. Include high-fat dairy products in the daily diet.
Answer: 2, 3, 4
At the conclusion of teaching parents about cerebral palsy, the nurse asks, "What is your hope for your toddler with cerebral palsy?" Which reply from a parent best indicates an understanding of a realistic achievement for the child? 1. "I hope my child qualifies for the Winter Olympics like I did." 2. "I hope my child just enjoys life." 3. "I hope my child will attend our neighborhood school." 4. "I hope my child is liked and accepted by other children."
Answer: 3
In working with parents of children with chronic diseases, the nurse is concerned with helping the parents to protect themselves from compassion fatigue. Which activities are appropriate for the nurse to encourage? Select all that apply. 1. Sleeping more than 9 hours per 24-hour period 2. Exercising 3. Fostering social relationships 4. Developing a hobby 5. Moving away
Answer: 2, 3, 4
A nurse working in a pediatric clinic is responsible for monitoring and maintaining the vaccinations on site. Which actions are appropriate for this nurse to implement? Select all that apply. 1. Fluctuate refrigerator and freezer temperatures each day. 2. Store vaccines in the center of the unit. 3. Check and record the temperature of the unit twice each day. 4. Have a plan for power outages. 5. Place bottles of water in each unit to help keep temperatures consistent.
Answer: 2, 3, 4, 5
The child and family come to the clinic requesting information about causes of cardiac defects. The father has high incidence of cardiac defects in his family, and the child is frequently cyanotic around the lips. What causes should the nurse tell the family about? Select all that apply. 1. Decreased maternal age 2. Chromosomal abnormalities 3. Fetal exposure to maternal drugs 4. Maternal viral infections 5. Maternal metabolic disorders
Answer: 2, 3, 4, 5
The nurse is preparing to discharge an infant with a congenital heart defect. The infant will be cared for at home by the parents until surgery. Which items will the nurse include in the discharge teaching for this infant and family? Select all that apply. 1. Allow the infant to feed for 60 minutes. 2. Hold the infant at a 45-degree angle. 3. Encourage frequent hand hygiene. 4. Notify the health care provider for fever. 5. Pump the breasts and feed with a bottle if weight gain is an issue.
Answer: 2, 3, 4, 5
The nurse is teaching a prenatal class about infant care. Under which circumstances should the nurse emphasize that parents should call their healthcare provider immediately? Select all that apply. 1. Child 4 months old, received a DTaP immunization yesterday, and has a temperature of 38.0°C (100.4°F) 2. Child under 3 months old and has a temperature over 40.1°C (104.2°F) 3. Child difficult to awaken and has a pulsing fontanel 4. Child has purple spots on the skin and is lethargic. 5. Child has a stiff neck and has been irritable for three days.
Answer: 2, 3, 4, 5
A nurse is assessing a child after an open reduction of a fractured femur. Which assessment findings would indicate that the child is experiencing compartment syndrome? Select all that apply. 1. Pink, warm extremity 2. Pain not relieved by pain medication 3. Dorsalis pedis pulse present 4. Prolonged capillary-refill time with paresthesia 5. Skin appears tense.
Answer: 2, 4, 5
What are some common health problems associated with the poor and/or homeless child? Select all that apply. 1. Asthma 2. Sexually transmitted infections 3. Good dentition 4. Mental illness 5. Tuberculosis
Answer: 2, 4, 5
Which nursing interventions would be best for the nursing diagnosis of Powerlessness Related to Relinquishing Control to the Healthcare Team? Select all that apply. 1. Provide a primary nursing care model. 2. Prepare the child in advance for procedures. 3. Provide optimal pain relief. 4. Explain procedures in developmentally appropriate terms. 5. Incorporate home rituals when possible.
Answer: 2, 4, 5
Concerned parents call the school nurse because of changes in their 15-year-old adolescent's behavior. Which behavior would the nurse indicate as indicative of adolescent substance abuse? 1. Buying baggy, oversized clothing at thrift shops and dying her hair black 2. Becoming very involved with friends and in activities related to the basketball team that she is on; never seeming to be home; and, when she is home, preferring to be in her room with the door shut 3. Receiving numerous detentions lately from teachers for sleeping in class 4. Becoming very moody, dramatically crying and weeping one minute and then being cheerful and excited the next
Answer: 3
During a well-child physical, an adolescent female has a normal history and physical except for an excessive amount of tooth enamel erosion, a greater-than-normal number of filled cavities, and calluses on the back of her hand. Her body mass index is in the 50th to 75th percentile for her age. Which disorder is the nurse concerned about based on the assessment findings? 1. Anorexia nervosa 2. Kwashiorkor 3. Bulimia nervosa 4. Marasmus.
Answer: 3
During the recovery-management phase of burn treatment, which is the most common complication seen in children? 1. Shock 2. Metabolic acidosis 3. Burn-wound infection 4. Asphyxia
Answer: 3
A child has been admitted to the hospital unit in congestive heart failure (CHF). Which symptom would the nurse anticipate upon assessment of the child? 1. Weight loss 2. Bradycardia 3. Tachycardia 4. Increased blood pressure
Answer: 3
A child is admitted to the hospital unit with a diagnosis of minimal change nephrotic syndrome (MCNS). Which clinical manifestations does the nurse anticipate when conducting the admission assessment? 1. Hematuria, bacteriuria, weight gain 2. Gross hematuria, albuminuria, fever 3. Massive proteinuria, hypoalbuminemia, edema 4. Hypertension, weight loss, proteinuria
Answer: 3
A child with severe gastroenteritis is admitted to a semiprivate room on the pediatric unit. The charge nurse should place this client with which roommate? 1. An infant with meningitis 2. A child with fever and neutropenia 3. Another child with gastroenteritis 4. A child recovering from an appendectomy
Answer: 3
A high school student calls to ask the nurse for advice on how to care for a new navel piercing. Which response by the nurse is the most appropriate? 1. "Apply warm soaks to the area for the first two days to minimize swelling." 2. "Do not move or turn the jewelry for the first 3 days." 3. "Avoid contact with another person's bodily fluids until the area is well healed." 4. "Apply lotion to the area, rubbing gently, to prevent skin from becoming dry and irritated."
Answer: 3
A nurse is providing information to a group of new mothers. Which statement best explains why newborns and young infants are more susceptible to infection? 1. "They have high levels of maternal antibodies to diseases to which the mother has been exposed." 2. "They have passive transplacental immunity from maternal immunoglobulin G." 3. "They have immune systems that are not fully mature at birth." 4. "They have been exposed to microorganisms during the birth process."
Answer: 3
A nurse notes blue sclera during a newborn assessment. Which item will the newborn require further assessment for based on this finding? 1. Marfan syndrome 2. Achondroplasia 3. Osteogenesis imperfecta 4. Muscular dystrophy
Answer: 3
A school-age child with congenital heart block codes in the emergency department (ED). The parents witness this and stare at the resuscitation scene unfolding before them. Which nursing intervention is most appropriate in this situation? 1. Ask the parents to leave until the child has stabilized. 2. Ask the parents to call the family to come into watch the resuscitation. 3. Ask the parents to sit near the child's face and hold her hand. 4. Ask the parents to stand at the foot of the cart to watch.
Answer: 3
A school-age client, recently diagnosed with asthma, also has a peanut allergy. The nurse instructs the family to not only avoid peanuts but also to carefully check food label ingredients for peanut products and to make sure dishes and utensils are adequately washed prior to food preparation. The mother asks why this is specific for her child. Based on the client's history, the nurse knows that this client is at an increased risk for which complication? 1. Urticaria 2. Diarrhea 3. Anaphylaxis 4. Headache
Answer: 3
A social service coordinator is consulted to arrange for a phototherapy blanket at discharge for an infant/family with multiple social difficulties. Which social difficulty is more than likely to have the greatest influence on discharge? 1. Cultural practices and rituals 2. Financial difficulties 3. The family is homeless 4. The family does not have a healthcare provider 5. Religious beliefs
Answer: 3
A toddler client with a fever is prescribed amoxicillin clavulanate 250 mg/5 cc three times daily by mouth × 10 days for otitis media. Which teaching point will guard against antibiotic resistance to the disease process? 1. Administer a loading dose for the first dose. 2. Measure the prescribed dose in a household teaspoon. 3. Give the antibiotic for the full 10 days. 4. Stop the antibiotic if the child is afebrile.
Answer: 3
An infant has a severe case of oral thrush (Candida albicans). Which nursing diagnosis is the priority for this infant? 1. Activity Intolerance Related to Oral Thrush 2. Ineffective Airway Clearance Related to Mucus 3. Ineffective Infant Feeding Pattern Related to Discomfort 4. Ineffective Breathing Pattern Related to Oral Thrush
Answer: 3
The nurse is providing teaching to a community group regarding preventative strategies to reduce the risk of burn injury. Which topics will the nurse include in the teaching session? Select all that apply. 1. Avoid contact with unknown animals and wild animals. 2. Layer children's clothing for warmth. 3. Keep infants and toddlers off the lap when drinking hot beverages or eating soup. 4. Lower the temperature settings for hot water heaters. 5. Wear light-colored clothes and avoid eating sweetened foods and beverages when outside.
Answer: 3, 4
A 2-month-old client has a candidal diaper rash. Which medication does the nurse anticipate will be prescribed for this client? 1. Bacitracin ointment 2. Hydrocortisone ointment 3. Desitin 4. Nystatin given topically and orally
Answer: 4
A child returns from spinal-fusion surgery. Which item is the priority assessment for this child? 1. Increased intracranial pressure 2. Seizure activity 3. Impaired pupillary response during neurological checks 4. Impaired color, sensitivity, and movement to lower extremities
Answer: 4
A child with inflammatory bowel disease is prescribed prednisone daily. At which time is it most appropriate for the family to administer the prednisone? 1. Between meals 2. One hour before meals 3. At bedtime 4. With meals
Answer: 4
A mother of two school-age children tells the nurse that her husband has recently been deployed overseas. The mother is concerned about the children's constant interest in watching TV news coverage of military activities overseas. Which suggestion from the nurse is the most appropriate? 1. "Allow the children to watch as much television as they want. This is how they are coping with their father's absence." 2. "It will just take some time to adjust to their father's absence, then everything will return to normal." 3. "The less that you discuss this, the quicker the children will adjust to their father's absence. Try to keep them busy, and use distractions to keep their mind off of it." 4. "Spend time with your children and take cues from them about how much they want to discuss."
Answer: 4
A mother refuses to have her child be immunized with measles, mumps, and rubella (MMR) vaccine because she believes that letting her infant get these diseases will help him fight off other diseases later in life. Which response by the nurse is most appropriate? 1. Honor her request because she is the parent. 2. Explain that antibodies can fight many diseases. 3. Tell her that not immunizing her infant may protect pregnant women. 4. Explain that if her child contracts measles, mumps, or rubella, there could be very serious and permanent complications from these diseases.
Answer: 4
A parent reports that her school-age child, who has had all recommended immunizations, had a mild fever one week ago and now has bright red cheeks and a lacy red maculopapular rash on the trunk and arms. Which disease process does the nurse suspect based on the parent's description? 1. Chicken pox (varicella) 2. German measles (rubella) 3. Roseola (exanthem subitum) 4. Fifth disease (erythema infectiosum)
Answer: 4
A school bus carrying children in grades K-12 crashed into a ravine. The critically injured children were transported by ambulance and admitted to the pediatric intensive-care unit (PICU). The nurse is concerned about calming the frightened children. Which nursing intervention is most appropriate to achieve the goal of calming the frightened children? 1. Tell the children that the physicians are competent. 2. Assure the children that the nurses are caring. 3. Explain that the PICU equipment is state of the art. 4. Call the children's parents to come into the PICU.
Answer: 4
A school-age client is admitted to the hospital with osteomyelitis. Which statement regarding the treatment of osteomyelitis is most appropriate for the nurse to share with the parents? 1. "Cultures should be done immediately after the first dose of antibiotic infuses." 2. "Antibiotics are ineffective against this virus." 3. "Methicillin is the antibiotic of choice." 4. "Antibiotic therapy should continue for 3 to 6 weeks."
Answer: 4
A school-age client is recovering after abdominal surgery. The nurse is planning care for the return of bowel function. Which intervention should be included in the client's plan of care? 1. Fowler's position 3 times per day for 30 minutes each time 2. Assist the child in choosing a low-fat diet. 3. Commode at bedside 4. Ambulate 3 to 4 times a day.
Answer: 4
A toddler is started on digoxin (Lanoxin) for cardiac failure. Which is the initial symptom the nurse would assess if the child develops digoxin (Lanoxin) toxicity? 1. Lowered blood pressure 2. Tinnitus 3. Ataxia 4. A change in heart rhythm
Answer: 4
An adolescent with cystic fibrosis is intubated with an endotracheal tube. Which nursing diagnosis is most appropriate for this adolescent? 1. Potential for Imbalanced Nutrition, More Than Body Requirements Related to Inactivity 2. Anxiety Related to Leaving Chores Undone at Home 3. Potential for Fear of Future Pain Related to Medical Procedures 4. Powerlessness (Moderate) Related to Inability to Speak to or Communicate with Friends
Answer: 4
A child is prescribed cephalexin for treatment of cellulitis. The child weighs 15 kg. The pediatrician orders: cephalexin 40 mg/kg/day PO, give twice a day. Medication on hand: 250 mg/5 mL Calculate how many mLs the nurse must draw up for each dose.
Answer: 6 mL