Pediatrics Exam 3 (Ch. 43, 44, 53, 46, 47, 48, 45)

27) Which medication should the nurse include in a pamphlet to educate parents about methods to reduce the risk of children developing Reye syndrome? 1. Antibiotics 2. Acetaminophen 3. Ibuprofen 4. Aspirin

4. Aspirin

17) Which is a priority nursing assessment the nurse includes in the plan of care for a pediatric client who has received a cochlear implant? 1. Ringing in the ears 2. Pharyngitis 3. Hearing loss 4. Bacterial meningitis

4. Bacterial meningitis

8) A nurse is planning care for a child with hyperkalemia. Which manifestation associated with the documented hyperkalemia requires immediate intervention by the nurse? 1. Hyperthermia 2. Respiratory distress 3. Seizures 4. Cardiac arrhythmias

4. Cardiac arrhythmias

16) Which is the priority nursing action for a child who presents in the emergency department after a motor vehicle accident with a sucking wound of the chest? 1. Placing the child in a Trendelenburg position 2. Beginning rescue breathing for the child 3. Beginning cardiac resuscitation for the child 4. Covering the child's wound with an air occlusive dressing

4. Covering the child's wound with an air occlusive dressing

5) A nurse is caring for a visually impaired 20-month-old client who has not begun to walk. Which nursing diagnosis would be appropriate for this child? 1. Self-care Deficit 2. Impaired Physical Mobility 3. Impaired Home Maintenance 4. Delayed Development

4. Delayed Development

23) A school-age client is diagnosed with rheumatic fever. Which parental statement indicates the need for further education by the nurse? 1. "I understand rheumatic fever is a strep infection of the heart." 2. "My child will be on bed rest for several weeks." 3. "My child will be treated with aspirin and/or corticosteroids." 4. "Once my child has recovered, she will still need to be monitored for sequelae to the disease."

1. "I understand rheumatic fever is a strep infection of the heart."

9) After a severe allergic reaction, an EpiPen is prescribed for the school-age child. Which instructions should the nurse provide to this child's parents based on the current data? Select all that apply. 1. "It is important that your child always has access to this medication." 2. "Your child is too young to self-administer this medication." 3. "If you are able to administer the medication, there is no need for follow-up care." 4. "It is important to check the expiration date on the medication and replace if expired." 5. "Your child should wear a Medic Alert bracelet at all times."

1. "It is important that your child always has access to this medication." 4. "It is important to check the expiration date on the medication and replace if expired." 5. "Your child should wear a Medic Alert bracelet at all times."

19) Which infection control measures should the nurse include in the discharge instructions for the family of a child who is immunodeficient? Select all that apply. 1. "It is important that your child does not share cups with other members of the family." 2. "You should avoid washing your child's utensils in the dishwasher." 3. "You should allow your child to eat fresh fruit with the skin intact." 4. "It is important that everyone practices hand hygiene before touching your child." 5. "You should use alcohol wipes to cleanse your child's diaper area."

1. "It is important that your child does not share cups with other members of the family." 4. "It is important that everyone practices hand hygiene before touching your child."

1) A parent of a newborn asks the nurse why young children seem to become ill so often when compared with older children and adults. Which is the best response by the nurse? 1. "Newborns have lower numbers of natural killer cells." 2. "Newborns have high levels of IgA in their systems." 3. "Newborns are lacking lymphoid tissue." 4. "Newborns have an immature thymus gland."

1. "Newborns have lower numbers of natural killer cells."

15) Which statements should the nurse include in the discharge medication teaching for a child diagnosed with asthma who is prescribed cromolyn sodium (a mast cell stabilizer)? Select all that apply. 1. "The medication works to prevent exacerbations." 2. "The medication should be administered at the first symptom of an asthmatic attack." 3. "The medication should be taken on a daily basis." 4. "The medication should not be administered if the child has a cold." 5. "The medication desensitizes the child against specific allergens."

1. "The medication works to prevent exacerbations." 3. "The medication should be taken on a daily basis."

19) Which parental statement indicates correct understanding for the reason a cardiac catheterization is needed for a child who is diagnosed with a congenital heart defect? 1. "This procedure will keep the ductus arteriosus open and oxygenated and unoxygenated blood mixed." 2. "This procedure is used to close the ductus arteriosus to prevent mixing of arterial and venous blood." 3. "This procedure will redirect the blood so that blood bypasses the right ventricle." 4. "This procedure connects the ventricle to the atrium."

1. "This procedure will keep the ductus arteriosus open and oxygenated and unoxygenated blood mixed."

10) The nurse is expecting the admission of a child with severe isotonic dehydration. Which intravenous fluid prescription does the nurse anticipate for this child? 1. 0.9% normal saline (NS) 2. D 5 0.2% (¼) normal saline 3. D 5 W 4. Albumin

1. 0.9% NS

2) Which neonate requires a close nursing assessment for the development of retinopathy of prematurity (ROP)? 1. 28-weeks'-gestation infant who has been on long-term oxygen and weighed 1400 g 2. 32-weeks'-gestation infant of African heritage with a congenital heart defect who needed no oxygen and weighed 1850 g 3. 28-weeks'-gestation female infant who was on short-term oxygen, weighed 1420 g, and was treated with phototherapy 4. 36-weeks'-gestation, small-for-gestational-age infant who was in an oxyhood for 12 hours and weighed 1800 g

1. 28-weeks'-gestation infant who has been on long-term oxygen and weighed 1400 g

A nurse is providing education to a group of new mothers regarding immunity and infection. Which information regarding the development of immunity should the nurse include in the teaching session? 1. Acquired through immunization or exposure to the natural disease 2. Acquired through exposure to diseases from family members 3. Acquired through diseases from other children 4. Newborns being born with diseases already in their systems

1. Acquired through immunization or exposure to the natural disease

2) Which nursing diagnosis should the nurse include in the plan of care for an infant diagnosed with acute bronchiolitis due to respiratory syncytial virus (RSV)? 1. Activity Intolerance 2. Ineffective Peripheral Tissue Perfusion 3. Acute Pain 4. Decreased Cardiac Output

1. Activity Intolerance

5) An infant with tetralogy of Fallot (TOF) is having a hypercyanotic episode ("tet" spell). Which nursing interventions are appropriate? Select all that apply. 1. Administer oxygen. 2. Place the child in knee-chest position. 3. Administer morphine and propranolol intravenously as ordered. 4. Draw blood for a serum hemoglobin. 5. Administer diphenhydramine (Benadryl) as ordered.

1. Administer oxygen. 2. Place the child in knee-chest position. 3. Administer morphine and propranolol intravenously as ordered.

15) Which treatment options should the nurse anticipate for a 10-month-old infant admitted to the emergency department with supraventricular tachycardia? Select all that apply. 1. Administering intravenous adenosine (Adenocard) 2. Administering intravenous amiodarone (Cardarone) 3. Preparing for cardioversion 4. Applying ice to the face 5. Having the child perform a Valsalva maneuver

1. Administering intravenous adenosine (Adenocard) 2. Administering intravenous amiodarone (Cardarone) 3. Preparing for cardioversion 4. Applying ice to the face

16) The nurse is providing care for the family of a child who is diagnosed with acquired immunodeficiency syndrome (AIDS). Which priority nursing diagnosis should the nurse include in the plan of care? 1. Anticipatory Grieving 2. Risk for Impaired Parenting 3. Compromised Family Coping 4. Parental Role Conflict

1. Anticipatory Grieving

22) Which should the nurse include in the plan of care for a pediatric client who is diagnosed with periorbital ecchymosis? Select all that apply. 1. Apply ice to the site for 5 to 15 minutes every hour for the first 1 to 2 days. 2. Apply warm compresses beginning on day 3. 3. Apply antibiotic ointment to the conjunctiva for 7 to 10 days. 4. Apply a patch to the affected eye for 5 to 7 days. 5. Apply antibiotic drops to the conjunctiva for 7 to 10 days.

1. Apply ice to the site for 5 to 15 minutes every hour for the first 1 to 2 days. 2. Apply warm compresses beginning on day 3

22) The nurse is providing education to a family whose child experiences anaphylaxis when exposed to any amount of latex. Which items, often found in the home or school environment, should the nurse include in the teaching session? Select all that apply. 1. Art supplies 2. Toothpaste 3. Balloons 4. Perfumes 5. Chewing gum

1. Art supplies 3. Balloons 5. Chewing gum

19) Which nursing actions are appropriate when providing care to a pediatric client who has sustained a smoke-inhalation injury? Select all that apply. 1. Assessing for respiratory distress 2. Auscultating the lungs for wheezing 3. Prescribing oxygen for low saturations 4. Administering prescribed prophylactic antibiotic therapy 5. Providing support to the family

1. Assessing for respiratory distress 2. Auscultating the lungs for wheezing 5. Providing support to the family

8) A toddler is prescribed digoxin (Lanoxin) for cardiac failure. Which should the nurse instruct the toddler's parents to monitor for as a manifestation associated with digoxin toxicity? 1. Bradycardia 2. Tinnitus 3. Ataxia 4. Hypotension

1. Bradycardia

20) Which feeding techniques should the nurse include in the teaching session for the parents of an infant who is being discharged in order to gain weight for the corrective surgery needed for a congenital heart defect? Select all that apply. 1. Breastfeed if possible. 2. Complete each feeding within 30 minutes. 3. Position the infant flat to promote swallowing. 4. Dilute the formula with extra water to ensure adequate fluid intake. 5. Burp the infant frequently.

1. Breastfeed if possible. 2. Complete each feeding within 30 minutes. 5. Burp the infant frequently.

The nurse is teaching the mother of a newborn how the immune system functions. Which statement regarding the process that occurs when healthy children are exposed to infection indicates accurate understanding of the information presented? 1. "Children who are exposed to infection naturally develop antibodies." 2. "Children who are exposed to infection are found to be healthier." 3. "Children who are exposed to infection will acquire terminal illnesses." 4. "Children who are exposed to infection will have weakened immune systems."

1. Children who are exposed to infection naturally develop antibodies

22) A child is admitted to the pediatric medical unit with a diagnosis of Kawasaki disease. Which provider prescription should the nurse question? 1. Contact isolation 2. Oral aspirin every 8 hours 3. Echocardiogram 4. Vital signs every 4 hours

1. Contact isolation

31) Which vaccines should the nurse prepare to administer to a 6-month-old infant during a scheduled well-child visit? Select all that apply. 1. DTaP vaccine 2. Hib vaccine 3. HPV4 vaccine 4. MMR vaccine 5. PCV13 vaccine

1. DTaP vaccine 2. Hib vaccine 5. PCV13 vaccine

12) The nurse is teaching the caregiver of a child who is newly diagnosed with type 1 diabetes mellitus how to minimize pain with insulin injections. Which interventions should the nurse include in the teaching session? Select all that apply. 1. Do not reuse needles. 2. Remove all bubbles from the syringe before injecting. 3. Have the child flex the muscle during injection. 4. Inject insulin when it is cold. 5. Do not change the direction of the needle during insertion or withdrawal.

1. Do not reuse needles. 2. Remove all bubbles from the syringe before injecting. 5. Do not change the direction of the needle during insertion or withdrawal.

16) Which assessment data would cause the nurse to suspect that a pediatric client is experiencing hypovolemic shock? Select all that apply. 1. Dyspnea 2. Bradycardia 3. Tachycardia 4. Capillary refill time greater than 3 seconds. 5. Blood pressure 72/42 mmHg

1. Dyspnea 3. Tachycardia 4. Capillary refill time greater than 3 seconds.

11) Which is the priority nursing action when providing care to a pediatric client who has documented allergies to cow's milk, peanuts, and latex? 1. Evaluating the hospital room for equipment containing latex 2. Ordering an EpiPen for the child 3. Notifying dietary of the milk and peanut allergy 4. Placing a sign on the door which identifies all allergies

1. Evaluating the hospital room for equipment containing latex

12) A child is admitted to the hospital for hypercalcemia and is placed on diuretic therapy. Which diuretic would the nurse expect to give? 1. Furosemide (Lasix) 2. Hydrochlorothiazide (Aquazide) 3. Spironolactone (Aldactone) 4. Mannitol (Osmitrol)

1. Furosemide (Lasix)

15) A 2-year-old child with a fever is prescribed amoxicillin clavulanate 250 mg/5 mL 3 times daily by mouth for 10 days for otitis media. Which is the priority teaching instruction for the parents of this child? 1. Giving the antibiotic for the full 10 days 2. Measuring the prescribed dose in a household teaspoon 3. Spreading the dose evenly during daylight hours 4. Stopping the antibiotic when the child is afebrile

1. Giving the antibiotic for the full 10 days

14) Which athletic activity should the nurse recommend for a school-age child who is diagnosed with pulmonary artery hypertension? 1. Golf 2. Basketball 3. Cross-country running 4. Soccer

1. Golf

21) The nurse is assessing a pediatric client who is experiencing metabolic acidosis. Which assessment questions should the nurse include when interviewing the child's parents? Select all that apply. 1. "Has your child consumed any aspirin?" 2. "Has your child consumed any boric acid?" 3. "Has your child consumed any antifreeze?" 4. "Has your child consumed any baking soda?" 5. "Has your child consumed any antacids?"

1. Has your child consumed any aspirin? 2. Has your child consumed any boric acid? 3. Has your child consumed any antifreeze?

8) A child is prescribed oral corticosteroid for a rash caused by graft-versus-host disease. Which should the nurse monitor the child for after administering the drug? 1. Hyperglycemia 2. Hepatic toxicity 3. Seizures 4. Renal toxicity

1. Hyperglycemia

20) Which common eye disorders should the nurse include in a teaching session for the parents of pediatric clients? Select all that apply. 1. Hyperopia 2. Myopia 3. Astigmatism 4. Strabismus 5. Cataracts

1. Hyperopia 2. Myopia 3. Astigmatism

21) Which pediatric client diagnoses would cause the nurse to include information related to short stature? Select all that apply. 1. Hypothyroidism 2. Turner syndrome 3. Chronic renal failure 4. Cushing syndrome 5. Diabetes mellitus

1. Hypothyroidism 2. Turner syndrome 3. Chronic renal failure 4. Cushing syndrome

15) Which changes should the school nurse implement to decrease the risk for the development of type 2 diabetes mellitus for a population who is identified as being at risk? Select all that apply. 1. Increase the amount of daily physical activity. 2. Meet with all parents and explain the risk that is associated with obesity. 3. Test each child's urine monthly. 4. Teach the parents to avoid administering aspirin to their children. 5. Work with the cafeteria to decrease the amount of fat in the foods served.

1. Increase the amount of daily physical activity. 2. Meet with all parents and explain the risk that is associated with obesity. 5. Work with the cafeteria to decrease the amount of fat in the foods served.

24) Which is the priority action by the school nurse for an adolescent who drops to the ground and is unresponsive during a high school basketball game? 1. Initiating cardiopulmonary resuscitation (CPR) 2. Calling 911 3. Offering the parents comfort 4. Assessing for hemorrhage

1. Initiating cardiopulmonary resuscitation (CPR)

21) Which visual screenings should the school nurse conduct when conducting annual assessments for school-age children? Select all that apply. 1. Light reflex assessment 2. Cover-uncover test 3. Acuity testing 4. Visualization of the tympanic membrane 5. Cranial nerve VIII testing

1. Light reflex assessment 2. Cover-uncover test 3. Acuity testing

A nurse is providing information to a group of new mothers. Which rationale, indicating increased susceptibility for infant infection, should the nurse include in the teaching session? 1. Low levels of antibodies 2. High levels of maternal antibodies to diseases to which the mother has been exposed 3. Passive transplacental immunity from maternal immunoglobulin G 4. Exposure to microorganisms during the birth process

1. Low levels of antibodies

28) Which communicable diseases, preventable through childhood immunization, should the nurse include in a presentation to families at a local community center wellness fair? (Select all that apply.) 1. Measles 2. Chickenpox 3. Fifth disease 4. Mononucleosis 5. Whooping cough

1. Measles 2. Chickenpox 5. Whooping cough

18) Which should the nurse assess to determine oxygenation during the respiratory assessment for a pediatric client? Select all that apply. 1. Mucous membranes 2. Nail beds 3. Skin 4. Sclerae 5. Corneas

1. Mucous membranes 2. Nail beds 3. Skin

23) The nurse is providing care to a child who experienced an anaphylactic reaction to an unknown allergen. Which high-risk foods should the nurse question the family about regarding recent consumption? 1. Peanut butter 2. Shrimp 3. Eggs 4. Milk 5. Soda

1. Peanut butter 2. Shrimp 3. Eggs

21) Which interventions should the nurse include in the plan of care for a hospitalized child who is diagnosed with rheumatoid arthritis (RA)? Select all that apply. 1. Performing passive range-of-motion (ROM) exercises with the child 2. Discouraging the child from completing activities of daily living (ADLs) 3. Encouraging periods of rest for the child 4. Placing cool compresses on the child's joints 5. Performing daily weights

1. Performing passive range-of-motion (ROM) exercises with the child 3. Encouraging periods of rest for the child 5. Performing daily weights

13) Which independent nursing action is appropriate for a 2-month-old infant who is a direct admission to the pediatric unit with a diagnosis of ALTE (apparent life-threatening event)? 1. Place the child on an apnea monitor. 2. Place the child on nasal cannula oxygen. 3. Draw blood for arterial blood gases. 4. Place the child on contact isolation.

1. Place the child on an apnea monitor.

14) Which topics should the nurse include in a teaching session to the parents of a 10-month-old infant who experiences frequent ear infections? Select all that apply. 1. Prohibiting tobacco smoke in the home 2. Avoiding use of a pacifier while the child is sleeping 3. Breastfeeding the infant 4. Cleaning the child's ears nightly with peroxide 5. Avoiding use of wood-burning stoves

1. Prohibiting tobacco smoke in the home 2. Avoiding use of a pacifier while the child is sleeping 5. Avoiding use of wood-burning stoves

6) The nurse is caring for a child on bed rest who has severe edema in a left lower extremity due to blocked lymphatic drainage. Which nursing diagnosis would take priority? 1. Risk for Impaired Skin Integrity 2. Risk for Altered Body Image 3. Risk for Imbalanced Nutrition: Less Than Body Requirements 4. Risk for Activity Intolerance

1. Risk for impaired skin integrity

11) Which action related to insulin administration should the nurse include in the teaching plan for an adolescent client who has been newly diagnosed with diabetes mellitus to avoid the development of lipoatrophy? 1. Rotating injection sites 2. Checking blood sugars at mealtime and bedtime 3. Using a sliding scale for additional coverage 4. Administration of insulin via insulin pump

1. Rotating injection sites

23) Which functions of the adrenal androgens should the nurse include in a teaching session for a pediatric client diagnosed with alterations in adrenal function? Select all that apply. 1. Stimulates bone development 2. Increases sodium ion reabsorption 3. Stimulates secondary sexual characteristics 4. Increases potassium excretion by the kidneys 5. Activates the sympathetic nervous system

1. Stimulates bone development 3. Stimulates secondary sexual characteristics

11) Which clinical manifestation does the nurse anticipate for a pediatric client who is admitted with congestive heart failure (CHF)? 1. Tachycardia 2. Weight loss 3. Hypertension 4. Bradycardia

1. Tachycardia

26) Which cardiovascular manifestations should the nurse anticipate for a pediatric client diagnosed with early compensated hypovolemic shock? Select all that apply. 1. Tachycardia 2. Weak distal pulses 3. Thready distal pulses 4. Normal blood pressure 5. Decrease in systolic blood pressure

1. Tachycardia 2. Weak distal pulses 4. Normal blood pressure

10) The pediatric clinic has set a goal that 95% or more of the children attending the clinic will be fully immunized. Which should the clinic nurses teach the families to meet this goal? 1. The benefits of immunizations outweigh the risks of communicable diseases. 2. Immunizations should be completed by the time the child starts school. 3. Once a child receives a vaccination, that individual has lifelong immunity against that disease. 4. Vaccinations are 100% safe.

1. The benefits of immunizations outweigh the risks of communicable diseases.

16) Which assessment finding would cause the nurse to question whether a preschool-age boy, diagnosed with phenylketonuria shortly after birth, is following the prescribed dietary restrictions? 1. The child's body has a musty odor. 2. This child is a blue-eyed blond. 3. The child appears sleepy and uninterested in the surroundings. 4. The child has a sunburn over his entire body.

1. The child's body has a musty odor.

1) Which is the rationale for why young children are more prone to otitis media that the nurse should include in the teaching session with a parent? 1. The eustachian tube is shorter, wider, and horizontal in younger children. 2. The eustachian tube is shorter, more narrow, and horizontal in younger children. 3. The eustachian tube is longer, wider, and vertical in younger children. 4. The eustachian tube is longer, more narrow, and vertical in younger children.

1. The eustachian tube is shorter, wider, and horizontal in younger children.

3) A toddler-age client presents to the emergency department with a sore throat and difficulty swallowing. The nurse suspects acute epiglottitis. Which nursing action is avoided based on the current assessment data? 1. Throat culture 2. Medical history 3. Vital signs 4. Auscultation of breath sounds

1. Throat culture

24) Which diagnostic tests should the nurse include in the plan of care for a pediatric client who is at risk for short stature? Select all that apply. 1. Thyroid function studies 2. Adrenocorticotropic hormone (ACTH) and cortisol levels 3. Complete blood count 4. Blood culture 5. Urine creatinine

1. Thyroid function studies 2. Adrenocorticotropic hormone (ACTH) and cortisol levels 3. Complete blood count 5. Urine creatinine

13) Which assessment finding is considered normal for a school-age client? 1. Tonsils are large and seem to fill the throat. 2. Child is complaining of sore throat and drooling 3. White patches are observed on the tonsils. 4. Throat appears red, and child has a low-grade fever

1. Tonsils are large and seem to fill the throat.

9) Which nursing action is appropriate when providing care to a child with a mild hearing loss who reads lips to enhance adaptation during hospitalization? 1. Touching the child lightly before speaking 2. Using a picture board as the main means of communication 3. Speaking in a loud voice while facing the child 4. Speaking directly to the parents for communication

1. Touching the child lightly before speaking

A child who has not had a tetanus immunization steps on a rusty nail. Which term should the nurse use to identify the tetanus immunization when teaching the parents about the vaccine? 1. Toxoid 2. Live virus 3. Killed virus 4. Recombinant

1. Toxoid

20) The mother of an immunocompromised child expresses concern that her child will "catch" a disease from the scheduled vaccination. Which vaccines should be administered to this child as they carry no risk for acquiring the infection? 1. Toxoid 2. Killed virus vaccine 3. Live virus vaccine 4. Attenuated vaccine 5. Immunoglobulins

1. Toxoid 2. Killed virus vaccine 5. immunoglobulins

28) Which strategies should the nurse recommend for a school-age client who is at risk for developing hypertension as an adult? Select all that apply. 1. Using seasoning substitutes for salt 2. Providing a list of foods high in sodium 3. Decreasing television time 4. Increasing physical activity 5. Monitoring blood pressure daily

1. Using seasoning substitutes for salt 2. Providing a list of foods high in sodium 3. Decreasing television time 4. Increasing physical activity

19) Which pediatric client diagnoses necessitate close monitoring for respiratory acidosis? Select all that apply. 1. Aspiration 2. Epiglottitis 3. Sepsis 4. Meningitis 5. Cystic fibrosis

1. aspiration 2. epiglottis 5. cystic fibrosis

2) The nurse is providing information to an adolescent newly diagnosed with diabetes. Which clinical manifestations of diabetic ketoacidosis (DKA) should the nurse include in the teaching session? Select all that apply. 1. Change in mental status 2. Tachycardia 3. Fruity breath odor 4. Rapid, shallow respirations 5. Abdominal pain

1. change in mental status 3. fruity breath odor 5. abdominal pain

4) A 5-year-old child with a history of hypopituitarism presents with complaints of right hip and leg pain. Which prescribed medication for the diagnosis should the nurse identify as the cause for the current symptoms? 1. Daily growth hormone 2. Insulin before meals and bedtime 3. DDAVP (desmopressin) at bedtime 4. Cortisone injections

1. daily growth hormone

6) A hospitalized child has been diagnosed with SIADH (syndrome of inappropriate antidiuretic hormone), a complication of his meningitis. Which laboratory data should the nurse anticipate for this child? 1. Hyponatremia 2. Hypocalcemia 3. Hyperglycemia 4. Hypernatremia

1. hyponatremia

16) As a result of opioid administration, a child's respirations are slow and shallow. Which should the nurse anticipate when assessing the child's arterial blood gas? 1. Increased PCO 2 and respiratory acidosis 2. Decreased PCO 2 and respiratory alkalosis 3. Low pH and low PCO 2 4. High pH and high PCO 2

1. increased PCO2 and respiratory acidosis

11) A 6-year-old child is hypokalemic. Which menu choice should the nurse encourage for this child? 1. Pizza with a fruit plate 2. Chicken strips with chips 3. Fajita with rice TestBankWorld.org 4. A hamburger with French fries

1. pizza with a fruit plate

19) Which nursing action is most appropriate to decrease the risk of transmitting viral infections by clients and family members at a local clinic? 1. Sanitizing toys, telephones, and doorknobs to kill pathogens 2. Teaching parents safe food preparation and storage 3. Withholding immunizations for children with compromised immune systems 4. Allowing all children to congregate in the same waiting room

1. sanitizing toys, telephones, and doorknobs to kill pathogens

7) A nurse is planning care for a child with hyponatremia. The nurse, delegating care of this child to a licensed vocational nurse (LVN), cautions the LVN to immediately report which clinical manifestation? 1. Seizures 2. Respiratory distress 3. Hyperthermia 4. Bradycardia

1. seizures

5) In the morning, a nurse receives change-of-shift report on four pediatric clients, each of whom has some form of fluid-volume excess. Which of the children should the nurse see first? 1. The child with tachypnea and pulmonary congestion 2. The child with hepatomegaly and normal respiratory rate 3. The child with dependent and sacral edema and regular pulse 4. The child with periorbital edema and normal respiratory rate

1. the child with tachypnea and pulmonary congestion

12) Which should the nurse use when reconstituting vaccines? 1. The diluents provided 2. Normal saline 3. Any solution available 4. Sterile water

1. the diluents provided

25) The nurse administers the flu vaccine to a school-age child. Which should the nurse include in the documentation for the administration of this vaccine? Select all that apply. 1. The date of the last flu vaccine 2. The site of the vaccination 3. The lot and serial number of the vaccine 4. The date and time of administration. 5. Who assisted in restraining the child

2, 3, 4 the lot and serial number of the vaccine the date and time of administration who assisted in restraining the child

6) The nurse receives a phone call from the parent of a child who is prescribed rifampin (Rimactane) for treatment of tuberculosis because she saw that the child's urine was orange. Which response by the nurse is accurate? 1. "Encourage your child to drink cranberry juice." 2. "An orange discoloration of urine is expected while your child is on this medication." 3. "Bring your child to the clinic for a urinalysis." 4. "Bring your child to the clinic for a radiograph of the kidneys."

2. "An orange discoloration of urine is expected while your child is on this medication."

17) The nurse is providing discharge instructions to the family of a child who experienced an anaphylactic reaction. Which parental statements indicate accurate understanding of the action that histamine plays during this type of reaction? Select all that apply. 1. "Histamine releases IgE antibodies, which help to stop the reaction." 2. "Histamine causes smooth muscle contraction, which causes the wheezing." 3. "Histamine causes increased capillary permeability, which is what causes difficulty breathing." 4. "Histamine causes vasoconstriction leading to respiratory issues." 5. "Histamine causes the destruction of red blood cells, which is why we administer the EpiPen."

2. "Histamine causes smooth muscle contraction, which causes the wheezing." 3. "Histamine causes increased capillary permeability, which is what causes difficulty breathing."

8) Which parental statements indicate correct understanding of the care that is needed for a pediatric client after the insertion of tympanostomy tubes? Select all that apply. 1. "It is important to limit my child's diet after surgery and only allow soft, bland foods." 2. "I should restrict my child to quiet activities after surgery." 3. "I should plan to administer a decongestant to my child for 1 to 2 weeks following surgery." 4. "It is important for my child to drink plenty of fluids after the procedure." 5. "I will remind my child to use ear plugs prior to showering and swimming."

2. "I should restrict my child to quiet activities after surgery." 4. "It is important for my child to drink plenty of fluids after the procedure." 5. "I will remind my child to use ear plugs prior to showering and swimming."

6) An infant who is diagnosed with a mild heart defect will not have surgical correction for at least 2 years. Which information should the nurse include in the discharge teaching regarding management in the home environment? 1. "Your child will have a low-grade fever until the defect is repaired." 2. "It is important for your child to maintain normal activity." 3. "Your child is not at risk for congestive heart failure." 4. "It is important to avoid antipyretics for the treatment of fever."

2. "It is important for your child to maintain normal activity."

19) Which parental statements indicate correct understanding of the anatomy and physiology of the infant's mouth, nose, and throat? Select all that apply. 1. "My baby will breathe through her mouth during the first 3 months of life." 2. "When my baby has a cold she may have trouble with bottle feedings." 3. "My baby's tonsils will be largest during infancy." 4. "I should expect my baby's first tooth to erupt during the first 6 months of life." 5. "I should expect my baby to lose her first tooth during the first year of life."

2. "When my baby has a cold she may have trouble with bottle feedings." 4. "I should expect my baby's first tooth to erupt during the first 6 months of life."

14) A child is being treated for dehydration with intravenous fluids. The child currently weighs 13 kg and is estimated to have lost 7% of his normal body weight. The nurse is double-checking the IV rate the healthcare provider prescribed. The formula the healthcare provider used was for maintenance fluids: 1000 mL for 10 kg of body weight plus 50 mL for every kilogram over 10 for 24 hours. Replacement fluid is the percentage of lost body weight × 10 per kg of body weight. According to the calculation for maintenance plus replacement fluid, which hourly IV rate will the nurse implement for 24 hours? 1. 88 mL/hr 2. 86 mL/hr 3. 81 mL/hr 4. 83 mL/hr

2. 86mL/hr

20) Which pediatric clients would require a nursing assessment for blunt chest trauma? Select all that apply. 1. A preschool-age client who is admitted after a house fire. 2. A toddler-age client who is admitted for injuries sustained in a motor vehicle accident. 3. A school-age client who is admitted for observation after a skateboarding accident. 4. An adolescent client admitted for an asthma exacerbation. 5. An infant admitted to rule out cystic fibrosis.

2. A toddler-age client who is admitted for injuries sustained in a motor vehicle accident. 3. A school-age client who is admitted for observation after a skateboarding accident.

23) Which should the nurse include in the plan of care for a pediatric client diagnosed with otitis media with effusion? Select all that apply. 1. Administration of antibiotic drops per order 2. Administration of pain relief measures 3. Assessment of hearing acuity over several months 4. Assessment of speech 5. Assessment of development

2. Administration of pain relief measures 3. Assessment of hearing acuity over several months 4. Assessment of speech 5. Assessment of development

4) Which nursing action is appropriate for the parents of a 4-month-old infant who died due to sudden infant death syndrome (SIDS)? 1. Sheltering parents from the grief by not giving them any personal items of the infant, such as footprints 2. Allowing parents to hold, touch, and rock the infant 3. Advising parents that an autopsy is not necessary 4. Interviewing parents to determine the cause of the incident

2. Allowing parents to hold, touch, and rock the infant.

3) Which is the priority nursing assessment for a pediatric client who is postoperative for tonsillectomy? 1. Arrhythmias 2. Dehydration 3. Increased blood sugar 4. Increased urinary output

2. Dehydration

21) Which nursing assessment data would indicate that a pediatric client sustained a large pulmonary contusion in a motor vehicle crash? Select all that apply. 1. Eupnea 2. Dyspnea 3. Hemoptysis 4. Fever 5. Crackles

2. Dyspnea 3. Hemoptysis 4. Fever 5. Crackles

20) Which interventions should the nurse include in the plan of care to address nutrition for a child who is diagnosed with acquired immunodeficiency syndrome (AIDS)? Select all that apply. 1. Encourage three large meals each day. 2. Eliminate unpleasant odors from the environment during meals. 3. Weigh the child each day, using the same scale. 4. Assess skin turgor every 4 hours. 5. Include favorite foods in the meal plan.

2. Eliminate unpleasant odors from the environment during meals. 3. Weigh the child each day, using the same scale.. 5. Include favorite foods in the meal plan.

17) Which is the priority nursing action when providing care to a pediatric client who is diagnosed with hypovolemic shock? 1. Assessing the cause of bleeding 2. Establishing an open airway and administering oxygen 3. Administering analgesics for pain control 4. Providing replacement of volume

2. Establishing an open airway and administering oxygen

7) In which position should the nurse place a child who is experiencing an anaphylactic shock reaction? 1. Trendelenburg position 2. Flat, with legs slightly elevated 3. High Fowler position 4. Reverse Trendelenburg position

2. Flat, with legs slightly elevated

2) A premature neonate is at greater risk for infection than a full-term newborn because of a reduced number of which immunoglobulin? 1. IgE 2. IgG 3. IgA 4. IgM

2. IgG

15) Which is the reason for a healthcare provider to recommend that a preschool-age male client with a documented hearing loss should attend preschool at least 2 days per week? 1. Help the child recognize his hearing deficit. 2. Increase the child's socialization skills. 3. Improve the child's immunity by increased exposure to organisms. 4. Teach other children that children are different.

2. Increase the child's socialization skills.

22) Which functions of the adrenal hormone aldosterone should the nurse include in a teaching session for a pediatric client diagnosed with alterations in adrenal function? Select all that apply. 1. Stimulates bone development 2. Increases sodium ion reabsorption 3. Stimulates secondary sexual characteristics 4. Increases potassium excretion by the kidneys 5. Activates the sympathetic nervous system

2. Increases sodium ion reabsorption 4. Increases potassium excretion by the kidneys

The nurse is teaching a preschool-age child and parents the importance of hand washing after using the toilet. Which rationale for this practice should the nurse include in the teaching session? 1. Children's immune systems are not fully developed. 2. It is the main way to limit the transmission of disease. 3. Not all bathrooms are clean. 4. Children do not like to have dirty hands.

2. It is the main way to limit transmission of disease

1) Which assessment finding indicates adequate peripheral perfusion for a child after a cardiac catheterization? 1. Capillary refill is greater than 3 seconds. 2. Lower extremities are warm, with a capillary refill of less than 3 seconds. 3. Sensation is decreased with a weakened dorsalis pedis pulse. 4. Dorsalis pedis pulse is palpable but posterior tibial pulse is weak.

2. Lower extremities are warm, with a capillary refill of less than 3 seconds.

14) The nurse is providing care to a child who is diagnosed with Lyme disease. The mother wants to know how to protect her other children from contracting this disease from the infected child. Which should the nurse include in the teaching session regarding the transmission of this disease process? 1. Lyme disease is passed from person to person. 2. Lyme disease is passed from animals to person. 3. Lyme disease is passed from adults to children. 4. Lyme disease is passed from person to insects.

2. Lyme disease is passed from animal to person

15) A child with human immunodeficiency virus (HIV) is diagnosed with oral candidiasis. Which should the nurse include in the plan of care related to oral care based on this information? 1. Listerine 2. Normal saline 3. Viscous lidocaine 4. Scope

2. Normal saline

6) A nurse is caring for a visually impaired school-age child. Which is the priority nursing intervention during the admission process to the hospital? 1. Explaining playroom policies 2. Orienting the child to where furniture is placed in the room 3. Taking the child on a tour of the unit 4. Letting the child touch equipment that will be used during the child's hospitalization

2. Orienting the child to where furniture is placed in the room

1) The home health nurse is visiting a 3-month-old infant who is diagnosed with congenital hypothyroidism and is prescribed daily levothyroxine. Which should the nurse include in the infant's continued plan of care? 1. Stopping the medication as long as the child continues to grow 2. Preventing hypothermia with appropriate clothing 3. Changing formula because it is contraindicated with prescribed medication 4. Monitoring growth and development without any other prescribed interventions

2. Preventing hypothermia with appropriate clothing

11) Which positions are appropriate for the nurse to include in a plan of care for the infant who is diagnosed with acute respiratory distress? Select all that apply. 1. Upright 2. Semi-Fowler position 3. Prone position 4. With the infant's head hyperextended 5. With the infant's head in a sniffing position

2. Semi-Fowler position 5. With the infant's head in a sniffing position

17) Which data collected during the respiratory assessment would indicate the pediatric client is compromised? Select all that apply. 1. Lung sounds clear to auscultation 2. Stridor 3. Substernal retractions 4. Nasal flaring 5. Strong cry

2. Stridor 3. Substernal retractions 4. Nasal flaring

4) The nurse is assessing an infant brought to the clinic because of diarrhea. The infant is alert but has dry mucous membranes. Which additional assessment data indicates to the nurse that the infant is experiencing an early to moderate stage of dehydration? 1. Bradycardia 2. Tachycardia 3. Increased blood pressure 4. Normal fontanels

2. Tachycardia

20) The nurse is providing care to a newborn female who is born with ambiguous genitalia. The follow-up investigation discovers adrenogenital syndrome (also called congenital adrenal hyperplasia [CAH]). The parents question why the baby's genitalia looks more male than female. Which response by the nurse is accurate? 1. "The disorder caused your baby to be a hermaphrodite with both male and female sex organs." 2. "The changes in the genitalia are due to increased androgens secondary to deficient cortisol." 3. "The excessive cortisol caused the enlargement of the female tissue, creating a male appearance." 4. "Your baby has only one sex chromosome resulting in an XO configuration.

2. The changes in the genitalia are due to increased androgens secondary to deficient cortisol.

1) The mother of a toddler-age client states, "My daughter seems to be at an increased risk for complications associated with respiratory infections." Which response by the nurse is accurate? 1. "You are incorrect in your assessment." 2. "The younger child's airways are smaller and more easily occluded." 3. "Air passages are more likely to become blocked with mucus because younger children make more mucus than older children." 4. "Toddlers do not breathe as deeply as do older children."

2. The younger child's airways are smaller and more easily occluded.

12) Which nursing action is appropriate when providing care to a newborn with a respiratory rate of 102 breaths per minute with lungs that are clear to auscultation? 1. Administering the bath to the neonate in the nursery 2. Transferring to the neonatal intensive care unit for further observation 3. Allowing the neonate to room-in to promote bonding 4. Providing the first feeding in the nursery

2. Transferring to the neonatal intensive care unit for further observation

21) Which nursing actions allow a child to acquire active immunity against a disease? 1. Administering a dose of immunoglobulins 2. Administering a killed virus vaccine 3. Administering a toxoid vaccine 4. Administering antibiotic therapy 5. Administering antiviral therapy

2. administering a killed virus 3. administering a toxoid vaccine

17) The nurse is providing care to a newborn who is suspected of having Turner syndrome. Which should the nurse assess the newborn for based on the current diagnosis? 1. Club foot (talipes equinovarus) 2. Congenital heart anomalies 3. Hyperbilirubinemia due to liver abnormalities 4. Diaphragmatic hernia

2. congenital heart anomalies

Which common mode of infectious disease should the nurse include in a teaching session with parents within the community? 1. Playing with the same toy 2. Coughing without covering the mouth 3. Sitting together eating meals 4. Playing board games

2. coughing without covering the mouth

16) Which is the priority nursing action when it is suspected that an infectious agent has been used as a weapon by terrorists? 1. Separating clients according to age 2. Initiating airborne and contacts precautions 3. Separating clients according to level of development 4. Disposing of blood-contaminated needles in the lead-lined container

2. initiating airborne and contacts precautions

14) Which sequela should the nurse include in the teaching session for a parent who does not believe in medication for the treatment of the newborn's hypothyroidism? 1. Heart disease 2. Mental retardation 3. Renal failure 4. Thyroid storm

2. mental retardation

The nurse is teaching parents how to prevent the spread of infectious disease. Which is the priority health promotion strategy the nurse should recommend for all age groups of children? 1. Decreasing environmental exposure to pathogens 2. Performing hand hygiene 3. Ensuring all toys are clean and free from germs 4. Keeping child away from sick adults

2. performing hand hygiene

17) The hospital has instructed its nurses that they must participate in disease surveillance associated with infectious agents. Which disease(s) are likely to be the weapons of terrorists? 1. Rocky Mountain spotted fever and Lyme disease 2. Plague, anthrax, and smallpox 3. Rubella, mumps, and chickenpox 4. Severe acute respiratory syndrome (SARS)

2. plague, anthrax, and smallpox

15) A 9-month-old infant is hospitalized with vomiting and diarrhea. The mother questions why her child needed hospitalization since her school-age nephew had the same symptoms and was treated at home. Which should the nurse include in the explanation to the infant's mother? Select all that apply. 1. Infants have a lower proportion of their body weight as water. 2. The percentage of extracellular fluid is higher in the infant than the school-age child. 3. School-age children have a larger body surface area. 4. The school-age child's kidneys are more mature and better able to conserve water. 5. The metabolic rate of the school-age child is higher.

2. the percentage of extracellular fluid is higher in the infant than the school age child. 4. the school-age child's kidneys are more mature and better able to conserve water

23) Which age-appropriate techniques should the nurse implement in order to encourage a young child to participate in deep breathing exercises? Select all that apply. 1. Showing the child how to use the "blow bottle" 2. Using a pinwheel that the child plays with and asking the child to blow until it turns 3. Asking the child to blow bubbles in a glass of water using a straw 4. Having the child blow scraps of paper across the bedside table with a straw 5. Telling the child that a "shot" will be needed if the child does not follow the nurse's directions

2. using a pinwheel that the child plays with and asking the child to blow until it turns. 3. asking the child to blow bubbles in a glass of water using a straw. 4. having the child blow scraps of paper across the bedside table with a straw.

18) The nurse is teaching a pregnant client about fetal circulation. Which is the correct sequence of blood flow that indicates the pregnant client understands the information presented? 1. Ductus arteriosus 2. Ductus venosus 3. Foramen ovale

3, 1, 2 (in that order)

20) Which pediatric client diagnoses necessitate close monitoring for respiratory alkalosis? Select all that apply. 1. Aspiration 2. Epiglottitis 3. Sepsis 4. Meningitis 5. Cystic fibrosis

3. sepsis 4. meningitis

9) Which parental statement indicates correct understanding regarding pancreatic enzyme administration in the treatment of cystic fibrosis? 1. "I will administer this medication 4 times each day." 2. "I will administer this medication twice each day." 3. "I will administer this medication with meals and snacks." 4. "I will administer this medication every 6 hours around the clock."

3. "I will administer this medication with meals and snacks."

10) Which parental statement regarding the use of cyclosporin A after a heart transplant indicate correct understanding of the information presented by the nurse? 1. "This medication is used to treat hypertension." 2. "This medication is used to reduce serum cholesterol level." 3. "This medication is used to prevent rejection." 4. "This medication is used to treat infections."

3. "This medication is used to prevent rejection."

11) Which parental statement indicates correct understanding of discharge instructions for a pediatric client after a tonsillectomy? 1. "We will call the healthcare provider for any indication of ear pain." 2. "We will be sure to give our child adequate amounts of citrus juices." 3. "We will plan on administering acetaminophen (Tylenol) for pain." 4. "We will keep our child on bed rest for 10 days after the surgery."

3. "We will plan on administering acetaminophen (Tylenol) for pain."

2) Which initial laboratory data does the nurse anticipate for a child who is admitted to the hospital with a cyanotic heart defect? 1. A low platelet count 2. A high white blood cell count 3. A high hemoglobin 4. A low hematocrit

3. A high hemoglobin

8) The nurse prepares a DTaP (diphtheria, tetanus toxoid, and acellular pertussis) immunization for a 6-month-old infant. Which nursing action is accurate to safely administer this vaccine to the infant? 1. Administering the vaccine by ID (intradermal) injection 2. Administering the vaccine by SQ (subcutaneous) injection 3. Administering the vaccine by IM (intramuscular) injection 4. Administering the vaccine via a nasal spray

3. Administering the vaccine by IM (intramuscular) injection Rationale: DTaP is administered by an IM injection; not by ID injection, SQ injection, or nasal spray.

4) Which heart defect should the nurse suspect for an infant whose upper extremities have stronger pulses than the lower extremities and blood pressure is higher in the arms than in the legs? 1. Transposition of the great vessels 2. Patent ductus arteriosus 3. Coarctation of the aorta 4. Atrial septal defect

3. Coarctation of the aorta

4) An adolescent female client is diagnosed with systemic lupus erythematosus (SLE). Which action by the client indicates acceptance of the body changes that occur because of SLE? 1. Attends school but does not stay for after-school activities 2. Discusses the body changes with healthcare providers only 3. Discusses the body changes with her best friend 4. Only attends small parties at friends' homes

3. Discusses the body changes with her best friend

3) Which parental statement indicates correct understanding of preventive techniques for heat-related illnesses when children exercise? 1. "Wearing dark clothing during exercise is recommended." 2. "Water is the fluid of choice to replenish fluids." 3. "During activity, stop for fluids every 15 to 20 minutes." 4. "Hydration should occur at the end of an exercise session."

3. During activity, stop for fluids every 15 to 20 minutes

32) Which vaccines should the nurse prepare to administer to an 11-year-old child during a scheduled well-child visit? Select all that apply. 1. DTaP vaccine 2. Hib vaccine 3. HPV4 vaccine 4. MMR vaccine 5. MenACWY-D

3. HPV4 vaccine 5. MenACWY-D

1) A 4-year-old child is admitted to the hospital secondary to dehydration. Laboratory tests indicate a high hemoglobin and hematocrit, and the serum sodium is below normal levels. Which condition does the nurse suspect based on the current data? 1. Hypernatremia 2. Metabolic acidosis 3. Hypotonic dehydration 4. Isotonic dehydration

3. Hypotonic dehydration

7) The nurse is giving discharge instructions to the parents of a child whose adrenal glands have been removed due to a tumor. Which parental statement indicates the need for further education? 1. "I will call the doctor if my child has restlessness and confusion." 2. "If my child has any gastric irritation, I will give him antacids." 3. "If my child has vomiting and diarrhea, I will hold his hydrocortisone." 4. "I will give my child his hydrocortisone in the morning."

3. If my child has vomiting and diarrhea, I will hold his hydrocortisone.

12) Which is the rationale for ensuring the irrigation of blood products and ensuring that they are cytomegalovirus (CMV)-negative prior to administering a blood transfusion for a pediatric client diagnosed with severe combined immune deficiency (SCID)? 1. Transfusion reaction from lymphocytes and platelets in the donor blood. 2. Transfusion reaction and infection from lymphocytes in the donor blood. 3. Infection and graft-versus-host disease from lymphocytes in the donor blood. 4. Infection and graft-versus-host disease from erythrocytes in the donor blood.

3. Infection and graft-versus-host disease from lymphocytes in the donor blood.

29) Which live virus vaccines should the nurse teach to parents as being used to decrease the risk of communicable diseases? Select all that apply. 1. Poliovirus 2. Tetanus 3. Measles 4. Varicella 5. Hepatitis B

3. Measles 4. Varicella

8) The nurse is caring for a child just admitted with diabetic ketoacidosis (DKA). Which healthcare provider prescription should the nurse question? 1. Neurologic checks hourly 2. Insert urinary catheter and measure output hourly 3. NPH insulin IV at 0.1 unit/kg per hour 4. Stat serum electrolytes

3. NPH insulin IV at 0.1 unit/kg per hour

25) Which assessment data for a pediatric client supports the diagnosis of familial or idiopathic central diabetes insipidus (DI)? Select all that apply. 1. Polyuria 2. Polydipsia 3. Nocturia 4. Enuresis 5. Constipation

3. Nocturia 4. Enuresis 5. Constipation

7) A 2-month-old infant with a congenital heart defect is admitted to the pediatric intensive care unit with congestive heart failure. Which intervention should the nurse include in the infant's plan of care? 1. Monitor respirations during active periods. 2. Give larger feedings less often to conserve energy. 3. Organize activities to allow for uninterrupted sleep. 4. Force fluids appropriate for age.

3. Organize activities to allow for uninterrupted sleep

4) A neonate is diagnosed with a herpes simplex viral infection of the eye. Which medication should the nurse prepare to administer? 1. Oral erythromycin 2. Fluoroquinolone eyedrops or ointment 3. Parenteral acyclovir (Zovirax) and vidarabine (VIRA-A) ophthalmic ointment 4. Intravenous penicillin

3. Parenteral acyclovir (Zovirax) and vidarabine (VIRA-A) ophthalmic ointment

16) Which screening tool should the nurse use to screen a pediatric client for esotropia? 1. Examine the eye with an otoscope. 2. Check for the "red reflex" in the eyes. 3. Perform the cover-uncover test. 4. Use a tonometer to evaluate the eyes.

3. Perform the cover-uncover test.

18) Which nursing actions are appropriate when providing care to a 12-year-old client who has lost several teeth as a result of a facial injury? Select all that apply. 1. Not worrying about the tooth loss, as children this age still have their "baby" teeth 2. Only handling the lost tooth by the roots and avoiding touching the crown of the tooth 3. Rinsing the lost tooth with sterile saline 4. Placing the tooth back into its socket and taking the child to an emergency dental facility 5. Keeping the tooth clean and dry during transport to an emergency dental facility

3. Rinsing the lost tooth with sterile saline 4. Placing the tooth back into its socket and taking the child to an emergency dental facility

26) There has been an outbreak of communicable diseases in the community. To reduce parental anxiety, the nurse presents information about disease at the school's Parent Teacher Association meeting. Which vector-borne diseases, not communicable from person to person, should the nurse include in the teaching session? Select all that apply. 1. Measles 2. Whooping cough 3. Rocky Mountain spotted fever 4. West Nile virus 5. Lyme disease

3. Rocky Mountain spotted fever 4. West Nile Virus 5. Lyme disease

12) Which is the rationale the nurse provides to the parents of an infant diagnosed with congestive heart failure (CHF) for the prescribed spironolactone? 1. Produces rapid diuresis 2. Blocks reabsorption of sodium and water in renal tubules 3. Spares potassium 4. Promotes vascular relaxation

3. Spares potassium

10) Which should the nurse include in a teaching session for the mother of a 3-year-old client who is concerned about her child choking? 1. Show the mother how to do cardiac compressions and rescue breathing. 2. Recommend the mother perform back blows and chest thrusts. 3. Teach the mother how to perform abdominal thrusts. 4. Tell the mother to do nothing until the child loses consciousness.

3. Teach the mother how to perform abdominal thrusts

27) Which cardiovascular manifestations should the nurse anticipate for a pediatric client diagnosed with moderate uncompensated hypovolemic shock? Select all that apply. 1. Tachycardia 2. Weak distal pulses 3. Thready distal pulses 4. Normal blood pressure 5. Decrease in systolic blood pressure

3. Thready distal pulses 5. Decrease in systolic blood pressure

29) Which clinical manifestations does the nurse anticipate for a pediatric client who is diagnosed with the subacute stage of Kawasaki disease? Select all that apply. 1. High fever 2. Diarrhea 3. Thrombocytosis 4. Joint pain 5. Beau lines

3. Thrombocytosis 4. Joint pain

10) Which is an appropriate nursing intervention for a child who experiences epistaxis? 1. Laying the child down and applying a warm pack. 2. Tilting the child's head back, squeezing the bridge of the nose, and applying a warm moist pack to the nose. 3. Tilting the child's head forward, squeezing the nares below the nasal bone, and applying ice to the nose. 4. Immediately packing the nares with a cotton ball soaked with phenylephrine (Neo- Synephrine).

3. Tilting the child's head forward, squeezing the nares below the nasal bone, and applying ice to the nose

10) An adolescent female client is diagnosed with systemic lupus erythematosus (SLE). Which should the nurse include in the teaching session regarding an activity that should be avoided? 1. Receiving a manicure and a pedicure 2. Washing the hair with shampoo daily 3. Using a tanning bed 4. Attending late night parties and dances

3. Using a tanning bed

3) The nurse is planning care for a child with acquired immune deficiency syndrome (AIDS). Which vaccines should be avoided in the child with AIDS? 1. Inactivated polio vaccine 2. Tetanus toxoid vaccination 3. Varicella vaccine 4. Acellular pertussis vaccine

3. Varicella vaccine

9) An adolescent presents in the emergency department (ED) with confusion. The healthcare provider suspects diabetic ketoacidosis (DKA). A stat serum glucose is done, and the result is 7l5 mg/dL. Which clinical manifestations does the nurse anticipate upon assessment for this client? 1. Tachycardia, dehydration, and abdominal pain 2. Sweating, photophobia, and tremors 3. Dry mucous membranes, blurred vision, and weakness 4. Dry skin, shallow rapid breathing, and dehydration

3. dry mucous membranes, blurred vision, and weakness

A mother brings in her 4-month-old infant for a routine checkup and vaccinations. The mother reports that her child was exposed to the flu. Which nursing action is accurate based on the current data? 1. Withhold the DTaP vaccination but give the others as scheduled. 2. Give the infant the flu vaccination but withhold the others. 3. Give the vaccinations as scheduled. 4. Withhold the vaccinations.

3. give the vaccinations as scheduled.

10) Which teaching point should the nurse include when providing education to an adolescent client, who participates in soccer, regarding the plan of care for diabetes mellitus? 1. Decreased food intake 2. Increased doses of insulin 3. Increased food intake 4. Decreased doses of insulin

3. increased food intake

18) Which parental action indicates accurate understanding of information presented by the nurse to treat a fever related to otitis media? 1. Putting the child in a tub of cold water to reduce the fever 2. Alternating acetaminophen with ibuprofen every 2 hours 3. Offering generous amounts of fluids frequently 4. Using aspirin every 4 hours to reduce the fever

3. offering generous amounts of fluids frequently

5) Which clinical manifestations should the nurse anticipate when providing care to an adolescent client who presents with untreated Graves disease? 1. Hyperglycemia, ketonuria, and glucosuria 2. Weight gain, hirsutism, and muscle weakness 3. Tachycardia, fatigue, and heat intolerance 4. Dehydration, metabolic acidosis, and hypertension

3. tachycardia, fatigue, and heat intolerance

24) Which vaccine reaction, noted by the mother during a telephone conversation with a nurse, would require activation of emergency medical services? 1. A few hives are noted around the injection site. 2. The child is running a slight temperature. 3. The child has swelling of the face. 4. Fever and joint pains occurring within hours of the vaccination.

3. the child has swelling of the face

22) The nurse is preparing to administer a vaccine to a 14-month-old toddler. Which assessment factor would warrant a delay in the scheduled vaccination during the well-child visit? 1. The child is allergic to a substance in the vaccine. 2. The child has a low-grade fever and a runny nose. 3. The child received a dose of immune globulin 2 months ago. 4. The child is on antibiotics.

3. the child received a dose of immune globulin 2 months ago

9) A child with croup has an increased PCO 2 , a decreased pH, and a normal HCO 3 blood gas value. Which does the nurse report to the healthcare provider based on these data? 1. Uncompensated metabolic alkalosis 2. Uncompensated metabolic acidosis 3. Uncompensated respiratory acidosis 4. Uncompensated respiratory alkalosis

3. uncompensated respiratory acidosis

25) Which is an appropriate statement for the nurse to include in the discharge instructions to the parents of a child who is recovering from cardiac surgery? 1. "The child will have a fever for several weeks following the surgery." 2. "The child will be restricted from most play activities." 3. "The child will not receive routine immunizations." 4. "The child will receive prophylactic antibiotics prior to any dental procedures."

4. "The child will receive prophylactic antibiotics prior to any dental procedures."

7) Which parental statement at the conclusion of a teaching session regarding environmental controls for childhood asthma indicates correct understanding of the information presented? 1. "We're glad the dog can continue to sleep in our child's room." 2. "We'll keep the plants in our child's room dusted." 3. "We'll be sure to use the fireplace often to keep the house warm in the winter." 4. "We will replace the carpet in our child's bedroom with tile."

4. "We will replace the carpet in our child's bedroom with tile."

2) A nurse is taking care of four different pediatric clients. Which child is at greatest risk for dehydration? 1. 7-year-old child with migraine headaches 2. 4-year-old child with a broken arm 3. 2-year-old child with cellulitis of the left leg 4. 18-month-old child with tachypnea

4. 18 month old child with tachypnea

30) Which recombinant vaccines should the nurse teach to parents as being used to decrease the risk of communicable diseases? Select all that apply. 1. Poliovirus 2. Tetanus 3. Measles 4. Acellular pertussis 5. Hepatitis B

4. Acellular pertussis 5. Hepatitis B

7) Which should the nurse include in the discharge instructions for the parents of an infant who is diagnosed with acute otitis media? 1. Keep the baby in a flat position during sleep. 2. Administer a decongestant. 3. Place the baby to sleep with a pacifier. 4. Administer acetaminophen (Tylenol) to relieve discomfort.

4. Administer acetaminophen (Tylenol) to relieve discomfort.

13) Which laboratory test does the nurse anticipate for a child who is admitted to the hospital with suspected rheumatic fever? 1. Erythrocyte sedimentation rate 2. Throat culture 3. C-reactive protein 4. Antistreptolysin-O (ASO) titer

4. Antistreptolysin-O (ASO) titer

6) The nurse is caring for a child with rheumatoid arthritis. Which nonpharmacologic intervention should the nurse include in the plan of care for joint pain? 1. Elevation of the extremity 2. Immobilization 3. Massage 4. Application of moist heat

4. Application of moist heat

9) A mother refuses to have her child immunized with the 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 is an appropriate response by the nurse? 1. Telling the mother that by not immunizing the child she may be exposing pregnant women to the virus, which could cause fetal harm 2. Honoring the mother's request because she is the parent 3. Telling the mother that she is wrong and should have her child immunized 4. Explaining the potential complications of measles, mumps, and rubella infections

4. Explaining the potential complications of measles, mumps, and rubella infections.

13) A parent reports that her 5-year-old child, who has had all recommended immunizations, had a mild fever 1 week ago and now has bright red cheeks and a lacy red maculopapular rash on the trunk and arms. Which diagnosis does the nurse anticipate based on the current data? 1. Rubeola (measles) 2. German measles (rubella) 3. Chickenpox (varicella) 4. Fifth disease (erythema infectiosum)

4. Fifth disease (erythema infectiosum)

5) Which immunization should the nurse include in a teaching session for parents of a toddler-age client to decrease the risk for epiglottitis? 1. Hepatitis B 2. Polio 3. Measles, mumps, and rubella (MMR) 4. Haemophilus influenzae type B (HIB)

4. HIB

22) The nurse is assessing a pediatric client who is experiencing metabolic alkalosis. Which assessment questions should the nurse include when interviewing the child's parents? Select all that apply. 1. "Has your child consumed any aspirin?" 2. "Has your child consumed any boric acid?" 3. "Has your child consumed any antifreeze?" 4. "Has your child consumed any baking soda?" 5. "Has your child consumed any antacids?"

4. Has your child consumed any baking soda? 5. Has your child consumed any antacids?

18) When teaching a pregnant client about antibodies that are passed from mother to newborn, which antibody should the nurse include? 1. IgM 2. IgA 3. IgD 4. IgG

4. IgG

3) The nurse admits a child with a ventricular septal defect (VSD) to the pediatric unit. Which is the priority nursing diagnosis for this child? 1. Hypothermia related to decreased metabolic state 2. Acute Pain related to the effects of a congenital heart defect 3. Ineffective Tissue Perfusion (peripheral) related to cyanosis secondary to congenital heart defect 4. Impaired Gas Exchange related to pulmonary congestion secondary to the increased pulmonary blood flow

4. Impaired Gas Exchange related to pulmonary congestion secondary to the increased pulmonary blood flow

18) Which prescription regarding an oral hydrocortisone for a toddler-age client diagnosed with congenital adrenal insufficiency should the nurse anticipate when the client is admitted to the hospital with pneumonia? 1. It will be discontinued. 2. It will be reduced. 3. It will be continued as previously prescribed. 4. It will be increased.

4. It will be increased.

19) Which type of nutrition should the nurse include when planning care for a newborn who is diagnosed with galactosemia? 1. Goat's milk formula 2. Breast milk 3. Cow's milk-based formula 4. Lactose-free formula

4. Lactose-free formula

8) Which assessment data would cause the nurse to suspect that a newborn requires further testing for cystic fibrosis? 1. Rectal prolapse 2. Constipation 3. Steatorrheic stools 4. Meconium ileus

4. Meconium ileus

12) Which information should the nurse include in a teaching session regarding treatment for the common cold in the pediatric population? 1. Aspirin should be taken for alleviation of fever if the common cold is contracted. 2. Antibiotics will eliminate the nasopharyngitis virus. 3. Vaccinations can prevent contraction of a nasopharyngitis virus. 4. Proper hand washing can prevent the spread of the common cold.

4. Proper hand washing can prevent the spread of the common cold.

9) Which teaching point should the nurse include in the discharge instructions for a pediatric client who has undergone cardiac surgery? 1. Should not receive routine immunizations. 2. Should be restricted from most play activities. 3. Fever is expected for several weeks following the surgery. 4. Prophylactic antibiotics are required for any dental, oral, or upper respiratory tract procedures.

4. Prophylactic antibiotics are required for any dental, oral, or upper respiratory tract procedures.

14) Which is the priority nursing action for a premature neonate who is experiencing apnea? 1. Administering oxygen 2. Performing back blows and chest thrusts 3. Calling a code blue 4. Providing stimulation by stroking the back

4. Providing stimulation by stroking the back

14) A child is receiving a nucleoside reverse transcriptase inhibitor for human immunodeficiency virus (HIV). Which laboratory value should the nurse include in the plan of care as needing to monitor? 1. Glucose 2. Sodium 3. Potassium 4. Red blood cell count

4. Red blood cell count

13) A nurse is planning care for a child with human immunodeficiency virus (HIV). Which is the priority nursing diagnosis for this child? 1. Ineffective Peripheral Tissue Perfusion 2. Ineffective Thermoregulation 3. Risk for Fluid Volume Deficit 4. Risk for Infection

4. Risk for Infection

5) A school-age client diagnosed with rheumatoid arthritis (RA) wants to participate in the school sports programs. The client asks the nurse to recommend a sporting activity that is appropriate. Which activity would be the most appropriate for the nurse to recommend? 1. Baseball 2. Basketball 3. Football 4. Swimming

4. Swimming

21) Which age-appropriate information should the nurse provide to a 4-year-old girl who is being emotionally prepared for open heart surgery? 1. The name of the surgeon who will be performing the procedure 2. What the surgical procedure will entail 3. The purpose of the heart-lung machine used during the procedure 4. What the environment will look and sound like when the child wakes up

4. What the environment will look and sound like when the child wakes up

18) Which is the priority nursing assessment when providing care for an infant at risk for dehydration? 1. Urine output 2. Urine specific gravity 3. Vital signs 4. Daily weight

4. daily weight

3) A child weighing 18.2 kg with a history of diabetes insipidus (DI) has been admitted to the hospital. Which healthcare provider prescription should the nurse question? 1. Stat electrolytes 2. Urine specific gravity with each void 3. DDAVP (desmopressin) PO 4. Restrict oral fluids to 500 mL every 24 hours

4. restrict oral fluids to 500mL every 24 hrs

17) Which rationale will the seasoned nurse share with the novice nurse regarding why the specific gravity for infants is lower than for older children? 1. The infant has a greater body surface area. 2. The infant has a higher basal metabolic rate. 3. The infant has a greater percentage of body weight that is water. 4. The infant's kidneys are less able to concentrate urine.

4. the infant's kidneys are less able to concentrate urine

23) Which statement regarding what was found during the nurse's daily check of the vaccine refrigerator would cause concern about the potency of the vaccines? 1. The vaccine was frozen as labeled. 2. The vaccines have been stored in a refrigerator where the temperature has been maintained between 35 and 46 ° F. 3. The vaccine's expiration date expires within the next month. 4. The vaccine is stored in the door of the refrigerator.

4. the vaccine is stored in the door of the refrigerator

13) Which food should the nurse remove from the food tray for a toddler-age client who is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH)? 1. Oatmeal 2. Yogurt 3. Biscuit 4. Watermelon

4. watermelon

13) The nurse is completing the intake and output record for a child admitted for fluid volume deficit. The child has had the following intake and output during the shift: Intake: 4 oz of Pedialyte One-half of an 8-oz cup of clear orange Jell-O Two graham crackers 200 mL of D 51/2 sodium chloride IV Output: 345 mL of urine 50 mL of loose stool How many milliliters should the nurse document as the client's total intake? Give the numerical answer only. Do not include any units of measurement.

440mL