Peds Final Exam Practice Questions

solumedrol 1.5 mg/kg is ordered for a child weighing 74.8 lb. Solumedrol is available at 125 mg/2 ml. How many ml must the nurse give?

0.8

The nurse is implementing care for a school aged child admitted to the pediatric ICU in DKA. Which interventions should the nurse implement immediately? A) begin 0.9% saline IV as prescribed B) administer regular insulin IV as prescribed C) institute vitals and strict I/O monitoring D) need to make peers aware of the serious illness of the disease

A) begin 0.9% saline IV as prescribed B) administer regular insulin IV as prescribed C) institute vitals and strict I/O monitoring

Adam, age 4 months, has a VSD. The nurse is concerned that he may be developing CHF. The nurse should closely monitor which of the following as an EARLY indicator of CHF Select one or more A) changes in RR B) clubbing of fingers C) tiring more easily with feeding D) changes in abdominal girth

A) changes in RR C) tiring more easily with feeding

A mother is crying and tells the nurse that she should have brought her son in yesterday when he said his throat was sore. Which is the nurse's best response to this parent whose child is diagnosed with epiglottitis and in severe distress and in need of intubation? A) epiglottitis is rapidly progressive and you could not have predicted that the symptoms would worsen so quickly B) it is always better to have your child evaluated at the first sign of illness rather than wait until symptoms worsen C) epiglottitis is slowly progressive, so early interventions may have decreased the extent of your son's symptoms D) we are also never certain if symptoms are serious

A) epiglottitis is rapidly progressive and you could not have predicted that the symptoms would worsen so quickly

An 18 month old has an appointment for a well check. Which approach should the nurse use to conduct assessment? A) have the parent hold the toddler during the physical B) assess ears and mouth first C) carry out the head to toe assessment, toddles will always be defiant D) assess fine motor function by letting the child jump, run, and walk around the room

A) have the parent hold the toddler during the physical

from the choices listed below, what are some of the s/s of mild to moderate dehydration? Select one or more A) increased thirst B) increased WBC count and urine output C) dry mucous membranes and increased temp D) wt gain and edema

A) increased thirst C) dry mucous membranes and increased temp

an 18 month old with a congenital heart defect is to receive digoxin twice daily. Which should the nurse understand about digoxin? A) it enables the heart to pump more effectively with a slower and more regular rhythm B) the s/s of toxicity include loss of appetite, increased HR, vomiting, and visual disturbances C) it is absorbed better if taken on an empty stomach D) repeat the dose if the child vomits within 15 minutes of receiving it

A) it enables the heart to pump more effectively with a slower and more regular rhythm

An 8 yo with nephrotic syndrome is pale, lethargic, and has ascites. To determine if the ascites is increasing, the nurse should A) monitor and measure the abdominal girth B) weigh the child weekly C) track changes in BP D) assess the bowel sounds

A) monitor and measure the abdominal girth

Which of the following statements by a mother of a toddler diagnosed with nephrotic syndrome indicates that the mom understands the teaching about the disease? A) my child really likes chips & bologna. I guess we will have to find something else B) We'll have to encourage lots of fluids. Did you say about 3 L per day? C) we worry about surgery. Do you think we should investigate direct donation of blood/ D) we understand the need for ABX. I hope they can be given orally.

A) my child really likes chips & bologna. I guess we will have to find something else

the nurse is doing a neuro assessment on a 2 month old infant after a car accident. Moro, Tonic Neck, and withdrawal reflexes are present. The nurse should recognize that these reflexes are A) normal findings B) severe brain damage C) symptomatic of decorticate posturing D) symptomatic of decerebrate posturing

A) normal findings

which is characteristic of the development of type 2 DM? A) onset is usually gradual B) ketoacidosis is infrequent C) peak age of incidence is 8-10 yo in girls and 10-12 yo in boys D) oral agents are never available for treatment

A) onset is usually gradual

A father brings his 2.5 yo to the clinic and states he says "no" whenever he is asked to do something. The nurse should explain that negativism demonstrated by toddlers is frequently an expression of A) pursuit of autonomy B) Fear C) separation anxiety D) an identity crisis

A) pursuit of autonomy

From the list below please choose possible causes of acute renal failure in children SATA A) pyelonephritis B) tubular destruction C) severe dehydration D) upper tract biliary obstruction

A) pyelonephritis C) severe dehydration

a toddler arrives to the ER after falling out of a 2 story window of a building. The mother reports that the child had a brief loss of consciousness and vomited 4 times but has been "fine" since the episode. The mom asks why a CT scan is needed when the child seems to be fine. Which is the best explanation for the CT scan? A) she may have a brain injury that is not detectable by her physical s/s B) she needs this because at her age the skull has not completely developed C) she may start having seizures because of the injury she sustained D) she may probably have a fracture of her skull

A) she may have a brain injury that is not detectable by her physical s/s

a 10 yo child, w/o hx of previous seizures, experiences a tonic clonic seizure at school that lasts more than 5 minutes. Breathing is not impaired. Some postictal confusion occurs. The most appropriate action of the school nurse is which of the following? A) stay with the child and have someone else call EMS B) notify the parent and regular practitioner C) notify the parent that the child should go home D) stay with the child, offering calm reassurance

A) stay with the child and have someone else call EMS

a 12 yo diagnosed with Type 1 DM is prescribed by the provider regular insulin and NPH insulin subQ every morning. The nurse explains to the patient that the onset of REGULAR insulin is? A) within 5 min B) 1/2 to 1 hr C) 1 hr to 1.5 hrs D) 4-8 hrs

B) 1/2 to 1 hr

Please match the diseases listed below with the best choice of primary s/s that illness or disease exhibits S/S - neonatal hypoglycemia/hyperbilirubinemia, short stature, delayed skeletal maturation Options A) Hypothyroidism B) GH Deficiency C) APSGN D) Nephrotic Syndrome

B) GH Deficiency

a 9 yo with a cardiac defect weighs 55 lbs. He requires digoxin PO daily, the dose should be held if there are any s/s of toxicity. Pediatric maintenance dose is 5 mcg/kg daily given as a single dose after listening to the apical pulse rate for 1 full minute, you note it is only 50. Should you administer the digoxin as ordered? A) Yes B) No

B) No never give if < 70 for anyone

The nurse is assessing a 6 yo with a possible diagnosis of APSGN. Which s/s should the nurse communicate with the physician? A) increased appetite, peri-orbital edema, elevated lipid levels B) loss of appetite, periorbital edema, dark colored urine C) loss of appetite, desquamation of soles of feet, dark colored urine D) decreased appetite, periorbital edema, increased urination

B) loss of appetite, periorbital edema, dark colored urine

an infant returns from initial surgery Hirschsprung's disease. Which order below should the nurse EXCLUDE from the post op plan of care A) maintain NPO status until bowel sounds return B) monitor rectal temp every 4 hours C) reunite parents with child ASAP D) assess the surgical site every 2 hours

B) monitor rectal temp every 4 hours

the nurse is admitting a child with a diagnosis of "rule out appendicitis." The nurse assesses the child for which manifestations? Select one or more A) upper abd pain and flank pain B) peri umbilical pain localizing into RLQ C) fatty stools D) Elevated CBC, platelets, and WBCs

B) peri umbilical pain localizing into RLQ D) Elevated CBC, platelets, and WBCs

A toddler diagnosed with nephrotic syndrome has a nursing diagnosis of excess fluid related to fluid accumulation (generalized edema). Which nursing intervention would be the priority to include in the nursing plan of care? A) daily abd girth B) weigh the child before breakfast daily C) test urine for Cr and specific gravity every shift D) maintain on strict bed rest

B) weigh the child before breakfast daily

a 12 yo is being treated for acute respiratory distress. Which assessment finding would be indicative for applying the nursing diagnosis ineffective breathing pattern? A) oxygen saturation of 96% at rest B) heart rate of 100 bpm and temp of 99.8 C) bicarb level of 38 D) RR of 60-70 breaths per min

D) RR of 60-70 breaths per min

the parent of a chid with Type 1 asks the RN whether she should test the child's urine regularly. The nurse explains that urine testing is needed when: A) urine dipstick is needed before administration of insulin B) glucose is needed 4x per day C) a urine ketone level must be checked if BG levels are 180 or higher D) a urine ketone check is needed during an illness and when glucose level is 240 or higher even when illness is not present

D) a urine ketone check is needed during an illness and when glucose level is 240 or higher even when illness is not present

it is important that a child with acute streptococcal pharyngitis be treated with ABX in order to prevent the future risk for which of the following disorders? A) cystic fibrosis B) kidney failure C) an ASD D) acute rheumatic fever

D) acute rheumatic fever

a mother with sickle cell anemia asks the nurse why her child's hemoglobin was normal at birth and now the child has the S hemoglobin (sickle cell) Which of the following is an appropriate response from the nurse A) the placenta bars passage of hemoglobin S from the mom to the fetus B) the Red bone marrow does not begin to produce hemoglobin S until 5 years of life C) antibodies transmitted from you to the fetus provided the newborn with temporary immunity D) at birth, a newborn has a high concentration of fetal hemoglobin in blood, which over time, have been replaced by these abnormal S hemoglobin cells

D) at birth, a newborn has a high concentration of fetal hemoglobin in blood, which over time, have been replaced by these abnormal S hemoglobin cells

which is a nursing intervention to reduce the risk of increasing ICP in an unconscious child? A) suction child frequently B) turn head side to side every hour C) provide environmental stimulation D) avoid activities that cause pain, monitor for non verbal pain cues

D) avoid activities that cause pain, monitor for non verbal pain cues

when counseling an adolescent, what would you include in your teaching to prevent transmission of HIV? A) avoid public bathrooms B) only become involved in relationships with those that have received HPV vaccine C) dont share utensils or food from the same plate as others D) avoid getting tattoos and piercings except in licensed facilities which follow all required guidelines

D) avoid getting tattoos and piercings except in licensed facilities which follow all required guidelines

the therapeutic management of children with B-thalassemia major consists primarily of A) O2 therapy B) supplemental iron C) adequate hydration D) blood transfusions and chelation therapy

D) blood transfusions and chelation therapy

a 12 yo complains of being sweaty, having palpitations, and jitters approximately 1 hr after receiving his morning dose of insulin. The nurse should do which of the following? A) give o2 and call the MD B) start an IV and increase fluids C) give Nitroglycerin to prevent EKG changes D) check blood glucose and administer carbs

D) check blood glucose and administer carbs

a child with Type 1 DM eats some skittles after experiencing s/s of hypoglycemia. Which of the interventions should follow the rapid releasing sugar eaten by the child? A) just proteins & then check BG B) fruit juices & protein C) several glasses of water & a snack D) complex carbs & protein if next meals is more than 1 hr away

D) complex carbs & protein if next meals is more than 1 hr away

an 8 yo, newly diagnosed with type 1 DM, is hospitalized and being instructed on how to use dietary exchange method to manage the DM. Which of the following statements BEST describes the method for dietary management in DM? A) choose foods from each of the categories of the exchange list B) use a scale to weigh all foods C) select a diet from the food list according to the protein, fats, and carbs D) conduct a carb counting for each meal & snack

D) conduct a carb counting for each meal & snack

A 4 yo with nephrotic syndrome is experiencing severe periorbital edema. The best measure the nurse could institute to help reduce the periorbital edema is: A) apply cool sterile soaks to the child's head B) encourage the child to eat low protein food C) apply warm compresses D) elevate the head of the bed

D) elevate the head of the bed

the nurse is teaching the family of a child, age 8 years, with moderate hemophilia about home care. The best home treatment and therapy for a joint injury is A) NSAIDs B) DDAVP C) Factor VIII concentrations D) elevation and application of ice to involved joint

D) elevation and application of ice to involved joint

the earliest sign associated with Cystic Fibrosis is? A) steatorrhea with very foul odor stools B) clubbing of the fingers along with a low O2 sat C) increased sweating and low sodium levels D) meconium ileus

D) meconium ileus

Please match the diseases listed below with the best choice of primary s/s that illness or disease exhibits S/S - Severe edema and massive proteinuria are seen in this serious illness Options A) Hypothyroidism B) GH Deficiency C) APSGN D) Nephrotic Syndrome

D) nephrotic syndrome

the nurse is caring for a child who sustained a severe head trauma following a fall from a 3rd story window of a building. Which complication is often seen preceding imminent death d/t a head trauma? A) papilledema B) delirium C) dolls head maneuver D) periodic & irregular breathing

D) periodic & irregular breathing

the most common manifestations of new onset DM include A) lethargy B) confusion C) n/v D) polyuria, polydipsia, polyphagia

D) polyuria, polydipsia, polyphagia

A child with nephrotic syndrome exhibits generalized edema. Which intervention should the nurse carry out for the nursing diagnosis of impaired skin integrity r/t edema? A) ambulate every shift while awake even if SOB B) applies scented lotion on opposing skin surfaces while on bed rest C) apply talcum powder on child while on bed rest D) safely separate opposing skin surfaces while on bed rest to prevent skin tears & breakdown

D) safely separate opposing skin surfaces while on bed rest to prevent skin tears & breakdown

the nurse is caring for an 8 yo with Type 1 DM. The nurse should teach the child to monitor for which most common s/s of hypoglycemia? A) lethargy & pallor B) thirst & increased urination C) n/v D) shakiness & dizziness

D) shakiness & dizziness

which statement describes the reason infants are vulnerable to accelerated-decelerated injuries? A) anterior fontanel is not yet closed B) nervous tissue is not well developed C) the scalp of the head has extensive vascularity D) the musculoskeletal support of the head is not strong

D) the musculoskeletal support of the head is not strong

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

D) vaccinations to prevent pneumococcal and Haemophilus Influenzae type B meningitis are available

a nurse is caring for a child who has sickle cell crisis and is hospitalized. Nursing interventions to prevent infection include administering A) IV fluids with electrolyte replacement B) opioid pain medication C) a pneumococcal vaccine D) exchange transfusions

C) a pneumococcal vaccine

a child with epilepsy has been seizure free for 2 years. A father asks the nurse how much longer the child will need to take the anti-seizure meds. The nurse includes which of the following in the response? A) meds can be discontinued at this time B) the child will need to take the drugs for 5 years after the last seizure C) a step wise approach will be used to reduce the dosage gradually D) seizure disorders are a life long problem. Meds cannot be discontinued

C) a step wise approach will be used to reduce the dosage gradually

the parents of a child who has just been diagnosed with type 1 DM asks about exercise. The nurse should explain that A) exercise increases blood glucose B) extra insulin is required during exercise C) additional snacks are needed before exercise D) excessive physical activity should be restricted

C) additional snacks are needed before exercise

which should the nurse include when teaching the mother of a 9 month old infant about administering liquid iron preparations? A) give only with meals B) stop immediately if n/v occur C) adequate dosage will turn the stools a tarry green color and may cause constipation D) allow preparation to mix with saliva and bathe the teeth before swallowing

C) adequate dosage will turn the stools a tarry green color and may cause constipation

when caring for a child who is comatose with multiple injuries, the nurse would assess that pain A) cannot occur if the child is comatose B) may occur if the child suddenly regains consciousness C) can be expressed through nonverbal behaviors & physiologic changes D) cannot be assessed by family members who are familiar with the child

C) can be expressed through nonverbal behaviors & physiologic changes

a school aged child recently diagnosed with type 1 DM asks the nurse if he can still play soccer, baseball, and swim. The nurse's response should be based on the knowledge that A) exercise is discouraged with type 1 DM d/t difficulty maintaining blood sugar B) soccer and baseball are too strenuous, but swimming is acceptable C) exercise is not restricted unless indicated by other health conditions D) the level of activity depends on the type of insulin required at all times

C) exercise is not restricted unless indicated by other health conditions

which of the following explains why iron deficiency can occur during the infancy period? A) breast milk has no iron and always requires an iron supplement B) iron cannot be stored during fetal development C) fetal iron stores are depleted by 4-6 months of age D) dietary iron cannot be started until 12 months of age

C) fetal iron stores are depleted by 4-6 months of age

an adolescent with type 1 DM tells the nurse she is feeling lightheaded. The adolescents Blood glucose is 60. Which of the following interventions would be best to safely and effectively correct her blood sugar? A) give 15 mls of juice and some crackers, follow up with protein B) give 15 g of carbs, no protein and retest BG level in 1 hr C) give 15 g simple carbs, retest BG in 15 min and then follow up with 16 g complex carbs & 7 g protein if next meal is more than 60 min away D) give 15 oz of juice and retest BG in 15 min, then administer glucose tabs if BG is still low

C) give 15 g simple carbs, retest BG in 15 min and then follow up with 16 g complex carbs & 7 g protein if next meal is more than 60 min away

A child with severe anemia requiers a unit or RBCs. The nurse explains to the child that the transfusion is necessary to: A) allow her parents to come visit her B) fight the infection that she now has C) increase her energy so she will not be so tired D) help her body stop bleeding by forming a clot

C) increase her energy so she will not be so tired

which is the initial clinical manifestation (visible evidence that something exists) of generalized seizures? A) feeling of confusion B) feeling frightened C) loss of consciousness D) seeing flashing lights

C) loss of consciousness

to help the adolescent deal with DM, the nurse needs to consider which of the following characteristics of adolescence? A) desire to be unique B) Preoccupation with the future C) need to be perfect and similar to peers D) awareness of peers that DM is a severe disease

C) need to be perfect and similar to peers

in which of the following anemia conditions are all the components of the blood simultaneously depressed? A) thrombocytopenia B) sickle cell anemia C) pancytopenia D) iron deficiency anemia

C) pancytopenia

the nurse assesses an 8 lb wt loss in a child admitted 4 days prior with acute glomerulonephritis. This is most likely a result of which of the following? A) poor appetite B) decreased salt intake C) reduction of edema D) restriction to bed rest

C) reduction of edema

a child with growth hormone deficiency is being started on GH therapy. Nursing considerations should be based on knowledge of which of the following? A) treatment is most successful if started during adolescence B) treatment is considered successful if children attain full stature by adulthood C) replacement therapy may require daily SubQ injections D) replacement therapy will be required and stopped in intervals

C) replacement therapy may require daily SubQ injections

when assessing a 10 month old baby who mom has brought to pediatrician's office with a fever and what appears to be conjunctivitis the nurse notes white bumps in the baby's mouth along the buccal musoca. She knows that: A) these are probably normal and due to eruption of teeth B) they could be deciduous teeth and present since birth C) they may actually be Koplik spots and she could be in the catarrhal stage of measles D) they could actually be fever blisters and will resolve with administration of Tylenol as ordered

C) they may actually be Koplik spots and she could be in the catarrhal stage of measles

the nurse is caring for an infant on a strict I/O management. She changes the diaper and it weighs 73.5 g. The dry diaper wt is 62g. The newborn's urine output (in g) is:

11.5 g

the child has had open heart surgery to repair an area of Tetralogy of Fallot. The nurse is conducting teaching with the parents. Which should the nurse instruct the parents to do? Select one or more A) maintain adequate hydration with 10 glasses of water per day B) "tet" spells may still occur with crying, feeding, and stooling, do not leave the child alone during these episodes C) provides rest periods daily for the first few weeks post op D) restricts the ingestion of bananas and citrus fruits

B) "tet" spells may still occur with crying, feeding, and stooling, do not leave the child alone during these episodes C) provides rest periods daily for the first few weeks post op

The mother of a newborn expresses concern that her breastfeeding baby is not gaining weight. She tells the nurse that when she brought the baby home from the hospital, he weighed 8 lbs. The nurse weighs the baby at the 2 week checkup and notes that the infant now weighs 8 lbs 12 oz. The nurse should A) inform the mom that she should add rice cereal to the infant's diet to improve wt gain B) recommend supplementing breastfeeding with rice cereal C) Inform the mom that the infant's wt gain is normal D) encourage the mom to limit breastfeeding to every 4 hours because the infant is gaining too much wt

C) Inform the mom that the infant's wt gain is normal

The nurse assesses a 6 month old for vaccine readiness. Which finding would most likely indicate the need to delay administering the DTaP vaccine? A) a family hx of sudden infant death syndrome B) a fever of 38 C following the 4 month vaccination C) an acute bilateral ear infection D) living with a family member who is immunosuppressed

C) an acute bilateral ear infection

a parent asks the nurse to explain the basic problem involved in Hirschsprung's disease. the nurse's response is based on her knowledge that the primary defect in Hirschsprung's disease is: A) atrophy of the junction between the small and large intestine B) lack of internal anal sphincter muscle contraction C) atresia of the lower portion of the rectosigmoid D) absence of nerve innervation in a portion of the distal colon

D) absence of nerve innervation in a portion of the distal colon

the nurse is instructing a child with cystic fibrosis regarding the use of pancreatic capsules. Which of the following instructions should the nurse give to the patient? A) the same # of capsules is taken with all meals B) capsules are taken 30 min after meals to digest meals C) dose not open capsules and sprinkle on food D) capsules are taken with all meals and snacks

D) capsules are taken with all meals and snacks

a nurse is caring for a 10 yo with cystic fibrosis. The child reports that he feels like he really never gets enough air. Which of the clinical findings indicates that the child has been compensating for decreased serum oxygen levels? A) distended abdomen B) distended jugular veins C) edema in the upper extremities D) clubbing of fingers and toes

D) clubbing of fingers and toes

According to Erikson, the developmental task of the infant is to establish trust. Which intervention by a parent/guardian best fosters a sense of truth? A) holds infant during feeding B) speaks quietly to the infant C) immediately changing wet or soiled diapers D) consistently responds to needs

D) consistently responds to needs

a child diagnosed with Kawasaki Disease is to receive high dose immunoglobulin, along with aspirin. What is the desired effect of these meds? A) decrease incidence of rash B) decreased incidence of peripheral edema C) decreased incidence of peripheral lymphoma D) decrease incidence of aneurysms

D) decrease incidence of aneurysms

the nurse is teaching the parent of an infant about proper positioning of the pinna for instillation of ear drops. The nurse instructs the parents to gently pull the pinna A) up and forward B) up and backwards C) down and forward D) down and backwards

D) down and backwards

a nurse is assessing the growth and development of a 10 year old. What is the expected behavior of this child? A) enjoys physical demonstration of the affection B) is selfish and insensitive to the welfare of others C) is uncooperative in play and in school D) has a strong sense of justice & fairness

D) has a strong sense of justice & fairness

which statement by a parent indicates comprehension of the correct action to take when managing diarrhea in their infant? A) i should severely restrict food and fluids as long as my child has diarrhea B) i can give fluids along with Kaopectate for 3 days to manage it C) I should offer milk and crackers after each episode of diarrhea D) i should monitor the baby's temp, urine output, and behavior for possible changes

D) i should monitor the baby's temp, urine output, and behavior for possible changes

The nurse should assess the infant with pyloric stenosis for A) GERD and reflux B) frequent episodes of steatorrhea in spite of administration of imodium C) respiratory acidosis and low blood sugar D) metabolic alkalosis due to projectile vomiting

D) metabolic alkalosis due to projectile vomiting

the infant with congenital heart defects often has a need for A) increased calories B) increased fluids C) decreased electrolytes D) increased activity and physical therapy

A) increased calories

a humidified (moistened room air) atmosphere is recommended for a child with a virus such as croup because it helps to: (SATA) A) thin and loosen secretions B) provide oxygenation and excessively cool the child C) decrease inspiratory stridor and hoarseness D) soothe and decrease airway inflammation

A) thin and loosen secretions C) decrease inspiratory stridor and hoarseness D) soothe and decrease airway inflammation

the mother of a preschooler reports that her child creates a scene every night at bedtime. After a discussion, the mom agrees that the best course of action would be to A) allow the child to stay up later one or 2 nights a week B) establish a set bedtime and maintain the routine C) encourage play before bedtime D) give the child a prize if bedtime is pleasant

B) establish a set bedtime and maintain the routine

the nurse is examining a 3 yo boy who has a mild earache and a temp of 38.5C. Which action will be taken? A) with a small syringe, obtain a culture of middle ear fluid B) instruct the parent to watch for increasingly worse s/s C) administer ABX D) Administer antivirals

B) instruct the parent to watch for increasingly worse s/s

a parent asks why she should have her daughter immunized for the HPV when she is only 11 years old. Which of the following responses is appropriate by the nurse? A) i agree with you. I will ask your physician if the HPV can be delayed until she becomes sexually active B) it is recommended that children begin the vaccine series when they are preteens to have time to develop immunity C) although HPV is defined as an STD, it can also be transmitted if a person with an upper resp illness coughs or sneezes D) I understand. It is important to realize though that many students are exposed to this virus in high school

B) it is recommended that children begin the vaccine series when they are preteens to have time to develop immunity

in terms of cognitive development, a 3 yo child would be expected to: A) think abstractly B) use magical thinking C) understand conservation of matter D) see things from perspective of others

B) use magical thinking

the most common result of GI illness is A) intussusception B) diarrhea C) Dehydration D) Vomiting

C) Dehydration

bacterial pneumonia is suspected in a 4 yo boy with fever, HA, and chest pain. Which assessment finding would most likely indicate the need for this child to be hospitalized? A) frequent congested coughing B) oxygen saturation level of 96% C) tachypnea with retractions D) pale skin color

C) tachypnea with retractions

The nurse administered the prescribed dose of digoxin to an infant with a congenital heart defect. Within 15 minutes the infant vomits. The nurse should: A) repeat the dose because the med is essential to cardiac function B) repeat half of the dose prescribed C) give both doses together at the next scheduled time D) administered the next dose as scheduled do not repeat the earlier dose

D) administered the next dose as scheduled do not repeat the earlier dose

a 10 month old infant is admitted to the pediatric unit to rule out Hirschsprung's disease. The nurse should expect the infant's stool to be A) water, green in appearance B) currant jelly like in appearance C) steatorrhea like in appearance D) ribbon like in appearance

D) ribbon like in appearance

infuse 825 ml over the next 7 hrs by infusion pump. What is the IV flow rate in ml/hr

118

a 9 yo with a cardiac defect weighs 55 lbs. He requires digoxin PO daily, the dose should be held if there are any s/s of toxicity. Pediatric maintenance dose is 5 mcg/kg daily given as a single dose What is the child's daily dose of digoxin? (in mcg)

125

calculate the daily fluid requirements for a child weighing 35 lbs in ml

1295

A child weighs 52 lbs. The child has a fever and the doctor orders tylenol. The safe dose range of this med is 10-15 mg/kg every 6 hrs. What is the max safe dose range (in mg) this child can have per day (in 24 hrs)

1418.18

What would a 4kg infant's hourly rate of maintenance IV fluid be if he was getting 400 ml for daily fluid replacement?

16.67

Doctor Orders: 125 mg Bactrim PO every 8 hours On Hand: 50 mg/1mL How many mls will you give at each dose?

2.5 ml

calculate the daily fluid requirement in ml for a 4 kg infant

400

Calculate the flow in ml/hr of the following. Infuse 750 ml of D10W over 18 hours

41.67

mom is concerned that her child will experience pain after he receives the 5 yo vaccinations. The child weighs 30 kg. The doctor orders 450 mg Tylenol. The concentration is 50 mg/1mL What dose in milliliters should the mother give for the pain?

9

A 10 yo with APSGN has an elevated BP and low urine output for 15 hrs. Nursing care should include: SATA A) assess the child's neuro status B) encourage the child to drink more water C) have the child follow a low sodium diet D) have the child maintain normal activities

A) assess the child's neuro status C) have the child follow a low sodium diet

the nurse is assessing a 2 yo at his well visit using the Screening for Autism (STAT). Which answers to the questions are some possible red flags or early s/s this child may need further evaluation? SATA A) delayed speech or no social babbling/chatting B) does not look right at speaker, difficult to get child to make eye contact C) responds quickly when you call their name D) has developed rituals like lining toys up repetitively

A) delayed speech or no social babbling/chatting B) does not look right at speaker, difficult to get child to make eye contact D) has developed rituals like lining toys up repetitively

important nursing interventions when caring for a child who is experiencing a seizure would be: SATA A) describe & record the seizure activity observed B) gently turn pts onto their side C) place a tongue blade between the teeth if they become clenched D) institute measures to ensure patient safety

A) describe & record the seizure activity observed B) gently turn pts onto their side D) institute measures to ensure patient safety

the nurse administers prostaglandin E to an infant with transposition of the great vessels. The nurse expects which effects to occur from the medication? A) ductus arteriosus remains open B) ductus arteriosus closes allowing better oxygenation C) ductus venosus remains open, increasing amount of deoxygenated blood traveling in infant' body D) ductus venosus closes and is dependent on the prostaglandins

A) ductus arteriosus remains open

the nurse is caring for a 10 yo who has an acute head injury, has a pediatric glasgow coma scale of 9, and is unconscious. Which interventions should the nurse include in the child's plan? A) elevate HOB 15-30* with head maintained in midline B) maintain an active, stimulating environment C) perform chest percussion and suctioning ever 1-2 hrs D) instruct the child on performing active range of motion

A) elevate HOB 15-30* with head maintained in midline

which nursing consideration is important when caring for an infant that demonstrates failure to thrive? A) establish a structured routine that is followed consistently B) require the parent to room in and provide the child's care C) place the child within an infant seat during feedings to prevent overstimulation D) limit sensory play activities

A) establish a structured routine that is followed consistently

the most appropriate means of rehydration of a 7 month old with diarrhea and mild dehydration is A) oral rehydration therapy with an electrolyte solution B) administration of 20 ml/kg IV fluid bolus of LR or Normal Saline C) Administration of maintenance IV fluid of Dextrose 5% and 1/4 normal saline D) offering BRAT diet (bananas, rice, applesauce, toast)

A) oral rehydration therapy with an electrolyte solution

the most important factors that influences the development of UTIs are (SATA) A) poor hygiene B) congenital anomalies C) urinary stasis D) male gender

A) poor hygiene B) congenital anomalies C) urinary stasis

Which should be included in discharge teaching for the child who has undergone an uncomplicated Nissen Fundoplication A) the child may be unable to belch or vomit for some time following this procedure B) the child should avoid contact with children in daycare settings for several months C) this procedure may result in reflux and vomiting D) the child should return home on a cardiac respiratory monitor

A) the child may be unable to belch or vomit for some time following this procedure

compared with adults, why are infants and children at an increased risk for infection and communicable disease? A) the infant has limited exposure to disease and steadily loses passive immunity from maternal antibodies B) the infant demonstrates an increased inflammatory response C) cellular immunity is not functional at birth D) infants have an increased risk for infection until they receive their first set of immunizations, even though boosters will be needed

A) the infant has limited exposure to disease and steadily loses passive immunity from maternal antibodies

the nurse teaches parents 2 of the following s/s of post concussion syndrome may occur in their child and do not necessitate medical attention. These 2 manifestations will disappear over time Select 2 A) vomiting B) seizures C) behavioral changes D) episodes of temporary loss of consciousness

A) vomiting C) behavioral changes

the nurse is caring for a 2 yo who is post op from a VSD repair. Which findings should the nurse report to the physician? (Select 2) A) weight gain of 0.5 kg from the pre op weight B) Bilateral crackles within the lung fields when at rest C) BP of 90/62 D) O2 sat of 97% on 5L of o2

A) weight gain of 0.5 kg from the pre op weight B) Bilateral crackles within the lung fields when at rest

the physician has ordered IV mannitol for a child with a head injury. The best indicator that the med was effective is? A) increased urine output B) decreased ICP C) improved level of consciousness D) a decrease in peripheral edema

B) decreased ICP

the mom of a 7 month old asks the nurse if her daughter should receive the flu vaccine at her routine visit A) she is too young to receive the flu vaccine this season B) yes, once she is over 6 months she should receive the flu vaccine every year C) she still has immunity from mom at this time D) flu vaccine should be administered at a separate visit

B) yes, once she is over 6 months she should receive the flu vaccine every year

Please match the diseases listed below with the best choice of primary s/s that illness or disease exhibits S/S - patient exhibits elevated BP and periorbital edema Options A) Hypothyroidism B) GH Deficiency C) APSGN D) Nephrotic Syndrome

C) APSGN

The nurse is teaching the parents of a 3 yo who has been diagnosed with tonic clonic seizures. Which statement by the parent would indicate a correct understanding of the teaching? A) I should attempt to restrain my child during a seizure B) My child will need to avoid contact sports until adulthood C) I should position my child on her side during a seizure and stay with her D) my child will need to be taken to the ED after each seizure

C) I should position my child on her side during a seizure and stay with her

which answer is a clinical manifestation of increased ICP in infants? A) low pitched cry B) sunken fontanels C) bulging or very tense fontanel D) decreased BP

C) bulging or very tense fontanel

a 10 year old boy has been admitted with a diagnosis of "rule out appendicitis." When the nurse was conducting a routine assessment, the boy stated "it doesn't hurt anymore." the nurse suspects that A) the boy is afraid of going to surgery B) the boy is having difficulty expressing his pain adequately C) the appendix has ruptured D) this is a method the boy uses to receive attention

C) the appendix has ruptured

the nurse is assessing a 13 yo boy with type 2 DM. What would the nurse correlate with this disorder? A) the parents report that their child has had a "cold or flu" recently B) BP is decreased when checking vitals C) the parents report that heir son is constantly thirsty D) auscultation reveals Kussmaul respirations

C) the parents report that heir son is constantly thirsty

an 18 month old child with a history of cleft lip and palate has been admitted for palate surgery. The nurse would provide which explanation about why a toothbrush should not be used immediately after surgery A) the toothbrush would be frightening to the child B) the child no longer has deciduous teeth C) the suture line could be interrupted D) the child will be NPO for some time

C) the suture line could be interrupted

a child presents with FTT (failure to thrive) secondary to GER (Gastroesophageal reflux). Which of the following s/s may be seen in this child? A) avoidance of care giver attention B) an associated malabsorption defect C) weight that falls below the 5th percentile D) an abnormal achievement of developmental milestones

C) weight that falls below the 5th percentile

A child experiencing an acute asthma attack presents to the ED. Which is the first med the nurse expects to administer to the child? A) IV Terbutaline (Brethine) B) Fluticasone propionate/Salmeterol (advair, Flovent) via a powder inhaler C) prednisone (Deltasone) by mouth or IV D) Albuterol (Proventil, Proair) via nebulizer

D) Albuterol (Proventil, Proair) via nebulizer

a 2 yo presents with high fevers for 5 days, bilateral conjunctival injection and crackles. The nurse anticipates which of the following will be ordered? A) thrombocytopenia monitoring B) acetaminophen as ordered C) penicillin V to prevent renal complications D) IV immunoglobulin

D) IV immunoglobulin

which is considered a cardinal sign of DM? A) nausea B) Seizures C) Impaired vision D) frequent urination

D) frequent urination

A mother asks the nurse what would be an early indication that the acute glomerulonephritis illness was improving. The nurse's best response from the following would be? A) BP stabilizes and HR returns to normal B) the child will have more energy C) urine output will be free of protein & blood D) urine output will increase

D) urine output will increase

a mother calls the clinic because her 2 yo daughter has a rectal temp of 37.8 C (100*F). She wonders how high the fever should be before she gives medications to reduce it. What is the best response by the nurse? A) all fevers should be treated to prevent seizures B) Antipyretics should be used with any rise in temperature. they can help change the course of an infection C) Give you child aspirin when the fever is above 38 C (100.4*F) D) usually in a normal healthy child, if your child is not uncomfortable, fevers less than 38 C (100.4*F) do not require medication

D) usually in a normal healthy child, if your child is not uncomfortable, fevers less than 38 C (100.4*F) do not require medication

Which nursing diagnosis is the most appropriate for a child with anemia? A) activity intolerance related to generalized weakness and fatigue B) alteration in cardiac output related to abnormal hemoglobin C) potential for injury related to postural hypotension D) potential for injury, related to decreased renal perfusion

A) activity intolerance related to generalized weakness and fatigue

Which development is necessary for toilet training readiness for a 2 yo? A) adequate neuromuscular development of sphincter control and ability to communicate the need B) appropriate chronological age C) ability to play with and imitate other 2 yos D) development of motor skills to remove clothing

A) adequate neuromuscular development of sphincter control and ability to communicate the need

a toddler is admitted to the pediatric unit with presumptive bacterial meningitis. The initial orders include isolation, IV access, cultures, and antimicrobial agents. The nurse knows that ABX therapy will begin: A) as soon as blood and CSF cultures have been drawn B) begin ASAP once culture and sensitivity results are sent from lab C) be instituted after child's fluid & electrolyte balance is stabilized D) with oral ABX until the diagnosis is confirmed

A) as soon as blood and CSF cultures have been drawn

a 4 month old is brought to the well baby clinic for immunizations. In addition to the DTaP and polio vaccine, which vaccine should the baby receive? A) Hib B) Varicella C) Hep B D) MMR

A) Hib

which of the following vaccines provides some protection against bacterial meningitis, epiglottitis, and bacterial pneumonia? A) Hib vaccine B) hep B vaccine C) Varicella vaccine D) Influenza Vaccine

A) Hib vaccine

Please match the diseases listed below with the best choice of primary s/s that illness or disease exhibits S/S - hyporeflexia, bradycardia & anemia Options A) Hypothyroidism B) GH Deficiency C) APSGN D) Nephrotic Syndrome

A) Hypothyroidism

a 12 yo with rheumatic fever has a history of long term use of aspirin. Which statement alerts the nurse to notify the physician? A) I hearing ringing in my ears B) is it okay to put lotion on my itchy skin? C) my stomach hurts after I take the medicine on an empty stomach D) the pills make me cough

A) I hearing ringing in my ears

a doctor orders 200 mg of Rocephin to be taken by a 15.4 lb infant every 8 hrs. THe med label shows that 75-150 mg/kg per day is the appropriate dosage range. Is this doctor's order within the desired range? A) Yes B) No

A) Yes

After conducting an assessment, which parent would a nurse anticipate a potential for respiratory arrest? A) a 6 yo asthmatic that was previously wheezing and now has decreased breath sounds throughout the lung fields B) a 2 yo with epiglottitis who was intubated in the ED and is stable C) a 16 yo with a pneumothorax from a motor vehicle accident that now has a chest tube in place and who complains of pain at the site of the chest tube D) a 5 month old infant with RSV who is sleeping with a RR of 48 and has increased congestion

A) a 6 yo asthmatic that was previously wheezing and now has decreased breath sounds throughout the lung fields

we know that fifth disease is caused by parovirus B19. When teaching parents about care of their child who has fifth disease, what should we include in our teaching? SATA A) keep your child away from anyone who might be pregnant B) your child is contagious until the rash disappears C) administer ABX as ordered D) after the rash has appeared, your child is not likely contagious

A) keep your child away from anyone who might be pregnant D) after the rash has appeared, your child is not likely contagious

the nurse is mentoring a new nurse on the unit in caring for a group of cardiac patients on a pediatric unit. Which action by the new nurse indicates the experienced nurse should intervene immediately? A) new nurse assists a child to the bathroom 2 hours after cardiac cath B) new nurse places an infant having a cyanotic spell in a knee chest position C) new nurse takes an infant's apical pulse prior to administering digoxin D) new nurse brings breakfast to child scheduled for an EKG

A) new nurse assists a child to the bathroom 2 hours after cardiac cath

the nurse is conducting discharge teaching with a parent of a child with a VSD repair. Which statements should the nurse include in the teaching? select 1 or more A) pace the child's activities for the next 3 weeks B) give child sponge baths instead of tub baths to prevent cyanotic episodes C) prophylactic ABX may be required for dental procedures D) maintain pressure on the femoral vein until a follow up appointment

A) pace the child's activities for the next 3 weeks B) give child sponge baths instead of tub baths to prevent cyanotic episodes

a 13 month old has febrile seizures 3 weeks after the administration of the chickenpox vaccine. The nurse should A) report the event though the vaccine adverse reporting system (VAERS) B) recognize that these events are unrelated C) explain to the parents that this is a rare but acceptable risk D) dispose of that entire lot of varicella vaccine

A) report the event though the vaccine adverse reporting system (VAERS) report any adverse events within 30 days of a vaccine

a nurse conducts teaching with parents about the cause of tinea capitis. The nurse evaluates success of the teaching when the parent repeats which of the following? A) it is a result from overexposure to the sun B) it is caused by infestations with mites C) it is an allergic reaction D) it is a fungal infection of the scalp

D) it is a fungal infection of the scalp

a child returns from a cardiac cath in a crying state, anxious, and pale. There is a small amount of red blood on the bed and on the dressing. Which should the nurse do given the info provided? A) apply pressure over the site and have the physician notified B) immediately notify the physician of the emergency C) auscultate breath sounds and place the child on O2 depending on finding D) provide emotional comfort to settle the child down

A) apply pressure over the site and have the physician notified

a school age child has been admitted to the pediatric unit and placed on droplet precautions. Which communication with parents should the nurse include during the admission process? A) staff caring for their child will be wearing a face mask, gown, and gloves B) informing parents they can only stay in the room for 15 min at a time C) there will be a funny whooshing sound when the door is opened because the air is kept from going in the hallway D) informing the parents that everyone who comes into the room will have to wear full PPE and must be cleared by staff to visit the child

A) staff caring for their child will be wearing a face mask, gown, and gloves

a 2 month old is admitted to the ED with severe diarrhea. The physician orders IV fluids with potassium. Prior to starting the infusion, the nurse should assess for which of the following? A) that the child has voided B) anxiety C) the baby is resting comfortably D) has a temperature of 98.6

A) that the child has voided

a 1 yo child is being seen at the pediatricians for a well check. He has followed the normal immunization schedule. Mom asks if the child will be receiving any vaccines at this visit. Which response by the nurse is appropriate? A) the MMR, varicella, and HepA are all given once the child reaches 1 yo B) the last hepB is due to be administered C) the first influenza vaccine is due at one year of age and to be received at the same time each year D) the rotavirus vaccine should be given today

A) the MMR, varicella, and HepA are all given once the child reaches 1 yo

an adolescent with a diagnosis of Cystic Fibrosis attends a follow up appointment with his primary care provider after recently being hospitalized. Which statements reported by the adolescent should the nurse interpret as an indicator of continued problems with malabsorption? A) soft formed stools B) Large, soft, foul smelling stool C) lack of appetite and nausea after meals D) hard stools with streaks of blood

B) Large, soft, foul smelling stool

recommended daily dosage of phenobarbital is 6-8 mg/kg/day in 1-2 divided doses. You have on hand Phenobarbital 20 mg/5mL. The doctor orders 105 mg bid to be given at 9 am and again at bedtime for your 15 kg, 3 yo patient. Is that a safe dose? A) Yes B) No

B) No

a neonate who is 1 hour old has cyanosis unrelieved by O2. Which of the following congenital defects would present with these s/s. Choose 2 answers A) VSD B) Transposition of the great vessels C) ASD D) Tetralogy of fallot

B) Transposition of the great vessels D) Tetralogy of fallot

the nurse is discussing the process of a cardiac cath with the parent of a child who has a VSD. The nurse explains that the procedure involves: A) frequent long term side effects afterwards B) a catheter placed in a large vessel such as the femoral artery C) a cut down procedure D) general anesthesia in the operating room

B) a catheter placed in a large vessel such as the femoral artery

which statement by the parents of a 7 yo with asthma indicates comprehension of medication use for control of the illness? A) the meds are complex and require extensive teaching B) a spacer used on an inhaler helps trap the med so it is inhaled more readily C) if a spacer is used, a whistling sound indicates that the med is being inhaled correctly D) dry powder inhalers are better than metered dose inhalers for use in competitive sports

B) a spacer used on an inhaler helps trap the med so it is inhaled more readily

the parents of an adolescent hospitalized for a sickle cell crisis express concerns related to narcotic analgesics causing addiction in their child The nurse should explain that narcotics A) are often ordered but usually not needed B) are given when medically indicated and weaned safely to prevent adverse effects, such as addiction C) are given as a last resort because of the threat of addiction D) are used only if other measures such as ice packs do not work

B) are given when medically indicated and weaned safely to prevent adverse effects, such as addiction

a mother who intended to breastfeed has given birth to an infant with a cleft palate. Nursing interventions should include which of the following? Select one or more A) give medications to suppress lactation B) assist mother with breastfeeding if baby can latch, suck, and swallow safely C) teach mother to provide breastmilk by gavage D) if unable to breastfeed, recommend use of a breast pump to maintain lactation and feed with a special bottle, Haberman feeder

B) assist mother with breastfeeding if baby can latch, suck, and swallow safely D) if unable to breastfeed, recommend use of a breast pump to maintain lactation and feed with a special bottle, Haberman feeder

A group of nursing students are reviewing info about the variations in respiratory anatomy and physiology in children in comparison to adults. The students demonstrate understanding when they identify which finding? A) children's demand for oxygen is lower than that of adults B) children develops hypoxemia more rapidly than adults do C) an increase in oxygen saturation leads to a much larger decrease in pO2 D) children's bronchi are wider in diameter than those of an adult

B) children develops hypoxemia more rapidly than adults do

What would be the priority nursing action on finding varicella vaccine at room temp on the shelf in the med room? A) ensure the varicella vaccine's integrity is intact; if intact, follow the 5 rights of vaccine administration B) do not administer this batch of vaccine C) ensure the varicella vaccine's integrity is intact; if intact give the vaccine after verifying proper physician orders D) ask the mother if the child has had any prior reactions to varicella

B) do not administer this batch of vaccine

the nurse explains to a parent that the normal reaction an infant may experience 12-25 hrs after receiving a DTaP immunization. The nurse determines the teaching is effective when the parent asks: A) should i wake my baby up to breastfeed more frequently? B) how much acetaminophen should i give for the fever? C) can you give imodium to an infant? D) what kind of nose spray can I use for the baby's condition

B) how much acetaminophen should i give for the fever?

a 3 yo is admitted with gastroenteritis and diarrhea. He has mild dehydration (5%). The lab results of stool specimen sent shows a mildly elevated WBC and positive for e coli. Based on this info, which action should the nurse carry out? A) starting an IV infusion B) instituting contact precautions C) instructing family to wash hands D) VNA follow up care upon discharge

B) instituting contact precautions C) instructing family to wash hands

a child being treated for bacterial pneumonia is receiving ABX, bronchodilators, and acetaminophen. Which is the best indicator of the desired outcome from treatment for ineffective airway clearance? A) intake and output are equal B) oxygen saturation is now 97% C) temperature has been less than 99 degrees D) the child has a frequent very congested cough with epistaxis

B) oxygen saturation is now 97%

A young mother asks for advice about handling her 2 year old's negative behavior. Which statement is the best recommendation? A) ignore the behavior because it is expected in this age group B) set realistic limits for the child, then be sure to stick to them C) encourage the young mom to ask the grandmother for more help D) punish the child for misbehaving

B) set realistic limits for the child, then be sure to stick to them

the nurse is providing teaching to the parents of a child diagnosed with rheumatic fever. Which would be included within the teaching plan? A) a diagnosis of RF may have genetic implications for future offspring B) the child will need prophylactic ABX for invasive procedures C) the child will recover fully requiring no further treatment in the future D) there should be a management regimen for electrolyte imbalance

B) the child will need prophylactic ABX for invasive procedures

a 10 yo with a history of asthma recently acquired an upper resp infection. His best peak expiratory flow rate if 500 L/min when healthy. THe child's current peak flow is 350 L/min. The nurse interprets this reading as an indicator for A) the child's asthma is under acceptable control B) the need to start a SABA C) this is a medical emergency requiring a trip to the ED for treatment D) the child needs to begin with inhaled cromolyn solution

B) the need to start a SABA

the mother of a 20 month old infant calls the pediatrician for advice. She reports to the nurse that the child has a barking cough at night and that his temperature is 37 C. The nurse suspects croup and should recommend: A) control the fever with acetaminophen and call back if the cough worsens B) try a cool mist humidifier at night and watch for s/s of difficulty breathing C) try over the counter meds and make appointments to see the pediatrician D) take the patient to the hospital because of the potential for respiratory obstruction

B) try a cool mist humidifier at night and watch for s/s of difficulty breathing

After reading the vaccine info sheets provided, a parent of a 2 month old is hesitant to consent to a recommended vaccine. The nurse should first ask the parent: A) did you know that vaccines are required by law for school entry B) what personal beliefs or safety concerns do you have about vaccinations? C) would you prefer that fewer vaccines are given at a time? D) Do you wish to postpone the vaccines?

B) what personal beliefs or safety concerns do you have about vaccinations?

When caring for a child recovering from Scarlet Fever, the nurse knows that (SATA) A) this disease can be teratogenic for the developing fetus B) white coated strawberry tongue is a hallmark symptom C) antibiotics are not helpful since this is a virus D) droplet precautions should be followed

B) white coated strawberry tongue is a hallmark symptom D) droplet precautions should be followed

the nurse is discussing discharge instructions with the parents of a 6 yo who has had a tonsillectomy. What is the most important thing to stress? A) administer analgesics as needed for discomfort B) encourage the child to drink liquids C) carefully observe for s/s of bleeding from the throat D) apply an ice collar intermittently for the next several days

C) carefully observe for s/s of bleeding from the throat

an unimmunized child has been hospitalized for a puncture wound and diagnosed with tetanus. Which action is important for the nurse to do during the hospitalization? A) check that the child is maintained on airborne precautions B) ensure the parents remain with the child at all times C) collect a thorough history from the parent and begin education about vaccines D) order a hypothermia mattress and prescribe antivirals

C) collect a thorough history from the parent and begin education about vaccines

the school nurse is caring for a boy with hemophilia who fell on his arm during a playtime period. A) apply warm compresses to control bleeding B) apply pressure to the site for at least 1 minute C) cool compresses and elevate above the level of the heart D) begin passage range of motion unless pain is too severe

C) cool compresses and elevate above the level of the heart

an 11 yo is admitted to the hospital for treatment of an asthma attack. Which s/s indicate an immediate intervention is needed? A) green nasal drainage B) frequent productive coughing C) intercostal retractions D) RR of 20 breaths/min and O2 sat of 95%

C) intercostal retractions

a mother of a 3 yo expresses concern over the child's bedwetting when hospitalized. The best response by the nurse to the mom is: A) he was too immature to be toilet trained anyways B) Children are afraid in the hospital and frequently wet the bed C) it's very common for children to regress when they are in the hospital D) this is not unusual. He probably received too much fluid the night before

C) it's very common for children to regress when they are in the hospital

a nurse is assessing the growth and development of a 14 yo boy. He reports that his 13 yo sister is 2 inches taller than him. The nurse should explain to the boy that the growth spurt in adolescent boys compared with the growth spurt of adolescent girls A) occurs at the same time B) occurs 2 years earlier C) occurs 2 years later D) occurs 1 year later

C) occurs 2 years later

therapeutic management of infants and children with diarrhea and mild dehydration should usually begin with A) water and fresh fruit B) IV fluids C) oral rehydration solution, like pedialyte D) antidiarrheal drug therapy

C) oral rehydration solution, like pedialyte

which assessment would be consistent with a diagnosis of asthma? A) cyanosis on any exertion B) productive mucous when coughing C) primarily expiratory wheezes, possibly some on inspiration also D) intermittent rales and rhonchi

C) primarily expiratory wheezes, possibly some on inspiration also

the nurse is assessing an 8 yo child with a possible leg fracture from a bicycle accident. Which action would best determine the child's level of pain? A) observe the child's behavior and evaluate pain with the FLACC scale B) ask the child how bad the leg hurts C) provide the child with an appropriate pain rating scale D) ask the parent how much pain the child is in

C) provide the child with an appropriate pain rating scale

Pancreatic enzymes are administered to the child with cystic fibrosis. Which considerations should the nurse use when conducting teaching with parents? A) do not administer pancreatic enzymes if the child is receiving ABX B) decrease dose of pancreatic enzymes if the child is having frequently frothy, foamy, bulky stools C) administer pancreatic enzymes between meals with a full glass of water D) pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of the meal

D) pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of the meal

the parents of a chidl with congestive heart failure and a congenital heart defect express anxiety about giving digoxin. The most appropriate response by the nurse is: A) it is very safe and frequently used drug B) it is most effective when given with meals C) parents lack the expertise to administer the medication D) parents are provided specific guidelines for administering digoxin

D) parents are provided specific guidelines for administering digoxin

Which of the following is the most important intervention to consider when drawing blood from a child diagnosed with hemophilia VIII? A) use finger punctures for multiple lab samples B) be prepared to administer platelets for prolonged bleeding times C) apply heat to the extremity before venipuncture for hemodilution D) schedule all labs to be drawn at the same time to minimize needlesticks

D) schedule all labs to be drawn at the same time to minimize needlesticks

A mother is requesting info on when to introduce solids to her infant. Which of the following informational statements is the most appropriate for the nurse to use when educating a parent on the introduction of solid foods? A) solid foods should not be given until the extrusion reflex disappears at 8 months of age B) solid foods can be mixed in a bottle or infant feeder to make feeding easier C) solid foods should begin with fruits and vegetables D) solid foods should be introduced one at a time with 4-7 day interval

D) solid foods should be introduced one at a time with 4-7 day interval

the parent of a 9 month old is concerned that the infant's anterior fontanelle is somewhat open. The nurse should tell the parent: A) I will measure your baby's head circumference to see it is developing properly B) your infant will need to be referred for more testing C) you should contact the physician immediately, we expect closing of the cranial sutures by now D) this is a normal finding and usually closes somewhere between 12-18 months

D) this is a normal finding and usually closes somewhere between 12-18 months

a nurse is assessing a 3 yo who weight 15 kg and had cardiac surgery 12 hours ago. The nurse should notify the surgeon about which of the following findings? A) a urine output of 60 ml in 4 hours and no change in wt B) strong peripheral pulses within all 4 extremities C) fluctuations of the fluid within the collection chamber of a chest tube drainage system D) alteration in the child's level of consciousness

D) alteration in the child's level of consciousness

a nurse is assessing a 4 yo boy's pain after returning from surgery. The nurse is aware that the best way to assess pain in this age group is to: A) ask the parent/guardian accompanying patient B) ask the patient to rate his pain using a numeric scale C) ask the pt to rate his pain using the NIPS pain scale D) ask the patient to rate his pain using the Wong Baker Scale

D) ask the patient to rate his pain using the Wong Baker Scale

the nurse recognizes that the single most important factor to consider when communicating with children is: A) the child's physical condition B) presence or absence of the child's parents C) nonverbal behaviors of the child D) developmental level of the child

D) developmental level of the child

the doctor suggests to parents of a newborn that surgery should be performed for a PDA to prevent which complication? A) cardiac infection B) right to left shunt C) decrease workload in the Left side of the heart D) increased pulmonary congestion

D) increased pulmonary congestion