Peds Test 2

A. Anticholinergic agent ​Rationale: An anticholinergic agent is contraindicated in the client with urinary retention. Anticholinergics affect the autonomic nervous system and interfere with the normal urination process leading to the retention of urine.​ Diuretics, cholinergic​ agents, and antiflatulence agents are not contraindicated in urinary retention.

The nurse is caring for a client with newly diagnosed urinary retention. The nurse should question a medication order that falls into which​ classification? A. Anticholinergic agent B. Diuretic C. Cholinergic agent D. Antiflatulence agent

A. Attending daycare B. Down syndrome D. Allergies E. Using a pacifier ​Rationale: Risk factors for developing otitis media include having​ allergies, attending​ daycare, using a​ pacifier, and having preexisting medical conditions including Down syndrome. Breastfeeding appears to have a protective effect against the development of otitis media.

The nurse is teaching a group of expectant women about situations that increase an​ infant's risk of developing otitis media. Which situation should the nurse​ include? (Select all that​ apply.) A. Attending daycare B. Down syndrome C. Breastfeeding D. Allergies E. Using a pacifier

D. Fluid and electrolyte imbalance. A child with diarrhea is at increased risk for fluid and electrolyte deficits. The nursing interventions for this child should be focused on maintaining adequate fluid intake as the infection runs its course. Medications should not be given to stop diarrhea as this may trap the infection inside the body. Give the child a wet cloth if they experience burning sensation upon defecation, but this is not the nurse's greatest concern.

What is the biggest nursing concern for a child with infectious diarrhea? A. Fluid overload B. Constipation from medications C. Anal ring of fire from acidic incontinence D. Fluid and electrolyte imbalance.

D. Rotavirus Rotavirus is the most common cause of severe diarrhea in children under 5 years old. Typical management of the disease once diarrhea has occurred is fluid replacement with Pedialyte and medications to reduce the symptoms, but NOT TO STOP DIARRHEA. Diarrhea is the body's natural way of expelling toxins, and by inhibiting the diarrhea it can cause the toxin to remain in the body instead of being flushed out.

What is the most common cause of severe diarrhea in children under 5? A. Influenza B. Measles C. Death D. Rotavirus

B. Early identification Because of the rapidity of disease progression in perinatally transmitted HIV infection, early identification of infected infants is important to ensure the most effective treatment. Medical management of the infant begins with prevention of the spread of HIV from mother to newborn.

What is the most important aspect when it comes to treating an infant for HIV/AIDS? A. Antibiotics B. Early identification C. Analgesics D. Immunizations

A. Mom will pass it onto the fetus The main concern with Rubella and pregnancy is the mom may pass it onto the unborn fetus. Rubella in pregnancy can lead to birth defects including cataracts, heart defects, hearing impairment, and learning disabilities. It may also cause a miscarriage or stillbirth.

What is the most prominent concern about Rubella in pregnant women? A. Mom will pass it onto the fetus B. Rubella does not affect pregnant women due to a change in antibodies C. The child will be born large for gestational age D. The mom will develop a learning disabilities

B. Antiretrovirals inhibit the replication of the virus and prevent the spread of the infection Antiretrovirals are used to prevent the spread of HIV to healthy cells by targeting the replication of the virus. Mothers who have HIV should immediately be put on antivirals to best reduce the risk of transferring the disease across the placenta to the baby.

What is the purpose of antiretrovirals in the treatment of HIV/AIDS? A. Antiretrovirals cure the disease B. Antiretrovirals inhibit the replication of the virus and prevent the spread of the infection C. Antivirals increase the speed of HIV transformation into AIDS D. Antivirals are not used in the treatment of HIV/AIDS

B. The efficacy of the vaccine will be diminished INACTIVATED vaccines can be given to children with weakened immune systems with no increased risk, HOWEVER, the effectiveness of the vaccine may be reduced. There is no truth behind the statement that vaccines cause autism, or that inactivated vaccines cause the disease they are meant to prevent.

What is the risk of giving inactivated vaccines to children with weakened immune systems? A. Studies have shown vaccines will cause autism in these children B. The efficacy of the vaccine will be diminished C. The vaccine will cause the disease it was meant to prevent D. Vaccines should never be given to children with weakened immune systems

C. Severely immunocompromised children D. Children with AIDS E. Pregnant patients Live vaccines should never be administered to patients that are severely immunocompromised as it may cause serious adverse reactions. Children with HIV CAN receive vaccinations IF the CD4 count is adequate. Once the disease has progressed to full AIDS, all vaccines are contraindicated.

What population should we not administer live vaccines to? (select all that apply) A. Healthy children over the age of 5 B. None, vaccines are never contraindicated C. Severely Immunocompromised children D. Children with AIDS E. Pregnant patients

A. Date B. Name of manufacturer C. Title and signature of person giving vaccine D. Signature of parent F. If the parents were given the vaccination information G. Site administered H. Lot number The nurse should document all of these into the patient chart. He/she does not need the signature of the child.

What should a nurse document every time she gives a vaccine? (Select all that apply) A. Date B. Name of manufacturer C. Title and signature of person giving vaccine D. Signature of parent E. Signature of child F. If the parents were given the vaccination information G. Site administered H. Lot number

A. Cleft palate B. Down syndrome C. Immunosuppressed These types of children have Eustachian tube dysfunctions, or are immunocompromised, where Otitis Media can progress more rapidly than in normal children. In these instances, antibiotics would be ordered right away to prophylactically attack any bacterial infection.

What types of children would antibiotics be ordered right away to treat for Acute Otitis Media? (select all that apply) A. Cleft palate B. Down syndrome C. Immunosuppressed D. Children over the age of 3 E. None, there is no indication for antibiotics right away

A. VAR; MMRV VAR has a trade name of Varivax and MMRV is a combination vaccine with a trade name of ProQuad. The other vaccines listed do not immunize against varicella.

What vaccination should the nurse draw up for a Varicella Immunization? A. VAR; MMRV B. Hep A; Hep B C. Tdap; DTap D. DT; TD

A. RV1 or RV5 RV1 and RV5 are the vaccines used to immunize against Rotavirus. Their trade names respectively are Rotarix and RotaTeq.

What vaccine can the nurse expect to give to immunize against Rotavirus? A. RV1 or RV5 B. Hep B C. Tdap or DTap D. MMR

D. None There are no vaccines against fifth and sixth disease. Both are spread through respiratory secretions so the focus of the nurse should be to limit exposure of visitors and staff.

What vaccine can the nurse give to prevent Fifth and Sixth disease? A. ProQuad B. MMRV C. Varivax D. None

D. MMRV The MMRV vaccine is given to immunize against mumps. The child is put on standard and droplet precautions while contagious and the incubation period is 14-21 days.

What vaccine should the nurse expect to give when immunizing against Mumps? A. VAR B. Tdap C. DT D. MMRV

C. DTap The vaccine DTap (Diphtheria + Tetanus + acellular pertussis) has a trade name of Deptacel or Infanrix and can vaccinate against pertussis. The TDap vaccine (also known as Adacel or Boostrix) is a booster shot that can be used to protect against whooping cough as well.

What vaccine will the nurse draw up to immunize a child against Whooping Cough? A. DT B. TD C. DTap D. ABCD

A. Oral cavity C. Skin E. Cardiovascular system ​Rationale: Physical assessment for fluid and electrolyte status focuses on the​ skin, oral cavity and mucous​ membranes, eyes, cardiovascular and respiratory​ systems, and neurological and muscular status. The ears and endocrine system are not a particular focus of fluid and electrolyte status assessment.

A client has been experiencing severe diarrhea for nearly a week. On which areas should the nurse focus when assessing this​ client? (Select all that​ apply.) A. Oral cavity B. Endocrine system C. Skin D. Ears E. Cardiovascular system

C. Vertebra D. Ribs ​Rationale: The axial skeleton is made up of the​ ribs, sternum, vertebral​ column, and skull. The appendicular skeleton is made up of the pectoral​ girdles, upper​ limbs, pelvic​ girdle, and lower limbs.

A client is diagnosed with several fractures of the axial skeleton. Which bone fracture should the nurse anticipate providing care for in this​ client? (Select all that​ apply.) A. Femur B. Lower leg C. Vertebra D. Ribs E. Arm

A. Orthostatic hypotension B. Poor skin turgor C. Increased heart rate ​Rationale: Orthostatic​ hypotension, increased heart​ rate, and poor skin turgor are acute manifestations of fluid volume deficit. Increases in urine output and weight gain are not acute manifestations of fluid volume deficit.

A client is experiencing severe diarrhea. Which data should indicate to the nurse that the client is experiencing fluid volume​ deficit? (Select all that​ apply.) A. Orthostatic hypotension B. Poor skin turgor C. Increased heart rate D. Increased urine output E. Weight gain

D. ​"Labyrinthitis" ​Rationale: Inflammation of the inner ear is called otitis​ interna, or labyrinthitis. Inflammation of the middle ear is referred to as otitis media. Inflammation of the ear canal is called otitis​ externa, or​ swimmer's ear.

A client presents to the clinic with inflammation of the inner ear. How should the nurse communicate this condition to​ colleagues? A. ​"Swimmer's ear" B. ​"Otitis media" C. ​"Otitis externa" D. ​"Labyrinthitis"

D. Hemotympanum ​Rationale: Hemotympanum refers to bleeding into or behind the tympanic membrane. Vertigo refers to a sensation of whirling or rotating. Insufflation is the introduction of air into a body region or​ cavity, such as the ear. A myringotomy is a surgical procedure that involves incision of the tympanic membrane.

A client presents with bleeding behind the tympanic membrane. Which term should the nurse use when documenting this​ condition? A. Insufflation B. Myringotomy C. Vertigo D. Hemotympanum

A. Rubeola (Measles) A tell-tale characteristic of Measles is Koplik's spots. Koplik's spots appear 2 days before the appearance of a systemic rash. The child is contagious 4 days before to 5 days after the appearance of the systemic rash.

A newly admitted child presents to the floor with Koplik's spots, fever, runny nose, loss of appetite, and lethargy. 2 days later the child then develops a rash that starts on the face and spreads down to the trunk, arms, and legs. What should the nurse suspect is the cause of these symptoms? A. Rubeola (Measles) B. Rubella ( German Measles) C. HIV/Aids D. Fifth Disease

RV1 or RV5 are both vaccines against Rotavirus. The Rotavirus vaccines are the only ones given orally and are primarily given to infants.

A nurse is preparing an oral administration of a vaccine. Which vaccine(s) is she preparing? A. Varicella B. MMR C. RV1 or RV5 D. TDap

B. <200 The nurse should be aware that a normal CD4 count is 500-1400. When levels dip below 200, the nurse should be concerned the disease has progressed to AIDS.

A nurse is reviewing lab tests ordered on her patient who is diagnosed with HIV. What CD4 result might concern her that the disease has progressed to AIDS? A. 1000-2000 B. <200 C. >200 D. 500-1400

A. Using appropriate needle length B. Rotate injection sites if administering more than one injection D. Inject the least painful vaccine first Incorporating the parents help can help the nurse keep the child calm during a stressful time. The nurse should not give all vaccinations rectally...The best thing the nurse can do is give the least painful vaccine first*

A nurse preceptor is instructing new nurse Kat on tips and tricks for administering vaccinations to children. What tips should Kat expect to hear from her preceptor? (Select all that apply) A. Using appropriate needle length B. Rotate injection sites if administering more than one injection C. Do not incorporate the parents help as they will just get in the way D. Inject the least painful vaccine first E. Give all vaccinations rectally

A. Hep B C. DTap D. IPV E. MMR F. Varicella All of these vaccines are required for a child to attend a Publix school from kindergarten to 12th grade. If the child plans on attending daycare, it may be required for them to get the Hib and Prevnar13 immunizations as well. Daycares may have different requirements than school children.

A parent is preparing to send their child to school and wants to make sure their vaccines are up to date. The nurse should expect to see which immunizations listed in the child's medical history that will qualify the child to attend kindergarten-12th grade? (Select All that Apply) A. Hep B B. Rotavirus C. DTap D. IPV E. MMR F. Varicella G. Rubeola

D. Mononucleosis ​Rationale: Mononucleosis may be treated with corticosteroids to reduce inflammation. Corticosteroids are not used to treat​ rubella, measles, or chickenpox.

A preadolescent client is experiencing​ fatigue, headache, sore​ throat, and a​ low-grade fever over the last 2 days. Which disease process should the nurse assess for if this client has an allergy to​ corticosteroids? A. Chickenpox B. Rubella C. Measles D. Mononucleosis

C. HepB The HepB vaccine is the only vaccine given shortly after birth. Varicella and MMR are live vaccines that are not given to newborns.

A recently born child is about to get their first vaccine. Which vaccine should the nurse expect to be ordered by the MD? A. Hib B. Varicella C. HepB D. MMR

A. Administering prescribed intravenous antibiotics ​Rationale: Providing prescribed medications is a collaborative intervention. Using sterile​ technique, hand​ hygiene, and medical asepsis are independent nursing interventions.

A​ school-age client with a fever is being tested for possible kidney failure. Which collaborative intervention should the nurse make a priority for this​ client? A. Administering prescribed intravenous antibiotics B. Performing hand hygiene C. Using sterile technique D. Practicing medical asepsis

B. Dry mucous membranes and no tears when crying C. Very poor skin turgor E. Lethargy If an infant is dehydrated, it will show sings of dry mucous membranes, poor skin turgor (tenting) and lethargy. When assessing for dehydration, Haley might find LESS wet diapers than usual and SUNKEN fontanels rather than more wet diapers and bulging fontanels. Other S/S might include increased respiratory rate, sunken eyes with dark circles, abnormal skin color, hypotension, or low temperature.

Haley is assessing an infant for S/S of dehydration. What might she expect to see? (Select all that apply) A. More wet diapers than usual B. Dry mucous membranes and no tears when crying C. Very poor skin turgor D. Bulging fontanels E. Lethargy

C. VAERS The VAERS is the vaccine adverse event reporting system where a nurse can document a child's adverse reaction to a vaccine. She documents it using the manufacturer/lot number. If enough children have an adverse reaction to that lot #, it may be recommended for pediatricians to not give that specific lot of vaccines.

If the child has an adverse reaction to a vaccine, where should the nurse report it? A. CDC B. FDC C. VAERS D. AICS

D. Diarrhea The most important cause of diarrhea in children is Rotavirus. It is most severe in children 3-24 months and decreases in severity if vaccinized.

Rotavirus is known to cause what significant symptom in children? A. Epiglottitis B. Bronchitis C. Tachycardia D. Diarrhea

A. Cool and pale skin B. Cap refill >3 sec. D. Absence of sensation distal to injury site Cool and pale skin may indicate absence of blood flow to the area being assessed. Skin should be warm and pink. Cap refill time should be <2 sec not >3 which also indicates lack of blood flow. And absence of sensation is abnormal, as well as numbness or tingling in the extremities. Pulses +2 and adequate movement of digits are both normal findings.

Sarah H is performing a a neurovascular assessment on her 6 yo patient. Which S/S should she recognize as abnormal? (Select all that apply) A. Cool and pale skin B. Cap refill >3 sec. C. Pulses +2 distal to injury site D. Absence of sensation distal to injury site E. Adequate movement of digits

B. Strep Throat Scarlett fever is a strain of Group A Hemolytic Streptococci which is the same bacteria that causes strep throat but a different strain.

Scarlett fever is caused by the same bacteria (different strain) that causes what well known disease? A. Otitis Media B. Strep Throat C. Influenza D. Bacteremia

A. Antiviral Acyclovir is an antiviral medication used to target the specific phases of HIV replication cycle to prevent further growth of the virus. It is also used for children with chicken pox to decrease viral shedding and reduce the time of healing of lesions.

Acyclovir (Zovirax) is what type of medication? A. Antiviral B. Antibiotic C. Analgesic D. NSAID

C. ​"Frequent bowel movements can occur with​ breastfeeding." ​Rationale: Frequent bowel movements often occur with​ breastfeeding; therefore, this response is the most appropriate. There is no indication that the infant is losing weight. Control of defecation is not expected at 2 months of age. While feces that contain less water may be difficult to​ pass, the infant is not experiencing hard stools.

A breastfeeding mother of a​ 2-month-old infant is concerned that her son defecates too frequently. Which response by the nurse should address this​ mother's concern? A. ​"The increased frequency in defecation means your baby is at risk of weight​ loss." B. ​"Your baby should be able to control defecation by​ now." C. ​"Frequent bowel movements can occur with​ breastfeeding." D. ​"Feces containing less water may be difficult for infants to​ expel."

C. Screen time at night ​Rationale: School-age children need 10-11 hours of sleep per night. They may spend more time at the​ computer, playing video​ games, and watching​ TV, leading to difficulty falling asleep and fewer hours of sleep. A regular and consistent sleep schedule and bedtime routine need to be established. The client is not experiencing sundown syndrome. Nocturnal emissions and nightmares are not the cause of the​ client's symptoms.

A caregiver of a​ 10-year-old fifth grader reports to the nurse about the current behavior of the child. The teacher reported to the caregiver that the student is falling asleep in​ class, is distracted in interactions with the peer​ group, and has trouble​ concentrating, leading to poor grades on assignments. The caregiver also reports that the child often plays video games late into the night. Which issue does the nurse suspect as the cause of the​ behavior? A. Waking up frequently at night due to nightmares B. Sundown syndrome C. Screen time at night D. Nocturnal emissions

C. Shingles A child given the live vaccine of varicella is at increased risk of developing shingles later in life.

A child immunized with a live vaccine of Varicella is at risk of developing what disease later in life? A. Chicken pox B. Small pox C. Shingles D. AIDS

C. Pneumonia Pneumonia is a complication of Whooping cough that is the usual cause of death in infants. If a child is diagnosed with whooping cough, EVERYONE IN THE FAMILY NEEDS TO BE TREATED.

A child is admitted for an infection related to Bordetella Pertussis. THe child has a short rapid cough followed by a "whoop" sound. What complication of this disease is the usual cause of death in infants? A. Bacteremia B. Sore throat C. Pneumonia D. Bronchitis

B. Ok, but wait 24-48 hours to give the first dose Doctors will sometimes tell the parents to wait 24-48 hours to give the first dose. They will instruct the parent to monitor for signs and symptoms of otitis media. If the symptoms improve without the antibiotics, the infection may be viral and the child will not need the prescription.

A child is newly diagnosed with otitis media in your clinic. The parent tells the MD they want a prescription now. Knowing that doctors like to take a "wait and see" approach, what might the nurse expect the doctor to tell the parent? A. No B. Ok, but wait 24-48 hours to give the first dose C. Use acetaminophen and ibuprofen instead. They work better. D. Go to the hospital and get a prescription there.

A. Seizure B. Blood in urine C. Inflammation of stomach/intestines D. Difficulty breathing Abnormal reactions of vaccines include all of these except mild tenderness at the injection site. This is a known possible side effect and considered normal.

After administering a vaccine, the nurse instructs the parents to observe the child for abnormal reactions that include: (select all that apply) A. Seizure B. Blood in urine C. Inflammation of stomach/intestines D. Difficulty breathing E. Mild tenderness at injection site

D. Diarrhea In an infant or child, meningitis will cause: Irritability, poor feeding High pitched cry, difficult to soothe Fontanelles: tense, bulging Cranial sutures: separated Scalp veins: distended Headache Vomiting: with or without nausea Seizures Diplopia, blurred vision Diarrhea is a symptom commonly associated with Rotavirus.

All of the following are symptoms of meningitis in an infant except: A. Headache B. Bulging fontanelles C. Seizures D. Diarrhea

C. Abdominal pain All other symptoms listed are common occurrences in patients with Diphtheria.

All of these are symptoms of Diphtheria except? A. Weakness B. Sore throat C. Abdominal pain D. Fever E. Swollen glands in neck

A. Administering prescribed fluids C. Monitoring intake and output closely D. Administering prescribed antipyretics ​Rationale: Treatment for an infection includes fluid​ therapy, monitoring of intake and​ output, and providing antipyretics as prescribed. The client has a fever and may be uncomfortable with a warming blanket. Vaccination teaching is not a priority for this client.

A​ preschool-age client is experiencing​ "burning" with urination and a fever of​ 102°F (38.9°C). Which intervention should the nurse make a priority​? ​(Select all that​ apply.) A. Administering prescribed fluids B. Providing warming blankets C. Monitoring intake and output closely D. Administering prescribed antipyretics E. Teaching about vaccinations

C. Rotavirus Bacterial meningitis can be caused by any of the three infections Streptococcus pneumonia, E. coli, and Group B strep, as well as many other bacterial infections. Rotavirus is a viral infection and not likely to cause meningitis.

Bacterial meningitis is an acute inflammation of the CNS and can be caused by all of the following except: A. Streptococcus pneumoniae B. E. Coli C. Rotavirus D. GBS

C. The vaccine information sheet from the CDC Before administering the vaccine, parents should be allowed to see the vaccine information from the CDC. The nurse should not give her phone number to the parents or administer the vaccine to the parents first.

Before administering a vaccine, the nurse should give the parents what? A. A taste of their own medicine B. Her phone number in case there is an adverse reaction C. The vaccine information sheet from the CDC D. The vaccines to make sure they aren't harmful to the child.

B. Teach personal hygiene C. The importance of hand-washing D. The importance of a clean water supply Diarrhea is spread through the fecal-oral route. It can be as simple as a toddler touching a toy that has been contaminated with fecal matter. Hand and personal hygiene is always important in preventing the spread of infection. Eating under-cooked foods can contain salmonella which might increase the likelihood of diarrhea, not prevent it.

Brittni is teaching the parents of a 4 year old about how to prevent diarrhea in their child. What should she include in her teaching? (Select all that apply) A. Most diarrhea is spread through skin to skin contact route. B. Teach personal hygiene C. The importance of hand-washing D. The importance of a clean water supply E. Eat more under-cooked foods as this will expose the body to more pathogens for greater immunity

A. Measles A vitamin A supplement is given sometimes due to a link between measles and vitamin A deficiency.

Deficiency of vitamin A has been linked to what communicable disease? A. Measles B. Mumps C. Rotavirus D. Infuenza

A. Diphtheria B. Tetanus C. Acellular pertussis D. Polio A child with HIV should be vaccinated for: Diphtheria Tetanus Acellular pertussis Inactivated poliovirus Haemophilus influenzae type b (Hib) Hepatitis B Pneumococcal vaccine Annual influenza vaccine As soon as them reach recommended age. Vaccines with inactivated viruses can be used in children with weakened immune systems with no increased risk, but the effectiveness may be reduced in some cases

Children with HIV should be immunized as soon as they reach the age recommended for: (Select all that apply) A. Diphtheria B. Tetanus C. Acellular pertussis D. Polio E. Live flu vaccine F. None

A. HCPs like to take a wait and see approach. B. Antibiotics won't help an infection caused by a virus D. Antibiotics cause side effects Antibiotics DO NOT drain middle ear fluid and they DO NOT relieve pain in the first 24 hours. The MD's like to take a wait and see approach to determine if the infection is viral or bacterial. If it is viral, antibiotics will not help, therefore MD's wait to order them.

Christina is teaching the parents of a child diagnosed with otitis media about why antibiotics are not ordered right away. What topics should she include? (Select all that apply) A. HCPs like to take a wait and see approach. B. Antibiotics won't help an infection caused by a virus C. Antibiotics drain middle ear fluid which is harmful to the child D. Antibiotics cause side effects E. Antibiotics relieve pain in the first 24 hours, which can negate the ability of the doctor to know if the infection is viral or bacterial.

A. MMR The MMR vaccine is the most painful vaccine, therefore it should be given last so the child is more cooperative during the other vaccine shots.

Cody is preparing to give multiple vaccines. Based on his knowledge of administration techniques, which vaccine will he give last? A. MMR B. Varicella C. Rotavirus D. HepB

A. Vegetables C. Beans D. Whole grains E. Deez nuts F. Fruits Steaks are not a great sources of fiber, however, nuts, fruits, beans, veggies, and whole grains are greats sources of fiber.

Cody is suggesting foods high in fiber to the parents of a child with impaired elimination. What foods should he include? (Select all that apply) A. Vegetables B. Steak C. Beans D. Whole grains E. Deez nuts F. Fruits

A. Rubeola B. Rubella D. Varicella Zoster E. Rotavirus The full list of viral exanthems includes: Rubeola (Measles) Rubella (German Measles) Fifth Disease (Parvovirus B19) Roseola Infantum HPV Varicella Zoster - Chicken Pox Rotavirus HIV/AIDS Scarlett fever is caused by a bacterial streptococcal infection and is not a viral exanthem.

Diseases that form from viral agents include: (select all that apply) A. Rubeola B. Rubella C. Scarlett Fever D. Varicella Zoster E. Rotavirus

A. ​"A 3-year-old child needs 10 to 13 hours of sleep each​ night." ​Rationale: Growing children require more sleep than adults. The​ 3-year-old child requires 10 to 13 hours of sleep each night. Infants need 14 to 17 hours of sleep in 24 hours. Adolescents require 8 to 10 hours of sleep each night. Adults need 7 to 9 hours of sleep each night.

During a preschool​ screening, the caregiver of a​ 3-year-old child asks the nurse how many hours of sleep the child requires each night. Which response by the nurse is​ appropriate? A. ​"A 3-year-old child needs 10 to 13 hours of sleep each​ night." B. ​"A 3-year-old child needs 14 to 17 hours of sleep each​ night." C. ​"A 3-year-old child needs 8 to 10 hours of sleep each​ night." D. ​"A 3-year-old child needs 7 to 9 hours of sleep each​ night."

B. ​"Boys have more muscle mass than​ girls." ​Rationale: Boys have more muscle mass than girls. Muscle growth in girls peaks between the ages of 16 and 20. Eating more will not increase the amount of muscle. Boys and girls have the same amount of muscle until age 13.

During a​ well-child visit, a female high school student complains about their inability to do as much physically as their twin brother. Which response by the nurse is​ accurate? A. ​"Muscle growth in girls peaks at age​ 13." B. ​"Boys have more muscle mass than​ girls." C. ​"Girls have less muscle after the age of​ 16." D. ​"Girls need to eat more to have more​ muscle."

B. Tofranil acts on the smooth muscle of the bladder neck and may reduce stress incontinence. Tofranil is often used for enuresis in children OVER the age of 6. It can be used for bed-wetters and may cause drowsiness so it should be given closer to bedtime.

Jeff is a new nurse working on a pediatric floor. He notices Tofranil (Imipramine) is an antidepressant ordered for his 7 year old patient. Jeff asks the Doctor why he would order this and the doctor responds: A. The child is most likely suicidal because they cancelled paw patrol B. Tofranil acts on the smooth muscle of the bladder neck and may reduce stress incontinence. C. I didn't mean to order that, no child over 6 should receive that medication D. Tofranil calms the lining of the intestines to reduce the episodes of bowel incontinence.

A. Prevent secondary infections B. Promote adherence to medication regimens E. Promote adequate nutrition The main goal when caring for a patient with AIDS is to promote care that reduces/eliminates chance of secondary, opportunistic infections. This is done through frequent hand hygiene (not infrequent), adherence to medication regimens, and adequate nutrition. Poor nutrition results in an increased risk of infection and higher mortality.

Kristina is a new nurse taking care of a newly admitted patient with AIDS. What are the goal(s) of care for this patient? (Select all that apply) A. Prevent secondary infections B. Promote adherence to medication regimens C. Promote infrequent hand hygiene D. Suggest invasive procedures in newborns E. Promote adequate nutrition

A. Take the full course of antibiotics, even after symptoms have subsided Parents should always continue the antibiotics for the full regimen and not stop them after symptoms disappear. Antibiotics are not helpful against viral infections.

Marisa is teaching a patient's parents about medication compliance regarding treatment for Otitis Media. What should she include in the teaching? A. Take the full course of antibiotics, even after symptoms have subsided B. Stop taking the antibiotics as soon as symptoms subside C. Rotate the antibiotics with acetaminophen to reduce pain. D. Take the antibiotics only if the doctor says the infection is viral

A. Hib Meningitis has shown decreased incidence following the use of the Hib vaccine.

Meningitis has decreased incidence following what vaccination? A. Hib B. TDap C. VAR D. MMRV

B. Parotitis The symptoms of mumps include fever, headache, and malaise followed by the classic sign of parotitis (inflammation of the salivary glands located on either side of the face. It produces a "chipmunk-like" effect similar to when someone has their wisdom teeth removed.

Mumps has what classic symptom? A. Bronchitis B. Parotitis C. Otitis Media D. Fibroditis

A. Persistent High fever lasting 3-4 days B. Rash appears after fever subsides D. Rash starts on trunk and moves to face and extremities Sixth disease is characterized by persistent high fever that subsides and develops into a rash that starts on the trunk and moves to the face and extremities. Children are rarely hospitalized for this infection.

Roseola (sixth disease) presents with what symptoms? (select all that apply) A. Persistent High fever lasting 3-4 days B. Rash appears after fever subsides C. Koplik's spots appear before rash D. Rash starts on trunk and moves to face and extremities E. blue fingernails and toenails

B. ACIP and CDC the Advisory Committee on Immunization Practices (ACIP) and the Centers for Disease Control (CDC) are the committees that provide recommendations for immunization schedules and treatments.

Recommendations for immunizations are provided by which two advisory committees? A. BPP and FDC B. ACIP and CDC C. FDA and EPA D. ROTC and FSU

A. Be older than 5 years old B. Have 2 episodes of incontinence per week for at least three months A child that struggles with enuresis and nocturnal enuresis will be diagnosed if (1) they are older than 5 (2) they have 2 episodes of incontinence per week for at least three months and (3) have urinary urgency/frequency. Organic causes of enuresis include structural defects, UTIs, impaired kidney function, neurologic deficits/ endocrine disorders (diabetes), or sickle cell disease. Enuresis can be treated with Tofranil, Oxybutynin, or DDAVP.

Tabitha is assessing a child at an outpatient clinic. The parent states that the child has struggled with bed wetting for a while now. Tabitha knows in order to diagnose enuresis, the child must: (Select all that apply) A. Be older than 5 years old B. Have 2 episodes of incontinence per week for at least three months C. Have no urinary urgency or frequency D. Must tell the doctor they are a bed wetter

A. Bladder training B. Fluid restriction before bedtime D. Medications that might be prescribed by the HCP E. Underwear zapper that shocks the child when they wet the bed Parents might be instructed to wake the child during the night to void in order to prevent episodes of bed wetting. Conditioned reflex response devices do exist to condition the child not to wet the bed....

Tabitha is educating the mom of a 6 yo patient recently diagnosed with nocturnal enuresis on how to prevent future episodes. What should she include? (Select all that apply) A. Bladder training B. Fluid restriction before bedtime C. Do not wake the child to pee during the night D. Medications that might be prescribed by the HCP E. Underwear zapper that shocks the child when they wet the bed

D. Urinary urge incontinence Ditropan is an antispasmodic agent that acts on the smooth muscle of the bladder to inhibit urge incontinence of urine in the child. It is mostly used for urge incontinence due to overactive bladder or inability to retain urine.

The HCP prescribes Oxybutynin (Ditropan) for a 6 year old patient. The nurse knows that this child likely has what? A. Stool incontinence B. Nausea and Vomiting C. Constipation D. Urinary urge incontinence

C. Meningitis Meningitis is defined as the inflammation of the meninges. The CNS has limited response to injury and lab studies are required to identify the causative agent.

What disease can cause inflammation of the meninges, brain, and/ or spinal cord? A. Pneumonia B. Otitis Media C. Meningitis D. Laryngitis

A. Enlarged adenoids C. Down syndrome D. Pacifier use E. Allergic rhinitis ​Rationale: Factors that may increase an​ infant's risk of developing otitis media include Down​ syndrome, enlarged​ adenoids, allergic​ rhinitis, and pacifier use. Breastfeeding appears to be protective against otitis media.

The community health nurse is giving a presentation to a group of new mothers about infant wellness promotion. The nurse teaches about factors that increase an​ infant's risk of developing otitis media. Which item is most appropriate for the nurse to include in the​ presentation? (Select all that​ apply.) A. Enlarged adenoids B. Breastfeeding C. Down syndrome D. Pacifier use E. Allergic rhinitis

A. Onset gradual B. Associated with measles, mumps, herpes, and leukemia E. Causative agents are principally viruses Viral meningitis differs from bacterial due to a slower onset, relation to other viral diseases, and its causative agents are typically viruses. Viral meningitis will have to dissipate on its own as antibiotics are not effective treatments.

The difference between Viral meningitis and bacterial meningitis is: (Select all that apply) A. Onset gradual B. Associated with measles, mumps, herpes, and leukemia C. Acute inflammation of CNS D. Treated with antibiotics E. Causative agents are principally viruses

A. ​"Children often achieve daytime bladder control prior to nighttime​ control." ​Rationale: Bladder control is attained by ages 2 to 5​ years, often with daytime control attained prior to nighttime control. Oliguria is scant urine​ output, and the other statements by the nurse do not address the​ father's concern.

The father of a​ 3-year-old boy is concerned that his child still wets the bed at night. Which explanation by the nurse is most appropriate regarding​ bedwetting? A. ​"Children often achieve daytime bladder control prior to nighttime​ control." B. ​"Oliguria is not uncommon in​ children." C. ​"Sometimes children experience​ nocturia." D. ​"By 24​ months, children are capable of holding urine beyond the urge to​ void."

B. Diarrhea Diarrhea is the leading cause of illness in children under 5 years old.

The leading cause of illness in children < 5 years of age is? A. Constipation B. Diarrhea C. UTIs D. ICP

C. Chicken Pox The viral agent VZV causes the disease Chicken Pox. Children with chicken pox are contagious 1 day before eruption of lesions until all vesicles are crusted over. Children in the hospital should be put on contact isolation.

What disease develops from the agent Varicella-Zoster Virus? A. Small Pox B. Leprosy C. Chicken Pox D. Herpes Simplex A

C. Enuresis E. Incontinence ​Rationale: The two types of involuntary urinary elimination are enuresis and urinary incontinence. Enuresis is repeated involuntary urination in children old enough for bladder control. Urinary incontinence is involuntary leakage of urine or loss of bladder control. Oliguria and anuria are alterations in urinary elimination but are not considered involuntary. Impaction is a term that refers to an accumulation of dry fecal contents in the bowel that cannot be expelled.

The nurse educator is planning a presentation on involuntary urinary elimination for a group of new nurse graduates. The nurse educator should include which condition related to the types of involuntary urinary​ elimination? (Select all that​ apply.) A. Anuria B. Oliguria C. Enuresis D. Impaction E. Incontinence

B. ​"Amoxicillin is the drug of choice for treatment of pediatric otitis​ media." D. ​"Vaccines may help reduce the risk of developing otitis​ media." E. ​"Topical anesthetic eardrops may be​ prescribed." ​Rationale: Treatment of acute otitis media in children may or may not include antibiotics. If antibiotics are​ indicated, amoxicillin is the​ first-line therapy for children. Topical anesthetic eardrops may be prescribed for pain relief if the tympanic membrane is intact. Immunizations such as the Haemophilus influenzae type B​ (Hib) vaccine and pneumococcal vaccine appear to decrease the incidence of otitis media caused by these pathogens. Treatment of serous otitis media may include an​ anti-inflammatory drug​ (for example, oral prednisone for 7​ days) to reduce mucosal edema of the eustachian tube.

The nurse educator is teaching a class about pharmacologic agents that are used in the prevention and treatment of otitis media in children. Which statement is most appropriate to​ include? (Select all that​ apply.) A. ​"Treatment always includes​ antibiotics." B. ​"Amoxicillin is the drug of choice for treatment of pediatric otitis​ media." C. ​"Oral prednisone is always​ prescribed." D. ​"Vaccines may help reduce the risk of developing otitis​ media." E. ​"Topical anesthetic eardrops may be​ prescribed."

B. Expense of immunizations C. Parental misconceptions E. Lack of public awareness Obstacles for nurses when it comes to immunizations include: Complexity of the health care system Expense of immunizations Parental misconceptions Inaccurate record keeping Reluctance of healthcare workers to give more than two vaccines at a time Lack of public awareness The nurse should be aware of these obstacles when talking to parents about immunizations.

The nurse is about to lecture a class of parents about recommended immunizations. What obstacles should the nurse be aware of before beginning the lecture? (Select all that apply) A. Simplicity of the health care system B. Expense of immunizations C. Parental misconceptions D. Accurate recordkeeping of prior immunizations E. Lack of public awareness

C. Cefotaxime (Claforan) Cefotaxime is a third generation cephalosporin used to treat URIs in children. As with Rocephin, Clarofan should not be given to premature neonates or those that appear jaundiced in color.

The nurse is assessing a child recently admitted for an Upper Respiratory Infection. The nurse notices that an antibiotic has been ordered q 8 hours. What antibiotic should the nurse see in the MAR? A. Ceftriaxone (Rocephin) B. Vancomycin C. Cefotaxime (Claforan) D. Desmopressin (DDAVP)

B. Virus ​Rationale: Infections are a normal part of​ childhood, and most children experience some kind of infection from time to time. The majority of these infections are caused by​ viruses, and for the most part they are transient and relatively benign and can be overcome by the​ body's natural defenses and supportive care.​ Bacteria, influenza, and parasites are not the reason for common infections seen in childhood.

The nurse is assessing a child who reports feeling nauseated and just​ "sick." Which type of organism should the nurse suspect is causing the​ child's illness? A. Bacteria B. Virus C. Influenza D. Parasite

C. Restless ​Rationale: Mild dehydration can be difficult to detect in young children because they tend to not show any​ symptoms, though they may be alert or restless. Mucous membranes and skin tends to remain warm and moist and urine does not always appear concentrated.

The nurse is assessing a young child in the community clinic. Which sign indicates to the nurse that the child is experiencing mild​ dehydration? A. Dry mucous membranes B. ​Cool, dry skin C. Restless D. Concentrated urine

A. Fifth Disease Erythema Infectiosum (Fifth Disease) is an infection caused by the human parvovirus B19 and causes a rash to develop in the three stages listed. The child should be put on droplet precautions ONLY IF they are in aplastic crisis or immunosuppressed.

The nurse is caring for a child diagnosed with a disease that causes a rash in three stages (1) a "slapped" face, (2) Maculopapular rash on extremities, (3) Rash subsides but reappears if skin is irritated by heat, cold, friction, etc. What disease causes these symptoms? A. Fifth Disease B. Sixth Disease C. Scarlett fever D. Rotavirus

A. Cane ​Rationale: Assistive devices are used to provide balance and support and increase confidence with independent ambulation. They also reduce pressure on an injured​ limb, prevent further​ injury, and promote healing. Canes are used by clients who can bear weight but are unsteady or have a weak limb. When using a​ walker, the arms support the majority of the body weight. For​ crutches, upper body and trunk strength is needed. A wheelchair will not assist with ambulation.

The nurse is caring for a client who can bear weight but has a weak limb. Which assistive device is the most appropriate for this​ client? A. Cane B. Walker C. Wheelchair D. Crutches

A. Antiretroviral ​Rationale: Antiretroviral medications target specific phases of the HIV replication​ cycle, requiring multiple drugs to be taken concurrently. Antibiotics may be used prophylactically to prevent infection or used to treat existing bacterial infection. A specific antibiotic is chosen based on the pathogen causing the infection. Antifungals are selective for fungal plasma membranes. They inhibit ergosterol synthesis. Antipyretics relieve pain and reduce fever.

The nurse is caring for a client who is positive for HIV. Which classification of medication that targets the phases of HIV replication should the nurse expect to be​ prescribed? A. Antiretroviral B. Antibiotic C. Antipyretic D. Antifungal

D. ​"Fluid in the blood vessels is unavailable for the body to​ use." ​Rationale: In third​ spacing, fluid moves from the vascular space into an area where it is not available to support normal physiological functioning. The fluid may move into the peritoneal space or​ pleura, where it is trapped. The unavailable fluid in third spacing may be located in the bowel or peritoneal cavity. The fluid loss that can be attributed to third spacing may be difficult to detect because the​ client's weight may remain stable and intake and output records may not indicate a fluid loss. Fluid does not leave the body or enter the intracellular space or subcutaneous tissue.

The nurse is caring for a client with third spacing. Which information should the nurse use to explain this health problem to the​ client's family? A. ​"Fluid moves into the fatty tissue under the​ skin." B. ​"Fluid leaves the body through increased​ urination." C. ​"Fluid moves into the space in the body​ cells." D. ​"Fluid in the blood vessels is unavailable for the body to​ use."

A. ​"In what position do you hold the baby to​ eat?" B. ​"Do you breastfeed or​ bottle-feed your​ infant?" C. ​"Do you or anyone else in your house​ smoke?" ​Rationale: An infant who is exposed to cigarette smoke is at higher risk of developing otitis media. The position of the infant during feedings can cause otitis media. Babies should be positioned upright to prevent feedings from refluxing into the eustachian tubes. Breastfeeding provides more immune properties and decreases the risk of otitis media. Increased irritability and bleeding or ear drainage are clinical manifestations of otitis media. They are not preventive measures.

The nurse is caring for an infant experiencing a third incidence of otitis media in 6 months. Which question should the nurse ask the parents to determine the cause of these​ infections? (Select all that​ apply.) A. ​"In what position do you hold the baby to​ eat?" B. ​"Do you breastfeed or​ bottle-feed your​ infant?" C. ​"Do you or anyone else in your house​ smoke?" D. ​"Has your baby been more irritable​ lately?" E. ​"Have you noticed any bleeding or ear​ drainage?"

A. Promote comfort C. Promote education D. Prevent injury ​Rationale: Independent nursing interventions for the client with an alteration in mobility focus on promoting education and comfort as well as preventing injury. Although promoting healthy relationships and recommending immunizations may be important for all​ clients, these nursing interventions are not specifically important to clients with alterations in mobility.

The nurse is developing a plan of care for a client experiencing an alteration in mobility. Which objective is most appropriate for the nurse to​ include? (Select all that​ apply.) A. Promote comfort B. Recommend immunizations C. Promote education D. Prevent injury E. Promote healthy relationships

C. The child will have normal motor and language development. ​Rationale: A child with new conductive hearing loss should still meet developmental milestones for growth and development. These include normal motor and language development. Receiving pain relief and being​ infection-free after treatment are goals related to otitis​ media, but not related to conductive hearing loss. Encouraging caregivers to administer medications appropriately is an important​ goal; however, it is unrelated to hearing loss.

The nurse is developing a plan of care for the child who has experienced multiple episodes of otitis media and now presents with conductive hearing loss. Which goal would be appropriate for this​ child? A. The child will report relief of pain after treatment. B. The caregivers will administer medications as prescribed. C. The child will have normal motor and language development. D. The child will be​ infection-free after completion of treatment.

B. Behavioral modification C. Psychological treatment D. Pharmacologic treatment of constipation E. Collaboration with school nurses and teachers ​Rationale: Appropriate therapies include psychological​ treatment, collaboration with school nurses and​ teachers, pharmacologic treatment of​ constipation, a​ high-fiber diet, and behavioral modification. A client experiencing encopresis should drink 6-8 glasses of fluid per day.

The nurse is planning care for a child experiencing encopresis. Which collaborative intervention should be​ included? (Select all that​ apply.) A. Limiting fluid intake B. Behavioral modification C. Psychological treatment D. Pharmacologic treatment of constipation E. Collaboration with school nurses and teachers

A. Emaciation B. Weakness C. Dehydration E. Skin breakdown ​Rationale: Persistent diarrhea generally results in irritation of the anal​ region, which can extend to the perineum and buttocks.​ Fatigue, weakness,​ malaise, and emaciation are the results of prolonged diarrhea. Dehydration can result for the loss of fluid and electrolytes.

The nurse is planning to teach a client about the consequences of persistent diarrhea. Which clinical manifestation should the nurse​ include? (Select all that​ apply.) A. Emaciation B. Weakness C. Dehydration D. Loss of appetite E. Skin breakdown

A. ProQuad ProQuad is the trade name for the MMRV vaccine used to immunize against Measles, Mumps, Rubella, and Varicella. Varivax is for varicella, Boostrix is the trade name for the Tdap vaccine, and Infanrix is the trade name for DTap vaccine.

The nurse is preparing to give a child the vaccine for Rubella (German Measles). Which vaccine should she draw up? A. ProQuad B. Varivax C. Boostrix D. Infanrix

C. MMRV; ProQuad The MMRV vaccine is a combination vaccine that includes the vaccinations for Measles, Mumps, Rubella, and Varicella. The trade name is ProQuad. RV1 and RV5 are vaccinations for Rotavirus and VAR is the vaccination for Varicella.

The nurse is preparing to give a child the vaccine for Rubeola (Measles). Which vaccine should she draw up? A. RV1; Rotarix B. RV5; RotaTeq C. MMRV; ProQuad D. VAR; Varivax

C. Droplet The child that is diagnosed with Rubella should be put on Droplet precautions as the disease is spread through body fluid secretions.

The nurse is preparing to put a child diagnosed with contagious Rubella onto hospital isolation precautions. What precautions should she put in? A. Airborne B. Contact C. Droplet D. Contact Bleach

C. Epiglottitis Epiglottitis is a severe complication of the disease Haemophilus Influenzae Type b (Hib).

What disease is caused by a severe complication of Haemophilus Influenzae Type b? A. Scarlett Fever B. Common Cold C. Epiglottitis D. Pharyngitis

A. ​"Proper hand hygiene should be used​ consistently." ​Rationale: Hand​ hygiene, comprehensive​ immunizations, proper​ nutrition, adequate​ hydration, and appropriate rest are essential to preventing or treating infections in children. Children do not have natural immunity. Vitamin supplements are used if prescribed by the healthcare professional. There is no reason to restrict the​ child's exposure to others.

The nurse is teaching a group of new mothers about the best way to prevent infections in children. Which statement by the new mothers should indicate to the nurse that the teaching was​ effective? A. ​"Proper hand hygiene should be used​ consistently." B. ​"My child has a natural immunity to most​ microorganisms." C. ​"I should not take my child out in public more than once a​ week." D. ​"I should make sure my child takes a full spectrum of​ vitamins."

B. Ceftriaxone (Rocephin) Rocephin is an antibiotic that can be given IM to treat infections. It should not be given to neonates that were born prematurely or who appear jaundiced in color.

The nurse is treating a child recently diagnosed with an acute case of bacterial Otitis Media. The nurse anticipates an antibiotic to be ordered IM. Which antibiotic should the nurse expect? A. Ceftriaxone (Rocephin) B. Cefotaxime (Claforan) C. Vancomycin D. Desmopressin (DDAVP)

A. Treat symptoms as they appear C. Oral rehydration using pedialyte D. Support the child and family The nurse's role in caring for a child with Rotavirus is to support the patient and family, maintain fluid balance through adequate intake of Pedialyte, and treating symptoms as they occur. The nurse should be aware that severe diarrhea can lead to fluid imbalance and dehydration. The nurse would NEVER stop the diarrhea as it is the body's way of expelling the malignant organism. By stopping the diarrhea, it traps the virus inside the intestines causing further harm.

The nurse is treating a child with Rotavirus. What should the nurse expect for the treatment plan? (Select all that apply) A. Treat symptoms as they appear B. Give medication to stop the diarrhea C. Oral rehydration using pedialyte D. Support the child and family

A. Local tenderness at site B. Erythema D. Swelling Normal side effects of immunization shots include: Local tenderness at site Erythema Swelling Fever Behavioral Changes Ecchymosis is not a normal side effect and neither is tachycardia.

The nurse just gave an immunization to a child. What possible normal side effects should she inform the parents about? (Select all that apply) A. Local tenderness at site B. Erythema C. Ecchymosis D. Swelling E. Tachycarrdia

A. Cefotaxime (Claforan) has a shorter half life and requires more doses Comparatively, both antibiotics are third-generation cephalosporins. Cefotaxime (Claforan) has a shorter half-life meaning it will require more frequent doses throughout a 24 hour time period to be effective. Ceftriaxone (Rocephin) has a longer half-life that allows it to be given as an IM injection once per day and still be effective. Both are given to treat bacterial infections in children, however the dosing schedule will differ based on which antibiotic is ordered.

The nurse questions the HCP why has ordered 3 doses of Cefotaxime vs one dose of Ceftriaxone. The HCP Provider is most likely to respond: A. Cefotaxime (Claforan) has a shorter half life and requires more doses B. Ceftriaxone (Rocephin) is less expensive C. I felt like it D. Cefotaxime (Rocephin) works better

C. A​ 17-year-old female with diarrhea after gastroenteritis ​Rationale: The most common reason for electrolyte imbalances and FVD in children and adolescents is diarrhea or gastroenteritis. Heavy​ exercise, insensible​ loss, and not drinking enough are also potential causes of electrolyte imbalance and​ FVD, but they are not the prominent reasons in adolescents.

The nurse reviews a list of clients waiting to be seen in a community health clinic. Which client should the nurse identify as experiencing the most common cause of an electrolyte imbalance in​ adolescents? A. A​ 16-year-old male who is not drinking enough at wrestling practice B. A​ 16-year-old female participating in heavy exercise to lose weight for a school dance C. A​ 17-year-old female with diarrhea after gastroenteritis D. A​ 14-year-old male who is losing water through increased insensible water loss

A. Rotavirus The most common spread of Rotavirus is through the fecal oral route. Hand Hygiene is especially important to prevent spread of the disease.

The nurse witnesses a child put their hand in their diaper and proceed to remove it and play with a toy. Any toddler that touches that toy may be at risk for developing which disease? A. Rotavirus B. Mumps C. Rubella D. Varicella

A. Sharing needles B. Having unprotected sex E. Getting tattoos ​Rationale: HIV is spread through contact with blood and body fluids.​ Therefore, the nurse should instruct the adolescent to refrain from getting​ tattoos, sharing​ needles, and having unprotected sex. Using public restrooms does not increase an​ individual's likelihood of contracting HIV. Smoking crack cocaine does not lead to the spread of​ HIV, because there is no contact with blood or body fluids.

The nurse working in a clinic discusses HIV prevention with an adolescent. Which behavior should the nurse instruct the adolescent to avoid to minimize the risk of contracting​ HIV? (Select all that​ apply.) A. Sharing needles B. Having unprotected sex C. Smoking crack cocaine D. Using public restrooms E. Getting tattoos

B. Droplet In the hospital, droplet isolation is used for meningitis patients.

What hospital isolation will the nurse enact if a patient has been diagnosed with meningitis? A. Airborne B. Droplet C. Standard D. Contact

B. It decrease your child's urge to pee, especially at night. Desmopressin is a synthetic form of the hormone ADH (anti-diuretic hormone) which is naturally produced by the pituitary gland. The use of Desmopressin in children is to control urinary urgency, especially for nocturnal enuresis, by signaling the bladder to retain urine.

The parent of a child asks the nurse in a clinic what Desmopressin (DDAVP) is prescribed for. The nurse's best response is? A. It will help your child urinate more frequently B. It will decrease your child's urge to pee, especially at night. C. It will help your child with his stool incontinence D. It is used to help your child fall asleep faster.

D. ​"Has your child had an upper respiratory​ infection?" ​Rationale: Upper respiratory infections are a causative factor for the development of otitis media in children because of the angle of the eustachian tubes.​ So, the nurse should ask about recent upper respiratory infections. It is important for the nurse to ask when the symptoms​ began, but this will not determine the cause. Drinking from a bottle rather than a sippy cup does not lead to otitis media. Bottle feeding at night is a risk factor for frequent infections. Whether or not the child has received the flu vaccine is not a causative factor for otitis media.

The parents of a child present to the urgent care center reporting the child is tugging on the right ear. Which question should the nurse ask to determine the​ cause, based on the​ parents' observation? A. ​"When did you first notice the symptoms​ start?" B. ​"Does your child drink from a bottle or sippy​ cup?" C. ​"Did your child receive the influenza​ immunization?" D. ​"Has your child had an upper respiratory​ infection?"

A. Children with temperature over 39°C ​(102°​F) C. Adults with acute otitis media D. Children over 6 months of age E. Children with otalgia for 48 hours ​Rationale: Because of the possibility of developing antibiotic​ resistance, healthcare providers do not prescribe antibiotics for the treatment of otitis media unless the following parameters are​ present: adults with acute otitis​ media, children over the age of 6 months with the presence of otalgia for longer than 48​ hours, or a temperature over​ 39°C (102°F). Antibiotics are not administered for otitis media for pregnant clients because of the risk of fetal harm.

The parents of a​ 4-month-old infant with otitis media ask the nurse why the healthcare provider did not prescribe antibiotics. Under which parameter would the nurse explain that antibiotics are​ warranted? (Select all that​ apply.) A. Children with temperature over 39°C ​(102°​F) B. Pregnant clients in the third trimester C. Adults with acute otitis media D. Children over 6 months of age E. Children with otalgia for 48 hours

A. Move afternoon recess to a cooler morning hour. Rationale: To prevent​ heat-related illness, it would be best to move recess from the hottest part of the day to a cooler part of the day. Children should be encouraged to take frequent water breaks and drink before they begin to feel​ thirsty, not just when they feel thirsty or only before recess. Children should also be encouraged to take frequent rest breaks during​ recess, not just afterward.

The school nurse notes that a​ school-age child is experiencing mild heat exhaustion after playing outside during recess. Which recommendation should the nurse make to help prevent future occurrences of​ heat-related illness? A. Move afternoon recess to a cooler morning hour. B. Encourage children to drink water when they feel thirsty. C. Provide a time for children to rest after recess. D. Teach children to drink water only before recess.

D. Hib All of the other vaccines listed are vaccines that immunize against polio and diphtheria. Hib does not protect against polio or diphtheria.

Vaccines for Diphtheria and Poliomyelitis include all of the following except: A. DTap-HepB-IPV B. DTap-IPV/Hib C. DTap-IPV D. Hib

A. Age < 2 years B. Exposure to poor air quality C. More common in children attending child care centers E. Exposure to tobacco smoke Children with Down syndrome or cleft palate are more likely to have otitis media due to Eustachian tube dysfunction or malformation.

What are risk factors of Otitis Media? (Select all that apply) A. Age < 2 years B. Exposure to poor air quality C. More common in children attending child care centers D. Less common in children with Down Syndrome or Cleft palate E. Exposure to tobacco smoke

A. Drooling B. Dysphagia (difficulty swallowing) D. Dysphonia (difficulty talking) E. Distressed respiratory efforts When epiglottitis is expected, the nurse's main priority is maintaining an adequate airway. Epiglottitis is the inflammation of the small cartilage "lid" that covers the windpipe when swallowing. If this becomes inflamed, it can cause severe respiratory distress and occluded airway. When assessing for S/S, anything associated with respiratory distress or inadequate airway is typically correct. NEVER LEAVE A CHILD UNATTENDED OR PERFORM A CULTURE SWAB IF EPIGLOTTITIS IS SUSPECTED.

What are the cardinal S/S of epiglottitis? (select all that apply) A. Drooling B. Dysphagia C. Adequate swallowing D. Dysphonia E. Distressed respiratory efforts

A. Fever B. Vomiting D. Abdominal Pain E. Pharyngitis These are all symptoms of Scarlett Fever except diarrhea. That is most commonly a symptom of Rotavirus.

What are the symptoms of Scarlett Fever? (Select all that apply) A. Fever B. Vomiting C. Diarrhea D. Abdominal Pain E. Pharyngitis

A. Antibiotic therapy and importance of completing all doses B. S/S of acute OM C. Pain relief techniques within the nurse's scope D. Preventative measures Education would include teaching about antibiotic therapy and S/S to observe for in their child. The nurse would also stress the importance of follow-up examinations, as well as possible side effects of the medication. Pain relief techniques include correct administration of prescribed eardrops and positioning of head slightly elevated to relieve pressure on the tympanic membranes. OM is most common during Winter months NOT summer months.

What can the nurse educate the family on regarding Otitis Media? (Select all that apply) A. Antibiotic therapy and importance of completing all doses B. S/S of acute OM C. Pain relief techniques within the nurse's scope D. Preventative measures E. Infection is most common during Summer months

D. Lumbar Puncture Because the organisms of meningitis spread through the CSF fluid, a lumbar puncture is used to culture the CSF. It is the definitive test to determine if a patient has meningitis.

What diagnostic test is used to definitively diagnose meningitis? A. CBC B. CMP C. Urinalysis D. Lumbar Puncture

A. Possible side effects B. The safety of the vaccine(s) being given C. Possible abnormal reactions The nurse should educate the parents of possible side effects such as: local tenderness at injection site, erythema, swelling, fever, or behavioral changes. She should also educate the parents that vaccines are among the safest and most reliable drugs in the world and contrary to some beliefs, they do not cause autism or infect the child. The last thing to educate the parents about is potential adverse reactions.

When administering a vaccination, the nurse should educate the parents about: (Select all that apply) A. Possible side effects B. The safety of the vaccine(s) being given C. Possible abnormal reactions D. The risk of autism E. The risk of contracting the disease from the dead virus

B. ​Intake/output ​Rationale: A​ client's intake and output is an important measurement that can provide information about fluid balance in the body. The nurse should ensure that this is documented correctly in order to monitor for resolving dehydration. Respiratory rate and oxygen saturation are important but not the priority for this client. There is no information to support the need for a catheter or catheter care.

When caring for a client with severe​ dehydration, the nurse should ensure which results are​ documented? A. Catheter care B. ​Intake/output C. Oxygen saturation D. Respiratory rate

C. Pedialyte Pedialyte is the most preferred method for orally re-hydrating children.

When orally re-hydrating a child, the best method is? A. Water B. Juice C. Pedialyte D. Rectal enema of IV solution

C. After the pre-adolescent growth spurt Scoliosis is most noticeable at this time. It is the most common spinal deformity and may be congenital or develop during childhood. It may have multiple potential causes, but most cases are idiopathic.

When would scoliosis become most noticeable? A. Upon birth B. After age 25 C. After the pre-adolescent growth spurt D. Before birth in utero

B. Serous otitis media lasting longer than 4 months C. Persistent conductive hearing loss Rationale: The child who has persistent conductive hearing loss or serous otitis media that lasts longer than 4 months is a good candidate for tympanostomy tube insertion. Recurrent episodes of acute otitis media are treated with antibiotics and do not require tympanostomy tube insertion. Tubes are not used for barotitis media.​ Instead, lifestyle modifications are​ incorporated, such as decreasing the amount of flying. Neither antibiotics nor tympanostomy tubes are used in the treatment of severe otitis media.

Which clinical manifestation displayed by the child would necessitate the insertion of tympanostomy​ tubes? (Select all that​ apply.) A. Recurrent episodes of acute otitis media B. Serous otitis media lasting longer than 4 months C. Persistent conductive hearing loss D. Severe otitis media unresponsive to antibiotics E. Barotitis media for those who frequently fly

B. Pulling at ear E. Bulging tympanic membrane ​Rationale: Acute otitis media typically has a fast onset. Manifestations of acute otitis media in children may include pulling at the affected ear and poor feeding. On otoscopic​ examination, findings associated with acute otitis media include a bulging tympanic membrane that demonstrates decreased mobility or immobility.

Which clinical manifestation should the nurse expect when caring for a child with acute otitis​ media? (Select all that​ apply.) A. Slow onset of symptoms B. Pulling at ear C. Increased appetite D. Increased mobility of tympanic membrane E. Bulging tympanic membrane

A. Type 1 B. Type 2 C. Type 3 Types 1, 2, and 3 all are agents of polio. They are transmitted through fecal and oropharyngeal secretions of infected persons and direct contact with those fluids.

Which enteroviruses cause Polio? (Select all that apply) A. Type 1 B. Type 2 C. Type 3 D. Type 4 E. Type P

B. Bulging D. Bleeding E. Amber color ​Rationale: The tympanic membrane will be​ bulging, have possible​ bleeding, and be amber in color in a client with otitis media. Normal findings in a healthy eardrum include the ability to move and​ semi-transparent in color.

Which finding during an otoscopic exam of the tympanic membrane would confirm the presence of otitis​ media? (Select all that​ apply.) A. Movement B. Bulging C. ​Semi-transparent D. Bleeding E. Amber color

C. ​"Know signs of ear​ infection." D. ​"Promote breastfeeding." E. ​"Keep infants away from​ smoke." ​Rationale: The nurse should instruct parents to report signs of otitis​ media, such as ear​ tugging, fever, increased​ irritability, and poor appetite. Breastfeeding decreases the risk of otitis media.​ Therefore, the nurse would promote breastfeeding over bottle feeding.​ Second-hand smoke exposure can cause otitis media in children. The nurse should instruct the parents to smoke outside the buildings in which the child is staying. Child care centers have greater numbers of​ children, and otitis media can spread more easily. It is better to use​ in-home child care. Pacifier use increases the incidence of otitis​ media; therefore, the nurse would discourage the use of pacifiers.

Which information should the nurse plan to include for a teaching session regarding health promotion and prevention of otitis media with a group of new​ mothers? (Select all that​ apply.) A. ​"Use child care​ centers." B.​"Encourage pacifier​ use." C. ​"Know signs of ear​ infection." D. ​"Promote breastfeeding." E. ​"Keep infants away from​ smoke."

A. Immobility B. Lack of privacy C. Chronic laxative use D. Suppressing the urge to defecate ​Rationale: Lack of privacy and immobility can lead to constipation. Chronic use of laxatives and the dilation of the bowel with loss of smooth muscle tone in the colon can cause constipation. Ignoring the urge to defecate causes the muscles and mucosa in the rectal area to become insensitive to the presence of​ stool, which becomes more difficult to expel. High levels of dietary fiber and high fluid intake decrease the chance of constipation.

Which is a risk factor for​ constipation? (Select all that​ apply.) A. Immobility B. Lack of privacy C. Chronic laxative use D. Suppressing the urge to defecate E. Intake of high levels of dietary fiber

B. Streptococcus pneumoniae Streptococcus pneumoniae is the most common cause of otitis media. Others include Haemophilus influenzae and Moraxella catarrhalis. Escherichia​ coli, Pseudomonas​ aeruginosa, and MRSA cause other infections such as urinary tract or wound infections.

Which pathogen is the most common causative agent of otitis​ media? A. ​Methicillin-resistant Staphylococcus aureus ​(MRSA) B. Streptococcus pneumoniae C. Pseudomonas aeruginosa D. Escherichia coli

C. Speech language pathologist ​Rationale: The speech language pathologist would be best to assist a child in developing better speech patterns and improved verbal communication. Physical therapy helps clients increase mobility and function and decrease pain. Occupational therapy helps to train clients in activities of daily living. The primary healthcare provider coordinates all care.

Which professional would benefit a child with repeated episodes of otitis media who presents with impaired verbal​ communication? A. Physical therapist B. Primary healthcare provider C. Speech language pathologist D. Occupational therapist

D. ​"I plan to breastfeed my baby to save money on infant​ formula." ​Rationale: When the pregnant client who is HIV positive states that they wish to​ breastfeed, it requires​ correction, because breastfeeding can increase the risk of disease transmission to the infant. Women who are HIV positive will undergo a cesarean section to decrease the risk of transmission. The newborn will begin zidovudine after birth to decrease the risk of seroconversion.

Which statement made by a​ 34-week pregnant client who is HIV positive indicates a need for further​ teaching? A. ​"If I follow the treatment​ regimen, my baby may not develop HIV​ infection." B. ​"My newborn baby will begin treatment with zidovudine after​ birth." C. ​"I will enter the hospital in a month for a planned cesarean​ section." D. ​"I plan to breastfeed my baby to save money on infant​ formula."

A. Diphtheria and Poliomyelitis These two diseases have been almost entirely eradicated due to vigorous vaccinations.

Which two diseases are now rarely seen due to vigorous immunization over the years? A. Diphtheria and Poliomyelitis B. Pneumonia and Bacteremia C. Scarlett Fever and Fifth Disease D. HIV and AIDS

D. MMR and Varicella The two main vaccines given via the subQ route are the MMR and Varicella vaccines. These are both live vaccines.

Which two live vaccines are given via the SubQ route? A. Hep A and Hep B B. TDap and DTap C. No vaccine is given via the subQ route D. MMR and Varicella

D. Isometric exercise ​Rationale: Isometric exercise is used to maintain strength when a joint is immobilized. It is performed by contracting a specific muscle group against another muscle group or immovable object. Resistive exercise is active exercise where the client works against resistance to increase muscle strength.​ Range-of-motion exercises help maintain joint mobility during periods of restricted activity. Passive exercises are performed by a physical therapist or nurse for the client.

Which type of exercise should the nurse implement to maintain the strength of a limb with an immobilized​ joint? A. Passive exercise B. Resistive exercise C. ​Range-of-motion exercise D. Isometric exercise

A. MenACWY-D B. MenACWY-CRM D. MenB-4C E. MenB-FHbp These vaccines are used to protect against meningitis. The first two are used to immunize against meningococcal serogroups A, C, W, and Y; while the last two are used to immunize against serogroup B.

Which vaccines are used to immunize against meningitis? (Select all that apply) A. MenACWY-D B. MenACWY-CRM C. MenACDC-FSM D. MenB-4C E. MenB-FHbp

D. Hib (PRP-T); Hib (PRP-OMP) The Hib vaccine protects the patient against Haemophilus Influenzae Type b, which can cause a severe complication that turns into Epiglottitis; therefore the Hib vaccine is used to protect against epiglottitis.

Which vaccines protect against epiglottitis? A. TDap (Boostrix); DTap (Infanrix) B. ProQuad C. DT; Td D. Hib (PRP-T); Hib (PRP-OMP)

A. Adults We as adults are often the carriers that expose children to whooping cough. Because we are vaccinated, the disease does not affect us, but infants who are immunocompromised are very susceptible to the disease.

Who is often the leading carrier of Whooping Cough? A. Adults B. Dogs C. Squirrels D. Dust Mites

C. Their kidneys cannot concentrate urine The newborn's lack of ability to concentrate urine puts them at greatest risk for fluid imbalance from the disease.

Why is the rotavirus most severe in children 3-24 months of age? A. They cannot change their own diapers B. They do not poop a lot so the disease gets stuck in their bowels C. Their kidneys cannot concentrate urine D. They aren't eligible for the vaccine yet