Practice Exam 4

When providing teaching to the caregivers of a 3-year-old girl who is toilet training and just diagnosed with a UTI, what statements by the caregivers indicate further teaching is needed? Select all that apply.

"Baths are fine as long as we avoid using bubbles" "It is important to make sure wiping after urination is back to front" "We will limit fluids until the pain from the UTI improves to limit amount of painful urination episodes"

A nurse is educating parents about the Pavlik harness for their 6-month-old infant with developmental dysplasia of the hip. Which of the following parent statements indicates understanding of the teaching? Select all that apply.

"Frequent skin checks are important." "The diaper should be applied under the straps."

A nurse is teaching a child's caregiver about spica cast care at home. Which of the following responses from the caregiver indicates further teaching is needed? Select all that apply.

"If the cast gets wet, I should use a hairdryer to quickly dry the cast" "Small dents in the cast may happen, especially the longer the child has the cast" "If itching occurs under the cast, they should be sure to use a long device, so it does not get stuck under the cast"

A child is diagnosed with a fracture and a cast is applied. At discharge, the nurse is teaching the caregiver how to assess for poikilothermia. The nurse knows the caregiver understands by which of the following statements?

"If the child's fractured left leg begins to feel cooler in temperature than the other leg, I should notify the health-care provider"

A student nurse preparing a pamphlet about scabies for community awareness should include which information? Select all that apply.

"Living in close quarters such as summer camp, dorm, or hearing a bed increases the risk" "All members in a family must be treated for scabies if one person is diagnosed"

The parent of a 7-year-old child calls the nurse triage line. The parent is concerned because the child camped outside last night and this morning, the mother removed a tick from the child. The child has a red round edematous area where the tick was removed. The mother expresses concern the child has contracted Lyme disease. What is the appropriate response from the nurse?

"The red swollen area is an allergic reaction not Lyme disease"

A 5-year-old child is diagnosed with impetigo around the nose. The nurse knows teaching to the caregivers has been understood based on what statements? Select all that apply.

"We will try to keep him from scratching the lesions" "We will change his linens daily while the lesions are draining"

A student nurse is learning about the pediatric musculoskeletal system. The student correctly identifies which of the following true statements pertains to the pediatric musculoskeletal system?

A child with a broken femur will likely heal faster than an adult with the same injury

Thomas is a 3-year-old who is being started on prophylactic antibiotics for vesicoureteral reflux (VUR). Proper teaching about this treatment should include:

A urine culture should be obtained at least every 3 months

When preparing to administer dialysis to a child using an AV fistula, with which finding would you notify the physician immediately?

Absence of thrill

While caring for a child with fluid volume excess due to renal disease, what priority nursing interventions should be performed for the volume excess? Select all that apply.

Administer ordered furosemide Monitor lung sounds Monitor level of consciousness

A nurse is caring for a child in the pediatric emergency room with suspected postinfectious acute glomerulonephritis. The nurse anticipates which test that is ordered will confirm diagnosis?

Anti-streptolysin-O (ASO) titer

Seven-year-old Charlie is seen in the outpatient clinic for a minor burn on his arm. Which of the following are appropriate nursing interventions when providing care to Charlie? Select all that apply.

Apply bacitracin to the burn cover the burn with gauze

Which of the following interventions would the nurse provide when providing care for a patient with juvenile rheumatoid arthritis that is impairing their mobility?

Assist with active and passive ROM exercises Preambulation pain medication administration

The child in the figure below presents to the health-care provider's office. The child states, "It itches a lot." In reviewing the chart, the child is noted to have a history of asthma. The child denies any use of new detergents, soaps, or lotions or exposure to known allergens and states, "It's like the rashes I have gotten in the past, and it's uncomfortable". The nurse suspects the rash is:

Atopic dermatitis

A child with a diagnosis of developmental dysplasia of the hip has just returned from surgery with a spica cast. Which intervention is the nurse's priority for the child?

Circulatory assessment

When caring for a child, which of the following lab findings would warrant further investigation? Select all that apply.

Creatinine is 2.1 mg/dL BUN is 35 mg/dL Urine specific gravity is 1.025

A newborn is admitted to the nursery immediately after birth. The following figure indicates where the urethral opening is on the newborn during assessment. This nurse documents this as:

Epispadias

Which of the following are risk factors for hypothermia? Select all that apply.

Exposure to cold air Wet clothes Immersion in water Burns Prematurity

A 6-month-old is seen in the health-care provider's office, and a urine specimen is collected due to concern of a urinary tract infection (UTI). Which signs and symptoms support a UTI diagnosis? Select all that apply.

Fever colic irritability

Katelyn, a 4-year-old girl, is brought into the ER by her caregivers. On assessment, the child is edematous, BP is 142/92, with all other vitals within normal limits. Skin assessment reveals circular ankle lesions that are crusted with yellow sticky drainage that have caused itching. Per the caregivers, she has had a poor appetite and fatigue over the last few days. The nurse suspects which renal condition?

Glomerulonephritis

While working in the pediatric ER, a nurse admits an 8-year-old admitted with facial and chest burns from an accident at a campfire. What nursing diagnosis has highest priority when caring for the child?

Impaired breathing related to edema of airway from smoke inhalation and burns

A caregiver brings a 2-year-old to the health-care provider's office for concerns of lesions on the child's face that have been present for several days and do not seem to be improving. On assessment, the lesions are draining a honey-colored fluid, and in some areas, lesions are crusty. The mother states the child has been scratching the itchy lesions. The nurse suspects the lesions are due to:

Impetigo contagiosa

Tommy, a 4-year-old child, is being treated in the emergency room for severe dehydration due to gastroenteritis causing severe vomiting and diarrhea. His sodium blood level is within a normal range. The nurse caring for him knows Tommy likely has which type of dehydration?

Isotonic

A nurse is caring for a 12-year-old in the hospital with osteomyelitis. The child was started on IV antibiotics 3 days ago. The child's current vital signs consist of an oral temperature of 102.4°F, blood pressure is 96/58, pulse is 102, and respiratory rate is 26. The physician has been notified and writes orders to prepare the child for surgery. The nurse understands the likely reason for surgical treatment is:

Lack of response to antibiotics with need for debridement.

Which of the following nursing interventions should the nurse include in the care of a child who has a spica cast? Select all that apply.

Medication administration for pain Repositioning every 2 to 4 hours while the patient is awake Increasing fluid intake and adjusting diet to prevent constipation

A nurse caring for a 5-year-old boy notes he has symptoms consistent with Legg-Calvé-Perthes disease (LCPD). Which of the following would support this diagnosis?

Muscle wasting in quadriceps and buttocks

When teaching the caregiver of a child who was just diagnosed with a urinary tract infection about risk factors, what should be included? Select all that apply.

Obstruction Reflux Diaper rash Toilet training Constipation

A 2-year-old boy is admitted to the emergency room. On assessment, his scrotum is dusky colored with a palpable mass. There is no pain when moving the testicles. Immediate interventions include which of the following? Select all that apply.

Obtain surgical consent NPO Insert IV

A home-health nurse caring for a 7-year-old diagnosed with osteogenesis imperfecta (OI) should focus care on which of the following long-term interventions? Select all that apply.

Prevent deformities ensure proper nutrition to prevent obesity multidisciplinary care coordination with physical therapists

A nurse receives report on a child who with nephrotic syndrome is being transferred to the pediatric floor from the emergency room. Which findings would the nurse find in this child that are consistent with the diagnosis? Select all that apply.

Proteinuria Edema Hyperlipidemia

Which of the following are assessment findings for a patient with acute postinfectious glomerulonephritis? Select all that apply.

Pulmonary edema hematuria ascites

When teaching caregivers about their child with osteogenesis imperfecta, which of the following are appropriate nursing actions? Select all that apply.

Refer the parents to a genetic counselor before having future children. Provide information about special care considerations for the child such as different positioning and diapering. Encourage nutritional support to increase intake of vitamin D. Teach the caregivers to watch for signs of a fracture.

A 3-year-old presents to the health-care provider's office with the caregiver who states that the child has been having a lot of itching, especially at night. On visual assessment, the nurse notices a gray line in the webs of the fingers. What condition does the nurse suspect?

Scabies

Seventeen-year-old Zach is in the health-care provider's office and has just been diagnosed with tinea pedis. What assessment findings are consistent with this diagnosis?

Scaly, pruritic, weepy skin between the toes and on bottom of feet.

A caregiver brings the 3-month-old infant seen in the figure to the outpatient clinic for complaints of the yellowish flaking seen on the infant's scalp, which the nurse identifies as:

Seborrheic dermatitis

A nurse working in a pediatric burn unit is helping assess a 16-year-old girl who has been brought in with burn injuries. What is used to assess the amount of burns this patient has sustained?

The rule of nines

A 7-year-old presents to the outpatient clinic with the skin lesion seen in the figure. Based on initial visualization of the lesion, the nurse suspects:

Tinea corporis

When caring for an adolescent with severe acne who is about to start isotretinoin, the nurse should include which teaching points? Select all that apply.

Two pregnancy tests must be taken prior to starting the medication Blood levels must be drawn at least biweekly Child's mood should be monitored closely

Which assessment finding in a child is concerning after a cast is applied for an elbow fracture? Select all that apply.

Unrelieved pain paresthesia pale in color

Oxybutynin chloride is prescribed to a post-op child after surgical correction of hypospadias. This medication helps prevent what common side effect?

bladder spasms

A nursing student is assessing a 2-year-old child in the hospital with fluid volume deficit. The nursing instructor provides remediation when the student states which signs and symptoms support the child's condition? Select all that apply.

increased urinary output urine specific gravity of 1.010 bradycardia