Exam 1, 2 3, practice questions PEDS

15. The nurse is collecting assessment information on a pediatric patient who is 13 years of age. The patient is at the clinic for recurrent gastrointestinal distress. Which questions are appropriate for the nurse to ask the patient? Select all that apply. 1. "Can you describe the pain you are having?" 2. "Do you ever have cramping or bloating?" 3. "Is there a family history of GI problems?" 4. "Do you have a history of previous illnesses?" 5. "Are there any changes at home or school?"

1. "Can you describe the pain you are having?" 2. "Do you ever have cramping or bloating?" 5. "Are there any changes at home or school?"

17. The nurse case manager is providing care and support to a mother with AIDS who has an infant who also tests positive for the condition. Which statement by the mother indicates to the nurse that additional teaching is needed? Select all that apply. 1. "I wish I could control the baby's pain without so much medication." 2. "I am so looking forward to the time when the baby is no longer infectious." 3. "I absolutely do not want the day-care staff to know about the baby's condition." 4. "If I am to become a better mother, I need to work on my self-esteem and self-value." 5. "I keep hoping every day that a cure for my baby and me can be found."

1. "I wish I could control the baby's pain without so much medication." 2. "I am so looking forward to the time when the baby is no longer infectious." 3. "I absolutely do not want the day-care staff to know about the baby's condition."

11. The nurse is providing care for a 9-year-old patient diagnosed with postinfectious glomerulonephritis. The nurse is aware of hypertension and a prescribed dose of nifedipine 0.5 mg/kg/dose every 4 hours. The patient weighs 63 pounds. Which dose does the nurse give every 4 hours? 1. 14 mg 2. 18 mg 3. 22 mg 4. 30 mg

1. 14 mg

19. The nurse works in a pediatric clinic with patients who have heart disease or who have undergone treatment for heart disease. The nurse is frequently asked about the need for prophylactic antibiotics for these patients during invasive dental care. Which patients does the nurse identify as being at risk for endocarditis and being in need of antibiotic therapy? Select all that apply. 1. A child with a prosthetic heart valve 2. A child with a congenital defect scheduled for surgical repair 3. A child who was previously diagnosed with endocarditis 4. A child with a confirmed diagnosis of rheumatic heart disease 5. A child who had a congenital heart defect repaired 9 months ago

1. A child with a prosthetic heart valve 2. A child with a congenital defect scheduled for surgical repair 3. A child who was previously diagnosed with endocarditis 4. A child with a confirmed diagnosis of rheumatic heart disease

7. The nurse in a pediatric clinic is assessing an infant 2 months of age. The mother states, "He always spits up, but it has become so much worse. Vomit goes everywhere." Which additional assessment will help the nurse identify a possible diagnosis for the infant? 1. A hard mass is palpated in the mid-epigastrium. 2. Vomiting occurs both before and after eating. 3. Weight is normal even with frequent vomiting. 4. Normal skin turgor is noted over the sternum.

1. A hard mass is palpated in the mid-epigastrium.

11. The nurse is admitting an infant who is 3 months of age. The parents sought medical attention when the infant began passing pale-colored stools that are nearly white. The infant had been diagnosed with biliary atresia at birth and underwent corrective surgery. For which treatment will the nurse prepare the parents? 1. A liver transplant 2. A second corrective surgery 3. Initiating comfort care 4. Focusing on diet therapy

1. A liver transplant

18. The pediatric nurse is providing care for a school-age patient diagnosed with rheumatic heart disease. When developing a plan of care for the patient's hospital stay, which interventions does the nurse include? Select all that apply. 1. Administer inflammatory and antibiotic medications as prescribed. 2. Assess for the presence of strep throat or other throat infections. 3. Include chest pain and heart palpation assessment with vital signs. 4. Begin patient/family teaching about the possibility of surgery. 5. Organize daily care and treatments to provide for joint pain relief.

1. Administer inflammatory and antibiotic medications as prescribed. 3. Include chest pain and heart palpation assessment with vital signs. 5. Organize daily care and treatments to provide for joint pain relief.

17. The nurse is providing care for a 10-year-old patient admitted for chronic kidney disease (CKD). The patient is diagnosed with CKD stage 3. Which nursing actions are most important for the nurse to include on the patient's plan of care? Select all that apply. 1. Arrange for hemodialysis. 2. Correct electrolyte imbalances. 3. Monitor blood pressure. 4. Prepare for renal replacement. 5. Obtain accurate daily I&O and weight.

1. Arrange for hemodialysis. 2. Correct electrolyte imbalances. 3. Monitor blood pressure. 5. Obtain accurate daily I&O and weight.

19. A patient who is 17 years old comes to his health-care provider for a sports physical. The nurse's visual assessment places the patient in high percentiles for both weight and height. Which additional assessments does the nurse expect to be conducted for a complete health evaluation? Select all that apply. 1. Body mass index 2. Bedtime cortisol levels 3. Glucose levels after meals 4. Lipid profile 5. Thyroid-stimulating hormone level

1. Body mass index 4. Lipid profile 5. Thyroid-stimulating hormone level

15. An adolescent who is 15 years of age is brought to the pediatric clinic because of bloody urine. Which additional finding during assessment will cause the nurse to consider acute kidney injury (AKI)? 1. Bruising in the flank area 2. Tenderness in the lower back 3. Hesitation and pain with urination 4. Suprapubic swelling and pain

1. Bruising in the flank area

6. A 13-year-old male patient is diagnosed with hypopituitarism and is prescribed to begin growth hormone replacement therapy. Which patient teaching information will best optimize the replacement therapy outcomes for the patient? 1. Clear communication about side effects of therapy and how they are managed 2. The chemical makeup and differences between the brands of somatotropin 3. How much and how quickly the patient will see the effects of the therapy 4. Psychotherapy for the family to deal with emotional problems of the condition

1. Clear communication about side effects of therapy and how they are managed

17. The nurse is preparing a teaching plan for a patient and family. The patient is diagnosed with hyperpituitarism. Which teaching information will optimize therapy outcomes for the patient? Select all that apply. 1. Education about home administration of medications 2. Education about the disorder and treatment options 3. Explanations of long-term complications for noncompliance 4. Signs of excess bone growth and other features of gigantism 5. The impact of a tumor on or near the hypothalamus or pituitary gland

1. Education about home administration of medications 2. Education about the disorder and treatment options 3. Explanations of long-term complications for noncompliance

16. The pediatric nurse is preparing a community education program for parents and children who have endocrine disorders. With which normal regulatory functions does the nurse begin the presentation before covering endocrine disorders? Select all that apply. 1. Growth and development 2. Sexual development 3. Energy use and storage 4. An individual's response to stress 5. Levels of glucose, fluid, and sodium in the blood

1. Growth and development 2. Sexual development 3. Energy use and storage 4. An individual's response to stress 5. Levels of glucose, fluid, and sodium in the blood

1. The school nurse is teaching a middle-school class about the hormones that regulate body functions. Which information provided by the nurse is accurate? 1. Hormones are chemicals secreted by endocrine glands. 2. Hormones act specifically on the glands that produce them. 3. Hormones react with negative feedback as levels decline. 4. Hormones are made from proteins, fats, and carbohydrates.

1. Hormones are chemicals secreted by endocrine glands.

17. The nurse in a neonatal nursery is mentoring a newly hired nurse. The new nurse expresses uncertainty about the facts of physiological and pathological jaundice. Which information does the nurse provide? Select all that apply. 1. In newborns, a low level of jaundice is normal. 2. Normal jaundice usually appears within a week of birth. 3. Immaturity of the liver prevents effective metabolization of bilirubin. 4. Greatest concern is when jaundice develops before the first 24 hours. 5. High levels of bilirubin cause hyperactivity and insatiable hunger.

1. In newborns, a low level of jaundice is normal. 3. Immaturity of the liver prevents effective metabolization of bilirubin. 4. Greatest concern is when jaundice develops before the first 24 hours.

5. The nurse on a pediatric unit is admitting a 6-week-old infant. Symptoms include a wet daily diaper count of 10 to 12 a day, irritability, constipation, and dehydration. For which medical prescription does the nurse contact the physician? 1. Limit oral intake of water to 200 mL per shift. 2. Weigh diapers to measure 24-hour urine output. 3. Check urine-specific gravity every 8 hours. 4. Allow the mother to continue breastfeeding.

1. Limit oral intake of water to 200 mL per shift.

12. The nurse is providing care for a neonate diagnosed with tetralogy of Fallot. Prostaglandin E1 therapy is prescribed to keep the foramen ovale and the ductus arteriosus open. Which is the most important intervention for the nurse to include in the neonate's plan of care? 1. Maintain a separate IV access for continuous administration of the medication. 2. Watch for respiratory distress or apnea after adding medication to the breathing tube. 3. Monitor for and document evidence of flushing, bradycardia, and irritability as expected. 4. Monitor weight and adjust the dosage using a scale of 0.05 to 0.1 mcg/kg/min IV infusion.

1. Maintain a separate IV access for continuous administration of the medication.

16. The nurse is providing care for a 9-year-old patient who was recently diagnosed with cardiomyopathy after a viral infection. Which teaching does the nurse provide to the patient's parents about the diagnosed condition? Select all that apply. 1. Need for intensive care of the patient 2. Preparation for anticipatory grieving 3. The necessity for physical activity 4. Allowing patient to discuss feelings 5. Reasons for frequent medical visits

1. Need for intensive care of the patient 2. Preparation for anticipatory grieving 4. Allowing patient to discuss feelings 5. Reasons for frequent medical visits

16. A neonate is born with a 6-cm omphalocele, in which the stomach and intestines are contained within a sac of amnio, peritoneum, and Wharton's jelly outside of the abdomen. For which additional anomalies will the nurse assess? Select all that apply. 1. Neural tube defects 2. Cardiac defects 3. Rupture of the sac 4. Herniation of the brainstem 5. Exstrophy of the urinary bladder

1. Neural tube defects 2. Cardiac defects 5. Exstrophy of the urinary bladder

5. The nurse is assisting with high school sports physicals. The nurse performs a physical assessment on a male student who is tall and thin, with disproportionately long arms. Which additional finding will prompt the nurse to recommend a cardiac evaluation? 1. Notable laxity of joints 2. Sparsity of body hair 3. Deep tone to the voice 4. Slow, rhythmic gait

1. Notable laxity of joints

18. The nurse in a pediatric clinic is performing a physical examination of a patient who is 8 years of age. The patient's weight is over the 95th percentile on the growth chart. The patient also expresses the presence of knee and abdominal pain. The patient's parent states, "He will outgrow it; all my boys start off like this." Which information does the nurse present to the parent? Select all that apply. 1. Obesity is related to the development of diabetes mellitus. 2. Being a social outcast can cause feelings of poor self-esteem. 3. Children with obesity are more likely to drop out of school. 4. There is a high risk for cardiac disease and hypertension. 5. Obesity adversely affects joint health and function.

1. Obesity is related to the development of diabetes mellitus. 4. There is a high risk for cardiac disease and hypertension. 5. Obesity adversely affects joint health and function.

9. A 3-month-old infant is diagnosed with pulmonary stenosis. Which parent teaching does the nurse provide? 1. Options for treatment include a repair of the artery or the valve. 2. Balloon angioplasty is performed as an outpatient procedure. 3. Pulmonary stenosis repair can be delayed until 1 year of age. 4. After repair, the child is no longer at risk for cardiac problems

1. Options for treatment include a repair of the artery or the valve.

3. The nurse is aware the neonate's blood circulation is different before birth than after birth. Which circulation pattern does the nurse recognize as occurring prior to birth? 1. Oxygenated blood flows from the right atrium to the left atrium through the foramen ovale. 2. Oxygenated blood flows from the right ventricle to the lungs and then to the left ventricle. 3. For a short time after birth, the neonate continues to depend on the mother for oxygen supply. 4. Once the neonate takes a first breath, the ductus venosus closes and blood goes to the lungs

1. Oxygenated blood flows from the right atrium to the left atrium through the foramen ovale.

14. A new mother brings her 2-week-old neonate to the pediatrician's office, stating, "I think something is wrong with my baby." When the infant is undressed, the nurse notices signs of possible cardiac problems. Which assessment findings support the nurse's suspicions? Select all that apply. 1. Prolonged capillary refill time 2. Bluish tinge to oral structures 3. Peripheral cyanosis of left leg 4. Amount of urinary output 5. Mottled appearance of skin

1. Prolonged capillary refill time 2. Bluish tinge to oral structures 5. Mottled appearance of skin

11. The nurse is providing patient teaching for a school-age patient and parents. Chemotherapy is prescribed for cancer treatment. Before the first dose is administered on an outpatient basis, which teaching is most important for the nurse to provide? 1. Prompt recognition of adverse effects after the therapy. 2. Explain how to immediately initiate protective precautions. 3. Promote nutrition with the preparation of favorite foods. 4. Have icy drinks available to improve oral fluid intake.

1. Prompt recognition of adverse effects after the therapy.

10. A 12-year-old patient has a diagnosis of hyperthyroidism and is hospitalized for the manifestations of a thyroid storm. Which home-care concept will the nurse include in the care of the patient during hospitalization? 1. Provide a low-stress, low-pressure environment. 2. Ensure medications are given on the home schedule. 3. Limit intake of caffeine and carbonated fluids. 4. Increase intake of foods high in calcium and vitamin K.

1. Provide a low-stress, low-pressure environment.

12. The nurse is preparing teaching materials for an adolescent patient recently diagnosed with nonalcoholic fatty liver disease (NAFLD). The adolescent initially presented with right upper quadrant pain, obesity, and hepatomegaly. Which teaching will the nurse initially present? 1. Review lifestyle changes and diet modification with the adolescent. 2. Explain the care that is provided in the event acute liver failure occurs. 3. Discuss feelings the adolescent has related to the disease diagnosis. 4. Begin to introduce the probability for a liver transplant later in life.

1. Review lifestyle changes and diet modification with the adolescent.

20. The nurse is providing teaching to the parents of a preschool-age toddler diagnosed with chronic kidney disease (CKD). Which information does the nurse cover regarding vaccinations for the toddler? Select all that apply. 1. Routine immunizations given to healthy children are administered. 2. Annual pneumococcal conjugate vaccinations are encouraged. 3. Live viral vaccinations such as varicella and MMR are appropriate. 4. Intranasal influenza vaccine are preferred for children with CKD. 5. Annual attenuated influenza vaccinations are recommended.

1. Routine immunizations given to healthy children are administered. 2. Annual pneumococcal conjugate vaccinations are encouraged. 5. Annual attenuated influenza vaccinations are recommended.

20. An adolescent 16 years of age and the parents and health-care team agree that the patient is to undergo HSCT. Which specific nursing interventions will be included for the care of this patient? Select all that apply. 1. Sterility of the central line must be maintained. 2. High-dose chemotherapy and/or total body irradiation is administered. 3. IV for the administration of stem cells is established and maintained. 4. Fluid loss from urine, vomiting, and/or diarrhea is closely monitored. 5. Anti-T-cell immunotoxins are administered immediately after the transfusion.

1. Sterility of the central line must be maintained. 2. High-dose chemotherapy and/or total body irradiation is administered. 3. IV for the administration of stem cells is established and maintained.

5. The nurse is counseling a couple with a 3-year-old toddler diagnosed with hemophilia after experiencing excessive bleeding after a minor injury from a fall. Which teaching is most important for the nurse to provide to the parents? 1. Stressing the need for preventing injury in the environment with supervision, helmet use, and activity restrictions 2. Sharing the availability of resources from the National Hemophilia Foundation publications 3. Preparing them for the possibility of altered family dynamics and how illness may impact financial resource 4. Explaining the importance of allowing the toddler to grow up as normally as possible

1. Stressing the need for preventing injury in the environment with supervision, helmet use, and activity restrictions

11. The nurse is assessing a 4-month-old infant who has a diagnosis of hypoparathyroidism. In which manner will the nurse assess the infant for pain related to the diagnosis? 1. Tap on a facial nerve and note the response. 2. Monitor closely for signs of seizure activity. 3. Assess for hyperreflexia of the muscles. 4. Carefully monitor cardiovascular status.

1. Tap on a facial nerve and note the response.

20. A grandmother brings a toddler to a pediatric clinic and states, "I am worried that my grandchild is not getting adequate care." The nurse is able to verify the child is underweight for height and age. Which findings will cause the nurse to initiate additional assessment? Select all that apply. 1. The grandmother cannot provide an adequate feeding history. 2. The toddler's weight for height is less than the 20th percentile. 3. The toddler repeatedly asks if the nurse will get some food. 4. The toddler's evaluation at birth indicates prematurity. 5. The mother is a single parent and lives alone with the toddler.

1. The grandmother cannot provide an adequate feeding history. 3. The toddler repeatedly asks if the nurse will get some food. 4. The toddler's evaluation at birth indicates prematurity. 5. The mother is a single parent and lives alone with the toddler.

15. A neonate became dusky and developed respiratory distress at the age of 4 days and is diagnosed with a hypoplastic left heart. The surgeon obtains an informed consent from the parents to perform emergency surgery. Which information will the nurse provide to promote parental understanding? Select all that apply. 1. The left side of the neonate's heart did not develop correctly. 2. The function of left side of the heart is to pump blood to the body. 3. Provide reassurance to the parents that surgery will fix the problem. 4. Share that medical management of the condition is needed for one year. 5. A normally existing hole in the wall of the heart at birth will be enlarged.

1. The left side of the neonate's heart did not develop correctly. 2. The function of left side of the heart is to pump blood to the body. 5. A normally existing hole in the wall of the heart at birth will be enlarged.

1. The pediatric nurse in a clinic is mentoring a newly hired nurse who has no experience in pediatrics. The new nurse is performing a physical assessment on an infant who is 1 month of age. Which observation will prompt the nurse to discuss assessment skills with the new nurse? 1. The new nurse states, "How can I hear bowel sounds when he cries?" 2. The new nurse keeps the sleeping infant covered for parts of the assessment. 3. The new nurse performs all observations before physical assessment. 4. The new nurse informs the attending parent about the assessment actions

1. The new nurse states, "How can I hear bowel sounds when he cries?"

13. The nurse in a pediatric office is aware that certain factors may be indicators of heart disease in children. Which children does the nurse recognize with manifestations related to heart disease? Select all that apply. 1. The newborn with dysmorphic facial features 2. The school-age patient with slow capillary refill 3. Identification of scoliosis in a new adolescent patient 4. An infant who is unable to meet developmental milestones 5. A toddler with clubbing and erythema of the fingers and toes

1. The newborn with dysmorphic facial features 3. Identification of scoliosis in a new adolescent patient 4. An infant who is unable to meet developmental milestones 5. A toddler with clubbing and erythema of the fingers and toes

19. A 19-year-old patient has a history of hyperthyroidism that is managed with medication. The patient recently moved into an apartment and is living independently. Which behavior indicates to the nurse the patient is continuing appropriate health management? Select all that apply. 1. The patient called for refills of antithyroid medications and beta-blocking agents. 2. The patient went to an urgent care facility over the weekend for a sore throat and fever. 3. The patient reports experiencing tachycardia, restlessness, and tremors for a week. 4. The patient's last laboratory results indicates a high level of T4. 5. The patient stops the medication for 1 month once a year to promote hair regrowth.

1. The patient called for refills of antithyroid medications and beta-blocking agents. 2. The patient went to an urgent care facility over the weekend for a sore throat and fever.

15. During the treatment of a preschool child for anemia, laboratory tests reveal the child is also positive for lead poisoning. The child is currently living in an older home being renovated by the parents. Which teaching does the nurse provide to the parents? Select all that apply. 1. The possibility of removing the child from the environment 2. Methods to remove paint chips or dust from the environment 3. Details about behavior changes indicating additional exposure 4. Recommendation of foods that will decrease absorption of lead 5. The need for a child development specialist to evaluate the child

1. The possibility of removing the child from the environment 2. Methods to remove paint chips or dust from the environment 5. The need for a child development specialist to evaluate the child

4. The nurse in a pediatric clinic is collecting information for the reason a parent has brought a toddler to the clinic. The parent states the toddler cries with urination and is sometimes incontinent. The nurse obtains an axillary temperature of 101.2°F (38.4°C). For which additional reason does the nurse suspect a urinary tract infection (UTI)? 1. The toddler is 3 years of age. 2. The toddler attends a preschool. 3. The toddler is a circumcised male. 4. The symptoms are comparable to an adult UTI

1. The toddler is 3 years of age.

10. The nurse is providing care for a 4-year-old child diagnosed with non-Hodgkin's lymphoma. The nurse is aware that multiple blood samples are ordered, and the child is scheduled for a lumbar puncture with bone marrow aspiration. Which intervention will the nurse plan to prepare the patient for the testing? 1. Use simple terms and provide a needless syringe for treatment on a stuffed animal. 2. Provide information to the child's parents and encourage them to explain procedures. 3. Withhold details from the patient until right before testing procedures are performed. 4. Expect that a 4-year-old patient is incapable of understanding or cooperating during procedures.

1. Use simple terms and provide a needless syringe for treatment on a stuffed animal.

2. A 9-year-old male patient arrives at the emergency department with suprapubic tenderness, nausea, vomiting, and painful urination. Which laboratory result does the nurse expect from a urinalysis? 1. White blood cells: 15,000 cells/mL 2. Positive for glucose and protein 3. Potassium: 3.5-5.0 mEq/L 4. Hematocrit: 37%

1. White blood cells: 15,000 cells/mL

4. The nurse is providing care for a neonate diagnosed with a cardiovascular disorder immediately after birth. When gathering assessment information from the mother, which comment will the nurse recognize as the most likely contributing factor for the defect? 1. "We live in the country, and we get all our water from a well." 2. "I quit my preschool job when a child was diagnosed with measles." 3. "The baby was born a week early; I hope that is not the cause." 4. "We were in a European country before pregnancy was confirmed."

2. "I quit my preschool job when a child was diagnosed with measles."

3. The nurse is providing care to two children on a pediatric unit. One child is diagnosed with iron-deficiency anemia, and the other has sickle cell disease. Which manifestation does the nurse recognize as being different between the two children? 1. A child with iron deficiency expresses significant pain and discomfort. 2. A child with sickle cell disease experiences varying amounts of joint pain. 3. A child with iron-deficiency anemia experiences normal physical growth. 4. Sickle cell disease is transmitted as a dominant trait from one parent.

2. A child with sickle cell disease experiences varying amounts of joint pain.

A 15-year-old female asks the pediatric nurse how tall she may be as an adult. The adolescent's father is 6 feet 0 inches tall; her mother is 5 feet 4 inches tall. Which calculation will the nurse use to provide a probable answer? 1. Add the parents' heights in inches together; divide by 2; add 2.5 inches. 2. Add the parents' heights in inches together; divide by 2; subtract 2.5 inches. 3. Add the parents' heights in inches together and divide the total by 4. 4. Add the parents' heights in inches together; divide by 4; add 2.5 inches

2. Add the parents' heights in inches together; divide by 2; subtract 2.5 inches.

18. An adolescent who is 16 years of age is being discharged home after treatment for kidney stones. The nurse provides the patient and parents with written instructions for reference at home. Which information will the nurse include? Select all that apply. 1. The patient is not on a restricted diet or fluid intake at this time. 2. All urine is to be strained and sediment kept for analysis. 3. The thiazide diuretic may be discontinued on discharge. 4. The patient and parents need to understand any medication regimen. 5. A metabolic workup is no longer necessary.

2. All urine is to be strained and sediment kept for analysis. 4. The patient and parents need to understand any medication regimen.

19. A pediatric patient has acute myelocytic leukemia, and patient and family are considering treatment options aimed at long-term success. Which contemplated treatment involves using the patient's stem cells collected before radiation of cancerous bone marrow? Select all that apply. 1. Allogenic 2. Autologous 3. Peripheral blood stem cells (PBSC) 4. Umbilical cord stem cells 5. Platelet transfusion

2. Autologous 3. Peripheral blood stem cells (PBSC)

6. The nurse in a pediatric clinic is obtaining a health history on a child who is 9 years of age. The nurse learns the child exhibits a chronic cough, midsternal discomfort, and frequent sore throats without infection. Physical assessment indicates the child is on the 50th percentile on the height chart and on the 85th percentile for weight. Which recommendation does the nurse make? 1. Serve citrus juices instead of carbonated beverages. 2. Begin an age-appropriate weight loss program. 3. Initiate a practice of no eating or drinking after dinner. 4. Encourage lying on the left side after eating a meal.

2. Begin an age-appropriate weight loss program.

9. A 19-year-old college student is being treated for non-metastatic Hodgkin's lymphoma with chemotherapy. Which recommendation by the nurse was made prior to beginning chemotherapy in order to promote a level of health? 1. Gain weight before treatment to offset weight loss. 2. Consider sperm banking because of expected sterilization. 3. Move in with parents to initiate quarantine protocols. 4. Withdraw from all college courses because of fatigue.

2. Consider sperm banking because of expected sterilization.

4. The nurse is preparing teaching materials for parents with children diagnosed with anemia. Which information will be marked as being specifically for the child diagnosed with sickle cell anemia? 1. Follow a balanced nutritious diet. 2. Encourage drinking as much fluids as possible. 3. Allow low-energy activities and rest periods. 4. Make sure that immunizations are up to date.

2. Encourage drinking as much fluids as possible.

7. The nurse is providing care for a child who is diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Which laboratory result does the nurse expect with this condition? 1. Low urine-specific gravity 2. High urine and low serum osmolarity 3. High serum sodium level 4. Increase in the hematocrit level

2. High urine and low serum osmolarity

18. A toddler who is 2 years of age is cared for by a grandmother because of the death of the toddler's mother from AIDS. A critical nursing intervention is for the nurse to provide home-care instructions. Which points should the nurse emphasize? Select all that apply. 1. Hand hygiene precautions during hospitalization 2. Importance of keeping up to date with all childhood immunizations 3. Proper nutrition for a toddler diagnosed with the disease 4. Monitoring playmates in order to avoid childhood viruses 5. Prevention of bacterial infections as the treatment focus

2. Importance of keeping up to date with all childhood immunizations 3. Proper nutrition for a toddler diagnosed with the disease 4. Monitoring playmates in order to avoid childhood viruses

7. The nurse is admitting a 6-month-old infant for testing because of a second UTI and suprapubic pain with palpation. Diagnostic tests reveal a grade II vesicoureteral reflux (VUR). Which information does the nurse provide to the family? 1. Preparation necessary for surgery 2. Information about medication therapy 3. Importance of genetic counseling 4. Necessity of establishing dialysis

2. Information about medication therapy

5. A parent brings an 18-month-old toddler to the pediatric emergency department for abdominal pain and stool mixed with blood and mucus. The pain is recurring three to four times an hour. Which intervention will the nurse initiate first? 1. Assess laboratory results. 2. Initiate intravenous access. 3. Maintain strict intake and output. 4. Prepare for ultrasound studies.

2. Initiate intravenous access.

10. The parents are preparing to take their newborn, who was diagnosed with tetralogy of Fallot with pulmonary atresia, home. The nurse is developing a teaching sheet regarding care of the newborn for the parents. Which information does the nurse need to include in the teaching plan? 1. There is no need to limit activities. 2. It is important to maintain caloric intake. 3. No secondary complications are expected. 4. The neonate has natural immunity to infections

2. It is important to maintain caloric intake.

13. The nurse is providing care for a 2-month-old infant admitted to the hospital for testing because of a persistent low-grade fever. Laboratory tests and ultrasound of the abdomen confirm the presence of gallstones. Which procedure does the nurse expect to be prescribed for this infant? 1. Immediate preparation for abdominal surgery 2. Monitoring without surgical interventions 3. Endoscopic removal of stones and gallbladder 4. Placing the infant on low-fat, soy-based formula

2. Monitoring without surgical interventions

16. The nurse is providing care for an adolescent female who just gave birth to a neonate. The mother tests positive for HIV; however, the mother did not receive prenatal care. Based on the nurse's understanding about HIV/AIDS, which interventions does the nurse expect? Select all that apply. 1. Placement of the neonate in foster care because of deficient parenteral care 2. Performance of HIV polymerase chain reaction (PCR) test on the neonate 3. Recommended virological diagnostic testing for the neonate 4. Immediate immunization of the neonate against common childhood illnesses 5. Nutritional management that includes high-calorie, nutrient-dense foods

2. Performance of HIV polymerase chain reaction (PCR) test on the neonate 3. Recommended virological diagnostic testing for the neonate 5. Nutritional management that includes high-calorie, nutrient-dense foods

4. The nurse is providing care for an adolescent diagnosed with Crohn's disease. The nurse provides patient teaching regarding which manifestation of the condition? 1. Urgency to defecate 2. Possibility of oral aphthous ulcers 3. Episodic epigastric pain 4. Nocturnal awakening events

2. Possibility of oral aphthous ulcers

19. The nurse is providing care for a 3-year-old toddler admitted with a diagnosis of nephrotic syndrome related to a recent upper respiratory infection. In preparation for discharge, which teaching does the nurse provide for the parents? Select all that apply. 1. Administration of prophylactic antibiotic medication 2. Reason for checking feet and lower legs for edema 3. Method to use when strictly monitoring daily weight 4. Suggestions about maintaining a low activity level 5. Provision of written material about diet and fluid restriction

2. Reason for checking feet and lower legs for edema 3. Method to use when strictly monitoring daily weight 5. Provision of written material about diet and fluid restriction

7. The nurse is performing a physical assessment on a 7-year-old child as a requirement for playing a sport at school. The nurse reports which assessment finding as abnormal and requests a follow-up from a primary care physician? 1. Systolic blood pressure is 84 mm Hg. 2. Systolic blood pressure is 90 mm Hg and diastolic is 20 mm Hg. 3. Pulse oximeter reading is 95% on room air. 4. PMI is at 4th or 5th intercostal space at the midclavicular line.

2. Systolic blood pressure is 90 mm Hg and diastolic is 20 mm Hg.

16. Shortly after the birth of a male neonate, the parents are informed about the diagnosis of hypospadias. The physician explains that the neonate's urethral opening is located midpenile, and surgery will occur between the ages of 6 and 12 months. Which additional explanation does the nurse provide to the parents? 1. The neonate should be circumcised immediately. 2. The diagnosis is usually an isolated anomaly. 3. A ventral curvature of the penis is likely. 4. A pediatric surgeon will perform the surgery.

2. The diagnosis is usually an isolated anomaly.

15. A 10-year-old patient is diagnosed with type 2 diabetes mellitus. Which medical history finding will help the nurse identify alternative interventions for managing the patient's condition? 1. The patient's ethnicity group is African American. 2. The patient's BMI is greater than 85th percentile for age and weight. 3. The patient's mother had gestational diabetes during her pregnancy. 4. The patient's extended family exhibits a high incidence of diabetes.

2. The patient's BMI is greater than 85th percentile for age and weight.

12. The nurse in a pediatric oncology unit understands that painful tests and treatments are common for children with cancer. Which interventions does the nurse decide to use to help manage pain for a 6-year-old patient scheduled for diagnostic testing? 1. Avoid too many details that may scare the child. 2. Use language that is age appropriate for the child. 3. Promise the child a toy for cooperating and not crying. 4. Explain why the test is performed without pain medication.

2. Use language that is age appropriate for the child.

20. A parent brings a 2-year-old child with a fever and a rash to the pediatric clinic. The health-care provider suggests the child may have one of several conditions that present with similar symptoms, but wants to rule out Kawasaki disease. Which tests does the nurse expect to be performed? Select all that apply. 1. Chest x-ray 2. White blood cell count 3. Allergy testing 4. Baseline echocardiograms 5. MRI of the chest

2. White blood cell count 4. Baseline echocardiograms

13. The nurse is providing teaching for the parents of a child diagnosed with hemolytic uremic syndrome (HUS) 10 months ago. Which statement by a parent indicates the teaching is understood? 1. "The diet will be low calorie, low carbohydrate, no added salt, and low potassium." 2. "Nonsteroidal medications are used only if acetaminophen is not effective." 3. "Careful skin inspection and care is given because of swelling and poor circulation." 4. "We can initially treat diarrhea with over-the-counter antidiarrheal medications."

3. "Careful skin inspection and care is given because of swelling and poor circulation."

11. The nurse is reviewing medications for the treatment of a heart rhythm disorder in a patient who is 8 years of age. The parent of the patient states that the physician recently prescribed medication to treat the patient's attention deficit-hyperactivity disorder. Using knowledge of recent professional recommendations, which statement by the nurse is correct? 1. "We need to remind the physician there is a heart condition." 2. "Do not start the medication until I can check for safety warnings." 3. "Children with heart disorders have a higher incidence of ADHD." 4. "Giving the medication can cause death if there is a cardiac issue."

3. "Children with heart disorders have a higher incidence of ADHD."

2. A 5-month-old infant is brought to the pediatrician's office, and the nurse is collecting information from the mother. The mother reports the infant is irritable, eats poorly, and is less active. The nurse identifies tachycardia and a systolic murmur. Which comment by the mother helps the nurse identify the infant's condition? 1. "I am pleased that he sleeps well at night." 2. "Up until recently he was a happy baby." 3. "Formula made him gassy and constipated." 4. "He has not been what I call really sick."

3. "Formula made him gassy and constipated."

10. The nurse in a pediatric clinic is gathering information from the parent of a toddler who has anorexia, generalized edema, and joint pain following a bout with strep throat. Which question(s) will most likely give the nurse information for a specific condition? 1. "What behavior did you see to indicate joint pain?" 2. "When and where did you first notice swelling?" 3. "Is the child urinating, and what color is the urine?" 4. "How were you managing the symptoms at home?"

3. "Is the child urinating, and what color is the urine?"

18. The nurse on a pediatric unit is providing care for a preschool child with syndrome of inappropriate antidiuretic hormone (SIADH). The parents brought the child to the hospital to receive IV therapy. Which statements by the parents indicate to the nurse that the child is receiving appropriate care? Select all that apply. 1. "We were getting concerned about her loving salt." 2. "Popsicles have become a favorite daytime snack." 3. "We recognized the symptoms of sodium depletion." 4. "The confusion, headache, and irritability are unusual." 5. "She loves her new little bracelet and shows it to everyone."

3. "We recognized the symptoms of sodium depletion." 4. "The confusion, headache, and irritability are unusual." 5. "She loves her new little bracelet and shows it to everyone."

3. A 6-year-old patient is brought to the pediatrician's office with symptoms of feeling ill, periorbital edema, weight gain, and anorexia. The nurse suspects nephrotic syndrome. Which laboratory value confirms the nurse's suspicion? 1. Serum sodium of 138 mEq/L 2. Serum potassium of 4.5 mEq/L 3. A high level of protein in the urine 4. Low serum levels of HDL and LDLs

3. A high level of protein in the urine

17. The nurse on a pediatric unit is providing care for a 5-year-old child diagnosed with congestive heart failure. The physician prescribes digoxin therapy. Which medication-focused interventions does the nurse include when creating a plan of care for the patient? Select all that apply. 1. Hold medication if an antibiotic is prescribed. 2. Evaluate parent's ability to obtain radial pulse. 3. Administer medication at the same time every day. 4. Administer 1 hour before or 2 hours after meals. 5. Replace medication if a dose is vomited within 1 hour.

3. Administer medication at the same time every day. 4. Administer 1 hour before or 2 hours after meals.

14. The nurse is planning a teaching session for a 10-year-old patient and the patient's parents. The patient is newly diagnosed with type 1 diabetes mellitus. Which is the most important topic for the nurse to cover? 1. Methods for preventing hypoglycemia during exercise 2. The purpose of setting up a dietary consult for the patient 3. All procedures involved in insulin administration 4. Instructions for blood glucose and urine ketone testing

3. All procedures involved in insulin administration

7. A 12-year-old patient is experiencing pain in the abdomen after receiving chemotherapy. When developing a care plan, for which interventions will the nurse plan for pain management? 1. Application of heating pads to the abdomen 2. Application of cold packs to the chest area 3. Alternative therapy such as aromatherapy 4. Medication for alleviation of abdominal pain

3. Alternative therapy such as aromatherapy

9. The nurse in a NICU nursery is providing care for a newborn diagnosed with congenital hypothyroidism. During hospitalization, which home-care concept will the nurse include in the newborn's care? 1. Mix thyroid replacement hormone medication in a bottle of milk. 2. Increase dietary fiber with a soy-based formula to prevent constipation. 3. Ask the breastfeeding mother to bring breastmilk to the hospital. 4. Administer hormone replacement medication using a medicine dropper.

3. Ask the breastfeeding mother to bring breastmilk to the hospital.

14. The parents of a 4-year-old toddler bring the child to the pediatrician because a lump is found in the toddler's waist area. Diagnostic testing verifies the toddler has a Wilms' tumor on the right kidney. The toddler is to be sent home until scheduled surgery. Which teaching is essential for the parents regarding preoperative care? 1. Promote hydration by increasing fluid intake. 2. Maintain a side position with pillows for sleeping. 3. Avoid palpating the tumor and pushing or lifting in the area. 4. Provide information about postoperative care.

3. Avoid palpating the tumor and pushing or lifting in the area.

8. The nurse is providing care for an adolescent patient admitted with a diagnosis of nephrolithiasis. The patient's symptoms include flank pain, hematuria, and vomiting. The nurse notices an hourly output of 20 mL/hour. Patient's medical history includes UTIs, type 1 diabetes mellitus, and one kidney at birth. Which medical prescription does the nurse expect immediately from the physician? 1. Increase IV fluids to 125 mL/hour. 2. Cover blood glucose on a sliding scale. 3. Establish NPO status and prepare patient for surgery. 4. Administer IV morphine 5 mg every 2 hours for pain.

3. Establish NPO status and prepare patient for surgery.

13. A 9-year-old child is being treated for a brain tumor. The patient asks the nurse why there is pain in his head. Which reply by the nurse includes pathophysiology and age-appropriate communication? 1. Explain there is a blockage of blood flow to the brain. 2. State the cancer puts pressure on the neck and causes nerve pain. 3. Explain the growing brain tumor presses on some nerves in the head. 4. State the medications being given are causing the headache.

3. Explain the growing brain tumor presses on some nerves in the head.

20. The nurse is providing family teaching for a child diagnosed with hypoparathyroidism. Which additional teaching will the nurse include related to alternative dietary management? Select all that apply. 1. Avoiding caffeine and limiting the intake of carbonated beverages 2. Encouraging foods high in calcium and vitamin K 3. Including dietary supplements such as magnesium and boron 4. Giving calcium and vitamin D with acidic substances 5. Providing green leafy vegetables as the primary source of calcium

3. Including dietary supplements such as magnesium and boron 4. Giving calcium and vitamin D with acidic substances

8. The nurse is preparing an 8-year-old patient for a cardiac catheterization. Which intervention will the nurse initiate immediately postprocedure? 1. Observe for signs and symptoms of infection. 2. Hold food and fluids until gag reflex returns. 3. Keep the involved extremity straight for 4 to 6 hours. 4. Notify physician if green or yellow drainage is noted.

3. Keep the involved extremity straight for 4 to 6 hours.

8. The nurse in a pediatric clinic is working with a preschool patient and a parent about managing the child's functional constipation. Which is the most important information for the nurse to share? 1. The child is allowed to select a reward for having a bowel movement. 2. The child is informed of the treatments for constipation and/or impaction. 3. Parental action is required for the onset of vomiting or severe abdominal pain. 4. The parents expect the child to sit on the toilet for a period of time each day.

3. Parental action is required for the onset of vomiting or severe abdominal pain.

6. The nurse is providing care for a 12-year-old patient who is hospitalized with generalized weakness and muscle wasting, which began in the hips, pelvic area, thighs, and shoulders. The physician suspects Duchenne muscular dystrophy. Which action by the physician does the nurse expect? 1. Prescribe physical therapy to improve muscle strength. 2. Suggest homeschooling until the acute stage ends. 3. Perform an echocardiogram to evaluate cardiac functioning. 4. Perform muscle biopsies to identify the stage of the disease.

3. Perform an echocardiogram to evaluate cardiac functioning.

10. A neonate is born with gastroschisis. Which action will the nurse perform immediately? 1. Prepare the mother for a serious birth defect in the neonate. 2. Promote nonnutritive sucking to fulfill the neonate's needs. 3. Protect the defect with a nonadherent sterile saline dressing. 4. Place an orogastric tube to decompress the neonate's intestines.

3. Protect the defect with a nonadherent sterile saline dressing.

8. An 8-year-old child arrives at the emergency department with abdominal pain and fever. The child has a medical history of leukemia in remission. The nurse receives medical orders for the child. Which order does the nurse recognize as the priority? 1. Draw blood work for a CBC and blood culture. 2. Complete a thorough physical assessment. 3. Set up neutropenic precautions for the child. 4. Prepare the child to be transported to radiology.

3. Set up neutropenic precautions for the child.

3. The nurse in a pediatric clinic is obtaining information about a 7-month-old infant with GI symptoms. The parent informs the nurse that bloating, flatulence, and foul-smelling stools occurred with the introduction of wheat cereal. Which additional information will cause the nurse to initiate emergency care? 1. Dental enamel defects of the teeth 2. Presence of dermatitis herpetiformis 3. Severe vomiting and diarrhea 4. Weight loss indicated by thinness of extremities

3. Severe vomiting and diarrhea

8. The nurse is providing care for a 12-month-old patient who is experiencing poor weight gain. Physical assessment reveals an open anterior fontanel and open cranial sutures. To differentiate between a decrease in growth hormone and a congenital thyroid problem, which laboratory test does the nurse expect to be ordered? 1. Serum calcium 2. CBC 3. TSH 4. FSH

3. TSH

2. The nurse at a pediatric clinic is assessing a 12-year-old female. The patient ask the nurse, "I am scared about what's happening to my body. How does it happen?" Which information from the nurse is most appropriate? 1. The ovaries are located on each side of the uterus. 2. The ovaries secrete hormones that regulate the menstrual cycle. 3. The ovaries play a role in the regulation of puberty and fertility. 4. The body changes will indicate the patient is a woman and not a child.

3. The ovaries play a role in the regulation of puberty and fertility.

2. The nurse is teaching a pediatric electrocardiogram (EKG) class to nurses in a pediatric cardiac unit. Which anatomical structure does the nurse use to describe the initiation of cardiac electrical conduction? 1. The Purkinje fibers in the ventricles 2. The bundle branch in the left atrium 3. The sinoatrial node in the right atrium 4. The bundle of His in the ventricle walls

3. The sinoatrial node in the right atrium

1. The nurse is providing information to the parents of a toddler who is scheduled for surgery for the replacement of the pulmonic valve. The parents have many questions about the function of the valve. Which information from the nurse is correct? 1. The valve must work correctly to get oxygen from the lungs to the body. 2. If the valve does not work correctly, blood is kept from entering the heart. 3. When the valve is defective, the blood leaving the heart is decreased. 4. A defect in the valve causes less blood to get to the lungs for oxygenation.

4. A defect in the valve causes less blood to get to the lungs for oxygenation.

14. An adult female arrives in the emergency department following a spontaneous birth at home. The female indicates that no prenatal care has been received. Which assessment finding about the female causes the nurse greatest concern for the newborn? 1. A laboratory result reveals a positive hepatitis A anti-HAV-total. 2. The mother is emaciated and has indications of drug abuse. 3. The mother has no permanent address and denies having family. 4. A laboratory result reveals a positive hepatitis B e antigen (HBeAg).

4. A laboratory result reveals a positive hepatitis B e antigen (HBeAg).

6. A 16-year-old adolescent is diagnosed with osteosarcoma and has evidence of metastasis. The nurse calculates the absolute neutrophil count (ANC) daily. The patient asks the nurse to explain the ANC. Which information does the nurse provide? 1. The ANC is a measure of how well treatment is being tolerated by the body. 2. The ANC is total percentage of eosinophils plus the total percentage of basophils divided by the RBC. 3. The ANC provides a daily count of the number of antibodies in the circulating blood. 4. ANC measures of three types of white blood cells. A lower ANC indicates vulnerability to infection.

4. ANC measures of three types of white blood cells. A lower ANC indicates vulnerability to infection.

1. The nurse is admitting an adolescent who is 19 years of age with a diagnosis of acute renal infection. While obtaining medical and health history information, which finding does the nurse identify as supporting the diagnosis? 1. Hospitalization for removal of tonsils at 10 years of age 2. Prolonged use of acetaminophen for frequent headaches 3. A family history that is positive for renal calculi formation 4. Acknowledgment of being sexually active since 14 years of age

4. Acknowledgment of being sexually active since 14 years of age

12. The nurse in a pediatric emergency department is providing care for a 1-year-old patient with a history of congenital adrenal hyperplasia (CAH). The patient is exhibiting the manifestations of a febrile illness. Which medical intervention does the nurse expect to be prescribed? 1. Laboratory testing for elevated serum 17-OHP level 2. Cultures and testing for the cause of the febrile illness 3. A quiet, cool environment for the patient 4. Administration of corticosteroids by injection

4. Administration of corticosteroids by injection

9. The nurse is providing care for a 7-year-old child whose admitting diagnosis is poststreptococcal glomerulonephritis. The nurse expects which care to be prescribed for the child? 1. Hemodialysis 2. Nifedipine orally 3. Increase fluids 4. Antibiotic therapy

4. Antibiotic therapy

2. The NICU nurse is providing care for a neonate who presents with an overabundance of secretions that the neonate cannot manage. The nurse also identifies the neonate is anorectal and exhibits some limb deformity. Which assessment process will the nurse perform first? 1. Check whether there are deformities of the palate. 2. Check for choking after a feeding tube is passed. 3. Observe if cyanosis occurs during bottle feeding. 4. Determine the extent to which a feeding tube can be passed.

4. Determine the extent to which a feeding tube can be passed.

13. A 16-year-old adolescent has Addison's disease. The adolescent's current medication involves corticosteroid and mineralocorticoid replacement therapy. During sports practice, the adolescent collapses and loses consciousness with sudden, penetrating pain in the lower back and legs. Which action is taken by the school nurse? 1. Administer the glucagon kept for the adolescent in the clinic. 2. Place the adolescent in side-lying position in case vomiting occurs. 3. Notify the parents of the incident and request permission to transport to the hospital. 4. Give IM Solu-Cortef and call the paramedics for emergency IV infusion.

4. Give IM Solu-Cortef and call the paramedics for emergency IV infusion.

4. The nurse in a pediatrician's office is assessing a 9-year-old male patient who is being monitored for the possible diagnosis of hypopituitarism. Which assessment finding does the nurse recognize specifically as an indication of growth hormone deficiency? 1. High weight-to-height ratio 2. Large hands and feet for body size 3. Severe aching in knees and ankles 4. Height increase of 1.75 inches in 12 months

4. Height increase of 1.75 inches in 12 months

6. The pediatric nurse receives a medical prescription to obtain a urine sample for culture from an infant 6 months of age diagnosed with a UTI. By which method will the nurse collect the sample? 1. Applying clean catch techniques 2. Attaching an external urine bag 3. Catching urine in a sterile diaper 4. Performing urinary catheterization

4. Performing urinary catheterization

1. The nurse in a pediatric clinic is assessing an infant who is 6 months of age. The infant is pale with poor muscle tone. Auscultation reveals tachycardia; in addition, the infant is at the 35th percentile for both height and weight. The physician orders laboratory testing. Which laboratory value does the nurse expect? 1. Erythropoietin level of 1.9 mIU 2. Serum iron 24 mcg/dL 3. Normal RBC index in CBC 4. RBCs small in size and pale

4. RBCs small in size and pale

12. The nurse is providing care to a school-age child admitted because of the presence of colicky abdominal pain, palpable purpura on the lower extremities, edema of the face and lips, and anorexia. The suspected diagnosis is Henoch-Schönlein purpura. Which diagnostic test result does the nurse expect to validate the diagnosis? 1. Elevated serum creatinine 2. Positive for proteinuria 3. Stool positive for occult blood 4. Renal biopsy shows IgA deposition

4. Renal biopsy shows IgA deposition

14. A high school male adolescent arrives at the emergency department following a fall sustained while rock climbing. The physician prescribes diagnostic tests to rule out acute kidney injury (AKI). Which diagnostic finding does the nurse report immediately to the health-care provider? 1. Serum creatinine level of 0.6 2. Hematocrit level of 38% 3. Serum BUN of 20 mg/dL 4. Serum potassium of 5.7 mEq/L

4. Serum potassium of 5.7 mEq/L

9. The nurse is informing a new mother of the concern about her newborn who is 36 hours old and has not passed any meconium. The nurse shares a suspicion of Hirschsprung's disease. The mother asks the nurse multiple questions about the condition. Which information will the nurse provide? 1. Retained meconium is a source of severe infection in newborns. 2. A positive diagnosis indicates the newborn is terminally ill. 3. The absence of nerves in the colon also indicates mobility issues. 4. The condition is congenital and causes blockage of the intestines

4. The condition is congenital and causes blockage of the intestines

5. A parent brings a 12-month-old toddler to the pediatrician because the toddler cries a lot and then stops on her own. The parent has noticed a little blood in the diaper every time it is wet. Assessment reveals a temperature of 101.3°F (38.5°C). Which condition does the nurse anticipate after a urinalysis? 1. Hypospadias 2. Henoch-Schönlein purpura 3. Acute kidney injury 4. Urinary tract infection

4. Urinary tract infection