Exam

What is an essential component in caring for the very low or extremely lowbirth-weight infant? a. Holding the infant to help develop trust b. Using electronic monitoring devices exclusively c. Coordinating care to reduce environmental stress d. Incorporating infant stimulation elements during assessment

Coordinating care to reduce environmental stress

What should the nurse anticipate in an infant who was exposed to cocaine during pregnancy? a. Seizures b. Hyperglycemia c. Large for gestational age d. Hypertonia and jitteriness

Hypertonia and jitteriness

The nurse has been caring for an infant who has just died. The parents are present but appear to be afraid to hold the dead infant. What is the most appropriate nursing intervention? a. Tell them there is nothing to fear. b. Insist that they hold the infant one last time. c. Respect their wishes and release the body to the morgue. d. Keep the infants body available for a few hours in case they change their minds.

Keep the infants body available for a few hours in case they change their minds.

A preterm infant who is being fed commercial formula by gavage has had an increase in gastric residuals, abdominal distention, and apneic episodes. Which is the most appropriate nursing action? a. Notify the practitioner. b. Reduce the amount fed by gavage. c. Feed human milk by gavage. d. Feed only a glucose solution until the infant stabilizes.

Notify the practitioner.

The nurse is caring for a neonate with respiratory distress syndrome. The infant has an endotracheal tube. What should nursing considerations related to suctioning include? a. Suctioning should not be carried out routinely. b. The infant should be in the Trendelenburg position for suctioning. c. Routine suctioning, usually every 15 minutes, is necessary. d. Frequent suctioning is necessary to maintain the patency of the bronchi.

Suctioning should not be carried out routinely.

A tonsillectomy or adenoidectomy is contraindicated in what conditions? (Select all that apply.) a. Cleft palate b. Seizure disorders c. Blood dyscrasias d. Sickle cell disease e. Acute infection at the time of surgery

a. Cleft palate c. Blood dyscrasias e. Acute infection at the time of surgery

Pertussis vaccination should begin at which age? a. Birth b. 2 months c. 6 months d. 12 months

2 months

When should the nurse expect breastfeeding-associated jaundice to first appear in a normal infant? a. 2 to 12 hours b. 12 to 24 hours c. 2 to 4 days d. After the fifth day

2 to 4 days

A school-age child has asthma. The nurse should teach the child that if a peak expiratory flow rate is in the yellow zone, this means that the asthma control is what? a. 80% of a personal best, and the routine treatment plan can be followed. b. 50% to 79% of a personal best and needs an increase in the usual therapy. c. 50 % of a personal best and needs immediate emergency bronchodilators. d. Less than 50% of a personal best and needs immediate hospitalization.

50% to 79% of a personal best and needs an increase in the usual therapy.

After returning from cardiac catheterization, the nurse monitors the childs vital signs. The heart rate should be counted for how many seconds? a. 15 b. 30 c. 60 d. 120

60

What child has a cyanotic congenital heart defect? a. An infant with patent ductus arteriosus b. A 1-year-old infant with atrial septal defect c. A 2-month-old infant with tetralogy of Fallot d. A 6-month-old infant with repaired ventricular septal defect

A 2-month-old infant with tetralogy of Fallot

The clinic nurse is administering influenza vaccinations. Which children should not receive the live attenuated influenza vaccine (LAIV)? (Select all that apply.) a. A child with asthma b. A child with diabetes c. A child with hemophilia A d. A child with cancer receiving chemotherapy e. A child with gastroesophageal reflux disease

A child with asthma A child with diabetes A child with cancer receiving chemotherapy

A 3-year-old child woke up in the middle of the night with a croupy cough and inspiratory stridor. The parents bring the child to the emergency department, but by the time they arrive, the cough is gone, and the stridor has resolved. What can the nurse teach the parents with regard to this type of croup? a. A bath in tepid water can help resolve this type of croup. b. Tylenol can help to relieve the cough and stridor. c. A cool mist vaporizer at the bedside can help prevent this type of croup. d. Antibiotics need to be given to reduce the inflammation.

A cool mist vaporizer at the bedside can help prevent this type of croup.

Chronic otitis media with effusion (OME) differs from acute otitis media (AOM) because it is usually characterized by which signs or symptoms? a. Severe pain in the ear b. Anorexia and vomiting c. A feeling of fullness in the ear d. Fever as high as 40 C (104 F)

A feeling of fullness in the ear

A 1-year-old child has acute otitis media (AOM) and is being treated with oral antibiotics. What should the nurse include in the discharge teaching to the infants parents? a. A follow-up visit should be done after all medicine has been given. b. After an episode of acute otitis media, hearing loss usually occurs. c. Tylenol should not be given because it may mask symptoms. d. The infant will probably need a myringotomy procedure and tubes.

A follow-up visit should be done after all medicine has been given.

Which term is defined as a vaguely outlined area of edematous tissue situated over the portion of the scalp that presents in a vertex delivery? a. Hydrocephalus b. Cephalhematoma c. Caput succedaneum d. Subdural hematoma

Caput succedaneum

The nurse should know what about Lyme disease? a. Very difficult to prevent b. Easily treated with oral antibiotics in stages 1, 2, and 3 c. Caused by a spirochete that enters the skin through a tick bite d. Common in geographic areas where the soil contains the mycotic spores that cause the disease

Caused by a spirochete that enters the skin through a tick bite

What statement best represents infectious mononucleosis? a. Herpes simplex type 2 is the principal cause. b. A complete blood count shows a characteristic leukopenia. c. A short course of ampicillin is used when pharyngitis is present. d. Clinical signs and symptoms and blood tests are both needed to establish the diagnosis.

Clinical signs and symptoms and blood tests are both needed to establish the diagnosis.

What medication is contraindicated in children post tonsillectomy and adenoidectomy? a. Codeine b. Ondansetron (Zofran) b. Amoxil (amoxicillin) c. Acetaminophen (Tylenol)

Codeine

Early diagnosis of congenital hypothyroidism (CH) and phenylketonuria (PKU) is essential to prevent which? a. Obesity b. Diabetes c. Cognitive impairment d. Respiratory distress

Cognitive impairment

The nurse is assessing a child with croup in the emergency department. The child has a sore throat and is drooling. Examining the childs throat using a tongue depressor might precipitate what condition? a. Sore throat b. Inspiratory stridor c. Complete obstruction d. Respiratory tract infection

Complete obstruction

What statement best identifies the cause of heart failure (HF)? a. Disease related to cardiac defects b. Consequence of an underlying cardiac defect c. Inherited disorder associated with a variety of defects d. Result of diminished workload imposed on an abnormal myocardium

Consequence of an underlying cardiac defect

An infant with bronchiolitis is hospitalized. The causative organism is respiratory syncytial virus (RSV). The nurse knows that a child infected with this virus requires what type of isolation? a. Reverse isolation b. Airborne isolation c. Contact Precautions d. Standard Precautions

Contact Precautions

What should nursing care of an infant with oral candidiasis (thrush) include? a. Avoid use of a pacifier. b. Continue medication for the prescribed number of days. c. Remove the characteristic white patches with a soft cloth. d. Apply medication to the oral mucosa, being careful that none is ingested.

Continue medication for the prescribed number of days.

A 6-year-old child has had a tonsillectomy. The child is spitting up small amounts of dark brown blood in the immediate postoperative period. The nurse should take what action? a. Notify the health care provider. b. Continue to assess for bleeding. c. Give the child a red flavored ice pop. d. Position the child in a Trendelenburg position.

Continue to assess for bleeding.

The nurse is assisting a child with celiac disease to select foods from a menu. What foods should the nurse suggest? a. Hamburger on a bun b. Spaghetti with meat sauce c. Corn on the cob with butter d. Peanut butter and crackers

Corn on the cob with butter

A newborn is diagnosed with retinopathy of prematurity. What should the nurse know about this condition? a. Blindness cannot be prevented. b. No treatment is currently available. c. Cryotherapy and laser therapy are effective treatments. d. Long-term administration of oxygen will be necessary.

Cryotherapy and laser therapy are effective treatments.

The home care nurse is visiting a 6-month-old infant with bronchopulmonary dysplasia (BPD). The nurse assesses the child for which signs of overhydration?(Select all that apply.) a. Edema b. Serum sodium of 140 mEq/L c. Urine specific gravity of 1.008 d. Weight gain of 1 lb in 1 week

Edema Weight gain of 1 lb in 1 week

A child is recovering from Kawasaki disease (KD). The child should be monitored for which? a. Anemia b. Electrocardiograph (ECG) changes c. Elevated white blood cell count d. Decreased platelets

Electrocardiograph (ECG) changes

A 3-year-old is brought to the emergency department with symptoms of stridor, fever, restlessness, and drooling. No coughing is observed. Based on these findings, the nurse should be prepared to assist with what action? a. Throat culture b. Nasal pharynx washing c. Administration of corticosteroids d. Emergency intubation

Emergency intubation

What is an infant with severe jaundice at risk for developing? a. Encephalopathy b. Bullous impetigo c. Respiratory distress d. Blood incompatibility

Encephalopathy

A preschool child has asthma, and a goal is to extend expiratory time and increase expiratory effectiveness. What action should the nurse implement to meet this goal? a. Encourage increased fluid intake. b. Recommend increased use of a budesonide (Pulmicort) inhaler. c. Administer an antitussive to suppress coughing. d. Encourage the child to blow a pinwheel every 6 hours while awake.

Encourage the child to blow a pinwheel every 6 hours while awake.

A 12-year-old girl is newly diagnosed with diabetes when she develops ketoacidosis. How should the nurse structure a successful education program? a. Essential information is presented initially. b. Teaching should take place in the childs semiprivate room. c. Education is focused toward the parents because the child is too young. d. All information needed for self-management of diabetes is taught at once.

Essential information is presented initially.

A preterm neonate has begun breastfeeding, but the infant tires easily and has weak sucking and swallowing reflexes. What is the most appropriate nursing intervention? a. Encourage the mother to breastfeed. b. Resume orogastric feedings of formula. c. Try nipple feeding the preterm infant formula. d. Feed the remainder of breast milk by the orogastric route.

Feed the remainder of breast milk by the orogastric route.

What is the most common cause of iatrogenic anemia in preterm infants? a. Frequent blood sampling b. Respiratory distress syndrome c. Meconium aspiration syndrome d. Persistent pulmonary hypertension

Frequent blood sampling

A neonate is born with mild clubfeet. When the parents ask the nurse how this will be corrected, what should the nurse explain? a. Traction is tried first. b. Surgical intervention is needed. c. Frequent, serial casting is tried first. d. Children outgrow this condition when they learn to walk.

Frequent, serial casting is tried first.

A preterm infant of 33 weeks of gestation is admitted to the neonatal intensive care unit. Approximately 2 hours after birth, the neonate begins having difficulty breathing, with grunting, tachypnea, and nasal flaring. What should the nurse recognize? a. This is a normal finding. b. Further evaluation is needed. c. Improvement should occur within 24 hours. d. This is not significant unless cyanosis is present.

Further evaluation is needed.

A quantitative sweat chloride test has been done on an 8-month-old child. What value should be indicative of cystic fibrosis (CF)? a. Less than 18 mEq/L b. 18 to 40 mEq/L c. 40 to 60 mEq/L d. Greater than 60 mEq/L

Greater than 60 mEq/L

Women who smoke during pregnancy are most likely to have infants who are what? a. Large for gestational age b. Preterm but size appropriate for gestational age c. Growth restricted in weight only d. Growth restricted in weight, length, and chest and head circumference

Growth restricted in weight, length, and chest and head circumference

The parents of an infant who has just died decide they want to hold the infant after their infant has gone to the morgue. What is the most appropriate nursing intervention at this time? a. Explain gently that this is no longer possible. b. Encourage the parents to accept the loss of their infant. c. Offer to take a photograph of their infant because they cannot hold the infant. d. Have the infant brought back to the unit, wrapped in a blanket, and rewarmed in a radiant warmer.

Have the infant brought back to the unit, wrapped in a blanket, and rewarmed in a radiant warmer.

A cardiac defect that allows blood to shunt from the (high pressure) left side of the heart to the (lower pressure) right side can result in which condition? a. Cyanosis b. Heart failure c. Decreased pulmonary blood flow d. Bounding pulses in upper extremities

Heart failure

The nurse is giving discharge instructions to the parents of a 5-year-old child who had a tonsillectomy 4 hours ago. What statement by the parent indicates a correct understanding of the teaching? a. I can use an ice collar on my child for pain control along with analgesics. b. My child should clear the throat frequently to clear the secretions. c. I should allow my child to be as active as tolerated. d. My child should gargle and brush teeth at least three times per day.

I can use an ice collar on my child for pain control along with analgesics.

The nurse is giving discharge instructions to the parent of a 6-year-old child who had a cardiac catheterization 4 hours ago. What statement by the parent indicates a correct understanding of the teaching? a. My child should not attend school for the next 5 days. b. I should change the bandage every day for the next 2 days. c. My child can take a tub bath but should avoid taking a shower for the next 4 days. d. I should expect the site to be red and swollen for the next 3 days.

I should change the bandage every day for the next 2 days.

The nurse is teaching the parent of a 4-year-old child with a cast on the arm about care at home. What statement by the parent indicates a correct understanding of the teaching? a. I should have the affected limb hang in a dependent position. b. I will use an ice pack to relieve the itching. c. I should avoid keeping the injured arm elevated. d. I will expect the fingers to be swollen for the next 3 days.

I will use an ice pack to relieve the itching.

The nurse is teaching the family with a child with cerebral palsy (CP) strategies to prevent constipation. What should the nurse include in the teaching session? (Select all that apply.) a. Increase fluid intake. b. Increase fiber in the diet. c. Administer stool softeners daily as prescribed. d. Increase the amount of dairy products in the diet. e. Allow the child to decide when to try to have a bowel movement.

Increase fluid intake. b. Increase fiber in the diet. c. Administer stool softeners daily as prescribed.

What nutritional component should be altered in the infant with heart failure (HF)? a. Decrease in fats b. Increase in fluids c. Decrease in protein d. Increase in calories

Increase in calories

Which intervention may decrease the incidence of physiologic jaundice in a healthy full-term infant? a. Institute early and frequent feedings. b. Bathe newborn when the axillary temperature is 36.3 C (97.5 F). c. Place the newborns crib near a window for exposure to sunlight. d. Suggest that the mother initiate breastfeeding when the danger of jaundice has passed.

Institute early and frequent feedings.

The nurse is assessing a child suspected of having pinworms. Which is the most common symptom the nurse expects to assess? a. Restlessness b. Distractibility c. Rectal discharge d. Intense perianal itching

Intense perianal itching

What is the primary method of treating osteomyelitis? a. Joint replacement b. Bracing and casting c. Intravenous antibiotic therapy d. Long-term corticosteroid therapy

Intravenous antibiotic therapy

What should the nurse explain about ringworm? a. It is not contagious. b. It is a sign of uncleanliness. c. It is expected to resolve spontaneously. d. It is spread by both direct and indirect contact.

It is spread by both direct and indirect contact.

The nurse is teaching an adolescent about giving insulin injections. The adolescent asks if the disposable needles and syringes can be used more than once. The nurses response should be based on which knowledge? a. It is unsafe. b. It is acceptable for up to 24 hours. c. It is acceptable for families with very limited resources. d. It is suitable for up to 3 days if stored in the refrigerator.

It is suitable for up to 3 days if stored in the refrigerator.

What explains why a neutral thermal environment is essential for a high-risk neonate? a. The neonate produces heat by increasing activity and shivering. b. Metabolism slows dramatically in the neonate experiencing cold stress. c. It permits the neonate to maintain a normal core temperature with minimum oxygen consumption. d. It permits the neonate to maintain a normal core temperature with increased caloric consumption.

It permits the neonate to maintain a normal core temperature with minimum oxygen consumption.

The nurse is caring for a neonate with an intraventricular hemorrhage. What interventions should the nurse avoid to prevent any increase in intracranial pressure? (Select all that apply.) a. Keeping the head of the bed flat b. Keeping the environment quiet c. Handling the neonate minimally d. Suctioning the endotracheal tube frequently e. Maintaining the neonates head in a midline position

Keeping the head of the bed flat Suctioning the endotracheal tube frequently

Which is a sex chromosome abnormality that is caused by the presence of one or more additional X chromosomes in a male? a. Turner b. Triple X c. Klinefelter d. Trisomy 13

Klinefelter

A woman in premature labor delivers an extremely lowbirth-weight (ELBW) infant. Transport to a neonatal intensive care unit is indicated. The nurse explains that which level of service is needed? a. Level I b. Level IA c. Level II d. Level IIIB

Level IIIB

The nurse is caring for a school-age girl who has had a cardiac catheterization. The child tells the nurse that her bandage is too wet. The nurse finds the bandage and bed soaked with blood. What nursing action is most appropriate to institute initially? a. Notify the physician. b. Place the child in Trendelenburg position. c. Apply a new bandage with more pressure. d. Apply direct pressure above the catheterization site.

Apply direct pressure above the catheterization site.

Decreasing the demands on the heart is a priority in care for the infant with heart failure (HF). In evaluating the infants status, which finding is indicative of achieving this goal? a. Irritability when awake b. Capillary refill of more than 5 seconds c. Appropriate weight gain for age d. Positioned in high Fowler position to maintain oxygen saturation at 90%

Appropriate weight gain for age

A mother planned to breastfeed her infant before giving birth at 33 weeks of gestation. The infant is stable and receiving oxygen. What is the most appropriate nursing action related to this? a. Assist the mother in expressing breast milk. b. Assess the infants readiness to breastfeed. c. Explain to the mother that the infant is too small to receive breast milk. d. Reassure the mother that infant formula is a good alternative to breastfeeding.

Assess the infants readiness to breastfeed.

Which finding on a newborn assessment should the nurse recognize as suggestive of a clavicle fracture? a. Positive scarf sign b. Asymmetric Moro reflex c. Swelling of fingers on affected side d. Paralysis of affected extremity and muscles

Asymmetric Moro reflex

An infants parents ask the nurse about preventing otitis media (OM). What information should be provided? a. Avoid tobacco smoke. b. Use nasal decongestants. c. Avoid children with OM. d. Bottle- or breastfeed in a supine position.

Avoid tobacco smoke

Parents bring their 15-month-old infant to the emergency department at 3:00 AM because the toddler has a temperature of 39 C (102.2 F), is crying inconsolably, and is tugging at the ears. A diagnosis of otitis media (OM) is made. In addition to antibiotic therapy, the nurse practitioner should instruct the parents to use what medication? a. Decongestants to ease stuffy nose b. Antihistamines to help the child sleep c. Aspirin for pain and fever management d. Benzocaine ear drops for topical pain relief

Benzocaine ear drops for topical pain relief

The parents of a newborn ask the nurse what caused the babys facial nerve paralysis. The nurses response is based on remembering that this is caused by what? a. Birth injury b. Genetic defect c. Spinal cord injury d. Inborn error of metabolism

Birth injury

Which birth injuries should the nurse assess for if an infant was born with the use of a vacuum extractor? (Select all that apply.) a. Torticollis b. Brachial palsy c. Fractured clavicle d. Cephalhematoma e. Subgaleal hemorrhage

Brachial palsy Cephalhematoma Subgaleal hemorrhage

The nurse is preparing to admit a 7-year-old child with acute laryngotracheobronchitis (LTB). What clinical manifestations should the nurse expect to observe? (Select all that apply.) a. Dysphagia b. Brassy cough c. Low-grade fever d. Toxic appearance e. Slowly progressive

Brassy cough Low-grade fever Slowly progressive

The nurse is caring for a breastfed full-term infant who was born after an uneventful pregnancy and delivery. The infants blood glucose level is 36 mg/dL. Which action should the nurse implement? a. Bring the infant to the mother and initiate breastfeeding. b. Place a nasogastric tube and administer 5% dextrose water. c. Start a peripheral intravenous line and administer 10% dextrose. d. Monitor the infant in the nursery and obtain a blood glucose level in 4 hours.

Bring the infant to the mother and initiate breastfeeding.

What are possible premature infant complications from oxygen therapy and mechanical ventilation? a. Bronchopulmonary dysplasia and retinopathy of prematurity b. Anemia and necrotizing enterocolitis c. Cerebral palsy and persistent patent ductus arteriosus d. Congestive heart failure and cerebral edema

Bronchopulmonary dysplasia and retinopathy of prematurity

A school-age child with diabetes gets 30 units of NPH insulin at 0800. According to when this insulin peaks, the child should be at greatest risk for a hypoglycemic episode between when? a. Lunch and dinner b. Breakfast and lunch c. 0830 to his midmorning snack d. Bedtime and breakfast the next morning

Lunch and dinner

A 3-month-old infant is admitted to the pediatric unit for treatment of bronchiolitis. The infants vital signs are T, 101.6 F; P, 106 beats/min apical; and R, 70 breaths/min. The infant is irritable and fussy and coughs frequently. IV fluids are given via a peripheral venipuncture. Fluids by mouth were initially contraindicated for what reason? a. Tachypnea b. Paroxysmal cough c. Irritability d. Fever

Tachypnea

One of the goals for children with asthma is to maintain the childs normal functioning. What principle of treatment helps to accomplish this goal? a. Limit participation in sports. b. Reduce underlying inflammation. c. Minimize use of pharmacologic agents. d. Have yearly evaluations by a health care provider.

Reduce underlying inflammation.

What action by the school nurse is important in the prevention of rheumatic fever (RF)? a. Encourage routine cholesterol screenings. b. Conduct routine blood pressure screenings. c. Refer children with sore throats for throat cultures. d. Recommend salicylates instead of acetaminophen for minor discomforts.

Refer children with sore throats for throat cultures.

The nurse knows that during deep sleep the neonate should not be disturbed if possible. Characteristics of deep sleep include what? a. Regular breathing b. Occasional smiling c. Rapid eye movements d. Apneic pauses of less than 20 seconds

Regular breathing

The nurse is caring for an infant who will be discharged on home phototherapy. What instructions should the nurse include in the discharge teaching to the parents? a. Apply an oil-based lotion to the infants skin two times per day to prevent the skin from drying out under the phototherapy light. b. Keep the eye shields on the infants eyes even when the phototherapy light is turned off. c. Take the infants temperature every 2 hours while the newborn is under the phototherapy light. d. Make a follow-up visit with the health care provider within 2 or 3 days after your infant has been on phototherapy.

Make a follow-up visit with the health care provider within 2 or 3 days after your infant has been on phototherapy.

The nurse should suspect a child has cerebral palsy (CP) if the parent says what? a. My 6-month-old baby is rolling from back to prone now. b. My 4-month-old doesnt lift his head when on his tummy. c. My 8-month-old can sit without support. d. My 10-month-old is not walking.

My 4-month-old doesnt lift his head when on his tummy.

Neuropathic bladder disorders are common among children with which disorder? a. Plagiocephaly b. Meningocele c. Craniosynostosis d. Myelomeningocele

Myelomeningocele

Which is an important nursing action related to the use of tape or adhesives on premature neonates? a. Avoid using tape and adhesives until skin is more mature. b. Remove adhesives with water, mineral oil, or petrolatum. c. Use scissors carefully to remove tape instead of pulling off the tape. d. Use solvents to remove tape and adhesives instead of pulling on the skin.

Remove adhesives with water, mineral oil, or petrolatum.

The nurse is caring for a high-risk neonate who has an umbilical catheter and is in a radiant warmer. The nurse notes blanching of the feet. Which is the most appropriate nursing action? a. Place socks on the infants feet. b. Elevate the infants feet 15 degrees. c. Wrap the infants feet loosely in a prewarmed blanket. d. Report the findings immediately to the practitioner.

Report the findings immediately to the practitioner.

What do the initial signs of respiratory syncytial virus (RSV) infection in an infant include? a. Rhinorrhea, wheezing, and fever b. Tachypnea, cyanosis, and apnea c. Retractions, fever, and listlessness d. Poor breath sounds and air hunger

Rhinorrhea, wheezing, and fever

A school-age child with cystic fibrosis takes four enzyme capsules with meals. The child is having four or five bowel movements per day. The nurses action in regard to the pancreatic enzymes is based on the knowledge that the dosage is what? a. Adequate b. Adequate but should be taken between meals c. Needs to be increased to increase the number of bowel movements per day d. Needs to be increased to decrease the number of bowel movements per day

Needs to be increased to decrease the number of bowel movements per day

The nurse is caring for a 1-month-old infant with respiratory syncytial virus (RSV) who is receiving 23% oxygen via a plastic hood. The childs SaO2 saturation is 88%, respiratory rate is 45 breaths/min, and pulse is 140 beats/min. Based on these assessments, what action should the nurse take? a. Withhold feedings. b. Notify the health care provider. c. Put the infant in an infant seat. d. Keep the infant in the plastic hood.

Notify the health care provider

A child with heart failure is on Lanoxin (digoxin). The laboratory value a nurse must closely monitor is which? a. Serum sodium b. Serum potassium c. Serum glucose d. Serum chloride

Serum potassium

What drug is usually given first in the emergency treatment of an acute, severe asthma episode in a young child? a. Ephedrine b. Theophylline c. Aminophylline d. Short-acting b2-agonists

Short-acting b2-agonists

Which refers to an infant whose rate of intrauterine growth has slowed and whose birth weight falls below the 10th percentile on intrauterine growth charts? a. Postterm b. Postmature c. Low birth weight d. Small for gestational age

Small for gestational age

What most accurately describes bowel function in children born with a myelomeningocele? a. Incontinence cannot be prevented. b. Enemas and laxatives are contraindicated. c. Some degree of fecal continence can usually be achieved. d. Colostomy is usually required by the time the child reaches adolescence.

Some degree of fecal continence can usually be achieved.

A child with a hip spica cast is being prepared for discharge. Recognizing that caring for a child at home is complex, the nurse should include what instructions for the parents discharge teaching? a. Turn every 8 hours. b. Specially designed car restraints are necessary. c. Diapers should be avoided to reduce soiling of the cast. d. Use an abduction bar between the legs to aid in turning.

Specially designed car restraints are necessary.

The nurse is caring for a 3-week-old boy born at 29 weeks of gestation. While taking vital signs and changing his diaper after stooling, the nurse observes his color is pink but slightly mottled, his arms and legs are limp and extended, he has the hiccups, his respirations are deep and rapid, and his heart rate is regular and rapid. The nurse should recognize these behaviors as signs of what? a. Stress b. Subtle seizures c. Preterm behaviors d. Onset of respiratory distress

Stress

What is most descriptive of the signs observed in neonatal sepsis? a. Seizures b. Sudden hyperthermia c. Decreased urinary output d. Subtle, vague, and nonspecific physical signs

Subtle, vague, and nonspecific physical signs

Which statement best describes the characteristics of preterm infants? a. Thermoregulation is well established. b. Extremities remain in attitude of flexion. c. Sucking reflex is absent, weak, or ineffectual. d. The head is proportionately small in relation to the body.

Sucking reflex is absent, weak, or ineffectual.

In about 1 week, a stable preterm infant will be discharged. The nurse should teach the parents to place the infant in which position for sleep? a. Prone b. Supine c. Position of comfort d. Abdomen with head elevated

Supine

A 4-year-old girl is brought to the emergency department. She has a froglike croaking sound on inspiration, is agitated, and is drooling. She insists on sitting upright. The nurse should intervene in which manner? a. Make her lie down and rest quietly. b. Examine her oral pharynx and report to the physician. c. Auscultate her lungs and prepare for placement in a mist tent. d. Notify the physician immediately and be prepared to assist with a tracheostomy or intubation.

Notify the physician immediately and be prepared to assist with a tracheostomy or intubation.

A 4-year-old child is placed in Buck extension traction for Legg-Calv-Perthes disease. He is crying with pain as the nurse assesses the skin of his right foot and sees that it is pale with an absence of pulse. What should the nurse do first? a. Reposition the child and notify the practitioner. b. Notify the practitioner of the changes noted. c. Give the child medication to relieve the pain. d. Chart the observations and check the extremity again in 15 minutes.

Notify the practitioner of the changes noted.

What does the nursing care for infants with fetal alcohol syndrome (FAS) include? a. Nutritional guidance b. An intensive stimulation program c. Facilitation of improvement in cardiovascular status d. An individualized program based on maternal alcohol consumption

Nutritional guidance

The nurse is planning care for an infant with candidiasis (moniliasis) diaper dermatitis. Which topical ointments may be prescribed for the patient? (Select all that apply.) a. Nystatin b. Bactroban c. Neosporin d. Miconazole e. Clotrimazole

Nystatin Miconazole Clotrimazole

Parents are considering treatment options for their 5-year-old child with Legg-Calv-Perthes disease. Both surgical and conservative therapies are appropriate. They are able to verbalize the differences between the therapies when they make what statement? a. All therapies require extended periods of bed rest. b. Conservative therapy will be required until puberty. c. Our child cannot attend school during the treatment phase. d. Surgical correction requires a 3- to 4-month recovery period.

Surgical correction requires a 3- to 4-month recovery period

What tests aid in the diagnosis of cystic fibrosis (CF)? a. Sweat test, stool for fat, chest radiography b. Sweat test, bronchoscopy, duodenal fluid analysis c. Sweat test, stool for trypsin, biopsy of intestinal mucosa d. Stool for fat, gastric contents for hydrochloride, radiography

Sweat test, stool for fat, chest radiography

What is an important nursing intervention for a full-term infant receiving phototherapy? a. Observing for signs of dehydration b. Using sunscreen to protect the infants skin c. Keeping the infant diapered to collect frequent stools d. Informing the mother why breastfeeding must be discontinued

Observing for signs of dehydration

The nurse is preparing to admit a 7-year-old child with type 2 diabetes. What clinical features of type 2 diabetes should the nurse recognize? (Select all that apply.) a. Oral agents are effective. b. Insulin is usually needed. c. Ketoacidosis is infrequent. d. Diet only is often effective. e. Chronic complications frequently occur.

Oral agents are effective. Ketoacidosis is infrequent. Diet only is often effective.

Pancreatic enzymes are administered to the child with cystic fibrosis. What nursing consideration should be included in the plan of care? a. Give pancreatic enzymes between meals if at all possible. b. Do not administer pancreatic enzymes if the child is receiving antibiotics. c. Decrease the dose of pancreatic enzymes if the child is having frequent, bulky stools. d. Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal.

Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal.

A child is in the hospital for cystic fibrosis. What health care providers prescription should the nurse clarify before implementing? a. Dornase alfa (Pulmozyme) nebulizer treatment bid b. Pancreatic enzymes every 6 hours c. Vitamin A, D, E, and K supplements daily d. Proventil (albuterol) nebulizer treatments tid

Pancreatic enzymes every 6 hours

Which is a characteristic of postmature infants? a. Abundant lanugo b. Lack of scalp hair c. Plump appearance d. Parchment-like skin

Parchment-like skin

The parents of a young child with heart failure (HF) tell the nurse that they are nervous about giving digoxin. The nurses response should be based on which knowledge? a. It is a safe, frequently used drug. b. Parents lack the expertise necessary to administer digoxin. c. It is difficult to either overmedicate or undermedicate with digoxin. d. Parents need to learn specific, important guidelines for administration of digoxin.

Parents need to learn specific, important guidelines for administration of digoxin.

The most important nursing intervention when caring for an infant with myelomeningocele in the preoperative stage is which? a. Take vital signs every hour. b. Place the infant on the side to decrease pressure on the spinal sac. c. Watch for signs that might indicate developing hydrocephalus. d. Apply a heat lamp to facilitate drying and toughening of the sac.

Place the infant on the side to decrease pressure on the spinal sac.

The nurse is caring for a preterm neonate who requires mechanical ventilation for treatment of respiratory distress syndrome. Because of the mechanical ventilation, the nurse should recognize an increased risk of what? a. Pneumothorax b. Transient tachypnea c. Meconium aspiration d. Retractions and nasal flaring

Pneumothorax

The parent of a child with cystic fibrosis (CF) calls the clinic nurse to report that the child has developed tachypnea, tachycardia, dyspnea, pallor, and cyanosis. The nurse should tell the parent to bring the child to the clinic because these signs and symptoms are suggestive of what condition? a. Pneumothorax b. Bronchodilation c. Carbon dioxide retention d. Increased viscosity of sputum

Pneumothorax

What sign/symptom is a major clinical manifestation of rheumatic fever (RF)? a. Fever b. Polyarthritis c. Osler nodes d. Janeway spots

Polyarthritis

An infant has tetralogy of Fallot. In reviewing the record, what laboratory result should the nurse expect to be documented? a. Leukopenia b. Polycythemia c. Anemia d. Increased platelet level

Polycythemia

The parents of a child with spastic cerebral palsy (CP) state that their child seems to have significant pain. In addition to systemic pharmacologic management, the nurse includes which teaching? a. Patterning b. Positions to reduce spasticity c. Stretching exercises after meals d. Topical analgesics for muscle spasms

Positions to reduce spasticity

Herpes zoster is caused by the varicella virus and has an affinity for which? a. Sympathetic nerve fibers b. Parasympathetic nerve fibers c. Lateral and dorsal columns of the spinal cord d. Posterior root ganglia and posterior horn of the spinal cord

Posterior root ganglia and posterior horn of the spinal cord

A 6-year-old child is scheduled for a cardiac catheterization. What consideration is most important in planning preoperative teaching? a. Preoperative teaching should be directed at his parents because he is too young to understand. b. Preoperative teaching should be adapted to his level of development so that he can understand. c. Preoperative teaching should be done several days before the procedure so he will be prepared. d. Preoperative teaching should provide details about the actual procedures so he will know what to expect.

Preoperative teaching should be adapted to his level of development so that he can understand.

An infant with a congenital heart defect is to receive a dose of palivizumab (Synagis). What is the purpose of this? a. Prevent RSV infection. b. Prevent secondary bacterial infection. c. Decrease toxicity of antiviral agents. d. Make isolation of infant with RSV unnecessary.

Prevent RSV infection.

The nurse is caring for a newborn who was born at 35 weeks of gestation and is considered a late preterm infant. What intervention should be included in the infants care plan? a. Feed the infant dextrose water as the first feeding after 12 hours. b. Promote skin-to-skin care in the immediate postpartum period. c. Avoid administration of the hepatitis B vaccine until after discharge. d. Delay the newborn screening and hearing test until the infant is at 40 weeks corrected age.

Promote skin-to-skin care in the immediate postpartum period.

The nurse is preparing to administer a gavage feeding to an infant. The nurse should place the infant in which position for the feeding? a. Supine with the head flat b. Sitting upright in a car seat c. Left side-lying with the head flat d. Prone with the head slightly elevated

Prone with the head slightly elevated

The nurse is caring for a neonate born with a myelomeningocele. Surgery to repair the defect is scheduled the next day. What is the most appropriate way to position and feed this neonate? a. Prone with the head turned to the side b. On the side c. Supine in an infant carrier d. Supine, with defect supported with rolled blankets

Prone with the head turned to the side

A preterm infant is being fed by gavage. What is an important consideration for this infant? a. Warm the feeding to body temperature before feeding. b. Feed the infant in an isolette to minimize handling. c. Provide a pacifier for nonnutritive sucking during bolus feeding. d. Do not allow the infant to have increased stress by becoming hungry.

Provide a pacifier for nonnutritive sucking during bolus feeding.

The mother of a 20-month-old boy tells the nurse that he has a barking cough at night. His temperature is 37 C (98.6 F). The nurse suspects mild croup and should recommend which intervention? a. Admit to the hospital and observe for impending epiglottitis. b. Provide fluids that the child likes and use comfort measures. c. Control fever with acetaminophen and call if cough gets worse tonight. d. Try over-the-counter cough medicine and come to the clinic tomorrow if no improvement.

Provide fluids that the child likes and use comfort measures.

The health care provider suggests surgery be performed for ventricular septal defect to prevent what complication? a. Pulmonary hypertension b. Right-to-left shunt of blood c. Pulmonary embolism d. Left ventricular hypertrophy

Pulmonary hypertension

A child is admitted with acute laryngotracheobronchitis (LTB). The child will most likely be treated with which? a. Racemic epinephrine and corticosteroids b. Nebulizer treatments and oxygen c. Antibiotics and albuterol d. Chest physiotherapy and humidity

Racemic epinephrine and corticosteroids

While a mother is feeding her high-risk neonate, the nurse observes the neonate having occasional apnea, pallor, and bradycardia. What is the most appropriate nursing action? a. Let the neonate rest before breastfeeding again. b. Resume gavage feedings until the neonate is asymptomatic. c. Recognize that this may indicate an underlying illness. d. Use a high-flow, pliable nipple because it requires less energy to use.

Recognize that this may indicate an underlying illness.

After returning from cardiac catheterization, the nurse determines that the pulse distal to the catheter insertion site is weaker. How should the nurse respond? a. Elevate the affected extremity. b. Notify the practitioner of the observation. c. Record data on the assessment flow record. d. Apply warm compresses to the insertion site.

Record data on the assessment flow record.

The nurse is preparing a community outreach program for adolescents about the characteristic differences between type 1 and type 2 diabetes mellitus (DM). What concepts should the nurse include? (Select all that apply.) a. Type 1 DM has an abrupt onset. b. Type 1 DM is often controlled with oral glucose agents. c. Type 1 DM occurs primarily in whites. d. Type 2 DM always requires insulin therapy. e. Type 2 DM frequently has a familial history. f. Type 2 DM occurs in people who are overweight.

Type 1 DM has an abrupt onset. Type 1 DM occurs primarily in whites. Type 2 DM frequently has a familial history. Type 2 DM occurs in people who are overweight.

What form of diabetes is characterized by destruction of pancreatic beta cells, resulting in insulin deficiency? Type 1 diabetes Type 2 diabetes Gestational diabetes Maturity-onset diabetes of the young (MODY)

Type 1 diabetes

The neonatal intensive care nurse is planning care for an infant in an incubator. Which interventions should the nurse plan to assure therapeutic visual stimulation for the neonate? a. Use an incubator cover. b. Keep lights bright in the unit. c. Place a cloth over the infants face. d. Leave a visual stimulus at the head of the infants bed.

Use an incubator cover.

A family requires home care teaching with regard to preventative measures to use at home to avoid an asthmatic episode. What strategy should the nurse teach? a. Use a humidifier in the childs room. b. Launder bedding daily in cold water. c. Replace wood flooring with carpet. d. Use an indoor air purifier with HEPA filter.

Use an indoor air purifier with HEPA filter.

The nurse is preparing an airborne infection isolation room for a patient. Which communicable disease does the patient likely have? a. Varicella b. Pertussis c. Influenza d. Scarlet fever

Varicella

An immunocompromised child has been exposed to chickenpox. What should the nurse anticipate to be prescribed to the exposed child? a. Acyclovir (Zovirax) b. Valacyclovir (Valtrex) c. Amantadine (Symmetrel) d. Varicella-zoster immune globulin

Varicella-zoster immune globulin

A 6-month-old infant presents to the clinic with failure to thrive, a history of frequent respiratory infections, and increasing exhaustion during feedings. On physical examination, a systolic murmur is detected, no central cyanosis, and chest radiography reveals cardiomegaly. An echocardiogram is done that shows left-to-right shunting. This assessment data is characteristic of what? a. Tetralogy of Fallot b. Coarctation of the aorta c. Pulmonary stenosis d. Ventricular septal defect

Ventricular septal defect

The health care provider has prescribed surfactant, beractant (Survanta), to be administered to an infant with respiratory distress syndrome (RDS). The nurse understands that the beractant will be administered by which route? a. Orally b. Intravenously c. Via the ET tube d. Intramuscularly

Via the ET tube

The nurse is caring for a preterm infant who is receiving caffeine citrate for treatment of apnea of prematurity. What signs should indicate caffeine toxicity? Bradycardia and hypotension Oliguria and sleepiness Vomiting and irritability Constipation and weight loss

Vomiting and irritability

When caring for a child after a tonsillectomy, what intervention should the nurse do? a. Watch for continuous swallowing. b. Encourage gargling to reduce discomfort. c. Apply warm compresses to the throat. d. Position the child on the back for sleeping.

Watch for continuous swallowing.

The clinic nurse is instructing parents about caring for a toddler with ascariasis (common roundworm). Which statement made by the parents indicates a need for further teaching? a. We will wash our hands often, especially after diaper changes. b. We know that roundworm can be transmitted from person to person. c. We will be sure to continue the nitazoxanide (Alinia) orally for 3 days. d. We will bring a stool sample to the clinic for examination in 2 weeks.

We know that roundworm can be transmitted from person to person.

Heart failure (HF) is a problem after the child has had a congenital heart defect repaired. The nurse knows a sign of HF is what? a. Wheezing b. Increased blood pressure c. Increased urine output d. Decreased heart rate

Wheezing

Then should the nurse expect jaundice to be present in a full-term infant with hemolytic disease? a. At birth b. Within 24 hours after birth c. 25 to 48 hours after birth d. 49 to 72 hours after birth

Within 24 hours after birth

Parents of an infant born at 36 weeks gestation ask the nurse, Will our infant need a car seat trial before being discharged? What is the nurses best response? a. Yes, to see if the car seat is the appropriate size. b. Yes, to determine if blanket rolls will be needed. c. No, your infant was old enough at birth to not need a trial. d. Yes, to monitor for possible apnea and bradycardia while in the seat.

Yes, to monitor for possible apnea and bradycardia while in the seat.

The nurse is preparing to administer a topical application of 1 ml of nystatin (Mycostatin) to an infant with oral thrush. Which actions should the nurse plan to implement? (Select all that apply.) a. Administer after a feeding. b. Use a sponge applicator to swab the oral mucosa and tongue. c. Administer after warming the medication under running warm water. d. If white patches are no longer present, hold the medication. e. Deposit the remainder of the dose in the mouth with a syringe so the infant swallows a small amount.

a. Administer after a feeding. b. Use a sponge applicator to swab the oral mucosa and tongue. e. Deposit the remainder of the dose in the mouth with a syringe so the infant swallows a small amount.

The nurse is planning care for a child with chickenpox (varicella). Which prescribed supportive measures should the nurse plan to implement? (Select all that apply.) a. Administration of acyclovir (Zovirax) b. Administration of azithromycin (Zithromax) c. Administration of Vitamin A supplementation d. Administration of acetaminophen (Tylenol) for fever e. Administration of diphenhydramine (Benadryl) for itching

a. Administration of acyclovir (Zovirax) d. Administration of acetaminophen (Tylenol) for fever e. Administration of diphenhydramine (Benadryl) for itching

The nurse suspects a newborn has a fractured clavicle. What are signs of a fractured clavicle? (Select all that apply.) a. An asymmetric Moro reflex b. Limited use of the affected arm c. Crying when the arm is moved d. Muscles of the hand are paralyzed e. The arm hangs limp alongside the body

a. An asymmetric Moro reflex b. Limited use of the affected arm c. Crying when the arm is moved

The nursery nurse is aware that which are risk factors for hyperbilirubinemia?(Select all that apply.) a. An infant born prematurely b. An infant born to a mother with diabetes c. An infant born to a white mother d. An infant fed exclusively with formula e. An infant born with a metabolic disease

a. An infant born prematurely b. An infant born to a mother with diabetes e. An infant born with a metabolic disease

The nurse is preparing to admit a 2-year-old child with spina bifida occulta. What clinical manifestations of spina bifida occulta should the nurse expect to observe? (Select all that apply.) a. Dark tufts of hair b. Skin depression or dimple c. Port-wine angiomatous nevi d. Soft, subcutaneous lipomas e. Bladder and sphincter paralysis

a. Dark tufts of hair b. Skin depression or dimple c. Port-wine angiomatous nevi d. Soft, subcutaneous lipomas

The nurse is monitoring an infants temperature to avoid cold stress. The nurse understands that cold stress in the infant can cause which complications? (Select all that apply.) a. Hypoxia b. Hypoglycemia c. Metabolic acidosis d. Respiratory alkalosis e. Increased shivering response

a. Hypoxia b. Hypoglycemia c. Metabolic acidosis

The nurse is assisting with application of a synthetic cast on a child with a fractured humerus. What are the advantages of a synthetic cast over a plaster of Paris cast? (Select all that apply.) a. Less bulky b. Drying time is faster c. Molds readily to body part d. Permits regular clothing to be worn e. Can be cleaned with small amount of soap and water

a. Less bulky b. Drying time is faster d. Permits regular clothing to be worn e. Can be cleaned with small amount of soap and water

Which interventions should the nurse implement for a newborn with a subgaleal hemorrhage? (Select all that apply.) a. Monitor bilirubin levels. b. Monitor hematocrit levels. c. Prepare the newborn for skull radiography. d. Monitor the newborns level of consciousness. e. Place a warm compress on the affected area.

a. Monitor bilirubin levels. b. Monitor hematocrit levels. d. Monitor the newborns level of consciousness.

The nurse is teaching a new nurse about types of physical injuries that can occur at birth. Which soft tissue injuries should the nurse include in the teaching? (Select all that apply.) a. Petechiae b. Retinal hemorrhage c. Facial paralysis d. Cephalhematoma e. Subdural hematoma f. Subconjunctival hemorrhage

a. Petechiae b. Retinal hemorrhage f. Subconjunctival hemorrhage

The nurse is caring for a neonate on positive-pressure ventilation. The nurse monitors for which complications of positive-pressure ventilation? (Select all that apply.) a. Pneumothorax b. Pneumomediastinum c. Respiratory distress syndrome d. Meconium aspiration syndrome e. Pulmonary interstitial emphysema

a. Pneumothorax b. Pneumomediastinum e. Pulmonary interstitial emphysema

The nurse is preparing to admit a 6-year-old child with celiac disease. What clinical manifestations should the nurse expect to observe? (Select all that apply.) a. Steatorrhea b. Polycythemia c. Malnutrition d. Melena stools e. Foul-smelling stools

a. Steatorrhea c. Malnutrition e. Foul-smelling stools

The nurse is admitting a drug-exposed newborn to the neonatal intensive care unit. The nurse should assess the newborn for which signs of withdrawal? (Select all that apply.) a. Tremors b. Nasal stuffiness c. Loose, watery stools d. Hypoactive Moro reflex e. Decrease in respiratory rate

a. Tremors b. Nasal stuffiness c. Loose, watery stools

What are some of the associated disabilities seen with cerebral palsy? (Select all that apply.) a. Visual impairment b. Hearing impairment c. Speech difficulties d. Intellectual impairment e. Associated heart defects

a. Visual impairment b. Hearing impairment c. Speech difficulties d. Intellectual impairment

The nurse is preparing to admit a 7-year-old child with ataxic cerebral palsy. What clinical manifestations of ataxic cerebral palsy should the nurse expect to observe? (Select all that apply.) a. Wide-based gait b. Rapid, repetitive movements performed poorly c. Slow, twisting movements of the trunk or extremities d. Hypertonicity with poor control of posture, balance, and coordinated motion e. Disintegration of movements of the upper extremities when the child reaches for objects

a. Wide-based gait b. Rapid, repetitive movements performed poorly e. Disintegration of movements of the upper extremities when the child reaches for objects

A child has a chronic cough and diffuse wheezing during the expiratory phase of respiration. This suggests what condition? a. Asthma b. Pneumonia c. Bronchiolitis d. Foreign body in trachea

asthma

What condition is the leading cause of chronic illness in children? a. Asthma b. Pertussis c. Tuberculosis d. Cystic fibrosis

asthma

Legg-Calve-Perthes

avascular necrosis of the proximal femoral head resulting from compromise of the tenuous blood supply to this area

What interventions should the nurse anticipate being administered to a child with supraventricular tachycardia (SVT)? a. Bed rest b. Applying ice to the face c. Administration of atropine d. Administration of adenosine (Adenocor) e. Having the child perform a Valsalva maneuver

b. Applying ice to the face d. Administration of adenosine (Adenocor) e. Having the child perform a Valsalva maneuver

The nurse is caring for a child with Kawasaki disease in the acute phase. What clinical manifestations should the nurse expect to observe? (Select all that apply.) a. Osler nodes b. Cervical lymphadenopathy c. Strawberry tongue d. Chorea e. Erythematous palms f. Polyarthritis

b. Cervical lymphadenopathy c. Strawberry tongue e. Erythematous palms

The nurse is preparing to admit a 1-year-old child with pertussis (whooping cough). Which clinical manifestations of pertussis should the nurse expect to observe? (Select all that apply.) a. Earache b. Coryza c. Conjunctivitis d. Low-grade fever e. Dry hacking cough

b. Coryza d. Low-grade fever e. Dry hacking cough

A child has had a short-arm synthetic cast applied. What should the nurse teach to the child and parents about cast care? (Select all that apply.) a. Relieve itching with heat. b. Elevate the arm when resting. c. Observe the fingers for any evidence of discoloration. d. Do not allow the child to put anything inside the cast. e. Examine the skin at the cast edges for any breakdown.

b. Elevate the arm when resting. c. Observe the fingers for any evidence of discoloration. d. Do not allow the child to put anything inside the cast. e. Examine the skin at the cast edges for any breakdown.

The nurse is preparing to admit a 5-year-old child who developed lesions of varicella (chickenpox) 3 days ago. Which clinical manifestations of varicella should the nurse expect to observe? (Select all that apply.) a. Nonpruritic rash b. Elevated temperature c. Discrete rose pink rash d. Vesicles surrounded by an erythematous base e. Centripetal rash in all three stages (papule, vesicle, and crust)

b. Elevated temperature d. Vesicles surrounded by an erythematous base e. Centripetal rash in all three stages (papule, vesicle, and crust)

The nurse is caring for a child with celiac disease. The nurse understands that what may precipitate a celiac crisis? (Select all that apply.) a. Exercise b. Infections c. Fluid overload d. Electrolyte depletion e. Emotional disturbance

b. Infections d. Electrolyte depletion e. Emotional disturbance

The nurse is preparing to admit a 3-year-old child with intussusception. What clinical manifestations should the nurse expect to observe? (Select all that apply.) a. Absent bowel sounds b. Passage of red, currant jellylike stools c. Anorexia d. Tender, distended abdomen e. Hematemesis f. Sudden acute abdominal pain

b. Passage of red, currant jellylike stools d. Tender, distended abdomen f. Sudden acute abdominal pain

The clinic nurse is assessing a child with bacterial conjunctivitis (pink eye). Which assessment findings should the nurse expect? (Select all that apply.) a. Itching b. Swollen eyelids c. Inflamed conjunctiva d. Purulent eye drainage e. Crusting of eyelids in the morning

b. Swollen eyelids c. Inflamed conjunctiva d. Purulent eye drainage e. Crusting of eyelids in the morning

The nurse is positioning a preterm neonate. What are therapeutic positions the nurse should implement? (Select all that apply.) a. Elbows extended b. Hands at the side c. Neutral or slightly flexed neck d. Trunk slightly rounded with pelvic tilt e. Hips partially flexed and adducted to near midline

c. Neutral or slightly flexed neck d. Trunk slightly rounded with pelvic tilt e. Hips partially flexed and adducted to near midline

The nurse is teaching parents of a bottle-fed preterm infant techniques to facilitate feeding. Which techniques should the nurse include? (Select all that apply.) a. Choose a soft nipple. b. Avoid arousing the infant. c. Recognize the infants limits. d. Prepare a calm, quiet area for the feeding. e. Ensure a restful environment between feedings.

c. Recognize the infants limits. d. Prepare a calm, quiet area for the feeding. e. Ensure a restful environment between feedings.

The nurse is preparing a staff education program about pediatric asthma. What concepts should the nurse include when discussing the asthma severity classification system? (Select all that apply.) a. Children with mild persistent asthma have nighttime signs or symptoms less than two times a month. b. Children with moderate persistent asthma use a short-acting b-agonist more than two times per week. c. Children with severe persistent asthma have a peak expiratory flow (PEF) of 60% to 80% of predicted value. d. Children with mild persistent asthma have signs or symptoms more than two times per week. e. Children with moderate persistent asthma have some limitations with normal activity. f. Children with severe persistent asthma have frequent nighttime signs or symptoms.

d. Children with mild persistent asthma have signs or symptoms more than two times per week. e. Children with moderate persistent asthma have some limitations with normal activity. f. Children with severe persistent asthma have frequent nighttime signs or symptoms.

Which is usually the only symptom of pediculosis capitis (head lice)? a. Itching b. Vesicles c. Scalp rash d. Localized inflammatory response

itching

Children who are taking long-term inhaled steroids should be assessed frequently for what potential complication? a. Cough b. Osteoporosis c. Slowed growth d. Cushing syndrome

slowed growth

The school reviewed the pediculosis capitis (head lice) policy and removed the no nit requirement. The nurse explains that now, when a child is found to have nits, the parents must do which before the child can return to school? a. No treatment is necessary with the policy change. b. Shampoo and then trim the childs hair to prevent reinfestation. c. The child can remain in school with treatment done at home. d. Treat the child with a shampoo to treat lice and comb with a fine-tooth comb every day until nits are eliminated.

The child can remain in school with treatment done at home.

The parents of a 3-year-old child with congenital heart disease are afraid to let their child play with other children because of possible overexertion. How should the nurse reply to this concern? a. The parents should meet all the childs needs. b. The child needs opportunities to play with peers. c. Constant parental supervision is needed to avoid overexertion. d. The child needs to understand that peers activities are too strenuous.

The child needs opportunities to play with peers.

Nursing care of the child with Kawasaki disease is challenging because of which occurrence? a. The childs irritability b. Predictable disease course c. Complex antibiotic therapy d. The childs ongoing requests for food

The childs irritability

What statement is the most descriptive of asthma? a. It is inherited. b. There is heightened airway reactivity. c. There is decreased resistance in the airway. d. The single cause of asthma is an allergic hypersensitivity.

There is heightened airway reactivity.

A child with asthma is having pulmonary function tests. What rationale explains the purpose of the peak expiratory flow rate? a. To assess severity of asthma b. To determine cause of asthma c. To identify triggers of asthma d. To confirm diagnosis of asthma

To assess severity of asthma

A preterm infant with respiratory distress syndrome is receiving inhaled nitric oxide (NO). What is the reason for administering the inhaled nitric oxide? a. To mature the lungs b. To deliver a level of oxygen that is safe c. To increase the removal of pulmonary debris such as meconium d. To reduce pulmonary vasoconstriction and pulmonary hypertension

To reduce pulmonary vasoconstriction and pulmonary hypertension

When caring for a neonate in a radiant warmer, what should the nurse be alert to? a. Exposure to prolonged cold stress b. Need for Plexiglas shields to protect the infant c. Transepidermal water loss leading to dehydration d. Increased risk of infection from the open environment

Transepidermal water loss leading to dehydration

Which abnormality is a common sex chromosome defect? a. Down syndrome b. Turner syndrome c. Marfan syndrome d. Hemophilia

Turner syndrome

A 3-year-old child is experiencing pain after a tonsillectomy. The child has not taken in any fluids and does not want to drink anything, saying, My tummy hurts. The following health care prescriptions are available: acetaminophen (Tylenol) PO (orally) or PR (rectally) PRN, ice chips, clear liquids. What should the nurse implement to relieve the childs pain? a. Ice chips b. Tylenol PO c. Tylenol PR d. Popsicle

Tylenol PR

The nurse is caring for an infant born at 37 weeks of gestation of a nondiabetic mother just admitted to the neonatal intensive care unit for observation. The nurse notes that which lecithin/sphingomyelin (L/S) ratio obtained before delivery indicates no risk of respiratory distress syndrome (RDS)? a. 1.4:1 b. 1.6:1 c. 1.8:1 d. 2:1

2:1

The nurse is placing an infant in a servocontrol radiant warmer. The nurse should attach the temperature probe to which area of the infants body? a. Scapula b. Sternum c. Abdomen d. Front of the lower leg

Abdomen

The parents of an infant with cerebral palsy (CP) ask the nurse if their child will have cognitive impairment. The nurses response should be based on which knowledge? a. Affected children have some degree of cognitive impairment. b. Around 20% of affected children have normal intelligence. c. About 45% of affected children have normal intelligence. d. Cognitive impairment is expected if motor and sensory deficits are severe.

About 45% of affected children have normal intelligence.

What signs should the nurse expect when a pneumothorax occurs in an infant on mechanical ventilation? a. Tachycardia b. Clear, distinct heart tones c. Widened pulse pressure d. Abrupt duskiness or cyanosis

Abrupt duskiness or cyanosis

Turner syndrome is suspected in an adolescent girl with short stature. What causes this? a. Absence of one of the X chromosomes b. Presence of an incomplete Y chromosome c. Precocious puberty in an otherwise healthy child d. Excess production of both androgens and estrogens

Absence of one of the X chromosomes

What are characteristics of diabetic ketoacidosis? (Select all that apply.) a. Pallor b. Acidosis c. Bradypnea d. Dehydration e. Electrolyte imbalance

Acidosis Dehydration Electrolyte imbalance

An 18-month-old child is seen in the clinic with otitis media (OM). Oral amoxicillin is prescribed. What instructions should be given to the parent? a. Administer all of the prescribed medication. b. Continue medication until all symptoms subside. c. Immediately stop giving medication if hearing loss develops. d. Stop giving medication and come to the clinic if fever is still present in 24 hours.

Administer all of the prescribed medication.

A child with cystic fibrosis (CF) receives aerosolized bronchodilator medication. When should this medication be administered? a. After chest physiotherapy (CPT) b. Before chest physiotherapy (CPT) c. After receiving 100% oxygen d. Before receiving 100% oxygen

Before chest physiotherapy (CPT)

What can stroking infants who are physiologically unstable result in? a. Fewer sleep periods b. Increased weight gain c. Shortened hospital stay d. Decreased oxygen saturation

Decreased oxygen saturation

Which is a central factor responsible for respiratory distress syndrome in a newborn? a. Absence of alveoli b. Immature bronchioles c. Overdeveloped alveoli d. Deficient surfactant production

Deficient surfactant production

The nurse is teaching the family of a child with type 1 diabetes about insulin. What should the nurse include in the teaching session? (Select all that apply.) a. Unopened vials are good for 60 days. b. Diabetic supplies should not be left in a hot environment. c. Insulin can be placed in the freezer if not used every day. d. After it has been opened, insulin is good for up to 28 to 30 days. e. Insulin bottles that have been opened should be stored at room temperature or refrigerated.

Diabetic supplies should not be left in a hot environment. After it has been opened, insulin is good for up to 28 to 30 days. Insulin bottles that have been opened should be stored at room temperature or refrigerated.

In providing nourishment for a child with cystic fibrosis (CF), what factors should the nurse keep in mind? a. Fats and proteins must be greatly curtailed. b. Most fruits and vegetables are not well tolerated. c. Diet should be high in calories, proteins, and unrestricted fats. d. Diet should be low fat but high in calories and proteins.

Diet should be high in calories, proteins, and unrestricted fats.

The nurse is providing care to a preterm infant. Which characteristic of daily care should be considered supportive? a. Coordinated with parental visiting times b. Given on a fixed schedule to ensure needs are met c. Provided when infants heart rate is at its lowest level d. Directed toward development of sleep organization

Directed toward development of sleep organization

A child with cystic fibrosis is receiving recombinant human deoxyribonuclease (DNase). What statement about DNase is true? a. Given subcutaneously b. May cause voice alterations c. May cause mucus to thicken d. Not indicated for children younger than age 12 years

May cause voice alterations

Cystic fibrosis (CF) may affect single or multiple systems of the body. What is the primary factor responsible for possible multiple clinical manifestations in CF? a. Hyperactivity of sweat glands b. Hypoactivity of autonomic nervous system c. Atrophic changes in mucosal wall of intestines d. Mechanical obstruction caused by increased viscosity of mucous gland secretions

Mechanical obstruction caused by increased viscosity of mucous gland secretions

What is the earliest recognizable clinical manifestation(s) of cystic fibrosis (CF)? a. Meconium ileus b. History of poor intestinal absorption c. Foul-smelling, frothy, greasy stools d. Recurrent pneumonia and lung infections

Meconium ileus

The nurse is caring for a newborn with Erb palsy. The nurse understands that which reflex is absent with this condition? a. Root reflex b. Suck reflex c. Grasp reflex d. Moro reflex

Moro reflex

The nurse is attending a delivery of a full-term infant with meconium noted in the amniotic fluid. The nurse should understand that what action should be performed in the delivery room? a. The infant will be suctioned with a DeLee trap suctioning device after delivery of the head while the chest is still compressed in the birth canal. b. The infants nose will be suctioned at the delivery of the head; subsequent suctioning of the mouth will occur after completion of the delivery. c. The infant will need to take the first breath after delivery of the head and shoulders and will require tracheal suctioning. d. The infants mouth, nose, and posterior pharynx will be suctioned just after the head is delivered while the chest is still compressed in the birth canal.

The infants mouth, nose, and posterior pharynx will be suctioned just after the head is delivered while the chest is still compressed in the birth canal.

An infant of a mother with herpes simplex infection has just been born. What should nursing considerations include? a. The infant should be isolated in a nursery. b. No special precautions are necessary. c. The mother and infant should be together in a private room. d. Immediate discharge is indicated to prevent spread of infection.

The mother and infant should be together in a private room.

The nurse encourages the mother of a toddler with acute laryngotracheobronchitis to stay at the bedside as much as possible. What is the primary rationale for this action? a. Mothers of hospitalized toddlers often experience guilt. b. The mothers presence will reduce anxiety and ease the childs respiratory efforts. c. Separation from the mother is a major developmental threat at this age. d. The mother can provide constant observations of the childs respiratory efforts.

The mothers presence will reduce anxiety and ease the childs respiratory efforts.

The nurse is planning care for a family expecting their newborn infant to die because of an incurable birth defect. What should the nurses interventions be based on? a. Tangible remembrances of the infant (e.g., lock of hair, picture) prolong grief. b. Photographs of infants should not be taken after death. c. Funerals are not recommended because the mother is still recovering from childbirth. d. The parents should be given the opportunity to parent the infant, including seeing, holding, touching, or talking to the infant in private.

The parents should be given the opportunity to parent the infant, including seeing, holding, touching, or talking to the infant in private.

Which statement is true concerning the nutritional needs of preterm infants? a. The secretion of lactase is low. b. Carbohydrates and fats are better tolerated than protein. c. The demand for nutrients is less than in full-term infants. d. Breast milk lacks the proper concentration of nutrients.

The secretion of lactase is low.

When caring for the child with Kawasaki disease, what should the nurse know to provide safe and effective care? a. Aspirin is contraindicated. b. The principal area of involvement is the joints. c. The childs fever is usually responsive to antibiotics within 48 hours. d. Therapeutic management includes administration of gamma globulin and salicylates.

Therapeutic management includes administration of gamma globulin and salicylates.