Final Exam Review Questions

A 3-year-old child with asthma and a respiratory tract infection is prescribed an antibiotic and a bronchodilator. The nurse notes the following during assessment: oral temperature 100.2°F (37.9°C), respirations 52 breaths/minute, heart rate 90 beats/minute, O2 saturation 95% on room air. Which action will the nurse take first? A. administer the bronchodilator via a nebulizer B. apply oxygen at 2 liter via a nasal cannula C. give the antibiotic as prescribed D. apply a cardiac monitor to the child

A

Which of the following is a symptom of bacterial pharyngitis? A. WBC in normal range B. fever as high as 104 F C. rhinitis D. symptoms have a gradual onset

B

During an extended initial resuscitation, what additional complications may be experienced by the infant during the resuscitation? Select all that apply. A. leukocytosis B. hypoglycemia C. dehydration D. hypokalemia E. anemia

B, C

After assessing a child, the nurse suspects coarctation of the aorta based on a finding of: A. bounding pulse B. femoral pulse weaker than brachial pulse C. hepatomegely D. narrow pulse

B

A 4-year-old boy has a febrile seizure during a well-child visit. What action would be a priority? A. using a tongue blade to pry open the child's jaw B. hyperextending the child's head while placing him on his side C. protecting the child from harm during the seizure D. loosening the child's clothing to ensure a patent airway

C

A pregnant client has developed iron-deficiency anemia and has been prescribed 200 mg of elemental iron per day. The nurse should encourage the client to take this medication with which substance? A. a full meal B. milk C. orange juice D. water

C

The nurse is assessing the site of a client's Mantoux skin test. The client is HIV positive. The nurse notes the induration to be 10 mm. Which action will the nurse take next? A. document the finding in the client's medical record B. determine if the client has been exposed to TB C. schedule the client for a chest x-ray D. place the client on droplet precaution

C

The nurse is examining a 4-year-old who is injured and crying. What might the nurse document about the child's breathing? A. respirations are slow and shallow B. tachycardia C. tachypnea D. respirations are regular

C

Which piece of equipment is most helpful in determining airway obstruction in the client with asthma? A. an inhaler B. a nebulizer C. a peak flow meter D. an incentive spirometer

C

A child is brought to the emergency department late one evening and is diagnosed with croup. The child was noted to have a shrill, harsh respiratory sound when breathing in. This symptom is referred to as: A. barking cough B. hoarseness C. wheezing D. stridor

D

The nurse is examining an 8-year-old boy with tachycardia and tachypnea. The nurse anticipates which test as most helpful in determining the extent of the child's hypoxia?

pulse oximetry

The nurse is caring for a child who has been admitted with a possible diagnosis of cystic fibrosis. Which laboratory/diagnostic tools would most likely be used to help determine the diagnosis of this child? A. purified protein derivative test B. blood culture and sensitivity C. pulmonary functions test D. sweat sodium chloride test

D

Which of the following childhood diseases used to be fatal and now needs a holistic approach to care? A. BPD B. Asthma C. Pneumonia D. cystic fibrosis

D

The nurse is reinforcing teaching with the family caregivers of a child diagnosed with tuberculosis who is being treated with the drug rifampin. Which statement made by the caregivers indicates an understanding of this medication? A. "he will not be able to attend school for the first few months that he is on this medication" B. "While she is taking this medication, I won't worry if her tears look orange." C. "This medication may cause slight bleeding when she urinates." D. "My son will have to take this medication the rest of his life."

B

The physician has ordered rectal diazepam for a 2-year-old boy with status epilepticus. Which instruction is essential for the nurse to teach the parents? A. monitor for an allergic reaction to the medication B. monitor their child's level of sedation C. gradually reduce the dosage as seizures stop D. watch for fever indicating infection

B

What is a symptom of bacterial pharyngitis? A. white blood cell (WBC) count in normal range B. fever C. symptoms have a gradual onset D. rhinitis

B

The caregiver of a 6-week-old boy calls the nurse concerned about her child. The child has been vomiting, has diarrhea, and is sneezing. The child's temperature is normal. The nurse suspects that the cause of the symptoms is: A. a pollen-based allergy B. cystic fibrosis C. pneumonia D. a common cold

D

The nurse cares for a 7-year-old child with new-onset seizure disorder. Which prescription will the nurse anticipate for this client? A. ketogenic diet B. vagus nerve stimulation C. frequent temperature assessment D. use of anticonvulsant medications

D

The nurse is caring for an infant who is at risk for increased intracranial pressure. What statement by the parent would alert the nurse to further assess the child's neurological status? A. "She always cries when the person holding her has on glasses...I guess glasses scare her." B. "She has been irritable for the last hour....seems like she is just upset for some reason." C. "She is a pretty happy baby, unless her diaper is wet, then she cries until we change her diaper." D. "She typically breastfeeds, but lately we have had to supplement with some rice cereal."

B

A nurse assisting in a birth notices that the amniotic fluid is stained greenish black as the baby is being born. Which intervention should the nurse implement as a result of this finding? A. intubation and suctioning of the trachea B. flicking the sole of the infant's foot C. gently shaking the infant D. administering of oxygen via a bag and mask

A

The nurse is caring for a child with a suspected head injury. The nurse observes for what response to the child's eye reflex exam that would indicate potential increased intracranial pressure (ICP)? A. While turning the child's head to the left, the eyes turn to the right. B. While running a piece of cotton over the child's eye, the child fails to blink. C. while assessing the child's pupils, they are not equal in size. D. While calling the child's name, the child stares straight ahead and does not turn to the sound.

A

The nurse is developing a plan of care for an infant with heart failure who is receiving digoxin. The nurse would hold the dose of digoxin and notify the physician if the infant's apical pulse rate was: A. 80 bpm B. 100 bpm C. 140 bpm D. 120 bpm

A

When caring for an infant who is hospitalized with Haemophilus influenzae meningitis, an important nursing intervention for the child would be for the nurse to: A. check the child's neurological status every 2 hours B. monitor intake and output and increase fluid intake every 4 hours C. place the child in a side-lying position and keep position using pillows D. restrain the child before and during a seizure

A

The nurse is performing a respiratory assessment on a child. The nurse includes five steps in her assessing technique: observation, inspection, palpation, and percussion. Which step was left out of her techniques? A. feeding the child B. touching C. listening to the lung sounds D. playing with the child

C

When conducting a physical examination of a child with suspected Kawasaki disease, which finding would the nurse expect to assess? A. malar rash B. cafe au lait spots C. strawberry tongue D. hirsutism or striae

C

The nurse is caring for a child diagnosed with rheumatic fever. When addressing the child's pain, the nurse should perform which intervention(s)? Select all that apply. A. Prioritize nonpharmacologic interventions over pharmacologic interventions. B. Administer intravenous morphine as prescribed. C. Administer salicylates after meals or with milk. D. Carefully handle the child's knees, ankles, elbows and wrists when moving the child. E. Teach the child how to use a patient-controlled analgesia system.

C, D

The nurse is preparing the room for a client admitted from the emergency department with suspected tuberculosis (TB). Which type of infection control precautions would the nurse anticipate? A. contact precautions B. droplet precautions C. standard precautions D. airborne precautions

D

Which nursing action should be included in the care plan to promote comfort in a 4-year-old child hospitalized with meningitis? A. keep the lights on brightly so that he can see his mother B. have the child's 2-year-old brother stay in the room C. rock the child frequently D. avoid making noise when in the child's room

D

The nurse is caring for a 3-year-old girl with a respiratory disorder. The nurse anticipates the need for providing supplemental oxygen to the child when performing which action? A. providing tracheostomy care B. suctioning with a bulb syringe C. administering drugs with a nebulizer D. suctioning a tracheostomy tube

D

A woman with cardiac disease at 32 weeks' gestation reports she has been having spells of light-headedness and dizziness every few days. Which instruction should the nurse prioritize? A. increase fluids and take more vitamins B. discuss induction of labor with the primary care provider C. bed rest and bathroom privileges only until birth D. decrease activity and rest more often

D

An infant that is diagnosed with meconium aspiration displays which symptom? A. no heart murmur B. respirations of 45 C. pink skin D. intercostal and substernal retractions

D

The nurse is caring for a 12-month-old infant diagnosed with Haemophilus influenzae meningitis. Which clinical manifestation would likely have been noted in this child? A. severe vomiting and confusion B. shaking the head and pulling the ear C. body stiffening and loss of consciousness D. high pitched cry and nuchal rigidity

D