Pediatric Nursing HESI Remediation
Which information about a child's seizure episode is most important for the nurse to document? a. Classification. b. Duration. c. Etiology. d. Expected outcome.
b
Which information about toxic shock syndrome should the nurse emphasize when counseling an adolescent female client? a. Symptoms. b. Prevention. c. Medication. d. Treatment.
b
Which immunosuppressive medication is used to manage the symptoms of systemic lupus erythematosus (SLE) in the pediatric population? a. Otezla. b. Quinine. c. Methotrexate. d. Mefloquine.
c
Which is recognized as a contributing factor to the development of anorexia nervosa in adolescents? a. Complaisant parenting. b. Peer pressure. c. Rigid family rules. d. Dropping out of high school.
c
A child with cataracts has an increased risk for developing which condition? a. Amblyopia. b. Glaucoma. c. Hyperopia. d. Myopia.
a
What is the recommended serving size of vegetables for a toddler? a. 1 tablespoon. b. 1 teaspoon. c. 1/2 teaspoon. d. 1/2 tablespoon.
a
Which medication is administered to premature infants to reduce the severity of symptoms associated with respiratory syncytial virus (RSV) infection? a. Respaire. b. Singulair. c. Menomune. d. Synagis.
d
Why is meperidine (Demerol) contraindicated for pain relief in clients with sickle cell disease? a. It is ineffective. b. It can cause GI ulcers. c. It is too sedating. d. It can induce seizures.
d
Which action by the nurse is most helpful in communicating with a preschool-aged child? a. Speak clearly and directly to the child. b. Use a doll to play and communicate. c. Approach when a parent is not present. d. Play a board game with the child.
b
A female teenager is taking oral tetracycline HCL (Achromycin V) for acne vulgaris. What is the most important instruction for the nurse to include in this client's teaching plan? a. "Use sunscreen when lying by the pool." b. "Cleanse the skin at least 4 times a day." c. "Take the medication with a glass of milk." d. "Menstrual periods may become irregular."
a
A first grade teacher tells the school nurse that she is having trouble keeping the attention of one of the students. The child gets off track and will not stay engaged. The teacher states that the student gets bored and just stares off into space and daydreams several times during the day. What should the nurse suspect about this child's behavior? a. Absence seizures. b. Developmental delay. c. Attention deficit disorder. d. Intellectually gifted yet bored.
a
A 10-year-old client was brought to the emergency department due to collapsing and experiencing jerky motor movements after being hit in the forehead with a baseball. Upon examination, the child's pupils appear widely dilated and reactive bilaterally. Based on this finding, which condition should the nurse suspect the client experienced? a. Seizure. b. Nerve damage. c. Hydrocephalus. d. Subdural hematoma.
a
A 12-month-old client is being discharged with a body spica cast. Which information should the nurse include in the parents' discharge teaching plan? a. Foul odor from cast may indicate infection or skin breakdown. b. Pillows should not be placed under cast. c. The child can be safely transported in a stroller. d. Use pillows to elevate the child's head.
a
A 2-year-old child with Down syndrome is brought to the clinic for his regular physical examination. The nurse knows which problem is frequently associated with Down syndrome? a. Congenital heart disease. b. Fragile X chromosome. c. Trisomy 13. d. Pyloric stenosis.
a
A 3-month-old infant develops oral thrush. Which pharmacologic agent should the nurse plan to administer for treatment of this disorder? a. Nystatin (Mycostatin). b. Nitrofurantoin (Macrodantin). c. Norfloxacin (Noroxin). d. Neomycin sulfate (Mycifradin).
a
A 4-year-old boy was admitted to the emergency room with a fractured right ulna and a short arm cast was applied. When preparing the parents to take the child home, which discharge instruction has the highest priority? a. "Call the healthcare provider immediately if his nail beds appear blue." b. "Check his fingers hourly for the first 48 hours to see that he is able to move them without pain." c. "Be sure your child's arm remains above his heart for the first 24 hours." d. "Take his temperature every four hours for the next two days and call if an elevation is noted."
a
A 6-month-old infant with congestive heart failure (CHF) is receiving digoxin elixir. Which observation by the nurse warrants immediate intervention? a. Apical heart rate of 60. b. Sweating across the forehead. c. Doesn't suck well. d. Respiratory rate of 30 breaths per minute.
a
A 6-year-old is admitted to the pediatric unit after falling off a bicycle. Which intervention should the nurse implement to assist the child's adjustment to hospitalization? a. Explain hospital schedules to the child, such as mealtimes. b. Use terms, such as "honey" and "dear," to show a caring attitude. c. Provide a list of rules that limits visitation of siblings in the hospital. d. Orient the parents to the hospital unit and refreshment areas.
a
A child has been diagnosed with chicken pox and the nurse teaches the parent not to give the child aspirin. Which condition may result when a child with chickenpox is given aspirin? a. Reye's syndrome. b. Huntington's chorea. c. Raynaud syndrome. d. Purpura disorder.
a
A child is being treated with penicillin for bacterial pneumonitis. The nurse teaches the parent to monitor for signs of an allergic reaction to the new medication. Which sign is the parent most likely to observe? a. Skin rash. b. Nasal congestion. c. Diarrhea. d. Vomiting.
a
A child who is recovering from surgery for removal of a Wilms tumor develops abdominal pain and distension, absence of bowel sounds, and vomiting. Which complication should the nurse suspect? a. Intestinal obstruction. b. Abdominal peritonitis. c. Pyloric stenosis. d. Infectious gastritis.
a
A mother is worried that her three-year-old toddler may have inherited hemophilia because the toddler has few scattered bruises on thier body from playing on the playground and the father of the baby has hemophilia. What is the most common inheritance pattern in clients with hemophilia? a. X-linked recessive. b. X-linked dominant. c. Y-linked recessive. d. Y-linked dominant.
a
A school nurse presented a parent-approved lesson about "Prevention transmitting Herpes Simplex Virus 2" (HSV-2) to a group of adolescent students. Which statement from one of the students would demonstrate a proper understanding of the lesson? a. There is currently no cure for HSV-2. b. Condoms are 100% effective in protecting again HSV-2. c. HSV-2 cannot be passed through vaginal secretions. d. When no lesions are visibly, the HSV-2 cannot be passed on.
a
As part of the physical assessment of children, the nurse observes and palpates the fontanels. Which child's fontanel finding should be reported to the healthcare provider? a. A 6-month-old with failure to thrive that has a closed anterior fontanel. b. A 24-month-old with gastroenteritis that has a closed posterior fontanel. c. A 2-month-old with chickenpox that has an open posterior fontanel. d. A 28-month-old with hydrocephalus that has an open anterior fontanel.
a
Children under 2 years old who are diagnosed with a urinary tract infection (UTI) are at risk for which complication? a. Progressive renal injury. b. Vesicoureteral reflux. c. High relapse rate. d. Persistent bedwetting.
a
The nurse is admitting an infant diagnosed with gastroenteritis with frequent episodes of diarrhea. Which complication can diarrhea can lead to? a. Acid-base imbalance with acidosis. b. Acid-base imbalance with alkalosis. c. Intestinal obstruction. d. Intestinal perforation.
a
The nurse is assessing a 4-year old child. Which best descirbe this chiild's concept of illness? a. Possesses magical thoughts of how and why illness occurs. b. Demonstrates deep understanding of the cause of illness. c. Has a very concrete and rigid idea, but no abstract understanding. d. Little comprehension due to lack of life experiences, but can list the symptoms.
a
The nurse is assessing a 4-year-old child who presents with hematuria and an abdominal mass. The parents report no other observable changes, and the child denies any complaints. Assessment reveals a firm, non-tender mass in the right upper quadrant of the abdomen. Based on this information, which condition should the nurse suspect? a. Wilms tumor. b. Ruptured appendix. c. Meckel's diverticulum. d. Splenomegaly.
a
The nurse is assessing the neurovascular status of a child in Russell's traction. Which finding should the nurse report to the healthcare provider? a. Pale bluish coloration of the toes. b. Skin is warm and dry to the touch. c. Toes are wiggled upon command. d. Capillary refill less than 3 seconds.
a
The nurse is caring for a 2-week-old infant, who was just diagnosed with developmental dysplasia of the hip (DDH). Which treatment should the nurse expect to be implemented for this client? a. Pavlik harness. b. Fixed abduction brace. c. Closed reduction surgery. d. Open reduction surgery.
a
The nurse is caring for a child who has just recovered from a transient period of low cardiac output. Which complication should the nurse be vigilant in assessing for in this client? a. Renal failure. b. Rebound hypertension. c. Persistent pallor. d. Liver failure.
a
The nurse is caring for a client with gastroesophageal reflux disease (GERD) who has not responded to conventional medical treatments. The nurse should anticipate the need for which surgical intervention? a. Nissen fundoplication. b. Esophagectomy. c. Heller myotomy. d. Whipple procedure.
a
The nurse is caring for a pediatric client with a skin infection. A honey-colored crusted exudate is seen overlying the infected area. This appearance is consistent with which condition? a. Impetigo. b. Ringworm. c. Scarlet fever. d. Rubella.
a
The nurse is caring for an infant who demonstrates temperature of 96.8° F (36° C), mottled skin appearance, lethargic, and episodic apnea. The CBC with differential revealed a low white blood cell count and elevated immature neutrophils, with changes in neutrophil morphology. This presentation is likely due to which condition? a. Sepsis. b. Hodgkin's disease. c. Apnea of prematurity. d. Osteosarcoma.
a
The nurse is counseling a teenage girl who was recently diagnosed with gonorrhea. The nurse should inform the client that untreated gonorrhea may lead to which complication? a. Pelvic inflammatory disease. b. Gastrointestinal bleeding. c. Renal failure. d. Pyelonephritis.
a
The nurse is counseling the parents of a child with adrenocortical insufficiency. The nurse should educate the parents about the signs and symptoms of which condition that can occur as a result of prolonged hydrocortisone therapy? a. Gastric ulcers. b. Weight loss. c. Drowsiness. d. Decreased blood pressure.
a
The nurse is developing a nursing care plan (NCP) for a 5-year-old child who is newly diagnosed with Legg-Calve-Perthes disease. Which nursing outcome would be the most appropriate for this client? a. The client is smiling while quietly coloring pictures. b. The client has gained 2 pounds (0.9 kg) since admission. c. The client is able to put full weight bearing on affected limb. d. The client has been able to maintain a steady normal glucose level .
a
The nurse is having difficulty communicating with a hospitalized 6-year-old child. Which approach by the nurse is most helpful in establishing communication? a. Engage the child through drawing pictures. b. Suggest that the parent read a book to the child. c. Provide paper and pencil for the child to keep a diary. d. Ask the parent if the child is always uncommunicative.
a
The nurse is performing an assessment on a three-year-old near drowning victim. The client presents with abnormal involuntary muscle contractions that cause rigid flexion in the upper extremities, extension of the legs, and plantar flexed feet. How should the nurse document this finding? a. Decorticate posturing. b. Cervical dystonia. c. Cranial dystonia. d. Decerebrate posturing.
a
The nurse is preparing to administer furosemide (lasix) to an adolescent who has developed congestive heart failure as the result of cystic fibrosis. Which condition would indicate the medication regime is being effective? a. Decreased of crackles. b. Decreased of BMI. c. Decreased of urine output. d. Decreased of blood glucose.
a
The nurse is providing anticipatory guidance to a group of new parents. How should the nurse explain the sequence in the development of fine and gross motor skills? a. Development predictably occurs from the head to the toes. b. The distal part of the body develops first, followed by the proximal. c. For right-handed dominance, the right side of body develops first, then left. d. The central portion of the body develops after peripheral growth.
a
The nurse is providing emergency care for an unconscious child who presents with a head injury sustained in a fall. Which is the highest nursing priority? a. Establish an airway. b. Assess neurological status. c. Stabilize the spine. d. Obtain vital signs.
a
The nurse is reviewing an electronic medical record (EMR) of a four-year-old child who is scheduled for an outpatient cardiac catheterization. The child has midazolam prescribed pre-procedure to alleviate anxiety. Which prescription should the nurse seek further clarification from the healthcare provider? a. Parents may administered the medication just prior to coming to hospital. b. The child may have clear liquids up to two hours prior to administration of medicine. c. The child is to be accompanied with resuscitative equipment during transport to cardiac suite. d. Parents may accompany the child during transportation to cardiac procedure room.
a
The nurse receives a lab report stating a child with asthma has a theophylline level of 15 mcg/dl. What action will the nurse take? a. Pass the information on in the report. b. Notify the healthcare provider because the value is high. c. Repeat the lab study because the value is too high. d. Hold the next dose of theophylline.
a
The nurse reviews the latest laboratory results for a child who received chemotherapy last week and identifies a reduced neutrophil count. Which nursing diagnosis has the highest priority for this child? a. Risk for infection. b. Risk for hemorrhage. c. Altered skin integrity. d. Disturbance in body image.
a
The nursing interventions for a 4-year-old victim of a scald burn of maintaining correct body alignment and function; frequent position changes; braced extremities; and active and passive range of motion are primarily implemented to prevent which complication from severe burns? a. Contractures. b. Pneumonia. c. Decubitus ulcers. d. Deep vein thrombosis.
a
The parents of a 13-year-old male client are concerned that he may not have started puberty. The client's stage of puberty is assessed using the Tanner scale of development. Which type of test is performed to determine this child's Tanner stage? a. Orchidometry. b. Radiological examination. c. Bone densitometry. d. Muscle mass calculation.
a
The parents of a 3-week-old infant report that the child eats well but, vomits after each feeding. What information is most important for the nurse to obtain? a. Description of vomiting episodes in past 24 hours. b. Number of wet diapers in last 24 hours. c. Feeding and sleep schedule. d. Amount of formula consumed during the past 24 hours.
a
Upon inspection, a nurse visualizes a blade of grass clipping stuck under the right upper eyelid of a teenage client complaining of eye pain, increased tear production, and redden sclera. What should the nurse use to remove the grass clipping? a. Moist gauze pad. b. Dry cotton swab. c. Plastic tweezer. d. Irrigation solution.
a
What is the purpose of a Whitaker perfusion test in a child with a genitourinary disorder? a. Evaluate for upper urinary tract obstruction. b. Check for ureteral dilatation. c. Detect pathogens in the kidneys. d. Visualize a cross-section of the ureter.
a
When assessing a child with asthma, the nurse should expect intercostal retractions during a. inspiration. b. coughing. c. apneic episodes. d. expiration.
a
When counseling the mother of an infant with a hepatitis B infection, the nurse should include which information? a. Infected newborns are normally asymptomatic. b. Infected mothers should refrain from breastfeeding. c. Vaccination is not needed if the mother is a carrier. d. The infection is usually transmitted during pregnancy.
a
When discussing discipline with the mother of a 4-year-old child, the nurse should include which guideline? a. Parental control should be consistent. b. Children as young as 4 years rarely need reprimand or punishment. c. Withdrawal of approval is effective. d. Parents should enforce rigid rules to be followed without question.
a
Which action should the nurse perform during preoperative management of a child with intestinal bleeding? a. Record appearance of blood in stools. b. Apply abdominal compression wrap. c. Begin fluid replacement therapy. d. Measure body weight every 6 hours.
a
Which information is important for the nurse to include when providing discharge teaching to the parents of a child with Kawasaki disease? a. Live immunizations should be deferred for 11 months. b. Associated arthritis symptoms will persist for life. c. Passive range of motion exercises are generally ineffective. d. Warm packs can be used to ease pain of peeling skin.
a
Which intervention should the nurse implement to assist a child and the family to reduce the risk of an asthma exacerbation? a. Help them recognize triggers. b. Encourage peak pulmonary flow measurement. c. Demonstrate use of MDI spacer. d. Provide emergency treatment plan.
a
Which menu selection by a child with celiac disease indicates to the nurse that the child understands necessary dietary considerations? a. Oven-baked potato chips and cola. b. Peanut butter and banana sandwich. c. Oatmeal-raisin cookies and milk. d. Graham crackers and fruit juice.
a
Which presentation is typically seen in a child with hyperthyroidism? a. Nervousness, palpitations, weight loss. b. Fever, weight gain, decreased appetite. c. Abdominal pain, vomiting, constipation. d. Diminished reflexes, dyspnea, bradycardia.
a
What issues should be addressed when conducting a psychosocial interview with an adolescent? Select all that apply. a. Home life. b. Financial status. c. School performance. d. Genetic disorders. e. Safety in neighborhood.
a,c,e
Which measurements should be used to accurately calculate a pediatric medication dosage? Select all that apply. a. Child's height and weight. b. Adult dosage of medication. c. Body surface area of child. d. Average adult's body surface area. e. Average pediatric dosage of medication. f. Nomogram determined mathematical constant.
a,c,f
A three-year-old toddler has recently developed a rash on the trunk and buttocks. Which question should the nurse asked the child's parent first? a. Has your child been swimming in a pool lately? b. Have you changed your laundry detergent lately? c. Has your child's dietary habits been altered lately? d. Have you applied sunscreen on your child's skin lately?
b
What history evaluation should the nurse prioritize when providing chemotherapeutic treatment for childhood leukemia? a. Family history. b. Known allergies. c. Previous surgeries. d. Recent hospitalizations.
b
A 10-year-old child has undergone a cardiac catheterization through the left femoral artery. During a postprocedural assessment, the nurse finds the left foot is pulseless and cool to touch. Which is the likely cause? a. Hemorrhage. b. Hematoma. c. Fasciculation. d. Tamponade.
b
A 12-year-old athlete reports severe ankle pain and an audible "popping" sound in the ankle after a fall at soccer practice. The nurse upon inspection observes moderate swelling, bruising, and joint instability. Initial radiographs of the ankle appear normal. Which type of injury should the nurse suspect? a. Strain. b. Sprain. c. Fracture. d. Dislocation.
b
A 12-year-old client presents suddenly with signs of shock; weak and rapid pulse; bronchoconstriction and laryngeal edema. What should the nurse suspect is the cause of this presentation? a. Bronchial asthma. b. Anaphylaxis. c. Bronchiolitis. d. Respiratory distress syndrome.
b
A 3-year-old client being treated for sepsis has begun bleeding from multiple sites. The nurse's assessment reveals widespread petechiae and bleeding from the nose, mouth, and rectum. Laboratory results reveal a prolonged prothrombin time (PT), elevated d-dimer, and low platelet count. Which disorder should the nurse suspect? a. Von Willebrand disease. b. Disseminated intravascular coagulation. c. Hemophilia type A. d. Hypoplastic anemia.
b
A 3-year-old client with sickle cell anemia is admitted to the Emergency Department with abdominal pain. The nurse palpates an enlarged liver, an x-ray reveals an enlarged spleen, and a CBC reveals anemia. These findings indicate which type of crisis? a. Aplastic. b. Sequestration. c. Hyperhemolytic. d. Vaso-occlusive.
b
A 5-month-old is admitted to the hospital with vomiting and diarrhea. The pediatrician prescribes dextrose 5% and 0.25% normal saline with 2 mEq KCl/100 ml to be infused at 25 ml/hour. Prior to initiating the infusion, the nurse should obtain which assessment finding? a. Frequency of emesis in the last 8 hours. b. Serum BUN and creatinine levels. c. Current blood sugar level. d. Appearance of the stool.
b
A child diagnosed with Wilms tumor is being treated with dactinomycin. What class of drug is this medication? a. Mitotic inhibitor. b. Antitumor antibiotic. c. Corticosteroid. d. Alkylating agent.
b
A child is brought to the emergency department after ingesting a large amount of household drain cleaner. Which is the nurse's first priority when caring for this client? a. Perform nasogastric suctioning. b. Assess and maintain an open airway. c. Give small amounts of water to ingest. d. Obtain chest and abdomen radiographs.
b
A child recently treated for strep throat presents with gross hematuria, facial swelling, and elevated blood pressure. Laboratory tests reveal proteinuria and azotemia. Which condition should the nurse suspect? a. Acute pyelonephritis. b. Acute glomerular nephritis. c. Nephrotic syndrome. d. IgA nephropathy.
b
A child with cystic fibrosis (CF) is experiencing recurrent lung infections. Which lung condition is this client likely to develop? a. Pleurisy. b. Bronchiectasis. c. Bronchiolitis. d. Asthma.
b
A five-year-old client who had been prescribed amoxicillin, presents to the clinic with urticaria. Which medication is recommended for initial treatment of this condition? a. Epinephrine. b. Diphenhydramine. c. Ibuprofen. d. Doxepin.
b
A mother is visiting her one-month-old infant who was delivered at 27-weeks gestation and is currently in the neonatal intensive care unit (NICU). Which is the best way for the nurse to encourage parent-infant bonding? a. Educate the parents about well-baby care. b. Invite the parents to participate in diaper changes. c. Facilitate frequent but short parent visits. d. Demonstrate bottle feeding techniques to parents.
b
A pediatric client is admitted with sepsis and a high-grade fever following an episode of gastritis. The nurse's assessment reveals cool skin; normal pulse and blood pressure; decreased urinary output; and a diminished mental state. Which term describes this stage of septic shock? a. Hyperdynamic. b. Normodynamic. c. Macrodynamic. d. Hypodynamic.
b
A premature newborn girl, born 24 hours ago, is diagnosed with a patent ductus arteriosus (PDA) and placed under an oxygen hood at 35%. The parents visit the nursery and ask to hold her. Which response should the nurse provide to the parents? a. "Studies have shown that handling a sick newborn is not good for the baby and upsets the parents." b. "The oxygen hood is holding the baby's oxygen level just at the point which is needed. You may stroke and talk to her." c. "Since your baby has been doing well under oxygen for 24 hours, I can let you hold the baby without oxygen." d. "You can hold the baby with the oxygen blowing in the baby's face since the level is very close to room air."
b
A teenager is admitted to the hospital diagnosed with anorexia nervosa. Which condition should the nurse evaluate the client for? a. Osteoarthritis. b. Cardiac arrhythmia. c. Asthma. d. Bowel ischemia.
b
When teaching a family to care for a child with hemophilia, which symptom should the nurse explain is a sign of internal bleeding? a. Pale color. b. Slurred speech. c. Weakness. d. Green stools.
b
At 8 a.m. the unlicensed assistive personnel (UAP) informs the charge nurse that a female adolescent client with acute glomerulonephritis has a blood pressure of 210/110. The 4 a.m. blood pressure reading was 170/88. The client reports to the UAP that she is upset because her boyfriend did not visit last night. What action should the nurse take first? a. Give the client her 9 a.m. prescription for an oral diuretic early. b. Administer PRN prescription of nifedipine (Procardia) sublingually. c. Notify the healthcare provider and inform the nursing supervisor of the client's condition. d. Attempt to calm the client and retake the blood pressure in thirty minutes.
b
During a routine well-child exam, the nurse observes that a 12-month-old child is unable to pronounce any simple words or syllables. Which possible cause should the child be evaluated for first? a. Brain injury. b. Hearing loss. c. Autism. d. Apraxia of speech.
b
During discharge teaching of a child with juvenile rheumatoid arthritis, the nurse should stress to the parents the importance of obtaining which diagnostic testing? a. Hearing tests. b. Eye exams. c. Chest x-rays. d. Fasting blood glucose tests.
b
The emergency department nurse is assessing a three-month-old infant suspected to be a victim of "shaken baby syndrome". Which type of intracranial hemorrhage is caused by tearing of a meningeal artery that causes an inward expansion of blood from the inner surface of the skull? a. Subarachnoid. b. Epidural. c. Subdural. d. Intracerebral.
b
The mother of a 6-month-old asks the nurse when her baby will get the first measles, mumps, and rubella (MMR) vaccine. Based on the recommended childhood immunization schedule published by the Centers for Disease Control, which response is accurate? a. 3 to 6 months. b. 12 to 15 months. c. 18 to 24 months. d. 4 to 6 years.
b
The mother of a preschool-aged child asks the nurse if it is all right to administer bismuth subsalicylate (Pepto Bismol, Bismylate) to her son when he "has a tummy ache." After reminding the mother to check the label of all over-the-counter drugs for the presence of aspirin, which instruction should the nurse include when replying to this mother's question? a. If the child's tongue darkens, discontinue the Pepto Bismol immediately. b. Do not give if the child has chickenpox, the flu, or any other viral illness. c. Avoid the use of Pepto Bismol until the child is at least 16 years old. d/ Pepto Bismol may cause a rebound hyperacidity, worsening the "tummy ache."
b
The nurse assigning care for a 5-year-old child with otitis media is concerned about the child's increasing temperature over the past 24 hours. Which statement is accurate and should be considered when planning care for the remainder of the shift? a. An RN should be assigned to take temperatures frequently. b. Tympanic and oral temperatures are equally accurate. c. The PN should take rectal temperatures on this child. d. The pediatrician should decide how to assess the temperature.
b
The nurse is assigned to care for an irritable and fatigue 11-year-old child who has been unable to gain weight despite excessive consumption of calories. While talking to the client, the nurse noticed the child appeared to be restless and demonstrated a slight tremor, and possessed physical characteristics of bulging eyes, and a goiter. Which condition should the nurse suspect? a. Hypoparathyroidism. b. Hyperthyroidism. c. Hyperparathyroidism. d. Hypothyroidism.
b
The nurse is caring for a 12-year-old with Syndrome of Inappropriate Antidiuretic Hormone (SIADH). This child should be carefully assessed for which complication? a. Poor skin turgor resulting from dehydration. b. Changes in level of consciousness. c. Premature aging as the disease progresses. d. Severe edema from an excess of water and sodium.
b
The nurse is caring for an 8-year-old child who is recovering from major burn injuries sustained in a house fire. The client has become increasingly lethargic and difficult to awaken. The following vital signs were obtained: T 96°.2 F (35.7°C), BP 100/72, P 132, and RR 36. Which complication should the nurse suspect? a. Hypothermia. b. Early sepsis. c. Acute renal failure. d. Hypovolemia.
b
The nurse is counseling the parents of a 10-year-old child diagnosed with Klinefelter syndrome. Which physical sign should the nurse tell the parents to anticipate during puberty? a. Short stature. b. Enlarged breasts. c. Narrow hips. d. Excessive body hair.
b
The nurse is preparing a health teaching program for parents of toddlers and preschoolers and plans to include information about prevention of accidental poisonings. It is most important for the nurse to include which instruction? a. Tell children they should not taste anything but food. b. Store all toxic agents and medicines in locked cabinets. c. Provide special play areas in the house and restrict play in other areas. d. Punish children if they open cabinets that contain household chemicals.
b
The nurse is preparing to collect a fingerstick blood glucose from a 2 year old client. Which pain relief intervention would work best? a. Telling jokes. b. Singing songs. c. Guided imagery. d. Massage therapy.
b
The nurse recognizes signs that a 9-month-old toddler may be living in an abusive home. Which action is the priority for the nurse? a. Encourage the child to speak freely. b. Report the suspected abuse to local authorities. c. Document from head to feet, the physical signs of abuse. d. Test the child for sexually-transmitted diseases.
b
The parents of a newborn diagnosed with hypospadias, requests that their son to be circumcised prior to being discharged from the hospital? How should the nurse respond to the parent's request of circumcision? a. Contact the healthcare provider about the parent's request . b. Explain the reason to the parents that circumcision is not an option. c. Fill out the surgical consent form and have the parent's sign consent for the procedure. d. Place the infant on nothing by mouth status (NPO), and prepare the surgical tray for the procedure.
b
The vital signs of a 4-year-old child with polyuria are: BP 80/40, Pulse 118, and Respirations 24. The child's pedal pulses are present with a volume of +1, and no edema is observed. What action should the nurse implement first? a. Insert an indwelling urinary catheter. b. Start an IV infusion of normal saline. c. Send a specimen to the lab for urinalysis. d. Document the child's vital signs and pulses.
b
Which action should the nurse take when caring for a child with epiglottitis? a. Examine the throat with tongue depressor. b. Set up emergency airway equipment at bedside. c. Place the child in supine position. d. Perform a throat culture.
b
Which class of antiinfective drugs is contraindicated for use in children under 8 years of age? a. Aminoglycosides. b. Tetracyclines. c. Penicillins. d. Quinolones.
b
Which information is important for the nurse to include when educating the parents of a two-month-old with gastroesophageal reflux disease (GERD)? a. The child should sleep in the supine position. b. The child's condition should improve over time. c. The child's oral cavity should be cleaned before each feeding. d. The child should be fed while in the prone position.
b
Which is an indication for surgical intervention in a child with vesicoureteral reflux (VUR)? a. Positive voiding cystourethrogram. b. Intolerance to antibiotics. c. Mild to moderate reflux. d. Renal scarring.
b
Which medication is recommended for a 7-year-old client who demonstrates status epilepticus in the hospital setting? a. Phenobarbital. b. Lorazepam. c. Naloxone. d. Fosphenytoin.
b
Which treatment regimen reduces the risk of pneumococcal infection in a pediatric client with sickle cell anemia? a. Annual flu shot. b. Penicillin prophylaxis. c. Vitamin E supplementation. d. Tdap vaccination series.
b
Which type of visual impairment is corrected by increasing visual stimulation to the weaker eye, by patching the stronger eye? a. Myectopia b. Strabismus. c. Ophritis d. Anisometropia.
b
he vital signs of a 4-year-old child with polyuria are: BP 80/40, Pulse 118, and Respirations 24. The child's pedal pulses are present with a volume of +1, and no edema is observed. What action should the nurse implement first? a. Insert an indwelling urinary catheter. b. Start an IV infusion of normal saline. c. Send a specimen to the lab for urinalysis. d. Document the child's vital signs and pulses.
b
Which situations lead to exacerbation of acne in an adolescent female? Select all that apply. a. The consumption of chocolate products. b. Cosmetics containing lanolin and lauryl alcohol. c. Food products containing high levels of caffeine. d. Frequent exposure to cooking oils and grease. e. The premenstrual days leading up to a menstrual cycle.
b,d,e
A 10-year-old client with asthma arrives at an urgent care clinic with apparent bronchial constriction. Which class of drugs should the nurse expect to be administered for this condition? a. Methylxanthines. b. Anticholinergics. c. Long-acting beta2 agonists. d. Oral corticosteroids.
d
A 12-month-old boy is admitted with a respiratory infection and possible pneumonia. He is placed in a mist tent with oxygen. Which nursing intervention has the greatest priority for this infant? a. Give small, frequent feedings of fluids. b. Accurately chart observations regarding breath sounds. c. Have a bulb syringe readily available to remove secretions. d. Encourage older siblings to visit.
c
A 16-year-old is brought to the Emergency Center with a crushed leg after falling off a horse. The adolescent's last tetanus toxoid booster was received eight years ago. What action should the nurse take? a. Dispense a tetanus antitoxin. b. Prepare human tetanus immune globulin. c. Administer tetanus toxoid booster. d. Delay the tetanus toxoid booster until due.
c
A child diagnosed with HIV is being enrolled in a new school. Who has the right to inform the school of this child's HIV status? a. Doctors or nurses. b. Social workers. c. Parents or legal guardians. d. Child welfare department.
c
A child is brought to the clinic because of concerns about the child's excessive thirst, frequent urination, and failure to gain weight despite an adequate intake of calories. Which disorder should the nurse suspect? a. Cushing syndrome. b. Hypothyroidism. c. Type 1 diabetes mellitus. d. Congenital adrenal hyperplasia.
c
A child with severe burns begins to exhibit decreased level of consciousness and lethargy four days after being admitted to the burn unit. The nurse's assessment reveals a low-grade fever, but the client's other vital signs are stable. The nurse should be alert for which potential complication? a. Respiratory failure. b. Dehydration. c. Sepsis. d. Hypovolemia.
c
A father calls the nurse at an urgent care clinic and states his child has touched poison oak plants and the palms of the child's hands are now covered with a sticky substance. Which instructions should the nurse provide to the father? a. Immediately wrap the child's hands with gauze. b. Immediately apply calamine lotion to the child's hands. c. Immediately flush the child's hands with cold running water. d. Immediately scrub the child's hands with soap detergent and hot water.
c
A mother brings in a three-year-old child who has respiratory rate of 36 breathes per minute; heart rate of 160 beats per minute; weaken and thready pulse; and pale and sweaty skin. The nurse suspects the child is going into shock which action should the nurse perform first? a. Obtain blood gases. b. Obtain baseline vital signs. c. Administer oxygen. d. Establish intravenous access.
c
A pediatric client is placed on a drug regimen for management of aplastic anemia. What should the nurse identify as the expected outcome of this treatment? a. Replace clotting factors. b. Increase intravascular volume. c. Restore bone marrow function. d. Increase iron levels in the blood.
c
A preschool-age child who is hospitalized for hypospadias repair is most strongly influenced by which behavior? a. Ability to communicate verbally. b. Response to separation from family. c. Concern for body integrity. d. Socialization with other children.
c
A six-year-old client, who received a kidney transplant presents with signs including fever, decreased urine output, and tenderness over the transplanted organ. Laboratory results reveal an elevated serum creatinine level. This presentation is likely due to which cause? a. Immunosuppression medications. b. Obstructive uropathy. c. Transplant rejection. d. Nephrotic syndrome.
c
A three-year-old child who is lethargic, vomiting and complaining of abdominal pain is being assessed for acetominophen poisoning. Which medication is used for treatment of acetaminophen poisoning? a. Deferoxamine. b. Vitamin K. c. N-acetylcysteine. d. Sodium bicarbonate.
c
A two-month-old infant is brought to the clinic with a temperature of 101° F (38.3° C), flaring of nostrils, respiratory rate of 36 breaths per minute, expiratory wheezing and intercostal retractions. The healthcare provider prescribes a test for respiratory syncytial virus (RSV). The nurse should be prepared to take what samples to test for the RSV antigen? a. Clean catch urine. b. Venous blood sampling. c. Nasopharygneal secretions. d. Rectal and stool swabs.
c
An infant is born with a ventricular septal defect (VSD) and surgery is planned to correct the defect. The nurse recognizes that surgical correction is designed to achieve which outcome? a. Stop the flow of unoxygenated blood into systemic circulation. b. Increase the flow of unoxygenated blood to the lungs. c. Prevent the return of oxygenated blood to the lungs. d. Reduce peripheral tissue hypoxia and nailbed clubbing.
c
During administration of a blood transfusion, a child complains of chills, headache, and nausea. Which action should the nurse implement? a. Start another IV of dextrose solution and stay with the child. b. Continue the transfusion and monitor the child's vital signs. c. Stop the infusion immediately and notify the healthcare provider. d. Slow the transfusion and assess for cessation of symptoms.
c
In developing a teaching plan for a 5-year-old child with diabetes, which component of diabetic management should the nurse plan for the child to manage first? a. Food planning and selection. b. Administering insulin injections. c. Process of glucose testing. d. Drawing up the correct insulin dose.
c
Intracranial pressure (ICP) monitoring is required for a child with a severe brain injury. To obtain the most accurate readings, a catheter is inserted into which area of the brain? a. Subdural space. b. Epidural space. c. Lateral ventricle. d. Anterior fontanel.
c
The Kasai procedure is performed for children who suffer from a disorder that causes the child to become jaundiced in appearance? a. Esophageal stricture. b. Imperforate anus. c. Biliary atresia. d. Cystic fibrosis.
c
The nurse is assessing a 2-year-old child. What behavior indicates that the child's language development is within normal limits? a. Is able to name four colors. b. Can count five blocks. c. Is capable of making a three word sentence. d. Half of child's speech is understandable.
c
The nurse is assessing a child who is undergoing treatment for leukemia. The nurse should monitor for what late side effect of the treatment? a. Anemia. b. GI disturbances. c. Secondary malignancy. d. Cardiac irregularities.
c
The nurse is assessing a four year old victim who was an improperly restrained passenger of a high speed impact motor vehicle collision. The victim presents with a falling blood pressure, poor capillary refill, low central venous pressure, tachycardia and bruising noted upper left quadrant of the abdomen. Which condition should the nurse suspect? a. Neurogenic shock. b. Cardiogenic shock. c. Hypovolemic shock. d. Distributive shock.
c
The nurse is assessing a two-month-old in preparation for surgery for coarctation of the aorta repair. Which best describes the pathophysiology of coarctation of the aorta? a. Acyanotic defect, increased pulmonary blood flow. b. Cyanotic defect, obstructed blood flow from ventricles. c. Acyanotic defect, obstructed blood flow from ventricles. d. Cyanotic defect, decreased pulmonary blood flow.
c
The nurse is assessing an agitated three-year-old child who is leaning forward with their chin thrust out, mouth open, and tongue protruded with copious amount of drooling present. The client's vital signs are tympanic temperature of 103.1°F (39.5°C), pulse of 110 beats per minute and respiratory rate of 28 per minute. Which condition should the nurse suspect? a. Croup. b. Bronchiolitis. c. Acute epiglottitis. d. Gastroesophageal reflux.
c
The nurse is assigned to provide care to a child with a ventricular septal defect present. Which correctly describes the flow of the blood flow within the cardiac circulation? a. Right to left shunting of blood. b. Decreased blood flow to the left ventricle. c. Left to right shunting of blood. d. Increased blood flow into the aorta.
c
The nurse is developing a plan of care for a 3-year-old who is scheduled for a cardiac catheterization. To assist in decreasing anxiety for the child on the day of the procedure, which intervention is best for the nurse to implement? a. Reassure the parents that 3-year-olds are cooperative and therefore are less likely to be anxious. b. Obtain a video film of a cardiac catheterization to show to the child prior to the procedure. c. Give the child a ride on a gurney to visit the cardiac catheterization lab and meet a nurse who works there. d. Obtain a cardiac catheter and demonstrate the procedure by pretending to put the catheter in a doll or stuffed animal.
c
The nurse is reviewing the lab values for an eight-year-old client and notes that the child's absolute neutrophil count (ANC) is below 500 cells/mm3. Which nursing intervention should the nurse implement first? a. Transfer the child to a negative pressure room. b. Notify the healthcare provider of the laboratory result. c. Initiate reverse isolation precautions for this child. d. Call the lab and request a "stat" unit of platelets.
c
The nurse is teaching the parents of a 5-year-old child with cystic fibrosis about respiratory treatments. Which statement indicates to the nurse that the parents understand? a. Perform postural drainage before starting the aerosol therapy. b. Give respiratory treatments when the child is coughing a lot. c. Administer aerosol therapy followed by postural drainage before meals. d. Ensure respiratory therapy is done daily during any respiratory infection.
c
The nurse must prevent a 2-year-old with severe eczema on the face, neck, and scalp from scratching the affected areas. Which nursing intervention is most effective in preventing further excoriation due to the pruritis? a. Obtain gloves for the child's hands. b. Apply finger cots on the child's fingers. c. Place elbow restraints on the child's arms. d. Apply soft restraints to the child's wrists.
c
The nurse's assessment of a 14-year-old client reveals somewhat thicken, and dry reddish, silver-looking patches along the hairline of the scalp, with some noted on the knees and elbows. Which skin disorder should the nurse suspect? a. Eczema. b. Impetigo. c. Psoriasis. d. Ichthyosis.
c
The school nurse is reviewing the electronic health record of a child diagnosed with conductive hearing loss who is unable to understand conversational speech, experiences difficulty with classroom discussion, and is enrolled in speech therapy. Which classification of hearing impairment does the child have? a. Slight. b. Mild to moderate. c. Moderately severe. d. Severe.
c
When educating the parents of a 12-year-old client with newly diagnosed with diabetes type I, which information should the nurse emphasize? a. The child should be weighed daily. b. The should parent remind the child to check glucose levels. c. The child should wear a medical alert bracelet. d. The parent should not let the child inject insulin.
c
Which approach should the nurse take when teaching a 12-year-old client about puberty? a. Use good-natured teasing about bodily changes. b. Point out that the client may be late in maturing. c. Tell the client that the changes are normal and healthy. d. Discuss sensitive or confidential information with a parent present.
c
Which behavior would the nurse expect a two-year-old child to exhibit? a. Build a house with blocks. b. Ride a tricycle. c. Display possessiveness of toys. d. Look at a picture book for 15 minutes.
c
Which is the best method a nurse can teach a mother of an infant to minimize the occurrence of a diaper rash? a. To place talcum powder in the diaper. b. To dry the infant's buttocks with a hair dryer. c. To change the diaper as soon as it is soiled. d. To place petrolatum on the infant's buttocks.
c
Which restraint should be used for a toddler after a cleft palate repair? a. Clove hitch. b. Mummy. c. Elbow. d. Jacket.
c
While performing the initial physical examination of a newborn, the nurse elicits a positive Ortolani test. Which skeletal defect does this indicate? a. Septic arthritis. b. Legg-Calve-Perthes disease. c. Developmental dysplasia of the hip. d. Slipped capital femoral epiphysis.
c
A 2-year-old child recently diagnosed with hemophilia A is discharged home. What information should the nurse include in a teaching plan about home care? a. Minimize interactive play with other children to lessen chances for injury. b. Give low-dose children's chewable aspirin in orange flavor for joint discomfort. c. Use a firm and dry toothbrush to clean teeth at least twice per day. d. Apply pressure and ice for bleeding while elevating and resting the extremity.
d
A 2-year-old child with gastro-esophageal reflux has developed a fear of eating. What instruction should the nurse include in the parents' teaching plan? a. Invite other children home to share meals. b. Accept that he will eat when he is hungry. c. Reward the child with a nap after eating. d. Consistently follow a set mealtime routine.
d
A child recently underwent cardiac surgery and is admitted with a suspected diagnosis of infective endocarditis. Which presentation should the nurse expect when assessing this client? a. Bradycardia, lethargy, speech disturbances. b. High fever, irregular movement of joints, involuntary facial grimaces. c. Tachycardia, chest pain, swollen and painful joints. d. Low-grade fever, anorexia, splinter hemorrhages under the nails.
d
A child with cystic fibrosis is having stools that float and are foul smelling. Which descriptive term should the nurse use to document the finding? a. Diarrhea. b. Rhinorrhea. c. Galactorrhea. d. Steatorrhea.
d
A nurse is assessing a three year old diagnosed with psoriasis. Which is a common treatment for most forms of psoriasis? a. Exfoliation. b. Cryotherapy. c. Oral antibiotics. d. Phototherapy.
d
A school nurse is assessing rashes on a child's lower shins and forearms that appear streaked and inflamed and are blistered with clear oozing substance present. The child reports that it is painful. Based on these signs and symptoms, what most likely caused this condition? a. Shellfish. b. Penicillin elixir. c. Laundry detergent. d. Poison ivy or oak.
d
A twelve-year-old with a left big toe infection which is non-responsive to current oral antibiotic therapy is being evaluated for possible osteomyelitis. Which diagnostic imaging modality is the most sensitive for detecting osteomyelitis? a. Radiography. b. Fluoroscopy. c. Computed tomography (CT). d. Magnetic resonance imaging (MRI).
d
An alert child has been treated for a submersion injury (near drowning). Which complication should the nurse anticipate? a. Hypertension. b. Edema. c. Oliguria. d. Hypothermia.
d
Newborn screening for hypothyroidism is performed on a 3-day-old infant. Which laboratory test results support a diagnosis of congenital hypothyroidism? a. High TSH levels with high T4 levels. b. Low TSH levels with low T4 levels. c. Low TSH levels with high T4 levels. d. High TSH levels with low T4 levels.
d
The mother of a 4-year-old child asks the nurse what she can do to help her other children cope with their sibling's repeated hospitalizations. Which is the best response that the nurse should offer? a. Inform the parent that the other children are too young to visit the hospital. b. Suggest that the other children visit a grandmother until the sibling returns home. c. Ask the mother if the children ask when the sibling will be discharged. d. Encourage the mother to have the children visit the hospitalized sibling.
d
The nurse applied 6 lpm of oxygen via a non-rebreather mask to a ten-year-old child with a history of asthma in the emergency department and began a nebulizer treatment. The child upon arrival had a respiratory rate of 32 breathes per minute, SpO2 of 86% on room air; substernal and intercostal retractions; and audible expiratory and inspiratory wheezing audible three feet away. After the nebulizer treatment, the nurse noted the audible wheezing had lessen and the lower lobes of the lungs were absent of breath sounds. The nurse should prepare for which intervention next? a. Peak expiratory flow measurement. b. Administration of albuterol. c. Chest physiotherapy. d. Endotracheal intubation.
d
The nurse is assessing a 2-year-old child at the pediatrician's office. The child's history is significant for prenatal brain trauma and low Apgar scores. The child exhibits hypertonia of the extremities, poor speech intonation, and is failing to meet expected motor skills milestones. Which disorder should the nurse suspect? a. Guillain-Barré syndrome. b. Spina bifida. c. Muscular dystrophy. d. Cerebral palsy.
d
The nurse is assessing the chest tube output of a 10 kilogram child status-post cardiac surgery. How many milliliters of drainage in one hour is a sign of possible postoperative hemorrhage? a. 10. b. 20. c. 40. d. 50.
d
The nurse is assigned to provide care to an adolescent admitted for placement of an arteriovenous (AV) fistula due to kidney failure. Which factor prevents the kidneys from maintaining fluid and electrolyte balance during end stage renal failure? a. Acute glomerular inflammation. b. Congested capillary lumen. c. Increased vascular hydrostatic pressure. d. Reduced number of functioning nephrons.
d
The nurse is caring for a client with a suspected diagnosis of celiac disease. In order to confirm this diagnosis, the nurse should prepare the client for which examination? a. Magnetic resonance imaging scan. b. Fluoroscopy with barium contrast. c. Computerized tomography scan. d. Endoscopy with small bowel biopsy.
d
The nurse is preparing to begin fluid replacement therapy to treat severe volume depletion in an infant. Which method of administration is recommended for the initial phase of therapy? a. Administer oral rehydration solution. b. Administer isotonic fluid by intravenous push. c. Administer rehydration solution via nasogastric route. d. Administer isotonic fluid slowly by IV bolus.
d
The nurse is providing pre-operative teaching for a 12-year old child who will have a tonsillectomy in the morning. Which statement by the child best demonstrates the expected level of understanding about the concept of illness? a. "I need to save my tonsils in case I want them back in my mouth." b. "Tonsils were important for my immunity and infection prevention when I was a baby." c. "When I wake up my throat will hurt but I can eat all the ice cream I want and then I go home." d. "My friend had a tonsillectomy and threw up after surgery, so I guess that will happen to me."
d
What clinical manifestation is the nurse likely to observe in a child with human immunodeficiency virus (HIV)? a. Petechiae. b. Visual disturbances. c. Bruising. d. Oral candidiasis.
d
What preoperative nursing intervention should be included in the plan of care for an infant with pyloric stenosis? a. Monitor for signs of metabolic acidosis. b. Estimate the quantity of diarrhea stools. c. Place in a supine position after feeding. d. Observe for projectile vomiting.
d
