Pediatrics
A nurse is performing a physical assessment on a 6-month-old infant. Which of the following reflexes should the nurse expect to find? A. Stepping B. Babinski C. Extrusion D. Moro
B. Babinski
A school nurse is caring for a child who is experiencing an acute asthma attack. Which of the following medications should the nurse plan to administer to the child? A. Zafirlukast B. Budesonide C. Montelukast D. Albuterol
D. Albuterol
A nurse is assessing a 4-year-old child. The nurse should expect the child to be able to perform which of the following activities? A. Fastening buttons on a shirt B. Tying shoelaces C. Parting a combing hair D. Cutting the meat at dinner
A. Fastening buttons on a shirt
A nurse is caring for a child who has a possible intussusception. The parents of the child ask the nurse how the diagnosis is determined. Which of the following responses should the nurse make? A. "An abdominal ultrasound will confirm the pocket in the intestine." B. "Genotyping will be done to identify this condition." C. "A biopsy will be done on a small amount of tissue from the colon." D. "An upper GI series should identify the area involved."
A. "An abdominal ultrasound will confirm the pocket in the intestine."
A nurse is teaching the parents of a 4-month-old infant who has gastroesophageal reflux. Which of the following statements by a parent indicated an understanding of the teaching? A. "I will add 1 teaspoon of rice cereal per ounce to my baby's formula." B "I will place my baby on her side when sleeping." C. "I will decrease the number of feedings my baby receives per day." D. "I will give my baby loperamide with each feeding."
A. "I will add 1 teaspoon of rice cereal per ounce to my baby's formula."
A nurse is caring for a 2-day-old infant who has myelomeningocele. Which of the following actions should the nurse take? A. Monitor the infant's head circumference B. Position the infant supine C. Place the infant under a radiant warmer D. Tape a piece of plastic over the protruding membranes
A. Monitor the infant's head circumference
A nurse is providing teaching to the parent of an infant who has developmental hip dysplasia and a new prescription for a Pavlik harness. Which of the following parent statements indicates an understanding of the teaching? A. "I will apply the harness over a t-shirt and knee socks." B. "I will put the baby's diaper over the harness." C. "I will make the required harness adjustments as my baby grows." D. "I will apply powder around the harness buckles each day."
A. "I will apply the harness over a t-shirt and knee socks."
A nurse is caring for a child who has sickle cell anemia and is experiencing a vaso-occlusive crisis. Which of the following actions should the nurse take? A. Administer ibuprofen B. Limit daily fluid intake C. Apply cold compresses to painful joints D. Withhold live virus immunizations
A. Administer ibuprofen
A nurse is caring for a preschooler who was brought to an outpatient clinic with a 2-day history if vesicular, honey-colored crusty region around the nose and mouth. The provider determines the lesions to be impetigo contagiosa, what should the nurse anticipate teaching the child's parents about the illness? (Select all that apply.) A. Apply a topical antibacterial ointment to the lesions B. Wash the child's bed linens daily with hot water C. Administer acyclovir oral suspension to prevent recurrence D. Allow the crust covering the infected lesions to remain intact E. Wash hands before and after contact with the affected area
A. Apply a topical antibacterial ointment to the lesions B. Wash the child's bed linens daily with hot water E. Wash hands before and after contact with the affected area
A nurse is providing teaching about home care to the guardian of an adolescent who has hemophilia. Which of the following pieces of information should the nurse provide? A. Encourage the adolescent to participate in non-contact sports B. Provide the adolescent with a firm-bristled toothbrush C. Administer aspirin to adolescent for episodes of pain D. Provide disposable razors to the adolescent for shaving
A. Encourage the adolescent to participate in non-contact sports
A nurse is providing dietary teaching to the parent of a child who has cystic fibrosis. Which of the following dietary recommendations should the nurse make? A. Increase the child's protein intake B. Decrease the child's calorie intake C. Increase the child's fiber intake D. Decrease the child's salt intake
A. Increase the child's protein intake
A nurse is assessing a toddler who has measles (rubeola). Which of the following findings should the nurse expect? A. Koplik spots B. Parotitis C. Strawberry tongue D. Paroxysmal coughing
A. Koplik spots
A nurse is caring for an infant who is experiencing dehydration. Which of the following assessments is the nurse's priority? A. Measure the client's weight daily B. Check for tears C. Palpate the fontanel D. Assess skin turgor
A. Measure the client's weight daily
A nurse is assessing a 6-year-old client at a well-child visit. Which of the following findings requires further assessment by the nurse? A. Presence of sparse, fine pubic hair B. Decreased head circumference compared to full height C. Increased leg length in relation to height D. Presence of a loose central incisor
A. Presence of sparse, fine pubic hair
A nurse is planning care for a 4-year-old child who has nephrotic syndrome. Which of the following actions should the nurse take? A. Provide thorough skin care B. Test for blood type and cross-match C. Allow ample hydrating fluids D. Maintain a low-carbohydrate diet
A. Provide thorough skin care
A nurse is caring for a 2-year-old child who has frequent urinary tract infections. When educating the parents about the prevention of urinary tract infections, which of the following instructions should the nurse include? A. Teach the child to wipe from front to back B. Give the child frequent bubble baths C. Urge the child to urinate every 6 hr D. Administer oxybutynin daily
A. Teach the child to wipe from front to back
A nurse is preparing to assess a 3-month-old infant during a well-child visit. Which of the following observations should the nurse expect? A. The infant looks at his hands B. The infant has a pincer grasp C. The infant has no head lag when pulled to a sitting position D. The infant can independently roll from his back to his abdomen
A. The infant looks at his hands
A nurse is caring for a group of infants with congenital heart defects. For which of the following defects should the nurse expect to observe cyanosis? A. Transposition of the great arteries B. Ventricular septal defect C. Coarctation of the aorta D. Patent ductus arteriosus
A. Transposition of the great arteries
A nurse is providing teaching to an adolescent who has scoliosis and a new prescription for a Boston brace. Which of the following responses by the adolescent indicates an understanding of the teaching? A. "I can take my brace off to sleep every night at bedtime." B. "I can take my brace off for about an hour daily to shower." C. "I should loosen the straps on my brace if it is rubbing against my skin." D. "I should place the pads of the brace against my skin with a t-shirt over them."
B. "I can take my brace off for about an hour daily to shower."
A nurse is providing teaching about disease management to the parent of a preschooler who has a new diagnosis of asthma. Which of the following parent statements indicates an understanding of the teaching? A. "My child should not receive live virus vaccines." B. "I will encourage my child to participate in sports." C. "I will give my child aspirin when she has a fever." D. "My child will outgrow asthma by adulthood."
B. "I will encourage my child to participate in sports."
A nurse is providing teaching for a 14-year old client who has acne. Which of the following instruction should the nurse include? A. "Use an exfoliating cleanser." B. "Keep hair off your forehead." C. "Take tetracycline after meals." D. "Squeeze acne lesions as they appear."
B. "Keep hair off your forehead."
A nurse is providing teaching about immunizations to the parents of a severely immunocompromised child who has human immunodeficiency virus (HIV). Which of the following statements should the nurse include in the teaching? A. "Your child's immunizations today will be half-doses." B. "The pneumococcal and influenza vaccines are recommended for your child." C. "immunizations will be delayed until your child tests HIV-negative." D. "Your child will need to restart the immunization schedule once your child's laboratory values are within the reference range."
B. "The pneumococcal and influenza vaccines are recommended for your child."
A nurse is caring for a child who has paralytic poliomyelitis. Which of the following actions should the nurse take? A. Implement droplet precautions B. Administer oral analgesics prior to exercises C. Use humidified oxygen to thin secretions D. Initiate seizure precautions
B. Administer oral analgesics prior to exercises
A nurse is assessing the visual acuity of a group of school-aged children. Which of the following actions should the nurse take? A. Position each child with their heels at a line that is 6 m (20 ft) away from the Snellen chart B. Allow each child to wear his or her glasses during the exam C. Start the screening by covering each child's right eye D. Begin by having each child read the largest line of letters at the top of the Snellen chart
B. Allow each child to wear his or her glasses during the exam
A nurse is facilitating a group discussion with preschool teachers about child abuse. Which of the following examples should the nurse use to illustrate a suggestive finding? A. Bruising of both knees with sutures on 1 B. Arm cast for a spiral fracture of the forearm C. Consistent bedwetting at nap time D. Frequent, vague reports of a stomachache or a headache
B. Arm cast for a spiral fracture of the forearm
A nurse is assessing a child who has stage 1 Hodkin disease. Which of the following findings should the nurse expect? A. Generalized petechiae B. Enlarged lymph nodes C. Chronic vomiting D. Dependent edema
B. Enlarged lymph nodes
A nurse is reviewing the laboratory report of a toddler who is receiving chemotherapy for leukemia. Which of the following laboratory values should the nurse report to the provider? A. Platelets 150,000/mm^3 B. Hgb 6 g/dL C. WBC 6,000/mm^3 D. Potassium 4.5 mEq/L
B. Hgb 6 g/dL
A nurse is providing teaching to the guardian of a child about bicycle safety. Which of the following pieces of information should the nurse include? A. Instruct the child to ride against the flow of traffic B. Instruct the child to walk the bike through intersections C. Provide a larger bike that the child will be able to grow into D. Ensure the child's helmet covers the ears
B. Instruct the child to walk the bike through intersections
A nurse is caring for an infant who has a tracheoesophageal fistula. Which of the following actions should the nurse take? A. Place the infant in a lateral position B. Perform oropharyngeal suctioning C. Administer ranitidine orally D. Thicken the infant's formula
B. Perform oropharyngeal suctioning
A nurse is planning care for a child who has hyperthermia. Which of the following actions should the nurse take? A. Administer antipyretics to the child every 4 to 6 hr B. Position the child on a cooling blanket and cover her with a sheet C. Place the child in a tub filled with water cooled to 26.7 to 29.4 C (80 to 85 F) D. Assess the child's temperature every 2 hr during the cooling
B. Position the child on a cooling blanket and cover her with a sheet
A nurse is assessing a 9-month-old infant. Which of the following findings should the nurse report to the provider as a delay in development? A. Using a pincer grasp to pick up blocks B. Requiring support to sit for prolonged periods C. Turning the head towards the parent's voice D. Reaching for the mother and saying "mama"
B. Requiring support to sit for prolonged periods
A nurse is providing teaching to an adolescent client who has juvenile idiopathic arthritis. Which of the following instructions should the nurse include in the teaching? A. "Apply cold compresses to relieve your joint pain." B. "Take opioids routinely." C. "Attend school regularly." D. "Adhere to an arthritis diet."
C. "Attend school regularly."
A nurse is providing teaching to a parent of a preschooler who has impetigo. Which of the following statements by the parent indicates an understanding of the teaching? A. "Impetigo is caused by a virus." B. "Impetigo is contagious for 48 hours after vesicles rupture." C. "I will wash my child's clothes in hot water." D. "My child now has immunity against impetigo."
C. "I will wash my child's clothes in hot water."
A nurse is providing teaching to the parent of a toddler who is undergoing insertion of tympanostomy tubes. which of the following statements should the nurse include? A. "The doctor will replace the tubes routinely about every 2 years." B. "If your child gets water in her ears will not cause any further problems." C. "The tubes should stay in place until they fall out on their own." D. "Now that the tubes are in place, she should not have any further problems with hearing."
C. "The tubes should stay in place until they fall out on their own."
A nurse is caring for a school-age child who has glomerulonephritis. The child has decreased urinary output and a blood pressure of 160/78 mmHg and is receiving hydralazine. Which of the following lunch choices should the nurse recommend? A. 1 hot dog, 22 potato chips, and 120 mL (4 oz) of orange juice B. 1 sandwich with lettuce, tomato, and 4 slices of bacon; a small apple; and 240 mL (8 oz) of milk C. 3 oz grilled chicken, 1 cup of pear slices, and 120 (4 oz) of apple juice D. 1 cup of cottage cheese, a small banana, and 240 mL (8 oz) of soda
C. 3 oz grilled chicken, 1 cup of pear slices, and 120 (4 oz) of apple juice
A nurse is assessing a 1-week-old infant at a well-child visit. The nurse should notify the provider about which of the following assessment findings? A. A flat, dark pink area between the eyes that blanches B. An area of deep blue pigmentation over the buttocks C. A blue coloring of the sclera D. A patchy, red rash with raised centers
C. A blue coloring of the sclera
A nurse is caring for a child who has epistaxis. Which of the following actions should the nurse perform? A. Apply a warm cloth to the bridge of the child's nose B. Tilt the child's head back C. Apply continuous pressure to the child's nose for at least 10 min D. Administer aspirin for the child's pain
C. Apply continuous pressure to the child's nose for at least 10 min
A nurse is planning care for a 3-month-old infant who has an ileostomy. Which of the following interventions should the nurse include in the plan? A. Avoid laying the infant on his abdomen B. Avoid tucking the appliance into the infant's diaper C. Check the bag for stool every 4 hours D. Replace the appliance every 3 days
C. Check the bag for stool every 4 hours
A nurse is assessing the vital signs of a 1-month-old infant. Which of the following actions should the nurse perform? A. Use a cuff to auscultate blood pressure B. Determine heart rate by taking the radial pulse C. Count respirations before taking other vital signs D. Measure temperature by placing the thermometer in the infant's ear
C. Count respirations before taking other vital signs
A nurse is caring for a toddler. Which of the following laboratory findings should the nurse report to the provider? A. BUN 8 mg/dL B. Uric acid 3.0 mg/dL C. Creatinine 0.9 mg/dL D. Urine specific gravity 1.010
C. Creatinine 0.9 mg/dL (Creatinine 0.3 to 0.7 BUN 5 to 18 Uric acid 2.0 to 5.5 Specific gravity 1.001 to 1.030)
A nurse is assessing an 18-month-old infant who is postoperative. Which of the following pain scales should the nurse use? A. FACES B. CRIES C. FLACC D. PIPP
C. FLACC Facial expression, leg movement, activity, cry, and consolability (2 months - 7 years)
A nurse is providing teaching for a parent about pinworm testing. At which of the following times should the nurse advise the parent to perform the tape test? A. Immediately after the child has a bowel movement B. After being on a clear liquid diet for 24 hours C. Immediately after the child wakes up in the morning D. After soaking for 20 minutes in a warm bath
C. Immediately after the child wakes up in the morning
A nurse in an emergency department is assessing infant who has laryngotracheobronchitis. Which of the following findings should the nurse report as an indication of impending airway obstruction? A. Bradycardia B. Respiratory depression C. Nasal flaring D. Barking cough
C. Nasal flaring
A nurse is planning care for an infant with an unrepaired myelomeningocele. Which of the following actions should the nurse take? A. Fasten the diaper loosely B. Cleanse the meningeal sac with povidone-iodine daily C. Palpate the abdomen for bladder distension D. Cover the sac with a dry, sterile gauze dressing
C. Palpate the abdomen for bladder distension
A nurse is providing nutritional teaching to an adolescent client who has celiac disease. Which of the following breakfast foods should the nurse recommend? A. Plain flour pastry B. Wheat cereal C. Scrambled eggs D. Rye toast
C. Scrambled eggs
A nurse is teaching a group of parents of toddlers about growth and development. A parent asks, "Why does my child's abdomen stick out?" Which of the following replies should the nurse provide? A. "You should give your child a stool softener daily." B. "Toddlers gain weight at a rapid pace." C. "You should have your child assessed for a spinal deformity." D. "Toddlers do not have well-developed abdominal muscles."
D. "Toddlers do not have well-developed abdominal muscles."
A nurse is performing an annual physical assessment of a preschooler. The parent expresses concern about the child's 1.8 kg (4 lb) weight gain over the past year. Which of the following responses should the nurse make? A. "This amount of weight gain could likely indicate a serious problem." B. "This weight change seems to be the result of poor eating habits." C. "Your child should have gained double this amount in a year." D. "Your child's weight change is expected for this age group."
D. "Your child's weight change is expected for this age group."
A nurse is providing teaching to the parents of an infant who is breastfeeding. When should the nurse instruct the parents to introduce solid food in the infant's diet? A. After the rooting reflex disappears B. At 2 to 3 months of age C. After the infant's first tooth erupts D. At 4 to 6 months of age
D. At 4 to 6 months of age
A nurse is assessing a toddler who has AIDS. Which of the following findings is an indication of an opportunistic infection? A. Koplik spots B. Peripheral neuropathy C. Chancre D. Candidiasis
D. Candidiasis
A nurse is assessing a preschooler who has HIV. Which of the following manifestations should the nurse expect? A. Generalized petechiae B. Jaundice C. Obesity D. Chronic diarrhea
D. Chronic diarrhea
A nurse is caring for a 5-year-old child who has a fever and begins to have a seizure. Which of the following actions should the nurse take? A. Give acetaminophen 240 mg PO immediately following the seizure B. Sponge the child's skin with a mixture of cold water and rubbing alcohol C. Administer rectal diazepam if the seizure lasts longer than 2 minutes D. Place the child in a side-lying position
D. Place the child in a side-lying position
A nurse is teaching a school-age child with asthma how to use a metered-dose inhaler. In which order should the nurse instruct the child to perform the following steps and evaluate return demonstration? Slowly inhale the medication. Hold the breath for 5 to 10 sec. Position mouthpiece in the mouth. Shake the inhaler while holding it upright.
Shake the inhaler while holding it upright. Position the mouthpiece in the mouth. Slowly inhale the medication. Hold the breath for 5 to 10 sec.
A nurse is assessing a child who is receiving IV chemotherapy. Assessment findings include extravasation of the tissues surrounding the IV insertion site. In which order should the nurse take the following actions? Remove the IV line Stop the infusion Elevate the extremity Notify the provider
Stop the infusion Elevate the extremity Notify the provider Remove the IV line
A nurse is providing teaching about home care to the parent of a child who has a newly applied fiberglass leg cast. Which of the following statements should the nurse include? A. "Monitor the color of your child's toes every 4 hours for 24 hours." B. "Your child can scratch the skin inside the cast with a small wooden ruler." C. "Expect the cast to remain damp for 72 hours." D. "You can take your child swimming and give baths as usual."
A. "Monitor the color of your child's toes every 4 hours for 24 hours."
A nurse in a provider's office is observing children playing in the waiting room. The nurse should expect to identify parallel behavior in which of the following age groups? A. Infants B. Toddlers C. Preschoolers D. School-age children
B. Toddlers
A nurse is caring for a school-aged child who has acute post-streptococcal glomerulonephritis. Which of the following manifestations should the nurse expect? A. Hypotension B. Elevated serum lipid levels C. Decreased serum potassium levels D. Hematuria
D. Hematuria
A nurse is preparing to administer an enema to a 10-month-old infant. Which of the following actions should the nurse plan to take? A. Administer the enema using room-temperature tap water B. Insert the tubing 7.5 cm (3 in) into the rectum C. Position the infant sitting upright on a bedpan while administering the enema D. Hold the infant's buttocks together after administering the fluid
D. Hold the infant's buttocks together after administering the fluid
A nurse is caring for a child with cystic fibrosis who has a pulmonary infection. Which of the following findings is the nurse's priority? A. Blood streaking of the sputum B. Dry mucous membranes C. Constipation D. Inability to clear secretions
D. Inability to clear secretions
A nurse is caring for a child who has tetralogy of Fallot. Which of the following laboratory values should the nurse expect to find? A. Platelet count of 20,000/mm^3 B. WBC 4,000/mm^3 C. Thyroid stimulating hormone 7.0 microunits/mL D. RBC 6.8 million/uL
D. RBC 6.8 million/uL
A nurse is assessing a school-aged child after a ventriculoperitoneal (VP) shunt replacement. Which of the following findings indicates a complication of this procedure? A. Abdominal distention B. Unequal peripheral pulses C. Pinpoint pupils D. Frontal bossing
A. Abdominal distention
A nurse on a pediatric mental health unit is caring for a school-age child. Which of the following questions or statements should the nurse provide to foster a rapport and encourage conversation? A. "Do you like school?" B. "Tell me about your favorite video game." C. "We have another child your age on the unit." D. "Would you like your friends to visit you?"
B. "Tell me about your favorite video game."
A nurse in a provider's office enters an examination room to assess an 8-month-old infant for the first time. Which of the following reactions by the infant should the nurse expect? A. The infant gives the nurse a social smile. B. The infant turns away when the nurse approaches. C. The infant reaches out to the nurse to be held. D. The infant is responsive and alert as the nurse comes closer.
B. The infant turns away when the nurse approaches.
A nurse is planning care for a preschooler who is scheduled for a surgical procedure. The nurse should identify that the preschooler is in which of the following of Erikson's psychosocial stages of development? A. Industry vs. inferiority B. Trust vs. mistrust C. Initiative vs. guilt D. Identity vs. role confusion
C. Initiative vs. guilt
A nurse is admitting a child who has a history of tonic-clonic seizures. Which of the following items is the priority to have in the child's room? A. Pulse oximeter B. Oxygen therapy C. Bag valve mask D. Suction equipment
D. Suction equipment
A nurse is assessing the fine motor skills of a 3-year-old preschooler. Which of the following findings should the nurse expect? A. The preschooler can draw a stick figure that has 7 parts B. The preschooler can print her first name C. The preschooler can cut out a picture using scissors D. The preschooler builds a tower of 9 cubes
D. The preschooler builds a tower of 9 cubes
A nurse is caring for a 4-month-old infant who has tetralogy of Fallot and experiences a hypercyanotic spell. Which of the following actions should the nurse take? A. Place the infant in knee-chest position B. Begin CPR C. Prepare to intubate the infant D. Administer IV adenosine
A. Place the infant in knee-chest position
A nurse is teaching the parent of a toddler about home safety. Which of the following statements by the parent indicated an understanding of the teaching? A. "I will lock my medications in the medicine cabinet." B. "I will keep my child's crib mattress at the highest level." C. "I will turn pot handles to the side of my stove while cooking." D. "I will give my child syrup of ipecac if she swallows something poisonous."
A. "I will lock my medications in the medicine cabinet."
A nurse is providing teach to the parents of a school-aged child who has type 1 diabetes mellitus about managing hypoglycemia. Which of the following responses by a parent indicates an understanding of the teaching? A. "I will make sure my child drinks 240 mL (8 oz) of milk as soon as possible." B. "I will give my child 2 units of regular insulin." C. " I will insist that my child lie down to rest for 30 min." D. "I will check my child's urine for glucose twice daily."
A. "I will make sure my child drinks 240 mL (8 oz) of milk as soon as possible."
A nurse is providing teaching to the parent of a 2-year-old toddler about nutrition. Which of the following statements by the parent indicates an understanding of the teaching? A. "My child should consume 1,00 calories per day." B. "My child should have 4 oz of protein per day." C. "I should give my child 32 oz (4 cups) of milk per day." D. "I should feed my child 4 oz (1/2 cup) of vegetables per day."
A. "My child should consume 1,00 calories per day."
A nurse is performing a neurological examination on a 15-month-old toddler. Which of the following finding should the nurse expect? A. Negative Babinski reflex B. Presence of the Moro reflex C. Absence of corneal reflexes D. Positive palmar grasp
A. Negative Babinski reflex
A nurse is providing teaching about home safety to the parent of a 2-month-old infant. Which of the following information should the nurse include? A. Remove bibs before the infant goes to sleep B. Cover the infant with a lightweight blanket at bedtime C. Place the infant in direct sunlight for at least 10 minutes each day D. Set the hot water heater to 60 C (140 F)
A. Remove bibs before the infant goes to sleep
A nurse is teaching an adolescent client who has type 1 diabetes mellitus about managing hypoglycemia. Which of the following statements should the nurse include in the teaching? A. "You should drink 8 oz of a regular soft drink if you experience hypoglycemia." B. "You should drink 4 oz of orange juice if you experience hypoglycemia." C. "You should take 2 glucose tablets if you experience hypoglycemia." D. "You should take 3 tsp of sugar if you experience hypoglycemia."
B. "You should drink 4 oz of orange juice if you experience hypoglycemia."
A nurse is caring for an infant who is postoperative following a myelomeningocele repair. Which of the following is the priority action the nurse should take? A. Measure the infant's intake and output B. Measure the infant's head circumference C. Check the infant's lower-extremity function D. Monitor the infant's blood pressure
B. Measure the infant's head circumference
A nurse is caring for an infant following the surgical repair of a cleft lip and palate. Which of the following actions should the nurse take? A. Keep the infant's mouth open by using a tongue blade for 4 hr following surgery B. Suction the infant gently with a bulb syringe PRN C. Place the infant in a prone position D. Clean the infant's incision with chlorhexidine
B. Suction the infant gently with a bulb syringe PRN
A nurse is assessing the pain level of a 3-year-old child who is postoperative following abdominal surgery. Which of the following pain scales should the nurse use? A. Word graphic rating scale B. Color tool C. FACES pain rating scale D. Numeric scale
C. FACES pain rating scale
A nurse is caring for a preschooler who is immediately postoperative following the removal of a brainstem tumor. Which of the following actions should the nurse take? A. Have the child deep-breathe and cough every hour B. Offer the child clear liquids 4 hours after the procedure C. Monitor the child's temperature every 30 minutes D. Place the child in Trendelenburg position
C. Monitor the child's temperature every 30 minutes
A nurse is caring for a 6-month-old infant who has intussusception. Which of the following actions should the nurse take? A. Prepare to administer high-dose steroids B. Give the child magnesium hydroxide PO C. Prepare the child for a barium enema D. Inform the parents that the child will need a colostomy
C. Prepare the child for a barium enema
A nurse is teaching the parent of a child who has ADHD and a new prescription for methylphenidate sustained-release tablets. Which of the following pieces of information should the nurse include in the teaching? A. "Crush the medication and mix it in your child's food." B. "Administer the medication 1 hour before bedtime." C. "Expect your child to have cloudy urine while he is taking this medication." D. "Weigh your child twice per week while he is taking this medication."
D. "Weigh your child twice per week while he is taking this medication."
A nurse is caring for an adolescent who is receiving pain medication via a PCA pump. When the nurse assesses the client's pain at 0800, the client describes the pain as a 3 on a scale of 1 to 10. At 1000, the client describes the pain as a 5. The nurse discovers the client has not pushed the button to deliver medication in the past 2 hr. Which of the following actions should the nurse take? A. Ask the provider to discontinue the PCA so the nurse can administer PRN pain medication B. Suggest the client's parent push the button for the client if the parent thinks the adolescent is having pain C. Reevaluate the client in 1 hr since a pain level of 5 is acceptable on a scale of 1 to 10 D. Reinforce teaching with the client about how to push the button to deliver the medication
D. Reinforce teaching with the client about how to push the button to deliver the medication
A nurse is teaching the parent of a preschool-aged child about the treatment for pinworms. Which of the following statements by the parent indicates an understanding of the teaching? A. "I will give my child a dose of albendazole today and again in 2 weeks." B. "I will collect specimens immediately after my child has a bowel movement." C. "I will give my child a tub bath twice each day." D. "I will place my child's bed linens in a sealed plastic bag for 7 days."
A. "I will give my child a dose of albendazole today and again in 2 weeks."
A nurse in the emergency department is caring for a child who has bruises that support a suspicion of child abuse. Which of the following actions should the nurse take? A. Ask the child if his parents are responsible for the abuse B. Notify the facility's risk manager C. Interview the child with his parents present D. Report the suspected abuse to local authorities
D. Report the suspected abuse to local authorities
A nurse is planning to implement relaxation strategies with a young child prior to a procedure. Which of the following actions should the nurse take? A. Ask the child to hold a breath and blow it out slowly B. Ask the child to describe a pleasurable event C. Bounce the child gently while holding him upright D. Rock the child using a long, rhythmic movements
D. Rock the child using a long, rhythmic movements
A nurse on a pediatric oncology unit is helping the parents of a child who is terminally ill to prepare for the impending loss of their child. Which of the following statements should the nurse make? A. "The nursing staff will bathe your child and take care of his daily needs." B. "Your child will be most comfortable in a low-stimulation environment." C. "Would you like assistance in planning where your child will die?" D. "Would you like hospice to continue providing curative care in your home?"
c. "Would you like assistance in planning where your child will die?"
A nurse is assessing a 12-year-old child during a well-child checkup. Which of the following physical findings should the nurse report to the provider? A. 5 cm (2 in) of growth in the past year B. Hyperopia C. Presence of pubic hair D. Weight gain of 3 kg (6.6 lb) in the last year
B. Hyperopia
A nurse is providing teaching about foods high in fiber to the guardian of a child who has chronic constipation. Which of the following food should the nurse recommend? A. 1/2 cup whole milk B. 1/2 cup cooked pinto beans C. 1 cup green leaf lettuce D. 1 cup apple juice
B. 1/2 cup cooked pinto beans
A nurse is caring for a school-age child who has skeletal traction applied to repair a pelvic fracture. Which of the following actions should the nurse take? A. Rest the child's traction weights on the floor for 8 hr during the night B. Ensure the child's meal tray contains no high-fiber foods C. Perform passive range-of-motion exercises on the child's involved joints every 4 hr D. Place the child on a pressure-reduction mattress
D. Place the child on a pressure-reduction mattress
A nurse is caring for an adolescent client who has a prescription for opioids. Which of the following findings should the nurse recognize as an adverse effect of opioids? A. Dilated pupils B. Tremors C. Yawning D. Pruritus
D. Pruritus
A nurse is assessing the development of a 3-year-old child. Which of the following gross motor skills should the nurse expect the child to be able to perform? A. Skipping around the room B. Hopping on 1 foot C. Throwing a ball overhead D. Standing on 1 foot
D. Standing on 1 foot
A nurse is teaching the parents of a toddler who has enterobiasis about managing this parasitic disease. Which of the following pieces of information should the nurse include in the teaching? A. "You should encourage your child to take a tub bath daily." B. "You should keep your child's fingernails trimmed short." C. "You should dress your child in a 2-piece outfit at bedtime." D. "You should expect your child not to have a recurrence of the parasitic disease."
B. "You should keep your child's fingernails trimmed short."
A nurse is teaching the parents of a child who has rheumatic fever. Which of the following statements by a parent indicates an understanding of the teaching? A. "My child may take aspirin for his joint pain." B. "My child will need a blood transfusion prior to discharge." C. "I will need to wear a gown when I'm in my child's room." D. "I will apply lotion to my child's peeling hands."
A. "My child may take aspirin for his joint pain."
A nurse is admitting a child who has a urinary tract infection (UTI) and a history of myelomeningocele. After completing the admission history, which of the following actions should the nurse plan to take? A. Attach a latex allergy alert identification band B. Initiate contact precautions C. Post signs in the client's bathroom to strain the client's yourine D. Administer folic acid with meals
A. Attach a latex allergy alert identification band
A nurse is caring for a 4-week-old infant who is 2 weeks postoperative following surgical correction of biliary atresia. Which of the following findings is an indication that the surgery was successful? A. The infant has lost 2.2 kg (1 lb) since the surgery. B. The infant has a total bilirubin level of 0.3 mg/dL. C. The infant has an aspartate aminotransferase (AST) level of 120 units/L. D. The infant's stools are gray in color.
B. The infant has a total bilirubin level of 0.3 mg/dL.
A nurse is providing teaching to a family of a child who has autism spectrum disorder. Which of the following statements indicates that the family understands the teaching? A. "Donepezil might slow the progression of the disorder." B. "My child will prefer group therapy with other children." C. "We can help our child by structuring our daily routine." D. "Our child probably has this condition as a result of prematurity."
C. "We can help our child by structuring our daily routine."
A nurse in the emergency department is assessing an infant who recently started taking digoxin to treat a supraventricular arrhythmia. Which of the following findings should the nurse identify as an indication of digoxin toxicity? A. Irritability B. Diaphoresis C. Vomiting D. Tachycardia
C. Vomiting
A nurse is caring for a 12-month-old infant following the surgical repair of a cleft palate. The nurse should plan to feed the infant using which of the following instruments? A. Spoon B. Straw C. Firm nipple D. Cup
D. Cup
A nurse is caring for the family of a preschooler who has a terminal illness. The nurse should teach the family to expect the preschooler to have which of the following concepts of death? A. People can come back to life after they die. B. Death eventually occurs for all people. C. Death is a scary monster that causes people to die. D. People are unable to be anything but alive.
A. People can come back to life after they die.
A nurse is providing teaching to an adolescent who has a fiberglass arm cast. Which of the following instructions should the nurse include in the teaching? A. Place a plastic bag over the cast when showering B. Insert a dull knitting needle into the cast to rub itchy skin C. Exercise fingers every 8 hr for the first 24 hr D. Draw on the cast using magic markers
A. Place a plastic bag over the cast when showering
A nurse is assessing an infant who develops respiratory distress, absence of breath sounds on one side, and deviation of the trachea away from the affected side. Based on these manifestations, which of the following conditions is the infant experiencing? A. Tension pneumothorax B. Flail chest C. Pulmonary contusion D. Fractured rib
A. Tension pneumothorax
A nurse in a pediatric clinic is caring for a 3-year-old who has a blood lead level of 3 mcg/dL. When teaching the toddler's parent about the correlation of nutrition with lead poisoning, which of the following pieces of information is appropriate for the nurse to include? A. Decrease the child's vitamin C intake until the blood lead level decreases to zero B. Administer a folic acid supplement to the child each day C. Give pancreatic enzymes to the child with meals and snacks D. Ensure the child's dietary intake of calcium and iron is adequate
D. Ensure the child's dietary intake of calcium and iron is adequate
A nurse is creating a plan of care for a preschooler who was admitted for the treatment of measles. Which of the following activities should the nurse include in the client's care plan? A. Constructing a model airplane B. Playing a video game in the playroom C. Pulling a wagon with toys in the hallway D. Putting together a puzzle with large pieces
D. Putting together a puzzle with large pieces