Peds Exam 2

A child is admitted with infective endocarditis. Which nursing intervention is most appropriate for this child? 1. Start an intravenous line. 2. Place the child in contact isolation. 3. Place the child on seizure precautions. 4. Assist with a lumbar puncture.

1

A child is diagnosed with a Wilms tumor. Which nursing action is most appropriate prior to surgery? 1. Careful bathing and handling 2. Monitoring of behavioral status 3. Maintenance of strict isolation 4. Administration of packed RBCs

1

A child is diagnosed with group A beta- hemolytic streptococcus (GABHS) infection of the throat. Which item will the nurse include in the teaching plan for the parents? 1. Complete the entire course of antibiotics. 2. Keep the child NPO (nothing by mouth). 3. Continue normal activities. 4. Do not allow the child to gargle with saltwater.

1

A child is diagnosed with rhabdomyosarcoma. Which nursing intervention is most appropriate for this child? 1. Position the child with the head elevated 2. Monitor for hematuria 3. Demonstrate the use of a conformer 4. Administer oxygen

1

A child is diagnosed with sickle cell disease. The parents are unsure how their child contracted the disease. Which explanation by the nurse is the most appropriate? 1. "Both the mother and the father have the sickle cell trait." 2. "The mother has the trait, but the father doesn't." 3. "The father has the trait, but the mother doesn't." 4. "The mother has sickle cell disease, but the father doesn't have the disease or the trait."

1

A child is diagnosed with thrombocytopenia secondary to chemotherapy treatments. Which action by the nurse is the most appropriate? 1. Refrain from administering any intramuscular injections (IM). 2. Perform oral hygiene. 3. Monitor intake and output. 4. Use palpation as a component of assessment.

1

A child recently diagnosed with aplastic anemia is being prepared for discharge. When planning support for the family, which service should the nurse plan to include in the discharge plan? 1. Referrals to support groups and social services 2. Short-term support 3. Genetic counseling 4. Nutrition counseling

1

A nurse is caring for a visually impaired 20- month-old who has not begun to walk. Which nursing diagnosis is the most appropriate for this client? 1. Delayed growth and development 2. Impaired physical mobility 3. Self-care deficit 4. Impaired home maintenance

1

A school- age child has epistaxis. Which intervention by the school nurse is the most appropriate? 1. Tilting the childs head forward, squeezing the nares below the nasal bone, and applying ice to the nose 2. Tilting the childs head back, squeezing the bridge of the nose, and applying a warm, moist pack to the nose 3. Lying the child down and applying no pressure, ice, or warm pack 4. Immediately packing the nares with a cotton ball soaked with Neo- Synephrine

1

The mother of a child with a heart defect is questioning the nurse about the child's diuretic. When teaching the mother about the medication, what should the emphasis from the nurse? 1. Close monitoring of output 2. The digitalization process 3. The possibility that pulses in the child might be weak 4. The child's increased appetite

1

The nurse admits a child with a ventricular septal defect (VSD) to the unit. Which nursing diagnosis for this child is the most appropriate? 1. Impaired Gas Exchange Related to Pulmonary Congestion Secondary to the Increased Pulmonary Blood Flow 2. Deficient Fluid Volume Related to Hyperthermia Secondary to the Congenital Heart Defect 3. Acute Pain Related to the Effects of a Congenital Heart Defect 4. Hypothermia Related to Decreased Metabolic State

1

The nurse has admitted a child with tricuspid atresia. The nurse would expect which initial lab result? 1. A high hemoglobin 2. A low hematocrit 3. A high WBC count 4. A low platelet count

1

The nurse is admitting an infant diagnosed with supra-ventricular tachycardia. Which intervention is the priority for this infant? 1. Apply ice to the face. 2. Perform Valsalva's maneuver. 3. Administer a beta blocker. 4. Prepare for cardioversion.

1

The nurse is performing the initial assessment of a child newly diagnosed Kawasaki disease. Which symptoms would the nurse expect to assess with this child? 1. Dry, swollen, fissured lips 2. Nonpalpable lymph nodes 3. Conjunctivitis with exudates 4. Cyanosis of the hands and feet

1

The nurse is providing care for an adolescent client who is experiencing pain related to a sickle cell crisis. Which medication does the nurse prepare to administer to this client? 1. Morphine sulfate 2. Meperidine 3. Acetaminophen 4. Ibuprofen

1

The nurse is providing care to a school-age client diagnosed with idiopathic thrombocytopenic purpura (ITP). Which nursing diagnosis is the priority for this client? 1. Risk for Injury 2. Ineffective Breathing Pattern 3. Nausea 4. Fluid-Volume Deficit.

1

The nurse prepares a DTaP (diphtheria, tetanus toxoid, and acellular pertussis) immunization for a 6-month-old infant. To administer this injection safely, the nurse chooses which needle, size and length, injection type, and injection site? 1. 25-gauge, 5/8-inch needle; IM (intramuscular); anterolateral thigh. 2. 22-gauge, 1/2-inch needle; IM (intramuscular); ventrogluteal. 3. 25-gauge, 5/8-inch needle; ID (intradermal); deltoid. 4. 25-gauge, 3/4-inch needle; SQ (subcutaneous); anterolateral thigh.

1

The nurse suspects that an infant has a visual disorder caused by abnormal musculature. Which test will the nurse perform to detect this disorder? 1. A cover/uncover test 2. An ophthalmologic exam 3. A vision-acuity exam 4. A pupil- reaction-to-light test

1

The nurse is providing an educational session for parents with children diagnosed with iron deficiency anemia. Which statements will the nurse include educate about the normal functions of RBCs? Select all that apply. 1. "RBCs transport oxygen from the lungs to the tissue." 2. "RBCs transport carbon dioxide to the lungs." 3. "RBCs protect the body against bacterial invaders." 4. "RBCs form hemostatic plugs to stop bleeding." 5. "RBCs are responsible for psychosocial development."

1,2

The pediatric nurse is providing care to a school-age child receiving chemotherapy to treat cancer. Which interventions are appropriate to include in the plan of care in order to monitor for oncologic emergencies? Select all that apply. 1. Monitor complete blood count (CBC). 2. Document intake and output. 3. Observe for behavioral changes. 4. Refer for psychosocial support. 5. Implement neutropenic precautions.

1,2,3

The nurse is providing care to a school-age client with neutropenia. Which clinical manifestations does the nurse anticipate when assessing this client? Select all that apply. 1. Fever 2. Fatigue 3. Tachycardia 4. Hypertension 5. Tachypnea

1,2,3,5

The nurse is teaching parents how to prevent a sickle cell crisis in the child with sickle cell disease. Which precipitating factors to a sickle cell crisis will the nurse include in the explanation?Select all that apply. 1. Fever 2. Dehydration 3. Regular exercise 4. Altitude 5. Increased fluid intake

1,2,4

The pediatric nurse educator is conducting an in-service for novice nurses who will begin working on the pediatric oncology unit. The educator wants to include the common clinical manifestations of cancer. Which manifestation will the educator include in the presentation? Select all that apply. 1. Cachexia 2. Anemia 3. Gene abnormalities 4. Palpable mass 5. Chromosomal abnormalities

1,2,4

A seasoned nurse is precepting a novice nurse on a pediatric oncology unit. The seasoned nurse would like to review the ongoing physiologic and psychosocial care of the children who survive cancer. Which topics will the seasoned nurse include in the discussion with the novice nurse?Select all that apply. 1. Developing other cancers 2. Recommending regular office visits 3. Encouraging school-age clients to manage their own care 4. Needing weekly laboratory tests 5. Providing educational and psychosocial support

1,2,5

An infant with tetralogy of Fallot is having a hypercyanotic episode ("tet" spell). Which nursing interventions are appropriate for the nurse to implement for this infant? Select all that apply. 1. Place the child in knee-chest position. 2. Draw blood for a serum hemoglobin. 3. Administer oxygen. 4. Administer morphine and propranolol intravenously as ordered. 5. Administer Benadryl as ordered.

1,3,4

The family has just been informed by the healthcare provider that their newborn is diagnosed with a congenital heart defect, Tetralogy of Fallot (TOF). The family tells the nurse that the healthcare provider told them that TOF is comprised of several defects, and they ask the nurse what the defects are. What will the nurse tell the family? Select all that apply. 1. Pulmonary stenosis 2. Coarctation of the aorta 3. Right ventricular hypertrophy 4. Ventral septal defect 5. Overriding aorta

1,3,4,5

A child who has undergone a hematopoietic stem cell transplantation (HSCT) is ready for discharge. Which items will the nurse include in the discharge teaching for this child and family? Select all that apply. 1. Recognize the signs of graft-versus-host disease. 2. Return the child to school within six weeks. 3. Practice good hand-washing. 4. Avoid obtaining influenza vaccinations. 5. Avoid live plants and fresh vegetables.

1,3,5

The nurse is providing care to a school-age client admitted to the emergency department following a motor vehicle crash. The client is exhibiting symptoms of hypovolemic shock. Which nursing interventions are appropriate for this client? Select all that apply. 1. Monitor hemoglobin and hematocrit. 2. Monitor liver enzymes. 3. Administer oxygen, as needed. 4. Administer a dextrose solution. 5. Monitor blood glucose.

1,3,5

The nurse teaches parents how to care for their child who has tympanostomy tubes inserted. Which actions by the parents indicate appropriate understanding of the teaching session? Standard Text: Select all that apply. 1. Encouraging the child to drink generous amounts of fluids 2. Administering a decongestant for one to two weeks following surgery 3. Restricting the child to quiet activities after surgery 4. Limiting diet to soft, bland foods 5. Avoiding getting water in ears during bath time

1,3,5

A child is admitted with a diagnosis of early localized Lyme disease. Which clinical manifestations would the nurse expect to find on the initial assessment of this client? Standard Text: Select all that apply. 1. Erythema 515 cm in diameter 2. Hyperactivity 3. Cranial nerve palsies 4. Fever 5. Headache

1,4,5

A 24-hour urine collection for vanillylmandelic acid (VMA) has been ordered on a child suspected of having neuroblastoma. When is the most appropriate time for the nurse to begin the collection? 1. At 0700 2. After the next time the child voids 3. At bedtime 4. When the order is noted

2

A child diagnosed with hemophilia plans on participating in a bicycling club. Which recommendation by the nurse is the most appropriate? 1. Consider a swim club instead of the bicycling club. 2. Wear kneepads, elbow pads, and a helmet while bicycling. 3. Participate only in the social activities of the club. 4. Not join the club.

2

A child recently had a heart transplant and the nurse teaches the parents the importance of administering cyclosporine A. Which statement by the parents indicates an appropriate understanding of the teaching session? 1. "Cyclosporin A reduces serum- cholesterol level." 2. "Cyclosporin A prevents rejection." 3. "Cyclosporin A treats hypertension." 4. "Cyclosporin A treats infections."

2

A child with a brain tumor is admitted to the pediatric intensive care unit (PICU) after brain surgery to remove the tumor. Which postoperative order would the nurse question? 1. Antibiotics 2. Sodium levels every 24 hours 3. Anticonvulsants 4. Hourly intake and output

2

A mother brings her 4-month-old infant in for a routine checkup and vaccinations. The mother reports that the infant was exposed to a brother who has the flu. Which action by the nurse is most appropriate based on these assessment findings? 1. Withhold the vaccinations.2. Give the vaccinations as scheduled. 3. Withhold the DTaP vaccination but give the others as scheduled. 4. Give the infant the flu vaccination but withhold the others.

2

A nurse is assessing infants for visually related developmental milestones. Which infant is showing a delay in meeting an expected milestone? 1. 4-month-old who has a social smile 2. 8-month-old who has just begun to inspect her own hand 3. 12-month-old who stacks blocks 4. 7-month-old who picks up a raisin by raking

2

A nurse is caring for a visually impaired school-age child. Which nursing intervention is the highest priority for this child during the admission process? 1. Explaining playroom policies 2. Orienting the child to where furniture is placed in the room 3. Letting the child touch equipment that will be used during the hospitalization 4. Taking the child on a tour of the unit

2

A parent brings her school-age child to the clinic because the child has a temperature of 100.2F. The child remains active without other symptoms. Which statement by the nurse to the parents is most appropriate? 1. Take the childs temperature every 2 hours and call the clinic if it reaches 102F or above. 2. Unless the fever bothers the child, it is best to let the natural body defenses respond to the infection. 3. Keep the child warm, because shivering often occurs with fever. 4. Alternate acetaminophen and ibuprofen to help keep the fever down and keep the child comfortable.

2

A preschool child is seen in the clinic, and the nurse anticipates a diagnosis of leukemia. Which reaction does the nurse anticipate this child will exhibit upon diagnosis? 1. Acceptance, especially if able to discuss the disease with children their own age 2. Thoughts that they caused their illness and are being punished 3. Understanding of what cancer is and how it is treated 4. Unawareness of the illness and its severity

2

A preschool-age child is brought to the clinic by the mother, who says the child has been lethargic and anorexic lately and complains of bone pain. On exam, the nurse notes petechiae, joint pain, and an enlarged liver. Which diagnosis does the nurse anticipate for this child? 1. Hodgkin disease 2. Leukemia 3. Rhabdomyosarcoma 4. Ewing sarcoma

2

An infant is diagnosed with acute otitis media. Which intervention is most appropriate for the nurse to teach the infants parents? 1. Keep the baby in a flat lying position during sleep. 2. Administer acetaminophen (Tylenol) to relieve discomfort. 3. Administer a decongestant. 4. Place baby to sleep with a pacifier.

2

During an admission assessment, the nurse notes that the child has impaired oral mucous membranes. Which intervention is most appropriate for the nurse to implement for this child? 1. Administering topical analgesics 2. Promoting an adequate intake of nutrients 3. Administering antibiotics as ordered 4. Using lemon and glycerin for oral hygiene

2

The nurse completes postoperative discharge teaching to the parents of a child who had a tonsillectomy. Which statement by the parents indicates correct understanding of the teaching session? 1. We will call the physician for any indication of ear pain. 2. We will plan on administering acetaminophen (Tylenol) for pain. 3. We will be sure to give our child adequate amounts of citrus juices. 4. We will keep our child on bed rest for 10 days after the surgery

2

The nurse is administering packed RBCs to a child with sickle cell disease (SCD). The nurse is monitoring for a transfusion reaction and knows it is most likely to occur during which time frame? 1. Six hours after the transfusion is given 2. Within the first 20 minutes of administration of the transfusion 3. At the end of the administration of the transfusion 4. Never; children with SCD do not have reactions.

2

The nurse is caring for a child with disseminated intravascular coagulation (DIC). Which nursing intervention is a priority for this child? 1. Frequent ambulation 2. Maintenance of skin integrity 3. Monitoring of fluid restriction 4. Preparation for x-ray procedures

2

The nurse is teaching the parents of a group of cardiac patients. Which teaching guideline will the nurse include for any child who has undergone cardiac surgery? 1. The child should be restricted from most play activities. 2. The child should be evaluated to determine if prophylactic antibiotics for dental, oral, or upper- respiratory-tract procedures are necessary. 3. The child should not receive routine immunizations. 4. The child can be expected to have a fever for several weeks following the surgery.

2

Which action by the parents demonstrates an understanding of the nurse's teaching with regard to prevention of iron-deficient anemia? 1. Feeding their infant with a formula that is not iron fortified 2. Starting iron-fortified infant cereal at 4 to 6 months of age 3. Introducing cow's milk at 6 months of age 4. Limiting vitamin C consumption after 1 year of age

2

The nurse is providing care to an adolescent child who is at risk for developing adult-onset cardiovascular disease. Which teaching points will decrease the adolescent's risk? Select all that apply. 1. Encourage a decrease in smoking. 2. Limit fat intake to 20 to 35 percent of intake. 3. Encourage participation in vigorous exercise for at least 30 minutes. 4. Maintain a normal weight. 5. Include high-fat dairy products in the daily diet.

2,3,4

A nurse working in a pediatric clinic is responsible for monitoring and maintaining the vaccinations on site. Which actions are appropriate for this nurse to implement? Standard Text: Select all that apply. 1. Fluctuate refrigerator and freezer temperatures each day. 2. Store vaccines in the center of the unit. 3. Check and record the temperature of the unit twice each day. 4. Have a plan for power outages. 5. Place bottles of water in each unit to help keep temperatures consistent.

2,3,4,5

The child and family come to the clinic requesting information about causes of cardiac defects. The father has high incidence of cardiac defects in his family, and the child is frequently cyanotic around the lips. What causes should the nurse tell the family about? Select all that apply. 1. Decreased maternal age 2. Chromosomal abnormalities 3. Fetal exposure to maternal drugs 4. Maternal viral infections 5. Maternal metabolic disorders

2,3,4,5

The nurse is preparing to discharge an infant with a congenital heart defect. The infant will be cared for at home by the parents until surgery. Which items will the nurse include in the discharge teaching for this infant and family? Select all that apply. 1. Allow the infant to feed for 60 minutes. 2. Hold the infant at a 45-degree angle. 3. Encourage frequent hand hygiene. 4. Notify the health care provider for fever. 5. Pump the breasts and feed with a bottle if weight gain is an issue.

2,3,4,5

The nurse is teaching a prenatal class about infant care. Under which circumstances should the nurse emphasize that parents should call their healthcare provider immediately? Standard Text: Select all that apply. 1. Child 4 months old, received a DTaP immunization yesterday, and has a temperature of 38.0 degrees C (100.4 degrees F) 2. Child under 3 months old and has a temperature over 40.1 degrees C (104.2 degrees F) 3. Child difficult to awaken and has a pulsing fontanel 4. Child has purple spots on the skin and is lethargic. 5. Child has a stiff neck and has been irritable for three days.

2,3,4,5

A child diagnosed with a Wilms tumor is prescribed chemotherapy. Which laboratory test will the nurse monitor prior to administering the chemotherapy to determine the child's infection-fighting capability? 1. Hemoglobin 2. RBC count 3. Absolute neutrophil count (ANC) 4. Platelets

3

A child has been admitted to the hospital unit in congestive heart failure (CHF). Which symptom would the nurse anticipate upon assessment of the child? 1. Weight loss 2. Bradycardia 3. Tachycardia 4. Increased blood pressure

3

A nurse is planning to teach school- age children about the common cold. Which information should the nurse include in the teaching session? 1. Vaccinations can prevent contraction of a nasopharyngitis virus. 2. Antibiotics will eliminate the nasopharyngitis virus. 3. Proper handwashing can prevent the spread of the infection. 4. Aspirin should be taken for alleviation of fever if the common cold is contracted.

3

A nurse is providing information to a group of new mothers. Which statement best explains why newborns and young infants are more susceptible to infection? 1. They have high levels of maternal antibodies to diseases to which the mother has been exposed. 2. They have passive transplacental immunity from maternal immunoglobulin G. 3. They have immune systems that are not fully mature at birth. 4. They have been exposed to microorganisms during the birth process.

3

A school-age child with hemophilia falls on the playground and goes to the nurse's office with superficial bleeding above the knee. Which action by the nurse is the most appropriate? 1. Apply a warm, moist pack to the area. 2. Perform some passive range of motion to the affected leg. 3. Apply pressure to the area for at least 15 minutes. 4. Keep the affected extremity in a dependent position.

3

A toddler client with a fever is prescribed amoxicillin clavulanate 250 mg/5 cc three times daily by mouth 10 days for otitis media. Which teaching point will guard against antibiotic resistance to the disease process? 1. Administer a loading dose for the first dose. 2. Measure the prescribed dose in a household teaspoon. 3. Give the antibiotic for the full 10 days. 4. Stop the antibiotic if the child is afebrile.

3

An adolescent is receiving methotrexate chemotherapy after undergoing limb- salvage surgery for osteogenic sarcoma. Which statement by the adolescent indicates understanding of the purpose of leucovorin therapy after the methotrexate? 1. "I'm glad I only need one dose of the leucovorin." 2. "I don't have any pain so I won't need to take the leucovorin this time." 3. "I know I will be taking the leucovorin every 6 hours for about the next 3 days." 4. "I don't have any nausea so I won't need the leucovorin."

3

The antiemetic drug ondansetron (Zofran) is administered to a child receiving chemotherapy. When should the nurse administer this medication? 1. Only if the child experiences nausea 2. After the chemotherapy has been administered 3. Before chemotherapy administration as a prophylactic measure 4. Never; this antiemetic is not effective for controlling nausea and vomiting associated with chemotherapy

3

The child is admitted to the hospital after being diagnosed with retinoblastoma. Which assessment finding does the nurse anticipate for this child? 1. A red reflex 2. Yellow sclera 3. A white pupil 4. Blue-tinged sclera

3

The hospital has just provided its nurses with information about biologic threats and terrorism. After completing the course, a group of nurses is discussing its responsibility in relation to bioterrorism. Which statement by the nurse indicates a correct understanding of the concepts presented? 1. It is important to separate clients according to age and illness to prevent the spread of disease. 2. It is important to dispose blood- contaminated needles in the lead-lined container. 3. I will notify the Centers for Disease Control (CDC) if a large number of persons with the same life-threatening infection present to the emergency room. 4. I will initiate isolation precautions for a hospitalized client with methicillin-resistant staphylococcus aureus (MRSA).

3

The nurse is caring for a child who is in a sickle cell crisis and has severe pain. Which nursing intervention is the most appropriate for this child? 1. Giving comfort measures, such as back rubs 2. Suggesting diversional activities, such as coloring 3. Administering pain medication 4. Preparing the child for painful procedures

3

The nurse is caring for four clients. Which client has the highest risk of developing retinopathy of prematurity? 1. 30-week- gestation infant who was in an Oxy-Hood for 12 hours and weighed 1800 grams. 2. 32-week- gestation infant who needed no oxygen and weighed 1850 grams. 3. 28-week- gestation infant who has been on long-term oxygen and weighed 1400 grams. 4. 28-week- gestation infant who was on short-term oxygen and weighed 1420 grams.

3

The nurse is discussing ways to treat fever in the home environment to a group of parents in the community. Which statement is appropriate for the nurse to include in the presentation? 1. Ibuprofen is the only effective means to reduce fever. 2. If the child requires more than one dose of acetaminophen antibiotics are needed. 3. Purchase a new bottle of acetaminophen for your newborn because it will have recommended medication concentration. 4. It is not necessary to follow the recommendations on the bottle of ibuprofen as this will not prevent an overdose for your child

3

The nurse is teaching a 10-year-old and family about the diagnosis of Ewing sarcoma. The nurse knows that instruction has been successful when the child and family indicate which is a common site? 1. Bone marrow 2. Head 3. Shaft 4. Growth plate 5. Bursae

3

Which athletic activity can the nurse recommend for a school-age client with pulmonary-artery hypertension? 1. Cross-country running 2. Soccer 3. Golf 4. Basketball

3

The nurse is caring for the 5-year-old just diagnosed with von Willebrand disease after a tooth extraction with increased bleeding. The family asks the nurse how the signs and symptoms of von Willebrand disease are manifested. What will the nurse tell the family? Select all that apply. 1. Decreased partial thromboplastin time 2. Factor VI deficiency 3. Frequent nosebleeds 4. Bleeding from mucous membranes 5. Frequent bruising

3,4,5

The school nurse is trying to prevent the spread of a flu virus through the school. Which infection-control strategies can be employed to prevent the spread of the flu virus? Standard Text: Select all that apply. 1. Teaching parents safe food preparation and storage 2. Withholding immunizations for children with compromised immune systems 3. Sanitizing toys, telephones, and door knobs to kill pathogens 4. Separating children with infections from children who are well 5. Teaching children to wash their hands after using the bathroom

3,4,5

A child who has beta-thalassemia is receiving numerous blood transfusions. The child is also receiving deferoxamine (Desferal) therapy. The parents ask how the deferoxamine will help their child. Which rationale does the nurse use when responding to the parents? 1. It prevents blood transfusion reactions. 2. It stimulates RBC production. 3. It provides vitamin supplementation. 4. It prevents iron overload.

4

A child who is diagnosed with leukemia has a sibling who is expressing feelings of anger and guilt. How would the nurse characterize this reaction by the sibling? 1. Abnormal; the sibling should be referred to a psychologist. 2. Normal; the illness doesn't affect the sibling. 3. Unexpected; the cancer is easily treated. 4. Normal; the sibling is affected too, and anger and guilt are expected feelings.

4

A child with meningococcemia is being admitted to the pediatric intensive-care unit. Which room assignment is the most appropriate for this child? 1. Semiprivate room 2. Private room, but not in isolation 3. Private room, in protective isolation 4. Private room, in respiratory isolation

4

A mother refuses to have her child be immunized with measles, mumps, and rubella (MMR) vaccine because she believes that letting her infant get these diseases will help him fight off other diseases later in life. Which response by the nurse is most appropriate? 1. Honor her request because she is the parent. 2. Explain that antibodies can fight many diseases. 3. Tell her that not immunizing her infant may protect pregnant women. 4. Explain that if her child contracts measles, mumps, or rubella, there could be very serious and permanent complications from these diseases.

4

A neonate has been diagnosed with a herpes simplex viral infection of the eye. Which medication will the nurse prepare to administer? 1. Fluoroquinolone eye drops or ointment 2. Intravenous penicillin 3. Oral erythromycin 4. Parenteral acyclovir (Zovirax) and vidarabine (VIRA-A) ophthalmic ointment

4

A parent reports that her school-age child, who has had all recommended immunizations, had a mild fever one week ago and now has bright red cheeks and a lacy red maculopapular rash on the trunk and arms. Which disease process does the nurse suspect based on the parents description? 1. Chicken pox (varicella) 2. German measles (rubella) 3. Roseola (exanthem subitum) 4. Fifth disease (erythema infectiosum)

4

A toddler is started on digoxin (Lanoxin) for cardiac failure. Which is the initial symptom the nurse would assess if the child develops digoxin (Lanoxin) toxicity? 1. Lowered blood pressure 2. Tinnitus 3. Ataxia 4. A change in heart rhythm

4

Reducing the number of preventable childhood illnesses is a major national goal in Healthy People 2020. What will the school nurse teach families regarding immunizations in order to reach this goal? 1. A minor illness with a low-grade fever is a contraindication to receiving an immunization according to Healthy People 2020. 2. Vaccines should be given one at a time for optimum active immunity in the prevention of illness and disease. 3. Premature infants and low-birth-weight infants should receive half doses of vaccines for protection from communicable diseases. 4. It is important to maintain vaccination coverage for recommended vaccines in early childhood and to maintain them through kindergarten.

4

The charge nurse on a pediatric unit is making a room assignment for a school-age child diagnosed with sickle cell disease, who is in splenic sequestration crisis. Which room assignment is most appropriate for this client? 1. Semiprivate room 2. Reverse-isolation room 3. Contact-isolation room 4. Private room

4

The child who had a tonsillectomy earlier today is now awake and tolerating fluids. The child asks for something to eat. Which food choice is most appropriate for this client? 1. Orange slices 2. Lemonade 3. Grapefruit juice 4. Applesauce

4

The hospital admitting nurse is taking a history of a childs illness from the parents. The nurse concludes that the parents treated their 6-year-old child appropriately for a fever related to otitis media. Which action by the parents brought the nurse to this conclusion? 1. Used aspirin every four hours to reduce the fever 2. Alternated acetaminophen with ibuprofen every two hours 3. Put the child in a tub of cold water to reduce the fever 4. Offered generous amounts of fluids frequently

4

The nurse finds that an infant has stronger pulses in the upper extremities than in the lower extremities, and higher blood pressure readings in the arms than in the legs. Which assessment will the nurse perform next on this infant? 1. Pedal pulses 2. Pulse oximetry level 3. Hemoglobin and hematocrit values 4. Blood pressure of the four extremities

4

The nurse is checking peripheral perfusion to a child's extremity following a cardiac catheterization. Which assessment finding indicates adequate peripheral circulation to the affected extremity? 1. A capillary refill of greater than three seconds 2. A palpable dorsalis pedis pulse but a weak posterior tibial pulse 3. A decrease in sensation with a weakened dorsalis pedis pulse 4. A capillary refill of less than three seconds with palpable warmth

4

The nurse is evaluating the activity tolerance of a 9-month-old with iron deficiency anemia. Which finding indicates that the infant is not tolerating activity? 1. Heart rate of 138 2. Increased alertness 3. Respiratory rate less than 40 with activity 4. Muscle weakness

4

The nurse is monitoring the urine specific gravity and pH on a child receiving chemotherapy. Which urinalysis result is the goal for this child? 1. Spec gravity 1.030; pH 6 2. Spec gravity 1.030; pH 7.5 3. Spec gravity 1.005; pH 6 4. Spec gravity 1.005; pH 7.5

4

A child diagnosed with cancer is prescribed chemotherapy. The latest lab value indicates the WBC count is very low. Which medication order does the nurse anticipate? 1. Filgrastim (Neupogen) 2. Ondansetron (Zofran) 3. Oprelvekin (Neumega) 4. Epoetin alfa (human recombinant erythropoietin)

1

The nurse prepares the second diphtheria, tetanus toxoid, and acellular pertussis (DTaP) and second inactivated polio vaccine (IPV) immunization injections for an infant who is 4 months old. The nurse may also give which of immunizations during the same well-child-care appointment? 1. Var (varicella) 2. TIV (influenza) 3. MMR (measles, mumps, rubella) 4. Haemophilus influenza type B (HIB)

4

Which action by the nurse can assist a child who has a mild hearing loss and reads lips to adapt to hospitalization? 1. Speaking directly to the parents for communication 2. Speaking in a loud voice while facing the child 3. Using a picture board as the main means of communication 4. Touching the child lightly before speaking

4

The child has just been diagnosed with osteosarcoma, and the nurse is teaching the family regarding this type of cancer. The nurse knows that instruction has been successful when the family states that osteosarcoma is common in which age group? 1. Infants 2. Toddlers 3. Preschool-age children 4. School-age children 5. Adolescents

5

A child undergoing chemotherapeutic treatment for cancer is being admitted to the hospital for fever of 102 degrees F and possible sepsis. Cultures, antibiotics, and acetaminophen (Tylenol) along with bed rest have been ordered for this child. Place the following steps in order from first to last. Response 1 Administer the antibiotics. Response 2 Administer the acetaminophen (Tylenol). Response 3 Obtain the cultures. Response 4 Ensure the child has bed rest.

Order: 2,3,1,4