Peds Exam #2
A Hemoglobin A1c levels of less than % are a goal for adolescents with type 1 diabetes. (Record your answer in a whole number.)
7.5
A. Place in order the interventions the nurse would implement starting with the highest-priority intervention sequencing to the lowest-priority intervention for a child experiencing a generalized seizure. Provide the answer using lowercase letters separated by commas (e.g., A, B, C, D, E) a. Monitor vital signs. b. Ease child to the floor. c. Evaluate postictal symptoms. d. Turn child to the side. e. Note onset of seizure.
E, B, D, A, C
The nurse is caring for a child with possible carbon monoxide poisoning associated with smoke inhalation. Which treatment is initiated immediately? a. Administer 100% humidified oxygen. b. Monitor arterial blood gases. c. Administer oxygen if respiratory distress develops. d. The child is rushed to endoscopy for a bronchoscopy.
a. Administer 100% humidified oxygen.
A child with growth hormone (GH) deficiency is receiving GH therapy. When is the best time for the GH to be administered? a. At bedtime b. After meals c. Before meals d. On arising in the morning
a. At bedtime
Four-year-old Brian appears to be upset by hospitalization. Which is an appropriate intervention? a. Let him know it is all right to cry. b. Give him time to gain control of himself. c. Show him how other children are cooperating. d. Tell him what a big boy he is to be so quiet.
a. Let him know it is all right to cry.
Advanced renal failure can result in which condition that results in retention of nitrogenous product that produce toxic symptoms? a. Uremia b. Oliguria c. Proteinuria d. Pyelonephritis
a. Uremia
In addition to allergens, which other substance or condition has a significant role in the development and expression of asthma? a. Medications b. A viral infection c. Exposure to cold air d. A diet high in protein
b. A viral infection
The nurse has documented that a child's level of consciousness is obtunded. Which describes this level of consciousness? a. Slow response to vigorous and repeated stimulation b. Impaired decision making c. Arousable with stimulation d. Confusion regarding time and place
c. Arousable with stimulation
In which type of play are children engaged in similar or identical activity, without organization, division of labor, or mutual goal? a. Solitary b. Parallel c. Associative d. Cooperative
c. Associative
When the parents of a newborn ask the nurse about the causative factor in clubfoot, which response is appropriate? a. A result of abnormal organizational cells b. A breakdown of previously normal tissue c. Condition is often caused by uterine constraint d. Fibrous bands of amnion wrapped around the leg
c. Condition is often caused by uterine constraint
The nurse is performing a Glasgow Coma Scale on a school-age child with a head injury. The child opens eyes spontaneously, obeys commands, and is oriented to person, time, and place. Which is the score the nurse would record? a. 8 b. 11 c. 13 d. 15
d. 15
Hyperglycemia associated with diabetic ketoacidosis is defined as a blood glucose measurement equal to or greater than mg/dl. a. 100 b. 120 c. 180 d. 200
d. 200
The nurse is caring for a child with severe head trauma after a car accident. Which is an ominous sign that often precedes death? a. Papilledema b. Delirium c. Doll's head maneuver d. Periodic and irregular breathing
d. Periodic and irregular breathing
Which is a characteristic of chronic sorrow often experience by parents who have a chronically ill child? a. Lack of acceptance of the child's limitation b. Lack of available support to prevent sorrow c. Periods of intensified sorrow when experiencing anger and guilt d. Periods of intensified sorrow and loss that occur in waves over time
d. Periods of intensified sorrow and loss that occur in waves over time
Which drug is usually given first in the emergency treatment of an acute, severe asthma episode in a young child? a. Ephedrine b. Theophylline c. Aminophylline d. Short-acting 2 agonists
d. Short-acting 2 agonists
Cystic fibrosis (CF) is suspected in a toddler. Which test aids in establishing this diagnosis? a. Bronchoscopy b. Serum calcium c. Urine creatinine d. Sweat chloride test
d. Sweat chloride test
The mother of a 13-month-old child states, "My child does not make noises like 'da' or 'na' like my sister's baby, who is only 9 months old." Which statement by the nurse would be most appropriate to make? a. "I am going to request a referral to a hearing specialist." b. "You should not compare your child to your sister's child." c. "I think your child is fine, but we will check again in 3 months." d. "You should ask other parents what noises their children made at this age."
a. "I am going to request a referral to a hearing specialist."
Which are appropriate statements the nurse would make to parents after the death of their child? (Select all that apply.) a. "We feel so sorry that we couldn't save your child." b. "Your child isn't suffering anymore." c. "I know how you feel." d. "You're feeling all the pain of losing a child." e. "You are still young enough to have another baby."
a. "We feel so sorry that we couldn't save your child." d. "You're feeling all the pain of losing a child."
Parents have understood teaching about prevention of childhood otitis media if they make which statement? (Select all that apply.) a. "We will avoid second hand smoke." b. "Breastfeeding will be discontinued after 4 months of age." c. "We will place the child flat right after feedings." d. "A conjugate vaccine may be administered." e. "We will adminster medications as prescribed."
a. "We will avoid second hand smoke." d. "A conjugate vaccine may be administered." e. "We will adminster medications as prescribed."
The Heimlich maneuver is recommended for airway obstruction in children older than year(s). a. 1 b. 4 c. 8 d. 12
a. 1
A nurse is interpreting the results of a tuberculin skin test (TST) on an adolescent who is HIV positive. Which induration size indicates a positive result 48 to 72 hours after the test? a. 5mm b. 10mm c. 15mm d. 20mm
a. 5mm
Turner syndrome is suspected in an adolescent girl with short stature. Which is the cause of this syndrome? a. Absence of one of the X chromosomes b. Presence of an incomplete Y chromosome c. Precocious puberty in an otherwise healthy child d. Excess production of both androgens and estrogens
a. Absence of one of the X chromosomes
A five-year-old patient tells the nurse that she "needs a Band-Aid" where she had an injection. Which is the best nursing action? a. Apply a Band-Aid. b. Ask her why she wants a Band-Aid. c. Explain why a Band-Aid is not needed. d. Show her that the bleeding has already stopped.
a. Apply a Band-Aid.
When would children with cognitive impairment be referred for stimulation and educational programs? a. As young as possible b. As soon as they have the ability to communicate in some way c. At age 3 years, when schools are required to provide services d. At age 5 or 6 years, when schools are required to provide services
a. As young as possible
An 18-month-old has just been admitted with croup. His parent is tearful and tells the nurse, "This is all my fault. I should have taken him to the doctor sooner so he wouldn't have to be here." Which is appropriate in the care plan for this parent who is experiencing guilt? a. Assist parent to understand this is a typical response to stress. b. Explain to the parent that the illness is not serious. c. Encourage the parent to maintain a sense of control. d. Assess further why the parent has excessive guilt feelings.
a. Assist parent to understand this is a typical response to stress.
Decongestant nose drops are prescribed for a 10-month-old infant with an upper respiratory tract infection. Instructions for nose drops would include which action? a. Avoid using for more than 3 days. b. Keep drops to use again for nasal congestion. c. Administer drops until nasal congestion subsides. d. Administer drops only when symtomatic.
a. Avoid using for more than 3 days.
The nurse is implementing care for a school-age child admitted to the pediatric intensive care in diabetic ketoacidosis (DKA). Which prescribed intervention would the nurse implement first? a. Begin 0.9% saline solution intravenously as prescribed. b. Administer regular insulin intravenously as prescribed. c. Place child on a cardiac monitor. d. Place child on a pulse oximetry monitor.
a. Begin 0.9% saline solution intravenously as prescribed.
An adolescent boy is brought to the emergency department after a motorcycle accident. His respirations are deep, periodic, and gasping, with extreme fluctuations in blood pressure, and pupils are dilated and fixed. The nurse would suspect which type of head injury? a. Brainstem b. Skull fracture c. Subdural hemorrhage d. Epidural hemorrhage
a. Brainstem
A school-age child had an upper respiratory tract infection for several days and then began having a persistent dry, hacking cough that was worse at night. This is most suggestive of which diagnosis? a. Bronchitis b. Bronchiolitis c. Viral-induced asthma d. Acute spasmodic laryngitis
a. Bronchitis
An infant gains head control before sitting unassisted. The nurse recognizes that this is which type of development? a. Cephalocaudal b. Proximodistal c. Mass to specific d. Sequential
a. Cephalocaudal
Nursing care of the child with a bacterial pneumonia includes which interventions? (Select all that apply.) a. Cluster care to conserve energy b. Round-the-clock administration of antitussive agents c. Strict intake and output to avoid congestive heart failure d. Administration of antibiotics e. Provide adequate hydration
a. Cluster care to conserve energy d. Administration of antibiotics e. Provide adequate hydration
The nurse recognizes that the most common type of hearing loss resulting from interference of transmission of sound to the middle ear is characteristic of which type of hearing loss? a. Conductive b. Sensorineural c. Mixed conductive-sensorineural d. Central auditory imperceptive
a. Conductive
Which is instituted for the therapeutic management of minimal change nephrotic syndrome? a. Corticosteroids b. Antihypertensive agents c. Long-term diuretics d. Increased fluids to promote diuresis
a. Corticosteroids
Which are adaptive coping patterns used by children with special needs? (Select all that apply.) a. Develops optimism b. Feels different and withdraws c. Accepts physical limitations d. Is irritable and moody e. Finds achievement in compensatory intellectual pursuits
a. Develops optimism c. Accepts physical limitations e. Finds achievement in compensatory intellectual pursuits
A child is being discharged from an ambulatory care center after an inguinal hernia repair. Which discharge interventions would the nurse implement? (Select all that apply.) a. Discuss dietary restrictions. b. Hold any analgesic medications until the child is home. c. Send a pain scale home with the family. d. Suggest the parents fill the prescriptions on the way home. e. Discuss complications that may occur, and steps to take if they do.
a. Discuss dietary restrictions. c. Send a pain scale home with the family. e. Discuss complications that may occur, and steps to take if they do.
The nurse is evaluating the laboratory results on cerebral spinal fluid (CSF) from a 3-year-old child with bacterial meningitis. Which findings confirm bacterial meningitis? (Select all that apply.) a. Elevated white blood cell (WBC) count b. Decreased glucose c. Normal protein d. Elevated red blood cell (RBC) count e. Positive Gram stain
a. Elevated white blood cell (WBC) count b. Decreased glucose e. Positive Gram stain
The nurse is caring for a 10-month-old infant with respiratory syncytial virus (RSV) bronchiolitis. Which intervention would be included in the child's care? (Select all that apply.) a. Ensure contact precautions are implemented. b. Administer antibiotics. c. Administer cough syrup. d. Provide 8 ounces of formula every 4 hours. e. Cluster care to encourage adequate rest. f. Place on noninvasive oxygen monitoring for oxygen saturation <90%.
a. Ensure contact precautions are implemented. e. Cluster care to encourage adequate rest. f. Place on noninvasive oxygen monitoring for oxygen saturation <90%.
A child is being admitted to the intensive care unit (ICU) and the parents are with the child. Which creates stressors for children and parents in ICUs? (Select all that apply.) a. Equipment noise b. Privacy c. Caring behavior by the nurse d. Unfamiliar smells e. Sleep deprivation
a. Equipment noise b. Privacy d. Unfamiliar smells e. Sleep deprivation
Which is the priority nursing intervention for an unconscious child after a fall? a. Establish adequate airway. b. Perform neurologic assessment. c. Monitor intracranial pressure. d. Determine whether a neck injury is present.
a. Establish adequate airway.
An 8-year-old is being admitted to the hospital from the emergency department with an injury from falling off her bicycle. Which will help her in her adjustment to the hospital? a. Explain hospital schedules to her, such as mealtimes. b. Use terms such as "honey" and "dear" to show a caring attitude. c. Explain when parents can visit and why siblings cannot come to see her. d. Orient her parents, because she is young, to her room and hospital facility.
a. Explain hospital schedules to her, such as mealtimes.
Which is the most appropriate nursing intervention to promote normalization in a school-age child with a chronic illness? a. Give the child as much control as possible. b. Ask the child's peer to make the child feel normal. c. Convince the child that nothing is wrong with him or her. d. Explain to parents that family rules for the child do not need to be the same as for healthy siblings.
a. Give the child as much control as possible.
Which clinical manifestations would the nurse prepare to assess if bacterial meningitis is confirmed? (Select all that apply.) a. Headache b. Photophobia c. Bulging anterior fontanel d. Seizures e. Poor muscle tone
a. Headache b. Photophobia d. Seizures
The inflammation associated with asthma contributes to which of the following? a. Heightened airway reactivity. b. Decreased resistance in the airway. c. Allergic hypersensitivity. d. Increased viscosity of mucous glad secretions.
a. Heightened airway reactivity.
Which assessment findings are consistent with Down Syndrome? (Select all that apply.) a. High arched narrow palate b. Protruding tongue c. Long, slender fingers d. Transverse palmar crease e. Hypertonic muscle tone
a. High arched narrow palate b. Protruding tongue d. Transverse palmar crease e. Hypertonic muscle tone
The nurse would expect to assess which clinical manifestations in an adolescent with Cushing syndrome? (Select all that apply.) a. Hyperglycemia b. Hyperkalemia c. Hypotension d. Cushingoid features e. Susceptibility to infections
a. Hyperglycemia d. Cushingoid features e. Susceptibility to infections
Which statement, made by the nurse, expresses accurately the genetic implications associated with cystic fibrosis? a. If it is present in a child, both parents are carriers of this defective gene. b. It is inherited as an autosomal dominant trait. c. It is a genetic defect found primarily in non-Caucasian population groups. d. There is a 50% chance that siblings of an affected child also will be affected.
a. If it is present in a child, both parents are carriers of this defective gene.
A previously "potty-trained" 30-month-old child has reverted to wearing diapers while hospitalized, and the nurse recognizes this as normal because of which reason? a. Is a typical reaction to stress. b. Developmental delays occur because of the hospitalization. c. The child is experiencing urinary urgency because of hospitalization. d. The child was too young to be "potty-trained."
a. Is a typical reaction to stress.
The parents of a child born with disabilities ask the nurse for advice about discipline. Which information about discipline would the nurse's response include? a. It is essential for normal development. b. It is too difficult to implement with a special-needs child. c. It is not needed unless the child becomes problematic. d. It is best achieved with punishment for misbehavior.
a. It is essential for normal development.
Which are clinical manifestations of increased intracranial pressure (ICP) in infants? (Select all that apply.) a. Lower extremity spasticity b. Sunken fontanel c. Diplopia and blurred vision d. Irritability e. Distended scalp veins f. Increased blood pressure
a. Lower extremity spasticity d. Irritability e. Distended scalp veins
A child with autism spectrum disorder (ASD) is admitted to the hospital with pneumonia. The nurse would plan which priority intervention when caring for the child? a. Maintain a structured routine and keep stimulation to a minimum. b. Place child in a room with a roommate of the same age. c. Maintain frequent touch and eye contact with the child. d. Take the child frequently to the playroom to play with other children.
a. Maintain a structured routine and keep stimulation to a minimum.
Which drug would the nurse expect to administer to a preschool child who has increased intracranial pressure (ICP) resulting from cerebral edema? a. Mannitol (Osmitrol) b. Epinephrine hydrochloride (Adrenalin) c. Atropine sulfate (Atropine) d. Sodium bicarbonate (Sodium bicarbonate)
a. Mannitol (Osmitrol)
Which interventions would the nurse plan to implement for a child with juvenile hypothyroidism? (Select all that apply.) a. Moisturizer for dry skin b. Antidiarrheal medications c. Medications to help with insomnia d. Implementation of thyroxine therapy e. Stool softener
a. Moisturizer for dry skin d. Implementation of thyroxine therapy e. Stool softener
The nurse is caring for a 5-year-old child who is scheduled for a tonsillectomy. Which action should the nurse include in the child's postoperative care plan? (Select all that apply.) a. Notify the surgeon if the child swallows frequently. b. Apply a heat collar to the child for pain relief. c. Place the child on the abdomen until fully awake. d. Prepare for oral liquids immediately following procedure. e. Encourage the child to cough frequently.
a. Notify the surgeon if the child swallows frequently. c. Place the child on the abdomen until fully awake.
An infant with hydrocephalus is hospitalized for surgical placement of a ventriculoperitoneal shunt. Which interventions would be included in the child's postoperative care? (Select all that apply.) a. Observe closely for signs of infection. b. Pump the shunt reservoir to maintain patency. c. Administer sedation to decrease irritability. d. Maintain Trendelenburg position to decrease pressure on the shunt. e. Observe for signs of increased intracranial pressure. f. Monitor for abdominal distention.
a. Observe closely for signs of infection. e. Observe for signs of increased intracranial pressure. f. Monitor for abdominal distention.
The nurse is taking care of a child who is alert but showing signs of increased intracranial pressure. Which test is contraindicated in this case? a. Oculovestibular response b. Doll's head maneuver c. Funduscopic examination for papilledema d. Assessment of pyramidal tract lesions
a. Oculovestibular response
Which are common features of acute glomerulonephritis? (Select all that apply.) a. Oliguria b. Hypotension c. Hematuria d. Proteinuria e. Hypovolemia
a. Oliguria c. Hematuria d. Proteinuria
Which describes avoidance behaviors parents may exhibit when learning that their child has a chronic condition? (Select all that apply.) a. Refuses to agree to treatment b. Shares burden of disorder with others c. Verbalizes possible loss of child d. Withdraws from outside world e. Punishes self because of guilt and shame
a. Refuses to agree to treatment d. Withdraws from outside world e. Punishes self because of guilt and shame
Which would be the major consideration when selecting toys for a child who is cognitively impaired? a. Safety b. Age appropriateness c. Ability to provide exercise d. Skill and dexterity
a. Safety
Which is the expected reaction from a hospitalized preschool child who is in isolation? a. Sees it as a punishment b. A threat to child's self-image c. An opportunity for regression d. Loss of companionship with friends
a. Sees it as a punishment
A nurse is caring for three toddlers and one preschooler. Which represents the major stressor of hospitalization for these four patients? a. Separation anxiety b. Loss of control c. Fear of bodily injury d. Fear of pain
a. Separation anxiety
The diagnostic criteria for autism include delayed or abnormal functioning in which areas? (Select all that apply.) a. Social communication b. Parallel play c. Gross motor development d. Growth below the 5th percentile for height and weight e. Symbolic or imaginative play f. Social interaction
a. Social communication c. Gross motor development e. Symbolic or imaginative play f. Social interaction
A nurse is instructing a nursing assistant on techniques to facilitate lipreading with a hearing- impaired child who lip reads. Which techniques would the nurse include? (Select all that apply.) a. Speak at eye level. b. Stand at a distance from the child. c. Speak words in a loud tone. d. Use facial expressions while speaking. e. Keep sentences short.
a. Speak at eye level. d. Use facial expressions while speaking. e. Keep sentences short.
When considering palliative care for a young child with a life-threatening illness, which is an important consideration? a. The family is included in the decision to shift the goals of treatment. b. The decision must be made by the health professionals involved in the child's care. c. The family needs to understand that palliative care takes place in the home. d. The decision should not be communicated to the family because it will encourage a sense of hopelessness.
a. The family is included in the decision to shift the goals of treatment.
The nurse is talking with the parents of a child who died 6 months ago. They sometimes still "hear" the child's voice and have trouble sleeping. How would the nurse interpret these feelings? a. These are normal grief responses. b. The pain of the loss is usually less by this time. c. These grief responses are more typical of the early stages of grief. d. This grieving is essential until the pain is gone and the child is gradually forgotten.
a. These are normal grief responses.
Which clinical manifestations would be expected in an upper or lower urinary tract infection in an infant? (Select all that apply.) a. Vomiting b. Jaundice c. Failure to gain weight d. Swelling of the face e. Persistent diaper rash f. Dyspnea
a. Vomiting c. Failure to gain weight e. Persistent diaper rash
Which would the nurse recommend to prevent urinary tract infections in young girls? a. Wear cotton underpants. b. Limit bathing as much as possible. c. Increase fluids; decrease salt intake. d. Cleanse perineum with water after voiding.
a. Wear cotton underpants.
Nursing care of a child diagnosed with a syndrome of inappropriate ADH would include which of the following? (Select all that apply.) a. Weigh daily b. Perform neurologic checks c. Turn frequently d. Maintain nothing by mouth (NPO) e. Restrict fluids
a. Weigh daily b. Perform neurologic checks e. Restrict fluids
The refractive disorder where light rays fall in front of the retina is referred to as ... a. myopia. b. amblyopia. c. cataract. d. glaucoma.
a. myopia.
The nurse comes into the room of a child who was just diagnosed with a chronic disability, and the child's parents begin to yell at the nurse about a variety of concerns. Which is the nurse's best response? a. "What is really wrong?" b. "Being angry is only natural." c. "Yelling at me will not change things." d. "I will come back when you settle down."
b. "Being angry is only natural."
The first term pregnant adolescent has understood the nurse's teaching if she makes which statement? (Select all that apply.) a. "I will be able to continue taking isotretinoin (Accutane) for my acne." b. "I will seek help immediately if I have a fever." c. "I should avoid any alcoholic beverages." d. "I can continue my phenytoin (Dilantin) dosage." e. "I will ensure my vaccinations are current and talk to my physician if they are not".
b. "I will seek help immediately if I have a fever." c. "I should avoid any alcoholic beverages." e. "I will ensure my vaccinations are current and talk to my physician if they are not".
A 5-year-old girl sustained a concussion when she fell out of a tree. In preparation for discharge, the nurse is discussing home care with her mother. Which statement made by the mother indicates a correct understanding of the teaching? (Select all that apply.) a. "I should expect my child to have a few episodes of vomiting." b. "My child may have changes in her normal sleep patterns." c. "My child may have some behavioral changes after the accident." d. "My child may experience headaches after the fall." e. "I will limit my child's physical activity for a minimum of one month."
b. "My child may have changes in her normal sleep patterns." c. "My child may have some behavioral changes after the accident." d. "My child may experience headaches after the fall."
The nurse has received report on four children. Which child would the nurse assess first? a. A school-age child in a coma with stable vital signs b. A preschool child with a head injury and decreasing level of consciousness c. An adolescent admitted after a motor vehicle accident is oriented to person and place d. A toddler in a persistent vegetative state with a low-grade fever
b. A preschool child with a head injury and decreasing level of consciousness
Parents of a child with Down syndrome ask the nurse about techniques for introducing solid food to their 8-month-old child's diet. The nurse would give the parents which priority instruction? a. It is too early to add solids; the parents should wait for 2 to 3 months. b. A small but long, straight-handled spoon should be used to push the food toward the back and side of the mouth. c. If the child thrusts the food out, the feeding should be stopped. d. Solids should be offered only three times a day.
b. A small but long, straight-handled spoon should be used to push the food toward
The nurse would suspect a hearing impairment in an infant who demonstrates which behavior? a. Absence of the Moro reflex b. Absence of babbling by age 7 months c. Lack of eye contact when being spoken to d. Lack of gesturing to indicate wants after age 15 months
b. Absence of babbling by age 7 months
What is chronic primary adrenocortical insufficiency also called? a. Graves disease b. Addison disease c. Cushing syndrome d. Hashimoto disease
b. Addison disease
Which would the nurse document as complementary or alternative medical practices? (Select all that apply.) a. Use of acetaminophen (Tylenol) for fever b. Administration of chamomile tea at bedtime c. Hypnotherapy for relief of pain d. Acupressure to relieve headaches e. Cool mist vaporizer at the bedside for "stuffiness"
b. Administration of chamomile tea at bedtime c. Hypnotherapy for relief of pain d. Acupressure to relieve headaches
A nurse in the emergency department is assessing a 5-year-old child with symptoms of pneumonia and a fever of 102 F. Which intervention can the nurse implement to promote a sense of control for the child? a. None; this is an emergency and the child should not participate in care. b. Allow the child to hold the digital thermometer while taking the child's blood pressure. c. Ask the child if it is OK to take a temperature in the ear. d. Have parents wait in the waiting room.
b. Allow the child to hold the digital thermometer while taking the child's blood pressure.
Which are the benefits of therapeutic play for a hospitalized child? (Select all that apply.) a. Serves as method to assist disturbed children. b. Allows the child to express feelings. c. The nurse can gain insight into the child's feelings. d. The child can deal with concerns and feelings. e. Gives the child a structured play environment.
b. Allows the child to express feelings. c. The nurse can gain insight into the child's feelings. d. The child can deal with concerns and feelings.
Which are late signs of increased intracranial pressure (ICP) in an infant? (Select all that apply.) a. Tachycardia b. Alteration in pupil size and reactivity c. Increased motor response d. Extension or flexion posturing e. Cheyne-Stokes respirations
b. Alteration in pupil size and reactivity d. Extension or flexion posturing e. Cheyne-Stokes respirations
The parents of a special health needs child is displaying an approach behavior when doing which of the following? a. Is unable to adjust to a progression of the disease or condition b. Anticipates future problems and seeks guidance and answers c. Looks for new cures without a perspective toward possible benefit d. Fails to recognize the seriousness of the child's condition despite physical evidence
b. Anticipates future problems and seeks guidance and answers
A nurse is caring for a school-age child with left unilateral pneumonia, pleural effusion, and a chest tube connected to closed chest drainage. Which interventions would the nurse implement when caring for this child? (Select all that apply.) a. Manual suctioning of the chest tube every shift b. Assessing the chest tube and drainage device for correct settings c. Administering prescribed doses of antibiotics d. Clamping the chest tube when child ambulates e. Monitoring for need of supplemental oxygen
b. Assessing the chest tube and drainage device for correct settings c. Administering prescribed doses of antibiotics e. Monitoring for need of supplemental oxygen
Calcium carbonate is given with meals to a child with chronic renal disease. Which is the purpose of administering calcium carbonate? a. Prevent vomiting b. Bind phosphorus c. Stimulate appetite d. Increase absorption of fat-soluble vitamins
b. Bind phosphorus
Which statement best describes a subdural hematoma? a. Bleeding occurs between the dura and the skull. b. Bleeding occurs between the dura and the arachnoid membrane. c. Bleeding is generally arterial, and brain compression occurs rapidly. d. The hematoma commonly occurs in the parietotemporal region.
b. Bleeding occurs between the dura and the arachnoid membrane.
Which is an implanted ear prosthesis for children with sensorineural hearing loss? a. Hearing aid b. Cochlear implant c. Auditory implant d. Amplification device
b. Cochlear implant
Examining the child's throat who has epiglottitis by using a tongue depressor might precipitate which symptom or condition? a. Inspiratory stridor b. Complete obstruction c. Sore throat d. Respiratory tract infection
b. Complete obstruction
A neonate born with ambiguous genitalia is diagnosed with congenital adrenogenital hyperplasia. Therapeutic management includes the administration of which substance? a. Vitamin D b. Cortisone c. Stool softeners d. Calcium carbonate
b. Cortisone
A nurse is reviewing the laboratory results on a school-age child with hypoparathyroidism. Which results are consistent with this condition? a. Decreased serum phosphorus b. Decreased serum calcium c. Increased serum glucose d. Decreased serum cortisol level
b. Decreased serum calcium
One of the clinical manifestations of chronic renal failure is uremic frost. Which best describes this term? a. Deposits of urea crystals in urine b. Deposits of urea crystals on skin c. Overexcretion of blood urea nitrogen d. Inability of body to tolerate cold temperatures
b. Deposits of urea crystals on skin
A nasal spray of desmopressin acetate (DDAVP) is used to treat which disorder? a. Hypopituitarism b. Diabetes insipidus c. Acute adrenocortical insufficiency d. Syndrome of inappropriate antidiuretic hormone
b. Diabetes insipidus
A mother reports that her 6-year-old child is highly active, irregular in habits and adapts slowly to new routines, people, or situations. How would the nurse chart this type of temperament? a. Easy b. Difficult c. Slow-to-warm-up d. Fast-to-warm-up
b. Difficult
Which intervention will encourage a sense of autonomy in a toddler with disabilities? a. Avoid separation from family during hospitalizations. b. Encourage independence in as many areas as possible. c. Expose child to pleasurable experiences as much as possible. d. Help parents learn special care needs of their child.
b. Encourage independence in as many areas as possible.
Which is an appropriate nursing intervention to minimize separation anxiety in a hospitalized toddler? a. Provide for privacy b. Encourage parents to room-in c. Explain procedures and routines d. Encourage contact with children the same age
b. Encourage parents to room-in
Which type of croup is always considered a medical emergency? a. Laryngitis b. Epiglottitis c. Spasmodic croup d. Laryngotracheobronchitis (LTB)
b. Epiglottitis
Which clinical manifestations would the nurse expect to assess in a child admitted with nephrotic syndrome? (Select all that apply.) a. Weight loss b. Facial edema c. Cloudy smoky brown-colored urine d. Fatigue e. Frothy-appearing urine
b. Facial edema d. Fatigue e. Frothy-appearing urine
The initial response from a parent when learning of a chronic or complex health condition is shock, which is followed by which response? a. Denial b. Guilt and self-accusation c. Social reintegration d. Acceptance of the child's limitations
b. Guilt and self-accusation
Which condition may cause exophthalmos (protruding eyeballs) in children? a. Hypothyroidism b. Hyperthyroidism c. Hypoparathyroidism d. Hyperparathyroidism
b. Hyperthyroidism
A 12-year-old child enjoys collecting stamps, playing soccer, and participating in Boy Scout activities. The nurse recognizes that the child is displaying which developmental task? a. Identity b. Industry c. Integrity d. Intimacy
b. Industry
The clinic nurse overhears school-age siblings tell their 6-year-old sister who is chronically ill, "It isn't fair that you get everything just because you are sick". Which is the nurse's best assessment of this situation? a. The siblings are immature and probably spoiled. b. Jealousy is a common reaction to the illness or hospitalization of a sibling. c. Family has ineffective coping mechanisms to deal with chronic illness. d. The siblings need to better understand their sister's illness and needs.
b. Jealousy is a common reaction to the illness or hospitalization of a sibling.
The nurse is caring for a child with acute respiratory distress syndrome (ARDS) associated with sepsis. Which is the priority nursing intervention? a. Forcing fluids b. Monitoring pulse oximetry c. Instituting seizure precautions d. Encouraging a high-protein diet
b. Monitoring pulse oximetry
Which are the vector reservoirs for agents causing viral encephalitis in the United States? a. Tarantula spiders b. Mosquitoes c. Carnivorous wild animals d. Domestic and wild animals
b. Mosquitoes
The nurse is closely monitoring a child who is unconscious after a fall and notices that the child suddenly has a fixed and dilated pupil. How would the nurse interpret these findings? a. Eye trauma b. Neurosurgical emergency c. Severe brainstem damage d. Indication of brain death
b. Neurosurgical emergency
A nurse is planning palliative care for a child with severe pain. Which would the nurse expect to be prescribed for pain relief? a. Opioids as needed b. Opioids on a regular schedule c. Distraction and relaxation techniques d. Nonsteroidal anti-inflammatory drugs
b. Opioids on a regular schedule
Which consideration is the most important in managing tuberculosis (TB) in children? a. Skin testing annually b. Pharmacotherapy c. Adequate nutrition d. Adequate hydration
b. Pharmacotherapy
The nurse is conducting a staff in-service on newborn defects of the genitourinary system. Which describes the narrowing of the preputial opening of the foreskin? a. Chordee b. Phimosis c. Epispadias d. Hypospadias
b. Phimosis
The feeling of guilt that the child "caused" the disability or illness is especially critical in which child? a. Toddler b. Preschooler c. School-age child d. Adolescent
b. Preschooler
Which are appropriate interventions to facilitate socialization of the cognitively impaired child? a. Provide age-appropriate toys and play activities. b. Provide peer experiences, such as scouting, when older. c. Avoid exposure to strangers who may not understand cognitive development. d. Emphasize mastery of physical skills because they are delayed more often than verbal skills.
b. Provide peer experiences, such as scouting, when older.
Which best describes why toddlers have fewer respiratory tract infections as they grow older? a. The amount of lymphoid tissue decreases. b. Repeated exposure to organisms causes increased immunity. c. Viral organisms are less prevalent in the population. d. Secondary infections rarely occur after viral illnesses.
b. Repeated exposure to organisms causes increased immunity.
Which is included in the diet of a child with minimal change nephrotic syndrome? a. High protein b. Salt restriction c. Low fat d. High carbohydrate
b. Salt restriction
Distortion of sound and problems in discrimination are characteristic of which type of hearing loss? a. Conductive b. Sensorineural c. Mixed conductive-sensorineural d. Central auditory imperceptive
b. Sensorineural
A school-age child with chronic renal failure is admitted to the hospital with a serum potassium level of 5.2 mEq/L. Which prescribed medication would the nurse plan to administer? a. Spironolactone (Aldactone) b. Sodium polystyrene sulfonate (Kayexalate) c. Lactulose (Cephulac) d. Calcium carbonate (Calcitab)
b. Sodium polystyrene sulfonate (Kayexalate)
Most cases of acute glomerulonephritis are associated with which of the following? a. Urinary tract infection b. Streptococcal infection c. Renal vascular disorders d. Structural anomalies of genitourinary tract
b. Streptococcal infection
A nurse is caring for a child who is near death. Which physical signs indicate the child is approaching death? (Select all that apply.) a. Body feels warm b. Tactile sensation decreasing c. Speech becomes rapid d. Change in respiratory pattern e. Difficulty swallowing
b. Tactile sensation decreasing d. Change in respiratory pattern e. Difficulty swallowing
Which would the nurse consider when discussing language development with parents of toddlers? a. Sentences by toddlers include adverbs and adjectives. b. The toddler expresses himself or herself with verbs or combination words. c. The toddler uses simple sentences. d. Pronouns are used frequently by the toddler.
b. The toddler expresses himself or herself with verbs or combination words.
A young child has an intelligence quotient (IQ) of 45. The nurse would document this finding as a. mild cognitive impairment. b. moderate cognitive impairment. c. severe cognitive impairment. d. profound cognitive impairment.
b. moderate cognitive impairment.
When taking the history of a child hospitalized with Reye syndrome, the nurse would not be surprised that a week ago the child had recovered from a. measles b. varicella. c. meningitis. d. hepatitis.
b. varicella.
The nurse is caring for an adolescent who had an external fixator placed after suffering a fracture of the wrist during a bicycle accident. Which statement by the adolescent would be expected about separation anxiety? a. "I wish my parents could spend the night with me while I am in the hospital." b. "I think I would like for my siblings to visit me but not my friends." c. "I hope my friends don't forget about visiting me." d. "I will be embarrassed if my friends come to the hospital to visit."
c. "I hope my friends don't forget about visiting me."
The nurse is teaching the parents of a child who is receiving methimazole (Tapazole) for the treatment of hyperthyroidism (Graves disease). Which statement made by the parent indicates a correct understanding of the teaching? a. "I would expect my child to gain weight while taking this medication." b. "I would expect my child to experience episodes of ear pain while taking this medication." c. "If my child develops a sore throat and fever, I should contact the physician immediately." d. "If my child develops the stomach flu, my child will need to be hospitalized."
c. "If my child develops a sore throat and fever, I should contact the physician immediately."
The nurse is teaching parents of a child with chronic renal failure (CRF) about the use of recombinant human erythropoietin (rHuEPO) subcutaneous injections. Which statement indicates the parents have understood the teaching? a. "These injections will help with the hypertension." b. "We're glad the injections only need to be given once a month." c. "The red blood cell count should begin to improve with these injections." d. "Urine output should begin to improve with these injections."
c. "The red blood cell count should begin to improve with these injections."
By Which age does birth length usually double? a. 1 year b. 2 years c. 4 years d. 6 years
c. 4 years
At which age do most children have an adult concept of death as being inevitable, universal, and irreversible? a. 4 to 5 years b. 6 to 7 years c. 9 to 10 years d. 12 to 13 years
c. 9 to 10 years
A 14-year-old boy is being admitted to the hospital for an appendectomy. Which roommate would the nurse assign with this patient? a. A 4-year-old boy post-appendectomy surgery b. A 6-year-old boy with pneumonia c. A 15-year-old boy admitted with a vasoocclusive sickle cell crisis d. A 12-year-old boy with cellulitis
c. A 15-year-old boy admitted with a vasoocclusive sickle cell crisis
The nurse observes that a seriously ill child passively accepts all painful procedures. Which would the nurse recognize this child is most likely experiencing? a. A sense of hopefulness b. A sense of chronic sorrow c. A belief that procedures are a deserved punishment d. A belief that procedures are an important part of care
c. A belief that procedures are a deserved punishment
When is it generally recommended that a child with acute streptococcal pharyngitis return to school? a. When sore throat has improved. b. If no complications develop. c. After taking antibiotics for 24 hours. d. After taking antibiotics for 3 days.
c. After taking antibiotics for 24 hours.
The parents of a hospitalized 3-year-old tell the nurse that they are going to buy her "a lot of new toys, because she will be in the hospital." The nurse's reply would be based on an understanding of which concept? a. New toys make hospitalization easier. b. New toys are usually better than older ones for children of this age. c. At this age, children often need the comfort and reassurance of familiar toys from home. d. Buying new toys for a hospitalized child is a maladaptive way to cope with parental guilt.
c. At this age, children often need the comfort and reassurance of familiar toys from home.
A school-age child, admitted for intravenous antibiotic therapy for osteomyelitis, reports difficulty in going to sleep at night. Which intervention would the nurse implement to assist the child in going to sleep at bedtime? a. Request a prescription for a sleeping pill. b. Allow the child to stay up late and sleep late in the morning. c. Create a schedule similar to the one the child follows at home. d. Plan passive activities in the morning and interactive activities right before bedtime.
c. Create a schedule similar to the one the child follows at home.
Which test is the most useful clinical indication of glomerular filtration rate? a. pH b. Osmolality c. Creatinine d. Protein level
c. Creatinine
The parents of a child who has just been diagnosed with type 1 diabetes asks about exercise. Which would the nurse explain about exercise in type 1 diabetes? a. Exercise will increase blood glucose. b. Exercise should be restricted. c. Extra snacks are needed before exercise. d. Extra insulin is required during exercise.
c. Extra snacks are needed before exercise
Which is the most common congenital anomaly associated with Down Syndrome? a. Pernicious anemia b. Pyloric stenosis c. Heart malformation d. Hip dysplasia
c. Heart malformation
The nurse is caring for a school-age child with hyperthyroidism (Graves disease). Which clinical manifestations would the nurse monitor that may indicate a thyroid storm? (Select all that apply.) a. Constipation b. Hypotension c. Hyperthermia d. Tachycardia e. Vomiting
c. Hyperthermia d. Tachycardia e. Vomiting
The nurse is discussing sexuality with the parents of an adolescent girl with moderate cognitive impairment. Which would the nurse consider with this topic? a. Sterilization is recommended for any adolescent with cognitive impairment. b. Sexual drive and interest are limited in individuals with cognitive impairment. c. Individuals with cognitive impairment need a well-defined, concrete code of sexual conduct. d. Contraceptive protection should not be considered an option.
c. Individuals with cognitive impairment need a well-defined, concrete code of sexual conduct.
A father calls the emergency department nurse saying that his daughter's eyes burn after getting some dishwasher detergent in them. The nurse should recommend which action before the child is transported to the Emergency Department for evaluation? a. Keep eyes closed. b. Apply cold compresses. c. Irrigate eyes copiously with tap water for 20 minutes. d. Prepare a normal saline solution (salt and water) and irrigate eyes for 20 minutes.
c. Irrigate eyes copiously with tap water for 20 minutes.
Place in order the sequence of cephalocaudal development that the nurse expects to find in the infant. Begin with the first development expected, sequencing to the final. Provide answers using lowercase letters separated by commas (e.g., A, B, C, D). a. Crawl b. Sit unsupported c. Lift head when prone d. Gain complete head control e. Walk
c. Lift head when prone d. Gain complete head control b. Sit unsupported a. Crawl e. Walk
Which is the initial clinical manifestation of generalized seizures? a. Being confused b. Feeling frightened c. Losing consciousness d. Seeing flashing lights
c. Losing consciousness
Which is an appropriate nursing intervention when caring for an unconscious child? a. Change the child's position infrequently to minimize the chance of increased ICP b. Avoid using narcotics or sedatives to provide comfort and pain relief c. Monitor fluid intake and output carefully to avoid fluid overload and cerebral edema d. Give tepid sponge baths to reduce fever because antipyretics are contraindicated
c. Monitor fluid intake and output carefully to avoid fluid overload and cerebral edema
Which insulin preparations are rapid and short acting? (Select all that apply.) a. Novolin N b. Lantus c. NovoLog d. Novolin R
c. NovoLog d. Novolin R
A nurse is preparing to complete an admission assessment on a 2-year-old child who is sitting on the parent's lap. Which technique would the nurse implement to complete the physical exam? a. Ask the parent to place the child in the hospital crib. b. Take the child and parent to the exam room. c. Perform the exam while the child is on the parent's lap. d. Ask the child to stand by the parent while completing the exam.
c. Perform the exam while the child is on the parent's lap.
A school-age child is diagnosed with a life-threatening illness, and the parents want to protect their child from knowing the seriousness of the illness. Which would the nurse tell the parents? a. This will help the child cope effectively by denial. b. This attitude is helpful to give parents time to cope. c. Terminally ill children know when they are seriously ill. d. Terminally ill children usually choose not to discuss the seriousness of their illness
c. Terminally ill children know when they are seriously ill.
A new nurse is orienting to the unit and displays an understanding of Fragile X Syndrome when using which descriptor? a. A chromosomal defect affecting females only b. A chromosomal defect that follows the pattern of X-linked recessive disorders c. The second most common genetic cause of cognitive impairment d. The most common cause of noninherited cognitive impairment
c. The second most common genetic cause of cognitive impairment
A 16-year-old with a chronic illness has recently become rebellious and is taking risks such as missing doses of his medication. Which is the best explanation for this behavior? a. Needs more discipline b. Needs more socialization with peers c. This is part of normal adolescence d. This is how he is asking for more parental control
c. This is part of normal adolescence
Which is a major complication in a child with chronic renal failure? a. Hypokalemia b. Metabolic alkalosis c. Water and sodium retention d. Excessive excretion of blood urea nitrogen
c. Water and sodium retention
A child with hypoparathyroidism is receiving vitamin D therapy. The parents would be advised to watch for which sign of vitamin D toxicity? a. Headache and seizures b. Physical restlessness and voracious appetite without weight gain c. Weakness and lassitude d. Anorexia and insomnia
c. Weakness and lassitude
An infant who weighs 7 pounds (3.18 kilograms) at birth would be expected to weigh how many pounds/kilograms at age 1 year? a. 15 lbs/6.80 kg b. 17 lbs/7.71 kg c. 19 lbs/8.62 kg d. 21 lbs/9.53 kg
d. 21 lbs/9.53 kg
Which statement is most characteristic of a preschooler's stage of moral development according to Kohlberg? a. Obeying the rules of correct behavior is important. b. Showing respect for authority is important behavior. c. Behavior that pleases others is considered good. d. Actions are determined as good or bad in terms of their consequences.
d. Actions are determined as good or bad in terms of their consequences.
The nurse is caring for a child with acute renal failure. Which clinical manifestation would the nurse recognize as a sign of hyperkalemia? a. Dyspnea b. Seizure c. Oliguria d. Cardiac arrhythmia
d. Cardiac arrhythmia
A nurse is preparing a teaching session for parents on prevention of childhood hearing loss. Which is the most common cause of hearing impairment in children? a. Auditory nerve damage b. Congenital ear defects c. Congenital rubella d. Chronic otitis media
d. Chronic otitis media
A nurse is planning play activities for school-age children. Which type of a play activity would the nurse plan? a. Solitary b. Parallel c. Associative d. Cooperative
d. Cooperative
Trauma to which site can result in a growth problem for children's long bones? a. Matrix b. Connective tissue c. Calcified cartilage d. Epiphyseal cartilage plate
d. Epiphyseal cartilage plate
Which is a common initial reaction of parents to illness or injury and hospitalization of their child? a. Anger b. Indifference c. Depression d. Helplessness
d. Helplessness
The mother of a toddler yells to the nurse, "Help! He is choking to death on his food." The nurse determines that lifesaving measures are necessary based on which symptom? a. Gagging b. Coughing c. Pulse over 100 beats/min d. Inability to speak
d. Inability to speak
Which is the most common cause of acute renal failure in children? a. Pyelonephritis b. Tubular destruction c. Urinary tract obstruction d. Inadequate perfusion
d. Inadequate perfusion
Which statement is accurate about lymphoid tissue? a. It reaches adult size by age 1 year. b. It quits growing by 6 years of age. c. Is poorly developed at birth. d. Is twice the adult size by ages 10 to 12 years.
d. Is twice the adult size by ages 10 to 12 years.
Which statement is true about the basal metabolic rate (BMR) in children? a. It is reduced by fever. b. It is lowest in newborn infants. c. It increases with age of child. d. It is slightly higher in boys than in girls at all ages.
d. It is slightly higher in boys than in girls at all ages.
A child is unconscious after a motor vehicle accident. The watery discharge from the nose tests positive for glucose. Which does this finding suggest? a. Diabetic coma b. Brainstem injury c. Upper respiratory tract infection d. Leaking of cerebrospinal fluid (CSF)
d. Leaking of cerebrospinal fluid (CSF)
The nurse is assessing a child who was just admitted to the hospital for observation after a head injury. Which is the most essential part of the nursing assessment to detect early signs of a worsening condition? a. Posturing b. Vital signs c. Focal neurologic signs d. Level of consciousness
d. Level of consciousness
The nurse recognizes that treatment for a child with precocious puberty will involve the injection of which synthetic medication? a. Thyrotropin b. Gonadotropins c. Somatotropic hormone d. Luteinizing hormone-releasing hormone
d. Luteinizing hormone-releasing hormone
Pancreatic enzymes are administered to the child with cystic fibrosis (CF). What nursing considerations should be included? a. Do not administer pancreatic enzymes if the child is receiving antibiotics. b. Decrease dose of pancreatic enzymes if the child is having frequent, bulky stools. c. Administer pancreatic enzymes between meals if at all possible. d. Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal.
d. Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal.
The nurse is caring for a preschool child with suspected diabetes insipidus. Which clinical manifestation would the nurse expect to observe? a. Oliguria b. Glycosuria c. Nausea and vomiting d. Polyuria and polydipsia
d. Polyuria and polydipsia
How is a 5-year-old child's skeletal age best determined? a. Assessment of dentition b. Assessment of height over time c. Facial bone development d. Radiographs of the hand and wrist
d. Radiographs of the hand and wrist
Which nursing intervention would the nurse include to help the siblings of a child with special needs cope? a. Explain to the siblings that embarrassment is unhealthy b. Encourage the parents not to expect siblings to help them care for the child with special needs c. Provide information to the siblings about the child's condition only as they request it d. Suggest to the parents ways of showing gratitude to the siblings who help care for the child with special needs
d. Suggest to the parents ways of showing gratitude to the siblings who help care for the child with special needs
The nurse is admitting a newborn with hypospadias to the nursery. The nurse expects which finding in this newborn? a. Absence of a urethral opening is noted. b. Penis appears shorter than usual for age. c. The urethral opening is along the dorsal surface of the penis. d. The urethral opening is along the ventral surface of the penis
d. The urethral opening is along the ventral surface of the penis
Because a visitor arrives at a daycare center during lunchtime, preschool children think that every time they have lunch a visitor will arrive. Which preoperational characteristic is being displayed? a. Egocentrism b. Conservation c. Intuitive reasoning d. Transductive reasoning
d. Transductive reasoning
A school nurse notes that school-age children generally obey the rules at school and attributes this to which stage of moral development? a. Preconventional b. Conventional c. Postconventional d. Undifferentiated e. Sense-pleasure
d. Undifferentiated
A child with diabetes mellitus presents to the clinic with a sore throat, cough, low-grade fever and a blood glucose level of 245 mg/dl. The nurse instructs the parent to do which of the following during the illness? a. Decrease fluid intake during convalescence. b. Check blood glucose levels every 30 minutes. c. Provide high calorie snacks every few hours. d. Urine testing for ketones every three hours.
d. Urine testing for ketones every three hours.
The mother of a 1-month-old infant tells the nurse she worries that her baby will get meningitis like her oldest son did when he was an infant. The nurse would base her response on which statement? a. Meningitis rarely occurs during infancy. b. Often a genetic predisposition to meningitis is found. c. Vaccination to prevent all types of meningitis is now available. d. Vaccination to prevent Haemophilus influenzae type B meningitis has decreased the frequency of this disease in children.
d. Vaccination to prevent Haemophilus influenzae type B meningitis has decreased the frequency of this disease in children.
A preschool child is being admitted to the hospital with dehydration and a urinary tract infection (UTI). Which urinalysis result would the nurse expect with these conditions? a. WBC <1; specific gravity 1.008 b. WBC <2; specific gravity 1.025 c. WBC >2; specific gravity 1.016 d. WBC >2; specific gravity 1.030
d. WBC >2; specific gravity 1.030
A nurse is conducting parenting classes for parents of children ranging in ages 2 to 7 years. The parents understand the term egocentrism when they indicate it means a. selfishness. b. self-centeredness. c. preferring to play alone. d. unable to put self in another's place.
d. unable to put self in another's place.
Children taking phenobarbital (phenobarbital sodium) and/or phenytoin (Dilantin) may experience a deficiency of a. calcium. b. vitamin C. c. fat-soluble vitamins. d. vitamin D and folic acid.
d. vitamin D and folic acid.