Peds EXAM 4

A nurse is caring for a 7-year-old girl scheduled for an intravenous pyelogram (IVP). Which action would be the priority before the test? A) Checking with the parents for any allergies B) Ensuring adequate hydration C) Giving the girl an enema D) Screening her for pregnancy

A) Checking with the parents for any allergies

An 8-month-old infant is brought to the clinic for evaluation. The mother tells the nurse that she has noticed some white patches on the infant's tongue that look like curdled milk after breastfeeding. The nurse suspects oral candidiasis (thrush). Which question would the nurse use to help confirm this suspicion? A) "Are you having breast pain when you nurse the baby?" B) "Has he had any dairy problems recently?" C) "Is he experiencing any vomiting lately?" D) "How have his stools been this past week?"

A) "Are you having breast pain when you nurse the baby?"

The nurse is taking a health history of an 11-year-old girl with recurrent abdominal pain. Which response would lead the nurse to suspect irritable bowel syndrome? A) "I always feel better after I have a bowel movement." B) "I don't take any medicine right now." C) "The pain comes and goes." D) "The pain doesn't wake me up in the middle of the night."

A) "I always feel better after I have a bowel movement."

The nurse is teaching the mother of a 5-year-old boy with a history of impaction how to administer enemas at home. Which response from the mother indicates a need for further teaching? A) "I should position him on his abdomen with knees bent." B) "He will require 250 to 500 mL of enema solution." C) "I should wash my hands and then wear gloves." D) "He should retain the solution for 5 to 10 minutes."

A) "I should position him on his abdomen with knees bent."

The nurse is caring for a 3-year-old girl with short bowel syndrome as a result of trauma to the small intestine. The girl's mother is extremely anxious and tells the nurse she is afraid she will never learn how to care for her daughter at home. How should the nurse respond? A) "I will help you become an expert on your daughter's care." B) "You must learn how to care for your daughter at home." C) "You really need the support of your husband." D) "There is a lot to learn and you need a positive attitude."

A) "I will help you become an expert on your daughter's care."

The nurse is caring for a 12-year-old girl with nephrotic syndrome. The girl confides that she feels like a "freak" compared to her peers because of her weight, edema, and moon face. Which response by the nurse would be most appropriate? A) "Let's put you in touch with some other girls who are also having the same body changes." B) "Luckily, this is just a temporary, unfortunate part of your condition; you need to accept it." C) "Your real friends do not care about your appearance and just want you to get well." D) "You are beautiful in your own way; what matters is what is on the inside."

A) "Let's put you in touch with some other girls who are also having the same body changes."

The nurse is caring for a 4-year-old girl with vulvovaginitis. After explaining to the girl's mother how to help prevent subsequent episodes, which statement by the mother indicates a need for additional teaching? A) "She needs to wipe from front to back." B) "I will make sure she changes her underwear every day." C) "She should probably avoid bubble baths." D) "I will help supervise her wiping after bowel movements."

A) "She needs to wipe from front to back."

An infant is diagnosed with a congenital cataract. What would the nurse expect to assess? A) Absent red reflex B) Rapid irregular eye movement C) Misalignment of the eyes D) Enlarged eye appearance

A) Absent red reflex

After assessing a child's blood pressure, the nurse determines the pulse pressure and finds that it is narrowed. What would the nurse identify as associated with this finding? A) Aortic stenosis B) Patent ductus arteriosus C) Aortic insufficiency D) Complete heart block

A) Aortic stenosis

The mother of a school-age child brings the child to the clinic for evaluation because he is having difficulty reading. His last visual screening was normal. He also reports headaches and dizziness. What would the nurse suspect? A) Astigmatism B) Myopia C) Hyperopia D) Nystagmus

A) Astigmatism

The nurse is caring for a 10-year-old with allergic conjunctivitis. The nurse would be alert to the child's increased risk for what issue? A) Atopic dermatitis B) Insect bite sensitivity C) Acute otitis media D) Frequent sore throats

A) Atopic dermatitis

A child with heart failure is receiving supplemental oxygen. The nurse understands that in addition to improving oxygen saturation, this intervention also has what effect? A) Cause vasodilation B) Increase pulmonary vascular resistance C) Promote diuresis D) Mobilize secretions

A) Cause vasodilation

A nurse is developing a plan of care for a child who is admitted to the hospital for surgery. The child is visually impaired. What would be most appropriate for the nurse to include in the child's plan of care? Select all that apply. A) Explaining instructions using simple and specific terms the child understands B) Allowing the child to explore the postoperative equipment with his hands C) Touching the child on his shoulder before letting the child know someone is there D) Using the child's body parts to refer to the area where he may have postoperative pain E) Speaking to the child in a voice that is slightly louder than the usual tone of voice

A) Explaining instructions using simple and specific terms the child understands B) Allowing the child to explore the postoperative equipment with his hands D) Using the child's body parts to refer to the area where he may have postoperative pain

The nurse is caring for a child who is experiencing an acute renal transplant rejection and is to receive muromonab-CD3. What would the nurse most likely expect to assess after the first dose is administered? A) Fever with chills, chest tightness B) Cough, hyperkalemia C) Photosensitivity, gastrointestinal (GI) upset D) Urinary retention, decreased appetite

A) Fever with chills, chest tightness

An infant is diagnosed with infantile glaucoma. When developing the plan of care for the infant, for what would the nurse expect to prepare the infant and family? A) Goniotomy B) Antibiotic therapy C) Contact lenses D) Patching of affected eye

A) Goniotomy

The nurse is developing a plan of care for a 5-year-old child with a severe hearing impairment focusing on psychosocial interventions based on assessment findings. Which behavior would the nurse have most likely assessed? A) Immature emotional behavior B) Self-stimulatory actions C) Inattention and vacant stare D) Head tilt or forward thrust

A) Immature emotional behavior

A child is diagnosed with Kawasaki disease and is in the acute phase of the disorder. What would the nurse expect the physician to prescribe? Select all that apply. A) Intravenous immunoglobulin B) Ibuprofen C) Acetaminophen D) Aspirin E) Alprostadil

A) Intravenous immunoglobulin C) Acetaminophen D) Aspirin

The nurse is educating the parents of a 7-year-old boy with asthma about the medications that have been prescribed. Which drug would the nurse identify as an adjunct to a b2-adrenergic agonist for treatment of bronchospasm? A) Ipratropium B) Montelukast C) Cromolyn D) Theophyllin

A) Ipratropium

The nurse is providing care to a child with pancreatitis. When reviewing the child's laboratory test results, what would the nurse expect to find? Select all that apply. A) Leukocytosis B) Decreased C-reactive protein C) Elevated serum amylase levels D) Positive stool culture E) Decreased serum lipase levels

A) Leukocytosis C) Elevated serum amylase levels

A nurse is reviewing the medical record of a child and finds that the child has a grade III murmur. After auscultating the child's heart sounds, how would the nurse document this murmur? A) Loud without a thrill B) Loud with a precordial thrill C) Soft and easily heard D) Loud, audible with a stethoscope

A) Loud without a thrill

The nurse is assessing a 7-year-old boy with pharyngitis. What assessment finding would suggest the child has developed a peritonsillar abscess? A) Palatal edema B) Difficulty swallowing C) Rash on the abdomen D) Sore throat and headache

A) Palatal edema

The nurse is preparing to provide tracheostomy care to an infant. After gathering the necessary equipment, which action would the nurse take next? A) Position the infant supine with a towel roll under the neck B) Cut the new tracheostomy ties to the appropriate length C) Cut the tracheostomy ties from around the tracheostomy tube D) Cleanse around the site of the tracheostomy with the prescribed solution

A) Position the infant supine with a towel roll under the neck

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

A) Suctioning a tracheostomy tube

A nurse is caring for a 14-year-old girl scheduled for a barium swallow/upper gastrointestinal (GI) series. Before providing instructions, what would be the priority? A) Screening the girl for pregnancy B) Reminding her to drink plenty of fluids after the procedure C) Ordering a bowel preparation D) Reminding the girl about potential light-colored stools

A) Screening the girl for pregnancy

The nurse is conducting a physical examination of a child with a suspected cardiovascular disorder. Which finding would the nurse most likely expect to assess if the child had transposition of the great vessels? A) Significant cyanosis without presence of a murmur B) Abrupt cessation of chest output with an increase in heart rate/filling pressure C) Soft systolic ejection D) Holosystolic murmur

A) Significant cyanosis without presence of a murmur

A child requires supplemental oxygen therapy at 8 liters per minute. Which delivery device would the nurse most likely expect to be used? A) Simple mask B) Venturi mask C) Nasal cannula D) Oxygen hood

A) Simple mask

The nurse is determining maintenance fluid requirements for a child who weighs 25 kg. How much fluid would the child need per day? A) 1,560 mL B) 1,600 mL C) 1,650 mL D) 1,700 mL

B) 1,600 mL

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

A) Suctioning a tracheostomy tube

A group of students are reviewing information about gallbladder disease in children. The students demonstrate a need for additional review when they state: A) cholesterol gallstones are more frequently found in males. B) pigment stones are found primarily in the common bile duct. C) pancreatitis is a common complication of cholecystitis in children. D) cholecystitis is due to chemical irritation from obstructed bile flow.

A) cholesterol gallstones are more frequently found in males.

A 15-year-old boy comes to the emergency department accompanied by his parents. The boy reports an abrupt onset of sudden pain on the right side of his scrotum. When asked to rate his pain on a scale of 1 to 10, with 10 being the most severe, the boy states, "It's a 12." Further assessment reveals a blue-black swelling on the affected side. The nurse suspects testicular torsion and immediately notifies the physician because: A) the condition is a surgical emergency. B) the boy is at risk for sepsis. C) intravenous antibiotics need to be initiated. D) renal failure is imminent

A) the condition is a surgical emergency.

A child returns from surgery in which a stoma was created in the abdominal wall to the bladder. The nurse identifies this as a: A) vesicostomy. B) ureteral stent. C) continent urinary diversion. D) bladder augmentation.

A) vesicostomy.

The nurse is assessing a child with acute poststreptococcal glomerulonephritis. What would the nurse expect to assess? Select all that apply. A) Irritability B) Abdominal pain C) Hypertension D) Crackles E) Polyphagia

B) Abdominal pain C) Hypertension D) Crackles

While presenting a panel discussion to a group of parents about urinary tract infections (UTIs) in children, one of the parents asks the nurse, "Why would my daughter be more at risk than my son?" Which response by the nurse would be most accurate? A) "Girls have a smaller bladder size than boys do." B) "A girl's urethra is closer to the rectal opening." C) "A girl's urethra is longer than a boy's urethra." D) "Her kidneys are less well protected."

B) "A girl's urethra is closer to the rectal opening."

The nurse is caring for a 2-month-old with a cleft palate. The child will undergo corrective surgery at age 3 months. The mother would like to continue breastfeeding the baby after surgery and wonders if it is possible. How should the nurse respond? A) "There is a good chance that you will be able to breastfeed almost immediately." B) "Breastfeeding is likely to be possible, but check with the surgeon." C) "After the suture line heals, breastfeeding can resume." D) "We will have to wait and see what happens after the surgery."

B) "Breastfeeding is likely to be possible, but check with the surgeon."

The nurse is taking a health history of a child with suspected acute poststreptococcal glomerulonephritis. Which response would alert the nurse to a confirmed risk factor for this condition? A) "She has been very healthy up to now." B) "He just got over a head cold with laryngitis." C) "My child is just 18 months old." D) "My child has not been sick at all."

B) "He just got over a head cold with laryngitis."

The nurse is caring for a 6-month-old with a cleft lip and palate. The mother of the child demonstrates understanding of the disorder with which statements? Select all that apply. A) "My smoking during pregnancy didn't have anything to do with this disorder. Smoking primarily causes low birth weight." B) "I know my baby takes a lot longer to feed than most children this age." C) "It really worries me that my baby may have some other disorders that haven't been detected yet." D) "I wonder if my baby will develop speech problems when language development begins?" E) "Thankfully there are doctors that specialize in correcting this type of disorder."

B) "I know my baby takes a lot longer to feed than most children this age." C) "It really worries me that my baby may have some other disorders that haven't been detected yet." D) "I wonder if my baby will develop speech problems when language development begins?" E) "Thankfully there are doctors that specialize in correcting this type of disorder."

The mother of a 3-week-old infant old brings her daughter in for an evaluation. During the visit, the mother tells the nurse that her baby is spitting up after feedings. Which response by the nurse would be most appropriate? A) "We need to tell the doctor about this." B) "Infants this age commonly spit up." C) "Your daughter might have an allergy." D) "Don't worry; you're just feeding her too much."

B) "Infants this age commonly spit up."

The parents of a 10-year-old girl with a refractive error ask the nurse about the possibility of laser surgery to correct the vision. Which statement by the nurse would be most appropriate? A) "As she gets older, her vision will begin to correct itself." B) "Laser surgery typically is not done until she's 18 years old." C) "She looks so cute in her glasses; why put her through surgery?" D) "She can use contact lenses soon, so surgery isn't necessary."

B) "Laser surgery typically is not done until she's 18 years old."

The nurse is caring for a 4-year-old with a suspected urinary tract infection. What would be most appropriate when obtaining a urine specimen from the child? A) "I will need a urine sample." B) "Let your mom help you tinkle in this cup." C) "Please tinkle in this cup right now." D) "Please void in this cup instead of the toilet."

B) "Let your mom help you tinkle in this cup."

A child is diagnosed with bacterial conjunctivitis and is prescribed topical antibiotic therapy. The child's mother asks when he can return to school. Which response by the nurse would be most appropriate? A) "You need to wait until you finish the entire prescription of antibiotic." B) "Once the drainage is gone, he can go back to school." C) "You can send him to school this afternoon after his first dose of antibiotic." D) "He needs to be symptom-free for at least 72 hours."

B) "Once the drainage is gone, he can go back to school."

The nurse is performing a gastrointestinal assessment on a 7-year-old boy. The parents are assisting with the history. Which assessment findings are indicative of constipation? Select all that apply. A) "Our child only has 3 to 4 bowel movements per week." B) "Our child complains of pain because his bowel movements are so hard." C) "Our child tells us that his belly hurts a lot of the time." D) "I can tell he holds his bowel movement much of the time because of the way he stands." E) "I find smears of stool in his underwear almost every day."

B) "Our child complains of pain because his bowel movements are so hard." C) "Our child tells us that his belly hurts a lot of the time." D) "I can tell he holds his bowel movement much of the time because of the way he stands." E) "I find smears of stool in his underwear almost every day."

The nurse is caring for an infant girl with a suspected cardiovascular disorder. Which statement by the mother would warrant further investigation? A) "My baby does not make any grunting noises." B) "The baby seems more comfortable over my shoulder." C) "The baby usually drinks all of her bottle." D) "I don't notice any rapid breathing patterns."

B) "The baby seems more comfortable over my shoulder."

The school nurse is working with a 10-year-old girl with recurrent abdominal pain. The girl's teacher has been less than understanding about the frequent absences and trips to the nurse's office. How should the nurse respond? A) "Be patient; she is trying some new medication." B) "The pain she is having is real." C) "The family is working toward improvement." D) "Please do not add to this family's stress."

B) "The pain she is having is real."

After teaching the parents of a child with a hydrocele about this condition, which statement indicates that the teaching was successful? A) "If this gets worse and we don't treat it, our son could become infertile." B) "This condition should gradually go away on its own." C) "The surgeon is going to operate on him immediately." D) "It's going to be difficult putting ice packs on his scrotum."

B) "This condition should gradually go away on its own."

After teaching a group of new parents about their newborns' eyes and vision, which statement by the group indicates effective teaching? A) "Our newborn can see at distances of about 1 to 2 feet." B) "We won't know the baby's eye color until he's at least 6 months old." C) "A baby can easily distinguish colors, but they must be bright colors." D) "A newborn can focus with both eyes at the same time shortly after birth."

B) "We won't know the baby's eye color until he's at least 6 months old."

The nurse is caring for a newborn diagnosed with an atrial septal defect (ASD). The parents voice concern and state, "I can't believe this is happening. Will our child be okay?" What is the nurse's best response? A) "If the defect isn't treated it can cause problems such as pulmonary hypertension, heart failure, atrial arrhythmias, or stroke." B) "While each case is different, the majority of these defects correct on their own. Let's see what the tests show, then speak with the doctor." C) "Since there are no symptoms being exhibited right now, your child will likely not require surgery until the age of 3 years." D) "Most children have no symptoms of this defect."

B) "While each case is different, the majority of these defects correct on their own. Let's see what the tests show, then speak with the doctor."

The nurse is preparing an 8-year-old girl for a cystoscopy. Which instruction would be most appropriate to give to the child? A) "You need to make sure that you don't go to the bathroom before the test." B) "You might feel some burning when you go to the bathroom afterward." C) "I'm going to have to put a tube into your bladder to empty it." D) "I have to put a thick tight rubber band around your arm to get a blood specimen."

B) "You might feel some burning when you go to the bathroom afterward."

A group of nursing students are reviewing the medications used to treat asthma. The students demonstrate understanding of the information when they identify which agent as appropriate for an acute episode of bronchospasm? A) Salmeterol B) Albuterol C) Ipratropium D) Cromolyn

B) Albuterol

The nurse is caring for an infant with a temporary ileostomy. As part of the plan of care, the nurse monitors for skin breakdown around the stoma. If redness occurs, what would be most appropriate to promote healing and prevent further skin breakdown? A) Clean the area well with a scented diaper wipe. B) Apply a barrier/healing cream or paste on the skin. C) Use a barrier wafer to attach the appliance. D) Sanitize the area with an alcohol wipe after each diaper change.

B) Apply a barrier/healing cream or paste on the skin.

The nurse is caring for an infant with bladder exstrophy. As part of the infant's preoperative plan of care, the nurse monitors for abdominal skin excoriation. Which action would be most appropriate for promoting healing and preventing further skin breakdown? A) Cleaning the area well with a scented diaper wipe B) Applying a barrier/healing cream or paste on skin C) Keeping the bladder moist and covered with a sterile bag D) Covering the area with sterile gauze pads after tub baths

B) Applying a barrier/healing cream or paste on skin

After teaching a class about the hemodynamic characteristics of congenital heart disease, the instructor determines that the teaching has been successful when the class identifies which defect as an example of a disorder involving increased pulmonary blood flow? A) Tetralogy of Fallot B) Atrial septal defect C) Hypoplastic left heart syndrome D) Transposition of the great vessels.

B) Atrial septal defect

The nurse is preparing a teaching plan for the parents of a child who has been diagnosed with a congenital heart defect. What would the nurse be least likely to include? A) Daily weight assessment B) Maintenance of strict bed rest C) Prevention of infection D) Signs of complications

B) Atrial septal defect

The nurse is preparing a teaching plan for the parents of a child with a urinary tract infection (UTI). What would the nurse encourage the parents to avoid? A) Liberal fluid intake B) Caffeine C) Cranberry juice D) Cotton underwear

B) Caffeine

A group of nursing students are reviewing information about the variations in respiratory anatomy and physiology in children in comparison to adults. The students demonstrate understanding of the information when they identify which finding? A) Children's demand for oxygen is lower than that of adults. B) Children develop hypoxemia more rapidly than adults do. C) An increase in oxygen saturation leads to a much larger decrease in pO2 D) Children's bronchi are wider in diameter than those of an adult.

B) Children develop hypoxemia more rapidly than adults do.

The nurse is visually inspecting a urine specimen from a 12-year-old boy. The nurse documents gross hematuria with a specimen of which color? A) Cloudy yellow B) Cola colored C) Pale to almost clear urine D) Light orange to moderately yellow colored

B) Cola colored

A child is diagnosed with hemolytic-uremic syndrome (HUS). Review of the child's laboratory test results would reveal which finding? A) Decreased blood urea nitrogen (BUN) and creatinine B) Decreased platelets and leukocytosis C) Hypernatremia and hypokalemia D) Respiratory acidosis and proteinuria

B) Decreased platelets and leukocytosis

The nurse is discussing discharge instructions with the parents of a 6-year-old who had a tonsillectomy. What is the most important thing to stress? A) Administer analgesics. B) Encourage the child to drink liquids. C) Inspect the throat for bleeding. D) Apply an ice collar.

B) Encourage the child to drink liquids.

A group of students are reviewing information about renal failure in children. The students demonstrate a need for additional teaching when they identify which agent as a potential contributor to renal failure? A) Vancomycin B) Gentamicin C) Co-trimoxazole D) Amoxicillin

D) Amoxicillin

A nurse is preparing a presentation for a local parent group about urinary tract infections (UTIs) in children. Which organism would the nurse incorporate into the presentation as the most common cause? A) Klebsiella B) Escherichia coli C) Staphylococcus aureus D) Pseudomonas

B) Escherichia coli

The parents of a 6-week-old boy come to the clinic for evaluation because the infant has been vomiting. The parents report that the vomiting has been increasing in frequency and forcefulness over the last week. The mother says, "Sometimes, it seems like it just bursts out of his mouth." A diagnosis of hypertrophic pyloric stenosis is suspected. When performing the physical examination, what would the nurse most likely find? A) Sausage-shaped mass in the upper midabdomen B) Hard, moveable, olive-shaped mass in the right upper quadrant C) Tenderness over the McBurney point in the right lower quadrant D) Abdominal pain in the epigastric or umbilical region

B) Hard, moveable, olive-shaped mass in the right upper quadrant

The nurse is caring for an infant with suspected patent ductus arteriosus. Which assessment finding would the nurse identify as helping to confirm this suspicion? A) Thrill at the base of the heart B) Harsh, continuous, machine-like murmur under the left clavicle C) Faint pulses D) Systolic murmur best heard along the left sternal border

B) Harsh, continuous, machine-like murmur under the left clavicle

The parents of a boy diagnosed with Hirschsprung disease are anxious and fearful of the upcoming surgery. The mother states, "I'm worried about having to care for our son's ostomy." Which intervention would be most helpful for the parents? A) Explaining to them about the diagnosis and surgery B) Having a wound, ostomy, and continence nurse meet with them C) Reinforcing that the ostomy will be temporary D) Teaching them about the medications used to slow stool output

B) Having a wound, ostomy, and continence nurse meet with them

The nurse is conducting a physical examination of a child with a ventricular septal defect. Which finding would the nurse expect to assess? A) Right ventricular heave B) Holosystolic harsh murmur along the left sternal border C) Fixed split-second heart sound D) Systolic ejection murmur

B) Holosystolic harsh murmur along the left sternal border

A nurse is preparing a teaching plan for the family of a child with allergic rhinitis. When describing the immune reaction that occurs, the nurse would identify the role of which immunoglobulin? A) IgA B) IgE C) IgG D) IgM

B) IgE

After teaching a group of students about acute rheumatic fever, the instructor determines that the teaching was successful when the students identify which assessment finding? A) Janeway lesions B) Jerky movements of the face and upper extremities C) Black lines D) Osler nodes

B) Jerky movements of the face and upper extremities

A mother brings her child to the health care clinic because she thinks that the child has conjunctivitis. Which assessment findings would lead the nurse to suspect bacterial conjunctivitis? Select all that apply. A) Itching of the eyes B) Inflamed conjunctiva C) Stringy discharge D) Photophobia E) Mild pain F) Tearing

B) Inflamed conjunctiva E) Mild pain

The nurse is examining a 3-year-old boy with acute otitis media who has a mild earache and a temperature of 38.5°C. Which action will be taken? A) Obtain a culture of the middle ear fluid. B) Instruct the parents to watch for worsening symptoms. C) Administer antibiotics. D) Administer antivirals.

B) Instruct the parents to watch for worsening symptoms.

A nursing instructor is preparing a class on chronic lung disease. What information would the instructor include when describing this disorder? A) It is a result of cystic fibrosis. B) It is seen most commonly in premature infants. C) It typically affects females more often than males. D) It is characterized by bradypnea.

B) It is seen most commonly in premature infants.

A nursing instructor is preparing a class on chronic lung disease. Which information would the instructor include when describing this disorder? A) It is a result of cystic fibrosis. B) It is seen most commonly in premature infants. C) It typically affects females more often than males. D) It is characterized by bradypnea.

B) It is seen most commonly in premature infants.

The nurse is reviewing the medical record of a child with infective endocarditis. What would the nurse expect to find? Select all that apply. A) White blood cell count revealing leukopenia B) Microscopic hematuria with urinalysis C) Electrocardiogram with prolonged PR interval D) Lungs clear on auscultation E) Petechiae on palpebral conjunctiva

B) Microscopic hematuria with urinalysis C) Electrocardiogram with prolonged PR interval E) Petechiae on palpebral conjunctiva

A nurse is reviewing the medical record of a child with hearing loss and notes that the child's hearing loss is in the range 40 to 60 decibels (dB). The nurse interprets this as indicating what level of hearing loss? A) Mild loss B) Moderate loss C) Severe loss D) Profound loss

B) Moderate loss

A group of nursing students are reviewing information about inflammatory bowel disease in preparation for a class discussion on the topic. The students demonstrate understanding of the material when they identify which characteristics of Crohn disease? Select all that apply. A) Distributed in a continuous fashion B) Most common between the ages of 10 to 20 years C) Elevated erythrocyte sedimentation rate D) Low serum iron levels E) Tenesmus F) Loss of haustra within bowel

B) Most common between the ages of 10 to 20 years C) Elevated erythrocyte sedimentation rate D) Low serum iron levels

The nurse is preparing to perform a physical examination of a child with asthma. Which technique would the nurse be least likely to perform? A) Inspection B) Palpation C) Percussion D) Auscultation

B) Palpation

After teaching the parents of a child diagnosed with celiac disease about nutrition, the nurse determines that the teaching was effective when the parents identify which foods as appropriate for their child? Select all answers that apply. A) Wheat germ B) Peanut butter C) Carbonated drinks D) Shellfish E) Jelly F) Flavored yogurt

B) Peanut butter

The nurse is conducting a physical examination of a child with suspected Crohn disease. Which finding would be the most suspicious of Crohn disease? A) Normal growth patterns B) Perianal skin tags or fissures C) Poor growth patterns D) Abdominal tenderness

B) Perianal skin tags or fissures

Assessment of a child leads the nurse to suspect viral conjunctivitis based on what finding? A) Mild pain B) Photophobia C) Itching D) Watery discharge

B) Photophobia

The nurse is examining an 8-year-old boy with tachycardia and tachypnea. The nurse anticipates which test as most helpful in determining the extent of the child's hypoxia? A) Pulmonary function test B) Pulse oximetry C) Peak expiratory flow D) Chest radiograph

B) Pulse oximetry

The nurse is assessing a child with suspected infective endocarditis. Which assessment finding would the nurse interpret as a sign of extracardiac emboli? A) Pruritus B) Roth spots C) Delayed capillary refill D) Erythema marginatum

B) Roth spots

The nurse is assessing a 5-year-old child's genitourinary system. Which findings would the nurse document as normal? Select all that apply. A) Labial fusion B) Round abdomen C) Positive bowel sounds D) Dullness over the spleen E) Undescended testicles

B) Round abdomen C) Positive bowel sounds D) Dullness over the spleen

When conducting a physical examination of a child with suspected Kawasaki disease, which finding would the nurse expect to assess? A) Hirsutism or striae B) Strawberry tongue C) Malar rash D) Café au lait spots

B) Strawberry tongue

A nurse is caring for a newborn with congenital heart disease (CHD). Which finding would the nurse interpret as indicating distress? A) Reduced respiratory rate during feeding B) Subcostal retraction at the time of feeding C) Perspiration on body after feeding D) Feeding lasting for 15-20 minutes

B) Subcostal retraction at the time of feeding

The nurse is caring for a 3-month-old with nasolacrimal duct obstruction. Which intervention would be most appropriate for the nurse to implement? A) Being careful to prevent spread of infection B) Teaching the parents how to gently massage the duct C) Applying hot, moist compresses to the affected eye D) Referring the child to an ophthalmologist

B) Teaching the parents how to gently massage the duct

The nurse is caring for a child that just returned from a coronary arteriogram in which the catheter was placed through the left femoral artery. Which nursing actions demonstrate knowledge of the procedure? Select all that apply. A) The nurse allows the patient up to the bathroom only. B) The nurse assesses the dorsalis pedis pulse in the left foot. C) The nurse assesses the puncture site frequently. D) The nurse tells the parents that the physician will discuss the results of the procedure with them. E) The nurse assesses the patient's vital signs every 8 hours.

B) The nurse assesses the dorsalis pedis pulse in the left foot. C) The nurse assesses the puncture site frequently. D) The nurse tells the parents that the physician will discuss the results of the procedure with them.

The nurse is caring for a newborn and knows that his vision, unlike his hearing, is not fully developed. Which aspect of the child's vision would the nurse expect to be similar to his father's vision? A) Adequate color detection B) Visual acuity of 20/100 C) Nearsightedness D) Monocular vision

B) Visual acuity of 20/100

The nurse is assessing a 5-year-old girl who is anxious, has a high fever, speaks in a whisper, and sits up with her neck thrust forward. Based on these findings, what would be least appropriate for the nurse to perform? A) Providing 100% oxygen B) Visualizing the throat C) Having the child sit forward D) Auscultating for lung sounds

B) Visualizing the throat

What would the nurse include when teaching parents how to prevent otitis externa? A) Daily ear cleaning with cotton swabs B) Wearing ear plugs when swimming C) Using a hair dryer on high to dry the ear canals D) Using hydrogen peroxide to dry the canal skin

B) Wearing ear plugs when swimming

A nurse is conducting a physical examination of an infant and observes the urethral opening on the dorsal side of the penis. The nurse documents this finding as: A) hypospadias. B) epispadias. C) varicocele. D) hydrocele

B) epispadias.

A child with a suspected cardiovascular disorder is to undergo diagnostic testing and is scheduled for an echocardiogram. When explaining this test to the child, what would the nurse most likely include? A) "This test will check the pattern of how your heart is beating." B) "They'll take a picture of your chest to look at the heart's size." C) "A special wand that picks up sound is used to check your heart." D) "Small patches are attached to your chest to check the heart rhythm."

C) "A special wand that picks up sound is used to check your heart."

An infant with congenital heart disease is to undergo surgery to correct the defect. The mother states, "I guess I'm going to have to stop breastfeeding her." Which response by the nurse would be most appropriate? A) "That's true, but we'll make sure she gets the best intravenous nutrition." B) "Unfortunately, your baby needs more nutrients than what breast milk can provide." C) "Breast milk may help to boost her immune system, so you can continue to use it." D) "She won't be able to suck, so we have to give her fortified formula through a tube."

C) "Breast milk may help to boost her immune system, so you can continue to use it."

The nurse is instructing a 7-year-old child and his parents about using his prescribed corrective lenses. What would the nurse include in these instructions? A) "Make sure to take your glasses off from time to time to allow your eyes to rest." B) "Remove your glasses with both hands and lay them with the lens upright on the surface." C) "Clean the glasses every day with a mild soap and water or commercial cleaning agent." D) "Use paper towels or tissues to dry and periodically clean the lenses.

C) "Clean the glasses every day with a mild soap and water or commercial cleaning agent."

A nurse is interviewing the parents of a child diagnosed with obstructive uropathy. Which statement by the parents would the nurse identify as significant? A) "She's been constipated quite a few times." B) "We've noticed that her bed is wet in the morning." C) "She had surgery to repair a problem with her anus." D) "She had a bacterial skin infection about a week ago."

C) "She had surgery to repair a problem with her anus."

A 9-year-old child has undergone a cardiac catheterization and is being prepared for discharge. The nurse is instructing the parents and child about postprocedure care. Which statement by the parents indicates that the teaching was successful? A) "This pressure dressing needs to stay on for 5 days from now." B) "He can't eat but he can drink fluids for the next 24 hours." C) "He should avoid taking a bath for about 3 days but he can shower." D) "It's normal if he says he feels like his heart skipped a beat."

C) "He should avoid taking a bath for about 3 days but he can shower."

The nurse is caring for a 2-month-old infant who has been diagnosed with acute heart failure. The nurse is providing teaching about nutrition. Which statement by the mother indicates a need for further teaching? A) "The baby may need as much as 150 calories/kg/day." B) "Small, frequent feedings are best if tolerated." C) "I need to feed him every hour to make sure he eats enough." D) "Gavage feedings may be required for now."

C) "I need to feed him every hour to make sure he eats enough."

A nurse is working with an adolescent who is slightly overweight and was recently diagnosed with hypertension. They are discussing nutritional management. Which statement by the adolescent demonstrates understanding of the information? A) "I have to make sure that I don't eat a lot of salty foods." B) "I can eat any amount at a meal as long as I don't eat between meals." C) "I should eat plenty of fresh fruits and vegetables." D) "If I skip breakfast, I can eat a much bigger lunch."

C) "I should eat plenty of fresh fruits and vegetables."

The mother of a 4 week old infant is tearful. She reports the physician has told her that her son has a small atrial septal defect. She reports she is worried and asks the nurse more about the condition. Which statement by the parents best indicates an understanding of the nurse's teaching? A) "This greatly places my son at risk for cardiac failure." B) "If this does not resolve by the time my child is 1 year old he will likely need surgery." C) "Most of the time this condition spontaneously resolves." D) "Since the surgery to correct this condition can be risky my son will need to be at least 40 pounds."

C) "Most of the time this condition spontaneously resolves."

. A parent asks the nurse about immunizing her 7-month-old daughter against the flu. Which response by the nurse would be most appropriate? A) "She really doesn't need the vaccine until she reaches 1 year of age." B) "She will probably receive it the next time she is to get her routine shots." C) "Since your daughter is older than 6 months, she should get the vaccine every year." D) "The vaccine has many side effects, so she wouldn't get it until she's ready to go to school."

C) "Since your daughter is older than 6 months, she should get the vaccine every year."

A child is scheduled for a lower endoscopy. What would the nurse include in the child's plan of care in preparation for this test? A) Explaining about the need to ingest barium B) Establishing an intravenous access for radionuclide administration C) Administering the prescribed bowel cleansing regimen D) Withholding prescribed proton pump inhibitors for 5 days before

C) Administering the prescribed bowel cleansing regimen

A nurse identifies a nursing diagnosis of impaired urinary elimination related to urinary tract infection. When developing the plan of care, what would be most important for the nurse to do first? A) Develop a schedule for bladder emptying. B) Encourage fluid intake. C) Assess usual voiding patterns. D) Monitor intake and output.

C) Assess usual voiding patterns.

The nurse is taking a health history for a 9-year-old girl. Which finding would alert the nurse to a possible risk factor specifically associated with visual impairment? A) Being born at 39 weeks' gestation B) Having several hours of homework daily C) Being of African American heritage D) Being active in sports

C) Being of African American heritage

A child with a pneumothorax has a chest tube attached to a water seal system. When assessing the child, the nurse notices that the chest tube has become disconnected from the drainage system. What would the nurse do first? A) Notify the physician. B) Apply an occlusive dressing. C) Clamp the chest tube. D) Perform a respiratory assessment.

C) Clamp the chest tube.

The nurse is providing instruction to the parents of a newborn boy. The parents have decided not to circumcise the child. What information should be included in the discussion? Select all answers that apply. A) The foreskin should be pulled back for cleaning at least once per day. B) The foreskin should be pulled back gently with each diaper change. C) Clean the penis gently with soap and water. D) If the foreskin is not retractable do not force it. E) When the foreskin is retracted, gently replace it prior to completing diapering.

C) Clean the penis gently with soap and water. D) If the foreskin is not retractable do not force it. E) When the foreskin is retracted, gently replace it prior to completing diapering.

The mother of a child with end-stage renal disease asks the nurse why her son is getting an injection of erythropoietin. When responding to the mother, the nurse explains this as the rationale. A) To treat low calcium levels B) To stimulate growth in stature C) To stimulate red blood cell growth D) To correct acidosis

C) To stimulate red blood cell growth

The nurse is providing care to a child with an intussusception. The child has a bowel movement and the nurse inspects the stool. The nurse would most likely document the stool's appearance as having what quality? A) Greasy B) Clay-colored C) Currant jelly-like D) Bloody

C) Currant jelly-like

The nurse is reviewing the laboratory test results of a child with nephrotic syndrome. What would the nurse least likely expect to find? A) Hyperlipidemia B) Hypoalbuminemia C) Decreased blood urea nitrogen (BUN) D) Hypoproteinemia

C) Decreased blood urea nitrogen (BUN)

When performing the physical examination of a child with cystic fibrosis, what would the nurse expect to assess? A) Dullness over the lung fields B) Increased diaphragmatic excursion C) Decreased tactile fremitus D) Hyperresonance over the liver

C) Decreased tactile fremitus

The nurse is caring for a client with hemolytic-uremic syndrome (HUS). The client is demonstrating oliguria. What does the nurse expect to find when reviewing the client's records? A) A pattern of below-normal blood pressure B) Higher fluid output than fluid intake C) Elevated BUN and creatinine levels D) Increased glomerular filtration rate (GFR)

C) Elevated BUN and creatinine levels

Auscultation of a child's heart reveals a loud murmur with a precordial thrill. The nurse documents this as which grade? A) Grade II B) Grade III C) Grade IV D) Grade V

C) Grade IV

A child with suspected dyslipidemia undergoes laboratory testing. The nurse is reviewing the results. Which finding would the nurse interpret as supporting the diagnosis? Select all that apply. A) Total cholesterol level of 150 mg/dL B) Total cholesterol level of 180 mg/dL C) Total cholesterol level of 220 mg/dL D) LDL level of 90 mg/dL E) LDL level of 120 mg/dL F) LDL level of 140 md/dL

C) Total cholesterol level of 220 mg/dL F) LDL level of 140 md/dL

A nurse is administering 100% oxygen to a child with a pneumothorax based on the understanding that this treatment is used primarily for which reason? A) Improve gas exchange B) Bypass the obstruction C) Hasten air reabsorption D) Prevent hypoxemia

C) Hasten air reabsorption

A nurse is preparing a teaching program for a parenting group about preventing foreign body aspiration. What information would the nurse include? A) Avoid giving popcorn to children younger than the age of 2 years. B) Withhold peanuts from children until they are at least 5 years of age. C) If an object fits through a standard toilet paper roll, the child can aspirate it. D) Keep pennies and dimes out of the child's reach; quarters do not pose a problem.

C) If an object fits through a standard toilet paper roll, the child can aspirate it.

A newborn is diagnosed with patent ductus arteriosus. The nurse anticipates that the physician will most likely order which medication? A) Alprostadil B) Heparin C) Indomethacin D) Spironolactone

C) Indomethacin

The nurse hears wheezing when auscultating a 4-year-old. Which condition would the nurse most likely rule out based on the assessment findings? A) Bronchiolitis B) Asthma C) Influenza D) Cystic fibrosis

C) Influenza

During a follow-up visit, the parents of a 5-month-old infant diagnosed with congenital heart disease tell the nurse, "We're just so tired and emotionally spent. All these tests and examinations are overwhelming. We just want to have a normal life. We're so focused on the baby that it seems like our 3-year-old is lost in the shuffle." Which nursing diagnosis would the nurse identify as most appropriate? A) Risk for delayed growth and development related to necessary treatments B) Deficient knowledge related to the care of a child with congenital heart disease C) Interrupted family processes related to demands of caring for the ill child D) Fear related to infant's cardiac condition and need for ongoing care

C) Interrupted family processes related to demands of caring for the ill child

The nurse is instructing the parents of a school-age child with an eye disorder how to care for her eye. Which condition would the nurse explain as resolving by itself without the use of antibiotics? A) Blepharitis B) Hordeolum C) Corneal abrasion D) Chalazion

D) Chalazion

A nurse is examining a 7-year-old boy with hordeolum. Which would the nurse expect to find? A) Redness B) Scaling C) Pain D) Edema

C) Pain

The nurse is examining a 7-year-old boy with blepharitis. What would the nurse least likely expect to assess? A) Redness B) Scaling C) Pain D) Edema

C) Pain

When examining the abdomen of a child, which technique would the nurse use last? A) Auscultation B) Percussion C) Palpation D) Inspection

C) Palpation

The nurse is applying a urine bag to a 15-month-old boy to collect a urine specimen. Which action would the nurse take first? A) Apply benzoin to the scrotal area. B) Tuck the bag downward inside the diaper. C) Pat the perineal area dry after cleaning. D) Apply the narrow portion of the bag on the perineal space.

C) Pat the perineal area dry after cleaning.

The parents of a 5-year-old bring their son to the emergency department because of significant eyelid edema. The mother states, "He scratched himself near his eye a couple of days ago while playing outside in the yard." The nurse suspects periorbital cellulitis based on which finding? A) Evidence of discharge B) Reddened conjunctiva C) Purplish discoloration of eyelid D) Altered visual acuity

C) Purplish discoloration of eyelid

After teaching a group of students about visual disorders, the instructor determines that the teaching was successful when the students identify what as the most common cause of visual difficulties in children? A) Astigmatism B) Strabismus C) Refractive errors D) Nystagmus

C) Refractive errors

A 6-year-old child has undergone a renal transplant and is receiving cyclosporine. The nurse instructs the parents to be especially alert for which complication? A) Weight loss B) Hypotension C) Signs of infection D) Hair loss

C) Signs of infection

Which finding would lead the nurse to suspect that a child is experiencing moderate dehydration? A) Dusky extremities B) Tenting of skin C) Sunken fontanels D) Hypotension

C) Sunken fontanels

Bacterial pneumonia is suspected in a 4-year-old boy with fever, headache, and chest pain. Which assessment finding would most likely indicate the need for this child to be hospitalized? A) Fever B) Oxygen saturation level of 96% C) Tachypnea with retractions D) Pale skin color

C) Tachypnea with retractions

After teaching a group of parents about ear infections in children, which statement indicates that the teaching was successful? A) Infants with congenital deformities have an increased risk for ear infections. B) Ear infections typically increase as the child gets older. C) The shorter and wider eustachian tubes of an infant increase the risk. D) Adenoids shrink as the child grows, allowing more bacteria to enter.

C) The shorter and wider eustachian tubes of an infant increase the risk.

A nurse is developing a plan of care for a child who is admitted to the hospital for surgery. The child is visually impaired. What would be most appropriate for the nurse to include in the child's plan of care? Select all that apply. A) Explaining instructions using simple and specific terms the child understands B) Allowing the child to explore the postoperative equipment with his hands C) Touching the child on his shoulder before letting the child know someone is there D) Using the child's body parts to refer to the area where he may have postoperative pain E) Speaking to the child in a voice that is slightly louder than the usual tone of voice"

C) Touching the child on his shoulder before letting the child know someone is there

The nurse is caring for a 6-year-old visually impaired boy and is about to begin the physical examination. Which intervention would be most appropriate to promote effective communication with the child? A) Show him the stethoscope. B) Describe the examination room. C) Use his name before touching him. D) Allow him to explore the exam room.

C) Use his name before touching him.

The nurse is caring for a 4-year-old boy who has undergone an appendectomy. The child is unwilling to use the incentive spirometer. Which approach would be most appropriate to elicit the child's cooperation? A) "Can you cough for me please?" B) "You must blow in this or you might get pneumonia." C) "If you don't try, I will have to get the doctor." D) "Can you blow this cotton ball across the tray?"

D) "Can you blow this cotton ball across the tray?"

A 7-year-old child with a family history of cardiovascular disease is being screened for hyperlipidemia. When reviewing the child's laboratory test results, which total cholesterol level would be of significant concern? A) 120 mg/dL B) 150 mg/dL C) 180 mg/dL D) 210 mg/dL

D) 210 mg/dL

After teaching the parents of a 6-year-old how to administer an enema, the nurse determines that the teaching was successful when they state that they will give how much solution to their child? A) 100 to 200 mL B) 200 to 300 mL C) 250 to 500 mL D) 500 to 1,000 mL

D) 500 to 1,000 mL

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

D) 80 beats per minute.

The nurse is providing care to several children who have been brought to the clinic by the parents reporting cold-like symptoms. The nurse would most likely suspect sinusitis in which child? A) A 2-year-old with thin watery nasal discharge B) A 3-year-old with sneezing and coughing C) A 5-year-old with nasal congestion and sore throat D) A 7-year-old with halitosis and thick, yellow nasal discharge

D) A 7-year-old with halitosis and thick, yellow nasal discharge

The nurse is administering digoxin as ordered and the child vomits the dose. What should the nurse do next? A) Contact the physician. B) Offer a snack and administer another dose. C) Immediately administer another dose. D) Administer next dose as ordered in 12 hours.

D) Administer next dose as ordered in 12 hours.

A nurse develops a plan of care for a child that includes patching the eye. This plan of care would be most appropriate for which condition? A) Astigmatism B) Hyperopia C) Myopia D) Amblyopia

D) Amblyopia

The parents of a child diagnosed with celiac disease ask the nurse what types of food they can offer their child. What recommendation would the nurse include in the teaching plan? A) Frozen yogurt B) Rye bread C) Creamed spinach D) Fruit juice

D) Fruit juice

An 8-year-old girl is scheduled for a renal ultrasound. What would the nurse include in the plan of care when preparing the child for this test? A) Withholding food and fluids after midnight B) Checking the child for allergies to shellfish C) Ensuring the child has a full bladder D) Informing the child she should feel no discomfort

D) Informing the child she should feel no discomfort

A child is brought to the emergency department by his parents because he suddenly developed a barking cough. Further assessment leads the nurse to suspect that the child is experiencing croup. What would the nurse have most likely assessed? A) High fever B) Dysphagia C) Toxic appearance D) Inspiratory stridor

D) Inspiratory stridor

A nurse is examining a child who has sustained blunt trauma to the eye area. The nurse suspects a simple contusion based on what finding? A) Pain in the eye B) Impaired visual acuity C) Blurred vision D) Intact extraocular movements

D) Intact extraocular movements

The nurse has developed a plan of care for a 12-month-old hospitalized with dehydration as a result of rotavirus. Which intervention would the nurse include in the plan of care? A) Encouraging consumption of fruit juice B) Offering Kool-Aid or popsicles as tolerated C) Encouraging milk products to boost caloric intake D) Maintaining the intravenous (IV) fluid rate as ordered

D) Maintaining the intravenous (IV) fluid rate as ordered

A nurse is teaching the parents of a child diagnosed with cystic fibrosis about medication therapy. Which would the nurse instruct the parents to administer orally? A) Recombinant human DNase B) Bronchodilators C) Anti-inflammatory agents D) Pancreatic enzymes

D) Pancreatic enzymes

A nursing instructor is developing a class presentation about the medications used to treat peptic ulcer disease. Which drug class would the instructor be least likely to include in the presentation? A) Antibiotics B) Proton pump inhibitors C) Histamine antagonists D) Prokinetics

D) Prokinetics

The nurse is caring for a 3-year-old boy with amblyopia. Which intervention would be most appropriate to include in the child's plan of care? A) Rinsing the eye with cool water B) Educating the family about the disease C) Encouraging frequent hand washing D) Promoting eye safety

D) Promoting eye safety

The nurse is examining a 5-year-old boy. Which sign or symptom is a reliable first indication of respiratory illness in children? A) Slow, irregular breathing B) A bluish tinge to the lips C) Increasing lethargy D) Rapid, shallow breathing

D) Rapid, shallow breathing

A group of students are reviewing information about the differences in the hearing and vision capabilities of a child when compared to an adult. The students demonstrate a need for additional study when they identify what as one of the differences? A) Hearing is completely developed at the time of birth. B) Visual acuity develops from birth throughout childhood. C) Binocular vision is usually achieved by 2 months of age. D) The ability to discriminate colors is completed by birth.

D) The ability to discriminate colors is completed by birth.

The nurse is providing postsurgical care for an infant who has undergone a hypospadias repair. Which action by the nurse would be most important to help keep the area clean while maintaining proper position of the drainage tubing? A) Keeping the drainage tube taped in an upright position B) Administering antibiotics as ordered C) Administering analgesics as prescribed D) Using a double-diapering technique

D) Using a double-diapering technique

A group of students are reviewing information about fluid balance and losses in children in comparison to adults. The students demonstrate a need for additional review when they state that: A) children have a proportionately greater amount of body water than do adults. B) fever plays a greater role in insensible fluid losses in infants and children. C) a higher metabolic rate plays a major role in increased insensible fluid losses. D) the infant's immature kidneys have a tendency to overconcentrate urine.

D) the infant's immature kidneys have a tendency to overconcentrate urine.