PEDS TEST BANK
Which nursing intervention is priority when caring for a child with HIV? A. Administer prescribed medications. B. Assist the child with daily activities. C. Assess pain after invasive procedures. D. Review laboratory CD4 counts daily.
A
Which type of diet should be included in the plan of care for a child diagnosed with Addison disease? A. High-protein, low-carbohydrate, high-sodium diet B. High-protein, high-carbohydrate, low-sodium diet C. Low-calorie, low-carbohydrate, low-sodium diet D. Low-calorie, low-cholesterol, low-saturated fat diet
A
A child has been admitted to the acute care facility for the management of dehydration. The nurse is preparing to administer intravenous fluid replacement to the child. Which fluids are suitable for use? Select all that apply. A. Lactated Ringer B. Normal saline C. 5% dextrose in water D. 0.45% saline E. 10% dextrose in water
A, B
A child is diagnosed with short bowel syndrome. What would the nurse expect to be included in the child's plan of care? Select all that apply. A. Antibiotics B. Vitamin supplements C. Total parenteral nutrition D. Laxatives E. Immunosuppressants
A, B, C
The adolescent has been diagnosed with gastroesophageal reflux disease (GERD). Which statements by the teen indicates that adequate learning has occurred? Select all that apply. A. "This famotidine may make me tired." B. "The omeprazole could give me a headache." C. "It sounds like the physician is reluctant to give me a prokinetic because of the side effects." D. "I will probably need a laxative because of the omeprazole." E. "I should try to lie down right after I eat."
A, B, C
The nurse caring for a young adolescent with Crohn's disease. After teaching the adolescent and her family about this condition, the nurse determines that the teaching was successful when they identify which of the following as a possible complication? Select all that apply. A. Stricture B. Fistula C. Intra-abdominal abscess formation D. Gallstones E. Pancreatitis
A, B, C
The nurse is caring for a teenager recently diagnosed with Addison disease. Which findings can be anticipated by the nurse? Select all that apply. A. Sodium level 128 mEq/L B. Potassium level 5.6 mEq/L C. Muscular weakness D. Rapid weight gain E. Facial acne
A, B, C
A 9-year-old girl has just been diagnosed with Grave's disease. Which symptom should the nurse expect in this child? Select all that apply. A. Exophthalmos (protruding eyes) B. Moist skin C. Nervousness D. Increased basal metabolic rate E. Obesity F. Lethargy
A, B, C, D
After teaching a class of students about genetics and inheritance, the instructor determines that the teaching was successful when the students identify this as the basic unit of heredity. A. Gene B. Chromosome C. Allele D. Autosome
A
A 10-year-old child is newly diagnosed with type 1 diabetes. The child's hemoglobin A1C level is being monitored. The nurse determines that additional intervention is needed with the child based on which result? A. 8.5% B. 6.5% C. 7.5 % D. 7.0%
A
A 10-year-old who is receiving chemotherapy has received ondansetron before this therapy session. About an hour later, the child tells the nurse that his mouth feels really dry. The child has urinated several times and his skin turgor is normal. Which response by the nurse would be most appropriate? A. "The drug you got to help with the nausea can cause dry mouth." B. "Let me increase your intravenous fluids." C. "You might be having a severe allergic reaction. Are you itchy?" D. "This indicates an infection. We need to start antibiotics."
A
A 12-year-old boy arrives at the emergency room experiencing nausea, vomiting, headache, and seizures. He is diagnosed with bacterial meningitis. Other findings include a decrease in urine production, hyponatremia, and water intoxication. Which pituitary gland disorder would be most associated with these symptoms? A. Syndrome of inappropriate antidiuretic hormone B. Diabetes insipidus C. Hyposecretion of somatotropin D. Hypersecretion of somatotropin
A
When describing the negative feedback system that controls endocrine function, the nurse explains that a decreased secretion of which correlates with a decrease in blood glucose levels? A. Insulin B. Glucagon C. Adrenocorticotropic hormone D. Glycogen
A
A 17-year-old adolescent is found wandering around. The adolescent is confused, sweaty, and pale. Which test would the nurse expect to be performed first? A. Blood glucose level B. CT scan C. Arterial blood gases D. Blood cultures
A
A 19-year-old client with hypothyroidism asks the nurse if she will need to take thyroid medication if she becomes pregnant. The nurse integrates understanding of which of the following when responding to the client? A. Regulation of thyroid medication is more difficult because the thyroid gland increases in size during pregnancy B. There is no need to take a thyroid medication because the fetus's thyroid produces thyroid stimulating hormone C. It is more difficult to maintain thyroid regulation during pregnancy due to the slowing of metabolism D. Fetal growth is arrested if the thyroid medications are continued during pregnancy.
A
A 7-year-old child is rushed into the emergency room after being stung by a yellow jacket. The child is nauseated and vomiting and is experiencing itching and swelling on the arm where stung. The is having trouble breathing. Which type of hypersensitivity response is the child experiencing? A. Type I: anaphylaxis B. Type II: cytotoxic response C. Type III: immune complex D. Type IV: cell-mediated hypersensitivity
A
A child with Addison's disease has been admitted with a history of nausea and vomiting for the past 3 days. The client is receiving IV glucocorticoids. Which intervention would the nurse implement? A. Take glucometer readings as ordered B. Measure intake and output C. Monitor sodium and potassium levels D. Weigh daily
A
A group of nursing students are reviewing information about neonatal screenings. The students demonstrate understanding of the information when the students identify which system of most consistently affected by metabolic disorders? A. Nervous system B. Cardiovascular system C. Gastrointestinal system D. Respiratory system
A
Diabetes insipidus a disorder of the posterior pituitary resulting in deficient secretion of which hormone? A. Antidiuretic hormone B. Adrenocorticotropic hormone C. Thyroid stimulating hormone D. Luteinizing hormone
A
During the assessment of a preschooler, the nurse notes that the child has abnormal dryness and thickening of the conjunctiva and dry and scaly skin. Which vitamin deficiency does the nurse suspect this child is experiencing? A. Vitamin A B. Vitamin B C. Vitamin D D. Vitamin E
A
Nursing students correctly label the group of cells whose job is to ingest, engulf, and neutralize pathogens as: A. macrophages. B. immunogens. C. immunoglobins. D. red blood cells.
A
The nurse is caring for a child who is scheduled for bone scan. It is suspected that the child has a growth hormone deficiency. Which finding would support this medical diagnosis? A. The bone scan would show bone age would be two or more deviations below normal. B. The bone scan would show a brain tumor. C. The bone scan would show bone age would be three or more deviations above normal. D. The bone scan would a tumor on the child's kidney.
A
The nurse is preparing an 18-month-old for discharge following treatment for dehydration secondary to diarrhea. What instruction would the nurse most likely include in the discharge teaching? A. "Encourage a bland diet." B. "Implement clear liquids." C. "Provide plenty of 100% fruit juice." D. "Offer flavored gelatin if hungry."
A
The nurse is preparing teaching materials for a family whose child is prescribed somatropin for a growth hormone deficiency. What should the nurse instruct the parents about the administration of this medication? A. This medication must be given by injection. B. This medication must be given in the morning before school. C. Hip or knee pain is an expected adverse effect of this medication. D. This medication does not interact with any other types of medication.
A
The nurse is speaking with the parents of a school-aged child recently diagnosed with diabetes mellitus regarding the differences between hypoglycemia and hyperglycemia. Which statement by a parent indicates a need for further teaching? A. "If I notice changes in my son like tearfulness or irritability, his blood sugar may be high." B. "When my son's breath smells fruity, it almost always indicates high blood sugar." C. "If my son says he feels shaky, his blood sugar may be low." D. "Dry flushed skin may be a sign if high blood sugar."
A
A nursing instructor teaching a class about immunity asks the students to identify the organs of the immune system. Which would the nursing instructor want them to include? (Select all that apply.) A. lymph nodes B. bone marrow C. thymus D. liver E. spleen F. tonsils
A, B, C, E, F
A child aged 3 months has been spitting up regularly since birth and is somewhat underweight. The nurse suggests which interventions to the parents? Select all that apply. A. Thicken feedings with rice cereal. B. Feed smaller amounts more frequently. C. Feed the infant in the supine position. D. Burp well when feeding
A, B, D
The nurse is caring for a child with a gastrointestinal disorder and measuring intake and output. The nurse observes that the child is demonstrating symptoms of adequate hydration when she/he has which of the following? Select all that apply. A. Fontanelles with normal tension B. Adequate skin turgor C. Oral intake D. Pink and moist mucous membranes E. Loose stools
A, B, D
The nurse is performing discharge teaching for a 16-year-old diagnosed with peptic ulcer disease. Which statements by the parents and client demonstrate learning has occurred? A. "I will need to make sure to take all of the antibiotic prescribed." B. "It's important to take my histamine agonist medication at the appropriate time." C. "My proton pump inhibitor should be taken when I feel discomfort." D. "The prednisone that I take for my rheumatoid arthritis may be a cause of my peptic ulcer disease." E. "My mom having peptic ulcer disease has nothing to do with my having it."
A, B, D
While observing the parents of a neonate with pyloric stenosis feeding the baby, the nurse notes that the parents are becoming frustrated. The nurse identifies a nursing diagnosis of risk for impaired parenting related to frustration and difficulty feeding neonate. Which would be appropriate for the nurse to include in the plan of care? Select all that apply. A. Encouraging rooming in with the neonate B. Helping them understand their stress level contributes to the neonate's vomiting C. Assisting the parents in holding and feeding their neonate D. Pointing out positive aspects about their neonate E. Informing the parents that the condition will require them to adjust their lifestyles
A, C, D
The nurse is caring for a newborn with a cleft palate. Which findings in the maternal medical record are considered to be contributing factors? Select all that apply. A. Maternal tobacco use. B. Moderate maternal alcohol use prior to pregnancy. C. Maternal age less than 18 years. D. Anticonvulsant therapy used to manage a seizure disorder. E. Reports of marijuana use in early pregnancy.
A, D
The young child has been diagnosed with hepatitis B. Which of the following statements by the child's mother indicates that further education is required? A. "We went swimming in a local lake 2 months ago and I just knew she drank some of the lake water." B. "Could I have this virus in my body, too?" C. "The virus is the reason her skin looks a little yellowish." D. "The only way you can get this virus is from intravenous drug use." E. "Her fever and rash are probably related to this virus."
A, D
The nurse is reviewing the immunization schedule with the parent of a child who is HIV positive. What information should the nurse provide? Select all that apply. A. Pneumococcal vaccination can be given. B. The child should receive live vaccines only. C. The human papillomavirus vaccine should not be given. D. The varicella vaccine should not be given if the child is symptomatic. E. If the CD4 count is low, the measles, mumps, and rubella vaccine should not be given.
A, D, E
Which nursing diagnosis will the nurse select as appropriate for the child with atopic dermatitis? Select all that apply. A. Impaired skin integrity related to skin barrier function B. Delayed growth related to chronicity of immune disorder C. Ineffective breathing pattern related to allergic bronchospasm D. Anxiety related to continuing or uncontrolled allergic response E. Powerlessness related to difficulty determining cause of allergy
A, D, E
The nurse knows that disorders of the pituitary gland depend on the location of the physiologic abnormality. Caring for a child who has issues with the anterior pituitary, the nurse would expect the child to have issues with which hormone? A. Vasopressin B. Antidiuretic hormone C. Oxytocin D. Growth hormone
D
A 25-year-old client wants to know if her baby boy is at risk for Down syndrome because one of her distant relatives was born with it. Which information would the nurse share with the client while counseling her about Down syndrome? A. Instances of Down syndrome in the family greatly increases the risk for the baby also having Down syndrome. B. Children with Down syndrome have extra genetic material in the 21 chromosome that occurs during development of the sperm or egg. C. Down syndrome occurs only in females, and there is no risk as the baby is male. D. Children with Down syndrome are usually born to older mothers.
B
A 4-month-old infant is seen at the ambulatory care clinic and diagnosed with nasolacrimal duct obstruction. The mother asks what can be done. What information should be included in the information provided to the parent? A. Once the child is 6 to 9 months old a specialist will be able to drain the duct. B. Most of these conditions will spontaneously resolve. C. Antiviral therapy can be prescribed to manage this condition. D. Over-the-counter drops can be used sparingly.
B
A 6-month-old girl is seen with retinoblastoma. When taking a health history from her father, which symptom would you expect him to report he has noticed? A. The infant always keeps her eyes tightly closed. B. He has noticed one pupil appears white. C. His daughter tugs and pulls at one ear. D. His daughter's eye appears to be protruding.
B
A 6-year-old is dealing with the death of a sibling. Which action should the nurse suggest to the family to best support the child with the grieving process? A. Having the child stay with a family friend instead of attending the funeral B. Assisting the child in drawing a picture to be placed in the sibling's casket C. Having the sibling stand in the receiving line with the parents at the funeral home D. Discouraging the child from interacting with family and friends while they express their sympathy
B
A child in the clinic has a fever and reports a sore neck. Upon assessment the nurse finds a swollen parotid gland. The nurse suspects which infectious disease? A. Measles B. Mumps C. Whooping cough D. Scabies
B
A nurse manages the interdisciplinary care for an infant born with an omphalocele. What is an accurate description of the care for an omphalocele? A. At birth, protect the exposed bowel by gently manipulating it back into the abdominal cavity. B. Obtain IV access to give fluid resuscitation and correct any electrolyte abnormalities. C. Administer corticosteroids as prescribed—either oral prednisone or prednisolone or as IV methylprednisolone. D. Insert an NG tube to decompress the stomach and to prevent gastric distention
B
A school-aged girl with Crohn's disease will receive total parenteral nutrition (TPN) for the next 6 weeks. Which would best help her accept the treatment plan? A. Help her ambulate with the bottles. B. Provide some time to talk to her several times a day. C. Help her give the bottles nicknames and personalities. D. Explain that TPN substitutes for normal food.
B
A young client is admitted to the hospital directly from the clinic. The physician suspects a problem with the child's immune system. What test does the nurse anticipate the physician will order for this client? A. Urine analysis B. Blood analysis C. EKG D. X-ray
B
An adolescent client has just been diagnosed with systemic lupus erythematosus (SLE). Following client education about the disease, which statement by the client demonstrates understanding of SLE? A. "SLE is a rheumatic disease that mostly affects my joints." B. "SLE is an autoimmune disorder that I will always have, with times of flare- ups and times of minimal to no symptoms." C. "If my SLE has been found early enough in the disease process, there is a good chance that medication can cure it." D. "SLE only affects my skin. It seldom causes problems in any other organs."
B
The nurse has completed an education session with parents of children diagnosed with food allergies. Which statement by a parent would indicate a need for additional education? A. "I will make sure my daughter always has her EpiPen® with her all the time." B. "If we need to use the EpiPen® we will need to notify her physician's office the next business day." C. "I have found a website that makes medical alert bracelets in my daughter's favorite color." D. "The grey part of the EpiPen® should never be removed until right before we use it."
B
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."
B
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. Increased hunger D. Abdominal tenderness
B
The nurse is providing teaching about food substitutions when cooking for the child with an allergy to eggs. Which response indicates a need for further teaching? A. "I must not feed my child eggs in any form." B. "I can use the egg white when baking, but not the yolk." C. "1 tsp yeast and 1/4 cups warm water is a substitute in baked goods." D. "1.5 Tbsp each water and oil plus 1 tsp baking powder equals one egg in a recipe."
B
A nurse suspects that a child is experiencing isotonic dehydration based on which assessment findings? Select all that apply. A. Extreme thirst B. Cool skin temperature C. Irritability D. Normal serum sodium level E. Clammy skin
B, C, D
The nurse is reviewing the history of an adolescent with peptic ulcer disease. Which client activity would the nurse identify as an associated contributing factor? Select all that apply. A. Use of acetaminophen B. Ingestion of diet colas C. High coffee intake D. Cigarette smoking E. High-fat diet
B, C, D
The child has a peanut allergy and accidentally ate food that contained peanuts. Which clinical manifestations of anaphylaxis should the nurse expect to find? Select all that apply. A. The child's pulse is 52 beats per minute. B. The child states that his tongue feels "too big" for his mouth. C. The child has developed hives on his face and trunk. D. The child states he feels like he might "throw up". E. The child states that he feels like he might faint.
B, C, D, E
The nurse is instructing parents on how atopic disorders affect the child. For which disorder would the nurse provide information and counseling? Select all that apply. A. Serum sickness B. Allergic rhinitis C. Asthma D. Eczema E. Hay fever
B, C, D, E
The nurse is preparing an educational program for members of the office staff. The topic is the warning signs of primary immunodeficiency. What information should be included? Select all apply. A. Two or more new episodes of acute otitis media in 1 year. B. Two or more episodes of severe sinusitis in 1 year. C. Failure to thrive in an infant. D. Two or more serious infections such as sepsis. E. History of infections requiring IV antibiotics to clear.
B, C, D, E
A child is receiving chemotherapy and develops stomatitis. The nurse identifies a nursing diagnosis of impaired oral mucous membranes related to the effects of chemotherapy. What instructions would the nurse include in the child's plan of care? Select all that apply. A. Vigorously rub the child's gums with gauze to clean them. B. Provide various soft and bland foods to minimize further irritation. C. Have the child rinse the mouth with lukewarm water three times a day. D. Give the child acidic foods (e.g., orange juice) to cleanse the mouth. E. Apply a lip balm or petroleum jelly to prevent cracking.
B, C, E
A nurse is developing a teaching plan for an adolescent diagnosed with gastroesophageal reflux disease. Which would the nurse include? Select all that apply. A. "Try sitting upright for an hour after eating." B. "You need to avoid acidic foods like oranges and grapefruits." C. "Eating smaller portions might be helpful." D. "You'll need to take your prescribed medications for about 6 to 8 weeks." E. "Try sleeping with your upper body elevated on a foam wedge."
B, C, E
The nurse is caring for a pediatric client newly diagnosed with Crohn's disease. When reviewing the client's subjective and objective data, which is consistent with the diagnostic criteria? Select all that apply. A. Severe bloody diarrhea B. Significant weight loss C. Perianal lesions D. Lesions limited to the colon and rectum E. Cobblestone appearance of intestinal surface
B, C, E
The nurse is recording vital signs in the client diagnosed with complications of anorexia nervosa. Which findings are consistent with the condition? Select all that apply. A. Hyperthermia B. Orthostatic hypotension C. Weak pulse D. Hypertension E. Hypothermia
B, C, E
The client has been prescribed antihistamines and a round of corticosteroids to treat an allergic reaction to an unknown food source. Which statement by the client indicates he understands the allergic condition and medication regimen? A. "The antihistamine will help the nasal swelling I am having." B. "Corticosteroids help the inflammation that goes along with an allergy." C. "I can stop taking my steroids as soon as I feel better in a couple of days." D. "I may have to undergo intradermal testing to determine what I am allergic to." E. "Once we figure out what I am allergic to, it is important for me to avoid that allergen."
B, D, E
A 16-year-old child suffering from alopecia related to chemotherapy treatment is refusing to let friends visit. Which action by the nurse is most appropriate? A. Respect the child's wishes and document refusal B. Have the parents explain the importance of letting friends visit C. Provide opportunities for the child to discuss his or her body image changes D. Allow friends to visit because socialization is important for adolescents
C
The parent of an infant born with trisomy 18 says to the nurse, "I am so lost...I can't even think about my baby not being healthy." How should the nurse respond? A. "I understand...we occasionally see clients with trisomy 18 and it is very sad." B. "This is a difficult time, but let's talk about the ways your baby will outgrow this." C. "I would encourage you to talk with the doctor about ways to cure this disorder." D. "This is a sad time for you. I will sit with you quietly in case you want to talk."
D
A 2-year-old client and the parents are at the office for a follow-up visit. The client has had excessive hormone levels in the recent blood work, and the parents question why this was not found sooner. Which response by the nurse would be most appropriate? A. "It takes time to determine the level of functioning of endocrine glands." B. "Have there been signs and symptoms that you should have reported to the doctor?" C. "As endocrine functions become more stable throughout childhood, alterations become more apparent." D. "Endocrine disorders are hard to detect and you are lucky that we have found it when we did."
C
A child has been prescribed Stimate (esmopressin) acetate for the treatment of diabetes insipidus. The client and the parents ask the nurse how this drug works. What is the correct response by the nurse? A. Stimate (esmopressin) acetate works on your pancreas to stimulate insulin production B. Stimate (esmopressin) acetate is a synthetic form of insulin used to lower your blood sugar C. Stimate (esmopressin) acetate is a synthetic antidiuretic hormone that will slow down your urine output D. Stimate (esmopressin) acetate works to help your kidneys work more efficiently
C
A child with allergic rhinitis is prescribed a nasal antihistamine spray. When advising the parents about the use of the sprays, what should the nurse explain about the rebound phenomenon? A. It causes a permanent increase in nasal secretions. B. It causes reflux of gastric contents into the esophagus. C. It causes an increase in nasal secretions after an initial decrease. D. It causes a decrease in histamine release after an initial increase.
C
The adoptive parents of a child who is 7 years old and HIV positive are concerned about telling their child about his condition. What information can be provided by the nurse? A. The child should not have information about their health provided at this age. B. Children at this age should have full disclosure of their condition. C. When providing health information to a child of this age it should be simplistic and at the child's level of understanding. D. Once a child is apprised of their health concerns they do not normally experience any after affects.
C
The nurse is completing the physical assessment of a 12-year-old child who has a series of bruises in various stages of healing. When asked about the bruises the child appears frightened and offers inconsistent accounts about how the child got the bruises. The nurse suspects abuse. Which initial action of the nurse is most appropriate? A. Take photographs of the bruises. B. Ask the child to provide a written statement of how he or she got the bruises. C. Document the bruises and any statements made by the child relating to them. D. Interview the child's parents about the origin of the bruises. E. Interview the child's parents about the origin of the bruises.
C
The nurse is doing an in-service training on clinical manifestations seen in communicable diseases. Which best describes a macule? A. Redness of the skin produced by congestion of the capillaries B. Small, circumscribed, solid elevation of the skin C. Discolored skin spot not elevated at the surface D. Small elevation of epidermis filled with a viscous fluid
C
The nurse is educating parents of a child admitted to the hospital with rubella (German measles). Which statement by the parents indicates the further education is needed? A. "Our child is contagious for 1 week after the rash appeared." B. "Acetaminophen or ibuprofen can be given to help with pain." C. "Antibiotics are needed to help our child recover from rubella." D. "Family members should wear a mask when coming to visit us."
C
The nurse realizes that the chemotherapy agents and radiation that a child is receiving are likely to irritate the bladder. What are the best measures that the nurse can take to diminish this risk? A. Administer chemotherapy during sleep periods, including naps and overnight B. Have the child wait to void until the bladder becomes full C. Keep intravenous (IV) fluids running to maintain excellent hydration and frequent voids D. Promote drinking of cranberry juice, making it an attractive oral fluid option
C
What should be included in the teaching plan for a child with type 1 diabetes mellitus who is going home on insulin therapy? A. Children show an increased need for insulin during the first months after glucose control is established. B. Once glucose control is established, there will never be a need for an increase in the amount of insulin administered. C. It is absolutely normal for the growing child to require an increase in insulin; this does not mean his/her condition is getting worse. D. All children should be on at least two types of insulin to establish glucose control.
C
Which of the following women has the greatest risk of having a child with Down syndrome? A. 25-year-old B. 30-year-old C. 42-year-old D. 35-year-old
C
The nurse is caring for a pediatric client who has a compromised immune system. When reviewing laboratory results, which bone marrow component identifies a dysfunction in bone marrow production? Select all that apply. A. Macrophages B. Antigens C. T lymphocytes D. B lymphocytes E. Haptens
C, D
The nurse is examining a child with hypoparathyroidism. The nurse would expect to assess which signs and symptoms? Select all that apply. A. Capillary refill B. Polyphagia C. Chvostek D. Babinski E. Trousseau
C, E
A child is admitted to the pediatric medical unit with the diagnosis of syndrome of inappropriate antidiuretic hormone (SIADH). Based on the typical signs and symptoms of this disorder, which nursing diagnosis will the nurse identify as relating to this client? A. Delayed growth and development B. Imbalanced nutrition: More than body requirements C. Noncompliance D. Excess fluid volume
D
A nurse is conducting a physical examination of a 12-year-old girl with suspected systemic lupus erythematosus (SLE). How would the nurse best interview the girl? A. "Do you notice any wheezing when you breathe or a runny nose?" B. "Do you have any shoulder pain or abdominal tenderness?" C. "Have you noticed any new bruising or different color patterns on your skin?" D. "Have you noticed any hair loss or redness on your face?"
D
The nurse is caring for a child and notes periorbital edema on the left eye with urticaria. Which action by the nurse is priority? A. Administer a corticosteroid. B. Ask if the child has allergies. C. Evaluate fluid volume status. D. Assess lung sounds bilaterally.
D
The nurse is monitoring the CD4 count of an infant who has contracted HIV from the mother in utero. The nurse is concerned that treatment with antiretroviral therapy is not effective when noting which CD4 level? A. 1900/mm3 B. 1700/mm3 C. 1500/mm3 D. 1300/mm3
D
The mother of a 2-month-old infant questions the nurse about autism. She reports a close family member has a child with this disorder and she is concerned about her child. What information can be provided to the child's mother? Select all that apply. A. "The cause of autism is largely considered to be related to immunizations administered in infancy." B. "Concerns are often noted as early as 3 to 6 months of age." C. "Once your child begins to speak it will be easier to make a determination." D. "In infancy a lack of loving behaviors such as cuddling is concerning." E. "Infants who are on the autism spectrum may have difficulty establishing or maintaining eye contact."
D, E
The nurse is comforting a family who were just informed by the health care provider that their baby will likely be born with a significant genetic abnormality. What actions by the nurse would be therapeutic? Select all that apply. A. Advise the parents to discuss their fears with only each other B. Discuss the nurse's personal beliefs regarding genetic abnormalities C. Encourage the family to ask questions after they have researched the disorder D. Refer the family to appropriate parent group or local family with similar needs E. Allow the family to discuss their emotions in an authentic and trusting environment
D, E
The parents of a 1-year-old child with Down syndrome are at a follow-up clinic visit for their child. What information would the nurse review with the parents at this time? Select all that apply. A. Plan to have the child's vision and hearing tested at the age of 18 months B. The child should be consuming added calories now that he is growing more C. Dental visits should be scheduled yearly from this age to adolescence D. Cervical x-rays need to be scheduled for the next visit in 3 months E. Monitor for symptoms of respiratory infections and ear infections F. A thyroid test will be scheduled for this visit to monitor for high or low thyroid concerns
E, F
When providing support and education to the family of a child who is diagnosed with a serious genetic abnormality, what would be the priority? A. Assisting with scheduling follow-up visits B. Establishing a trusting relationship C. Teaching the family what to expect D. Using measures to promote growth and development
B
The parents of a 5-year-old have just found out that their child has head lice. Which statement by the parents would support the nursing diagnosis of deficient knowledge? A. "I can't believe it. We're not unclean, poor people." B. "We'll have to get that special shampoo." C. "Everybody in the house will need to be checked." D. "That explains his complaints of itching on his neck."
A
When teaching about Turner's syndrome, what should the nurse include? A. Timing and use of growth hormone B. Use of hormone therapy to prevent infertility C. Long-term effects of decreased intellectual ability D. Treatment for gynecomastia
A
Which statement by the parent of a 12-month-old child diagnosed with Down syndrome shows the need for further education? A. "I will need to delay any further immunizations." B. "Thyroid testing is needed every year." C. "In a couple of years, my child will need an x-ray of the neck." D. "I will watch closely for development of respiratory infection."
A
A child receiving chemotherapy wants to have a large birthday party and invite all the classmates. When the parent asks the nurse about this, what is the nurse's best response? A. "That will be a good way to cheer your child up!" B. "It is better to avoid large groups right now." C. "What about taking your child to a movie instead?" D. "We can have the party here in the hospital play room."
B
A child with a diagnosis of Down syndrome has had which of the following chromosome abnormalities occur? A. 1 copy of the chromosome 8 has occurred instead of 2 copies. B. 3 copies of trisomy 21 has occurred instead of 2 copies. C. 3 copies of trisomy 18 has occurred instead of 2 copies. D. 3 copies of trisomy 13 has occurred instead of 2 copies.
B
A nurse is providing care to a toddler with nephroblastoma and is being evaluated. Which nursing action would be most important? A. Restricting the child's visitors B. Placing a "no abdominal palpation" sign above the child's bed C. Ensuring that the child be allowed nothing by mouth D. Preparing the child for chemotherapy E. Preventing weight-bearing activities
B
Antiemetics are ordered to control nausea and vomiting in the child undergoing chemotherapy. How can the nurse most effectively use these medications? A. Administer the antiemetic before starting chemotherapy B. Provide the antiemetic as needed (PRN) when nausea and vomiting are reported C. Use the antiemetic after it is clear that nonpharmacologic methods are not effective D. Start the antiemetic on a scheduled basis when the chemotherapy begins to cause nausea
A
The nurse is caring for a newborn diagnosed with an inborn error of metabolism with several referrals ordered. What referral would the nurse place as the priority for the infant? A. Spiritual advisor B. Dietitian C. Community support group D. Genetic counseling
B
The mother of a 10-year-old child diagnosed with rubella asks what can be done to help her child feel better during her illness. What information can be provided? A. Encourage rest and relaxation. B. Antibiotic therapy may be initiated. C. Antiviral medications can be prescribed. D. Range of motion to prevent contractures.
A
The mother of a 12-year-old with Reye syndrome approaches the nurse wanting to know how this happened to her child, saying, "I never give my kids aspirin!" Which response by the nurse would be most appropriate? A. "Sometimes it's hard to tell if a product contains aspirin." B. "Do you think that maybe your child took aspirin on his own?" C. "Don't worry; you're in good hands. We have it under control now." D. "Aspirin in combination with the virus will make the brain swell and the liver fail."
A
An adolescent is recovering from surgery, radiation, and chemotherapy following a diagnosis of Ewing sarcoma. Which statement by the family indicates that reteaching is needed? A. "Our child is looking forward to playing football again." B. "We will remind our child to care for the skin following radiation." C. "Our child's friends shaved their heads in solidarity to show their support." D. "We will watch for signs of infection and report it to our health care provider."
A
The nurse is assessing a 10-year-old girl with acute lymphoblastic leukemia. What information would lead the nurse to suspect that the cancer has infiltrated the central nervous system? A. Child reports of facial palsy and vision problems B. Observing petechiae, purpura, or unusual bruising C. Noting adventitious breath sounds during auscultation D. Palpation of abdomen reveals enlarged liver and spleen
A
A 15-year-old boy visits his primary care physician's office with fever, headache, and malaise, along with complaints of pain on chewing and pain in the jawline just in front of the ear lobe. The boy asks his mother to leave the exam room for a minute and then tells the nurse that he is also experiencing testicular pain and swelling. The nurse recognizes that this client most likely has which condition? A. Mumps B. Infectious mononucleosis C. Poliomyelitis D. Herpes zoster
A
A 17-year-old girl has been diagnosed with bulimia nervosa. Which complication should the nurse carefully assess for in this client? A. Severe erosion of teeth B. Hypertension C. Diabetes mellitus D. Atherosclerosis
A
A 6-month-old child has developed skin irritation due to an allergic reaction. He has been prescribed a topical skin ointment. The nurse will consider which of the following before administering the drug? A. That the infant's skin has greater permeability than that of an adult B. That there is less body surface area to be concerned about. C. That there is decreased absorption rates of topical drugs in infants. D. That there is a lower concentration of water in an infant's body compared with an adult.
A
A 9-year-old child with leukemia is scheduled to undergo an allogenic hematopoietic stem cell transplant. When teaching the child and parents, what information would the nurse include? A. "We'll need to have a match to a donor." B. "The risk for rejection is much less with this type of transplant." C. "You won't need to receive the high doses of chemotherapy before the transplant." D. "You'll need to have an incision in your hip area to instill the cells."
A
A child is to receive an oral corticosteroid as part of the treatment regimen for leukemia. After teaching the child and family about this drug, the nurse determines the need for additional teaching when they state: A. "We should administer the drug on an empty stomach." B. "We should check our son's urine for glucose." C. "He might develop a rounded face from this drug." D. "We will need to gradually decrease the dosage."
A
A child receiving chemotherapy is experiencing significant reduction in red blood cells secondary to myelosuppression. Which agent would the nurse most likely expect to be ordered? A. Epoetin alfa B. Filgrastim C. Sargramostim D. Gamma interferon
A
A child with attention deficit hyperactivity disorder (ADHD) is prescribed methylphenidate hydrochloride. What should the nurse instruct the parents regarding an adverse effect of this medication? A. Anorexia B. Sleepiness C. Garbled speech D. Rapid increase in height
A
A newborn was screened for hereditary metabolic disorder at 8 hours old. Which action by the nurse is most appropriate? A. Instruct the parent to have another screening in 1 to 2 weeks B. No further intervention is needed C. Repeat screening in 8 hours D. If the infant is premature, screening needs to be done every 8 hours for 48 hours
A
A nurse is caring for a 3-year-old girl with microcephaly. Which of the following actions is appropriate for the nurse to take? A. Playfully ask the child to touch her nose B. Teach the parents about ventriculoperitoneal (VP) shunts C. Prepare the child for the experience of cranial surgery D. Administer antipyretics as ordered
A
A nurse is communicating with a family about palliative care. Which of the following would be the best approach to take? A. Ask the family what they know, what they wish to know and be prepared to repeat the information you give to them several times B. Give the family as much information as possible to promote better decision-making C. Provide information during a crisis when the parent's senses are heightened and memory is improved D. Avoid pushing the family by asking too many questions.
A
A nurse is describing the underlying cause of trisomy 21 to a group of parents, integrating knowledge that the disorder is due to: A. nondisjunction. B. deletion. C. duplication. D. translocation.
A
A panicked mother calls the health care provider's office and reports that her 5-year-old has a high fever and just had a seizure. The mother asks the nurse what she should do. Which is the nurse's best response? A. Report to the emergency room for medical evaluation B. Immerse the child in a bathtub of tepid water C. Administer oral acetaminophen per package directions D. Remove any heavy clothing and cover with a thin sheet
A
An 11-year-old boy has recently been prescribed methylphenidate. The mother calls the pediatrician's office to speak with the advanced practice pediatric nurse practitioner. This mother has been extremely resistant to medication and insists that the medication is not working. How should the nurse respond? A. "Tell me what makes you think the medication is not working" B. "Do you want to try a different medication?" C. "Are you sure you are administering it properly" D. "Do you want to increase the dosage?"
A
An 8-year-old child is being treated for tonic-clonic seizures. What should the nurse emphasize when teaching the parents about this disorder? A. The child should maintain an active lifestyle. B. Immediately provide medication if a seizure begins. C. Have the child carry a padded tongue blade with her at all times. D. Ensure quiet time late in the day, when seizure activity is most likely to occur.
A
The nurse is assessing a 7-year-old with a hearing aid. His mother says he is losing his hearing again. Which finding would the nurse identify as contributing to this current complaint? A. Overproduction of cerumen B. Soreness of the outer ear C. History of a normal term birth D. The eardrum responds to a puff of air
A
The nurse is assessing an 8-week-old infant in the clinic. The parent states the infant was feeding well and gaining weight until a few weeks ago and now is noted to have lost weight and "isn't doing well" per the parent. What action would the nurse take next? A. Assess the infant further for an inborn error of metabolism B. Advise the parent to decrease the feedings daily to every 6 hours C. Suggest the child be fed in a supine position, using a car seat or carrier D. Refer the parents to a dietitian for education on increasing the child's appetite
A
The nurse is assessing the eyes of a 6-month-old and notices that she has wide-spaced eyes and bilateral epicanthal folds. Which condition associated with these findings should also be assessed for in this child? A. Low-set, malformed ears B. Amblyopia C. Strabismus D. Ptosis
A
The nurse is caring for a 1-year-old boy with Down syndrome. Which intervention would the nurse be least likely to include in the child's plan of care? A. Educating parents about how to deal with seizures B. Explaining developmental milestones to parents C. Promoting annual vision and hearing tests D. Describing the importance of a high-fiber diet
A
The nurse is caring for a 3-year-old girl who has just undergone a ventriculostomy. Which of the following would the nurse include in this child's plan of care to manage increased intracranial pressure (ICP)? A. Use pillows to support the child when lying on her side B. Support the parents in starting a ketogenic diet C. Pad the side rails on the bed D. Teach her to do deep breathing techniques
A
The nurse is conducting an assessment of a 5-year-old client. During the assessment, the nurse notes that the child does not maintain eye contract or speak. The nurse suspects an autism spectrum disorder. Which additional finding would help support the nurse's suspicion? A. The child constantly opens and closes the hands. B. The child is highly active and inattentive. C. The child has a slight decrease in head circumference. D. The child has a long face and prominent jaw.
A
The nurse is doing an in-service training on clinical manifestations seen in communicable diseases. Which skin condition best describes erythema? A. Redness of the skin produced by congestion of the capillaries B. Small, circumscribed, solid elevation of the skin C. Discolored skin spot not elevated at the surface D. Small elevation of epidermis filled with a viscous fluid
A
The nurse is educating an 18-year-old female client with Turner syndrome. What information will the nurse include in the teaching plan? A. Resources regarding infertility and family planning B. Requirements for post secondary educational needs C. The need to eliminate amino acids from the diet D. The options for a cure as the client enters adulthood
A
The nurse is educating parents of a male infant with Chiari type II malformation about the condition. Which of the following would be most important for the nurse to include? A. Taking time to feed the infant B. Laying the infant down after a feeding C. Being able to see major difference after surgery D. Not needing to change diapers as often
A
The nurse is preparing a discharge teaching plan for the parents of an 8-year-old girl with leukemia. Which instruction would be the priority? A. Calling the doctor if the child gets a sore throat B. Keeping a written copy of the treatment plan C. Writing down phone numbers and appointments D. Using acetaminophen if the child needs an analgesic
A
The nurse is preparing to post a sign above the crib of an infant with a Wilms tumor. Which statement should the nurse post immediately? A. "Do not palpate abdomen." B. "No intramuscular injections." C. "No milk or milk products allowed." D. "No blood sampling in lower extremities."
A
The nurse is providing education to the parents of a female with hydrocephalus who has just had a shunt inserted. When discussing the child's condition with the parents, which of the following would be most appropriate? A. "Tell me your concerns about your child's shunt." B. "Be sure to call the doctor if she gets a persistent headache." C. "Her autoregulation mechanism to absorb spinal fluid has failed." D. "Always keep her head raised 30 degrees."
A
The nurse is reviewing the medical record of a child with a mental health disorder and finds that the child is receiving cognitive behavioral therapy. How does the nurse interprets this information? A. Process that requires the individual to view a situation from a different perspective B. Interventions that address family dynamics and family coping C. Individual exploration of the person's conflicts and stressors D. Use of play to explore problems, issues, and conflicts
A
The nurse is taking a health history for a 9-year-old with conjunctivitis. Which statement by the parents leads the nurse to suspect that the child is experiencing allergic conjunctivitis? A. "He recently helped clean the basement. B. "He was exposed to several family members with an infection. C. He just recovered from an upper respiratory infection. D. We have a family history of conjunctivitis.
A
The nurse is teaching a group of parents about head lice. Which statement is essential to include during the presentation? A. Head lice are becoming very resistant to treatment. B. Send your child to school even if you suspect head lice, but have the school nurse check the child. C. Discourage the children from going to sleepovers. D. Wash the bed linens in hot water to kill the lice.
A
The nurse is teaching the parents of a child with varicella about the disorder. The nurse determines that the teaching was successful when the parents state which of the following? A. "We will make sure to remind him not to scratch the lesions." B. "We can give him aspirin for fever." C. "We should put him in a warm bath if he is itchy." D. "We can use salt solutions to help heal his oral lesions."
A
The parent of a child with mumps on one side of the face is concerned that the disease can develop on the other side in the future. How should the nurse respond to the mother about this concern? A. The child is immune to further attacks of the disease. B. It does not matter because mumps in adulthood is not serious. C. The child should receive active immunization against mumps. D. There is nothing that can be done to prevent another attack of mumps in the future.
A
After an assessment, the nurse is concerned that a school-age child is at risk for developing a mental health disorder. Which assessment data will the nurse use to develop an appropriate plan care? Select all that apply. A. The parents recently divorced B. The father is unemployed and mother is infrequently home C. The child is learning to play the clarinet in music class in school D. The child is expected to care for younger siblings while mother sleeps E. There is history of multiple injuries obtained from a motor vehicle crash
A, B, D, E
The nurse identifies the nursing diagnosis of risk for infection related to chemotherapy-induced immunosuppression. What would the nurse include in the teaching plan for the child and parents about reducing the child's risk? Select all that apply. A. Having the child sleep in a single bed and room B. Encouraging frequent, thorough handwashing C. Providing a low-carbohydrate, low-protein diet D. Encouraging frequent close contact with numerous visitors E. Cheering up the environment with fresh flowers and plants
A, B
A nurse is teaching the parents of a child diagnosed with attention deficit/hyperactivity disorder about the condition. The nurse determines that the teaching was successful when the parents make which statements? Select all that apply. A. "We need to set clear limits for our child's behavior." B. "A reward system would be useful to give our child positive feedback." C. "We need to limit the number of choices our child has." D. "We need to give our child all directions at once in case the child gets distracted." E. "If the child acts out, we can explain that this is being bad."
A, B, C
The nurse caring for a neonate experiencing seizures asks the charge nurse: "How can I tell if a baby is having a seizure or is just crying for attention?" Which response would be most appropriate? Select all that apply. A. "You will not be able to stop a seizure with gentle restraint." B. "The baby experiencing a seizure will be tachycardic." C. "Stimulating the baby by singing to him will not stop a seizure." D. "There will be no changes in the baby's vital signs with a seizure" E. "The baby will become more active with sensory stimulation with a seizure."
A, B, C
The nurse is caring for a child admitted to the pediatric medical unit with chickenpox who has infected vesicles. What personal protective equipment should the nurse use when measuring the child's vital signs? A. Gloves B. Gown C. N95 respirator D. Face mask E. Eye wear
A, B, C
A child comes to the clinic for evaluation of skin lesions and is diagnosed with impetigo. Which medications are potentially ordered with instructions placed on the discharge summary? Select all that apply. A. Penicillin B. Erythromycin C. Mupirocin D. Tetracycline E. Lindane
A, B, C PEM
During a routine well-child visit, the mother of a preadolescent patient asks the nurse to explain signs of sexual abuse. The mother is concerned because an older male neighbor has been making comments and overtly admiring the child when playing outdoors. What signs of sexual abuse should the nurse tell the mother to look out for? Select all that apply. A. Child reports abdominal pain. B. Child has a change in school performance. C. Child demonstrates anxiety or trouble sleeping. D. Child does not want to be left alone with a certain adult. E. Child spends a great deal of time with peer-group friends.
A, B, C, D
The nurse is performing a physical examination of a 5-year-old boy. Which documented findings would most strongly indicate maltreatment of the child? Select all that apply. A. Cuts and bruises on the hands B. Burns on the dorsal surface of the hand C. A curved laceration on the back D. Linear lesions across the chest and abdomen E. A bruise on the child's knee F. A scab on the child's elbow
A, B, C, D
A nurse is teaching parents of a child with a nursing diagnosis of pain related to pruritus from skin lesions. Which of the following would the nurse include in the instructions? Select all that apply. A. "Keep the child's fingernails short." B. "Wrap your child up snugly with blankets." C. "Bathe the child in lukewarm water and baking soda." D. "Have the child press on the itching area instead of scratching it." E. "Avoid having your child wear cotton clothing."
A, C, D
The nurse is caring for a child who has been hospitalized for maltreatment. When reviewing the child's records which findings may have placed the child at an increased risk for abuse? Select all that apply. A. The child's mother has a history of substance use disorder. B. Both parents work outside of the home. C. The child was born prematurely. D. The child has cerebral palsy. E. The child's father is the primary care taker.
A, C, D
The nurse is evaluating outcomes for teaching provided to the mother of a school-age child with an itchy rash. Which outcome indicates that teaching has been effective? A. Mother applies hot compresses to itchy skin areas every few hours B. Child drinks a glass of water every 1 to 2 hours throughout the day C. Child showers in hot water and uses soap on the rash every morning D. Child wearing long denim pants and a long-sleeve shirt while playing outside
B
The school nurse is educating the parents of a child with infectious conjunctivitis. Which of the following statements by the nurse would be most helpful for the parents related to prevention? A. "Use all the medication as directed." B. "Don't use anything that touches her face." C. "This could have started with a head cold." D. "Place the ointment inside the lower eyelid."
B
A 7-month-old is scheduled for surgical correction of strabismus. The child's mother says to the nurse, "I'm glad my child will never have to wear that patch again." Which of these responses would be most appropriate for the nurse to make? A. "Your child will never need to wear the patch again." B. "Your child will need to wear the patch for a few days to keep him/her from rubbing or putting pressure on the eye." C. "Your child will need to wear the patch for several months to keep the eye in alignment." D. "Your child will have to be in restraints for a week to keep him/her from rubbing the eye."
B
A nurse is obtaining the history from a parent of a child who experiences absence seizures. Which of the following would the nurse expect the mother to describe? A. Brief, sudden onset with muscles that become tense B. Loss of motor activity accompanied by a blank stare C. Sudden, brief jerking motions of a muscle group D. Loss of muscle tone and loss of consciousness
B ABSENCE= BLANK STARE
A nurse is assessing a 5-year-old boy and suspects that the child may have an autism spectrum disorder. Which assessments would help support the nurse's suspicions? Select all that apply. A. Inability to make eye contact B. Hypersensitivity to touch C. Lack of facial expression D. Distinct interest in others around him E. Easily distracted from playing
B, C
A 6-month-old infant is admitted with a diagnosis of bacterial meningitis. The nurse would place the infant in which room? A. A room with a 12-month-old infant with a urinary tract infection B. A room with an 8-month-old infant with failure to thrive C. A private room near the nurses' station D. A two-bed room in the middle of the hall
C
A high-school football player has been diagnosed as having osteosarcoma of the femur. The parents are angry because they told the adolescent not to play football. Which health teaching points would the nurse include in the teaching plan for the adolescent and parents? A. Osteosarcoma often follows trauma, such as a football injury. B. You can expect some discoloration of the leg following chemotherapy. C. Football injuries do not contribute to the development of a tumor. D. Tumor growth is related to your dislike of milk.
C
A nurse is assessing a child for possible obsessive-compulsive disorder. Which question would be most helpful for obtaining information from the child? A. "Are you having any recurring dreams about the trauma you experienced?" B. "Has anything happened at home recently that has upset you?" C. "Is there anything that you do over and over again and can't resist doing?" D. "Do you have times when you wake up during the night without any reason?"
C
A preschooler who received chemotherapy in the pediatric oncology outpatient department 1 week ago now has a temperature of 101.5°F (38.6°C). Which is the most appropriate response by the nurse? A. Tell the parent to administer acetaminophen every 4 hours until the fever dissipates. B. Ask whether any family members or other close associates are ill. C. Have the parent bring the child to the pediatric oncology clinic as soon as possible. D. Instruct the parent to immediately obtain and give the antibiotic that the oncologist will order.
C
An 18-month-old child is admitted with signs of increased intracranial pressure. What should the nurse observe when assessing this patient? A. Numbness of fingers and decreased temperature B. Increased pulse rate and decreased blood pressure C. Increased temperature and decreased respiratory rate D. Decreased level of consciousness and increased respiratory rate
C
An extremely thin preadolescent is being assessed by the nurse. Which client statement should the nurse identify as being consistent with that of a person with anorexia nervosa? A. "I'd like to grow up to be a model." B. "I'd like to gain weight but just can't." C. "I feel chubby no matter what I wear." D. "I'm afraid that someone is poisoning my food."
C
An otherwise healthy 18-month-old child with a history of febrile seizures is in the well-child clinic. Which statement by the father would indicate to the nurse that additional teaching should be done? A. "I have ibuprofen available in case it's needed." B. "My child will likely outgrow these seizures by age 5." C. "I always keep phenobarbital with me in case of a fever." D. "The most likely time for a seizure is when the fever is rising."
C
For which child's behavior should the nurse identify as being characteristic of separation anxiety disorder? A. An 8-month-old who cries when left with strangers B. A 7-year-old who withdraws from contact with all strangers C. An 8-year-old who will not stay overnight at a friend's house D. A 10-year-old who reports headaches if there is to be a test in school
C
The nurse instructs a hearing-impaired school-age child on to how self-inject a prescribed medication. Which observation indicates to the nurse that additional teaching is required? A. The child pinches the skin together before inserting the needle. B. The child injects the appropriate amount of air into the vial before withdrawing medication. C. The child places the filled syringe and uncapped needle on the bed to open the alcohol wipe. D. The child slowly pushes on the plunger to inject the medication before withdrawing the needle.
C
The nurse is caring for a 1-month-old girl with low-set ears and severe hypotonia who was diagnosed with trisomy 18. Which nursing diagnosis would the nurse identify as most likely? A. Interrupted family process related to the child's diagnosis B. Deficient knowledge deficit related to the genetic disorder C. Grieving related to the child's poor prognosis D. Ineffective coping related to stress of providing care
C
The parents of a child with a history of seizures who has been taking phenytoin (Dilantin) ask the nurse why it's difficult to maintain therapeutic plasma levels of this medication. Which statement by the nurse would be most accurate? A. "A drop in the plasma drug level will lead to a toxic state." B. "The capacity to metabolize the drug becomes overwhelmed over time." C. "Small increments in dosage lead to sharp increases in plasma drug levels." D. "Large increments in dosage lead to a more rapid stabilizing therapeutic effect."
C
The nurse is caring for a child recovering from surgery to correct strabismus. Which interventions should the nurse include when planning this child's care? Select all that apply. A. Apply an eye patch. B. Maintain on bed rest for 3 days. C. Support for nausea and vomiting. D. Provide pain medication as prescribed. E. Apply antibiotic ointment as prescribed.
C, D, E
A nurse is teaching parents about erythema infectiosum and describing the progression of the disease from earliest to latest. Place the following manifestations in the order in which the nurse would describe them. A. Intense red rash on the face B. Rash on the flexor surfaces of extremities and trunk C. Rash on extremity extensor surfaces D. Fever and headache E. Lace-like lesion appearance
D, A, C, B, E
Parents usually ask when their child can return to school after having chickenpox. The correct answer would be: A. not until all lesions have completely faded. B. as soon as the temperature is normal. C. 10 days after the initial lesions appear. D. as soon as all lesions are crusted.
D
The mother of a an 8-year-old boy with mumps tells the nurse that she does not understand how her son could have gotten mumps since he was immunized according to her physician's recommendations. What is the best response by the nurse? A. "I am sure it must be frustrating. Where did you have the immunizations performed?" B. "I am wondering if your physician followed the immunization schedule correctly?" C. "Are you sure your child received an immunization for mumps?" D. "While immunizations are highly effective they aren't 100% effective at preventing infectious diseases."
D
The nurse is assessing a 30-month-old child during a routine well-child visit. Which statement by the parent would alert the nurse to further assess for a learning disorder? A. "My child seems to prefer playing with certain toys and will not play with other toys very much." B. "My child likes a certain type of food and does not want to try new foods very often." C. "My child gets restless when we go to a restaurant to eat and we have to wait for our food." D. "My child does not say more than one or two words and grunts to indicate needs."
D
The nurse is caring for a 12-month-old child diagnosed with an autism spectrum disorder. What information from the mother during the health history should the nurse identify as being consistent with the disorder? A. The child speaks in complete sentences. B. The child sleeps at least 12 out of every 24 hours. C. The child responds warmly to the father but not to the mother. D. The child constantly stares at a rotating wheel on the crib mobile.
D
The nurse is caring for a school-age child with varicella. What should the nurse observe about the rash that is associated with this infection? A. Dark red color B. Noticeable crusts but no pruritus C. Dark red, macular, very pruritic lesions D. Various stages of lesions present at the same time
D
The nurse is counseling a couple who suspect that they could bear a child with a genetic abnormality. What would be most important for the nurse to incorporate into the plan of care when working with this family? A. Gathering information from at least three generations B. Informing the family of the need for a wide range of information C. Maintaining the confidentiality of the information D. Presenting the information in a nondirective manner
D
The nurse is educating a parent after the birth of a newborn who is diagnosed with phenylketonuria (PKU). Which parent statement indicates teaching has been effective? A. "I will supplement my breast milk with prescribed formula." B. "Once the baby is on solid foods, the dietary restriction will be gone." C. "The concern is the baby has an excess of a liver enzyme." D. "I will not breast feed the baby since breast milk contains phenylalanine."
D
The nurse is educating the parents of a 6-year-old boy about his learning disorder. Which of the following facts would the nurse integrate into the discussion? A. Learning disorders indicate lower intelligence. B. Learning disorders are synonymous with learning deficits. C. The disorder requires comprehensive special education. D. The disorder is caused by a difference in brain architecture.
D
The nurse is providing teaching to the parents of a child with varicella. Which statement indicates that the parents have understood the instructions? A. "We should apply alcohol to the lesions every four hours." B. "If he has a fever, we can give him some aspirin." C. "The lesions should eventually form soft crusts that drain." D. "We need to make sure that he washes his hands frequently."
D
