Quizzes for exam 2
The child post-stem cell transfusion tells a nurse that she has a rash, diarrhea, and abdominal pain. Which condition does the nurse suspect? A. Systemic lupus erythematosus B. Graft-versus-host disease C. Anaphylaxis D. Severe combined immunodeficiency disease
B
A child is diagnosed with lupus. Which nursing diagnosis is highest in priority? A. Alterations in Nutrition B. Pain (chronic) C. Decreased Cardiac Output D. Impaired Gas Exchange
B
The nurse is obtaining health histories on pediatric clinic clients. Which history finding would support the diagnosis of intellectual disability? A. Schizophrenia B. Fragile X syndrome C. Tourette syndrome D. Cerebral palsy
B
Which nursing diagnosis is most important for a teenager diagnosed with SLE? A. Activity Intolerance, Risk for B. Alterations in Nutrition C. Body Image, Disturbed D. Infection, Risk for
C
A 10-year-old child has just received his first immunization of influenza vaccine. His lips begin to swell, and he states, "It feels like my throat is closing shut and my chest is tight when I breathe." Which reaction does the nurse recognize that the child is experiencing? A. A local allergic reaction to the influenza vaccine injection B. An anxiety reaction due to receiving an injection C. A common systemic allergic reaction to immunization D. A life-threatening reaction to the influenza vaccine
D
A 12-year-old is being treated for acute respiratory distress syndrome. Which assessment finding would be indicative of the nursing diagnosis Impaired Gas Exchange? A. Bicarbonate level of 38 B. Heart rate of 100 bpm C. Respiratory rate of 30/min D. Oxygen saturation of 62%
D
Which assessment finding would indicate early hypovolemic shock? A. Decreased blood pressure B. Tachycardia C. Weak central pulses D. Pale, cold skin
B
The nurse is planning care for a child with an intellectual disability. Which intervention does the nurse teach is most important? A. Teaching communication skills B. Transitioning to a group home C. Maintaining a safe environment D. Allowing the child to provide self-care
C
The school nurse is assessing a 10-year-old with a very inflamed and closed eye who complains of severe pain of 5 days' duration. The child states that it is probably a bit of glass from breaking an old Christmas tree ornament. What is the priority action by the nurse? A. Instructing the parents to take the child to an ophthalmologist B. Asking why the parents did not care for the injury C. Looking into the eye with magnification D. Flushing the eye with normal saline
A
The medication ketoconazole (Nizoral) is ordered for a child with a fungal infection. The child weighs 22 pounds. The dose is 4 mg/kg per day. The daily dose for this child would be ____ mg.
40 22 / 2.2 = 10 kg 10 kg x 4 mg/kg = 40
A child is diagnosed with severe combined immunodeficiency. The nurse considers that dietary instruction to the parents is effective if which food is included in the child's diet? A. Chicken fingers and milkshakes B. Tuna salad and whole wheat bread C. Grilled cheese D. Hamburger and skim milk
A
A child with hemophilia states that he wants to participate in sports. Which sport should the nurse recommend as most appropriate for the child? A. Swimming B. Running C. Baseball D. Biking
A
A child with sickle cell anemia (SCA) requires a blood transfusion. Which intravenous solution should the nurse administer before and after the transfusion? A. Normal saline B. 0.45% NS C. D5W 0.45 NS D. D5W
A
A mother of a child with juvenile rheumatoid arthritis (JRA) asks the nurse what activities the child can enjoy. Which would be the most appropriate response based on knowledge of the physiologic aspects of JRA? A. Swimming B. Running C. Bicycling D. Skiing
A
A nurse is evaluating a 16-year-old female with bipolar disorder. Which finding would indicate that she is responding to her medication and therapy? A. Demonstrated interest in school, family, and other life events B. Absence of hallucinations C. No complaints of anxiety D. Absence of perfectionist behavior
A
A nurse is evaluating a child for a learning disability. The child has trouble only with math. Which diagnosis supports this type of learning disability? A. Dyscalculia B. Dysgraphia C. Dyslexia D. Dyspraxia
A
A nurse is making a home visit for a 6-year-old with intellectual disability. Which assessment finding would indicate the need for further discussion with the family? A. The nurse notices household cleaners stored under the kitchen sink. B. The parents state that they are comfortable with caring for the child's toileting needs. C. The child has an individualized education plan (IEP). D. The family has support watching the child from a grandparent.
A
A parent asks the nurse why her children get fewer ear infections as they grow older. On which aspects of the infant's Eustachian tube does the nurse base her answer? A. It is shorter, wider, and more horizontal than an older child's Eustachian tube. B. It is shorter, narrower, and more diagonal than an older child's Eustachian tube. C. It is shorter, wider, and more diagonal than an older child's Eustachian tube. D. It is shorter, narrower, and more horizontal than an older child's Eustachian tube.
A
Following a motor vehicle accident and successful cardiopulmonary resuscitation, arterial blood gases are drawn from a 13-year-old client. What will the nurse identify as the result of this test? A. Acid-base balance B. Carbonic acid level C. Prognosis D. Capillary metabolic exchange
A
If the nurse is triaging a child with autism, which intervention would be appropriate? A. Use speech and pictures to communicate with the child. B. Let the child sit in the waiting room as long as possible to reduce movement. C. While caring for the child, move her to several different areas of the office. D. Play music at a high volume.
A
In addition to an impaired gas exchange, which other diagnosis will a child in the early stages often have as well? A. Anxiety related to hypoxia B. Delayed Development related to hypoxia C. Injury related to fatigue and dehydration D. Fatigue related to air trapping
A
The neonatal nurse explains to new parents that infants are at greater risk for fluid and electrolyte imbalance than older children are. Which parent comment would indicate that further education is needed? A. "Infants maintain their temperature by losing heat through their heads." B. "Infants lose water through their skin, and they have a larger proportion of skin surface area than older children do." C. "Compared to an adult, an infant has little body water for reserve." D. "Infants have a higher metabolic rate than older children do."
A
The nurse concludes that a parent of an otherwise healthy child with varicella (chickenpox) has an accurate understanding of the disease. Which statement by the parents is appropriate following education about the disease process? A. "I will send my child back to school when all the lesions are dry and crusted over." B. "I will give my child acetaminophen 120 mg three times a day for the duration of the illness." C. "I will take my child to our primary healthcare provider to request antibiotics." D. "I will take my child to our primary healthcare provider to request acyclovir."
A
The nurse is providing teaching to the mother of a 10-month-old regarding the administration of iron to her baby. Teaching would be considered effective if the mother administered the iron supplement with which substance? A. Orange juice B. Formula C. Milk D. Water
A
The parent of a 2-year-old brings the child to the emergency department because he is lethargic. Upon assessment, the nurse finds the child has the following vital signs: T 99°F, P 60, R 40, B/P 60/40. Which condition is imminent based on these findings? A. Cardiac arrest B. Endocarditis C. Congestive heart failure D. Cyanosis
A
The nurse is discussing the risks and benefits of vaccines with a family and must secure signed, informed consent for the children to be immunized. The nurse emphasizes that which reaction to vaccines is very rare? A. Fever of 100°F (37.8°C) B. Maculopapular rash C. Encephalopathy D. Urticaria around the injection site
C
The school nurse sees a 14-year-old child who presents with fatigue and a nagging cough of 3 weeks' duration that has become productive with thick mucus and is much worse at night. The school nurse suspects pertussis (whooping cough), because vaccine protection wanes in 5-10 years. What is the school nurse's first nursing action? A. Isolate the child and contact the parents. B. Encourage fluids to prevent dehydration. C. Provide emotional support to the parents. D. Report the case to the Centers for Disease Control and Prevention (CDC).
A
Which nursing diagnosis would be appropriate for a child with hyperlipidemia? A. Knowledge Deficit B. Decreased Cardiac Output C. Fluid Volume Deficit D. Activity Intolerance
A
A nurse develops a plan to prevent and manage visual impairment in her community. Which strategies would she include for infants and children as old as 10 years? (Select all that apply.) A. Collaborating with the Maternal-Child Division to prevent preterm births B. Organizing a support group for parents of visually impaired children C. Collaborating with the school nurses regarding safety programs in schools D. Meeting with sports coaches to plan for all athletes to purchase protective eyewear E. Organizing a playgroup for visually impaired children
A, B, C, E
A parent calls the clinic to determine whether a 6-month-old infant needs to be seen by a healthcare provider for cold-like symptoms. Which questions yield answers that will provide the nurse with the information needed to respond to the parent? (Select all that apply.) A. "What is the infant's temperature?" B. "Is the infant wheezing?" C. "Does the infant cough?" D. "What makes you think that your baby might need to be seen in the clinic?" E. "Does the infant have nasal drainage?"
A, B, D
The nurse is evaluating a 14-year-old on a selective serotonin reuptake inhibitor. Which assessment findings would be indicative of a side effect known as serotonin syndrome? (Select all that apply.) A. Confusion B. Muscle twitching C. Hirsutism D. Fever E. Headaches
A, B, D
The nurse teaches a parent of a child with sickle cell anemia (SCA) about recommended immunizations for the child. Which immunizations would be recommended? (Select all that apply.) A. MMR B. Hib C. Synagist D. Pneumococcal E. Influenza
A, B, D, E
A nurse is evaluating an adolescent for a mental health problem. Which assessment criteria would be the most important? (Select all that apply.) A. Height B. How many hours of television are watched per day C. Blood pressure D. Substance-use activity E. Review of systems
A, C, D, E
A nurse is evaluating a child with a cardiac defect. What should the nurse include as part of the activity and behavior assessment? (Select all that apply.) A. Change in activity B. Growth patterns C. Exercise intolerance D. Dusky color E. Irritability
A, C, E
A 10-year-old child presents to the emergency department with decreased urinary output, lethargy, and confusion. The nurse suspects hypernatremia. About what condition is the nurse most concerned and how can the hypernatremia be treated? A. Anuresis/tap water B. Seizures/hypotonic fluid C. Coma/hypertonic fluid D. Confusion/salt tablets
B
A child is 24 hours postoperative following major trauma, and has received a total of eight units of packed red blood cells during the perioperative period. The child is flaccid, and has diarrhea and peaked T-waves on the electrocardiogram. About which electrolyte abnormality would the nurse call the primary healthcare provider to obtain an electrolyte panel? A. Hypermagnesemia B. Hyperkalemia C. Hypernatremia D. Hypercalcemia
B
A child is diagnosed with the HIV. The child's mother expresses concern about transmission at the daycare setting. What should the nurse teach the family regarding handling soiled diapers? A. Use gowns and goggles. B. Use standard precautions. C. Use gowns and gloves. D. Use gowns, gloves, and masks.
B
A mother refuses to have her child receive any immunizations, based on her religious beliefs. What is the priority nursing diagnosis when planning health teaching for this family? A. Knowledge Deficit (parent) related to potential side effects of vaccines B. Risk for Infection related to incomplete immunization series C. Acute Pain related to injection and associated anxiety D. Risk for Injury related to vaccine reaction
B
A nurse explains why a 4-year-old presenting with respiratory distress has retractions. Which statement by the parent indicates that the teaching was understood? A. "Retractions occur in all children, because their ribs are soft and pliable. They are not related to respiratory distress." B. "Children breathe primarily with their diaphragm, but when distress occurs, the muscles between the rib cage work with extra effort to move air through narrow airways." C. "Children breathe primarily with the muscles between the ribs, so when distress occurs, the extra work of breathing causes retractions." D. "When distress occurs, children swallow air, leading to expansion of the rib cage and retractions."
B
A parent of a child with cyanotic heart defects expresses concerns regarding potential developmental problems due to lack of oxygen to the brain. Which of the following is the most appropriate response by the nurse? A. "Speech therapy might be needed." B. "Developmental specialists might be needed." C. "Physical therapy might be needed." D. "Expressive therapy might be needed."
B
An 8-year-old client is brought into the emergency department with profound anemia and pallor. The mother states, "He was so sick last month with fifth disease and now this." Which complication does the nurse suspect? A. Vaso-occlusive crisis B. Aplastic sickle cell crisis C. Spherocytosis D. Hemophilia
B
Nursing assessment of a school-age child reveals inflamed joints, rash on the trunk, and aimless movements of the extremities. The nurse recognizes these findings as characteristic of which cardiac disorder? A. Valvular insufficiency B. Rheumatic fever C. Infective endocarditis D. Kawasaki disease
B
Teaching is a significant role of the nurse caring for children with congenital cardiac defects. When planning teaching interventions for the families of these clients, which content area should be taught first? A. Elimination alterations B. Medication administration C. Nutrition needs D. Growth and development concerns
B
The nurse is caring for a child following cardiac catheterization. Which instruction to the child's parents would have the highest priority? A. Monitor the child's intake and output. B. Alert the nurse if the bandage becomes bloody. C. Leave the bandage in place until given instructions to remove it. D. Report any dizziness to the nurse.
B
The nurse is teaching a prenatal class about respiratory infections. Which statement by a parent indicates that further teaching is necessary? A. "I should keep my newborn's nose clean so he can breathe and eat without difficulty." B. "When my newborn has a stuffy nose, he will be okay because newborns are obligatory mouth breathers." C. "Children's narrower airways cause them to breathe harder when they are congested." D. "The only time a newborn breathes through the mouth is when he's crying."
B
Which intervention by the nurse is most important when taking care of a child with severe dehydration? A. Monitor for crackles in the lungs. B. Monitor weight daily. C. Monitor level of consciousness. D. Monitor serum sodium levels.
B
Which statement by a 17-year-old girl indicates the need for additional counseling regarding the use of medications for TB treatment? A. Rifampin: "I need to stop taking my birth control pills." B. Isoniazid: "I should take this when I eat." C. Rifampin: "My contact lenses will turn orange." D. Isoniazid: "No more drinking parties for me."
B
For which reasons do nurses recognize that children are more vulnerable than adults during a bioterrorism attack? (Select all that apply.) A. Slower respiratory rate B. Immunization is not complete C. Large blood volume D. Immature immune system and immature blood-brain barrier E. Passively acquired maternal antibodies
B, D, E
Which tasks should the nurse perform rather than delegate to an assistant? (Select all that apply.) A. Changing the diaper of the 3-month-old infant recovering from RSV B. Suctioning a 2-year-old with a tracheostomy C. Walking with a 2-year-old who has an IV receiving antibiotics for pneumonia D. Relieving the nurse who is watching a 2-year-old with croup, because he now sounds quiet E. Taking the temperature of an 8-month-old infant with bronchiolitis whose respirations are 68 and who is irritable
B, D, E
A 10-year-old was in a motor vehicle crash with her father and presents to the emergency department in critical condition. Which life-threatening condition does the nurse suspect? A. Cardiogenic shock B. Tetralogy of Fallot C. Myocardial contusion D. Commotio cordis
C
A 6-year-old child is to receive regularly scheduled immunizations. The parent states that the child is not feeling well and asks the nurse to defer the immunizations until next week. What is the best response by the nurse? A. Ask whether the child has ever had a reaction to immunizations. B. Ask whether the child has missed school. C. Check the child's temperature. D. Give the parent an immunization appointment for next week.
C
A child is diagnosed with lupus and is experiencing a skin exacerbation. What should the nurse encourage the parents to do when providing care in order to decrease the risk factors associated with exacerbation in skin? A. Provide a high-protein diet. B. Use antimicrobial soap. C. Use sunscreen products of 30 SPF. D. Provide oral rehydration products.
C
A mother of a premature infant asks the nurse about the baby's need for supplemental iron. What is the nurse's best response? A. "All infants require iron supplements." B. "The small body size of the preterm infant calls for supplemental iron to promote growth." C. "Because iron stores are developed during the third trimester of pregnancy, premature infants require supplemental iron." D. "Preterm infants have decreased ability to synthesize iron."
C
A nurse performs vision screening in the community. Which child should the nurse refer for additional evaluation? A. An infant whose optic disc the nurse is unable to visualize B. An 11-month-old infant who looks at books for a minute and tosses them away C. A toddler who tends to hold his head to the right side more than the left D. A preschool-age boy who often attends school in clothes with clashing colors
C
A preschool-age child diagnosed with AIDS has developed respiratory compromise. Which technique would the nurse utilize to encourage effective lung expansion? A. Incentive spirometry B. Chest physiotherapy C. Bubble blowing D. Coughing and deep breathing
C
A school nurse initiates an asthma action plan after checking a student's peak expiratory flow averages after three readings. Which peak expiratory flow average indicates that no action be taken? A. 35% B. 65% C. 85% D. 40%
C
As the nurse performs auditory screening on an infant, the parents ask about potential causes of hearing loss. The nurse has reviewed many causes of hearing loss. Which cause of hearing loss does he view as the most common? A. Mechanical ventilation B. Bacterial meningitis C. Genetic recessive inheritance D. Aminoglycoside medication use
C
The nurse assesses a 4-year-old who was adopted from Russia and has had no immunizations. The child does not appear ill but has a fine, pink, maculopapular rash that progressed from the face to the neck, chest, and back, then to the extremities within 3 days. Cervical and occipital lymph nodes are tender and enlarged. Which communicable disease would the nurse suspect? A. Hand, foot, and mouth disease B. Meningococcus C. Rubella (German measles) D. Scarlet fever
C
The nurse is assessing a child with tetralogy of Fallot. The nurse's assessment reveals hypoxemia as indicated by cyanosis, SaO2 of 84%, and bradycardia. What action should the nurse anticipate taking first? A. IV placement B. Notifying the physician C. Administering oxygen D. Preparing the family for imminent surgery
C
The nurse is caring for a child following a bone marrow transplant (BMT). What is the priority nursing diagnosis for this child? A. Ineffective Coping B. Alterations in Nutrition C. Risk of Infection D. Pain
C
The nurse is caring for a school-age child who has chronic fluid overload with edema, and teaches the parents about skin care for their child. Which statement by the parents indicates the need to review the material further? A. "We should check the skin daily to look for any red areas." B. "Places where the skin rubs together are risk areas for breakdown." C. "Pajamas sound ideal for clothes." D. "It is best to buy clothes that are loose-fitting, so they do not rub the skin."
C
The nurse is monitoring a 6-year-old admitted to the emergency department with sixth disease. For which medical emergency does the nurse watch closely? A. Increased pain B. Excessive diarrhea C. Seizure activity D. Sore throat
C
The parent of a child diagnosed with sickle cell anemia (SCA) asks the nurse about air travel with the child. Which is the best response by the nurse? A. "Air travel is not recommended, because it will increase the child's risk for dehydration." B. "Flying will present a risk for infection secondary to crowds." C. "Flying at high altitudes can be associated with less available oxygen, causing more red blood cells to assume the sickle shape." D. "Flying does not pose any particular risks for the child with SCA."
C
Which adolescent would the nurse identify as being at highest risk to commit suicide? A. A male varsity athlete who has been depressed over losing a job B. A female who has talked about killing herself but stated that she feels supported by her mother C. A male who has guns at home and just broke up with a girlfriend D. A female honor student who just broke up with a boyfriend
C
Which comments by the parents of a 7-year-old child with asthma indicate comprehension of instructions regarding medication use for control of the illness? A. If a spacer is used, a whistling sound indicates that the medication is being inhaled correctly. B. Dry powder inhalers are for adult use only. C. A spacer used on an inhaler helps trap the medication so it is inhaled more readily. D. The medications are too complicated for a 7-year-old to understand.
C
A 6-month-old infant is admitted with severe dehydration. Effectiveness of therapy is evaluated with which assessment measures? (Select all that apply.) A. Documenting abdominal girth every shift B. Daily weights each day on a rotating shift C. Documenting mucous membrane moisture every shift D. Recording intake and output accurately E. Evaluating level of consciousness continuously
C, D, E
A child is diagnosed with lupus and is placed on steroid therapy. Which diet should be included in the child's plan of care? A. Increased iron B. Increased carbohydrates C. Increased protein D. Increased calcium
D
A limp 10-year-old boy is carried into the emergency department by a parent who states that the child has a severe nosebleed. What is the priority action by the nurse? A. Administering oxygen B. Suctioning the blood C. Obtaining a history D. Assessing for airway patency
D
A mother questions the nurse regarding feeding her baby cow's milk before the age of 1 year. Which is the most appropriate response? A. "The fat content of cow's milk is harmful to infants." B. "Infants require cow's milk because of the need for increased fat." C. "Cow's milk is fine as long as there is vitamin supplementation." D. "The baby's GI system is underdeveloped, and the milk might cause bleeding."
D
A newborn infant has a high red blood cell (RBC) count obtained by a heelstick. The mom asks the nurse why the heelstick must be repeated. What is the nurse's best response? A. "Two samples are required in all situations." B. "Hospital policy requires a second sample when results are abnormal." C. "The primary healthcare provider ordered two samples." D. "Falsely elevated RBCs might be seen in newborns."
D
A nurse obtains a history from a single, breastfeeding mother with a small but hydrated 3-month-old infant who is listless following what the mother describes as a seizure. Which question would be most important for the nurse to ask? A. "Are you sure you didn't hurt the baby?" B. "Did you have gestational diabetes during pregnancy?" C. "Is this your first baby?" D. "Has your baby had seizures before?"
D
An 8-year-old is admitted to the hospital with a severe sore throat, fever of 102°F, difficulty speaking, and ear pain. Which diagnosis does the nurse suspect based on these clinical manifestations? A. Tonsillitis B. Viral pharyngitis C. Strep throat D. Peritonsillar abscess
D
An infant has acute otitis media. Which would be the most important instruction for the nurse to teach the parents? A. Administer a decongestant. B. Place the baby to sleep with a pacifier. C. Keep the baby in a flat position during sleep. D. Administer acetaminophen to relieve discomfort.
D
Arterial blood gases results indicate pH 7.33 and PCO2 of 38 mmHg following arrest and subsequent resuscitation of a 3-year-old child. Which nursing intervention should be utilized to attempt to correct this metabolic disorder? A. Administer sodium bicarbonate 1 mEq/kg IV. B. Determine whether the endotracheal tube is positioned correctly. C. Assess the effectiveness of the respiratory pattern. D. Treat the cause of the acidosis.
D
The mother of a 2-year-old calls the clinic nurse in a panic, stating, "I think my child swallowed a marble!" Which signs does the nurse know are indicative of a foreign-body aspiration? A. Hypoxia and choking B. Fear and wheezing C. Nasal flaring and crying D. Coughing and dysphonia
D
The nurse at the clinic is teaching a class on childhood upper respiratory infections to parents of preschoolers. Which statement about tonsillectomy indicates further teaching is necessary? A. "I should use acetaminophen for pain after a tonsillectomy." B. "I will call the healthcare provider if my child develops a fever of 102°F after a tonsillectomy." C. "I can use an ice collar to help decrease swelling." D. "I know that a sore throat 7 days after a tonsillectomy indicates an ear infection."
D
The nurse notes several changes in the past 24 hours in a child with heart failure. Which finding is the most significant in assessing the child for fluid volume overload? A. Presence of lung crackles B. Bounding pulse C. Jugular venous distention D. Weight gain of .4 kg
D
The nurse teaches parents about pediatric immunizations. What is considered an absolute contraindication to pediatric immunizations? A. Respiratory illness with low-grade fever B. Soreness, redness, and swelling at the previous injection site C. Febrile seizure 1 month after the previous injection of vaccine D. Anaphylactic reaction to previous immunization
D
When assessing a 6-year-old female diagnosed with intellectual disability during a routine clinic visit, the nurse notes the child has a low nasal bridge with a short upturned nose and a history of hearing loss and poor coordination. Which type of intellectual disability does the nurse suspect? A. Maternal infection B. Fragile X syndrome C. Down syndrome D. Fetal alcohol syndrome
D
n which child does the nurse anticipate a potential respiratory arrest following an assessment? A. A 2-year-old with epiglottitis who was intubated in the emergency department B. A 5-month-old infant with RSV who is sleeping and has a respiratory rate of 24 C. A 4-year-old, status post-tension pneumothorax from a motor vehicle accident with a chest tube in place, who complains of pain D. A 6-year-old with asthma who was previously wheezing and now has decreased breath sounds
D
