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1. The nurse is conducting a well-child examination of a 5-year-old girl, who was 40 in tall at her last examination at age 4. Which height measurement would be within the normal range of growth expected for a preschooler? A) 41 in B) 43 in C) 45 in D) 47 in Ans: B

1. The nurse is obtaining a health history from parents whose 4-month-old boy has congenital hypothyroidism. What would the nurse most likely assess? A) The child has above-normal growth for his age. B) The child is active and playful. C) The skin is pink and healthy looking. D) It is difficult to keep the child awake.

1. The nurse is performing a physical assessment of a 10-year-old boy. The nurse notes that during last year's check-up, the child weighed 80 lb. According to average growth for this age group, what would be his expected current weight? A) 81 lb B) 85 lb C) 87 lb D) 89 lb

1. The nurse is performing a physical assessment of a 3-year-old girl. What finding would be a concern for the nurse? A) The toddler gained 4 lb in weight since last year. B) The toddler gained 3 in in height since last year. C) The toddler's anterior fontanel is not fully closed. D) The circumference of the child's head increased 1 in since last year.

1. The nurse is teaching the mother of a 12-year-old boy about the risk factors associated with drug and alcohol abuse. Which response by the mother indicates a need for further teaching? A) "A family history of alcoholism is a risk factor for substance abuse." B) "Just because his friends are experimenting does not mean that he will." C) "If my husband or I have a substance abuse problem it could increase his risk." D) "Negative life events are a potential risk factor."

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

11.Which tool would be the least appropriate scale for the nurse to use when assessing a 4-year-old child's pain? A)FACES pain rating scale B)Oucher pain rating scale C)Poker chip tool D)Numeric pain intensity scale

13.The nurse is caring for a 4-year-old boy with Ewing sarcoma who is scheduled for a computed axial tomography (CAT) scan tomorrow. Which is the best example of therapeutic communication? A)Telling him he will get a shot when he wakes up tomorrow morning B)Telling him how cool he looks in his baseball cap and pajamas C)Using family-familiar words and soft words when possible D)Describing what it is like to get a CAT scan using words he understands

BDF

13.The nurse is completing an admission of a 10-year-old boy. Which actions will help the nurse establish a trusting and caring relationship with the child and his family? Select all that apply. A)The nurse should not minimize the child's fears by smiling. B)The nurse should initiate introductions. C)The nurse should not use formal titles at the introduction. D)The nurse should maintain eye contact at the appropriate level. E)The nurse should start communication with the child first and then move on to the family. F)The nurse should use age-appropriate communication with the child.

2. A nurse is caring for a 12-year-old girl with a severe peanut allergy. The girl's parents are upset because the school does not permit her to carry her EpiPen with her. It must remain in the school's office per school regulations. Which response by the nurse would be most appropriate? A) "She is allowed by law to carry her EpiPen with her; I will talk to school authorities." B) "Let's file an action plan and keep it in the school office in the event of anaphylaxis." C) "Make sure she wears a medical alert bracelet so that school staff know she has allergies." D) "I will be happy to train school authorities and staff to recognize anaphylaxis."

2. The nurse is caring for an 8-year-old girl with hyperpituitarism. What ordered treatment will the nurse expect to perform? A) Give desmopressin acetate intranasally B) Inject octreotide acetate C) Give 1 mg/kg/day of methimazole D) Administer glipizide orally

2. The nurse is caring for an adolescent girl with anorexia nervosa. What findings would indicate to the nurse that the girl requires hospitalization? A) Weight gain of one-half pound per week B) Food refusal C) Body mass index of 18 D) Soft, sparse body hair and dry, sallow skin

2. The nurse is describing the maturation of various organ systems during toddlerhood to the parents. What would the nurse correctly include in this description? A) Myelination of the brain and spinal cord is complete at about 24 months. B) Alveoli reach adult numbers by 3 years of age. C) Urine output in a toddler typically averages approximately 30 mL/hour. D) Toddlers typically have strong abdominal muscles by the age of 2.

24. The nurse is assessing a child with pauciarticular-type juvenile idiopathic arthritis. What would the nurse expect to assess? A) Fever B) Rash C) Eye inflammation D) Splenomegaly

29.A mother of three brings her children in for their vaccinations. The mother tells the nurse that her mother recently died and her husband just lost his job due to his company downsizing. Which parenting behaviors is the nurse likely to observe? Select all that apply. A)The mother rarely looks at her infant when the nurse is assessing the child. B)The mother voices pride in the academic accomplishments of her 7-year-old child. C)The mother becomes very frustrated and tells the nurse she can't handle her toddler's temper tantrum. D)The mother asks if the nurse has suggestions on ways to potty train her toddler. E)The mother utilizes the correct size of infant car seat for her 3-month-old child.

29.A teenage client tells the nurse that she is being abused by her boyfriend but she doesn't want her parents to know because they won't let her see him any longer. What is the best response by the nurse? A)"It's my responsibility to tell your parents if you are in danger." B)"I understand your fear, but I am obligated to be sure your parents know you are in danger. Would you like for us to talk to them together?" C)"I won't tell them this time, but I must inform you that legally I must inform your parents if abuse is occurring. Next time it happens, I will have to tell them." D)"You need to tell them because the abuse isn't going to get any better. It will only escalate no matter what your boyfriend says."

29.Pentazocine is prescribed for a child with moderate pain. The nurse identifies this drug as an example of which type? A)Nonsteroidal anti-inflammatory drug (NSAID) B)Prostaglandin inhibitor C)Opioid D)Mixed opioid agonist-antagonist

29.The mother of a 7-year-old boy with autism tearfully reports feeling as if she is not qualified to care for her child. Which initial action by the nurse is most appropriate? A)Tell the child's mother that this is a common feeling when caring for a special needs child. B)Encourage the child's mother to keep a journal to best identify areas needing improvement in the home routine. C)Recognize the mother's positive accomplishments in caring for her child. D)Recommend the child's mother seek counseling.

BCE

39. A nurse is providing instructions to the parents of a 3-month-old with developmental dysplasia of the hip who is being treated with a Pavlik harness. Which statements by the parents demonstrate understanding of the instructions? Select all that apply. A) "We need to adjust the straps so that they are snug but not too tight." B) "We should change her diaper without taking her out of the harness." C) "We need to check the area behind her knees for redness and irritation." D) "We need to send the harness to the dry cleaners to have it cleaned." E) "We need to call the healthcare provider if she is not able to actively kick her legs."

4. The nurse is assessing a 9-year-old girl with a history of tuberculosis at age 6 years. She has been losing weight and has no appetite. The nurse suspects Addison disease based on which assessment findings? A) Arrested height and increased weight B) Thin, fragile skin and multiple bruises C) Hyperpigmentation and hypotension D) Blurred vision and enuresis

4. The nurse is caring for a 10-year-old with Duchenne muscular dystrophy. As part of the plan of care, the nurse focuses on maintaining his cardiopulmonary function. Which intervention would the nurse implement to best promote maximum chest expansion? A) Deep-breathing exercises B) Upright positioning C) Coughing D) Chest percussion

4. The nurse is caring for a 5-year-old girl posttonsillectomy. The girl looks out the window and tells the nurse that it is raining and says, "The sky is crying because it is sad that my throat hurts." The nurse understands that the girl is demonstrating which mental process? A) Magical thinking B) Centration C) Transduction D) Animism

9.The nurse is performing a physical examination on a sleeping newborn. Which body system should the nurse examine last? A)Heart B)Abdomen C)Lungs D)Throat

14.The nurse is helping a 20-year-old woman transition to adult care. Which would be the mostimportant role of the nurse following a successful transition? A)Teacher B)Consultant C)Care provider D)Advocate

14.The nurse is performing risk assessments on adolescents in the school setting. Which teen should the nurse screen for hypertension? A)An Asian female B)A white male C)An African-American male D)A Jewish male

14.The nurse is teaching a new mother the proper techniques for breastfeeding her newborn. Which is a recommended guideline that should be implemented? A)Wash the hands and breasts thoroughly prior to breastfeeding. B)Stroke the nipple against the baby's chin to stimulate wide opening of the baby's mouth. C)Bring the baby's wide-open mouth to the breast to form a seal around all of the nipple and areola. D)When finished, the mother can break the suction by firmly pulling the baby's mouth away from the nipple.

14.The nurse tells a joke to a 12-year-old to distract him from a painful procedure. What pain management technique is the nurse using? A)Relaxation B)Distraction C)Imagery D)Thought stopping

15. A child with depression is prescribed fluoxetine. The nurse identifies this as belonging to which class of drugs? A) Atypical antidepressant B) Tricyclic antidepressant C) Selective serotonin reuptake inhibitor D) Psychostimulant

15. A child with spastic cerebral palsy is to receive botulin toxin. The nurse prepares the child for administration of this drug by which route? A) Oral B) Subcutaneous injection C) Intramuscular injection D) Intravenous infusion

15. A group of nursing students are reviewing information about the endocrine system in infants and children. The students demonstrate understanding of the information when they state: A) Endocrine glands begin developing in the third trimester of gestation. B) At birth, the endocrine glands are completely functional. C) Infants have difficulty balancing glucose and electrolytes. D) A child's endocrine system has little effect on growth and development.

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

26.The nurse is preparing a class for a group of adolescents about promoting safety. What would the nurse plan to include as the leading cause of adolescent injuries? A)Motor vehicles B)Firearms C)Water D)Fires

27. A child has been prescribed growth hormone. When collecting data from this client, which report is of the greatest concern? A) "I sometimes have headaches." B) "I feel tired." C) "My hips often hurt." D) "I take this medication with food."

5. A 6-year-old boy with cerebral palsy has been admitted to the hospital for some tests. His condition is stable. The boy's mother remains with her son, but she is obviously exhausted and stressed. Which response by the nurse would be most appropriate? A) "Would you like me to bring you a blanket and pillow?" B) "You are doing such a wonderful job with your son." C) "He's in good hands; consider going home to get some sleep." D) "Are you planning to spend the night or to go home?"

5. A nurse is caring for a 10-year-old boy with a nursing diagnosis of ineffective coping related to an inability to deal with stressors secondary to anxiety. What action should the nurse to take first? A) Set clear limits on the child's behavior B) Teach the child problem-solving skills C) Encourage a discussion of the child's thoughts and feelings D) Role model appropriate social and conversation skills

5. A nurse is caring for a 5-year-old in Bucks traction. When conducting a skin examination for signs of pressure ulcers, the nurse pays particular attention to which area? A) Sacral area B) Hip area C) Occiput D) Upper arm

15.The nurse is assessing heart rate for children on the pediatric ward. What is a normal finding based on developmental age? A)An infant's rate is 90 bpm. B)A toddler's rate is 150 bpm. C)A preschooler's rate is 130 bpm. D)A school-age child's rate is 50 bpm.

20.The nurse is transporting a 6-month-old with a suspected blood disorder to the nursery. What is the most appropriate method of transporting the child by the nurse? A)A wagon with rails B)Cradle hold C)A crib with rails D)Over-the-shoulder

15.The nurse is caring for a 10-year-old girl who is in an isolation room. Which intervention would be a priority intervention for this child? A)Reduce noise as much as possible. B)Provide age-appropriate toys and games. C)Discourage visits from family members. D)Put on mask prior to entering the room.

19. The parents of a 4-year-old who is a picky eater ask the nurse what foods to include in their child's diet to provide adequate iron consumption. Which food would the nurse recommend? A) Cooked lentils B) Whole milk C) Oranges D) Sweet potatoes

1. The nurse is teaching the mother of a 5-year-old boy with a myelomeningocele who has developed a sensitivity to latex. Which response from his mother indicates a need for further teaching? A) "He needs to get a medical alert identification." B) "I will need to discuss this with his caregivers." C) "A product's label indicates whether it is latex-free." D) "He must avoid all contact with latex."

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

1. The nurse is teaching the mother of a toddler about burn prevention. Which response by the mother indicates a need for further teaching? A) "We will leave fireworks displays to the professionals." B) "I will set our water heater at 130 degrees." C) "All sleepwear should be flame retardant." D) "The handles of pots on the stove should face inward."

13.The nurse is providing teaching on how to administer nasal drops. Which response by the parents indicates a need for further teaching? A)"We need to be careful not to stimulate a sneeze." B)"She needs to remain still for at least 10 minutes after administration." C)"Our daughter should lie on her back with her head hyperextended." D)"We must not let the dropper make contact with the nasal membranes."

2. The nurse is providing postoperative care for a 14-month-old girl who has undergone a myelomeningocele repair. The girl's mother is extremely anxious and tells the nurse she is afraid she will never learn how to care for her daughter at home. Which response by the nurse would be most appropriate? A) "I will help you become comfortable in caring for your daughter." B) "You must learn how to care for your daughter at home." C) "You will need to learn to collaborate with all the caregivers." D) "There is a lot to learn, and you need a positive attitude."

ABC

3. The nurse is assessing the psychosocial development of a preschooler. What are normal activities characteristic of the preschooler? Select all that apply. A) Plans activities and makes up games. B) Initiates activities with others. C) Acts out roles of other people. D) Engages in parallel play with peers. E) Classifies or groups objects by their common elements. F) Understands relationships among objects.

33. An 8-year-old boy with a fractured forearm is to have a fiberglass cast applied. What information would the nurse include when teaching the child about the cast? A) The cast will take a day or two to dry completely. B) The edges will be covered with a soft material to prevent irritation. C) The child initially may experience a very warm feeling inside the cast. D) The child will need to keep his arm down at his side for 48 hours.

7.The neonatal nurse assesses newborns for iron deficiency anemia. Which newborn is at highest risk for this disorder? A)A postterm newborn B)A term newborn with jaundice C)A newborn born to a diabetic mother D)A premature newborn

9.The nurse is caring for an 8-year-old boy who has chronic epilepsy. What would be most important to address when teaching the child and parents about living with this condition? A)Multiple corrective surgeries to slowly remove diseased parts of his brain B)Physical, occupational, and speech therapy to maximize his potential C)Support for maintaining self-esteem because of his altered lifestyle D)Hyperventilation therapy to counteract the periods of decreased oxygenation

ADEF

9.The nurse is preparing to administer medication to a child with a gastrostomy tube in place. What is a recommended guideline for this procedure? Select all that apply. A)Verify proper tube placement prior to instilling medication. B)Mix liquid medications with a small amount of water and add directly into the tube. C)Mix powdered medications well with cold water first. D)Crush tablets and mix with warm water to prevent tube occlusion. E)Open up capsules and mix the contents with warm water. F)Flush the tube with water after administering medications.

9.The nurse is teaching a new mother about the development of sensory skills in her newborn. What would alert the mother to a sensory deficit in her child? A)The newborn's eyes wander and occasionally are crossed. B)The newborn does not respond to a loud noise. C)The newborn's eyes focus on near objects. D)The newborn becomes more alert with stroking when drowsy.

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

16.The nurse is preparing to administer an intramuscular injection to an 8-month-old infant. Which site would the nurse select? A)Rectus femoris B)Vastus lateralis C)Dorsogluteal muscle D)Deltoid

18.For which child would nonopioid analgesics be recommended? A)A child with juvenile arthritis B)A child with end-stage cancer C)A child with a broken arm D)A child with severe postoperative pain

18.The nurse is determining the amount of IV fluids to administer in a 24-hour period to a child who weighs 40 kg. How many milliliters should the nurse administer? A)1,000 mL B)1,500 mL C)1,750 mL D)1,900 mL

14.The nurse inspects the eyes of a child and observes that the sclera is showing over the top of the iris. The nurse documents this finding as: A)Decorticate posturing B)Nystagmus C)Doll's eye D)Sunsetting

15.What finding would lead the nurse to suspect that a child is beginning to develop increased intracranial pressure? A)Bradycardia B)Cheyne--Stokes respirations C)Fixed, dilated pupils D)Projectile vomiting

26.Assessment reveals that a child weighs 73 lb and is 4 ft 1 in tall. The nurse calculates this child's body mass index as: A)19.1 B)20.7 C)21.4 D)24.5

BCD

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

ABC

30.The nurse is researching behavioral-cognitive pain relief strategies to use on a 5-year-old child with unrelieved pain. Which methods might the nurse choose? Select all that apply. A)Relaxation B)Distraction C)Thought stopping D)Massage E)Sucking

4. The nurse is caring for a 7-year-old with Tourette syndrome. The nurse would be alert for which comorbid condition? A) Depression B) Anxiety disorder C) Attention deficit/hyperactivity disorder D) Asperger syndrome

4. The nurse is using the formula for bladder capacity to measure the bladder capacity of a 9-year-old girl. What number would the nurse document for this measurement? A) 9 ounces B) 10 ounces C) 11 ounces D) 12 ounces

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

1.The nurse is teaching a group of parents with premature infants about the various medical and developmental problems that may occur. The nurse determines that additional teaching is needed when the group identifies what as a problem? A)Sudden infant death syndrome B)Hydrocephalus C)Peptic ulcer D)Bronchopulmonary dysplasia

1. While providing care to a 5-month-old girl whose family has a history of food allergies, the nurse instructs the parents about foods to be avoided in the first year of life. Which response by the parents indicates a need for further teaching? A) "She cannot have any cow's milk." B) "I should continue breastfeeding until at least 6 months." C) "Peanuts in any form should be avoided." D) "Any kind of fruit is acceptable."

1.The nurse caring for a 6-year-old client enters the room to administer an oral medication in the form of a pill. The dad at the bedside looks at the pill and tells the nurse that his daughter has a hard time swallowing pills. What is the best response by the nurse? A)Ask the child to try swallowing the pill and offer a choice of drinks to take with it. B)Crush the pill and add it to applesauce. C)Request that the healthcare provider prescribe the medication in liquid form. D)Call the pharmacy and ask if the pill can be crushed.

1.The nurse educator working in the emergency room monitors the admission of children. For which admission diagnosis, should the nurse educator encourage the emergency room staff to be the mostprepared? A)Mental health problems B)Injuries C)Respiratory disorders D)Gastrointestinal disorders

CEF

1.The nurse is caring for children in a healthcare provider's office where health supervision is practiced. Which are some points of focus of health supervision? Select all that apply. A)Making referrals for all healthcare needs B)Monitoring disease incidence C)Optimizing the child's level of functioning D)Monitoring quality of care provided E)Teaching parents to prevent injury F)Providing care developed from national guidelines

1.The nurse is conducting a health history for a 9-year-old child with stomach pains. What is a recommended guideline when approaching the child for information? A)Wear a white examination coat when conducting the interview. B)Allow the child to control the pace and order of the health history. C)Use quick deliberate gestures to get your point across. D)Do not make physical contact with the child during the interview.

1.The nurse is examining a 10-month-old boy who was born 10 weeks early. Which finding is cause for concern? A)The child has doubled his birth weight. B)The child exhibits plantar grasp reflex. C)The child's head circumference is 49.53 cm. D)No primary teeth have erupted yet.

ABF

1.The nurse is providing atraumatic care to children in a hospital setting. What are principles of this philosophy of care? Select all that apply. A)Avoid or reduce painful procedures. B)Avoid or reduce physical distress. C)Minimize parent-child interactions. D)Provide child-centered care. E)Minimize child control. F)Use core primary nursing.

10.The nurse is administering immunizations to children in a neighborhood clinic. What is the mostfrequent route of administration? A)Oral B)Intradermal C)Intramuscular D)Topical

BCDF

1.The nurse is teaching the student nurse the physiology involved in pain transmission. Which statements accurately describe a physiologic event in the nervous system related to pain transmission? Select all that apply. A)Thermal stimulation may involve the release of mediators, such as histamine, prostaglandins, leukotrienes, or bradykinin. B)When nociceptors are activated by noxious stimuli, the stimuli are converted to electrical impulses that are relayed to the spinal cord and brain. C)Myelinated A-delta fibers are large fibers that conduct the impulse at very rapid rates; unmyelinated small C fibers transmit the impulse slowly. D)Once in the dorsal horn of the spinal cord, the nerve fibers divide and then cross to the opposite side and rise upward to the thalamus. E)The point at which the person first feels the highest intensity of the painful stimulus is termed the pain threshold. F)Peripheral sensitization allows the nerve fibers to react to a stimulus that is of lower intensity than would be needed to cause pain.

1.The nurse teaches parents of adolescents that adolescents need the support of parents and nurses to facilitate healthy lifestyles. What should be a priority focus of this guidance? A)Reducing risk-taking behavior B)Promoting adequate physical growth C)Maximizing learning potential D)Teaching personal hygiene routines

1.When providing care to a newborn infant who was born at 29 weeks' gestation, the nurse integrates knowledge of potential complications, being alert for signs and symptoms of what priority condition? A)Neonatal conjunctivitis B)Facial deformities C)Intracranial hemorrhage D)Incomplete myelinization

10. After teaching a group of parents about language development in toddlers, what if stated by a member of the group indicates successful teaching? A) "When my 3-year-old asks 'why?' all the time, this is completely normal." B) "A 15-month-old should be able to point to his eyes when asked to do so." C) "At age 2 years, my son should be able to understand things like under or on." D) "An 18-month-old would most likely use words and gestures to communicate."

10. The mother of a 4-year-old boy tells the nurse that her son occasionally wets his pants during the day. How should the nurse respond? A) "Is there a family history of diabetes?" B) "Suddenly having accidents can be a sign of diabetes." C) "That's normal; don't worry about it." D) "Tell me about the circumstances when this occurs."

10. The nurse is administering intravenous immune globulin (IVIG). The nurse assesses vital signs and for adverse reactions every 15 minutes for the first hour of administration. After the first hour, the nurse most likely would continue to assess the child at which frequency? A) Every 30 minutes B) Every 45 minutes C) Every 60 minutes D) Every 2 hours

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

10. The nurse is caring for a child with bipolar disorder. The child is taking lithium as ordered. The parents inquire about the potential side effects. Which response by the nurse would be most appropriate? A) "You might see excessive urination and thirst, tremor, nausea, weight gain, and diarrhea." B) "He might experience a significant decrease in his appetite and difficulty sleeping." C) "You need to watch for dry mouth, urinary retention, and constipation." D) "This medication can cause seizures, agitation, headache, and nausea."

10. The nurse is caring for a child with widespread itching and has recommended bathing as a relief measure. After teaching the mother about this, which statement from the mother indicates a need for further instruction? A) "After bathing, I need to rub his skin everywhere to make sure he is completely dry." B) "I must make sure I use lukewarm water instead of hot water." C) "Oatmeal baths are helpful; we can add Aveeno skin relief bath treatment." D) "We should leave his skin moist before applying medication or moisturizer."

10. The school nurse is conducting vision screening for a 7-year-old girl and documents the condition "amblyopia." What would the nurse tell the parents about this condition? A) "Amblyopia is an uncorrected refractive error of the eye." B) "Amblyopia is reduced vision in an eye that has not been adequately used during early development." C) "Amblyopia is a malalignment of the eye, which occurs at birth." D) "Amblyopia is a clouding of the lens of the eye caused by trauma to the eye."

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

10. What finding would the nurse expect to assess in a child with hypothyroidism? A) Nervousness B) Heat intolerance C) Smooth velvety skin D) Weight gain

10. When developing the plan of care for a child with cerebral palsy, which treatment would the nurse expect as least likely? A) Skeletal traction B) Physical therapy C) Orthotics D) Occupational therapy

10.A 4-year-old boy has a history of seizures and has been started on a ketogenic diet. Which food selection would be most appropriate for his lunch? A)Fried eggs, bacon, and iced tea B)A hamburger on a bun, French fries, and milk C)Spaghetti with meatballs, garlic bread, and a cola drink D)A grilled cheese sandwich, potato chips, and a milkshake

10.During the health history, the mother of a 4-month-old child tells the nurse she is concerned that her baby is not doing what he should be at this age. What is the nurse's best response? A)"I'll be able to tell you more after I do his physical." B)"Fill out the questionnaire and then I can let you know." C)"Tell me what concerns you." D)"All mothers worry about their babies. I'm sure he's doing well."

10.The mother of a hospitalized child reports that her daughter, who is having some difficulty eating, just had a 4-ounce cup of ice chips. The nurse documents this on the child's intake flow sheet as how much? A)2 ounces B)4 ounces C)6 ounces D)8 ounces

10.The nurse is assessing a 4-month-old boy during a scheduled visit. Which findings might suggest a developmental problem? A)The child does not babble. B)The child does not vocally respond to voices. C)The child never squeals or yells. D)The child does not say dada or mama.

10.The nurse is incorporating nonverbal communication with verbal communication when explaining the treatment plan for a child with juvenile diabetes. What should the nurse do to communicate effectively with this family? A)Relax; maintain an open posture, with the arms crossed. B)Sit opposite the family and lean forward slightly. C)Use eye contact sparingly to avoid embarrassment. D)Speak a verbal yes or no; do not use head nods.

10.The nurse is teaching the student nurse the sequence for performing the assessment techniques during a physical examination. What is the appropriate order? A)Inspection, palpation, percussion, auscultation B)Inspection, percussion, palpation, auscultation C)Palpation, percussion, inspection, auscultation D)Inspection, auscultation, palpation, percussion

ABF

10.The school nurse is conducting a seminar for parents of adolescents on how to communicate with teenagers. Which guidelines might the nurse recommend? Select all that apply. A)Talk face to face and be aware of body language. B)Ask questions to see why he or she feels that way. C)Do not give praise unless the adolescent deserves it. D)Speak to your child as an authority figure, not an equal. E)Don't admit that you make mistakes. F)Don't pretend you know all the answers.

10.When the nurse is assessing a child's pain, which action by the nurse is most important? A)Obtaining a pain rating from the child with each assessment B)Using the same tool to assess the child's pain each time C)Documenting the child's pain assessment D)Asking the parents about the child's pain tolerance

10.Which would be least appropriate to include in the discharge plan for a medically fragile child? A)Assisting with referrals for financial support B)Arranging for necessary care equipment and supplies C)Assessing the family's home environment D)Encouraging passive caregiving

11. A child with attention deficit/hyperactivity disorder is prescribed long-acting methylphenidate. What information would the nurse include when teaching the child and his parents about this drug? A) "Give the drug three times a day: morning, midday, and after school." B) "This drug may cause drowsiness, so be careful when doing things." C) "Some increase in appetite may occur, so watch how much you eat." D) "Take this drug every day in the morning when you wake up." Ans: D

11. A nurse is preparing a program for a group of parents about injury prevention. What would the nurse include as an important contributing factor for cervical spine injury in a child? A) Exposure to teratogens while in utero B) Immaturity of the central nervous system C) Increased mobility of the spine D) Incomplete myelinization

11. After teaching a class about the differences in the skin of infants and adults, the nurse determines that additional teaching is necessary when the class states: A) "An infant's skin is thinner than an adult's, so substances placed on the skin are absorbed more readily." B) "The infant's epidermis is loosely connected to the dermis, increasing the risk for breakdown." C) "The infant has a lower risk for damage from ultraviolet radiation because the skin is more pigmented." D) "An infant has less subcutaneous fat, which places the infant at a higher risk for heat loss."

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

11. The nurse is explaining to parents that the preschooler's developmental task is focused on the development of initiative rather than guilt. What is a priority intervention the nurse might recommend for parents of preschoolers to stimulate initiative? A) Reward the child for initiative in order to build self-esteem. B) Change the routine of the preschooler often to stimulate initiative. C) Do not set limits on the preschooler's behavior as this results in low self-esteem. D) As a parent, decide how and with whom the child will play.

11. The nurse is testing the sensory development of a toddler brought to the clinic for a well visit. What might alert the nurse to a potential problem with the child's sensory development? A) The toddler places the nurse's stethoscope in his mouth. B) The toddler's vision tests at 20/50 in both eyes. C) The toddler does not respond to commands whispered in his ear. D) The toddler's taste discrimination is not at adult levels yet.

11. The parents of a child with congenital adrenal hyperplasia bring the child to the emergency department for evaluation because the child has had persistent vomiting. What finding would lead the nurse to suspect that the child is experiencing an acute adrenal crisis? A) Hypernatremia B) Bradycardia C) Hypertension D) Hyperkalemia

11. The school nurse knows that school-age children are developing metalinguistic awareness. Which is an example of this skill? A) The child enjoys reading books. B) The child enjoys conversations with peers. C) The child enjoys speaking on the phone. D) The child enjoys telling jokes.

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

11. When reviewing the history of a child with suspected primary immunodeficiency, what would the nurse be least likely to find? A) Weight appropriate for height B) Antibiotic therapy for the past 3 months without effect C) Ten episodes of otitis media in the last year D) Three bouts of sinusitis within a year's time

11.A 3-year-old child is scheduled for a hearing screening. The nurse would prepare the child for screening by which method? A)Auditory brainstem response B)Evoked otoacoustic emissions C)Visual reinforcement audiometry D)Conditioned play audiometry

11.A child with increased intracranial pressure is being treated with hyperventilation. The nurse understands the need for this treatment is based on what? A)PaCO2 levels decrease, causing vasoconstriction. B)Drainage of cerebrospinal fluid occurs. C)Activity is controlled via a stimulator. D)Hyperexcitability of the nerves is reduced.

11.The nurse is examining the posture of a male toddler and notes lordosis. What would be the appropriate reaction of the nurse to this finding? A)Explain that the child will need a back brace. B)Refer the toddler to a physical therapist. C)Do nothing; this is a normal condition for toddlers. D)Notify the primary care healthcare provider about the condition. Ans:C

CDF

11.The nurse is looking into the Individuals with Disabilities Education Improvement Act of 2004 to help provide resources for a client with multiple chronic diseases. What are mandates of this legislation? Select all that apply. A)The law mandates government-funded care coordination and special education for children up to 8 years of age. B)This early intervention program is a state-funded program run at the federal level. C)This federal law allows each state to define "developmental disability" differently. D)An evaluation of the child's physical, language, emotional, and social capabilities is performed to determine eligibility. E)The primary care nurse manages the developmental services and special education that the child requires. F)The goal is to maintain a natural environment, so most services occur in the home or day care center.

11.The nurse is preparing a nursing care plan for a child hospitalized for cardiac surgery. Which are examples of interventions that nurses perform in the "building a trusting relationship" stage? Select all that apply. A)Gathering information about the child using the child's own toys B)Preparing the child for a procedure by playing games C)Explaining in simple terms what will happen during surgery D)Allowing the child to devise an exercise plan following surgery E)Praising the child for how well he is doing following instructions F)Giving the child a favorite toy to cuddle following a painful procedure

11.The nurse is preparing to administer insulin to a diabetic child. Which would be the recommended route for this administration? A)Subcutaneous B)Intradermal C)Intramuscular D)Oral

11.The nurse is teaching the parents of a 12-year-old boy about appropriate approaches when raising an adolescent. Which comment should be included in the discussion? A)"Find out if his friends are worthy of him." B)"Try to be open to his views." C)"Maintain a firm set of rules." D)"Remind him that he is still your little boy."

11.The nurse is teaching the student nurse how to communicate effectively with children. Which method would the nurse recommend? A)Position self above the child's level to denote authority. B)If possible, communicate with the child apart from the parent. C)Direct questions and explanations to the child. D)Use the medical terms for body parts and medical care.

BCDF

11.The nurse observes an infant interacting with his parents. What are normal social behavioral developments for this age group? Select all that apply. A)Around 5 months, the infant may develop stranger anxiety. B)Around 2 months, the infant exhibits a first real smile. C)Around 3 months, the infant smiles widely and gurgles when interacting with the caregiver. D)Around 3 months, the infant will mimic the parent's facial movements, such as sticking out the tongue. E)Around 3 to 6 months of age, the infant may enjoy socially interactive games such as patty-cake and peek-a-boo. F)Separation anxiety may also start in the last few months of infancy.

12. A child with Duchenne muscular dystrophy is to receive prednisone as part of his treatment plan. After teaching the child's parents about this drug, which statement by the parents indicates the need for additional teaching? A) "We should give this drug before he eats anything." B) "We need to watch carefully for possible infection." C) "The drug should not be stopped suddenly." D) "He might gain some weight with this drug."

12. A child with diabetes reports that he is feeling a little shaky. Further assessment reveals that the child is coherent but with some slight tremors and sweating. A fingerstick blood glucose level is 70 mg/dL. What would the nurse do next? A) Administer a sliding-scale dose of insulin. B) Give 10 to 15 g of a simple carbohydrate. C) Offer a complex carbohydrate snack. D) Administer glucagon intramuscularly.

12. A mother brings her 6-year-old son in for a check-up because the child is reporting stomachaches. It is the beginning of the school year. What might the mother also mention? A) The child cries before going to school. B) The child made friends the first day of school. C) The child fights with siblings more often. D) The child loves the crowds in the lunchroom.

12. The nurse is preparing a class for a group of adolescents about reducing the risk of skin cancer. What information would the nurse include? A) Using a sunscreen with para-aminobenzoic acid (PABA) with an SPF of at least 10 B) Applying sunscreen at least 1 hour before going outside in the sun C) Avoiding sun exposure between the hours of 10 AM and 2 PM D) Using artificial ultraviolet (UV) tanning beds instead of sun exposure

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

12. The nurse observing toddlers in a day care center notes that they may be happy and pleasant one moment and overreact to limit setting the next minute by throwing a tantrum. What is the focus of the toddler's developmental task that is driving this behavior? A) The need for separation and control B) The need for love and belonging C) The need for safety and security D) The need for peer approval

12. The parents of a 5-year-old boy tell the nurse that their son is having frequent episodes of night terrors. Which statement would indicate that the boy is having nightmares instead of night terrors? A) "It usually happens about an hour after he falls asleep." B) "He will tell us about what happened in his dream." C) "He is completely unaware that we are there." D) "When we try to comfort him, he screams even more."

12. What would the nurse expect to find in a male infant with Wiskott--Aldrich syndrome? A) Eczema B) Thrombocytosis C) Lymphadenopathy D) Pneumonia

12. When reviewing the medical record of a child, what would the nurse interpret as the most sensitive indicator of intellectual disability? A) History of seizures B) Preterm birth C) Vision deficit D) Language delay

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

12.A 2-week-old child responds to a bell during an initial health supervision examination. The child's records do not show that a newborn hearing screening was done. Which is the best action for the nurse to take? A)Do nothing because responding to the bell proves he does not have a hearing deficit. B)Immediately schedule the infant for a newborn hearing screening. C)Ask the mother to observe for signs that the infant is not hearing well. D)Screen again with the bell at the 2-month-old health supervision visit.

12.The mother of a 14-year-old girl reports to the nurse that her daughter is moody, shuts herself in her room, and fights with her younger sister. Which comment is most valuable to the mother? A)"Calmly talk to her about your concerns." B)"This is normal for her age." C)"She may be hanging with a bad crowd." D)"Set some rules for family etiquette."

12.The nurse assesses a child's level of consciousness, noting that the child falls asleep unless he is stimulated. The nurse documents this finding as: A)Confusion B)Obtunded C)Stupor D)Coma

12.The nurse is assessing the temperature of a diaphoretic toddler who is crying and being uncooperative. What would be the best method to assess temperature in this child? A)Oral thermometer B)Axillary method C)Temporal scanning D)Rectal route

12.The nurse is caring for an 8-year-old girl who requires medication that is only available in an enteric tablet form. The nurse is teaching the mother how to help the girl swallow the medication. Which statement indicates a need for further teaching? A)"I can encourage her to place it on the back of her tongue." B)"I can pinch her nose to make it easier to swallow." C)"We cannot crush this type of pill as it will affect the delivery of the medication." D)"We can place the tablet in a spoonful of applesauce."

12.The nurse is implementing care for a hospitalized toddler. What communication technique would the nurse use with the child to reflect the child's developmental level? A)Allow the child extra time to complete thoughts. B)Communicate solely through play. C)Provide simple but honest and straightforward responses. D)Remain nonjudgmental to avoid alienation.

12.The nurse is performing a health assessment of a 3-month-old African-American boy. For what condition should this infant be monitored based on his race? A)Jaundice B)Iron deficiency C)Lactose intolerance D)Gastroesophageal reflux disease (GERD)

ADF

12.The nurse is preparing a hospitalized 7-year-old girl for a lumbar puncture. Which actions would help reduce her stress related to the procedure? Select all that apply. A)Pretend to perform the procedure on her doll. B)Explain the procedure to her in medical terms. C)Do not allow her to see or touch the equipment. D)Teach her the steps of the procedure. E)Tell her not to pay attention to any sounds she might hear. F)Introduce her to the health care personnel.

12.The nurse is reviewing the Adolescent Health Transition Project's recommended schedule for transition planning. According to the schedule, at what age should the nurse explore healthcare financing for young adults? A)12 years old B)14 years old C)17 years old D)19 years old

12.The nurse uses the FLACC behavioral scale to assess a 6-year-old's level of postoperative pain and obtains a score of 9. The nurse interprets this to indicate that the child is experiencing: A)little to no pain. B)mild pain. C)moderate pain. D)severe pain.

13. A child with growth hormone deficiency is receiving growth hormone. What result would the nurse interpret as indicating effectiveness of this therapy? A) Rapid weight gain B) Complaints of headaches C) Height increase of 4 in D) Growth plate closure

13. A nurse is assessing the skin of a child with cellulitis. What would the nurse expect to find? A) Red, raised hair follicles B) Warmth at skin disruption site C) Papules progressing to vesicles D) Honey-colored exudate

13. A school-age child diagnosed with depression is receiving antidepressant therapy. What behavior would the nurse instruct the parents to watch for and to notify the healthcare provider immediately if the child demonstrates it? A) Loss of interest B) Gastric upset C) Sedation D) Urinary retention

13. After teaching a class about humoral and cellular immunity, the nurse recognizes that additional teaching is needed when the class states that: A) humoral immunity crosses the placenta. B) cellular immunity involves the T lymphocytes. C) cellular immunity recognizes antigens. D) humoral immunity does not destroy the foreign cell.

13. The mother of a 5-year-old boy calls the nurse and seeks advice on how to assist the child with the recent death of his paternal grandfather. The boy keeps asking when his grandpa is coming back. How should the nurse respond? A) "It is best to just ignore this and to not respond to his questions." B) "This is normal; children his age do not understand the permanence of death." C) "You have to keep repeating that his grandfather is never coming back." D) "He will eventually figure this out on his own."

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

13. The nurse is teaching parents interventions appropriate to the emotional development of their toddlers. What is a recommended intervention for this age group? A) Remove children's security blankets at this stage to help them assert their autonomy. B) Distract toddlers from exploring their own body parts, particularly their genitals. C) Do not blame toddlers for aggressive behavior; instead, point out the results of their behavior. D) Offer toddlers many choices to foster control over their environment.

13. The nurse is teaching the parents of a 9-year-old girl about the socialization that is occurring in their child through school contacts. Which information would the nurse include in her teaching plan? A) Teachers are the most influential people in the development of the school-age child's social network. B) Continuous peer relationships provide the most important social interaction for school-age children. C) Parents should establish norms and standards that signify acceptance or rejection. D) A characteristic of school-age children is their formation of groups with no rules and values involved.

13. What information would the nurse include in the preoperative plan of care for an infant with myelomeningocele? A) Positioning supine with a pillow under the buttocks B) Covering the sac with saline-soaked nonadhesive gauze C) Wrapping the infant snugly in a blanket D) Applying a diaper to prevent fecal soiling of the sac

13.During a well-child visit, the nurse assesses an infant's ability to suck on a pacifier. The nurse is assessing which cranial nerve? A)Olfactory B)Trigeminal C)Facial D)Accessory

13.The adolescent continues to develop self-concept and self-esteem. What is most important to a teen's self-esteem? A)Strong authority figures B)Spirituality C)Morals and values D)Body image

13.The nurse is assessing the pain of a postoperative newborn. The nurse measures the infant's facial expression, body movement, sleep, verbal or vocal ability, consolability, and response to movements and touch. Which behavioral assessment tool is being used by the nurse? A)Riley Infant Pain Scale B)Pain Observation Scale for Young Children C)CRIES Scale for Neonatal Postoperative Pain Assessment D)FLACC Behavioral Scale for Postoperative Pain in Young Children

13.The nurse is caring for a 14-year-old girl with special health needs. What is the priorityintervention for this child? A)Encouraging the parents to promote the child's self-care B)Assessing the child for signs of depression C)Discussing how her care will change as she grows D)Monitoring for compliance with treatment

BCDE

13.The nurse is performing developmental surveillance for children at a medical home. Which infants are most at risk for developmental delays? Select all that apply. A)A child whose birthweight was 1,600 g B)A child whose parent has a mental illness C)A child raised by a single parent D)A child with a lead level above 10 mg/dL E)A child with hypertonia or hypotonia F)A child with gestational age more than 33 weeks

13.The nurse is preparing to take a tympanic temperature reading of a 4-year-old. In order to get an accurate reading, what does the nurse need to do? A)Pull the earlobe back and down. B)Direct the infrared sensor at the tympanic membrane. C)Pull the earlobe down and forward. D)Remove any visible cerumen from inside the ear canal.

13.The nurse is promoting a healthy diet to guide a mother when feeding her 2-week-old girl. Which is the most effective anticipatory guidance? A)Substituting cow's milk if breast milk is not available B)Advocating iron supplements with bottle-feeding C)Advising fluid intake per feeding of 5 or 6 ounces D)Discouraging the addition of fruit juice to the diet

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

14. After teaching the parents of a daughter with central precocious puberty about medication therapy, which statement by the parents indicates successful teaching? A) "She needs to use the nasal spray once every day." B) "She will start puberty again when the medication stops." C) "This medication will slow down the changes but not reverse them." D) "Once therapy is done, she'll need surgery."

14. During a well-child check-up, the parents of a 9-year-old boy tell the nurse that their son's friends told him that soccer is a stupid game, and now he wants to play baseball. Which comment by the nurse best explains the effects of peer groups? A) "The child's best friends will continue playing soccer." B) "The children will cheer for each other regardless of the sport being played." C) "Your child will rarely talk to you about his friends." D) "Acceptance by friends, especially of the same sex, is very important at this age."

14. The nurse is assessing a 3-year-old boy's development during a well-child visit. Which response by the child indicates the need for further assessment? A) He says a swear word when he hurts himself playing. B) He says "pew" when his sister has soiled her diaper. C) He laughs when his brother cries getting vaccinated. D) He constantly asks "why?" whenever he is told a fact.

14. The nurse is assessing a newborn who was delivered after a prolonged labor due to an abnormal presentation. The newborn sustained a cranial nerve injury. The nurse would most likely expect to assess deficits related to which cranial nerve? A) Optic B) Facial C) Acoustic D) Trigeminal

14. The nurse is developing a nursing care plan for a hospitalized 6-year-old. Which behavior would warrant nursing intervention? A) The child pretends he is talking to an imaginary friend when the nurse addresses the child. B) The child states that her fairy godmother is going to come and take her home. C) The child starts talking about his grandmother and then quickly changes the subject to a new toy he received. D) The child does not want to play games with other children on the hospital ward.

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

14. What would lead the nurse to suspect that an adolescent has bulimia? A) Body mass index less than 17 B) Calluses on back of knuckles C) Nail pitting D) Bradycardia

14. When developing the plan of care for a child with burns requiring fluid replacement therapy, what information would the nurse expect to include? A) Administration of colloid initially followed by a crystalloid B) Determination of fluid replacement based on the type of burn C) Administration of most of the volume during the first 8 hours D) Monitoring of hourly urine output to achieve less than 1 mL/kg/hr

14. When teaching a group of new parents about newborn care and development, which immunoglobulin would the nurse explain as being primarily responsible for the passive immunity exhibited by newborns? A) IgA B) IgG C) IgM D) IgE

14.A mother brings her 3-year-old daughter to the emergency department because the child has been vomiting and having diarrhea for the past 36 hours. When assessing this child's temperature, which method would be least appropriate? A)Oral B)Tympanic C)Rectal D)Axillary

14.The nurse is administering a liquid medication to a 3-year-old using an oral syringe. Which action would be most appropriate? A)Direct the liquid toward the anterior side of the mouth. B)Keep the child's hand away from the oral syringe when squirting the medication. C)Give all of the drug in the syringe at one time with one squirt. D)Allow the child time to swallow the medication in between amounts.

14.The nurse is caring for a 14-year-old boy with an osteosarcoma. Which communication technique would be least effective for him? A)Letting him choose juice or soda to take pills B)Seeking the teenager's input on all decisions C)Discussing the benefits of chemotherapy with him D)Avoiding undue criticism of noncompliance

14.The nurse is caring for an 11-year-old girl preparing to undergo a magnetic resonance imaging (MRI) scan. Which statement would best help prepare the girl for the diagnostic test and decrease anxiety? A)"You won't hear a sound if you wear your headphones." B)"The machine makes a very loud rattle; however, headphones will help." C)"There are a variety of loud sounds you will hear." D)"The MRI scanner sounds like a machine gun." Ans:B

14.The nurse is examining a 15-month-old child who was able to walk at the last visit and now can no longer walk. What would be the nurse's best intervention in this case? A)Schedule a full evaluation since this may indicate a neurologic disorder. B)Note the regression in the child's chart and recheck in another month. C)Document the findings as a developmental delay since this is a normal occurrence. D)Ask the parents if they have changed the child's schedule to a less active one.

ABCD

15. The nurse is caring for preschoolers in a day care center. For this age group, of what developmental milestones should the nurse be aware? Select all that apply. A) Counting 10 or more objects B) Correctly naming at least four colors C) Understanding the concept of time D) Knowing everyday objects E) Understanding the differences of others F) Forming concepts as logical as an adult's

15. The nurse is designing a nursing care plan for a toddler with lymphoma, who is hospitalized for treatment. What is a priority intervention that the nurse should include in this child's nursing plan? A) Limiting visitors to scheduled visiting hours B) Planning physical therapy for the child C) Introducing the toddler to other toddlers in the unit D) Monitoring the toddler for developmental delays

15. The nurse is performing a physical examination of an 11-year-old girl. What observations would be expected? A) The child has not gained weight since last year. B) The child has grown 2.5 in since last year. C) The child breathes abdominally. D) The child's third molars are about to erupt.

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

15. What would the nurse include when teaching an adolescent about tinea pedis? A) "Keep your feet moist and open to the air as much as possible." B) "Dry the area between your toes really well." C) "Wear nylon or synthetic socks every day." D) "Go barefoot when you are in the locker room at school."

15. Which exercise would the nurse suggest as most helpful to maintain mobility in a child with juvenile idiopathic arthritis? A) Jogging every other day B) Using a treadmill C) Swimming D) Playing basketball

15.After administering eye drops to a child, the nurse applies gentle pressure to the inside corner of the eye at the nose for which reason? A)To promote dispersion over the cornea B)To enhance systemic absorption C)To ensure the medication stays in the eye D)To stabilize the eyelid

15.During a physical assessment of a 5-month-old child, the nurse observes the first tooth has just erupted and uses the opportunity to advise the mother to schedule a dental examination for her baby. When is the correct time for the dentist visit? A)By the first birthday B)By the second birthday C)By entry into kindergarten D)By entry into first grade

15.The nurse caring for young children in a hospice setting is aware of the following statistics related to the occurrence of death in children. Which statement accurately reflects one of these statistics? A)Each year, about 50,000 children die in the United States; of those, about 15,000 are infants. B)It is unusual for a child's chronic illness to progress to the point of becoming a terminal illness. C)Despite strides made, diabetes remains the leading cause of death from disease in all children older than the age of 1 year. D)Congenital defects and traumatic injuries are the more common causes of diseases leading to death.

15.The nurse is educating a 16-year-old girl who has just been diagnosed with acute myelogenous leukemia. Which statement best demonstrates therapeutic communication? A)Discussing the treatment plan in detail for the next few weeks B)Using medical terms when describing the disease C)Assessing the adolescent's emotional status in private D)Talking about clothing and the stores where she shops

15.The nurse is providing discharge teaching regarding formula preparation for a new mother. Which guideline would the nurse include in the teaching plan? A)Always wash bottles and nipples in hot soapy water and rinse well; do not wash them in the dishwasher. B)Store tightly covered ready-to-feed formula can after opening in refrigerator for up to 24 hours. C)Warm bottle of formula by placing bottle in a container of hot water, or microwaving formula. D)Do not add cereal to the formula in the bottle or sweeten the formula with honey.

15.The nurse is providing instructions to a mother on how to use thought stopping to help her child deal with anxiety and fear associated with frequent painful injections. Which statement indicates the mother understands the technique? A)"We will imagine that we are on the beach in Florida." B)"We can talk about our favorite funny movie and laugh." C)"She can let her body parts go limp, working from head to toe." D)"We'll repeat 'quick stick, feel better, go home soon' several times."

15.The nurse knows that barriers to the adolescent's health and successful achievement of the tasks of adolescence exist. What is the major barrier to health for this population? A)Cultural B)Socioeconomic C)Marital status D)Racial

16. A child is diagnosed with atopic dermatitis. Which laboratory test would the nurse expect the child to undergo to provide additional evidence for this condition? A) Erythrocyte sedimentation rate B) Potassium hydroxide prep C) Wound culture D) Serum immunoglobulin E (IgE) level

16. A child is diagnosed with hyperthyroidism. Which agent would the nurse expect the healthcare provider to prescribe? A) Mineralocorticoid B) Methimazole C) Levothyroxine D) Dexamethasone

16. A child is diagnosed with juvenile idiopathic arthritis and is receiving several different medications listed in the medication administration record. Which agent would the nurse identify as being used to prevent disease progression? A) Aspirin B) Prednisone C) Ibuprofen D) Methotrexate

16. A child is receiving therapy in which he is learning to replace automatic negative thought patterns with alternative ones. The nurse interprets this as which type of therapy? A) Cognitive therapy B) Behavioral therapy C) Milieu therapy D) Individual therapy

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

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

16. The nurse is assessing the neuromusculoskeletal system of a newborn. What is an abnormal assessment finding? A) Sluggish deep tendon reflexes B) Full range of motion in extremities C) Absence of hypotonia D) Lack of purposeful muscular control

16. The nurse is watching toddlers at play. Which normal behavior would the nurse observe? A) Toddlers engage in parallel play. B) Toddlers engage in solitary play. C) Toddlers engage in cooperative play. D) Toddlers do not engage in play outside the home.

16. What finding would the nurse most likely discover in a 10-year-old child in the period of concrete operational thought? A) Participation in abstract thinking B) Ability to classify similar objects C) Problem solving via the scientific method D) Ability to make independent decisions

16. When observing a group of preschoolers at play in the clinic waiting room, which type of play would the nurse be least likely to note? A) Parallel play B) Cooperative play C) Dramatic play D) Fantasy play

16.A mother and her 4-week-old infant have arrived for a health maintenance visit. Which activity will the nurse perform? A)Assess the child for an upper respiratory infection. B)Take a health history for a minor injury. C)Administer a varicella injection. D)Plot the child's head circumference on a growth chart.

16.A nurse is talking with the parents of a child who has had a febrile seizure. The nurse would integrate an understanding of what information into the discussion? A)The child's risk for cognitive problems is greatly increased. B)Structural damage occurs with febrile seizure. C)The child's risk for epilepsy is now increased. D)Febrile seizures are benign in nature.

16.An adolescent is scheduled for outpatient arthroscopic surgery on his knee next week. As part of preparing him for the procedure, which action would be most appropriate? A)Discussing the events with the adolescent and his mother upon arrival the morning of the procedure B)Providing detailed explanations of the procedure at least a week in advance of the procedure C)Encouraging the parent to stay with the adolescent as much as possible before the procedure D)Answering the adolescent's questions with simple answers, encouraging him to ask the surgeon

16.The nurse is assessing the heart rate of a healthy school-age child. The nurse expects that the child's heart rate will be in what ranges? A)80 to 150 bpm B)70 to 120 bpm C)65 to 110 bpm D)60 to 100 bpm

16.The nurse is caring for a 4-week-old girl and her mother. Which is the most appropriate subject for anticipatory guidance? A)Promoting the digestibility of breast milk B)Telling how and when to introduce rice cereal C)Describing root reflex and latching on D)Advising how to choose a good formula

16.The nurse is performing a cultural assessment of an Asian family that has a child hospitalized for leukemia. What is the best technique for providing culturally competent care for this family? A)Research the culture and base care on findings. B)Ask other Asians to explain their culture. C)Just ask the family about their culture and listen. D)Hire an interpreter to explain the family culture.

16.The nurse is providing home care for the family of an 8-year-old boy who is dying of leukemia. Which action will be most supportive to the parents of the child? A)Encouraging organ and tissue donation B)Being patient with parental indecision C)Getting prior authorization for treatments D)Explaining how anorexia is a natural process

16.The nurse teaching safety to teens knows that which of these is the leading cause of death among adolescents? A)Drowning B)Poisoning C)Diseases D)Unintentional injuries

16.The student nurse is learning about the effects of heat and cold when used in a pain management plan. What accurately describes one of these effects? A)Cold results in vasodilation. B)Cold alters capillary permeability. C)Heat results in vasoconstriction. D)Heat decreases blood flow to the area.

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

17. A child with cerebral palsy has undergone surgery for placement of a baclofen pump. Which instruction would the nurse include when teaching the parents about caring for their child? A) Waiting 48 hours before allowing the child to take a tub bath B) Not allowing the child to sleep on his side for about 4 weeks C) Calling the healthcare provider if the child's temperature is over 100.5°F D) Discouraging the child from stretching or bending forward for 4 weeks

17. A child with diabetes insipidus is being treated with vasopressin. The nurse would assess the child closely for signs and symptoms of which condition? A) Syndrome of inappropriate antidiuretic hormone (SIADH) B) Thyroid storm C) Cushing syndrome D) Vitamin D toxicity

17. A group of nursing students are reviewing information about humoral and cellular immunity. The students demonstrate understanding of this material when they identify what as being involved in cellular immunity? A) B cells B) Antibodies C) Antigens D) T cells

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

17. A nurse is preparing a program for a parent group about various techniques that can be used to manage behavior. What would the nurse be least likely to include? A) Focus the child's attention on the negative behavior. B) Set limits with the child for responsible behavior. C) Ignore inappropriate behaviors. D) Provide positive feedback for self-control efforts.

17. After teaching the parents of a 9-year-old girl about safety, which statement indicates the need for additional teaching? A) "She can ride in the front seat of the car once she is 10 years old." B) "We need to buy her a helmet so she can ride her scooter." C) "She should ride her bike with the traffic on the side of the road." D) "We signed her up for swim lesions at the local community center."

17. The nurse is developing a teaching plan for toddler safety to present at a parenting seminar. Which safety intervention should the nurse address? A) Encourage parents to enroll toddlers in swimming classes to avoid the need for constant supervision around water. B) Advise parents to keep pot handles on stoves turned outward to avoid accidental burns. C) Encourage parents to smoke only in designated rooms in the house or outside the house. D) Advise parents to use a forward-facing car seat with harness straps and a clip, placed in the back seat of the car.

17. The nurse is providing care to a child with folliculitis. What would the nurse expect to administer? A) Topical mupirocin B) Oral cephalosporin C) Intravenous oxacillin D) Topical Eucerin cream

17. The nurse is supervising lunch time for children on a pediatric ward. Which observation, if noted by the nurse, would require further assessment? A) A child has a full set of primary teeth. B) A child has no difficulty chewing and swallowing meat. C) A child uses his fingers and refuses to use a fork. D) A child is a picky eater.

17.A nurse is preparing a school-aged child for a lumbar puncture. The nurse would expect to position the child in which manner? A)On her side with the head flexed forward and knees flexed to the abdomen B)Sitting upright with the head flexed forward to the chest C)Supine with arms and legs pronated and extended D)Prone with the arms flexed under the chest

17.The nurse is caring for children who are receiving IV therapy in the hospital setting. For which children would a central venous device be indicated? A)A child who is receiving an IV push B)A child who is receiving chemotherapy for leukemia C)A child who is receiving IV fluids for dehydration D)A child who is receiving a one-time dose of a medication

17.The nurse is preparing to assess the pulse of an 18-month-old child. Which pulse would be mostdifficult for the nurse to palpate? A)Radial B)Brachial C)Pedal D)Femoral

17.The nurse is providing anticipatory guidance to a mother of a 5-month-old boy about introducing solid foods. Which statement by the mother indicates that effective teaching has occurred? A)"I'll start with baby oatmeal cereal mixed with low-fat milk." B)"The cereal should be a fairly thin consistency at first." C)"I can puree the meat that we are eating to give to my baby." D)"Once he gets used to the cereal, then we'll try giving him a cup."

17.The nurse is providing developmentally appropriate care for a toddler hospitalized for observation following a fall down the steps. Which measures might the nurse consider when caring for this child? Select all that apply. A)Use the en face position when holding the toddler. B)Use a bed for toddlers who have an adult present. C)Avoid leaving small objects that can be swallowed in the bed. D)Explain activities in concrete, simple terms. E)Allow the child to select meals and activities. F)Encourage parents to stay to prevent separation anxiety.

17.The nurse is providing palliative care for a 9-year-old boy in hospice. Which is unique to hospice care for children? A)Encouraging visits from friends and family B)Educating parents about terminal dehydration C)Prolonging treatment that might possibly help D)Treating constipation to relieve abdominal pain

17.The nurse is screening a 6-year-old child for mental ability. Which test would the nurse use to assess intelligence? A)Denver Articulation Screening B)Denver PRQ C)Goodenough--Harris Drawing Test D)Parents' Evaluation of Developmental Status (PEDS)

17.The nurse is teaching an 8-year-old child and his family how to manage cancer pain using nonpharmacologic methods. Which parent statement signifies successful child teaching? A)"I will avoid using descriptive words like pinching, pulling, or heat." B)"I will not use positive reinforcement until the technique is perfected." C)"I will begin using the technique before he experiences pain." D)"I will be honest and tell him that the procedure will hurt a lot."

4.A large portion of the nurse's efforts is dedicated to health supervision for children who use the facility as their primary medical contact. At which facility does the nurse work? A)An urgent care center B)A pediatric practice C)A mobile outreach immunization program D)A dermatology practice

17.The nurse is using a family interpreter to teach home care to the deaf parents of a child with cystic fibrosis. Which technique of working with an interpreter is unique to this situation? A)Ensuring the parents can read printed material B)Using the child's aunt as interpreter C)Allowing time for interpretation and response D)Expecting the interpreter to know the medical terms

ABEF

17.When assessing adolescents for health risks, the nurse must keep in mind the factors related to the prevalence of adolescent injuries. What accurately describes these factors? Select all that apply. A)Increased physical growth B)Insufficient psychomotor coordination C)Tiredness, lack of energy D)Lack of impulsivity E)Peer pressure F)Inexperience

18. A nurse is preparing a class for parents of infants about managing diaper dermatitis. What advice would the nurse include in the presentation? Select all that apply. A) Applying topical nystatin to the diaper area B) Using a blow dryer on warm to dry the diaper area C) Refraining from using rubber pants over diapers D) Using scented diaper wipes to clean the area E) Washing the diaper area with an antibacterial soap

18. A nurse is preparing a plan of care for a child with a primary immunodeficiency. Which nursing diagnosis is the priority? A) Imbalanced nutrition, less than body requirements related to poor appetite B) Ineffective protection related to impaired humoral defenses C) Acute pain related to inflammatory processes D) Risk for delayed growth and development related to chronic illness

BDE

18. A nursing instructor is preparing for a class discussion on spinal muscular atrophy (SMA). When describing type 2 SMA, which information would the instructor include? Select all that apply. A) Onset before 6 months of age B) Weakness most severe in shoulders and hips C) Difficulty with swallowing D) Slowly progressing condition E) Genetic disease with autosomal recessive inheritance

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

18. During a health history, the nurse explores the sleeping habits of a 3-year-old boy by interviewing his parents. Which statement from the parents reflects a recommended guideline for promoting healthy sleep in this age group? A) "Our son sleeps through the night, and we insist that he takes two naps a day." B) "We keep a strict bedtime ritual for our son, which includes a bath and bedtime story." C) "Our son still sleeps in a crib because we feel it is the safest place for him at night." D) "Our son occasionally experiences night walking so we allow him to stay up later when this happens."

18. The nurse is reviewing the laboratory test results of a child with Addison disease. What would the nurse expect to find? A) Hypernatremia B) Hyperkalemia C) Hyperglycemia D) Hypercalcemia

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

18. The nurse is reviewing the medical record of a child who has dyspraxia. This child will experience difficulty with: A) reading and writing. B) mathematics and computation. C) manual dexterity and coordination. D) composition and spelling.

18. The nurse is teaching parents to plan nutritional meals for their 7-year-old son who is overweight. Which guideline might the nurse include in the teaching plan? A) School-age children with an average body weight of 20 to 35 kg need approximately 90 calories per kilogram daily. B) The average water requirement for a school-age child per 24 hours ranges from 2,000 to 2,500 mL per day. C) The school-age child needs 28 g of protein and 800 mg of calcium for maintenance of growth and good nutrition. D) In the school-age child, calories needed to sustain weight increase, while the appetite decreases.

18. The nurse of a preschool child is helping parents develop a healthy meal plan for their child. What nutritional requirements for this age group should the nurse consider? A) The 3- to 5-year-old requires 300 to 500 mg calcium and 10 mg iron daily. B) The 3-year-old should consume 10 mg dietary fiber daily. C) The 4- to 8-year-old requires 15 mg dietary fiber per day. D) The typical preschooler requires about 85 kcal/kg of body weight.

18.A group of nursing students are reviewing information related to seizures that occur in infants and children. The students demonstrate a need for additional review when they identify which type as common in neonates? A)Tonic B)Focal clonic C)Multifocal clonic D)Myoclonic

18.The nurse is explaining a discharge plan to the parents of an infant being discharged from the hospital. Which characteristic regarding adult learning should the nurse incorporate into her plan? A)Adults are dependent learners. B)Adults are problem focused. C)Adults are future focused. D)Adults do not value past learning.

18.The nurse is helping the parents and their underweight adolescent collaborate on planning a healthy menu. Of which nutritional requirement of adolescents should the nurse be aware? A)Teenagers have a need for increased calories, zinc, calcium, and iron for growth. B)Teenage girls who are active require about 1,800 calories per day. C)Teenage boys who are active require between 2,000 and 2,500 calories per day. D)Adolescents require about 1,000 to 1,200 mg of calcium each day.

DEF

18.The nurse is ordered to apply restraints to a toddler who keeps pulling at the tubes in his arm. Which criteria must occur to ensure proper use of these restraints? Select all that apply. A)The nurse must check the restraints every 15 minutes while they are in place. B)Secure the restraints with ties to the side rails, not the bed or crib frame. C)Assess the temperature of the affected extremities, pulses, and capillary refill every 15 minutes after placement. D)Use a clove-hitch type of knot to secure the restraints with ties. E)Remove the restraint every 2 hours to allow for range of motion and repositioning. F)Encourage parent participation, providing continuous explanations about the reasons and time frame for restraints.

18.The nurse is providing anticipatory guidance to the mother of a 9-month-old girl during a well-baby visit. Which topic would be most appropriate? A)Advising how to create a toddler-safe home B)Warning about small objects left on the floor C)Cautioning about putting the baby in a walker D)Telling about safety procedures during baths

18.When assessing the vision of a 2-month-old, what would the nurse use? A)Black-and-white checkerboard B)Red and blue circles C)Gray and blue animal drawings D)Green and yellow letters

18.When providing care to a dying child and his family, which would be most important? A)Focusing on the family as the unit of care B)Teaching the family appropriate care measures C)Offering the child support and encouragement D)Assisting the parents in decision making

18.While auscultating the heart of a 5-year-old child, the nurse notes a murmur that is soft and quiet and heard each time the heart is auscultated. The nurse documents this finding as what grade? A)Grade 1 B)Grade 2 C)Grade 3 D)Grade 4

19. A child with hypogammaglobulinemia is to receive intravenous immunoglobulin (IVIG). What action would not be correct to take? A) Shake the vial after reconstituting it B) Premedicate the child with acetaminophen C) Obtain preinfusion vital signs D) Check serum blood urea nitrogen and creatinine levels

ABD

19. A group of students are preparing for a class exam on skin disorders. As part of their preparation, they are reviewing information about acne vulgaris and its association with increased sebum production. The students demonstrate understanding of the information when they identify which areas as having the highest sebaceous gland activity? Select all that apply. A) Face B) Upper chest C) Neck D) Back E) Shoulders

19. A nurse is conducting a screening program for autism in infants and children. What would the nurse identify as a warning sign? A) Lack of babbling by 6 months B) Inability to say a single word by 16 months C) Lack of gestures by 8 months D) Inability to use two words by 18 months

19. A nurse is teaching the parents of an infant with congenital adrenal hyperplasia about the signs and symptoms of adrenal crisis. The nurse determines that the teaching was successful when the parents correctly identify what sign of adrenal crisis? A) Bradycardia B) Constipation C) Fluid overload D) Persistent vomiting

19. After teaching a class of nursing students about muscular dystrophy, the instructor determines that the teaching was successful when the students identify which type of muscular dystrophy as demonstrating an X-linked recessive pattern of inheritance? A) Limb-girdle B) Myotonic C) Distal D) Duchenne

19. The nurse has determined that an 8-year-old girl is at risk for being overweight. Which intervention would be a priority prior to developing the care plan? A) Determining the need for additional caloric intake B) Asking the parents who they want to work with the child C) Interviewing the parents about their eating habits D) Discussing the influence of peers on the child's diet

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

19. The nurse is teaching good sleep habits for toddlers to the mother of a 3-year-old boy. Which response indicates the mother understands sleep requirements for her son? A) "I'll put him to bed at 7 pm, except Friday and Saturday." B) "He needs 12 hours of sleep per day including his nap." C) "I need to put the side down on the crib so he can get out." D) "His father can give him a horseback ride into his bed."

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

19.A nurse has just administered medication via an orogastric tube. What is the priority nursing action following administration? A)Check tube placement. B)Retape the tube. C)Flush the tube. D)Remove the tube.

19.Hydrocephalus is suspected in a 4-month-old infant. Which would the nurse expect to assess? A)Sunken fontanels B)Diminished reflexes C)Lower extremity spasticity D)Skull symmetry

19.Prior to administering morphine to a 10-year-old child, the nurse reviews the adverse effects of the drug. Which system is primarily affected by the drug, causing most of the adverse effects? A)Central nervous system B)Peripheral nervous system C)Digestive system D)Musculoskeletal system

19.The nurse in a community clinic is caring for a 6-month-old boy and his mother. Which intervention is priority to promote adequate growth? A)Monitoring the child's weight and height B)Encouraging a more frequent feeding schedule C)Assessing the child's current feeding pattern D)Recommending higher-calorie solid foods

19.The nurse is caring for a 7-year-old boy who needs his left leg immobilized. What is the prioritynursing intervention? A)Enlist the assistance of a child life specialist. B)Explain to the boy that he must keep his leg very still. C)Apply a clove-hitch restraint to the boy's left leg. D)Explain that a restraint will be applied if he cannot hold still.

19.The nurse is educating the parents of a 7-year-old girl who has just been diagnosed with epilepsy. Which teaching technique would be most appropriate? A)Assessing the parents' knowledge of the anticonvulsant medications B)Demonstrating proper seizure safety procedures C)Discussing the surgical procedure for epilepsy D)Giving the parents information in small amounts at a time

19.The nurse is performing a risk assessment of a 5-year-old and determines the child has a risk factor for cystic fibrosis. What type of screening would the nurse perform to confirm or rule out this disease? A)Universal screening B)Selective screening C)Hyperlipidemia screening D)Developmental screening

19.The nurse is promoting nutrition to a 13-year-old boy who is overweight. Which comment should the nurse expect to include in the discussion? A)"You need to go on a low-fat diet." B)"Eat what your parents eat." C)"Go out for a sport at school." D)"Keep a food diary."

19.The parents of a 2-day-old girl are concerned because her feet and hands are slightly blue. How should the nurse respond? A)"Your daughter has acrocyanosis; this is causing her blue hands and feet." B)"Let's watch her carefully to make sure she does not have a circulatory problem." C)"This is normal; her circulatory system will take a few days to adjust." D)"This is a vasomotor response caused by cooling or warming."

19.The parents of an 11-year-old boy who is dying from cancer are concerned that he is not eating. Which intervention would serve both the parents' and child's needs? A)Urging the child to eat one good meal per day B)Serving small meals of things the child likes C)Straightening up around the child before meals D)Administering antiemetics as ordered for nausea

2. The nurse is performing an annual check-up for an 8-year-old child. Compared to the previous assessment of this child, which characteristic would most likely be observed? A) Breathing is diaphragmatic. B) Pulse rate is increased. C) Secondary sex characteristics are present. D) Blood pressure has reached adult level.

2. The nurse is providing parental teaching about home care for an 8-year-old boy with widespread sunburn on his back and shoulders. Which response indicates a need for further teaching? A) "Cool compresses may help cool the burn." B) "He should manually peel off any flaking skin." C) "Nonsteroidal anti-inflammatory drugs like ibuprofen are helpful." D) "He should avoid hot showers or baths for a couple of days."

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

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

2.For which children would the nurse conduct an immediate comprehensive health history? A)A child who is brought to the emergency room with labored breathing B)A child who is a new client in a pediatric office C)A child who is a routine client and presents with signs of a sinus infection D)A child whose condition is improving

2.The nurse has seen a 15-year-old girl and a 16-year-old boy during health surveillance visits. Which physical characteristics would be seen in both teenagers? A)Decreased respiratory rates of 15 to 20 breaths per minute B)Eruption of the last four molars C)Increased shoulder, chest, and hip widths D)Fully functioning sweat and sebaceous glands

CDE

2.The nurse is administering acetaminophen PRN to a 9-year-old child on the pediatric ward of the hospital. Which answers reflect nursing actions that follow the rules of the rights of pediatric medication administration? Select all that apply. A)The nurse identifies the child by checking the name on the child's chart. B)The nurse makes sure the medication is given within the hour of the ordered time. C)The nurse checks the documented time of the last dosage administered. D)The nurse calculates the dosage according to the child's weight. E)The nurse explains the therapeutic effects of the medication to the child and parents. F)The nurse administers the medication even though the child is adamant about not taking it.

2.The nurse is caring for a 7-year-old girl hospitalized in isolation. The nurse notices that she has begun sucking her thumb and changing her speech patterns to those of a toddler. What condition is the girl manifesting? A)Regression B)Suppression C)Repression D)Denial

2.The nurse is caring for a toddler with special needs. Which developmental tasks related to toddlerhood might be delayed in the child with special needs? A)Developing body image B)Developing peer relationships C)Developing language and motor skills D)Learning through sensorimotor exploration

CDE

2.The nurse is consulting with a child life specialist (CLS) to help minimize the stress of hospitalization for a child. Which services would the CLS provide? Select all that apply. A)Medical preparation for tests, surgeries, and other medical procedures B)Support before and after, but not during, medical procedures C)Activities to support normal growth and development D)Grief and bereavement support E)Emergency room interventions for children and families F)Only inpatient consultations with families

ACE

2.The nurse is managing children who have chronic diseases in a neighborhood clinic. What are some examples of chronic conditions? Select all that apply. A)Diabetes mellitus B)Myocardial infarction C)Rheumatoid arthritis D)Compound fracture E)Acute asthma F)Bronchopneumonia

2.The nurse is providing care for children in a pediatric medical home. What is a characteristic of care in these types of facilities? A)All insurance except Medicaid is accepted. B)Ambulatory care is not provided C)A centralized database contains all child information. D)Continuity of care is provided from infancy through adulthood.

2.The nurse is teaching a new mother about the drastic growth and developmental changes her infant will experience in the first year of life. Which statement describes a developmental milestone occurring in infancy? A)By 6 months of age, the infant's brain weighs half that of the adult brain; at age 12 months, the brain weighs 2.5 times what it did at birth. B)Most infants triple their birth weight by 4 to 6 months of age and quadruple their birth weight by the time they are 1 year old. C)The head circumference increases rapidly during the first 6 months: the average increase is about 1 in per month. D)The heart triples in size over the first year of life; the average pulse rate decreases from 120 to 140 in the newborn to about 100 in the 1-year-old.

2.The nurse knows that children have larger heads in relation to the body and a higher center of gravity. When developing a teaching plan for parents, the nurse includes information about an increased risk for which problem? A)Febrile seizures B)Head trauma C)Caput succedaneum D)Posterior plagiocephaly

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

20. A group of students are reviewing information about the various types of insulin used to treat type 1 diabetes. The students demonstrate understanding of the information when they identify which of these insulins as having the longest duration? A) Lispro B) Regular C) NPH D) Glargine

ABCD

20. A nurse is preparing a teaching session for a group of parents with children newly diagnosed with attention deficit/hyperactivity disorder (ADHD). When explaining this disorder to the parents, what would the nurse include as being involved? Select all that apply. A) Impulsivity B) Inattention C) Distractibility D) Hyperactivity E) Defiance F) Anxiety

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

ABD

20. A nursing student is reviewing information about primary immunodeficiencies. The student demonstrates understanding of the material by identifying which immunodeficiencies as affecting only males? Select all that apply. A) X-linked agammaglobulinemia B) Wiskott--Aldrich syndrome C) Selective IgA deficiency D) X-linked hyper-IgM syndrome E) IgG subclass deficiency F) Severe combined immune deficiency

20. An 8-year-old girl was diagnosed with a closed fracture of the radius at approximately 2 PM The fracture was reduced in the emergency department and her arm placed in a cast. At 11 PM her mother brings her back to the emergency department due to unrelenting pain that has not been relieved by the prescribed narcotics. Which action would be the priority? A) Notifying the healthcare provider immediately B) Applying ice C) Elevating the arm D) Giving additional pain medication as ordered

20. An instructor is developing a plan for a class of nursing students on various skin disorders. When describing urticaria, what would the instructor include? A) It is a type IV hypersensitivity reaction. B) Histamine release leads to vasodilation. C) Wheals appear first followed by erythema. D) The nonpruritic rash blanches with pressure.

20. The nurse is counseling parents of a picky eater on how to promote healthy eating habits in their child. Which intervention would be appropriate advice? A) Allow the child to pick out his or her own foods for meals. B) Present the food matter-of-factly and allow the child to choose what to eat. C) Offer high-fat snacks if the child does not eat, to get them to eat something. D) Offer the child a special treat if he or she eats all the food on the plate.

20. The parents of a 1-year-old girl, both of whom have perfect teeth, are concerned about their child getting dental caries. Which is the best advice the nurse can provide? A) Tell the parents to limit the child's eating to meal and snack times. B) Urge the parents to take the child to a dentist for a check-up. C) Advise the parents to reduce carbohydrates in the child's diet. D) Advise the parents to use fluoride toothpaste.

20. The school nurse is preparing a talk on the influence of the media on school-age children to present at the next PTO meeting. Which fact might the nurse include in the introduction? A) Children in the United States spend about 6 hours a day either watching TV or playing video games. B) A child will see 2,000 murders by the end of grade school and 20,000 commercials a year. C) A school-age child cannot determine what is real from what is fantasy; therefore, TV and video games can lead to aggressive behavior. D) Parents should limit television watching and video-game playing to 2 hours per day.

20.A nurse is assessing the fontanels of a crying newborn and notes that the posterior fontanel pulsates and briefly bulges. What do these findings indicate? A)Increased intracranial pressure B)Overhydration C)Dehydration D)These are normal findings

20.A nurse is caring for a 14-year-old with a gastrostomy tube. The girl has skin breakdown and irritation at the insertion site. Which would be the most appropriate method to clean and secure the gastrostomy tube? A)Make sure the tube cannot be moved in and out of the child's stomach. B)Use adhesive tape to tape the tube in place and prevent movement. C)Place a transparent dressing over the site whether there is drainage or not. D)If any drainage is present, use a presplit 2 × 2 and place it loosely around the site.

20.A nurse is providing teaching to the parents of a child who has had a shunt inserted as treatment for hydrocephalus. The parents demonstrate understanding of the teaching when they make what statement? A)"Having the shunt put in decreases his risk for developmental problems." B)"If he doesn't get an infection in the first week, the risk is greatly reduced." C)"He will need more surgeries to replace the shunt as he grows." D)"The shunt will help to prevent any further complications from his disease."

20.The nurse is administering pain medication to a child with continuous pain from internal injuries. Which method would be ordered to dispense the medication? A)Administer the medication PRN (as needed). B)Administer the mediation when pain has peaked. C)Administer the medication around the clock at timed intervals. D)Administer the medication when the child reports pain.

20.The nurse is caring for a 7-month-old girl during a well-child visit. Which intervention is mostappropriate for this child? A)Discussing the type of sippy cup to use B)Advising about increased caloric needs C)Explaining how to prepare table meats D)Describing the tongue extrusion reflex

20.The nurse is caring for a child involved in an automobile accident whose family has been informed that the child is brain dead. What teaching might the nurse provide the family regarding organ donation? A)The nurse should ask about organ donation when the family is informed of their child's condition. B)The nurse should explain that written consent is necessary for the organ donation. C)The nurse should make sure the parents know that procurement of organs may mar their child's appearance. D)The nurse should make sure the parents know that they will be responsible for expenses related to organ procurement.

20.The nurse is caring for an infant who had hyperbilirubinemia requiring exchange transfusion. Based on this information, this infant is at risk for what type of disorder? A)Vision loss B)Hearing loss C)Hypertension D)Hyperlipidemia

20.The nurse is enlisting the parents' assistance for therapeutic hugging prior to an otoscopic examination. What should the nurse emphasize to the parents? A)"You will need to keep his hands down and his head still." B)"If this does not work, we will have to apply restraints." C)"If you are not capable of this, let me know so I can get some assistance." D)"I may need you to leave the room if your son will not remain still."

20.The nurse is providing suggestions to a female adolescent about foods to help meet her nutritional requirements for iron. Which food would the nurse suggest as a good source of iron? A)Broccoli B)Yogurt C)Peanut butter D)White beans

21. A 5-year-old child with type 1 diabetes is brought to the clinic by his mother for a follow-up visit after having his hemoglobin A1C level drawn. Which result would indicate to the nurse that the child is achieving long-term glucose control? A) 9.0% B) 8.2% C) 7.3% D) 6.9%

21. A nurse is inspecting the skin of a child with atopic dermatitis. What would the nurse expect to observe? A) Erythematous papulovesicular rash B) Dry, red, scaly rash with lichenification C) Pustular vesicles with honey-colored exudates D) Hypopigmented oval scaly lesions

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

21. A school nurse is working with the parents of an 8-year-old who has Tourette syndrome on how best to accommodate the child. What advice would be most helpful? Select all that apply. A) Allowing for breaks when tics occur B) Providing for "time-outs" during the day C) Using a tape recorder to take notes D) Ensuring a specified amount of time for test taking E) Implementing a reward system for behavior

21. The mother of a 7-year-old girl tells the school nurse that her child is deathly afraid of going to school. What would be the best intervention the nurse could suggest in this situation? A) Return the child to school and investigate the cause of the fear. B) Have the child stay home from school until any issues causing this fear are resolved. C) Investigate a new school for the child to attend that the child will not be afraid of. D) Tell the child that privileges will be taken away if she does not return to school.

21. The nurse is caring for an active 14-year-old boy who has recently been diagnosed with scoliosis. He is dismayed that a "jock" like himself could have this condition, and is afraid it will impact his spot on the water polo team. Which response by the nurse would best address the boy's concerns? A) "If you wear your brace properly, you may not need surgery." B) "The good news is that you have very minimal curvature of your spine." C) "Let's talk to another boy with scoliosis, who is winning trophies for his swim team." D) "Let's talk to the healthcare provider about your treatment options."

BDE

21. The nurse is helping parents prepare a healthy meal plan for their toddler. Which guidelines for promoting nutrition should be followed when planning meals? Select all that apply. A) The child younger than 2 years of age should have his or her fat intake restricted. B) Extending breastfeeding into toddlerhood is believed to be beneficial to the child. C) Weaning from the bottle should occur by 6 to 12 months of age. D) Adequate calcium intake and appropriate exercise lay the foundation for proper bone mineralization. E) The toddler requires an average intake of 700 mg calcium per day. F) Toddlers tend to have the highest daily iron intake of any age group.

ACD

21. The nurse is reviewing the laboratory test results of a child who is suspected of having systemic lupus erythematosus (SLE). What would the nurse identify as supporting this diagnosis? Select all that apply. A) Positive antinuclear antibody (ANA) B) Increased C3 levels C) Thrombocytopenia D) Decreased C4 levels E) Increased hematocrit

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

21. Which food suggestion would be most appropriate for the mother of a preschooler to ensure an adequate intake of calcium? A) Spinach B) White beans C) Enriched bread D) Fortified cereal

21.A nurse is preparing a presentation for an expectant parent group about neural tube defects and how to prevent them. Which would the nurse emphasize? A)Smoking cessation B)Aerobic exercise C)Increased calcium intake D)Folic acid supplementation

21.During a health maintenance visit, a 15-year-old girl mentions that she is not happy with being overweight. Which approach is best for the nurse to take? A)"Good observation. Let's talk about diet and exercise." B)"Don't worry; you are within the weight and height guidelines." C)"What specifically have you been noticing?" D)"Tell me about your parents. Are they overweight?"

21.The nurse has applied EMLA cream as ordered. How does the nurse assess that the cream has achieved its purpose? A)Assess the skin for redness. B)Note any blanching of skin. C)Lightly tap the area where the cream is. D)Gently poke the child with a needle.

21.The nurse is assessing a 12-month-old boy with an English-speaking father and a Spanish-speaking mother. The boy does not say mama or dada yet. What is the priority intervention? A)Performing a developmental evaluation of the child B)Encouraging the parents to speak English to the child C)Asking the mother if the child uses Spanish words D)Referring the child to a developmental specialist

21.The nurse is assessing the neck of an 8-year-old child with Down syndrome. Which finding would the nurse expect during the examination? A)Webbing B)Excessive neck skin C)Lax neck skin D)Shortened neck

21.The nurse is caring for a preschool child who is receiving palliative care for end-stage cancer. What would be the focus of age-appropriate interventions for this child? A)Providing unconditional love and trust B)Providing a familiar and consistent routine C)Teaching the child that death is not punishment D)Providing specific, honest details of death

21.The nurse is caring for an immunosuppressed 3-year-old girl and is providing teaching to the mother about proper oral hygiene. Which response from the mother indicates a need for further teaching? A)"I really need to carefully check for skin breakdown." B)"I must really scrub her teeth and gums well." C)"I must use a soft toothbrush." D)"I can use a soft gauze sponge to care for her gums."

21.The nurse is explaining to the student nurse the therapeutic effects of total parenteral nutrition (TPN). What accurately describes the use of TPN? A)It is used short term to supply additional calories and nutrients as needed. B)It is delivered via the peripheral vein to allow rapid dilution of hypertonic solution. C)It is a highly concentrated solution of carbohydrates, electrolytes, vitamins, and minerals. D)It is usually used when the child's nutritional status is within acceptable parameters.

21.The nurse is performing a vision screening for a 4-year-old child. Which screening chart would be best for determining the child's visual acuity? A)Snellen B)Ishihara C)Allen figures D)Color Vision Testing Made Easy (CVTME)

21.The nurse is preparing to perform a dressing change on a 13-year-old client who is being treated for burns he received 2 weeks ago. The client prefers not to take pain medication before the dressing change because it causes drowsiness. What nursing interventions would provide atraumatic care? Select all that apply. A)The nurse asks the client if he would like the television on during the dressing change. B)The nurse asks the client if a small group of nursing students can observe the dressing change. C)The nurse encourages the client to wear headphones to listen to music during the dressing change. D)The nurse encourages the parent to talk to the child about taking pain medication prior to the procedure. E)The nurse tells the client that the dressing change will not be performed unless pain medication is taken.

ABE

22. A child is diagnosed with a food allergy to milk. When teaching the parents about this allergy, what would the nurse suggest as possible substitutions for milk? Select all that apply. A) Fruit juice B) Rice milk C) Yogurt D) Nondairy creamers E) Soy milk

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

22. A nurse is performing a primary survey on a child who has sustained partial thickness burns over his upper body areas. What action should the nurse take first? A) Inspect the child's skin color. B) Assess for a patent airway. C) Observe for symmetric breathing. D) Palpate the child's pulse.

22. The nurse is caring for a female infant with torticollis and is providing instructions to the parents about how to help their daughter. Which statement by the parents indicates a need for further teaching? A) "We must encourage our daughter to turn her head both ways." B) "Flatness on one side of the head is a common side effect." C) "We must apply firm pressure and stretching every other day." D) "We will do a daily stretching regimen with multiple sessions."

DEF

22. The nurse is choosing foods for a toddler's diet that are high in vitamin A. What foods could be added to the menu? Select all that apply. A) Applesauce B) Avocados C) Broccoli D) Sweet potatoes E) Spinach F) Carrots

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

22. The nurse is providing teaching about accidental poisoning to the family of a 3-year-old. The nurse understands that a child of this age is at increased risk of accidental ingestion due to which sensory alteration? A) A less discriminating sense of taste B) A lack of fully developed hearing C) Visual acuity that has not fully developed D) A less discriminating sense of touch

22. The parents of a 7-year-old girl with type 1 diabetes has been recording her blood glucose measurements before meals and at bedtime for the past 4 days; they are as follows: Monday Tuesday Wednesday Thursday B: 120 mg/dL 135 mg/dL 124 mg/dL 200 mg/dL L: 110 mg/dL 120 mg/dL 140 mg/dL 220 mg/dL D: 90 mg/dL 140 mg/dL 130 mg/dL 200 mg/dL Bed: 110 mg/dL 110 mg/dL 160 mg/dL 240 mg/dL The parents bring the child in for a follow-up visit and show the nurse the results. Based on the results, the nurse would need to obtain additional information from the parents and child about which day? A) Monday B) Tuesday C) Wednesday D) Thursday

22. Two working parents are discussing with the school nurse the possibility of their 12-year-old girl going home alone after school. What suggestion should the nurse make? A) Provide entertainment until the parents come home. B) Allow the child to go to a friend's house. C) Teach her how to take a message if someone calls. D) Purchase caller ID for the phone.

22. When assessing the adolescent with anorexia, what would the nurse expect to find? A) Tachycardia B) Hypertension C) Fever D) Sparse body hair

ABE

22.A 15-year-old adolescent is brought to the emergency department by his parents. The adolescent is febrile with chills that started suddenly. He states, "I had a sinus infection and sore throat a couple of days ago." The nurse suspects bacterial meningitis based on which findings? Select all that apply. A)Complaints of stiff neck B)Photophobia C)Absent headache D)Negative Brudzinski sign E)Vomiting

22.A 6-month-old girl weighs 14.7 lb during a scheduled check-up. Her birth weight was 8 lb. What is the priority nursing intervention? A)Talking about solid food consumption B)Discouraging daily fruit juice intake C)Increasing the number of breastfeedings D)Discussing the child's feeding patterns

22.The nurse is admitting a 7-year-old child to the medical-surgical unit. The child answers questions with very short answers, makes little eye contact with the nurse, and looks to the parent to answer most questions. Which interventions would be appropriate during this admission assessment? Select all that apply. A)Tell the child that you are going to be their nurse so it would be best if they answered your questions. B)When asking questions, look at the child as well as the parent. C)Sit at the child's eye level during the admission questioning process. D)Stop asking questions for the present time and return later when the child feels more comfortable. E)Ask the child if they are always nervous around new people.

22.The nurse is caring for a 5-year-old boy who is terminally ill. Which intervention would best meet the needs of this dying child? A)Offer the child decision-making opportunities. B)Provide the child with specific details. C)Assure the child that he did nothing wrong. D)Act as a confidant for the child's concerns.

22.The nurse is caring for a 6-year-old child who has multisystem trauma due to a motor vehicle accident. The child is receiving total parenteral nutrition (TPN). What is a recommended nursing intervention for children on TPN? A)Initially, check blood glucose levels frequently, such as every 4 to 6 hours, to evaluate for hyperglycemia. B)Be vigilant in monitoring the infusion rate, change the rate as necessary, and report any changes to the healthcare provider or nurse practitioner. C)If for any reason the TPN infusion is interrupted or stops, begin an infusion of a 10% saline at the same infusion rate as the TPN. D)Administer TPN continuously over an 8-hour period, or after initiation it may be given on a cyclic basis, such as over a 12-hour period during the night.

22.The nurse is conducting a routine health assessment of a 3-month-old boy and notices a flat occiput. The nurse provides teaching and emphasizes the importance of tummy time. Which response by the mother indicates a need for further teaching? A)"I should have him sleep on his tummy." B)"I need to watch him during his tummy time." C)"I need to change his head position while he is in an upright chair." D)"His head has flattened due to the pressure of his head position."

22.The nurse is explaining the difference between active and passive immunity to the student nurse. Which statement accurately describes a characteristic of the process of immunity? A)Active immunity is produced when the immunoglobulins of one person are transferred to another. B)Passive immunity can be obtained by injection of exogenous immunoglobulins. C)Active immunity can be transferred from mothers to infants via colostrum or the placenta. D)Passive immunity is acquired when a person's own immune system generates the immune response.

22.The nurse is preparing to administer a topical anesthetic for a 10-year-old girl with a chin laceration. The nurse would expect to apply which medication as ordered in preparation for sutures? A)TAC (tetracaine, epinephrine, cocaine) B)Iontophoretic lidocaine C)EMLA D)Vapocoolant spray

22.The school nurse knows that dating is a milestone for adolescents. Which statement accurately describes a trend in teen dating? A)Most late adolescents spend more time in activities with mixed-sex groups, such as dances and parties, than they do dating as a couple. B)Most teens have been involved in at least one romantic relationship by late adolescence. C)Teens that date frequently report slightly lower levels of self-esteem and decreased autonomy. D)Homosexual behavior as a teen usually indicates that the adolescent will maintain a homosexual orientation.

22.When preparing to apply a restraint to a child, what would be most important for the nurse to do? A)Expect to keep the restraint on for at least 8 hours. B)Explain that safety, not punishment, is the reason for the restraint. C)Plan to use a square knot to secure the restraint to the side rails. D)Use a limb restraint rather than a jacket restraint for most issues.

23. A 3-year-old child has sustained severe burns and is ordered to receive 100% oxygen. What would the nurse use to administer the oxygen? A) Nasal cannula B) Venturi mask C) Nonrebreather mask D) Oxygen hood

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

23. After teaching the parents of a child with attention deficit/hyperactivity disorder about ways to control the child's behavior, the nurse determines a need for additional teaching when the parents state: A) "If he starts to act out, we'll have him do a time-out to help him refocus." B) "We can use a reward system when he behaves appropriately." C) "If he misbehaves, we need to punish him instead of reward him." D) "We need to help him set realistic goals that he can achieve."

23. The nurse is administering 10 units of NPH insulin to a child at 8 AM. The nurse would expect this insulin to begin acting at which time? A) By 8:15 AM B) Between 8:30 and 9 AM C) Between 9 and 11 AM D) Around 12 noon

23. The nurse is caring for a 10-year-old in traction. While performing a skin assessment, the nurse notices that the skin over the calcaneus appears slightly red and irritated. Which action would the nurse take first? A) Reposition the child's foot on a pressure-reducing device. B) Apply lotion to his foot to maintain skin integrity. C) Make sure the skin is clean and dry. D) Gently massage his foot to promote circulation.

23. The nurse is conducting a well-child assessment for a 5-year-old boy in preparation for kindergarten. The boy's grandmother is his primary caregiver because the boy's mother has suffered from depression and substance abuse issues. The nurse understands that the child is at increased risk for which developmental problem? A) Lack of social and emotional readiness for school B) Stuttering C) Speech and language delays D) Fine motor skills delay

23. The nurse is talking to the parents of a child who has been diagnosed with severe combined immune deficiency (SCID). Which statement by the parents best indicates that they understand their child's condition? A) "He'll need to receive intravenous immunoglobulin routinely." B) "We'll need to prepare him and ourselves for a bone marrow transplant." C) "He'll need to receive several different types of antiviral medications." D) "We'll make sure that he has his EpiPen with him at all times."

23. The parents of an 8-year-old boy are interested in promoting learning through reading to their son. Which suggestion by the nurse would best promote this goal? A) Have the parents choose what he should read initially. B) Tell the child to read instead of watch TV with his parents. C) Tell the parents that reading is for the child to do by himself. D) Take the child to the library to check out some books.

23. When instructing the parents of a toddler about appropriate nutrition, what would the nurse recommend? A) About 12 to 16 ounces of fruit juice per day B) Approximately 16 to 24 ounces of milk per day C) Fat intake of 30% to 40% of total calories D) An average of 10 to 12 grams of fiber per day

23.A child is brought to the emergency department after sustaining a concussion. The child is to be discharged home with his parents. What would the nurse include in the child's discharge instructions? A)"Expect his headache to get worse initially and then disappear." B)"Wake him every 2 to 4 hours to check his movement and responses." C)"Call your medical provider if he vomits more than five times." D)"Any watery fluid draining from his ears is normal."

23.During a health check-up without his parents, a 17-year-old tells the nurse he is gay. Which approach should the nurse take? A)"Tell me what makes you think you are gay." B)"This puts you in an at-risk category." C)"We need to talk about safe sex." D)"You're not gay; you're confused."

23.The nurse has completed diabetic education regarding insulin administration to a 14-year-old child newly diagnosed with diabetes and his family. The nurse knows the teaching was effective if the client and family: A)can list appropriate sites for insulin administration. B)have demonstrated correct insulin administration over the past several days. C)indicate that they understand proper nutrition for a person with diabetes. D)state that they understand hypoglycemic reaction signs and symptoms.

23.The nurse is administering a hepatitis B vaccine to a child. What is the classification of this type of vaccine? A)Killed vaccines B)Toxoid vaccines C)Conjugate vaccines D)Recombinant vaccines

23.The nurse is caring for a child who is receiving total parenteral nutrition (TPN) for failure to thrive. Which nursing action might the nurse take to prevent complications from this therapy? A)Adhere to clean technique when caring for the catheter and administering TPN. B)Ensure that the system remains an open system at all times. C)Secure all connections and open the catheter during tubing and cap changes. D)Use occlusive dressings and chlorhexidine-impregnated sponge dressings.

23.The nurse is caring for a child who reports chronic pain. What is the priority nursing assessment? A)How the pain impacts the child's and family's stress level B)The pain's history, onset, intensity, duration, and location C)The child's and parents' feeling of anxiety and depression D)The child's cognitive level and emotional response

23.The nurse is educating a first-time mother who has a 1-week-old boy. Which is the most accurate anticipatory guidance? A)Describing the effect of neonatal teeth on breastfeeding B)Explaining that the stomach holds less than 1 ounce C)Informing that fontanels will close by 6 months D)Telling that the step reflex persists until the child walks

23.The nurse is measuring the blood pressure of a 12-year-old boy with an oscillometric device. The boy's reading is greater than the 90th percentile for gender and height. What is the appropriate nursing action? A)Repeat the reading with the oscillometric device. B)Repeat the blood pressure reading using auscultation. C)Measure the blood pressure in all four extremities. D)Measure the blood pressure with a Doppler.

23.The nurse is providing discharge planning for a 12-year-old boy with multiple medical conditions. What would be the best teaching method for this child and his family? A)Demonstrate the care and ask for a return demonstration. B)Provide and review educational booklets and materials. C)Provide a written schedule for the child's care. D)Provide a trial period of home care.

23.What would the nurse include in the plan of care for a dying child with pain? A)Administering analgesics as needed B)Using measures the nurse finds comforting C)Playing the television or radio so the child can hear it D)Changing the child's position frequently but gently

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

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

24. A nurse is caring for a 4-year-old girl. The mother says that the girl is afraid of cats and dogs and does not like to go to the playground anymore because she wants to avoid the dogs that are often being walked at the park. What should the nurse tell the mother? A) "It is best to avoid the playground until she outgrows the fear." B) "She needs to face her fears head-on; take her to the park as much as possible." C) "Acknowledge her fear and help her develop a strategy for dealing with it." D) "Try to minimize her fears and insist that she go to the park."

BDE

24. A nurse is reviewing the medical record of an 11-year-old child with a conduct disorder. What would the nurse identify as characteristics of this disorder? Select all that apply. A) Easily annoyed B) Initiator of physical fights C) Temper tantrums D) Truancy E) Arrest for arson

24. As part of a clinical conference with a group of nursing students, the instructor is describing the burn classification. The instructor determines that the teaching has been successful when the group identifies what as characteristic of full-thickness burns? A) Skin that is reddened, dry, and slightly swollen B) Skin appearing wet with significant pain C) Skin with blistering and swelling D) Skin that is leathery and dry with some numbness

24. The nurse is caring for a 14-month-old boy with rickets who was recently adopted from overseas. His condition was likely a result of a diet very low in milk products. The nurse is providing teaching regarding treatment. Which response by the parents indicates a need for further teaching? A) "We must give him calcium and phosphorus with food every morning." B) "He must take vitamin D as prescribed and spend some time in the sunlight." C) "He must take calcium at breakfast and phosphorus at bedtime." D) "We should encourage him to have fish, dairy, and liver if he will eat it."

24. The nurse is caring for a 7-year-old girl who is scheduled for a hernia repair and is very scared. Which fear would she also most likely have at this age? A) Fear of being kidnapped B) Fear of cutting her finger C) Fear of sudden loud noises D) Fear of the neighbor's dog

24. The nurse is teaching the parents of an overweight 18-month-old girl about diet. Which intervention will be most effective for promoting proportionate growth? A) Remove high-calorie, low-nutrient foods from the diet. B) Ensure 30 minutes of unstructured activity per day. C) Avoid sharing your snacks and candy with the child. D) Reduce the amount of high-fat food the child eats.

CDF

24. The nurse suspects that a 4 year old with type 1 diabetes is experiencing hypoglycemia based on what findings? Select all that apply. A) Blurred vision B) Dry, flushed skin C) Diaphoresis D) Slurred speech E) Fruity breath odor F) Tachycardia

24.A healthcare provider orders a medication dosage that is above the normal dosage. The nurse administers the medication without questioning the dosage. What error did the nurse make? A)The nurse violated one of the "rights" of medication administration. B)The nurse performed an act outside the scope of practice for nursing. C)The nurse has not made an error, but the healthcare provider did by ordering the wrong dosage of medication. D)The nurse has committed an act of maleficence by administering the medication.

24.A mother is concerned about her infant's spitting up. Which suggestion would be mostappropriate? A)"Put the infant in an infant seat after eating." B)"Limit burping to once during a feeding." C)"Feed the same amount but space out the feedings." D)"Keep the baby sitting up for about 30 minutes afterward."

24.A nurse is preparing a presentation for a local health fair about meningitis and has developed a display that lists the following causes: Streptococcus group B Haemophilus influenzae type B Streptococcus pneumoniae Neisseria meningitidis What would the nurse highlight as the most common cause of meningitis in newborns? A)Streptococcus group B B)Haemophilus influenzae type B C)Streptococcus pneumoniae D)Neisseria meningitides

24.The nurse is caring for a child who is scheduled to begin chemotherapy. When planning education for the parents, what action by the nurse is most correct? A)Obtain a large classroom to allow the nurse to stand at the front and present information. B)Obtain a small conference room and arrange the chairs in a circle for both the nurse and family members to sit. C)Provide written information to the family and allow them to review it, with instructions to contact the nurse if there are additional questions. D)Provide a video of information to the family, with instructions to contact the nurse if there are additional questions.

24.The nurse is discussing vaccination for Haemophilus influenzae type B (Hib) with the mother of a 6-month-old child. Which comment provides the most compelling reason to get the vaccination? A)"These bacteria live in every human." B)"Young children are especially susceptible to these bacteria." C)"You have a choice of two excellent vaccines." D)"Your child needs this final dose for protection."

24.The nurse is inspecting the fingernails of an 18-month-old girl. What finding indicates chronic hypoxemia? A)Nails that curve inward B)Clubbing of the nails C)Nails that curve outward D)Dry, brittle nails

24.The nurse is monitoring a child who has received epidural analgesia with morphine. The nurse is careful to monitor for which adverse effect of the medication? A)Epidural hematoma B)Arachnoiditis C)Spinal headache D)Respiratory depression

24.The nurse is promoting learning and school attendance to a 13-year-old girl. Which factor will affect the child's attitude most? A)Her parents' values and desires B)The dramatic changes to her body C)Peer group behaviors and attitudes D)Desire for attention from boys

24.The nurse is working as a community health care nurse. What would be the nurse's focus when providing care of the child? A)Providing care to the individual and family in acute care settings B)Providing care to the indigent in family care settings C)Providing care in geographically and culturally diverse settings D)Providing care for particular age groups or particular diagnoses

24.When describing organ donation to the family of a dying child, what would the nurse include in the discussion? A)Telling them that further harm may occur to the child through the process B)Tell them that their cultural and religious beliefs will be considered C)Including this topic in the discussion of impending death D)Informing the family that organ donation will delay the funeral

25. A 4-year-old is brought to the emergency department with a burn. What would alert the nurse to the possibility of child abuse? A) Burn assessment correlates with mother's report of contact with a portable heater. B) Parents state that the injury occurred approximately 15 to 20 minutes ago. C) Clear delineations are noted between burned and nonburned skin areas. D) The burn area appears asymmetric and nonuniform.

25. A child with systemic lupus erythematosus is receiving high-dose corticosteroid therapy over the long term. The nurse would instruct the parents and child to report: A) difficulty urinating. B) visual changes. C) joint pain. D) rash.

CDE

25. A nurse is preparing a presentation for a group of parents of adolescents diagnosed with type 1 diabetes. What issues would the nurse need to address? Select all that apply. A) Self-monitoring of blood glucose levels B) Feelings of being different C) Deficient decision-making skills D) Body image conflicts E) Struggle for independence

BCDE

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

25. The nurse identifies a nursing diagnosis of impaired social interaction related to altered social skills as evidenced by impulsivity and intrusive behavior. The nurse plans to identify factors that aggravate the child's behavior for which reason? A) Minimize stimuli that exacerbate the child's undesired behaviors. B) Improve the child's ability to deal with external stressors. C) Promote increased ability to follow through. D) Encourage the child to adopt expectations into his routine.

25. The nurse is caring for a 13-year-old boy in traction prior to surgery for slipped capital femoral epiphysis. He has been in an acute care setting for 2 weeks and will require an additional 10 days in the hospital. He is complaining that he feels isolated and is resisting further treatment. Which response by the nurse would be most appropriate? A) "I know it is boring, but you must remain immobile for 2 more weeks." B) "If there are no complications, you only have 2 more weeks here." C) "Let's come up with things to do like books, movies, games, and friends to visit." D) "If you resist your treatment, your condition will only get worse."

25. The nurse is counseling the parents of a 10-year-old child who was caught stealing at school. Which topic should the nurse cover? A) Having the child return the property in front of his or her class B) Discussing ways for the child to save face C) Finding out what is currently going on at home D) Reminding the child daily that stealing is wrong

25. The nurse is providing anticipatory guidance to the parents of an 18-month-old girl. Which guidance will be most helpful for toilet teaching? A) Telling them either one may demonstrate toilet use B) Assuring them that bladder control occurs first C) Telling them that curiosity is a sure sign of readiness D) Advising them to use praise, not scolding

25. The nurse is providing teaching about car safety to the parents of a 5-year-old girl who weighs 45 lb. What should the nurse instruct the parents to do? A) "Place her in a booster seat with lap and shoulder belts in the front seat." B) "Place her in the back seat with the lap and shoulder belts in place." C) "Place her in a forward-facing car seat with a harness and top tether." D) "Place her in a booster seat with lap and shoulder belts in the back seat."

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

25.A child is admitted to the hospital with a spinal cord injury resulting in paralysis below the level of the waist. When should the nurse begin planning with the parents for rehabilitation placement for this child after acute hospitalization? A)After hospitalization when the parents are ready B)As soon after the patient is admitted as possible C)When the child starts showing improvement in their condition D)Once the child and the parent feel it is time to seek extended care

25.A group of students are reviewing information about head injuries in children. The students demonstrate understanding of this information when they identify what as the most common type of skull fracture in children? A)Linear B)Depressed C)Diastatic D)Basilar

25.The mother of a 15-month-old child is questioning the nurse about the need for the hepatitis B vaccination. Which comment provides the most compelling reason for the vaccine? A)"The most common side effect is injection site soreness." B)"This is a recombinant or genetically engineered vaccine." C)"Immunizations are needed to protect the general population." D)"This protects your child from infection that can cause liver disease." Ans:D

ACD

25.The nurse has obtained the services of an interpreter to assist with communicating with a child and parents who have a limited understanding of English. Which behaviors may impede the communication? Select all that apply. A)The nurse speaks to the interpreter, who then translates the information to the parents and child. B)The nurse speaks with the parents and child, and then the interpreter translates the information to the parents and child. C)The nurse limits the sessions with the interpreter to 1 hour. D)The nurse stops talking every 45 to 60 seconds to allow the interpreter to catch up with the information provided. E)The nurse avoids the use of slang in the exchange of information.

25.The nurse is providing anticipatory guidance to a mother to help promote healthy sleep for her 3-week-old baby. Which recommended guideline might be included in the teaching plan? A)Place the baby on a soft mattress with a firm, flat pillow for the head. B)Place the head of the bed near the window to provide fresh air, weather permitting. C)Place the baby on his or her back when sleeping. D)If the baby sleeps through the night, wake him or her up for the night feeding.

7. A nurse is caring for a 14-year-old girl who received an electrical burn. The nurse would anticipate preparing the girl for which diagnostic tests as ordered? A) Pulse oximetry B) Fiberoptic bronchoscopy C) Xenon ventilation-perfusion scanning D) Electrocardiographic monitoring

25.The nurse is providing teaching to the parents of a newborn prior to a heelstick. The nurse is describing the procedure and recommending various methods for the parents to help comfort their baby. Which statement by the parents indicates a need for further teaching? A)"It's better if we are not in the room for this." B)"We can use kangaroo care before and after." C)"We hope you are using a very tiny needle." D)"We can offer him nonnutritive sucking to calm him."

25.The nurse is using pulse oximetry to measure oxygen saturation in a 3-year-old girl. The nurse understands that falsely high readings may be associated with which situation or condition? A)A nonsecure connection B)Cold extremities C)Hypovolemia D)Anemia

25.The nurse notes that a child with a swallowing difficulty is receiving a continuous tube feeding. The child is very active and the feeding frequently gets interrupted because the tube becomes disconnected. What should the nurse discuss with the healthcare provider about the tube feeding? A)The nurse should ask the healthcare provider if the client could receive total parenteral nutrition. B)The nurse should ask the healthcare provider if the client could receive bolus rather than continuous tube feedings. C)The nurse should ask the healthcare provider if the client could receive the tube feedings during the night rather than continuously during all hours. D)The nurse should ask the healthcare provider if the client could be given oral rather than tube feedings. E)The nurse should ask the healthcare provider if the client could be given a sedative in order to prevent disruption of the tube feedings.

25.The nurse working in community nursing uses epidemiology as a tool. What information can be obtained using this process? A)Health needs of a population B)Cultural needs of a population C)Income levels of a population D)Mortality rates of a population

25.The school nurse is preparing a program on sexuality and birth control for a class of 14 to 16 year olds. Which behavior will have the most influence on how the information is presented? A)Teens are adjusting to new body images. B)Adolescents tend to take risks. C)Teenagers are able to think in the abstract. D)Adolescents understand that actions have consequences.

26. A child is prescribed trazodone. What would the nurse be least likely to include in the plan of care related to this drug? A) Monitoring blood pressure for orthostatic hypotension B) Assessing the child for sedation and drowsiness C) Administering the drug with a snack D) Monitoring for tardive dyskinesia

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

BCD

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

26. A group of nursing students are reviewing the components of the endocrine system. The students demonstrate understanding of the review when they identify what as the primary function of this system? A) Regulation of water balance B) Hormonal secretion C) Cellular metabolism D) Growth stimulation

ABCD

26. A nurse is assessing a child who may have a latex allergy. The nurse asks the child about allergic reactions to certain foods. Which foods if identified by the child as experiencing an allergic reaction would help support the suspected latex allergy? Select all that apply. A) Peaches B) Plums C) Carrots D) Tomatoes E) Milk F) Lettuce

26. A nurse is preparing a presentation for a local parent group about burn prevention and care in children. What would the nurse be least likely to include in the presentation when describing how to care for a superficial burn? A) Using cool water over the burned area until the pain lessens B) Applying ice directly to the burned skin area C) Covering the burn with a clean, nonadhesive bandage D) Giving the child acetaminophen for pain relief

26. The nurse is caring for a 2-year-old girl in a bilateral brace with tibia vara. Her parents are upset by their toddler's limited mobility. Which response by the nurse would be most appropriate? A) "If you don't follow the therapy, your daughter could develop severe bowing of her legs." B) "It's important to use the brace or your daughter may need surgery." C) "You are doing a great job. Let's put our heads together on how to keep her busy." D) "You'll need to accept this since treatment may be required for several years."

26. The nurse is caring for a premature baby in the NICU. The mother reports that the infant's normally happy and outgoing 5-year-old sister is acting sad and withdrawn. The nurse understands that due to her developmental stage, the girl is at risk of what happening? A) Viewing her baby sister's illness as her fault B) Harming the baby C) Experiencing clinical depression D) Creating an imaginary friend to cope with the situation

26. The parents of a 2-year-old girl are frustrated by the frequent confrontations they have with their child. Which is the best anticipatory guidance the nurse can offer to prevent confrontations? A) "Respond in a calm but firm manner." B) "You need to adhere to various routines." C) "Put her in time-out when she misbehaves." D) "It's important to toddler-proof your home."

26. When providing anticipatory guidance to a group of parents with school-age children, what would the nurse describe as the most important aspect of social interaction? A) School B) Peer relationships C) Family D) Temperament

26.After teaching the mother about follow-up immunizations for her daughter, who received the varicella vaccine at age 14 months, the nurse determines that the teaching was successful when the mother states that a follow-up dose should be given at which time? A)When the child is 20 to 36 months of age B)When the child is 4 to 6 years of age C)When the child is 11 to 12 years of age D)When the child is 13 to 15 years of age

7.The school nurse is performing a physical examination on a 13-year-old boy who is on the soccer team. What is a physical quality that develops during these early adolescent years? A)Coordination B)Endurance C)Speed D)Accuracy

26.During class, a student states, "I did not think children could have strokes. I thought this only occurred in older adults." When responding to the student, what would be most important for the instructor to integrate into the response? A)Strokes in children often have an identifiable cause. B)The signs and symptoms in children are different from an adult. C)Research has identified specific treatments for children. D)Ischemic strokes are more common than hemorrhagic strokes.

26.The nurse is caring for a teen who will be hospitalized for physical rehabilitation for an extended period of time after an auto accident. When working to promote a good working relationship with the teen, what action by the nurse will be most beneficial? A)Allow the teen to control the daily schedule. B)Keep your word with regard to promises and statements made to the teen. C)Allow the teen to make decisions about the plan of care. D)Include the teen in the weekly interdisciplinary care conferences

26.The nurse is conducting a pain assessment of a 10-year-old boy who has been taking acetaminophen for chronic knee pain. The assessment indicates that the recommended dose is no longer providing adequate relief. What is the appropriate nursing action? A)Increase the dosage of the acetaminophen. B)Tell the child he is experiencing the ceiling effect. C)Use guided imagery to help his pain. D)Obtain an order for a different medication.

26.The nurse is counseling the mother of a newborn who is concerned about her baby's constant crying. What teaching would be appropriate for this mother? A)Carrying the baby may increase the length of crying. B)Reducing stimulation may decrease the length of crying. C)Using vibration, white noise, or swaddling may increase crying. D)Using a swing or car ride may increase the incidence of crying episodes.

26.The parents of a child receiving total parenteral nutrition ask the nurse why their child must have their blood glucose monitored so frequently since they are not diabetic. What is the best response by the nurse? A)"We like to keep a close check on the blood glucose for all children receiving total parenteral nutrition." B)"It is important to monitor the blood glucose level because the solution has a high concentration of carbohydrates that convert to glucose." C)"This is a good time for us to monitor your child in case they start developing signs of diabetes related to receiving total parenteral nutrition." D)"I would suggest you ask the healthcare provider why blood glucose checks have been ordered so frequently."

26.The parents of a child with a developmental disability tell the nurse that they feel guilty because they sometimes find themselves feeling sad and wondering how their child would be without the disability. Which response by the nurse best shows empathy and encourages the parents to vent their feelings? A)"I'm sure it must be difficult to have a child developmentally delayed." B)"There are lots of parents that are experiencing the difficulty and feelings of hopelessness and grief you're having. Maybe if you talk to someone it might help you both." C)"I can only imagine how hard it is for you. You should know that it is common for parents to have these feelings when having a child with special needs." D)"It's important to focus on the positives that can come from the experience of being the parents of a child that has these issues."

26.When speaking to a group of parents at a local elementary school, the nurse describes school nursing as a specialized practice of nursing based on the fact that a healthy child has a better chance to succeed in school. What best describes the strategy school nurses use to achieve student success? A)They coordinate all school health programs. B)They link community health services. C)They work to minimize health-related barriers to learning. D)They promote student health and safety.

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

27. The mother of a 5-year-old child with allergies to a variety of foods including eggs, milk, peanuts and shellfish, asks if her child will "always have these problems." What response by the nurse is most accurate? A) "Sadly, allergies to foods will persist." B) "Most children with allergies will outgrow them." C) "We cannot be sure at this point but most children who are allergic to peanuts will not have this allergy in adulthood." D) "In most cases allergies to peanuts and shellfish persist into adulthood but the others may diminish and disappear."

27. The nurse is conducting a physical examination of a child with suspected developmental dysplasia of the hip. Which finding would help confirm this diagnosis? A) Abduction occurs to 75 degrees and adduction to within 30 degrees (with stable pelvis). B) A distinct "clunk" is heard with Barlow and Ortolani maneuvers. C) A high-pitched "click" is heard with hip flexion or extension. D) The thigh and gluteal folds are symmetric.

27. The nurse is interviewing the mother of a 6-month-old being seen at a well-child visit. The mother reports she has used an over-the-counter topical ointment intended for adults on her child for a skin rash. What is the most appropriate response by the nurse? A) "This is dangerous so please do not do this again." B) "Why did you do that instead of contacting your healthcare provider?" C) "Children have thin skin and can absorb medications differently than adults." D) "How often do you use this medication?"

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

27. The nurse is preparing an educational program on behavioral management techniques used in children to help alter negative behavior. What information should the nurse include? Select all that apply. A) Set limits and hold the child responsible for their behavior. B) Do not argue, bargain, or negotiate about the limits once established. C) Change caregivers occasionally so the child learns to respond to different people. D) Use a high-pitched voice and remain calm when speaking with the child. E) Ignore inappropriate behaviors.

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

27. The nurse is providing guidance after observing a mother interact with her negative 2-year-old boy. For which interaction will the nurse advise the mother that she is handling the negativism properly? A) Telling the child to stop tearing pages from magazines B) Asking the child if he would please quit throwing toys C) Telling the child firmly that we don't scream in the office D) Saying, "Please come over here and sit in this chair. OK?"

27. The school nurse is teaching parents about the effects of bullying on school children. What accurately describes this developmental concern? A) Children who bully are those who report themselves as being lonely and having difficulty in forming friendships. B) Children with health issues, such as, disabilities, obesity, and food allergies, are at a decreased risk of being bullied. C) In general, about 20% of all children attending school are frightened and afraid most of the day. D) Both boys and girls are bullied; boys usually bully boys and use force more often.

27. When providing anticipatory guidance to parents about their preschool son who was caught in a lie, what would the nurse emphasize? A) "You need to determine the reason for lying before punishing the child." B) "Lying should never be tolerated and the child should be punished." C) "The misbehavior is usually more serious than the lying itself." D) "It is okay to become angry when dealing with the child's lying."

27.A 10-month-old is brought to the emergency department by her parents after they found her face down in the bathtub. The mother said, "I just left the bathroom to answer the phone. When I came back, I found her." Which assessment would be the priority? A)Airway, breathing, and circulation B)Level of consciousness C)Vital signs D)Pupillary response

27.The nurse is discussing ways to promote discipline with parents who are becoming increasingly frustrated with their teenager. What would the nurse identify as most important? A)Establish rules and expectations. B)Collaborate to determine consequence. C)Make your responses consistent. D)Explain the rules to the adolescent.

27.The nurse is preparing a child for a lumbar puncture. How far ahead of the procedure should the nurse apply the EMLA cream? A)30 minutes B)1 hour C)3 hours D)4 hours

27.The nurse is teaching the student nurse about abnormal findings when assessing the breasts of children. What may be associated with renal disorders? A)Swollen nipples upon inspection of a newborn's breasts B)Tender nodule palpated under the nipple of a 10-year-old C)Observation of enlarged breast tissue in a male adolescent D)Observation of a supernumerary nipple along the mammary ridge

ACDE

27.The nurse referring a child to home care services discusses the advantages and disadvantages with the child's family. What are disadvantages of this method of health care? Select all that apply. A)The nurse is performing care of the child in the family's home. B)The home care nurse is not always equipped to perform technical care. C)The out-of-pocket cost of home care is more expensive. D)The technical procedures may be overwhelming for the family. E)The financial burden may cause more stress for the family. F)The child does not receive continuity of care provided in the hospital setting.

27.The nurse working in a community clinic attempts to establish a free vaccination program to refer low-income families. What is the key strategy for success when implementing a health promotion activity? A)Partnership development B)Funding for projects C)Finding an audience D)Adequate staffing

27.The parent of a 6-month-old infant asks the nurse for advice about his son's thumb sucking. What would be the nurse's best response to this parent? A)"Thumb sucking is a healthy self-comforting activity." B)"Thumb sucking leads to the need for orthodontic braces." C)"Caregivers should pay special attention to the thumb sucking to stop it." D)"Thumb sucking should be replaced with the use of a pacifier."

27.The parents of a child with physical and developmental special needs state, "We wish our child could get some kind of educational experience." How should the nurse respond? A)"This must be difficult for you. Let's talk with the social worker to see what programs are available for your child." B)"I am sure it must be difficult to know that your child will never be able to go to school like other children." C)"Since all children can attend school regardless of their special need, I suggest you talk with your local school about enrolling your child." D)"It would be very difficult for your child to attend school with all of their disabilities. It's unfortunate, but it is reality."

BCE

27.The student nurse is preparing to administer eye drops to a 2-year-old child. Which actions indicate the need for additional instruction? Select all that apply. A)The student nurse explains the medication regimen to the child's parents. B)The nurse holds the medication bottle 3 inches from the child's nurse during administration. C)The child is instructed to look down during the instillation of the medication in the eyes. D)The student nurse seeks assistance to hold the child during the medication administration. E)The child is turned so the medication flows toward the outer corner of the eye.

28. A 6-year-old child has been diagnosed with growth hormone deficiency. The child's mother requests more information about this condition. Which statements should be included in the nurse's response? Select all that apply. A) "The majority of children who have this condition are born of normal weight and length." B) "There are several potential causes of this condition." C) "This condition is most likely related to dwarfism in past generations of your family." D) "Most children with this condition are nutritionally deprived." E) "Your child most likely does not eat adequate amounts of protein."

28. The mother of a 15-year-old girl has contacted the clinic to report that her daughter has burned the back of her hand with a curling iron. The child's mother reports the burn is mild but states her daughter is complaining of pain. After consulting with the healthcare provider, what instructions can the nurse anticipate will be recommended? Select all that apply. A) Apply a thin film of protective cocoa butter. B) Run cool water over the injured area. C) Apply ice for 15 to 20 minutes each hour until the pain subsides. D) Take acetaminophen using the manufacturer's guidelines. E) Apply a thin layer of petroleum jelly to the burned area.

BCD

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

BCDE

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

28. The nurse is caring for an infant with osteogenesis imperfecta and is providing instruction on how to reduce the risk of injury. Which response from the mother indicates a need for further teaching? A) "I need to avoid pushing or pulling on an arm or leg." B) "I must carefully lift the baby from under the armpits." C) "I should not bend an arm or leg into an awkward position." D) "We must avoid lifting the legs by the ankles to change diapers."

28. The nurse is providing a class for a group of childcare providers. When discussing allergic reactions, which statement by a participant indicates the need for further instruction? A) "Most allergic reactions will happen within a few minutes of eating a problematic food." B) "If a child has previously eaten a food and not had a reaction they are not 'truly' allergic to it." C) "Allergic reactions can happen hours after eating something." D) "In addition to hives some children may also have vomiting and diarrhea when having an allergic reaction to a food."

28. The nurse is providing anticipatory guidance for parents of a preschooler regarding sex education. What is a recommended guideline when dealing with this issue? A) Be prepared to thoroughly cover a topic before the child asks about it. B) Before answering questions, find out what the child thinks about the subject. C) Expand upon the topic when answering questions to prevent further confusion. D) Provide a less than honest response to shelter the child from knowledge that is too advanced.

28. The nurse is providing anticipatory guidance for parents of a school-age child on teaching the dangers of drugs and alcohol. What advice might be helpful for these parents? A) School-age children are not ready to absorb information that deals with drugs and alcohol. B) School-age children can think critically to interpret messages seen in advertising, media, and sports. C) Parents must prevent their child from being exposed to messages that are in conflict with their values. D) Discussions with children need to be based on facts and focused on the past and future.

28. The nurse is speaking with a parent regarding their child's recent diagnosis of oppositional defiant disorder. Which statement by the parent would cause the nurse to question the diagnosis? A) "I am so tired of arguing with my daughter all the time." B) "My son purposely does exactly the opposite of what his father tells him to do." C) "I feel so bad that my daughter intentionally hurt the neighbor's cat." D) "My daughter gets so annoyed at me when she doesn't get her way."

28. The nurse is teaching the parents of a 2-year-old girl how to deal with common toddler situations. Which is the best advice? A) Discipline the child for regressive behavior. B) Scold the child for public thumb sucking. C) Tell the older sibling to not act like a baby. D) Have the child help clean up a bowel accident.

28.A 10-year-old boy is seen in the emergency department after falling down a flight of stairs and hitting his head. The child will be monitored overnight for complications. Which occurrence in the coming hours will warrant further assessment? A)The child reports a backache. B)The child is increasingly irritable with his mother and caregivers. C)The child refuses offers of snacks. D)The child reports his stomach is upset.

28.At which age would the nurse expect to find the beginning of object permanence? A)1 month B)6 months C)9 months D)12 months

28.The nurse is explaining the effects of heat application for pain relief. Which effect would the nurse be likely to include? A)Decreased blood flow to the area B)Increased pressure on nociceptive fibers C)Possible release of endogenous opioids D)Altered capillary permeability

28.The nurse is inspecting the genitals of a prepubescent girl. Which is a normal sign of the onset of puberty? A)Appearance of pubic hair around 11 to 13 years old B)Swelling or redness of the labia minora C)Presence of labial adhesions D)Lesions on the external genitalia

CDE

28.The nurse is meeting with the parents of a 7-year-old boy with Down syndrome. The child's mother reports an interest in hippotherapy. The child's father reports that this seems to be a waste of money. The parents then ask the nurse for additional information. What information may be included in the nurse's response? Select all that apply. A)Hippotherapy has limited research demonstrating its actual effectiveness. B)This type of therapy is most helpful for teens. C)A variety of conditions including Down syndrome have used hippotherapy with success. D)Self-esteem may be improved with hippotherapy. E)The benefits of hippotherapy are both physical and psychological. Ans:C, D, E

28.The nurse is monitoring the output for a 10-year-old child. The medical record indicates the child weighs 78 lb (35 kg). How much urine can be anticipated for this child for a 12-hour period? A)300 to 1200 mL B)360 to 900 mL C)420 to 840 mL D)600 to 1200 mL Ans:C

28.The nurse is providing anticipatory guidance to an obese teenager. Which intervention would be most likely to promote healthy weight in teenagers? A)Make the focus of the program weight centered. B)Begin directly advising children about their weight at age 6. C)Focus physical activity on competitive sports and activities. D)Obtain nutritional histories directly from the school-age child and adolescent.

28.The nurse working with children in a hospital setting notes that they are being discharged earlier and earlier. Which is a primary reason for this trend? A)Nursing shortages B)Increased funding for home care C)National healthcare initiatives D)Cost containment

ABEF

28.The school nurse is teaching parents risk factors for suicide in adolescents. What would the nurse discuss? Select all that apply. A)Mental health changes B)History of previous suicide attempt C)Higher socioeconomic status D)Greatly improved school performance E)Family disorganization F)Substance abuse

29. A 12-year-old girl is experiencing prepubescence, and tells the school nurse that she feels "very out of place" in her school. What would be acceptable responses by the nurse? Select all that apply. A) "It must be difficult for you. Why don't you sit down and we can talk about it." B) "I would suggest that you talk to your parents about your feelings. This isn't something that I can talk to you about." C) "All of the girls and boys will be going through the same thing as you so that should make you feel a little better." D) "Tell me how this makes you feel. Talking about your feelings may help you feel better about school." E) "I went through the same thing when I was in school. I know it doesn't feel like it now but I promise it will get easier."

29. The nurse is assessing a 2-year-old boy who has missed some developmental milestones. Which finding will point to the cause of motor skill delays? A) The mother is suffering from depression. B) The child is homeless and has no toys. C) The mother describes an inadequate diet. D) The child is unperturbed by a loud noise.

ABC

29. The nurse is caring for a 9-year-old client newly diagnosed with diabetes. The client has polyuria, polydipsia, and weight loss. Which nursing diagnoses will the nurse include in the care plan? Select all that apply. A) Imbalanced nutrition: less than body requirements B) Deficient fluid volume C) Deficient knowledge regarding disease process D) Noncompliance E) Delayed growth and development

29. The nurse is caring for a child who takes dextroamphetamine for treatment of ADHD. Which comments by the client or family would concern the nurse? Select all that apply. A) "I take my sustained released capsule at night before I go to bed." B) "We have noticed that our child shows very little emotion over the last few weeks." C) "I haven't noticed any difference in my appetite." D) "Sometimes my head hurts a little for a short time after I take my medicine." E) "We notice our child gets a little irritable occasionally."

ABC

29. The nurse is caring for a school-age child with tinea captitis. The child has open lesions from the disease and has lost hair in the areas affected. Which nursing diagnoses would be a part of this client's care plan? Select all that apply. A) Impaired skin integrity B) Risk for infection C) Disturbed body image D) Bathing, self-care deficit E) Altered nutrition

29. The nurse is developing a teaching plan for a child who is to have his cast removed. What instruction would the nurse most likely include? A) Applying petroleum jelly to the dry skin B) Rubbing the skin vigorously to remove the dead skin C) Soaking the area in warm water every day D) Washing the skin with dilute peroxide and water

BCDE

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

CDE

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

29. The parents of a preschooler express concern to the nurse about their son's new habit of masturbating. What is an appropriate response to this concern? A) Tell the child in a firm manner that this behavior is not acceptable. B) When the child displays this behavior, place him in a "time-out." C) Treat the action in a matter-of-fact manner emphasizing safety. D) Consult a psychotherapist to determine the reason for this behavior.

ABC

29. While performing an assessment of a client who is immunocompromised, the nurse notes the child to have thrush in the mouth, tenderness over the spleen upon palpation, and a white blood cell count of 3,000. Which nursing diagnoses will the nurse include in the care plan of this child based on these findings? Select all that apply. A) Ineffective protection B) Risk for imbalanced nutrition, less than body requirements C) Pain D) Impaired skin integrity E) Delayed growth and development

29.The nurse caring for a child on a pediatric intensive care unit notices that when the parents go to work the child is very angry and cries easily. What does the nurse suspect is occurring with this client? A)Protest phase of separation anxiety B)Regressive behavior C)Detachment from the parents D)Despair

29.The nurse if checking placement on a child's feeding tube. When the pH is checked, it is 5.3. What action by the nurse is indicated? A)Remove the tube. B)Document the findings as normal. C)Contact the healthcare provider. D)Reevaluate the pH again in 2 hours.

ABD

29.The nurse is assessing the infants in the nursery for the six stages of consciousness. The nurse becomes concerned when assessing which infants? Select all that apply. A)An infant rapidly moves from deep sleep to crying. B)An infant moves from active alert state to drowsiness. C)An infant progresses slowly from deep sleep to light sleep. D)An infant frequently skips the quiet alert state during the six stages of consciousness. E)An infant ends the stages of consciousness with crying.

29.The nurse is caring for a 19-month-old boy who has been admitted to the emergency department with a skull fracture. The parents state that the child fell down when running through the house and hit his head on the floor. Based on normal characteristics of skull fractures, what should be the initial focus of the assessment? A)Possible physical abuse B)Possible bone cancer C)Possible chronic neurologic disease D)Possible developmental delay

ABC

29.The nurse is performing a cognitive assessment on a 16-year-old client. Which behaviors demonstrated will the nurse identify as middle formal operational, according to Piaget's theory? Select all that apply. A)Reporting that he smokes marijuana occasionally. B)Wanting to make decisions about health care independently C)Being very concerned with implications of the Affordable Care Act regarding healthcare benefits D)Wanting their friends to visit them in the hospital more than their parents E)Difficulty understanding the implications their diagnosis might present

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

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

3. The nurse is caring for a newborn whose mother is HIV positive. The nurse would expect to administer a 6-week course of which medication? A) Lopinavir B) Ritonavir C) Nevirapine D) Zidovudine

3. The nurse is caring for an adolescent girl with a suspected anxiety disorder. The girl states that she is constantly double-checking that she has unplugged her curling iron and must make sure that everything is in perfect order in her room before she leaves the house. The nurse interprets these findings as indicating which disorder? A) Generalized anxiety disorder B) Posttraumatic stress disorder C) Social phobia D) Obsessive-compulsive disorder

3. The nurse is conducting a physical examination of a child with a brachial plexus injury. Which finding would lead the nurse to be highly suspicious of Erb palsy? A) The child is unable to close one of his eyes. B) The involved extremity is adducted, prone, and internally rotated. C) Asymmetry of the face occurs when the child is crying. D) The mouth is drawn to the noninvolved side.

3. The nurse is developing a plan of care for a 7-year-old boy with diabetes insipidus. What is the priority nursing diagnosis? A) Deficient fluid volume related to dehydration B) Excess fluid volume related to edema C) Deficient knowledge related to fluid intake regimen D) Imbalanced nutrition, more than body requirements related to excess weight

3. The nurse is providing care for a 14-year-old girl with severe acne. The girl expresses sadness and distress about her appearance. Which response by the nurse would be most appropriate? A) "Are you using your medicine every day?" B) "Your condition will most likely improve in a year or two." C) "Many people feel this way; I know someone who can help." D) "If you have any scarring you can undergo dermabrasion."

3. The nurse is teaching the parents of a 2-year-old toddler methods of dealing with their child's "negativism." Based on Erikson's theory of development, what would be an appropriate intervention for this child? A) Discourage solitary play; encourage playing with other children. B) Encourage the child to pick out his own clothes. C) Use "time-outs" whenever the child says "no" inappropriately. D) Encourage the child to take turns when playing games.

BCEF

3. The pediatric nurse is aware of the maturation of organ systems in the school-age child. What accurately describes these changes? Select all that apply. A) The brain grows very slowly during the school-age years and growth is complete by the time the child is 12 years of age. B) Respiratory rates decrease, abdominal breathing disappears, and respirations become diaphragmatic in nature. C) The school-age child's blood pressure increases and the pulse rate decreases, and the heart grows more slowly during the middle years. D) The school-age child experiences more gastrointestinal upsets compared with earlier years since the stomach capacity increases. E) Bladder capacity increases, but varies among individual children, and girls generally have a greater bladder capacity than boys. F) Prepubescence typically occurs in the 2 years before the beginning of puberty and is characterized by the development of secondary sexual characteristics.

ADF

3.The nurse is assessing the respiratory system of a newborn. Which anatomic differences place the infant at risk for respiratory compromise? Select all that apply. A)The nasal passages are narrower. B)The trachea and chest wall are less compliant. C)The bronchi and bronchioles are shorter and wider. D)The larynx is more funnel shaped. E)The tongue is smaller. F)There are significantly fewer alveoli.

3.The nurse is caring for a child hospitalized with Reye syndrome who is in the acute stage of the illness. The nurse would assess the child most carefully for what finding? A)Indications of increased intracranial pressure B)An increase in the blood glucose level C)A decrease in the liver enzymes D)A presence of protein in the urine

3.The nurse is caring for a child who is recovering from an appendectomy. What is the appropriate term for the pain this child is experiencing? A)Nociceptive pain B)Neuropathic pain C)Chronic pain D)Superficial somatic pain

3.The nurse is caring for an 8-year-old boy hospitalized for a bone marrow transplant. His parents are in and out of his room throughout the day. Which behaviors of the child would alert the nurse that he is in the second stage of separation anxiety? A)He ignores his parents when they return to his room. B)He cries uncontrollably whenever they leave. C)He forms superficial relationships with his caregivers. D)He sits quietly and is uninterested in playing and eating.

3.The nurse is implementing interventions to prevent physical stressors for a 9-year-old child receiving chemotherapy in the hospital. How will the nurse provide atraumatic care for this child? A)Use restraint or "holding down" of the child during the procedure to prevent injury. B)Have the parent stand near and/or rub the child's feet during the procedure. C)Insert a saline lock if the child will require multiple doses of parenteral medications. D)Avoid using numbing techniques for multiple blood draws or IV insertion.

3.The nurse is performing a health history on a 6-year-old boy who is having trouble adjusting to school. Which question would be most likely to elicit valuable information? A)"Do you like your new school?" B)"Are you happy with your teacher?" C)"Do you enjoy reading a book?" D)"What are your new classmates like?"

3.The nurse is performing an assessment of the reproductive system of a 17-year-old girl. What would alert the nurse to a developmental delay in this girl? A)Areola and papilla separate from the contour of the breast B)Mature distribution and coarseness of pubic hair C)Developed breast tissue D)Absence of first menstrual period Ans:D3.The nurse is performing an assessment of the reproductive system of a 17-year-old girl. What would alert the nurse to a developmental delay in this girl? A)Areola and papilla separate from the contour of the breast B)Mature distribution and coarseness of pubic hair C)Developed breast tissue D)Absence of first menstrual period

3.The nurse is preparing a presentation to a local parent group about pediatric health supervision. Which would the nurse emphasize as the focus? A)Injury prevention B)Wellness C)Health maintenance D)Developmental surveillance

3.The nurse is providing home care for a 1-year-old girl who is technologically dependent. Which intervention will best support the family process? A)Finding an integrated health program for the family B)Teaching modifications of the medical regimen for vacation C)Assessing family expectations for the special needs child D)Creating schedules for therapies and interventions

3.The nurse is teaching the student nurse the factors that affect the pharmacodynamics of the medications being administered. What is a factor affecting this property of medication in children? A)Immature body systems B)Weight C)Body surface D)Body composition

30. A 16-year-old client has just been diagnosed with HIV. Which statement by the parent indicates understanding of the diagnosis? A) "It is important for our child to get started on drug therapy for a better chance of a cure of the infection." B) "I must be infected with HIV and passed it to our child while in the uterus for the infection to have occurred." C) "We don't want to face the fact that it is likely our child contracted HIV through sexual contact or IV drug use." D) "Infections as a result of being HIV positive are a low risk since the diagnosis came early."

30. A teenage girl diagnosed with polycystic ovary syndrome tells the nurse, "I refuse to take oral contraceptives since I am not sexually active." What is the best response to the girl? A) "It's important for you to take the pills even if you're not sexually active in order to prevent unwanted symptoms of the disease." B) "The healthcare provider has prescribed these for you because it is an effective treatment method for the disease." C) "I know it's hard remembering to take those pills every day. Tell me more about what is making you not want to take the oral contraceptives." D) "Do your parents know that you are not taking the treatment medication your healthcare provider prescribed?"

30. A teenage girl with psoriasis tells the nurse that she is so embarrassed by the plaque on her skin that she doesn't want to go to school. What is the best response by the nurse? A) "Have you been applying your medication and emollients to your skin as directed by your healthcare provider?" B) "It must be really difficult for you. Tell me how you are taking care of your skin on a daily basis." C) "Sunlight really helps the plaque areas heal. Maybe going to a tanning bed routinely will help." D) "You can't miss school because of your skin. Can you wear clothes that will cover the areas?"

30. The mother of a 12-year-old boy is talking with the school nurse about her son's clumsiness. She reports that he seems to fall a lot, his writing is horrible, and as much as he practices he can't play his guitar very well. How should the nurse respond to the mother? A) "Boys tend to take a bit longer than girls to mature." B) "Have you spoken with your pediatrician about your observations?" C) "Boys tend to refine their fine motor skills by this age." D) "I will make a note of your observations and talk to his teachers."

30. The nurse emphasizes that a toddler younger than the age of 18 months should never be spanked primarily for which reason? A) Spanking in a child this age predisposes the child to a pro-violence attitude. B) The child will become resentful and angry, leading to more outbursts. C) Spanking demonstrates a poor model for problem-solving skills. D) There is an increased risk for physical injury in this age group.

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

545.45

30. The nurse is preparing to administer intravenous fluids to manage a child with dehydration. The medical record indicates the child weighs 60 lb (27.2 kg). How many milliliters will initially be administered? Record your answer using two decimal places.

30. The nurse working in a pediatric mental health clinic is assessing a 4-year-old child who has suffered from physical abuse. Which type of therapy does the nurse anticipate will be most helpful in developing a trusting relationship as well as assisting in determining the client's current emotional state? A) Behavioral therapy B) Play therapy C) Cognitive behavioral therapy D) Family therapy

30. The parents of a 5-year-old are concerned that their son is too short for his age. The nurse measures the child's height at 40 in (101.6 cm). How should the nurse respond? A) "Some children are short for their age during the preschool years but usually catch up during early childhood." B) "Are most of the adults in your family short? It may be hereditary that your child will be shorter than average." C) "The average height for a 5-year-old is 43 in tall (118.5 cm), so your son is within the normal range for height." D) "I am sure his height is a concern, but if you start choosing nutrient-dense foods, he will likely catch up to normal in height." Ans: C

30. When teaching a group of students about the skeletal development in children, what information would the instructor include? A) The growth plate is made up of the epiphysis. B) A young child's bones commonly bend instead of break with an injury. C) The infant's skeleton has undergone complete ossification by birth. D) Children's bones have a thin periosteum and limited blood supply.

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

30.A 12-year-old boy reports to the nurse that he is one of the shortest kids in his class. He asks the nurse if he will ever grow. What response by the nurse is most appropriate? A)"At your age, you are largely done growing taller." B)"Since you are the shortest now, you will likely always be the shortest in the class." C)"Boys do not have their growth spurt until about age 17." D)"There is no way to know how tall you will grow because you are still well within the window for growth."

ABC

30.A new mother tells the nurse that she is having difficulty breastfeeding her baby. When observing the mother, which actions prompt the nurse to provide teaching about proper breastfeeding techniques? Select all that apply. A)The mother carefully washes her breasts prior to feeding the infant. B)The mother feeds the infant every hour. C)The mother supplements feedings with water. D)The mother holds her breast in the "C" position. E)The mother strokes the nipple against the infant's face.

BCDE

30.The community health nurse has just completed a presentation to a group of parents regarding drowning prevention. Which statements by the parents indicate understanding of the teaching? Select all that apply. A)"I am so glad our 6-year-old child had swim lessons. We really can't afford a fence around our pool." B)"Since we have a 16-year-old I am really concerned about supervision when our child is swimming in the ocean." C)"We always make sure our babysitter keeps her CPR training up to date." D)"It is scary to think that we have a pool and drowning is the second leading cause of accidental death in children." E)"We make sure to keep our bathroom door closed when our 10-month-old is walking around the house since the door handle is too high to reach."

30.The nurse is collecting information from the parents of a 3-year-old child about her sleeping patterns. Which question by the nurse will best elicit information from the parents? A)"How are things going at home?" B)"Is your child sleeping well at night?" C)"How many hours does your child sleep at night?" D)"What time does your child go to bed at night?"

30.The nurse is reviewing the therapist's documentation in the medical record of an assigned client who has cerebral palsy. The therapist has noted the parents may be experiencing vulnerable child syndrome. Which observation of the family unit best supports this potential diagnosis? A)The parents regularly attend a support group for parents of special needs children. B)The child has been diagnosed with pneumonia twice in the past year. C)The parents report they feel their child requires more therapy than the care team has indicated will be needed. D)The child is schooled at home with a private tutor.

30.Three children in a family, ages 7 months, 4 years, and 9 years have been tested for lead poisoning. The two younger children's tests reflect elevated lead levels and they will be undergoing treatment. The children's mother questions why her younger children were not "spared" as their older sibling was. What response by the nurse is most correct? A)"Some children are better able to metabolize toxins such as lead after exposure." B)"Your older child has a stronger liver and kidneys, which have helped her to better rid her body of the lead." C)"Younger children are often impacted because of their play behaviors place them on the floors and they often put things into their mouths." D)"It is likely your older child may have had elevated levels earlier in life but has gotten over the condition."

31. The mother of a 5-year-old child with eczema is getting a check-up for her child before school starts. What will the nurse do during the visit? A) Change the bandage on a cut on the child's hand. B) Assess the compliance with treatment regimens. C) Discuss systemic corticosteroid therapy. D) Assess the child's fluid volume.

31. The school nurse is presenting a class to a group of students about common overuse disorders. Which disorder would the school nurse include? A) Dislocated radial head B) Transient synovitis of the hip C) Osgood--Schlatter disease D) Scoliosis

32. The nurse is assessing a child with a possible fracture. What would the nurse identify as the most reliable indicator? A) Lack of spontaneous movement B) Point tenderness C) Bruising D) Inability to bear weight

34. A child has undergone surgery using steel bar placement to correct pectus excavatum. What position would the nurse instruct the parents to avoid? A) Semi-Fowler B) Supine C) High Fowler D) Side-lying

35. A newborn is diagnosed with metatarsus adductus. The parents ask the nurse how this occurred. Which response by the nurse would be most appropriate? A) "This condition is due to a genetic defect in the bones." B) "It's most likely from how the baby was positioned in utero." C) "They really don't know what causes this condition." D) "There is probably an underlying deformity of the baby's hip."

36. A nurse is preparing a presentation for a parent group about musculoskeletal injuries. When describing a child's risk for this type of injury, the nurse integrates knowledge that bone growth occurs primarily in which area? A) Growth plate B) Epiphysis C) Physis D) Metaphysis

37. A group of nursing students are reviewing information about the types of skin and skeletal traction. The students demonstrate understanding of this information when they identify which of these as a type of skeletal traction? A) Russell traction B) Bryant traction C) Buck traction D) Knee 90--90 traction

38. The nurse is providing care to a child with a long-leg hip spica cast. What is the priority nursing diagnosis? A) Risk for impaired skin integrity due to cast and location B) Deficient knowledge related to cast care C) Risk for delayed development related to immobility D) Self-care deficit related to immobility

4. The nurse is caring for a child who is having an anaphylactic reaction with bronchospasm. The nurse would expect to administer what medication for bronchospasm as ordered? A) Epinephrine B) Corticosteroid C) Albuterol D) Diphenhydramine

4. The nurse is caring for a toddler who is in Piaget's sensorimotor stage of cognitive development. Which task would the nurse expect the toddler to be able to perform? A) Completing puzzles with four pieces B) Winding up a mechanical toy C) Playing make-believe with dolls D) Knowing which are his or her toys

4. The nurse is conducting a physical examination of a 9-month-old baby with a flat, discolored area on the skin. The nurse documents this as a: A) papule. B) macule. C) vesicle. D) scale.

4.A new mother shows the nurse that her baby grasps her finger when she touches the baby's palm. How might the nurse respond to this information? A)"This is a primitive reflex known as the plantar grasp." B)"This is a primitive reflex known as the palmar grasp." C)"This is a protective reflex known as rooting." D)"This is a protective reflex known as the Moro reflex."

4.The healthcare provider has ordered rectal diazepam for a 2-year-old boy with status epilepticus. Which instruction is essential for the nurse to teach the parents? A)Monitor their child's level of sedation B)Watch for fever indicating infection C)Gradually reduce the dosage as seizures stop D)Monitor for an allergic reaction to the medication

4.The nurse contacts a child life specialist (CLS) to work with children on a pediatric ward. What is the primary goal of the CLS? A)Decrease anxiety and fear during hospitalization and painful procedure. B)Keep children who are hospitalized distracted from pain. C)Perform medical procedures using atraumatic principles. D)Act as a liaison between the nurse and the child.

4.The nurse is caring for a 4-year-old girl who has been hospitalized for over a week with severe burns. Which would be a priority intervention to help satisfy this preschool child's basic needs? A)Encourage friends to visit as often as possible. B)Suggest that a family member be present with her 24 hours a day. C)Explain necessary procedures in simple language that she will understand. D)Allow her to make choices about her meals and activities as much as permitted.

4.The nurse is caring for families with vulnerable child syndrome. Which situation would be mostlikely to predispose the family to this condition? A)Having a postterm infant B)Having an infant who is reluctant to feed properly C)Having a child diagnosed with impetigo at age 10 D)Having a child with juvenile diabetes

4.The nurse is conducting an assessment of a high school track athlete. The client tells the nurse he is experiencing pain along his outer thigh. He describes it as tight, achy, and tender, particularly after he runs. The nurse understands that he is most likely experiencing what kind of pain? A)Cutaneous B)Neuropathic C)Visceral D)Deep somatic

4.The nurse performing a health history on a child asks the parents if their child has experienced increased appetite or thirst. What body system is the nurse assessing with this question? A)Endocrine B)Genitourinary C)Hematologic D)Neurologic

4.The school nurse is performing health assessments on students in middle school. Of what developmental milestone should the nurse be aware? A)Height in girls increases rapidly after menarche and usually ceases immediately after menarche. B)Boys' growth spurts usually begin between the ages of 8 and 14 years and end between the ages of 131/2 and 171/2 years. C)Peak height velocity (PHV) occurs at approximately 12 years of age in girls or about 6 to 12 months after menarche. D)Boys reach PHV and peak weight velocity (PWV) at about 16 years of age.

4.When describing the differences affecting the pharmacokinetics of drugs administered to children, which would the nurse include? A)Oral drugs are absorbed more quickly in children than adults. B)Absorption of intramuscularly administered drugs is fairly constant. C)Topical drugs are absorbed more quickly in young children than adults. D)Absorption of drugs administered by subcutaneous injection is increased.

40. When assessing a child for slipped capital femoral epiphysis, what would the nurse identify as possible risk factors? Select all that apply. A) Age younger than 8 years B) African American ethnicity C) History of cystic fibrosis D) Excessive activity E) Male gender

41. The nurse is assessing an 11-year-old girl with scoliosis. What would the nurse expect to find? Select all that apply. A) Complaints of severe back pain B) Asymmetric shoulder elevation C) Even curve at the waistline D) Pronounced one-sided hump on bending over E) Diminished motor function F) Hyperactive reflexes

42. An 18-month-old was brought to the emergency department by her mother, who states, "I think she broke her arm." The child is sent for a radiograph to confirm the fracture. Additional assessment of the child leads the nurse to suspect possible child abuse. Which type of fracture would the radiograph most likely reveal? A) Plastic deformity B) Buckle fracture C) Spiral fracture D) Greenstick fracture

43. A 10-year-old girl is brought to the emergency department by her father after tripping over a rock while running in the yard. She tells the nurse, "I think I twisted my ankle." When assessing the child, what would the nurse most likely assess? A) Bruising B) Edema C) Limited range of motion D) Absent pulse

5. The nurse is caring for a 13-year-old girl with delayed puberty. Based on the nurse's knowledge of this condition, the nurse would include which nursing diagnosis in the child's plan of care? A) Disabled family coping related to the child's disorder B) Imbalanced nutrition, less than body requirements related to the child's short stature C) Noncompliance related to the need for lifelong hormone therapy D) Deficient knowledge related to the administration of estradiol

5. The nurse is caring for a child undergoing highly active antiretroviral therapy (HAART) for HIV infection. The nurse is preparing to administer the prescribed medication. In addition to the nucleoside analog reverse transcriptase inhibitors (NRTIs) and the nonnucleoside analog reverse transcriptase inhibitors (NNRTIs), the nurse is cognizant that the child will be taking which additional medication as part of the three-drug regimen? A) Protease inhibitors B) Corticosteroids C) Cytotoxic drugs D) Disease-modifying antirheumatic drugs (DMARDs)

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

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

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

5. The nurse is observing a 24-month-old boy in a day care center. Which finding suggests delayed motor development? A) The child has trouble undressing himself. B) The child is unable to push a toy lawnmower. C) The child is unable to unscrew a jar lid. D) The child falls when he bends over.

5. The nurse knows that the school-age child is in Erikson's stage of industry versus inferiority. Which best exemplifies a school-ager working toward accomplishing this developmental task? A) The child signs up for after-school activities. B) The child performs his bedtime preparations autonomously. C) The child becomes aware of the opposite sex. D) The child is developing a conscience.

5. The parents of a 4-year-old ask the nurse when their child will be able to differentiate right from wrong and develop morals. What would be the best response of the nurse? A) "The preschooler has no sense of right and wrong." B) "The preschooler is developing a conscience." C) "The preschooler sees morality as internal to self." D) "The preschooler's morals are his or her own, right or wrong."

5.A 7-year-old boy has reentered the hospital for the second time in a month. Which intervention is particularly important at this time? A)Assessing his parents' coping abilities B)Seeking his parents' input about their child's needs C)Educating his family about the procedure D)Notifying the care team about his hospitalization

5.After assessing a 10-year-old girl, the nurse documents the appearance of breast buds, identifying this as what body change? A)Menarche B)Thelarche C)Puberty D)Tanner stage 5

5.As a result of seizure activity, a computed tomography (CT) scan was performed and indicated that an 18-month-old child has intracranial arteriovenous malformation. When developing the child's plan of care, what would the nurse expect to implement actions to prevent? A)Drug interactions B)Developmental disabilities C)Hemorrhagic stroke D)Respiratory paralysis

5.The nurse is caring for a child who is experiencing pain related to chemotherapy treatment. What is a behavioral factor that might affect the child's pain experience? A)Knowledge of the therapy B)Fear about the outcome of therapy C)Participation in normal routine activities D)Ability to identify pain triggers

5.The nurse is caring for a hospitalized 13-year-old girl, who is questioning everything the medical staff is doing and is resistant to treatment. How should the nurse respond? A)"Let's work together to plan your day along with your treatments." B)"The sooner you cooperate, the sooner you are going to leave." C)"If you are more cooperative, perhaps we can arrange a visit from friends." D)"Please don't make me call your parents about this."

5.The nurse is preparing a child and his family for a lumbar puncture. Which would be a primary intervention instituted to keep the child safe? A)Distraction methods B)Stimulation methods C)Therapeutic hugging D)Therapeutic touch Ans:C

5.The nurse is providing teaching for the mother of an infant who receives all of his nutrition through a nasogastric feeding tube. The nurse is reviewing interventions to promote growth and development. Which response from the mother indicates a need for further teaching? A)"I will give him a pacifier during feeding time." B)"We need to keep feeding time very quiet." C)"We need to make sure he doesn't lose the desire to eat by mouth." D)"Sucking produces saliva, which aids in digestion."

ABF

5.The nurse is questioning the parents of a 2-year-old child to obtain a functional history. Which topics might the nurse include? Select all that apply. A)The child's toileting habits B)Use of car seats and other safety measures C)Problems with growth and development D)Prenatal and perinatal histories E)The child's race and ethnicity F)Use of supplements and vitamins

5.The nurse strives to provide culturally competent care for children in a health clinic that follows the principles of health supervision. Which nursing action reflects this type of care? A)The nurse treats all children the same regardless of their culture. B)The nurse negotiates a care plan with the child and family. C)The nurse researches the child's culture and provides care based on the findings. D)The nurse provides future-based care for culturally diverse children.

5.Which reflex, if found in a 4-month-old infant, would cause the nurse to be concerned? A)Plantar grasp B)Step C)Babinski D)Neck righting

6. A 6-year-old boy has been admitted to the hospital with burns. The nurse notes carbonaceous sputum. What action would be the priority? A) Determining the burn depth B) Eliciting a description of the burn C) Estimating burn extent D) Ensuring a patent airway

6. A nurse is caring for a 14-year-old girl following a myelography. What is the priority nursing action? A) Monitoring for a decrease in spasticity B) Observing for signs of meningeal irritation C) Assessing motor function D) Observing for mental confusion or hallucinations

6. The nurse is caring for a 3-year-old boy. The parents are concerned that he is exhibiting signs of cognitive delays. Which statement by the parents would lead the nurse to suspect autism spectrum disorder rather than possible learning disability? A) "He is not speaking in complete sentences." B) "We can understand a lot of what he says, but no one else can." C) "He seems to be speaking words less and less frequently." D) "He is unable to sit still for a short story."

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

6. The nurse is preparing a teaching plan for the family and their 6-year-old son who has just been diagnosed with diabetes mellitus. What would the nurse identify as the initial goal for the teaching plan? A) Developing management and decision-making skills B) Educating the parents about diabetes mellitus type 1 C) Developing a nutritionally sound, 30-day meal plan D) Promoting independence with self-administration of insulin

6. The nurse is providing home care instructions for a 13-year-old girl recently diagnosed with systemic lupus erythematosus. Which response by the girl indicates a need for further teaching? A) "I need to wear sunscreen in the summer to prevent rashes." B) "I need to eat a healthy diet, exercise, and get plenty of sleep." C) "I need an eye examination every year." D) "I need to be careful when it is cold; I should always wear gloves."

ABCF

6. The school nurse providing school health screenings knows that the 7- to 11-year-old is in Piaget's stage of concrete operational thoughts. What should this age group accomplish when developing operations? Select all that apply. A) Ability to assimilate and coordinate information about the world from different dimensions B) Ability to see things from another person's point of view and think through an action C) Ability to use stored memories of past experiences to evaluate and interpret present situations D) Ability to think about a problem from all points of view, ranking the possible solutions while solving the problem E) Ability to think outside of the present and incorporate into thinking concepts that do exist as well as concepts that might exist F) Ability to understand the principle of conservation—that matter does not change when its form changes

6. What activity would the nurse expect to find in an 18-month-old? A) Standing on tiptoes B) Pedaling a tricycle C) Climbing stairs with assistance D) Carrying a large toy while walking

6. Which activity would the nurse least likely include as exemplifying the preconceptual phase of Piaget's preoperational stage? A) Displays of animism B) Use of active imaginations C) Understanding of opposites D) Beginning questioning of parents' values

6.A 16-year-old boy reports to the school nurse reporting headaches and a stiff neck. Which sign or symptom would alert the nurse that the child may have bacterial meningitis? A)Fixed and dilated pupils B)Frequent urination C)Sunset eyes D)Sunlight is "too bright"

6.A new mother expresses concern to the nurse that her baby is crying and grunting when passing stool. What is the nurse's best response to this observation? A)"This is normal behavior for infants unless the stool passed is hard and dry." B)"This is normal behavior for infants due to the immaturity of the gastrointestinal system." C)"This indicates a blockage in the intestine and must be reported to the healthcare provider." D)"This is normal behavior for infants unless the stool passed is black or green."

6.The child life specialist (CLS) is preparing a 6-year-old child for a magnetic resonance imaging (MRI) scan. Which statement reflects the use of atraumatic principles when explaining the procedure? A)"You will be taken to a magnetic resonance imaging machine for an x-ray of your liver." B)"You may hear some loud noises when you are lying in the machine, but they won't hurt you." C)"You have nothing to worry about; the MRI machine is safe and will not cause you any pain." D)"Let's just get you to the x-ray department for your test and you'll see how simple it is."

ACE

6.The nurse caring for infants in the neonatal intensive care unit (NICU) relies on the use of behavioral and physiologic indicators for determining pain. Which examples are behavioral indicators? Select all that apply. A)The infant grimaces. B)The infant's heart rate is elevated. C)The infant flails his arms and legs. D)The infant's respiratory rate is elevated. E)The infant is crying uncontrollably. F)The infant's oxygen saturation is low.

ACE

6.The nurse is aware that the community affects the health of its members. Which statements accurately reflect a community influence of health care? Select all that apply. A)A community can be a contributor to a child's health or be the cause of his or her illnesses. B)The child's health should be separated from the health of the surrounding community. C)Community support and resources are necessary for children with significant problems. D)Poverty has not been linked to an increase in health problems in communities. E)The breakdown of community and family support systems can lead to depression and violence. F)Ideally, the child's medical home is located outside the community.

6.The nurse is caring for a 10-year-old boy who is in traction. The boy has a nursing diagnosis of deficient diversional activity related to confinement in bed that is evidenced by verbalization of boredom and lack of participation in play, reading, and schoolwork. What would be the bestintervention? A)Offer the child reading materials. B)Enlist the aid of a child life specialist. C)Encourage the child to complete his homework. D)Ask for the parents' assistance.

6.The nurse is caring for a special needs infant. Which intervention will be most important in helping the child reach his or her maximum developmental potential? A)Directing her parents to an early intervention program B)Monitoring her progress in elementary school C)Serving on an individualized education program committee D)Preparing a plan for her to transition to college

6.The nurse is conducting a physical examination of a child following a comprehensive health history. What should be the focus of the physical examination? A)The child B)The parents C)Chief complaint D)Developmental age

6.The nurse is preparing to administer oral ampicillin to a child who weighs 40 kg. The safe dose for children is 50 to 100 mg/kg/day divided in doses administered every 6 hours. What would be the low single safe dose and high single safe dose per day for this child? A)50 to 100 mg per dose B)100 to 500 mg per dose C)500 to 1,000 mg per dose D)1,000 to 5,000 mg per dose

6.When describing the various changes that occur in organ systems during adolescence, what would the nurse include? A)Significant increase in brain size B)Ossification completed later in girls C)Decrease in heart rate D)Decrease in activity of sebaceous glands Ans:C

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

7. A nurse is caring for a 5-year-old girl with depression. The girl is having difficulty coping with her feelings of sadness and fear, which stem from her parents' separation and recent divorce. The girl has been prescribed antidepressant medication but the mother thinks the girl would benefit from therapy. The nurse anticipates a referral to a therapist that specializes in: A) individual therapy. B) play therapy. C) behavioral therapy. D) hypnosis.

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

7. The nurse explains to parents of school-age children that according to Kohlberg's theory of moral development, their child is at the conventional stage of moral development. Which is the nurse's bestexplanation for the motivation for school-age children to follow rules? A) They follow rules out of a sense of being a "good person." B) They follow rules out of fear of being punished. C) They follow rules in order to receive praise from caretakers. D) They follow rules because it is in their nature to do so.

7. The nurse has developed a plan of care for a 6-year-old with muscular dystrophy. He was recently injured when he fell out of bed at home. Which intervention would the nurse suggest to prevent further injury? A) Recommend the bed's side rails be raised throughout the day and night. B) Suggest a caregiver be present continuously to prevent falls from bed. C) Encourage a loose restraint to be used when he is in bed. D) Recommend raising the bed's side rails when a caregiver is not present.

7. The nurse is assessing the motor skills of a 5-year-old girl. Which finding would cause the nurse to be concerned? A) Can copy a square on another piece of paper B) Can dress and undress herself without help C) Draws a person with three body parts D) Is beginning to tie her own shoelaces

7. The nurse is caring for a child who is taking corticosteroids for systemic lupus erythematosus. The nurse closely monitors the child based on the understanding that corticosteroids exert which major action? A) They increase liver enzymes. B) They can mask signs of infection. C) They cause bone marrow suppression. D) They decrease renal function.

7. The nurse is caring for an 8-year-old girl with an endocrine disorder involving the posterior pituitary gland. What care would the nurse expect to implement? A) Instructing the parents to report adverse reactions to the growth hormone treatment B) Teaching the parents how to administer the desmopressin acetate C) Informing the parents that treatment stops when puberty begins D) Educating the parents to report signs of acute adrenal crisis

7. The pediatric nurse is planning quiet activities for a hospitalized 18-month-old. What would be an appropriate activity for a child of this age group? A) Painting by number B) Putting shapes into appropriate holes C) Stacking blocks D) Using crayons to color in a coloring book

7.A 4-year-old boy has a febrile seizure during a well-child visit. What action would be a priority? A)Hyperextending the child's head while placing him on his side B)Using a tongue blade to pry open the child's jaw C)Loosening the child's clothing to ensure a patent airway D)Protecting the child from harm during the seizure

7.A nurse is providing teaching to the mother of an adolescent girl about how to manage menstrual pain nonpharmacologically. Which statement by the mother indicates a need for further teaching? A)"I need to help her learn techniques to distract her; card games, for example." B)"I need to be able to identify the subtle ways she shows pain." C)"I need to follow these instructions exactly for them to work properly." D)"I need to encourage her to practice and utilize these techniques."

7.The nurse is caring for a 13-year-old girl hospitalized for complications from type 1 diabetes. The girl has a nursing diagnosis of powerlessness related to lack of control of multiple demands associated with hospitalization, procedures, treatments, and changes in usual routine. How can the nurse help promote control? A)Ask the child to identify her areas of concern. B)Encourage participation of parents in care activities. C)Offer the girl as many choices as possible. D)Enlist the family's assistance in creating a time schedule.

7.The nurse is caring for a 4-year-old girl with special care needs in the hospital. Which intervention would have the most positive effect on this child? A)Taking her on an adventure down the hall B)Helping her do a simple craft project C)Introducing her to children in the playroom D)Limiting the staff providing care for her

ABC

7.The nurse is conducting a psychosocial assessment of a child with asthma brought to the healthcare provider's office for a check-up. Which psychosocial issues may be assessed? Select all that apply. A)Health insurance coverage B)Transportation to healthcare facilities C)School's response to the chronic illness D)Past medical history E)Future treatment plans F)Health maintenance needs

7.The nurse is preparing to administer a medication to a 5-year-old who weighs 35 lb. The prescribed single dose is 1 to 2 mg/kg/day. Which is the appropriate dose range for this child? A)8 to 16 mg B)16 to 32 mg C)35 to 70 mg D)70 to 140 mg

7.The nurse is teaching the student nurse how to perform a physical assessment based on the child's developmental stage. Which statement accurately describes a recommended guideline for setting the tone of the examination for a school-age child? A)Keep up a running dialogue with the caregiver, explaining each step as you do it. B)Include the child in all parts of the examination; speak to the caregiver before and after the examination. C)Speak to the child using mature language and appeal to his or her desire for self-care. D)Address the child by name; speak to the caregiver and do the most invasive parts last.

7.The nurse uses family-centered care to provide care for children in a pediatric office. Upon what concept is family-centered care based? A)The family is the constant in the child's life and the primary source of strength. B)The care provider is the constant in the child's life and the primary source of strength. C)The child must be prepared to be his or her own source of strength during times of crisis. D)The wishes of the family should direct the nursing care plan for the child.

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

8. The nurse is assessing a 13-year-old boy with type 2 diabetes mellitus. What would the nurse correlate with disorder? A) The parents report that their child had "a cold or flu" recently. B) Blood pressure is decreased when checking vital signs. C) The parents report that their son "can't drink enough water." D) Auscultation reveals Kussmaul breathing.

8. The nurse is caring for a 13-year-old boy with a history of inappropriate behavior. Which statement by the mother would lead the nurse to suspect oppositional defiant disorder rather than conduct disorder? A) "He has frequent temper tantrums." B) "He was pulling the neighbor's dog around by his leash." C) "He is constantly lying to me." D) "He has stolen hundreds of dollars from my purse."

8. The nurse is caring for a 2-month-old with cerebral palsy. The infant is limp and flaccid with uncontrolled, slow, worm-like, writhing, and twisting movements. What word would the nurse use when documenting these observations? A) Spastic B) Athetoid C) Ataxic D) Mixed

8. The nurse is caring for an infant with candidal diaper rash. Which topical agent would the nurse expect the healthcare provider to order? A) Corticosteroids B) Antifungals C) Antibiotics D) Retinoids

8. The nurse is performing a cognitive assessment of a 2-year-old. Which behavior would alert the nurse to a developmental delay in this area? A) The child cannot say name, age, and gender. B) The child cannot follow a series of two independent commands. C) The child has a vocabulary of 40 to 50 words. D) The child does not point to named body parts.

8. The nurse is talking with a chatty 7-year-old girl during her regular check-up. Which behaviors would the child also be expected to exhibit? A) Showing no interest in what the nurse sees in her ears B) Explaining what is right and what is wrong C) Demonstrating independence from her mother D) Showing no concern when the nurse hurts her own finger

ABDE

8. The school nurse is helping parents choose books for their preschoolers. What literacy skills present in the preschooler would the nurse consider when making choices? Select all that apply. A) Preschoolers enjoy books with pictures that tell stories. B) Preschoolers like stories with repeated phrases as they help keep their attention. C) Preschoolers like stories that describe experiences different from their own. D) Preschoolers demonstrate early literacy skills by reciting stories or portions of books. E) Preschoolers may retell the story from the book, pretend to read books, and ask questions about the story. F) Preschoolers do not have enough focus and expanded attention to notice when a page is skipped during reading.

8. The school nurse is walking through the lunchroom when one of the children says she started to feel strange after trading lunches with a friend. Which assessment would be most important? A) Asking if she has a rash anywhere B) Checking if she has any nausea C) Determining if her throat itches D) Asking if she has abdominal pain

8.Based on Erikson's developmental theory, what is the major developmental task of the adolescent? A)Gaining independence B)Finding an identity C)Coordinating information D)Mastering motor skills

ADEF

8.The nurse caring for newborns knows that infants exhibit phenomenal increases in their gross motor skills over the first 12 months of life. Which statements accurately describe the typical infant's achievement of these milestones? Select all that apply. A)At 1 month, the infant lifts and turns the head to the side in the prone position. B)At 2 months, the infant rolls from supine to prone to back again. C)At 6 months, the infant pulls to stand up. D)At 7 months, the infant sits alone with some use of hands for support. E)At 9 months, the infant crawls with the abdomen off the floor. F)At 12 months, the infant walks independently.

8.The nurse has developed a teaching plan for the family of a 2-year-old boy who holds his breath when he gets frustrated. What will be most important to include in this plan? A)Provide cuddle time whenever the child begins to act out. B)Explain the child's behavior to the parents. C)Encourage the parents to interact more with the child. D)Stay close to prevent injury when he gets frustrated.

8.The nurse is administering a crushed tablet to an 18-month-old infant. What is a recommended guideline for this intervention? A)Mix the crushed tablet with a small amount of applesauce. B)Place the crushed tablet in the infant's formula. C)Mix the crushed tablet with the infant's cereal. D)Crushed tablets should only be mixed with water.

8.The nurse is caring for an 8-year-old girl who requires numerous venipunctures and injections daily. The nurse understands that the child is exhibiting signs of sensory overload and enlists the assistance of the child life specialist. What should the therapeutic play involve to best deal with the child's stressors? A)Puppets and dolls B)Drawing paper and crayons C)Wooden hammer and pegs D)Sewing puppets with needles

ABDE

8.The nurse is caring for infants with failure to thrive (FTT). Which infants would be at risk for this condition? Select all that apply. A)A newborn baby with tetralogy of Fallot B)An infant with a cleft palate C)An infant born to a diabetic mother D)An infant born to an impoverished mother E)An infant with bronchopulmonary dysplasia F)An infant born to a teenage mother

8.The nurse is counseling the parents of a 9-year-old boy who is receiving morphine for postoperative pain. Which statement from the nurse accurately reflects the pain experience in children? A)"You can expect that your child will tell you when he is experiencing pain." B)"Your child will learn to adapt to the pain he is experiencing." C)"Your child will experience more adverse effects to narcotics than adults." D)"It is very rare that children become addicted to narcotics."

8.The nurse is examining a 2-year-old child who was adopted from Guatemala. What would be a priority screening for this child? A)Screening for congenital defects B)Screening for abuse C)Screening for childhood illnesses D)Screening for infectious diseases

8.The nurse knows that effective communication with children and their parents is critical to providing atraumatic quality nursing care. Which statement accurately describes the communication patterns of children? A)Communication patterns are similar from one child to the next. B)Children often use more words than adults to describe their fears. C)Children rely more on nonverbal communication and silence. D)Parents more often require affective communication rather than neutral communication.

8.Which would be least effective in gaining the cooperation of a toddler during a physical examination? A)Tell the child that another child the same age wasn't afraid. B)Allow the child to touch and hold the equipment when possible. C)Permit the child to sit on the parent's lap during the examination. D)Offer immediate praise for holding still or doing what was asked.

9. The nurse is assessing the gross motor skills of an 8-year-old boy. Which interview question would facilitate this assessment? A) "Do you like to do puzzles?" B) "Do you play any instruments?" C) "Do you participate in any sports?" D) "Do you like to construct models?"

9. The nurse is caring for a 15-year-old boy who has sustained burn injuries. The nurse observes the burn developing a purplish color with discharge and a foul odor. The nurse suspects which infection? A) Burn wound cellulitis B) Invasive burn cellulitis C) Burn impetigo D) Staphylococcal scalded skin syndrome

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

9. The nurse is caring for a 5 year old. The child's mother reports that he is extremely sensitive to sounds that most people do not notice and that he prefers complete silence. She explains that the boy is resisting going to school due to the noise and commotion. Additionally, the mother states that he will only wear 100% cotton clothing with all of the tags cut out. The nurse interprets these findings as indicating which disorder or condition? A) Anxiety disorder B) Sensory processing disorder C) Depression D) Obsessive-compulsive disorder

9. The nurse is caring for a child who has undergone stem cell transplantation for severe combined immune deficiency. What finding would the nurse interpret as indicative of graft-versus-host disease? A) Presence of wheezing B) Splenomegaly C) Maculopapular rash D) Chronic or recurrent diarrhea

9. The nurse is interviewing a 3-year-old girl who tells the nurse: "Want go potty." The parents tell the nurse that their daughter often speaks in this type of broken speech. What would be the nurse's appropriate response to this concern? A) "This is a normal, common speech pattern in the 3-year-old and is called telegraphic speech." B) "This is considered a developmental delay in the 3-year-old and we should consult a speech therapist." C) "This is a condition known as echolalia and can be corrected if you work with your daughter on language skills." D) "This is a condition known as stuttering and it is a normal pattern of speech development in the toddler."

9. The nurse is preparing a teaching plan for a 10-year-old girl with hyperthyroidism. What information would the nurse include in the plan? A) Describing surgery to remove an anterior pituitary tumor B) Teaching her parents to give injections of growth hormone C) Explaining about the radioactive iodine procedure D) Showing her parents how to give DDAVP intranasally

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

9. The nurse is teaching a group of students about myelinization in a child. Which statement by the students indicates that the teaching was successful? A) Myelinization is completed by 4 years of age. B) The process occurs in a head-to-toe fashion. C) The speed of nerve impulses slows as myelinization occurs. D) Nerve impulses become less specific in focus with myelinization.

BDF

9. The parents of a preschooler ask the nurse to help them choose a preschool for their child. What are recommended guidelines and goals for choosing a preschool? Select all that apply. A) The main goal of preschool is to improve reading and writing skills and readiness for entering into grade school. B) When selecting a preschool, the parent may want to consider the accreditation of the school and the teachers' qualifications. C) The teachers should decide how focused on curriculum the school should be for each individual student. D) The parent should observe the classroom, evaluating the environment, noise level, and sanitary practices. E) The type of discipline used in the school is also an important factor. Parents should choose a preschool that uses corporal punishment. F) The parent should observe the classroom to determine how the children interact with each other and how the teachers interact with the children.

9.After teaching a group of students about therapeutic play, the instructor determines that additional teaching is needed when the students identify what as a characteristic of therapeutic play? A)Focus on coping B)Use of a highly structured format C)Dramatization of emotions D)Expression of feelings

9.The father of a 13-year-old boy reports his family has a strong history of depression. He questions screening for his son. What information should be provided by the nurse? A)"Are you having concerns about depression in your son?" B)"Screening in at risk teens should be completed annually after age 14." C)"Children should be screened for depression every year beginning at age 11." D)"If you notice that your son is having mood issues we can certainly refer him for an evaluation with a therapist." Ans:C

BCD

9.The nurse assesses the spirituality of an adolescent. What are normal moral and spiritual milestones in this age group? Select all that apply. A)Adolescents will base their actions on the avoidance of punishment and the attainment of pleasure. B)Adolescents develop their own set of morals and values and question the status quo. C)Adolescents undergo the process of developing their own set of morals at different rates. D)Adolescents are more interested in the spiritualism of their religion than in the actual practices of their religion. E)Adolescents can understand the concepts of right and wrong and are developing a conscience. F)Adolescents are able to understand and incorporate into their behavior the concept of the "golden rule."

9.The nurse is using the acronym QUESTT to assess the pain of a child. Which is an accurate descriptor of this process? A)Question the child's parents. B)Understand the child's pain level. C)Establish a caring relationship with the child. D)Take the cause of pain into account when intervening.

9.The nurse is using verbal skills to explain the nursing care plan to parents of a 10-year-old child with cancer. What describes a guideline the nurse should follow to provide appropriate verbal communication? A)Use closed-ended questions that do not restrict the child's or parent's answers. B)Allow the focus to change without redirecting the conversation. C)Restate the child's and parent's comments in your own words. D)Paraphrase the child's or parent's feelings to demonstrate empathy.

9.The nurse is weighing an underweight infant diagnosed with failure to thrive (FTT) and notes that the baby does not make eye contact and is less active than the other infants. What would be a probable cause for the FTT related to the infant's body language? A)Congenital heart defect B)Cleft palate C)Gastroesophageal reflux disease D)Maternal abuse

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