Comprehensive Exam

A young woman tells a nurse she is pregnant and concerned that her boyfriend may be "slow" mentally. The nurse should do which activity first? 1. Develop a pedigree. 2. Take a family history 3. Inform the provider about the concern 4. Refer the client for genetic counseling

3. Inform the provider about the concern

Three P-K children and their foreign-born parents come to a homeless shelter. The family has been homeless for 3 months. The children appear somewhat unkempt but nourished. One of the children has several enlarged cervical lymph nodes and is running a low-grade fever. Which chronic infectious illness should be suspected in the child? 1. Chlamydial pneumonia 2. Tuberculosis 3. Pertussis (whooping cough) 4. Asthma

2. Tuberculosis

A nurse is working in a well-child clinic administering immunizations to preschoolers. Which procedure will minimize local reactions to the injections? 1. Apply EMLA cream 1 hour before. 2. Change the needle on the syringe after drawing up the biological drug. 3. Inject into the vastus lateralis or ventrogluteal muscle. 4. Use distraction such as telling the child to hold their breath.

3. Inject into the vastus lateralis or ventrogluteal muscle.

Which would the nurse assess in a 4-week-old infant who has developmental dysphasia of the hip and is wearing a Pavlik harness? 1. Diaper dermatitis. 2. Talipes equinovarus 3. Leg shortening and limited abduction 4. Pain

3. Leg shortening and limited abduction

During the nurse's assessment, a child begins to have a generalized tonic-clinic seizure. The drug of choice and method of administration the nurse expects the health-care provider (HCP0 to order are which of the following? 1. Lorazepam and diazepam on an IV solution of D5W. 2. Lorazepam given IV or diazepam given directly into a vein 3. Phenobarbital administered in an IV solution of D5W, 0.45 normal saline 4. Phenytoin in a dextrose solution given IV over 1 hour.

2. Lorazepam given IV or diazepam given directly into a vein

Which does the nurse include in discharge teaching for a 15-year-old with systemic lupus erythematosus? SATA 1. High-protein diet 2. Low salt intake 3. Exposure to the sun 4. Killed-virus vaccines 5. Systemic corticosteroids 6. Antimalarial

2. Low salt intake 4. Killed-virus vaccines 5. Systemic corticosteroids 6. Antimalarial

The nurse is working in a clinic, and the next client is an infant with deaf parents. In addition to providing an interpreter for a deaf, the nurse should incorporate what additional aid in communicating with the family? 1. Talk just a with hearing families. 2. Maintain good eye contact to let them read the nurse's lips. 3. Explain procedures thoroughly. 4. Recommend a trained hearing dog.

2. Maintain good eye contact to let them read the nurse's lips.

While assisting with a lumbar puncture procedure on an infant or small child, the nurse should do which of the following? 1. Have the patient in a clean diaper to avoid contamination on the site. 2. Monitor the patient's cardiorespiratory status at all times. 3. Position the patient in the prone position with the head to the left. 4. Start an intravenous lien to facilitate use of conscious sedation

2. Monitor the patient's cardiorespiratory status at all times.

Parents of a 2-year-old with Down syndrome are told the child should be screened for atlantoaxial instability. The nurse tells the parents that which of the following are symptoms of this instability? 1. Mental retardation 2. Neck pain and torticollis. 3. Vision and hearing loss 4. Early onset of puberty

2. Neck pain and torticollis.

The nurse is caring for a newborn with Erb palsy and a phrenic nerve paralysis. The most effective way to promote respiratory effort is for the nurse to position the newborn in what way? 1. Supine 2. On the affected side 3. On the unaffected side 4. Prone

2. On the affected side

The parent of a school-age child who is a paraplegic and uses a wheelchair states that the child is allergic to latex. Which is the most important intervention for this child? 1. Giving antihistamines and steroids after procedures. 2. Prevention of contact with latex products. 3. Doing a radioallergosorbent test before each procedure. 4. Using only latex-free gloves when doing procedures.

2. Prevention of contact with latex products.

A parent tells the nurse that the 3-month-old infant is fussy, spits up constantly, and has a lot of gas, and there is a family history of allergies. These symptoms are related to which diagnosis? 1. Failure to thrive. 2. Sensitive to cow's milk. 3. Phenylketonuria 4. Pancreatic insufficiency.

2. Sensitive to cow's milk.

the nurse's unit is using the POPS pain scale for measuring pain in infants. The nurse know this tool is which of the following? 1. Pain Assessment Tool for infants 27 weeks to term gestation. 2. The Neonatal Infant Pain Scale for infants 3 to 12 months. 3. Premature Infant Pain Profile Scale for infants 32 weeks to term gestation. 4. Post-Operative Pain Score for infants 1 to 7 months.

4. Post-Operative Pain Score for infants 1 to 7 months.

The mother of a 6-month-old is going back to work. The nurse should make which of the following suggestions for ways to evaluate day-care options? SATA 1. Size of day-care center 2. Strict health and safety requirements. 3. Caretakers who are loving and kind. 4. Challenging activities for all the children. 5. Child-care ratios that maximize staff use. 6. Small class size.

2. Strict health and safety requirements. 3. Caretakers who are loving and kind. 6. Small class size.

A 12-year-old cut a hand while climbing a barbed-wire fence. What should the nurse discuss with the parents regarding need for tetanus vaccine? SATA 1. No tetanus vaccine is necessary; it is too soon since the child's scheduled Tdap was given. 2. Tetanus is a potentially fatal disease 3. Puncture wounds are less susceptible to tetanus 4. There will be mild soreness at the injection site 5. Tdap should be administered 6. Td should be administered

2. Tetanus is a potentially fatal disease 5. Tdap should be administered

Which approach gives the most support to parents grieving over a terminally ill newborn? 1. State, "You are both still young and will be able to have more children." 2. Avoid the parents; let them ask you questions 3. Offer rationalizations for the child's terminal illness. 4. State, "You are still feeling all the pain of your child's illness."

4. State, "You are still feeling all the pain of your child's illness.

An adolescent is complaining of knees swelling and hurting, hands and feet being cold all the time, frequent headaches, and a red rash on the cheeks and nose. Which does the nurse suspect? 1. Multiple sclerosis 2. Normal adolescent concerns 3. Myasthenia gravis 4. Systemic lupus erythematosus

4. Systemic lupus erythematosus

What are the two organizations in the US that make and govern the recommendations for immunization policies and procedures? 1. National Advisory Committee on Immunization and American Medical Association. 2. U.S. Public Health Service Centers for Disease Control and American Academy of Pediatrics 3. National Immunization Program and Pediatric Infectious Disease Association. 4. National Institutes of Health and Minister of National Health and Welfare.

2. U.S. Public Health Service Centers for Disease Control and American Academy of Pediatrics (ACIP)

A pregnant teen is to have prenatal testing. She is afraid of needles and wants to know the least invasive way she can get the testing. The nurse should suggest which testing procedure? 1. Triple marker screen 2. Ultrasound examination 3. Amniocentesis 4. Chorionic villus sampling.

2. Ultrasound examination

the nurse is caring a child dying from leukemia. The parents want to know how comfortable the nurse is in giving doses of pain medication that are larger than customary. Which ethical principle of care are the parents asking about? 1. Double effect 2. Justice 3. Honesty B. Beneficence

1. Double effect

A baby is brought into the clinic for follow-up review of phenylketonuria. The baby is 9 months old and weighs 22 lb. If the recommendation is to limit the phanylalanine in the diet to 25 mg/kg/day, this infant should have no more than _____ of phanylalanine/day.

250 mg

A child with moderate asthma is distressed because she has just learned that she is allergic to the family dog. Which intervention would most effectively address the physical and psychosocial needs of the child? 1. Skin testing for allergens 2. PCO2 levels 3. Biox level 4. Metered dose inhaler 5. Peak flow

3. Biox level 5. Peak flow

Which are associated with Guillain-Barre? SATA 1. Always fatal after 18 to 24 months. 2. Progress cephalocaudally 3. Complications are associated with immobility 4. Respiratory support is a nursing priority 5. Tube feedings or total parental nutrition may become necessary.

3. Complications are associated with immobility 4. Respiratory support is a nursing priority 5. Tube feedings or total parental nutrition may become necessary.

Parents are told by the genetic counselor that they have a 1 : 4 ratio probability of having a second child with cystic fibrosis (CF). They already have one child who is affected. The parents state their risk is lower now than when they had the previous child. What should the nurse tell the parents about the 1 : 4 probability? 1. Each pregnancy is an independent event. 2. The probability of having another child with CF is twice as likely as it was when they had the first child. 3. The probability of having a healthy child is twice as likely with this pregnancy. 4. The probability of miscarrying is greater now than with the previous pregnancy.

1. Each pregnancy is an independent event.

The nurse on the previous shift charted that a newborn demonstrated cutis marmorata. The nurse now caring for the baby should check which vital sign? 1. Blood pressure 2. Respirations 3. Skin color 4. Temperature

4. Temperature

A 10-month old has fallen out of the high chair and is brought to the ED. Place the following components of the nurse's assessment into order of priority: 1. Airway 2. Bleeding 3. Appetite 4. Breathing 5. circulation 6. Level of consciousness

1,4,5,6,2,3 1. Airway always 1st priority 4. Breathing, 2nd aspect of ABC priority 5. Circulation, 3rd aspect of ABC priority 6. LOC, Important after stabilization of the ABC 2. Bleeding, Important but not 1st priority 3. Appetite, Least important

Parents express concern that their 5-year-old has started having more temper tantrums. The parents want to know if this is normal for this age. What should the nurse ask the parent about the tantrums? SATA 1. "Do you notice and praise your child when your child does something right?" 2. "Are the tantrums related to one specific aspect of life?" 3. "Are the tantrums causing any harm to self or others?" 4. "Hove you consulted the Internet for any suggestions?" 5. "How do you handle your child during a tantrum?"

1. "Do you notice and praise your child when your child does something right?" 2. "Are the tantrums related to one specific aspect of life?" 3. "Are the tantrums causing any harm to self or others?" 5. "How do you handle your child during a tantrum?"

The parents of an infant with hydrocephalus ask about the future activities in which their child can participate in school and as an adolescent. The nurse should tell the parents which of the following is appropriate? 1. A helmet should be worn during any activity that could lead to head injury. 2. only-non-contact sports should be pursued, such as swimming or tennis 3. Because of the risk of shunt system infection, swimming is not a sports option 4. The child should wear a MedicAlert bracelet, than there is no need to be concerted about the shunt.

1. A helmet should be worn during any activity that could lead to head injury.

A child is taking haloperidol (Haldol) for schizophrenia, and the family has been instructed to watch for extrapyramidal side effects. Which are characteristic of these side effects? 1. Abnormal movements and twitches. 2. Inappropriate behaviors 3. Excessive aggressiveness 4. Thoughts of suicidi

1. Abnormal movements and twitches.

In preparing the patient and family for hospital discharge, which of the following signs and symptoms of shunt malfunction and infection should the nurse include in the teaching plan. SATA 1. Emesis, lethargy 2. A Change in neurological behavior 3. Fever, irritability 4. Diarrhea or constipation 5. Redness along the shunt system.

1. Emesis, lethargy 2. A Change in neurological behavior 3. Fever, irritability 5. Redness along the shunt system.

A sports physical examination is being performed on a 12-year-old male. He is evaluated as a Tanner stage II. Which physical characteristic would the nurse expect? 1. Enlarging penis 2. Height spurt 3. Gynecomastia 4. Deepening voice 5. Enlarging scrotum

1. Enlarging penis

Parents are interested in switching their child from a booster seat to a regular seat belt. The child is 7 years old and weighs 51 lb. What can the nurse tell the parents about switching the child to a seat belt? SATA 1. The safest place to ride in the car is in the front seat. 2. The child needs to weigh 60 lbs and be 8 years old to qualify legally for a seat belt. 3. The seat belt should be worn low on the hips. 4. Use a shoulder belt only if it does no cross the child's neck. 5. Tether straps are optional.

2. The child needs to weigh 60 lbs and be 8 years old to qualify legally for a seat belt. 3. The seat belt should be worn low on the hips. 4. Use a shoulder belt only if it does no cross the child's neck.

Match each generic term with its definition and function 1. Congenital 2. FISH analysis 3. Genome 4. Malformation 5. Phenotype 6. Syndrome A. Morphogenic defect of an organ B. Recognized pattern of malformation C. Present at birth D. Clinically exhibited characteristic E. Fluorescent in situ hybridization F. Complete genetic information of organism

1. Congenital- C Present at birth 2. FISH analysis- E. Fluorescent in situ hybridization 3. Genome- F. Complete genetic information of organism 4. Malformation A. Morphogenic defect of an organ 5. Phenotype D. Clinically exhibited characteristic 6. Syndrome B. Recognized pattern of malformation

Which is/are the most common, nonlethal complication(s) occurring from meningitis? 1. Cranial nerve deficits 2. Epilepsy 3. Bleeding intracranially 4. Cerebral palsy

1. Cranial nerve deficits

Which is assessed to diagnose pediculosis capitis? SATA 1. Crawling insects 2. White flakes in the hair. 3. Nits attached close to scalp 4. Inflammatory papules 5. Dark brown hair

1. Crawling insects 3. Nits attached close to scalp 4. Inflammatory papules

the nurse tells a parent which of the following data con be provided by a polysomnogram? SATA 1. Heart rate and respirations 2. Brain waves 3. Eye and body movements 4 .Cyanosis or plethora 5. End-tidal carbon dioxide

1. Heart rate and respirations 2. Brain wave 3. Eye and body movements 5. End-tidal carbon dioxide

A 17-month-old is brought into the clinic, and the nurse notes the toddler has tooth decay on the maxillary upper incisors. Which tactic(s) would the nurse suggest to wean the toddler from the bottle? SATA 1. Hide the bottle and tell the toddler that it is not needed anymore. 2. Put only tap water in the bottle. 3. Give the bottle only at night. 4. Give the toddler a pacifier and take the bottle away. 5. Do not give any bottles before bed.

1. Hide the bottle and tell the toddler that it is not needed anymore. 2. Put only tap water in the bottle. 5. Do not give any bottles before bed.

An infant with a lumbar myelomeningocele is admitted to the unit with an Arnold-Chiari malformation. The infant has which other diagnosis? 1. Hydrocephalus 2. Anencephaly. 3. Tethering of the spinal cord. 4. Perinatal hemorrhage.

1. Hydrocephalus

Which applies to cerebral palsy? SATA 1. It is them most common chronic disorder of childhood. 2. Hyperbilirubinemia increases the risk of CP 3. It is a progressive chronic disorder. 4. Most children do not experience any learning disabilities. 5. There is a familial tendency seen in children with CP.

1. It is them most common chronic disorder of childhood. 2. Hyperbilirubinemia increases the risk of CP

A family is adopting a child from a foreign country. What suggestions can be given to the parents for incorporating the child into the family? SATA 1. Learn as much about the child as possible before adoption 2. Expect conflict and determine how to work through it with the child. 3. Do not discuss the biological parents with the child 4. Discuss your expectations with the child. 5. Try to maintain a part of the child's original family name.

1. Learn as much about the child as possible before adoption 2. Expect conflict and determine how to work through it with the child. 4. Discuss your expectations with the child. 5. Try to maintain a part of the child's original family name.

An innocent murmur has which characteristics? SATA 1. Short induration 2. S2 murmur 3. Loudest in the pulmonic area 4. Fixed and can be heard in many positions 5. Grade III or less

1. Short induration 3. Loudest in the pulmonic area 5. Grade III or less

A child assigned to the nurse's floor has dysfluency. The nurse should recognize what symptoms? 1. Stuttering. 2. Substitution of one sound for another. 3. Speaking in a monotone. 4. Hypernasal speech

1. Stuttering.

The nurse in the Emergency department is caring for an 8-month-old who suffered a concussion from an automobile accident. The infant was in the car seat at the time. The nurse should assess the infant for which symptoms? 1. Sweating, irritability, and pallor 2. Plethora and hyperthermia. 3. Crying with fear. 4. Negative Babinski reflex

1. Sweating, irritability, and pallor

The nurse is working in a school health clinic, and a teen mentions that her older sister just had a baby born with a myelomeningocele. The teen is wondering if there is anything she can do to prevent this from happening to her baby when she decides to have children. Which is the best response? 1. Take a multivitamin with folic acid daily. 2. Eat more fruits and vegetables daily. 3. Have breakfast every morning. 4. There is nothing that can be done to decrease the risk.

1. Take a multivitamin with folic acid daily.

Which should the nurse teach the child and parents about Montelukast (Singulair) ordered for moderate persistent asthma? SATA 1. This is an add-on medication to the child's regular medications 2. It can be given when the child needs it. 3. It is not to be used to treat acute episodes. 4. the parents will need to give up smoking 5. The child will require chest physiotherapy in conjunction with the medication.

1. This is an add-on medication to the child's regular medications 3. It is not to be used to treat acute episodes.

Which best describes the type of seizure displayed in the accompanying figure? 1. Tonic-clonic 2. Absence 3. Atonic 4. Akinetic 5. Myoclonic 6. Infantile spasm

1. Tonic-clonic

The nurse is doing discharge teaching for a 3-month-old with a new shunt placed for hydrocephalus. Which are signs and symptoms of hydrocephalus that the parents may see if the shunt malfunctions? SATA 1. Vomiting 2. Irritability 3. Poor feeding 4. Headache 5. Sunken fontanel 6. Seizures 7. Inability to wake up infant 8 Hyperactivity

1. Vomiting 2. Irritability 3. Poor feeding 6. Seizures 7. Inability to wake up infant

A 2-year-old is brought to the emergency department for fever and ear pain. The parent reports the child has had many ear infections and that polyethylene tubes have been recommended, but the parent cannot afford surgery. The child is diagnosed with bilateral otitis media. The toddler is carrying a baby bottle full of juice, and the parent is carrying a pack of cigarettes. Which preventive measures could be taught to the parent to decrease the incidence of ear infections? SATA 1. Wean the toddler from the bottle. 2. Give the toddler a decongestant before bedtime. 3. Encourage the parent to smoke outside the house. 4. Counsel the parent to change his shirt and wash his hands after smoking. 5. Have the child's hearing checked.

1. Wean the toddler from the bottle. 3. Encourage the parent to smoke outside the house. 4. Counsel the parent to change his shirt and wash his hands after smoking.

The nurse working in the noewborn nursery has to draw a heel-stick blood sample before an infant's discharge. What can the nurse do to decrease the pain the infant feels from this procedure? SATA 1. Wrap the heel in a warm, damp cloth 2. Use EMLA before doing the stick 3. Swaddle the infant 4. have the infant do non-nutritive sucking 5. Do the stick while the infant is asleep.

1. Wrap the heel in a warm, damp cloth 3. Swaddle the infant 4. have the infant do non-nutritive sucking

A child returns from surgery, having had tonsils and adenoids removed. When the parents are getting ready for discharge, the nurse gives which of the following instructions about home care? SATA 1. some secretions may be blood-tinged for a few days. 2. Run a cool-mist vaporizer in the bedroom 3. Pain relief should be provided every 4 hrs. 4. The child can resume a normal diet. 5. The child should blow the nose and cough every 4 hours.

1. some secretions may be blood-tinged for a few days. 2. Run a cool-mist vaporizer in the bedroom 3. Pain relief should be provided every 4 hrs.

A fixed splitting of the S2 heart sound is heard in an otherwise healthy child. This is a diagnostic sign of which cardiac defect? 1. Mitral regurgitation. 2. Atrial septal defect 3. Functional murmur. 4. Pericardial friction rub

2. Atrial septal defect

When the parents of a 5-year-old tell the child they are divorcing, the parents need to be aware of which behaviors that the child may demonstrate? SATA 1. Increased self-esteem, bragging 2. Changes in sleep and appetite. 3. Feelings of abandonment. 4. Develops dictatorial attitude. 5. Verbalizes feelings about divorce-related changes.

2. Changes in sleep and appetite. 3. Feelings of abandonment. 5. Verbalizes feelings about divorce-related changes.

A 2-day-old baby is being readied for discharge but looks jaundiced. The nurse reviews the baby's birth records and notes that the baby has A blood type, and the mother has O blood type. The nurse should check which blood test? 1. Hepatitis B titer 2. Total bilirubin 3. Complete blood count 4. Sedimentation rate

2. Total bilirubin

The clinic is doing a lead screening program for children in a low-income community. The nurse working in the program wants to tell the parents the reasons. SATA 1. Young children absorb 10% of the lead to which they are exposed. 2. Homes built between 1900 and 1950 may contain lead-based pain. 3. The blood level of lead should be below 12.8 mcg/dL 4. Lead can affect any part of the body, but the brain and kidneys are at greatest risk. 5. Foods such as fruit, candy, and antacids contain lead.

2. Homes built between 1900 and 1950 may contain lead-based pain. 4. Lead can affect any part of the body, but the brain and kidneys are at greatest risk.

Parents are frustrated with toilet-training their 2-year-old. Both parents work full-time and claim they do not have time to spend on toilet-training. How will the nurse respond to the parents' concern? SATA 1. "You will have to invest some time if the child is to be toilet-trained." 2. "A child needs to be both physically and psychologically ready to learn the skills needed to be continent." 3. "Do you think your child is stubborn?" 4. "Have the child sit on the toilet until the child voids." 5. "If the child can stay dry for two hours, then he might be ready to toilet train."

2. "A child needs to be both physically and psychologically ready to learn the skills needed to be continent." 5. "If the child can stay dry for two hours, then he might be ready to toilet train."

Parents confide to the nurse that the child, who is 35 months old, does not talk and spends hours sitting on the floor watching the ceiling fan go around. They are concerned their child may have autism. The nurse should ask the parents which question? 1. "Does your child have brothers or sisters?" 2. "Does your child seek you out for comfort and love?" 3. "Do you have trouble getting babysitters for your child?" 4. Does your child receive speech therapy?"

2. "Does your child seek you out for comfort and love?"

The parent of a newborn wants to know what the newborn screening test does. 1. "It detects a large number or congenital diseases" 2. "It screens after birth for some inherited and congenital conditions" 3. "Parents choose which diseases to screen for" 4. "It screens for congenital diseases that insurance companies cover"

2. "It screens after birth for some inherited and congenital conditions"

A 14-year old sustained a grade III concussion while playing football. Which statement made by the parents indicates that further education is needed? 1. "Our child will not be able to play football until recovery is complete." 2. "Our child needs to get back to school quickly because there are midterms next week." 3. "Our child's headaches may continue for the next 6 nights; we should call the physician if the headaches get worse." 4. "If our child suffers another concussion before recovery is complete, brain injury will be compounded."

2. "Our child needs to get back to school quickly because there are midterms next week."

Which applies to brain tumors? SATA 1. Brain tumors are the most common malignancy in the US 2. Although an exact cause is unknown, an associations has been linked to paints and radiation. 3. All children with brain tumors present with very similar manifestations. 4. Brain tumors in children usually occur below the cerebellum. 5. Symptoms of brain tumors always appear rapidly.

2. Although an exact cause is unknown, an associations has been linked to paints and radiation. 4. Brain tumors in children usually occur below the cerebellum.

Parents of a child with generalized seizures ask the nurse for information to give their child's teachers. Which of the following should be included? 1. A soft-padded spoon should be kept nearby to put between the child's teeth at the onset of a seizure. 2. Roll the child onto the abdomen, with the head to the left, so any contents can flow from the mouth. 3. If the seizure lasts longer than 5 min., an ambulance should be called. 4. As the child grows, medication dosages may need to be adjusted to control seizure activity.

3. If the seizure lasts longer than 5 min., an ambulance should be called

The parents of a 19-year-old ask the nurse what they should do in terms of long-term care placement for their severely disabled child. Which is the nurse's best response? 1. "How much care do you want? 2. "Do you have other children who could take your child into their home?" 3. "Do you have a detailed plan of care?" 4. "Are you working with an agency or social worker about this matter?"

3. "Do you have a detailed plan of care?"

Which should the nurse teach the parent of a child with suspected meningitis? 1. Antibiotics are not initiated until the cerebrospinal fluid cultures are definitive for specificity to prevent resistance. 2. Antibiotics are useless against viral infections, so they are not used for meningitis. 3. Antibiotics should be started before the cerebrospinal fluid cultures are definitive; culture results may take up to 3 days. 4. Antibiotic initiations is based on the age, signs, and symptoms of the child, not on the causative agent.

3. Antibiotics should be started before the cerebrospinal fluid cultures are definitive; culture results may take up to 3 days.

A parent calls the nurse for dosing information for Pepto-Bismol and aspirin for children who are 8 and 9 years old and are ill. Which does the nurse advise? SATA 1. 15 mL of Pepto-Bismol after every diarrhea stool 2. 81 mg baby aspirin every 4 hours 3. No medications are necessary 4. Pepto-Bismol contains aspirin 5. Diet as tolerated 6. Reye syndrome is associated with aspirin use

3. No medications are necessary 4. Pepto-Bismol contains aspirin 5. Diet as tolerated 6 Reye syndrome is associated with aspirin use

Which is the nurse's best approach to teach a high school students about smoking prevention? 1. Discuss health consequences of smoking 2. Use scare tactics and point out the negative effects of smoking 3. Offer alternatives to smoking such as chewing gum or doing activities that distract. 4. Have the adolescents talk with their parents about smoking.

3. Offer alternatives to smoking such as chewing gum or doing activities that distract.

An 11-month-old was born at 28 weeks' gestation and required 2 weeks of ventilation. The baby is currently well and is being seen in the clinic. The physician recommends that the baby receive preventive therapy for respiratory syncytial virus (RSV) for the next 5 months since winter is approaching. Which medication will be ordered? 1. Respiratory syncytial virus immune globulin (RespiGam) 2. Ribavirin 3. Palivizumab (Synagis) 4. Pneumococcal vaccine

3. Palivizumab (Synagis)

Which is immediate postoperative care for shunt placement in an infant diagnosed with hydrocephalus? 1. Wet-to-dry dressing changes at both the shunt insertion site and the abdominal incision site. 2. Measure the child's head at least once day. 3. Position the infant's head off the shunt site for the first 2 postoperative days. 4. Complete vital signs and neurological checks every 4 hours.

3. Position the infant's head off the shunt site for the first 2 postoperative days.

Which outcome is expected in a breastfed newborn? 1. Voids spontaneously within 12 hrs of life 2. Loses 10% of body weight in the first 5 days. 3. Regains birth weight by the 14th day of life 4. Awakens spontaneously for all feedings.

3. Regains birth weight by the 14th day of life

A teenager is legally blind. The teen is wearing thick glasses and is carrying some schoolbooks. Which question should the nurse ask the teen? 1. "Just how blind are you" 2. can you see enough to read those books? 3. Tell me what you can see in this room? 4. Is you vision worse than 20/200 in either of your eyes?

3. Tell me what you can see in this room?

Parents are told they should start taking their toddler to the dentist. They are concerned the dentist will be too rough with their child. The nurse suggests the parents do which of the following before the dental visit? SATA 1. Tell the child it will not hurt. 2. Warn that they will have the dentist give a needle in case of bad behavior. 3. Tell the child they will go along to the dentist so that they can model comfortable, safe behavior. 4. Offer the child a treat for good behavior. 5. The dentist will look in their child's mouth and count the teeth.

3. Tell the child they will go along to the dentist so that they can model comfortable, safe behavior. 5. The dentist will look in their child's mouth and count the teeth.

An infant at 12 hours of age has a positive Coombs test result and a bilirubin level of 18 mg/dL. The provider has ordered an exchange transfusion for the infant. As the transfusion is proceeding, the nurse should watch for which sign? 1. Increasing jaundice 2. Lethargy 3. Temperature instability 4. Irritability

3. Temperature instability

Parents are concerned that their toddler refuses to sleep in the new toddler bed and wonder what to do. The nurse explains that the child is using "global organization." What does the nurse mean by this term? 1. The preoperational phase of developing cognitive thought starts around 3 years old. 2. the child is self-centered and does not want to learn. 3. The child sees changing to a toddler bed as changing the whole process of sleeping and going to bed. 4. The toddler may have a phobia to the bed.

3. The child sees changing to a toddler bed as changing the whole process of sleeping and going to bed.

Parents are concerned that Turner syndrome is suspected in their newborn. Which physical characteristics led to this suspicion? SATA 1. Cleft lip and palate 2. Weak, high-pitched cry 3. Webbed neck and lymphedema 4. Long arms and small genitalia 5. Coarctation of the aorta.

3. Webbed neck and lymphedema 5. Coarctation of the aorta.

A 16-year-old comes into the clinic for a physical examination. The teen weighs 180 lb and is 5 feet inches tall. According to the following figure, the teen's body mass index (BMI) is ______.

30

For the past 2 nights, and 18-month-old who attends day care has been having a barking, hoarse-sounding cough that comes in spasms with very noisy respirations. The parent is concerned that the child has picked up an infection at day care. The day-care staff indicates the child does not cough during the day, has no fever and is eating and drinking well. this description is most likely which condition? 1. Laryngotracheobronchitis 2. Bacterial tracheitis 3. Asthma 4. Acute spasmodic laryngitis

4. Acute spasmodic laryngitis

A child in a classroom is disruptive with loud talking has a short attention span, and has difficulty organizing work. Which is the most likely diagnosis for this child? 1. Enuresis 2. Sexual abuse 3. Learning disability 4. Attention deficit-hyperactivity disorder

4. Attention deficit-hyperactivity disorder

The nurse goes to the kindergarten classroom to evaluate a rash. A 5 year-old has patches of itchy vesicles on the chest and face. The teacher tells the nurse the child had a runny nose a couple of days ago. The nurse suspects that the rash is caused by which virus? 1. Fifth disease (parvovirus B-19) 2. Roseola (herpesvirus type 6) 3. Scarlet fever (group A beta-hemolytic Streptococcus). 4. Chickenpox (varicella zoster).

4. Chickenpox (varicella zoster).

Which is the primary goal for a newborn with a cleft of the soft palate? 1. Prevent ear infections. 2. Help the mother bond with the baby. 3. Repair the cleft palate 4. Establish feeding and sucking.

4. Establish feeding and sucking.

The nurse is working in a school health clinic, and a child comes in complaining of "something in my eye." Which should the nurse do first? 1. Have the child wash hands. 2. Refer the child to an ophthalmologist. 3. Wash out the affected eye with tap water. 4. Examine the eye for a foreign body.

4. Examine the eye for a foreign body.

The nurse is working in the newborn nursery and accidentally bumps the crib of one of the babies. This baby demonstrates a Moro reflex. The nurse sees this baby in which posture? 1. Trunk extended upward and head lifted 2. When placed on abdomen, crawling movement occurs 3. A "fencing" posture 4. Extremities extended and abducted and fingers fanned

4. Extremities extended and abducted and fingers fanned (Startle reflex)

The posture of a healthy term newborn is described as: 1. Hypotonic 2. Asymmetric 3. Extended 4. Flexed

4. Flexed

Which are early signs and symptoms of hydrocephalus in infants? 1. Confusion, headache, diplopia 2. Rapid head growth, poor feeding, confusion 3. Papilledema, irritability, headache 4. Full fontanels, poor feeding, rapid head growth

4. Full fontanels, poor feeding, rapid head growth

Which applies to encephalitis? SATA 1. Usually caused by a bacterial infection 2. A chronic disease 3. Most commonly seen after a varicella infection in the newborn population 4. Newborns diagnosed with encephalitis often have extensive neurological problems 5. Can be seen with meningitis

4. Newborns diagnosed with encephalitis often have extensive neurological problems 5. Can be seen with meningitis

A parent who is Jehovah's Witness has a child with leukemia and a very low RBC count. The nurse should recognize that the family faces which dilemma? 1. Numerous dietary kosher laws exist. 2. A belief that only Allah cures illness. 3. Desire for anointing of the sick. 4. Opposition to transfusions and vaccines.

4. Opposition to transfusions and vaccines.

A newborn with suspected hydrocephalus is transferred to the intensive care unit for further evaluation and treatment. the infant's nurse know which of the following? 1. To use sedation as needed to keep the baby from crying or being fussy. 2. To keep the crib in a flat and neutral position. 3. To expect the infant to sleep more than an infant without hydrocephalus. 4. To not use any scalp veins for intravenous infusions.

4. To not use any scalp veins for intravenous infusions.

The average newborn weights 3400 g. The nurse will tell the parents that the baby weighs ________ lb.

7.5 lbs (Change 3 400 g to kg, and then multiply by 2.2 lb/kg. Divide 3400 g by 1000 g/kg =3.4 kg. Multiply 3.4 kg by 2.2 lb/kg =7.48 lb. Round up to 7.5 lb.

A 9-year-old boy is brought to the clinic for a physical. The child's weight is 95 lb (97th percentile), and his height is 4 feet 4 inches (50th percentile). Blood pressure is 118/75. Reading the blood pressure graph in the following figure, the boy is in the _________percentile for systolic and in the ________percentile for diastolic readings for his age.

95th /90th

When introducing solid foods into an infant's diet, it is important to introduce one food at a time in order to rule out ______.

Allergies

A 15-year-old girl who is an avid basketball player comes to the clinic for menstrual irregularities. She skips meals and has lost some weight. She mentions that she has menstrual periods every 2 weeks. Women who have menstrual periods more often than every 21 days are: ______________

Anovulatory

The injection site of choice for a 6-month old receiving immunizations is the

Anterolateral thigh -vastus lateralis

A 12-year-old girl with a thoracic myelomeningocele has had numerous urinary tract infections and has difficulty doing her clean intermittent self-catherization. She and her parents are seeking an alternative way to empty her bladder. The surgeon has offered to do a Mitrofanoff procedure. The surgeon will use the _____________to create a continent conduit between the bladder and the abdominal wall.

Appendix

Parents tell the nurse that their 18-month-old is always curious about the environment and is learning new words every day. The toddler is entering a phase of rapid ____________development.

Cognitive

According to Piaget, the school-age child is in the _____stage of cognitive development.

Concrete operations

When the infant is born with a herniation of the abdominal wall with intestine present and the peritoneal sac absent, it is called ____________.

Gastroschisis

Seizures that originate in one hemisphere are called:

Partial or Focal seizures

According to Freud, the most significant achievement of toddlers is___________.

Toilet training

The term __________________ is commonly defined as stiffness of the neck.

Torticollis/Nuchal rigidity

A child is giggling and laughing, and the nurse gently places one hand on the child's front and the other on the back of the chest. The sounds can be felt through the skin. this finding is called ____________.

Vocal fremitus

Infants should ride in a ______ car seat until 2 years of age.

rear-facing