Dynamic Quiz
A nurse is talking with a parent of a preschooler. The parent reports that she struggles to get her child to go to bed at a consistent time. She explains that the child gets out of bed, enters his parents room, and cries when they tell him to stay in his own bed. Which of the following instructions should the nurse give the parent? A. use a stable, relaxing routine like a bath and story time before bed B. Make sure the room is completely dark when placing your child in bed C. Let you child go to sleep in your lap and then put him in his bed D. Respond consistently if your child cries out for you after putting him to bed
A. use a stable, relaxing routine like a bath and story time before bed Rationale: Routines are reassuring to preschoolers because they allow them to anticipate their environment and adapt appropriately. These actions help the child settle down prior to bedtime and allow parental-child interaction prior to bed.
A nurse is assessing a newborn at birth to assign Apgar scores. At 1 min of age, the newborn is crying vigorously with limbs flexed and has a heart rate of 120/min. The newborn's trunk is pink, but his hands and feet are cyanotic, and he cries when the soles of his feet are stimulated. Which of the following Apgar scores should the nurse assign this infant? A. 7 B. 8 C. 9 D. 10
C. 9 Apgar scoring is an evaluation of a newborns heart rate, muscle tone, reflexes, and color. A maximum score of 2 is assigned for each parameter. This infant lost 1 point for the presences of acrocyanosis.
A nurse is providing teaching to the guardian of a child who has Kawasaki disease. Which of the following statements by the guardian indicates an understanding of the teaching? (SATA) A. my child will likely be irritable for the next few weeks B. I will notify my child's doctor if the skin on her hands or feet begins to peel C. I will ensure my child does not receive any live vaccines for at least 18 months D. I will keep a record of my child's temperature until she has no fever for several days E. My child will have joint stiffness primarily at the end of the day
A, C, D A. my child will likely be irritable for the next few weeks C. I will ensure my child does not receive any live vaccines for at least 18 months D. I will keep a record of my child's temperature until she has no fever for several days
A nurse is providing education for the family of a 6-month-old infant about ways to stimulate language development. Which of the following instructions should the nurse include? A. "Explain what you are doing to the infant while providing care." B. "Promote fine-motor development of the tongue by offering a pacifier several times each day." C. "Exercise jaw muscles with foods that require chewing, such as hot dogs and carrots." D. "Leave a television playing in the child's room during nap time."
A. "Explain what you are doing to the infant while providing care." Rationale: The nurse should instruct the family that exposing the infant to expressive speech is the foundation for the development of expressive skills (the ability to make others understand needs and thoughts) and receptive skills (the ability to understand spoken words
A nurse is performing a physical assessment on a 6-month-old infant. Which of the following reflexes should the nurse expect to find? A. Babinski B. Stepping C. Extrusion D. Moro
A. Babinski (Rationale: present until 1 year of age) Stepping (Rationale: disappears age 4 weeks) Extrusion (Rationale: absent by 4 months) Moro (Rationale: disappears 3-4 months)
A school nurse is assessing an adolescent who returned to school following a case of mononucleosis. The child as a note from his provider excusing him from gym class. Which of the following findings should the nurse identify as the reason for his excusal? A. potential for sustaining abdominal trauma B. deficient dietary intake C. Exposing peers to the illness D. Straining sore joints
A. potential for sustaining abdominal trauma Rationale: An adolescent who has mononucleosis will have lymphadenopathy and often splenomegaly, which can persist for many months. For this reason, even after the adolescent is able to maintain his usual energy level and return to school, it is important for him to avoid activities that might result in trauma to the enlarged spleen.
A nurse is caring for a 10-year-old child who should reduce his fat intake. Which of the following menu choices should the nurse suggest? A. a hot dog on a whole-wheat bun B. 3 oz of baked chicken on a whole-wheat roll C. 1/2 cup of diced potatoes with scrambled eggs D. Medium blueberry muffin
B. 3 oz of baked chicken on a whole-wheat roll
A nurse is caring for a school-aged child who begins to have a tonic-clonic seizure when leaving the bathroom. Which of the following actions should the nurse take first? A. Obtain a portable suction machine and suction tubing B. Ease the child to the floor in Sim's position C. time the length of the seizure D. Notify the child's parents
B. Ease the child to the floor in Sim's position Rationale: The greatest risk to the child is an injury resulting from a fall; therefore, the nurse should first gently ease the child to the floor to decrease the chance of injury and turn the child on the left side to prevent aspiration.
A nurse is teaching the parent of a child who has type 1 diabetes mellitus how to manage the child's disorder during an illness such as a cold. Which of the following statements by the parent indicates an understanding of the teaching? A. I'll reduce my child's food intake B. I'll check his blood glucose more often C. I'll limit his fluid intake between meals D. I won't administer his long-acting insulin dose
B. I'll check his blood glucose more often Rationale: The parent should check the child's blood glucose every 3 hours during an illness because the level tends to rise even if the child eats less food.
A home health nurse is developing a plan of care a toddler who has hemophilia. Which of the following instructions for the parents should the nurse include in the plan? A. administer low-dose aspirin for pain B. Inspect the toddler's toys for sharp edges C. perform passive range-of-motion of the affected joint during a bleeding episode D. avoid contact with people who have respiratory infections
B. Inspect the toddler's toys for sharp edges Rationale: Inspect toys to decrease the risk of injury and bleeding to the toddler.
A nurse is teaching the parents of an infant who has acute otitis media about how to administer antibiotic eardrops. Which of the following instructions should the nurse include? A. chill the medication prior to administration B. Massage the anterior area of the infant's ear following administration C. Hyperextend the infant's neck during administration D. Pull the auricle up and back during medication administration
B. Massage the anterior area of the infant's ear following administration Rationale: The nurse should instruct the parents to massage the anterior area of the ear following the admin of eardrops to facilitate instillation of the medication.
A nurse in a pediatric clinic is assessing a toddler at a well-child visit. Which of the following actions should the nurse take? A. Perform the assessment in a head-to-toe sequence B. Minimize physical contact with the child initially C. Explain procedures using medical terminology D. Stop the assessment if the child becomes uncooperative
B. Minimize physical contact with the child initially Rationale: The nurse should initially minimize physical contact with the toddler and progress from the least traumatic to the most traumatic procedures.
A nurse is caring for a child who has an exacerbation of cystic fibrosis. Which of the following laboratory findings should the nurse report to the provider immediately? A. blood glucose 140 mg/dL B. Oxygen saturation 85% C. RBC 3.2 million/uL D. serum sodium 156 mEq/L
B. Oxygen saturation 85%
A nurse is teaching the parent of an infant about home safety. Which of the following pieces of information should the nurse include? SATA A. Use a wheeled infant walker B. Place soft pillows around the edge of the infant's crib C. Position the car seat so it is rear-facing D. Secure a safety gate at the top and bottom of the stairs. E. Maintain the water heater temperature at 49C (120F)
C, D, E C. Position the car seat so it is rear-facing D. Secure a safety gate at the top and bottom of the stairs. E. Maintain the water heater temperature at 49C (120F)
A nurse is preparing to administer recommended immunizations to a 2-month-old infant. Which of the following immunizations should the nurse plan to administer? A. Human papillomavirus (HPV) and hepatitis A B. Measles, mumps, and rubella (MMR) and tetanus, diphtheria, and acellular pertussis (TDaP) C. Haemophilus influenzae type B (Hib) and inactivated polio virus (IPV) D. Varicella (VAR) and live attenuated influenza vaccine (LAIV)
C. Haemophilus influenzae type B (Hib) and inactivated polio virus (IPV) Rationale: A. The HPV immunization series is started at the age of 11 years and hepatitis A immunization series is started at the age of 12 months B. MMR administered 12-15 months of age, TDaP administered 11-12 years of age D. Varicella not administered to children younger than 12 months, LAIV not administered to children under 2 years
A nurse is planning care for an infant with an unrepaired myelomeningocele. Which of the following actions should the nurse take? A. fasten the diaper loosely B. Cleanse the meningeal sac with povidone-iodine daily C. palpate the abdomen for bladder distention D. cover the sac with a dry, sterile gauze dressing
C. palpate the abdomen for bladder distention Rationale: A neurogenic bladder is a common complication of a myelomeningocele. Even if the infant is having wet diapers, the nurse should assess for bladder distention due to the possibility of incomplete emptying of the bladder.
A nurse is teaching the parent of a child who has ADHD and a new prescription for methylphenidate sustained-release tablets. Which of the following pieces of information should the nurse include in the teaching? A. crush the medication and mix it in your child's food B. administer the medication 1 hour before bedtime C. expect your child to have cloudy urine while he is taking this medication D. Weigh your child twice per week while he is taking this medication
D. Weigh your child twice per week while he is taking this medication Rationale: The nurse should instruct the parent to weigh the child 2 to 3 times per week to monitor for weight loss, which is an adverse effect of methylphenidate. The parent should report weight loss to the provider.
A nurse is creating a plan of care for a child who has leukopenia secondary to chemotherapy. Which of the following interventions should the nurse include in the plan? A. Maintain the child on bed rest B. Monitor the child for increased temperature C. Administer oxygen to the child D. Monitor the child for bleeding
B. Monitor the child for increased temperature Rationale: Leukopenia places the child at risk of infection; therefore, the nurse should monitor the child for a fever.
A nurse is admitting a child who has acute lymphocytic leukemia. Which of the following laboratory values should the nurse expect? A. PLatelets 500,000 B. RBCs 2.5 million C. WBCs 4,000 D. Hct 60%
B. RBCs 2.5 million
A nurse is planning care for a child who has hyperthermia. Which of the following actions should the nurse take? A. administer antipyretics to the child every 4 to 6 hr B. Position the child on a cooling blanket and cover her with a sheet C. Place the child in a tub filled with water cooled to 26.7 to 29.4 C 60-85F D. Assess the child's temperature every 2 hr during the cooling process
B. Position the child on a cooling blanket and cover her with a sheet Rationale: A cooling blanket will lower the temperature of the blood circulating at the skin's surface. This cooler blood will circulate to the viscera and lower the temperature of the organs and tissues. Heat from the internal organs will be circulated to the skin and dispensed to the cooler outside surface.
