NCLEX - peds
The parent of a two-year-old expresses frustration due to the child's refusal to follow directions. The nurse explains that this behavior is normal as the child is trying to meet which developmental need? Identity Autonomy Initiative Trust
Autonomy
A 17-year-old client with scoliosis is cared for by a nurse. What is the most difficult aspect of this condition for this client to handle? Activities of daily living performance Looking different from friends Physical therapy compliance Adequate social support maintenance
Looking different from friends
The nurse plans care for a preschool-aged client hospitalized multiple times for leukemia. After observing the client using several coping mechanisms, which intervention does the nurse include? Avoid painful procedures. Provide materials for journaling. Administer anti-anxiety medications promptly. Plan time for therapeutic play.
Plan time for therapeutic play.
A 3-year-old client is admitted to the hospital with suspected congenital heart disease. The nurse expects what assessment finding? Kidney infections Intellectual delays Weight gain Activity intolerance
Activity intolerance
The nurse cares for a young school-aged client with hemolytic uremic syndrome. The client's platelet count is 65,000/mm3 and a hemoglobin of 8 g/dL. Which prescribed intervention does the nurse implement first? Administer antihypertensive medication. Transfuse random donor platelets. Transfuse packed red blood cells. Administer IV fluid based on urine output.
Administer antihypertensive medication.
The health care provider applies a cast to a client with a broken leg. What is the first nursing action? Instruct client to wait before friends sign the cast. Educate on how to care for the cast. Teach the client the correct use of crutches. Clean the surrounding skin before the cast dries.
Clean the surrounding skin before the cast dries.
SATA --A toddler-aged client is held by the nurse during a lumbar puncture. Which describes the correct positioning for this procedure? Ensure that the client's head is slightly flexed. Place the client in a side-lying position. Hold the client from the posterior position. Place the client's back close to the edge of the exam table. Ensure that the client has the knees drawn up to the chest.
Ensure that the client's head is slightly flexed. Place the client in a side-lying position. Place the client's back close to the edge of the exam table. Ensure that the client has the knees drawn up to the chest.
SATA -- A twelve-year old client with depression was placed on a selective serotonin reuptake inhibitor (SSRI) three weeks ago. Today, he tells a classmate he feels hopeless and wants to "just die." Which actions does the school nurse take? Ask the client about recent losses or family conflict. Notify the client's parents about the friend's report. Ask the client about specific self-harm plans. Ask the client if the medication has been taken daily. Teach the client to wait for the medication to take effect.
Notify the client's parents about the friend's report. Ask the client about specific self-harm plans. Ask the client if the medication has been taken daily.
A school-age client admits to the pediatric unit with a diagnosis of sickle cell anemia. The parents ask the nurse what causes the symptoms, and the nurse responds with which cause? Elevated serum bilirubin levels Vitamin B12 deficiency Obstruction by red blood cells Decreased red blood cell production
Obstruction by red blood cells
A client with multiple partial-thickness burns is prescribed tramadol as needed. What assessment does the nurse complete to monitor the effectiveness of this medication? Wound healing Pain rating Quality of sleep O2 sats
Pain rating
A school-age client diagnosed with nephrotic syndrome appears bloated, weak, and eats less than expected. To encourage adequate protein intake, which action does the nurse take? Serve the child's favorite foods. Play games with the child during mealtimes. Use candy as a reward after meals. Avoid giving between-meal snacks.
Serve the child's favorite foods.
A school-age client is brought into the emergency room with severe diarrhea and emesis for three days. The parents tried to treat at home, but the client has diarrhea and vomiting after drinking clear liquids. What is the priority prescription for the nurse to initiate? Start intravenous fluid solution. Give antidiarrheal medication. Administer antibiotic therapy. Obtain stool cultures.
Start intravenous fluid solution.
A nurse inspects a four-year-old client's mouth at a routine office visit. When the parent asks how many teeth the child should have, which answer does the nurse give the parent? 20 16 24 12
20
A nurse assesses a group of infant clients for risk of sudden infant death syndrome (SIDS). Which infant does the nurse determine is least likely to develop SIDS? An infant who uses a pacifier An infant with prenatal drug exposure An infant who is bottle-fed An infant who is premature
An infant who uses a pacifier
The nurse provides home care instructions to the parent of a pediatric client with head lice. Which statement indicates that the parent has correctly understood the nurse's instructions? "I must keep my child at home for at least one week after treatment." "I must wash my child's hair with an antibacterial shampoo." "All family members must be treated." "I must discard all of my child's personal linens."
"All family members must be treated."
A nurse cares for a school-age client with asthma. Which statement by the client's parent indicates that the client has moderate persistent asthma? "About once per month, the inhaler is used during the daytime." "Once or twice a month, the asthma gets worse at night." "Asthma flare-ups seem to happen at least two times a week at night." "I notice inhaler use up to four times during the day every week."
"Asthma flare-ups seem to happen at least two times a week at night."
Parents of an eight-month-old client at a community outreach clinic ask the pediatric nurse how many teeth their baby should have. Which information does the nurse provide? "Your baby is not expected to have any teeth until age one." "All babies are different, and there is no way to estimate this." "At this age, babies should have eight to twelve teeth." "At this age, babies may have up to four teeth."
"At this age, babies may have up to four teeth."
SATA -- The nurse educates the parents of a toddler client with acute otitis media (AOM) on ways to reduce the risk of recurrence. Which instructions does the nurse include? "Avoid contact with people who have upper respiratory infections." "Place the child in a supine position to bottle feed." "Do not expose the child to second-hand smoke." "Clean the inside of the child's ear canals with cotton swabs after bathing." "Finish the course of antivirals, even after symptoms disappear."
"Avoid contact with people who have upper respiratory infections." "Do not expose the child to second-hand smoke."
Which teaching does the nurse include for the parents of an infant who is HIV-positive? "Clean feeding bottles with water and isopropyl alcohol." "Anyone changing the baby's diapers must wear gloves." "Avoid exposing healthy children to your sick baby." "Be sure to have the baby immunized as scheduled."
"Be sure to have the baby immunized as scheduled."
The nurse assesses the client who is 24 months of age. The nurse asks the parents to provide more information related to which statement concerning gross motor assessment finding? "Crawls up stairs without help" "Must balance to kick a ball" "Squats to picks up an object" "Runs with a widened stance"
"Crawls up stairs without help"
SATA - The clinic nurse assesses a school-age client with red, watery eyes and purulent drainage. Which client education does the nurse provide to the parent? "It is normal for the child's vision to be decreased for a few days." "Sterilize everything that the child has touched to reduce infection." "You will need to isolate the child from the cause of this allergy." "Discard tissues in the trash after each use." "Keep the child home from school until the symptoms are gone."
"Discard tissues in the trash after each use."
A nurse provides education to a client who is newly diagnosed with asthma. The nurse provides the steps for proper use of a metered dose inhaler (MDI) without a spacer using which instruction? "Place the inhaler between your open lips, press down on the canister, start inhaling slowly, hold for ten seconds, and exhale." "Exhale, place the inhaler between your open lips, start inhaling slowly, press down on the canister, continue inhaling, and hold for ten seconds." "Place the inhaler between your open lips, start inhaling slowly, press down on the canister, and exhale for ten seconds." "Exhale, place the inhaler between your open lips, press down on the canister, inhale quickly, and hold for ten seconds."
"Exhale, place the inhaler between your open lips, start inhaling slowly, press down on the canister, continue inhaling, and hold for ten seconds."
A pediatric client comes to the clinic and receives a diagnosis of iron deficiency anemia. The parent receives instruction for iron supplementation. Which statement by the parent suggests to the nurse that additional education is needed? "I will give the liquid supplement through a straw." "I expect to see greenish-black stools." "I will let my child drink orange juice after taking iron." "I will give the iron supplement with my child's yogurt snack."
"I will give the iron supplement with my child's yogurt snack."
A nurse prepares to administer a diphtheria, tetanus, and pertussis (DTaP) immunization to an infant client at the two-month checkup. Which information does the nurse include when educating the parents regarding the immunization? "This immunization is given earlier due to the increased risk of an allergic reaction as the infant grows." "This is the only dose of this vaccination your infant will receive until beginning kindergarten." "It is important for the infant to recieve the tetanus immunization series before crawling." "Infants receive this immunization because if they contract pertussis, the mortality rate is high."
"Infants receive this immunization because if they contract pertussis, the mortality rate is high."
A nurse cares for a postpartum client diagnosed with human immunodeficiency virus (HIV) who has a newborn. The client expresses relief when learning the infant's HIV test taken two weeks ago is negative for HIV. How does the nurse respond? "Tell me more about your feelings about having HIV and a new baby." "It must be a relief knowing the antiviral medication worked." "That is good to hear but remember that you can still pass on the virus." "That is great news. Have you arranged for the second test yet?"
"That is great news. Have you arranged for the second test yet?"
A nurse discharges a school-age client with sickle cell anemia after treatment for a sickle cell crisis. Which statement by the parents indicates to the nurse a need for further instruction? "We will not let our child play out in the snow too long this winter." "We should always make sure our child stays well hydrated." "The airplane on the way to Colorado should be pressurized." "Our child should avoid strenuous activities."
"The airplane on the way to Colorado should be pressurized."
A nurse is part of the health care team for a school-age client with symptoms of acute lymphoblastic leukemia (ALL). Which phrase represents an accurate educational statement from the nurse to the client's parents regarding the bone marrow aspiration and biopsy? "This test will determine if there is a blood based infection." "This test will help determine if cancer has spread to the brain." "This test will help the health care provider determine a diagnosis." "This test will help the health care provider determine kidney function."
"This test will help the health care provider determine a diagnosis."
SATA -- A public health nurse receives several calls from parents regarding a child in daycare who tested positive for measles. What education does the nurse provide the parents regarding measles? "Your child's school will always close following a confirmed case of measles." "Exposed children without proof of immunization are kept home for 24 hours after exposure." "Unvaccinated children who have been exposed should receive the vaccine as soon as possible." "If your child contracts measles, the child must remain out of the class for 4 days after the onset of the rash." "Your child is exposed after sharing the infected individual's space up to 12 hours after the individual left the space."
"Unvaccinated children who have been exposed should receive the vaccine as soon as possible." "If your child contracts measles, the child must remain out of the class for 4 days after the onset of the rash."
SATA - An eight-year old client is in the clinic for an annual health visit. Which questions does the nurse ask when gathering this client's health history? "Have you experimented with cigarettes?" "What kind of snacks do you like to eat?" "Where do you get most of your water?" "What do you do when you feel angry?" "Do you enjoy school and your classmates?"
"What kind of snacks do you like to eat?" "Where do you get most of your water?" "What do you do when you feel angry?" "Do you enjoy school and your classmates?"
A preschool client brought to the clinic with a foreign body in the eye refuses to allow the nurse to inspect the eye. What does the nurse say to the child to facilitate the examination? "Don't be upset. We can finish this later." "If you cooperate, this will soon be over." "Would you like to hold my flashlight?" "Don't be scared. I am not going to hurt you."
"Would you like to hold my flashlight?"
SATA -- A nurse admits a client with tuberculosis. What does the nurse include when educating the client about the disease? "You will need to be isolated for at least two weeks." ""Multiple drugs are used to treat the disease. "It is not likely the disease will return after treatment." "You will always test positive for the disease." "You may have to take medication for up to five months."
"You will need to be isolated for at least two weeks." ""Multiple drugs are used to treat the disease. "You will always test positive for the disease."
SATA - The nurse reviews an immunization schedule with the parent of an infant at the 2-month checkup, who has just received a polio vaccination. At which visits will the infant receive additional polio vaccination? 2 years 4 years 15 months 4 months 3 months
4 years 15 months 4 months
A health care provider prescribes lidocaine-prilocaine cream to apply to a client's skin before a wart-removal procedure scheduled for 10:00 a.m. What time does the nurse apply the cream? 9:45 am 9:30 am 9:00 am 6:00 am
9:00 am
A pediatric client is brought to the emergency room with a high fever, photophobia, and a headache. What important sign does the nurse use to check for meningeal irritation? Brudzinski sign McBurney sign Ortolani sign Cullen sign
Brudzinski sign
A school-age client diagnosed with acute lymphocytic leukemia (ALL) is receiving intrathecal chemotherapy. Which of the medications does the nurse clarify with the health care provider? Cytarabine Methotrexate Carbamazepine Dexamethasone
Carbamazepine
A nurse prepares to administer acetaminophen to a toddler-age client admitted to the hospital with an infection and fever. The medication reference states the maximum daily dosage of acetaminophen is 60 mg/kg. What action does the nurse take in response to the client's axillary temperature, recorded at 0015 on 06/14/18? (See exhibit.) Contact the health care provider for an alternate antipyretic medication prescription. Explain to the client's parent that it is too soon to give the medication, but you will give it as soon as allowed. Administer the prescribed dose of acetaminophen and recheck the client's temperature. Request the pharmacist adjust the prescription based on the client's weight.
Contact the health care provider for an alternate antipyretic medication prescription.
The nurse cares for a toddler-aged client with hemolytic uremic syndrome (HUS). The nurse educates the parents using which action? Help the parent use pictures to prepare the toddler for urethral catheter insertion. Describe the benefits and possible adverse effects of a blood transfusion. Explain the purpose and process of hemodialysis to the toddler's parents. Discuss with parents the course of action for related-donor kidney transplant.
Explain the purpose and process of hemodialysis to the toddler's parents.
A toddler client is prescribed azithromycin for an ear infection. The nurse instructs the parent about which common side effects of azithromycin? Sore throat Seizures Gastrointestinal upset Musculoskeletal pain
Gastrointestinal upset
A nurse interviews a teenage client during a sports physical. The client states, "I hate that I have to wear make-up so no one can see my acne." The nurse records that the client is in which stage of development? Industry vs. inferiority Basic trust vs. mistrust Identity vs. role confusion Initiative vs. guilt
Identity vs. role confusion
SATA -- A nurse administers inhalation therapy to a child with pneumonia. Which effect does the nurse expect with this therapy? Increased force of the diaphragm Improved gas exchange in the alveoli Increased use of intercostal muscles Improved effectiveness of respiratory cilia Increased depth of breathing
Improved gas exchange in the alveoli Improved effectiveness of respiratory cilia
The nurse assesses a toddler client admitted to the hospital with acute laryngotracheobronchitis. Which sign does the nurse recognize as an early indication of hypoxia? Mouth breathing Increased restlessness Flushing of the face Barking cough
Increased restlessness
When planning care for an infant client with dehydration, the nurse includes which intervention to accurately monitor hydration status? Measure intake and output. Assess skin turgor. Check electrolyte values. Monitor daily weight.
Monitor daily weight.
SATA -- The nurse assesses a preschool client with fair skin, urine with a musty odor, stunted growth, and intellectual disability. Based on these findings, the nurse provides which instructions to the parents? Eat fish at least once per week. Monitor intake of phenylalanine. Avoid drinks containing aspartame. Increase intake of nuts. Avoid dairy products.
Monitor intake of phenylalanine. Avoid drinks containing aspartame. Avoid dairy products.
The nurse cares for a client who is four years old at a well child check. What behavior observed by the nurse would be unexpected for the client who is 4 years old? Hides from health care provider. Needs parent to put on shirt. Speaks to a purple dragon. Throws toy at older sibling.
Needs parent to put on shirt.
A toddler-aged client with acute otitis media has had a febrile seizure. The parents brought the child to the emergency department. Which teaching does the nurse include in the discharge instructions? Instructions for hourly tepid sponge Administration of antipyretics around the clock Administration of anti-epileptic medications Reassurance that febrile seizures are benign
Reassurance that febrile seizures are benign
An adolescent client is pending a diagnosis of Hodgkin's lymphoma. Which test result will the nurse report to the health care provider? Philadelphia chromosome present Reactive lymph nodes present Lymphocytic WBCs present Reed-Sternberg cells present
Reed-Sternberg cells present
The nurse plans the care of an infant client who received a corrective casting for congenital clubfoot. What is the priority nursing diagnosis for this client? Risk for ineffective tissue perfusion Risk for impaired mobility Fear of strangers Alteration in skin integrity
Risk for ineffective tissue perfusion
SATA -- The nurse assesses a child with pulmonary stenosis. What assessment findings does the nurse attribute to pulmonary stenosis? Crackles to lungs bilaterally Systolic murmur at left upper sternal border Elevated blood pressure Systemic cyanosis Jugular vein distension
Systolic murmur at left upper sternal border Systemic cyanosis Jugular vein distension
SATA -- A nurse cares for an infant client who is seven months of age with cerebral palsy (CP). What does the nurse expect the client's parents to report? The client does not react to loud noises. The client is unable to roll over. The client does not recognize a parent's face. The client demonstrates the Moro reflex.
The client is unable to roll over. The client demonstrates the Moro reflex.
A toddler-age client undergoes an enucleation procedure for retinoblastoma. The nurse explains which to the parents about the procedure? The wound is clean, and drainage is minimal. There may be some permanent alteration to facial features. The other eye may have some vision loss. The eye socket will temporarily be sunken in.
The wound is clean, and drainage is minimal.
