Pedi Success - Cumulative Questions

60 meq

A chloride level greater than _____________________ is a positive diagnostic indicator of cystic fibrosis (CF).

D

According to developmental theories, which important event is essential to the development of the toddler? A. The child learns to feed self. B. The child develops friendships. C. The child learns to walk. D. The child participates in being potty-trained.

A

Parents are told by the genetic counselor that they have a 1:4 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? A. Each pregnancy is an independent event. B. The probability of having another child with CF is twice as likely as it was when they had the first child. C. The probability of having a healthy child is twice as likely with this pregnancy. D. The probability of miscarrying is greater now than with the previous pregnancy.

B

The clinical manifestations of minimal change nephrotic syndrome (MCNS) are due to which of the following? A. Chemical changes in the composition of albumin. B. Increased permeability of the glomeruli. C. Obstruction of the capillaries of the glomeruli. D. Loss of the kidney's ability to excrete waste and concentrate urine.

ABD

The mother of a child with Duchenne muscular dystrophy asks the nurse who in the family should have genetic screening. Who should the nurse say must be tested? Select all that apply. A. Mother B. Sister. C. Brother. D. Aunts and all female cousins. E. Uncles and all male cousins.

A

The parents of a preschooler diagnosed with muscular dystrophy are asking questions about the course of their child's disease. Which should the nurse tell them? A. "Muscular dystrophies usually result in progressive weakness." B. "The weakness that your child is having will probably not increase." C. "Your child will be able to function normally and not need any special accommodations." D. "The extent of weakness depends on doing daily physical therapy."

B

To obtain an adolescent's health information, the nurse should: A. Interview the adolescent using direct questions. B. Gather information during a casual conversation. C. Interview the adolescent only in the presence of the parents. D. Gather information only from the parents.

D

What is the most important piece of information that the nurse must ask the parent of a child in status asthmaticus? A. "What time did your child eat last?" B. "Has your child been exposed to any of the usual asthma triggers?" C. "When was your child last admitted to the hospital for asthma?" D. "When was your child's last dose of medication?"

D

A parent asks the nurse how to prevent the child from having minimal change nephrotic syndrome (MCNS) again. Which is the nurse's best response? A. "It is very rare for a child to have a relapse after having fully recovered." B. "Unfortunately, many children have cycles of relapses, and there is very little that can be done to prevent it." C. "Your child is much less likely to get sick again if sodium is decreased in the diet." D. "Try to keep your child away from sick children because relapses have been associated with infectious illnesses."

C

The mother of a child 2 years 6 months has arranged a play date with the neighbor and her child 2 years 9 months. During the play date the two mothers should expect that the children will do which of the following? A. Share and trade their toys while playing. B. Play with one another with little or no conflict. C. Play alongside one another but not actively with one another. D. Only play with one or two items, ignoring most of the other toys.

B

The mother of an 11-month-old with iron deficiency anemia tells the nurse that her infant is currently taking iron and a multivitamin. Which statement made by the mother should be of concern to the nurse? A. "I give the iron and multivitamin at the same time each morning." B. "I give the iron and multivitamin in the morning 6-oz bottle." C. "I give the iron and multivitamin 2 hours before I feed the morning bottle." D. "I give the iron and multivitamin in oral syringes toward the back of the cheek."

D

The mother of an adolescent complains that he has had some recent behavioral changes. He comes home from school every day, closes his door, and refrains from interaction with his family. The nurse's best response to the mother is: A. "You should speak with your son and ask him directly what is wrong with him." B. "You should set limits with your son and tell him that this is unacceptable behavior." C. "Your son's behavior is abnormal, and he is going to need a psychiatric referral." D. "Your son's behavior is normal. You should listen to him without being judgmental."

B

The parent of a child with frequent ear infections asks the nurse if there is anything that can be done to help avoid future ear infections. Which is the nurse's best response? A. "Your child should be put on a daily dose of Singulair (montelukast)." B. "Your child should be kept away from tobacco smoke." C. "Your child should be kept away from other children with otitis media." D. "Your child should always wear a hat when outside."

C

The parent of an infant with cystic fibrosis (CF) asks the nurse how to meet the child's increased nutritional needs. Which is the nurse's best suggestion? A. "You may need to increase the number of fresh fruits and vegetables you give your child." B. "You may need to advance your child's diet to whole cow's milk because it is higher in fat than formula." C. "You may need to change your child to a higher-calorie formula." D. "You may need to increase your child's carbohydrate intake."

C

Which finding requires immediate attention in a child with glomerulonephritis? A. Sleeping most of the day and being very "cranky" when awake; blood pressure is 170/90. B. Urine output is 190 mL in an 8-hour period and is the color of Coca-Cola. C. Complaining of a severe headache and photophobia. D. Refusing breakfast and lunch and stating he "just is not hungry."

D

Which foods would be best for a child with Duchenne muscular dystrophy? A. High-carbohydrate, high-protein foods. B. No special food combinations. C. Extra protein to help strengthen muscles. D. Low-calorie foods to prevent weight gain.

B

Which foods would the nurse recommend to the mother of a 2-year-old with anemia? A. 32 oz of whole cow's milk per day. B. Meats, eggs, and green vegetables. C. Fruits, whole grains, and rice. D. 8 oz of juice, three times per day.

B

Which is the nurse's best response to parents who ask what impact asthma will have on the child's future in sports? A. "As long as your child takes prescribed asthma medication, the child will be fine." B. "The earlier a child is diagnosed with asthma, the more significant the symptoms." C. "The earlier a child is diagnosed with asthma, the better the chance the child has of growing out of the disease." D. "Your child should avoid playing contact sports and sports that require a lot of running."

B

Which laboratory result will provide the most important information regarding the respiratory status of a child with an acute asthma exacerbation? A. CBC. B. ABG. C. BUN. D. PTT.

A

Which method is the most effective way to present an educational program on abstinence to adolescents? A. Use peer-led programs that emphasize the consequences of unprotected sexual contact. B. Teach students methods to resist peer pressure. C. Offer students the opportunity to care for a simulator infant for 1 week. D. Offer statistics, pamphlets, and films discussing the consequences of unprotected sexual contact.

C

Which nursing action is most appropriate to gain information about how a child is feeling? A. Actively attempt to make friends with the child before asking about her feelings. B. Ask the child's parents what feelings she has expressed in regard to her diagnosis. C. Provide the child with some paper to draw a picture of how she is feeling. D. Ask the child direct questions about how she is feeling.

C

Which nursing action would help foster a hospitalized 3-year-old's sense of autonomy? A. Let the child choose what time to take the oral antibiotics. B. Allow the child to have a doll for medical play. C. Allow the child to administer her own dose of Keflex (cephalexin) via oral syringe. D. Let the child watch age-appropriate videos.

A

Which outcome would indicate effective case management for a child with moderate to severe asthma? A. The child attends school regularly with few absences for the year. B. The child is able to tolerate a regular diet without constipation or diarrhea. C. The family does not fill prescriptions for prophylactic inhaled steroids. D. The child does not utilize the peak flowmeter when cared for at home.

C

Which should be included in instructions to the parent of a child prescribed amoxicillin to treat an ear infection? A. "Continue the amoxicillin until the child's symptoms subside." B. "Administer an over-the-counter antihistamine with the antibiotic." C. "Administer the amoxicillin until all the medication is gone." D. "Allow your child to administer his own dose of amoxicillin."

C

Which should the nurse administer to provide quick relief to a child with asthma who is coughing, wheezing, and having difficulty catching her breath? A. Prednisone. B. Singulair (montelukast). C. Albuterol. D. Flovent (fluticasone).

C

Which should the nurse do to prevent separation anxiety in a hospitalized toddler? A. Assume the parental role when parents are not able to be at the bedside. B. Encourage the parents to always remain at the bedside. C. Establish a routine similar to that of the child's home. D. Rotate nursing staff so the child becomes comfortable with a variety of nurses.

D

Which should the nurse stress to the parents of an infant in a Pavlik harness for treatment of developmental dysplasia of the hip (DDH)? A. Put socks on over the foot pieces of the harness to help stabilize the harness. B. Use lotions or powder on the skin to prevent rubbing of straps. C. Remove harness during diaper changes for ease of cleaning diaper area. D. Check under the straps at least two to three times daily for red areas.

D

Which statement accurately describes how the nurse should approach an 11-year-old to do a physical assessment? A. Ask the child's parents to remain in the room during the physical exam. B. Auscultate the heart, lungs, and abdomen first. C. Explain that the physical exam will not hurt. D. Explain what the nurse will be doing in basic understandable terms.

A

Which statement by a parent is most consistent with minimal change nephrotic syndrome (MCNS)? A. "My child missed 2 days of school last week because of a really bad cold." B. "After camping last week, my child's legs were covered in bug bites." C. "My child came home from school a week ago due to vomiting and stomach cramps." D. "We have a pet turtle but no one washes their hands after playing with the turtle."

A

Which statement by the mother of an 18-month-old would lead the nurse to believe that the child should be referred for further evaluation for developmental delay? A. "My child is able to stand but is not yet taking steps independently." B. "My child has a vocabulary of approximately 15 words." C. "My child is still sucking his thumb." D. "My child seems to be quite wary of strangers."

A

Which statement by the parent of a child using an albuterol inhaler leads the nurse to believe that further education is needed on how to administer the medication? A. "I should administer two quick puffs of the albuterol inhaler using a spacer." B. "I should always use a spacer when administering the albuterol inhaler." C. "I should be sure that my child is in an upright position when administering the inhaler." D. "I should always shake the inhaler before administering a dose."

C

Which statement by the parents of a toddler with repeated otitis media indicates they need additional teaching? A. "If I quit smoking, my child may have a decreased chance of getting an ear infection." B. "As my child gets older, he should have fewer ear infections, because his immune system will be more developed." C. "My child will have fewer ear infections if he has his tonsils removed." D. "My child may need a speech evaluation."

BCE

Which stressor is common in hospitalized toddlers? Select all that apply. A.. Social isolation. B. Interrupted routine. C. Sleep disturbances. D. Self-concept disturbances. E. Fear of being hurt.

C

Which technique should the nurse suggest to the mother of an 8-year-old who does not want to complete her chores? A. Grounding. B. Time-out. C. Reward system. D. Spanking.

B

Which toy is the best choice for a 12-month-old? A. Baby doll. B. Musical rattle. C. Board book. D. Colorful beads.

C

Which would the nurse expect to assess on a 3-week-old infant with developmental dysplasia of the hip (DDH)? A. Excessive hip abduction. B. Femoral lengthening of an affected leg. C. Asymmetry of gluteal and thigh folds. D. Pain when lying prone.

D

Which would the nurse explain to parents about the inheritance of cystic fibrosis? A. CF is an autosomal-dominant trait passed on from the child's mother. B. CF is an autosomal-dominant trait passed on from the child's father. C. The child of parents who are both carriers of the gene for CF has a 50% chance of acquiring CF. D. The child of a mother who has CF and a father who is a carrier of the gene for CF has a 50% chance of acquiring CF.

C

A 4-month-old has had vomiting and diarrhea for 24 hours. The infant is fussy, and the anterior fontanel is sunken. The nurse notes the infant does not produce tears when crying. Which task will help confirm the diagnosis of dehydration? A. Urinalysis obtained by bagged specimen. B. Urinalysis obtained by sterile catheterization. C. Analysis of serum electrolytes. D. Analysis of cerebrospinal fluid.

A

A 5-year-old has been diagnosed with pseudohypertrophic muscular dystrophy. Which nursing intervention would be appropriate? A. Discuss with the parents the potential need for respiratory support. B. Explain that this disease is easily treated with medication. C. Suggest exercises that will limit the use of muscles and prevent fatigue. D. Assist the parents in finding a nursing facility for future care.

C

A parent asks the nurse what will need to be done to relieve the constipation of her child who also has cystic fibrosis (CF). Which is the nurse's best response? A. "Your child likely has an obstruction and will require surgery." B. "Your child will likely be given IV fluids." C. "Your child will likely be given MiraLAX." D. "Your child will be placed on a clear liquid diet."

D

A school-age child is admitted to the hospital for a tonsillectomy. During the nurse's post-operative assessment, the child's parent tells the nurse that the child is in pain. Which of the following observations would be of most concern to the nurse? A. The child's heart rate and blood pressure are elevated. B. The child complains of having a sore throat. C. The child is refusing to eat solid foods. D. The child is swallowing excessively.

A

A young child hospitalized with asthma is ready for discharge. A home nebulizer is ordered by the physician. In order to obtain the nebulizer, a referral should be made to which staff member? A. Case manager. B. Nurse manager. C. Materials management staff. D. Child life staff.

C

An infant is not sleeping well, crying frequently, has yellow drainage from the ear, and is diagnosed with an ear infection. Which nursing objective is the priority for the family? A. Educating the parents about signs and symptoms of an ear infection. B. Providing emotional support for the parents. C. Providing pain relief for the child. D. Promoting the flow of drainage from the ear.

A

Expected nursing assessments of a newborn with suspected cystic fibrosis would include: A. Observe frequency and nature of stools. B. Provide chest physical therapy. C. Observe for weight gain. D. Assess parent's compliance with fluid restrictions.

C

How can the nurse best facilitate the trust relationship between infant and parents while the infant is hospitalized? The nurse should: A. Encourage the parents to remain at their child's bedside as much as possible. B. Keep parents informed about all aspects of their child's condition. C. Encourage the parents to hold their child as much as possible. D. Advise the parents to participate actively in their child's care.

C

The best method to explain a procedure to a hospitalized preschool-age child is to: A. Show the child a pamphlet with pictures showing the procedure. B. Have the 5-year-old next door tell the 4-year-old about the experience. C. Demonstrate the procedure on a doll. D. Show the child a video of the procedure

C

The nurse should tell the parents of a child with Duchenne (pseudohypertrophic) muscular dystrophy that some of the progressive complications include: A. Dry skin and hair, hirsutism, protruding tongue, and mental retardation. B. Anorexia, gingival hyperplasia, and dry skin and hair. C. Contractures, obesity, and pulmonary infections. D. Trembling, frequent loss of consciousness, and slurred speech.

B

The parent of a child with glomerulonephritis asks the nurse why the urine is such a funny color. Which is the nurse's best response? A. "It is not uncommon for the urine to be discolored when children are receiving steroids and blood pressure medications." B. "There is blood in your child's urine that causes it to be tea-colored." C. "Your child's urine is very concentrated, so it appears to be discolored." D. "A ketogenic diet often causes the urine to be tea-colored."

D

The parents of a 6-year-old who has a new diagnosis of asthma ask the nurse what to do to make their home a more allergy-free environment. Which is the nurse's best response? A. "Use a humidifier in your child's room." B. "Have your carpet cleaned chemically once a month." C. "Wash household pets weekly." D. "Avoid purchasing upholstered furniture."

A

Which will help a school-aged child with muscular dystrophy stay active longer? A. Normal activities, such as swimming. B. Using a treadmill every day. C. Several periods of rest every day. D. Using a wheelchair upon getting tired.

C

Which would the nurse assess in a 4-week-old infant who has developmental dysplasia of the hip and is wearing a Pavlik harness? A. Diaper dermatitis. B. Talipes equinovarus. C. Leg shortening and limited abduction. D. Pain.

B

A child had a tonsillectomy 6 days ago and was seen in the emergency room 4 hours ago due to post-operative hemorrhage. The parent noted that her child was "swallowing a lot and finally began vomiting large amounts of blood." The child's vital signs are as follows: T 99.5°F (37.5°C), HR 124, BP 84/48, and RR 26. The nurse knows that this child is at risk for which type of renal failure? A. CRF due to advanced disease process. B. Prerenal failure due to dehydration. C. Primary kidney damage due to a lack of urine flowing through the system. D. Postrenal failure due to a hypotensive state.

B

A child with cystic fibrosis (CF) is placed on an oral antibiotic to be given four times a day for 14 days. Which of the following schedules is the most appropriate? A. 8 a.m.,12 p.m., 4 p.m., 8 p.m. B. 7 a.m., 1 p.m., 7 p.m., 12 midnight. C. 9 a.m., 1 p.m., 5 p.m., 9 p.m. D. 10 a.m., 2 p.m., 6 p.m., 10 p.m.

C

An adolescent has a diagnosis of new-onset diabetes. What would most influence a teenager's food choices as he begins to make changes in his diet? A. Parents and their dietary choices. B. Cultural background. C. Peers and their dietary choices. D. Television and other forms of media influence.

B

How does the nurse interpret the laboratory analysis of a stool sample containing excessive amounts of azotorrhea and steatorrhea in a child with cystic fibrosis (CF)? The values indicate the child is A. Not compliant with taking her vitamins. B. Not compliant with taking her enzymes. C. Eating too many foods high in fat. D. Eating too many foods high in fiber.

D

The nurse is reviewing discharge instructions with the parents of a child who had a tonsillectomy 24 hours ago. The parents tell the nurse that the child is a big eater, and they want to know what foods to give the child for the next 24 hours. What is the nurse's best response? A. "The child's diet should not be restricted at all." B. "The child's diet should be restricted to clear liquids." C. "The child's diet should be restricted to ice cream and cold liquids." D. "The child's diet should be restricted to soft foods."

C

Which action is a developmentally appropriate method for eliciting a 4-year-old's cooperation in obtaining the blood pressure? A. Have the child's parents help put on the blood pressure cuff. B. Tell the child that if he sits still, the blood pressure machine will go quickly. C. Ask the child if he feels a squeezing of his arm. D. Tell the child that measuring the blood pressure will not hurt.

B

Which activity can the nurse provide for a 9-year-old to encourage a sense of industry? A. Allow the child to choose what time to take his medication. B. Provide the child with the homework his teacher has sent. C. Allow the child to assist with his bath. D. Allow the child to help with his dressing change.

A

Which child is at risk for developing glomerulonephritis? A. A 3-year-old who had impetigo 1 week ago. B. A 5-year-old with a history of five UTIs in the previous year. C. A 6-year-old with new-onset type 1 diabetes. D. A 10-year-old recovering from viral pneumonia.

C

Which is the best method of distraction for an 8-year-old who is having surgery later today and is NPO? A. Use the telephone to call friends. B. Watch television. C. Play a board game. D. Read the central line pamphlet he was given.

C

Which is the nurse's best response to the parent of an infant diagnosed with the first otitis media who wonders about long-term effects? A. "The child could suffer hearing loss." B. "The child could suffer some speech delays." C. "The child could suffer recurrent ear infections." D. "The child could require ear tubes."

C

Which statement would indicate to the nurse that a school-age child is not developmentally on track for age? A. The child is able to follow a four- to five-step command. B. The child started wetting the bed on admission to the hospital. C. The child has an imaginary friend named Kelly. D. The child enjoys playing board games with her sister.

B

A 16-year-old is having a discussion with the nurse about the teen's recent diagnosis of lupus. In explaining the child's prognosis, the nurse uses the knowledge that adolescents are: A. Preoccupied with thoughts of the here and now. B. Able to understand and imagine possibilities for the future. C. Capable of thinking only in concrete terms. D. Overly concerned with past events and relationships.

B

A 16-year-old male is hospitalized for cystic fibrosis. He will be an inpatient for 2 weeks while he receives IV antibiotics. Which action taken by the nurse will most enhance his psychosocial development? A. Fax the teen's teacher, and have her send in his homework. B. Encourage the teen's friends to visit him in the hospital. C. Encourage the teen's grandparents to visit frequently. D. Tell the teen he is free to use his phone to call or text friends.

D

A 2-year-old admitted to the hospital 2 days ago has been crying and is inconsolable much of the time. The nurse's best response to the child's parents who are concerned about this behavior is that the child is in the: A.Detachment phase of separation anxiety, which is normal for children during hospitalization. B. Despair stage of separation anxiety, which is normal for children during hospitalization. C. Bargaining stage of separation anxiety, which is normal for children during hospitalization. D. Protest stage of separation anxiety, which is normal for children during hospitalization.

A

A 13-year-old boy is hospitalized for a femur fracture. He was hit by a car while he and his friends were racing bikes near a major intersection. The child's parents are concerned about his judgment. The nurse should tell the parents that the behavior is: A. Typical of young teens. B. Related to hormonal surges during adolescence. C. An isolated incident and will not likely happen again. D. Related to teen rebellion.

C

The nurse is caring for a 2-year-old child who was admitted to the pediatric unit for moderate dehydration due to vomiting and diarrhea. The child is restless, with periods of irritability. The child is afebrile with a heart rate of 148 and a blood pressure of 90/42. Baseline laboratory tests reveal the following: Na 152, Cl 119, and glucose 115. The parents state that the child has not urinated in 12 hours. After establishing a saline lock, the nurse reviews the physician's orders. Which order should the nurse question? A. Administer a saline bolus of 10 mL/kg, which may be repeated if the child does not urinate. B. Recheck serum electrolytes in 12 hours. C. After the saline bolus, begin maintenance fluids of D5 1/4 NS with 10 mEq KCl/L. D. Give clear liquid diet as tolerated.

D

A 2-year-old has just been diagnosed with cystic fibrosis (CF). The parents ask the nurse what early respiratory symptoms they should expect to see in their child. Which is the nurse's best response? A. "You can expect your child to develop a barrel-shaped chest." B. "You can expect your child to develop a chronic productive cough." C. "You can expect your child to develop bronchiectasis." D. "You can expect your child to develop wheezing respirations."

A

A 2-year-old is brought to the emergency department for fever and ear pain. The parents report the child has had many ear infections and that polyethylene tubes have been recommended, but the parents cannot afford surgery. The child is diagnosed with bilateral otitis media. The toddler is carrying a baby bottle full of juice, and a parent is carrying a pack of cigarettes. Which one preventive measure could be taught to the parents to decrease the incidence of ear infections? A. Wean the toddler from the bottle. B. Give the toddler a decongestant before bedtime. C. Encourage the parent to smoke outside the house. D. Have the child's hearing checked.

B

A 3-year-old is attending her grandfather's funeral. Her parents told her that her grandfather is in heaven with God. Which statement describes a 3-year-old child's understanding of spirituality? A. "The body is here with us on Earth, and the spirit is in heaven." B. "He is in heaven. Is this heaven?" C. "The spirit is no longer in his body." D. "He won't need his body in heaven."

A

A 3-year-old is hospitalized for an ASD repair. The parents have decided to go home for a few hours to spend time with her siblings. The child asks when her mommy and daddy will be back. The nurse's best response is: A. "Your mommy and daddy will be back after your nap." B. "Your mommy and daddy will be back at 6:00 p.m." C. "Your mommy and daddy will be back later this evening." D. "Your mommy and daddy will be back in 3 hours."

A

A 4-month-old is brought to the emergency department with severe dehydration. The heart rate is 198, and her blood pressure is 68/38. The infant's anterior fontanel is sunken. The nurse notes that the infant does not cry when the intravenous line is inserted. The child's parents state that she has not "held anything down" in 18 hours. The nurse obtains a finger-stick blood sugar of 94. Which would the nurse expect to do immediately? A. Administer a bolus of normal saline. B. Administer a bolus of D10W. C. Administer a bolus of normal saline with 5% dextrose added to the solution. D. Offer the child an oral rehydrating solution such as Pedialyte.

B

A 9-year-old girl builds a clubhouse in her backyard. She hangs a sign outside her clubhouse that says "No boys allowed" printed on it. The child's parents are concerned that she is excluding their neighbor's son, and they are upset. What should the school nurse tell the child's parents? A. Her behavior is cause for concern and should be addressed. B. Her behavior is common among school-age children. C. Her feelings about boys will subside within the next year. D. They should have their daughter speak with the school counselor.

C

A child with minimal change nephrotic syndrome (MCNS) has generalized edema. The skin appears stretched, and areas of breakdown are noted over the bony prominences. The child has been receiving Lasix twice daily for several days. Which does the nurse expect to be included in the treatment plan to reduce edema? A. An increase in the amount and frequency of Lasix. B. Addition of a second diuretic, such as mannitol. C. Administration of intravenous albumin. D. Elimination of all fluids and sodium from the child's diet.

D

An 8-day-old was admitted to the hospital with vomiting and dehydration. The newborn's heart rate is 170, respiratory rate is 44, blood pressure is 85/52, and temperature is 99°F (37.2°C). What is the nurse's best response to the parents who ask if the vital signs are normal? A. "The blood pressure is elevated, but the other vital signs are within normal limits." B. "The temperature is elevated, but the other vital signs are within normal limits." C. "The respiratory rate is elevated, but the other vital signs are within normal limits." D. "The heart rate is elevated, but the other vital signs are within normal limits."

C

The nurse is caring for a 5-month-old infant with a diagnosis of intussusception. The infant has periods of irritability during which the knees are brought to chest and the infant cries, alternating with periods of lethargy. Vital signs are stable and within age-appropriate limits. The physician elects to give an enema. The parents ask the purpose of the enema. Select the nurse's most appropriate response. A. "The enema will confirm the diagnosis. If the test result is positive, your child will need to have surgery to correct the intussusception." B. "The enema will confirm the diagnosis. Although very unlikely, the enema may also help fix the intussusception so that your child will not immediately need surgery." C. "The enema will help confirm the diagnosis and has a good chance of fixing the intussusception." D. "The enema will help confirm the diagnosis and may temporarily fix the intussusception. If the bowel returns to normal, there is a strong likelihood that the intussusception will recur."

C

The nurse is caring for a 9-month-old with diarrhea secondary to rotavirus. The child has not vomited and is mildly dehydrated. Which is likely to be included in the discharge teaching? A. Administer Imodium as needed. B. Administer Kaopectate as needed. C. Continue breastfeeding per routine. D. The infant may return to day care 24 hours after antibiotics have been started.

B

The nurse is caring for a newborn who has just been diagnosed with tracheo-esophageal fistula and is scheduled for surgery. Which should the nurse expect to do in the pre-operative period? A. Keep the child in a monitored crib, obtain frequent vital signs, and allow the parents to visit but not hold their infant. B. Administer intravenous fluids and antibiotics. C. Place the infant on 100% oxygen via a non-rebreather mask. D. Have the mother feed the infant slowly in a monitored area, stopping all feedings 4 to 6 hours before surgery.

A

The nurse is caring for a newborn with esophageal atresia. When reviewing the mother's history, which would the nurse expect to find? A. Maternal polyhydramnios. B. Pregnancy lasting more than 38 weeks. C. Poor nutrition during pregnancy. D. Alcohol consumption during pregnancy.

D

The nurse is caring for a school-aged child with Duchenne muscular dystrophy in the elementary school. Which would be an appropriate nursing diagnosis? A. Anticipatory grieving. B. Anxiety reduction. C. Increased pain. D. Activity intolerance.

C

The nurse is giving discharge instructions to the parent of a 1-month-old infant with tracheoesophageal fistula and a gastrostomy tube (GT). The nurse knows the mother understands the discharge teaching when she states: A. "I will give my baby feedings through the GT but place liquid medications in the corner of the mouth to be absorbed." B. "I will flush the GT with 2 ounces of water after each feeding to prevent the GT from clogging." C. "I will clean the area around the GT with soap and water every day." D. "I will place petroleum jelly around the GT if any redness develops."

B

The nurse is instructing a new breastfeeding mother in the need to provide her premature infant with an adequate source of iron in her diet. Which statement reflects a need for further education of the new mother? A. "I will use only breast milk or an iron-fortified formula as a source of milk for my baby until she is at least 12 months old." B. "My baby will need to have iron supplements introduced when she is 4 months old." C. "I will need to add iron supplements to my baby's diet when she is 2 months old." D. "When my baby begins to eat solid foods, I should introduce iron-fortified cereals to her diet."

C

The nurse knows that teaching has been successful when the parent of a child with muscle weakness states that the diagnostic test for muscular dystrophy is which of the following? A. Electromyelogram. B. Nerve conduction velocity. C. Muscle biopsy. D. Creatine kinase level.

B

The nurse knows that teaching was successful when a parent states which of the following are early signs of muscular dystrophy? A. Increased muscle strength. B. Difficulty climbing stairs. C. High fevers and tiredness. D. Respiratory infections and obesity.

D

The nurse receives a call from the parent of a 10-month-old who has vomited three times in the past 8 hours. The parent describes the baby as playful and wanting to drink. The parent asks the nurse what to give the child. Select the nurse's best response. A. "Replace the next feeding with regular water, and see if that is better tolerated." B. "Do not allow your baby to eat any solids; give half the normal formula feeding, and see if that is better tolerated." C. "Do not let your baby eat or drink anything for 24 hours to give the stomach a chance to rest." D. "Give your child 1/2 ounce of Pedialyte every 10 minutes. If vomiting continues, wait an hour, and then repeat what you previously gave."

A

The parent of a 4-month-old with cystic fibrosis (CF) asks the nurse what time to begin the child's first chest physiotherapy (CPT) each day. Which is the nurse's best response? A. "Thirty minutes before feeding the child breakfast." B. "After deep-suctioning the child each morning." C. "Thirty minutes after feeding the child breakfast." D. "Only when the child has congestion or coughing."

C

The parent of a 5-year-old states that the child has been having diarrhea for 24 hours, vomited twice 2 hours ago, and now claims to be thirsty. The parent asks what to offer the child because the child is refusing Pedialyte. Select the nurse's most appropriate response. A. "You can offer clear diet soda such as Sprite and ginger ale." B. "Pedialyte is really the best thing for your child, who, if thirsty enough, will eventually drink it." C. "Pedialyte is really the best thing for your child. Allow your child some choice in the way to take it by offering small amounts in a spoon, medicine cup, or syringe." C. "It really does not matter what your child drinks as long as it is kept down. Try offering small amounts of fluids in medicine cups."

B

The parent of a child with cystic fibrosis (CF) is excited about the possibility of the child receiving a double lung transplant. What should the parent understand? A. The transplant will cure the child of CF and allow the child to lead a long and healthy life. B. The transplant will not cure the child of CF but will allow the child to have a longer life. C. The transplant will help to reverse the multisystem damage that has been caused by CF. D. The transplant will be the child's only chance at surviving long enough to graduate college.

D

The parents of a 5-week-old have just been told that their child has cystic fibrosis (CF). The mother had a sister who died of CF when she was 19 years of age. The parents are sad and ask the nurse about the current projected life expectancy. What is the nurse's best response? A. "The life expectancy for CF patients has improved significantly in recent years." B. "Your child might not follow the same course that the mother's sister did." C. "The physician will come to speak to you about treatment options." D. The nurse answers their questions briefly, listens to their concerns, and is available later after they've processed the information.

C

The parents of a child hospitalized with minimal change nephrotic syndrome (MCNS) ask why the last blood test revealed elevated lipids. Which is the nurse's best response? A. "If your child had just eaten a fatty meal, the lipids may have been falsely elevated." B. "It's not unusual to see elevated lipids in children because of the dietary habits of today." C. "Since your child is losing so much protein, the liver is stimulated and makes more lipids." D. "Your child's blood is very concentrated because of the edema, so the lipids are falsely elevated."

A

The parents of a child with glomerulonephritis ask how they will know their child is improving after they go home. Which is the nurse's best response? A. "Your child's urine output will increase, and the urine will become less tea-colored." B. "Your child will rest more comfortably as lab tests become more normal." C. "Your child's appetite will decrease as urine output increases." D. "Your child's laboratory values will become more normal."

A

What can a nurse do to reinforce a 5-year-old's intellectual initiative when he asks about his upcoming surgery? A. Answer the child's questions about his upcoming surgery in simple terms. B. Provide the child with a book that has vivid illustrations about his surgery. C. Tell the child he should wait and ask the doctor his questions. D. Tell the child that she will answer his questions at a later time.

ACDE

What does the therapeutic management of cystic fibrosis (CF) patients include? Select all that apply. A. Providing a high-protein, high-calorie diet. B. Providing a high-fat, high-carbohydrate diet. C. Encouraging exercise. D. Minimizing pulmonary complication. E. Encouraging medication compliance.

C

Which breathing exercises should the nurse have an asthmatic 3-year-old child do to increase her expiratory phase? A. Use an incentive spirometer. B. Breathe into a paper bag. C. Blow a pinwheel. D. Take several deep breaths.

D

Which can elicit the Gower sign? Have the patient: A. Close the eyes and touch the nose with alternating index fingers. B. Hop on one foot and then the other. C. Bend from the waist to touch the toes. D. Walk like a duck and rise from a squatting position.

ABC

Which can occur in untreated developmental dysplasia of the hip (DDH)? Select all that apply. A. Duck gait. B. Pain. C. Osteoarthritis in adulthood. D. Osteoporosis in adulthood. E. Increased flexibility of the hip joint in adulthood.

B

Which child can be discharged without further evaluation? A. A 2-year-old who has had 24 hours of watery diarrhea that has changed to bloody diarrhea in the past 12 hours. B. A 2-year-old who had a relapse of one diarrhea episode after restarting a normal diet. C. A 6-year-old who has been having vomiting and diarrhea for 2 days and has decreased urine output. D. A 10-year-old who has just returned from a Scout camping trip and has had several episodes of diarrhea.

ABCD

Which child may need extra fluids to prevent dehydration? Select all that apply. A. 7-day-old receiving phototherapy. B. 6-month-old with newly diagnosed pyloric stenosis. C. 2-year-old with pneumonia. D. 2-year-old with full-thickness burns to the chest, back, and abdomen. E. 13-year-old who has just started her menses.

C

Which child with asthma should the nurse see first? A. A 12-month-old who has a mild cry, is pale in color, has diminished breath sounds, and has an oxygen saturation of 93%. B. A 5-year-old who is speaking in complete sentences, is pink in color, is wheezing bilaterally, and has an oxygen saturation of 93%. C. A 9-year-old who is quiet, is pale in color, and is wheezing bilaterally with an oxygen saturation of 92%. D. A 16-year-old who is speaking in short sentences, is wheezing, is sitting upright, and has an oxygen saturation of 93%.

B

Which child would benefit most from having ear tubes placed? A. A 2-month-old who has had one ear infection. B. A 2-year-old who has had five previous ear infections. C. A 3-year-old whose sibling has had four ear infections. D. A 7-year-old who has had two ear infections this year.

C

Which combination of signs is commonly associated with glomerulonephritis? A. Massive proteinuria, hematuria, decreased urinary output, and lethargy. B. Mild proteinuria, increased urinary output, and lethargy. C. Mild proteinuria, hematuria, decreased urinary output, and lethargy. D. Massive proteinuria, decreased urinary output, and hypotension.

D

Which comment should the parent of a 2-year-old expect from the toddler about a new baby brother? A. "When the baby takes a nap, will you play with me?" B. "Can I play with the baby?" C. "The baby is so cute. I love him." D. "It is time to put him away so we can play."