Pediatric PrepU Exam 2 Questions

The nurse caring for an infant with craniosynostosis, specifically positional plagiocephaly, should prioritize which activity? a. measuring the intake and output every shift. b. moving the infant's head every 2 hours. c. giving the infant small feedings whenever he is fussy. d. massaging the scalp gently every 4 hours.

b. moving the infant's head every 2 hours.

A child has been admitted to the acute care facility for the management of dehydration. The nurse is preparing to administer IV fluid replacement to the child. Which fluid(s) is suitable for use? Select all that apply. a. 0.45% saline. b. normal saline. c. 10% dextrose in water. d. 5% dextrose in water. e. lactated Ringer's.

b. normal saline. e. lactated Ringer's.

A child is experiencing an acute exacerbation of Crohn disease for which she is prescribed prednisone. The nurse teaches the parents and child about this medication. Which statement by the parents indicates that the teaching was successful? a. "We should not stop this medication abruptly." b. "We might notice some of the medication in her stool." c. "This drug helps to control the abdominal cramping." d. "She might lose some weight initially."

a. "We should not stop this medication abruptly."

The nurse is providing care to a child with acute kidney injury. What assessment is priority for the nurse to determine if this child is developing hyperkalemia? a. pulse rate and rhythm. b. abdominal pain. c. muscle tone. d. blood pressure.

a. pulse rate and rhythm.

After teaching the parents of an 8-year-old girl with asthma about common allergens their child should avoid, the nurse determines that the parents need additional teaching when they identify what as a common allergen for asthma? a. shellfish. b. indoor molds. c. dust mites. d. pet dander.

a. shellfish.

The nurse is assessing a 4-year-old girl with ambiguous genitalia. Which finding suggests congenital adrenal hyperplasia? a. irregular heartbeat on auscultation. b. pubic hair and hirsutism. c. hyperpigmentation of the skin. d. pain from constipation on palpation.

b. pubic hair and hirsutism.

Most urinary tract infections seen in children are caused by: a. hereditary causes. b. fungal infections. c. intestinal bacteria. d. dietary insufficiencies.

c. intestinal bacteria.

A nurse is preparing a 7-year-old girl for bone marrow aspiration. Which site should she prepare? a. Anterior tibia. b. Sternum. c. Femur. d. Iliac crest.

d. Iliac crest.

A child is hospitalized and diagnosed with bacterial meningitis. What can the nurse anticipate will be included in the plan of care and treatment? Select all that apply. a. tepid baths as needed. b. antiviral medications. c. acetaminophen. d. antibiotic therapy. e. ice packs to reduce body temperature.

a. tepid baths as needed. c. acetaminophen. d. antibiotic therapy.

The nurse is assessing a 16-year-old girl who is in the office because she has not started menstruating. Which endocrine gland is most often affected by age-related changes? a. thyroid. b. adrenal. c. parathyroid. d. anterior pituitary.

a. thyroid.

Which of these age groups has the highest actual rate of death from drowning? a. toddlers. b. school-aged children. c. infants. d. preschool children.

a. toddlers.

In discussing the causes of iron-deficiency anemia in children with a group of nurses, the following statements are made. Which of these statements is a misconception related to iron-deficiency anemia? a. "Milk is a perfect food, and babies should be able to have all the milk they want." b. "Caregivers sometimes don't understand the importance of iron and proper nutrition." c. "Children have a hard time getting enough iron from food during their first few years." d. "A family's economic problems are often a cause of malnutrition."

a. "Milk is a perfect food, and babies should be able to have all the milk they want."

A nurse is caring for a 6-year-old girl recently diagnosed with celiac disease and is discussing dietary restrictions with the girl's mother. Which response indicates a need for further teaching? a. "My daughter can eat any kind of fruit." b. "There are many types of flour besides wheat." c. "There is gluten hidden in unexpected foods." d. "My daughter is eating more vegetables."

a. "My daughter can eat any kind of fruit."

The parents of a infant born with an abnormality on the back are told by the neonatologist that their child has a myelomeningocele. They ask the nurse what exactly that means. Which would be the nurse's best reply? a. "It is a herniation through the skin of the back of your child with both the spinal cord and nerve roots involved." b. "Your child's defect involves only the nerves to the bladder and bowel and can be easily repaired." c. "The sac is a very small cyst and should resolve within the first year of life." d. "The contents of the sac you see only has fluid in it and should cause the child no problem."

a. "It is a herniation through the skin of the back of your child with both the spinal cord and nerve roots involved."

The oncology nurse is alert for clients displaying signs and symptoms of disseminated intravascular coagulation (DIC). Which symptom would alert the nurse to this emergency condition? a. uncontrolled bleeding. b. increased antithrombin III levels. c. platelet count 10,000/mm3 (10 ×109/L). d. decreased D-dimer assay.

a. uncontrolled bleeding.

A 3-year-old child presents with bruising and mucous membrane bleeding from the nose and mouth. The nurse knows that these symptoms are indicative of: a. von Willebrand disease. b. hemophilia. c. disseminated intravascular coagulation (DIC). d. chronic iron-deficiency anemia.

a. von Willebrand disease.

The nurse is talking with a woman in her second trimester of pregnancy who has been diagnosed with polyhydramnios. The physician has ordered an ultrasound be performed to check for the presence of esophageal atresia. Which statement by the woman indicates an understanding of the relationship between these conditions? a. "Babies with esophageal atresia have an inability to swallow amniotic fluid causing the excess buildup." b. "Babies with esophageal atresia produce an excessive amount of amniotic fluid." c. "Reductions in amniotic fluid are associated with the development of esophageal atresia." d. "Enzymes in amniotic fluid can cause the development of esophageal atresia."

a. "Babies with esophageal atresia have an inability to swallow amniotic fluid causing the excess buildup."

The nurse is discussing treatment for a child diagnosed with scoliosis. Which statement indicates the parents understand the nurse's education? a. "Because our child is being treated by using braces, the braces will have to be worn almost all the time." b. "The most successful treatment for scoliosis is surgery before reaching adult age." c. "The treatment for our child's scoliosis is anticipated to last between 3 to 4 months." d. "Because our child has scoliosis, treatment will include halo traction."

a. "Because our child is being treated by using braces, the braces will have to be worn almost all the time."

A 4-year-old with bronchiolitis has been admitted to the hospital with respiratory compromise. The father asks the nurse why the physician won't prescribe an antibiotic, "My child just keeps getting worse." What is the best response by the nurse? a. "Bronchiolitis is almost always caused by the respiratory syncytial virus (RSV). Unfortunately, antibiotics don't work on viruses." b. "Your physician probably doesn't want to take a chance of your child building up an immunity to the antibiotic in

a. "Bronchiolitis is almost always caused by the respiratory syncytial virus (RSV). Unfortunately, antibiotics don't work on viruses."

Parents ask why their child just diagnosed with leukemia needs a "spinal tap." Which is the bestresponse by the nurse? a. "Checking the cerebrospinal fluid will reveal whether leukemic cells have entered the central nervous system." b. "The spinal tap will help relieve pressure and headache for your child." c. "It will help rule out a second malignancy." d. "A sample of cerebrospinal fluid is needed to check for possible central nervous system infection."

a. "Checking the cerebrospinal fluid will reveal whether leukemic cells have entered the central nervous system."

A 6-year-old has had a viral infection for the past 5 days and is having severe vomiting, confusion, and irritability, although he is now afebrile. During the assessment, the nurse should ask the parent which question? a. "Did you use any medications, like aspirin, for the fever?" b. "What type of fluids did your child take when he had a fever?" c. "Did you give your child any acetaminophen, such as Tylenol?" d. "How high did his temperature rise when he was ill?"

a. "Did you use any medications, like aspirin, for the fever?"

The nurse is teaching glucose monitoring and insulin administration to a child with type 1 diabetes and the parents. Which comment by a parent demonstrates a need for additional teaching? a. "During exercise we should wait to check blood sugars until after our child completes the activity." b. "We should check our child's blood glucose levels before meals." c. "Blood glucose level, food intake, and activity need to all be considered when calculating insulin dosage." d. "If our child is sick we should check blood glucose levels more often."

a. "During exercise we should wait to check blood sugars until after our child completes the activity."

The nurse is assessing a toddler and palpates a sausage-shaped mass in the upper mid abdomen. When taking the toddler's history, what question would the nurse ask the parent first? a. "Has your toddler been having different colored stools?" b. "How is your toddler's appetite?" c. "Has your toddler been around anyone who has been sick?" d. "Can you describe any pain your toddler is having?"

a. "Has your toddler been having different colored stools?"

A nurse caring for an infant born with a cleft palate notices that the parents rarely interact with their child. The nurse overhears the mother telling her spouse that she "feels like crying" every time she looks at their infant. What would be the best response from the nurse? a. "I sense you could use more information on caring for a cleft palate. Would you be interested in meeting with other parents who have dealt with this?" b. "Your infant needs you right now. You should put your negative feelings about the condition aside for your infant's sake." c, "Keep in mind that your infant's condition is not life-threatening and can be corrected eventually." d. "Many infants are born with this condition. Your infant's palate is not nearly as bad as some cases."

a. "I sense you could use more information on caring for a cleft palate. Would you be interested in meeting with other parents who have dealt with this?"

The mother of an infant tells the nurse during a routine visit to the clinic that she often notices a bulging mass in the lower abdominal and groin area when her baby cries. She asks the nurse if this is normal. How should the nurse respond? a. "I understand your concern. I will be sure to document this in your child's medical record and report this information to your child's physician immediately." b. "I will be sure to note this in your child's chart so it is something we will continue to monitor in future visits." c. "The muscle wall of infants are not yet strong so it isn't unusual to see this happening when the baby is crying or straining." d. "I didn't notice any masses while I was assessing your infant. It may just appear they have a mass due to pressure in the abdomen when crying."

a. "I understand your concern. I will be sure to document this in your child's medical record and report this information to your child's physician immediately."

The nurse is caring for an infant recently diagnosed with oral candidiasis (thrush) who has been prescribed nystatin. Which statement by the infant's mother would suggest a need for further education? a. "I will add the nystatin to her bottle four times per day." b. "I will make sure to clean all of her toys before I give them to her." c. "I will use a cotton tipped applicator to apply the medication to her mouth." d. "I will watch for diaper rash."

a. "I will add the nystatin to her bottle four times per day."

The nurse provides education to the parent of an infant being treated for hydrocephalus with a ventriculoperitoneal (VP) shunt. Which statement by the parent indicates the need for further instruction? a. "This shunt is the only surgery my baby will need." b. "I will watch my baby for irritability and difficulty feeding." c. "My baby's cerebrospinal fluid is increasing intracranial pressure." d. "The VP shunt will help drain fluid from my baby's brain."

a. "This shunt is the only surgery my baby will need."

An adolescent is diagnosed with Ewing sarcoma. The adolescent has undergone surgery following a course of chemotherapy and is currently undergoing radiation and additional chemotherapy. Which statement by the family indicates that reteaching is needed? a. "Our child is looking forward to playing football again." b. "Our child's friends shaved their heads in solidarity to show their support." c. "We will watch for signs of infection and report it to our health care provider." d. "We will remind our child to care for the skin following radiation."

a. "Our child is looking forward to playing football again."

The nurse is caring for the parents of a newborn who has an undescended testicle. Which comment by the parents indicates understanding of the condition? a. "Our son's condition may resolve on its own." b. "Our son will likely have a high risk of cancer in his teen years as a result of this condition." c. "Our son may have to go through life without two testes." d. "Our son may need surgery on his testes before we are discharged to go home."

a. "Our son's condition may resolve on its own."

A parent is angry about the adolescent's diagnosis of osteosarcoma. The parent is telling the adolescent that if he hadn't played football last year and broken his leg, this would not have happened. What is the nurse's best response to the parent's statement? a. "Playing sports does not cause osteosarcoma. It may draw attention to the weakened bone from the tumor, though." b. "Cancer in the bone can result from old injuries so it probably was not caused from getting hurt last year, but an earlier injury." c. "When your adolescent broke the leg last year, it may have weakened the bone, allowing cancer to start there." d. "Does bone cancer run in your family? Maybe your adolescent inherited it through genes."

a. "Playing sports does not cause osteosarcoma. It may draw attention to the weakened bone from the tumor, though."

A mother asks the nurse why her infant who was born at 34 weeks' gestation is being prescribed ferrous sulfate. Which response by the nurse is most appropriate? a. "Preterm infants are at risk for iron-deficiency anemia." b. "Ferrous sulfate helps improve red blood cell formation." c. "Infants with pyloric stenosis require ferrous sulfate." d. "Your infant may have been having excessive diarrhea."

a. "Preterm infants are at risk for iron-deficiency anemia."

The nurse is caring for an infant who is at risk for increased intracranial pressure. What statement by the parent would alert the nurse to further assess the child's neurological status? a. "She has been irritable for the last hour....seems like she is just upset for some reason." b. "She is a pretty happy baby, unless her diaper is wet, then she cries until we change her diaper." c. "She always cries when the person holding her has on glasses...I guess glasses scare her." d. "She typically breastfeeds, but lately we have had to supplement with some oat cereal."

a. "She has been irritable for the last hour....seems like she is just upset for some reason."

After explaining the causes of hypothyroidism to the parents of a newly diagnosed infant, the nurse should recognize that further education is needed when the parents ask which question? a. "So, hypothyroidism can be only temporary, right?" b. "Are you saying that hypothyroidism is caused by a problem in the way the thyroid gland develops?" c. "Do you mean that hypothyroidism may be caused by a problem in the way the body makes thyroxine?" d. "So, hypothyroidism can be treated by exposing our baby to a special light, right?"

a. "So, hypothyroidism can be only temporary, right?"

A 10-year-old child has been diagnosed with precocious puberty. When talking with the child, what statements are appropriate? Select all that apply. a. "Tell me about your feelings about what is happening to your body." b. "Developing is normal but your development is happening early." c. "Would talking with someone about your feelings help?" d. "Do you like boys yet?" e. "How are you doing in school?"

a. "Tell me about your feelings about what is happening to your body." b. "Developing is normal but your development is happening early." c. "Would talking with someone about your feelings help?" e. "How are you doing in school?"

The adolescent has been diagnosed with gastroesophageal reflux disease (GERD). Which statement(s) by the adolescent indicates that adequate learning has occurred? Select all that apply. a. "The omeprazole could give me a headache." b. "The famotidine may make me confused." c. "It sounds like the health care provider is reluctant to give me bisacodyl because of the side effects." d. "I will probably need a laxative because of the omeprazole." e. "I should try to lie down right after I eat."

a. "The omeprazole could give me a headache." b. "The famotidine may make me confused." c. "It sounds like the health care provider is reluctant to give me bisacodyl because of the side effects."

The nurse is discussing the treatment of congenital aganglionic megacolon with the caregivers of a child diagnosed with this disorder. Which statement is the best explanation of the treatment for this diagnosis? a. "The treatment for the disorder will be a surgical procedure." b. "Your child will receive counseling so the underlying concerns will be addressed." c. "Your child will be treated with oral iron preparations to correct the anemia." d. "We will give enemas until clear and then teach you how to do these at home."

a. "The treatment for the disorder will be a surgical procedure."

The nurse is caring for a child who has a hip spica cast. The child's mother asks why is there a hole cut in it. What is the best response by the nurse? a. "The window allows us to assess bowel sounds and helps to prevent abdominal distention." b. "The window helps to prevent a complication called compartment syndrome from happening." c. "The hole is called a window. It allows us to assess the incision on the hip." d. "The hole is called a window. They put them in areas where the hard cast isn't needed."

a. "The window allows us to assess bowel sounds and helps to prevent abdominal distention."

The nurse is caring for a child with aplastic anemia. The nurse is reviewing the child's blood work and notes the granulocyte count is about 500, platelet count is over 20,000, and the reticulocyte count is over 1%. The parents ask if these values have any significance. Which response by the nurse is appropriate? a. "These values will help us monitor the disease." b. "I'm really not allowed to discuss these findings with you." c. "These labs are just common labs for children with this disease." d. "The doctor will discuss these findings with you when he comes to the hospital."

a. "These values will help us monitor the disease."

A nurse has just admitted a client with symptoms of vulva inflammation, pain, odor, and pruritus. Based on these findings, the nurse could conclude that this client will be diagnosed with which condition? a. vulvovaginitis. b. vaginal inflammation. c. urinary tract infection (UTI). d. pelvic inflammatory disease (PID).

a. vulvovaginitis.

The nurse is caring for a 7-year-old who is being discharged following surgery with a Gore® Helex device to repair an atrial septal defect. The parents of the child demonstrate understanding of the procedure with which statements? Select all that apply. a. "We will be sure to monitor our child for any signs of infection and notify the doctor if we notice any." b. "We know how important our child's medications are so we will write out a schedule to be sure medications are taken as prescribed."

a. "We will be sure to monitor our child for any signs of infection and notify the doctor if we notice any." b. "We know how important our child's medications are so we will write out a schedule to be sure medications are taken as prescribed." e. "We will be sure to not allow our child to ride a bicycle for at least 2 weeks."

A 9-year-old child with leukemia is scheduled to undergo an allogeneic hematopoietic stem cell transplant. When teaching the child and parents, what information would the nurse include? a. "We'll need to have a match to a donor." b. "You'll need to have an incision in your hip area to instill the cells." c. "You won't need to receive the high doses of chemotherapy before the transplant." d. "The risk for rejection is much less with this type of transplant."

a. "We'll need to have a match to a donor."

The nurse is explaining the procedure of bone marrow aspiration to a 6-year-old child with leukemia. What explanation would be best to give to the child? a. "You may feel pressure on your hip during the procedure." b. "The numbing medicine on your skin will keep you from having pain." c. "You will have to lie on your back and hold your breath." d. "You will need to lie still afterward to prevent a headache."

a. "You may feel pressure on your hip during the procedure."

The nurse is teaching a group of peers regarding different types of fractures seen in children. Which statement best describes a complete fracture? a. A fracture in which the bone breaks into two pieces. b. A fracture in which the bone buckles rather than breaks. c. A fracture in which the bone bends without breaking. d. An incomplete fracture of the bone.

a. A fracture in which the bone breaks into two pieces.

The nurse is providing acute care for an 11-year-old boy with hypoparathyroidism. Which intervention is priority? a. Administering intravenous calcium gluconate as ordered. b. Providing administration of calcium and vitamin D. c. Monitoring fluid intake and urinary calcium output. d. Ensuring patency of the IV site to prevent tissue damage.

a. Administering intravenous calcium gluconate as ordered.

What information is most correct regarding the nervous system of the child? a. As the child grows, the gross and fine motor skills increase. b. The child has underdeveloped gross motor skills and well-developed fine motor skills. c. The child has underdeveloped fine motor skills and well-developed gross motor skills. d. The child's nervous system is fully developed at birth.

a. As the child grows, the gross and fine motor skills increase.

A 9-year-old client who suffered a head injury has strabismus. The nurse assesses the client for intracranial pressure (ICP). Which additional intervention is most important for the nurse to perform? a. Assess the level of consciousness (LOC). b. Place a patch over the client's affected eye. c. Notify the primary health care provider. d, Place the child on fall precaution.

a. Assess the level of consciousness (LOC).

Why will it be necessary for the nurse to be very supportive of parents' attempts to feed the infant with recently repaired myelomeningocele? a. Assuming the usual feeding position will be difficult. b. The infant will have a poor sucking reflex. c. Nausea and vomiting often follow repair of the cystic mass. d. Pain will interfere with the feeding process.

a. Assuming the usual feeding position will be difficult.

A health care provider and other health team members are discussing congenital heart disorders that increase pulmonary blood flow. Which disorders are topics for this discussion? Select all that apply. a. Atrioventricular canal defect. b. Patent ductus arteriosus. c. Pulmonary stenosis. d. Coarctation of the aorta. e. Ventricular septal defect.

a. Atrioventricular canal defect. b. Patent ductus arteriosus. e. Ventricular septal defect.

A 5-year-old is being prepared for diagnostic cardiac catheterization, in which the catheter will be inserted in the right femoral vein. What intervention should the nurse take to prevent infection? a. Avoid drawing a blood specimen from the right femoral vein before the procedure. b. Keep the child NPO for 2 to 4 hours before the procedure. c. Record pedal pulses. d. Apply EMLA cream to the catheter insertion site.

a. Avoid drawing a blood specimen from the right femoral vein before the procedure.

The nurse cares for adolescents with cancer. Which recommended psychosocial interventions will the nurse use to help the adolescents cope with their disease? Select all that apply. a. Be an advisor as well as a friend to the adolescents to promote cooperation in the care plan. b. Postpone return to school for as long as possible to ensure an eventual successful return. c. Encourage adolescents to engage in their usual activities. d. Encourage the adolescents to make plans for the future. e. Discourage relationships with other adolescents who have cancer. f. Control the amount of information given out about an adolescent's condition.

a. Be an advisor as well as a friend to the adolescents to promote cooperation in the care plan. c. Encourage adolescents to engage in their usual activities. d. Encourage the adolescents to make plans for the future. f. Control the amount of information given out about an adolescent's condition.

What is one advantage of an implanted port (central venous access device) that the nurse will explain to an adolescent? a. Body appearance changes very little. b. No tunneling is needed when the port is inserted. c. No special procedure is necessary for removal. d. Flushing of the device is not necessary.

a. Body appearance changes very little.

What will the nurse include in the feeding plan for a breastfed infant with congenital heart disease? a. Breastfeed with small, frequent feeds. b. Feed on schedule every 4 hours to promote rest. c. Assess weight gain monthly. d. Ensure output of a minimum 5 wet diapers daily.

a. Breastfeed with small, frequent feeds.

A nurse is teaching the parents of a boy with a neurogenic bladder about clean intermittent catheterization. Which response indicates a need for further teaching? a. "We need to soak the catheter in a vinegar and water solution daily." b. "The very first step is to apply water-based lubricant to the catheter." c. "My son may someday learn how to do this for himself." d. "We must be careful to use latex-free catheters."

b. "The very first step is to apply water-based lubricant to the catheter."

The father of an 8-year-old boy who is receiving radiation therapy is upset that his son has to go through 6 weeks of treatments. He doesn't understand why it takes so long. In explaining the need for radiation over such a long time, what should the nurse mention? a. Cells are only susceptible to treatment by radiation during certain phases of the cell cycle. b. Insurance companies typically allow only a short radiation treatment per week, to contain costs. c. Radiation therapy is very weak, and therefore it takes a long time to achieve therapeutic doses. d. It is difficult to locate where the cancer cells are in the body, so the entire body must be irradiated.

a. Cells are only susceptible to treatment by radiation during certain phases of the cell cycle.

The nurse is reviewing the laboratory test results of several children who have come to the clinic for evaluation. Which child would the nurse identify as having the least risk for hyperlipidemia? a. Child A with a total cholesterol of 150 mg/dl and low-density lipoprotein (LDL) of 80 mg/dl. b. Child C with a total cholesterol level of 190 mg/dl and LDL of 125 mg/dl. c. Child B with a total cholesterol level of 175 mg/dl and LDL of 105 mg/dl. d. Child D with a total cholesterol level of 220 mg/

a. Child A with a total cholesterol of 150 mg/dl and low-density lipoprotein (LDL) of 80 mg/dl.

A child is being evaluated for renal and urinary tract disease. What would the nurse expect to be ordered to evaluate the child's glomerular filtration rate? a. Creatinine clearance rate. b. Kidneys, ureter, and bladder x-ray. c. Computed tomography scan. d. Urinalysis.

a. Creatinine clearance rate.

A child presents with intermittent abdominal pain, severe anorexia, and diarrhea. The child's height and weight are significantly behind standards for age. There is skin breakdown in the anal region. The nurse explains that this presentation is consistent with which diagnosis? a. Crohn disease. b. food poisoning. c. Hirschsprung disease. d. ulcerative colitis.

a. Crohn disease.

A preschool-age child has just been admitted to the pediatric unit with a diagnosis of bacterial meningitis. The nurse would include which recommendation in the nursing plan? a. Decrease environmental stimulation. b. Monitor temperature every 4 hours. c. Encourage the parents to hold the child. d. Take vital signs every 4 hours.

a. Decrease environmental stimulation.

A parent is asking how to help the child deal with the peer ridicule at school in regards to enuresis. What is the best response by the nurse? a. Demonstrate love and acceptance at home. b. Take away a toy every time the child urinates in his or her pants. c. Demonstrate how to urinate in the bathroom every time the child has an occurrence. d. Discuss how the child can continue to go to the bathroom instead of in his or her underwear.

a. Demonstrate love and acceptance at home.

A child is prescribed glargine insulin. What information would the nurse include when teaching the child and parents about this insulin? a. Do not mix this insulin with other insulins. b. Give the dose first thing in the morning. c. Discard any opened vials after a week. d. Store the insulin in the refrigerator until just before giving it.

a. Do not mix this insulin with other insulins.

A nurse is reviewing with an 8-year-old how to self-administer insulin. Which of the following is the proper injection technique for insulin injections? a. Elevate the subcutaneous tissue before the injection. b. Aspirate the syringe for blood return before the injection. c. Place the needle with the bevel facing down before the injection. d. Spread the skin before the injection.

a. Elevate the subcutaneous tissue before the injection.

A school nurse is trying to prevent poststreptococcal glomerulonephritis in children. What would be the best way to prevent this? a. Encourage the child to take all the antibiotics if diagnosed with strep throat. b. Prophylactic antibiotics after strep throat are important. c. All children in the child's class should be tested for strep throat if one child has a positive test. d. Tell parents to give ibuprofen if their child has a sore throat.

a. Encourage the child to take all the antibiotics if diagnosed with strep throat.

A newborn is discovered to have congenital adrenogenital hyperplasia. What will the nurse most likely observe when assessing this client? a. Enlarged clitoris. b. Divergent vision. c. Small for gestational age. d. Abnormal facial features.

a. Enlarged clitoris.

The pediatric nurse reviews the radiographs of a child and observes that there are lesions on the bone. The nurse interprets this finding as suggesting which condition? a. Ewing sarcoma. b. Hodgkin disease. c. non-Hodgkin lymphoma. d. neuroblastoma.

a. Ewing sarcoma.

After hospital discharge, the parent of a child newly diagnosed with type 1 diabetes mellitus telephones the nurse because the child is acting confused and very sleepy. Which emergency measure would the nurse suggest the parent carry out before bringing the child to see the health care provider? a. Give the child a glass of orange juice. b. Give the child nothing by mouth so that a blood sugar can be drawn at the health care provider's office. c. Give the child a glass of orange juice with one unit regular insulin in it. d. Give the child one unit of regular insulin.

a. Give the child a glass of orange juice.

A 3-year-old child is hospitalized with a diagnosis of sickle cell anemia and is experiencing a pain crisis. Using the FACES scale, the nurse assesses the child's pain to be a 10 on a scale of 1 to 10. The child is receiving intravenous fluids and oxygen at 2 L/min via nasal cannula. The parent is at the bedside holding the child's hand and has a concerned look. What is the nurse's priority in caring for the child? a. Implement strategies to address the child's pain. b. Contact the health care provider to meet with the parent. c. Provide diversional activities for the child. d. Ask the parent if he or she has questions about the plan of care.

a. Implement strategies to address the child's pain.

The nurse is caring for a child with a diagnosis of pyloric stenosis during the preoperative phase of the child's treatment. What is the highest priority at this time? a. Improving hydration. b. Promoting comfort. c. Maintaining skin integrity. d. Preparing family for home care.

a. Improving hydration.

The nurse is educating the family of a 7-year-old with epilepsy about care and safety for this child. What comment will be most valuable in helping the parent and the child cope? a. "If he is out of bed, the helmet's on the head." b. "Use this information to teach family and friends." c. "You'll always need a monitor in his room." d. "Bike riding and swimming are just too dangerous."

b. "Use this information to teach family and friends."

The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of gastroesophageal reflux? a. In this disorder the sphincter that leads into the stomach is relaxed. b. A thickened, elongated muscle causes an obstruction at the end of the stomach. c. A partial or complete intestinal obstruction occurs. d. There are recurrent paroxysmal bouts of abdominal pain.

a. In this disorder the sphincter that leads into the stomach is relaxed.

Which nursing diagnosis would be most appropriate for a child with idiopathic thrombocytopenic purpura? a. Ineffective tissue perfusion related to poor platelet formation. b. Risk for altered urinary elimination related to kidney impairment. c. Ineffective breathing pattern related to decreased white blood count. d. Risk for infection related to abnormal immune system.

a. Ineffective tissue perfusion related to poor platelet formation.

Absence seizures are marked by what clinical manifestation? a. Loss of motor activity accompanied by a blank stare. b. Sudden, brief jerks of a muscle group. c. Loss of muscle tone and loss of consciousness. d. Brief, sudden onset of increased tone of the extensor muscle.

a. Loss of motor activity accompanied by a blank stare.

Which results would indicate to the nurse the possibility that a neonate has congenital hypothyroidism? a. Low T4 level and high TSH level. b. High thyroxine (T4) level and low thyroid stimulating hormone (TSH) level. c. Normal T4 level and low TSH level. d. Normal TSH level and high T4 level.

a. Low T4 level and high TSH level.

During a class for caregivers of children with asthma, a caregiver asks the nurse the following question when medications are being discussed. "They told me about a plastic device my child can hold in his a hand which will give him a premeasured and exact amount of his corticosteroid." The nurse recognizes that the caregiver is most likely referring to which device? a. Metered-dose inhaler. b. Needleless syringe. c. Medication cup. d. Nebulizer.

a. Metered-dose inhaler.

When providing care for a child immediately after a bone marrow aspiration, which nursing action is priority? a. Monitor the site dressing and vital signs. b. Educate the family on proper handwashing. c. Evaluate pain and administer medication. d. Allow the child to play with a doll and syringe.

a. Monitor the site dressing and vital signs.

The nurse is planning care for a child with idiopathic thrombocytopenic purpura. Which client education should be included? a. Not to pick or irritate the nose. b. To apply a soothing cream to lesions. c. What foods are high in folic acid. d. To use mainly cold water to wash.

a. Not to pick or irritate the nose.

A nurse is caring for a newborn client who is diagnosed with myelomeningocele. Which nursing intervention would protect the newborn from injury? a. Place the newborn in a prone or lateral position. b. Place petroleum jelly gauze on the spinal sac to keep it moist. c. Delay the parents from holding the newborn. d. Place a urine collection bag on newborn for the continuous leakage.

a. Place the newborn in a prone or lateral position.

Which findings should the nurse expect to assess when completing the health history of a child admitted for possible type 2 diabetes? Select all that apply. a. Polyuria. b. Polyphagia. c. Polydipsia. d. Marked weight loss. e. Abrupt onset of symptoms.

a. Polyuria. b. Polyphagia. c. Polydipsia.

In caring for an infant diagnosed with pyloric stenosis the nurse would anticipate which intervention? a. Prepare the infant for surgery. b. Change the infant's diet to one that is lactose-free. c. Medicate the infant with analgesics. d. Assist in doing a barium enema procedure on the infant.

a. Prepare the infant for surgery.

The nurse is reinforcing teaching about medications with the parents of a 2-year-old who has cystic fibrosis. The nurse suggests that pancreatic enzymes may be given by which method? a. Sprinkled onto the food. b. Directly into the vein. c. Using a nebulizer. d. Through a gastrostomy tube.

a. Sprinkled onto the food.

The nurse is taking a health history of a 12-year-old boy presenting with scrotal pain. Which assessment finding would indicate testicular torsion? a. Sudden onset of severe scrotal pain with significant hemorrhagic swelling. b. Fever, scrotal swelling, and urethral discharge. c. Hardened and tender epididymitis with edema and erythema of scrotum. d. Enlarged inguinal glands and fever.

a. Sudden onset of severe scrotal pain with significant hemorrhagic swelling.

The nurse is caring for a child who has been admitted with a possible diagnosis of cystic fibrosis. Which laboratory/diagnostic tools would most likely be used to help determine the diagnosis of this child? a. Sweat sodium chloride test. b. Blood culture and sensitivity. c. Pulmonary functions test. d. Purified protein derivative test.

a. Sweat sodium chloride test.

The nurse is assessing a 10-day-old infant for dehydration. Which finding indicates severe dehydration? a. Tenting of skin. b. Blood pressure of 80/42 mm Hg. c. Pale and slightly dry mucosa. d. Soft and flat fontanels (fontanelles).

a. Tenting of skin.

A caregiver brings her 7-year-old son to the pediatrician's office, concerned about the child's bedwetting after being completely toilet trained even at night for over 2 years. The caregiver further reports that the child has wet the bed every night since returning home from a 1-week fishing trip. The child refuses to talk about the bedwetting. The nurse notes the child is shy, skittish, and will not make eye contact. Further evaluation needs to be done to rule out what possible explanation for the bedwetting? a. The child has been sexually abused, maybe on the fishing trip. b. The child is out of the habit of waking himself up during the night to void. c. The child did not want to go on the fishing trip and is now retaliating against being made to go. d. The child has a urinary tract infection due to not bathing while on the fishing trip.

a. The child has been sexually abused, maybe on the fishing trip.

In caring for a child in traction, which intervention is the highest priority for the nurse? a. The nurse should monitor for decreased circulation every 4 hours. b. The nurse should clean the pin sites at least once every 8 hours. c. The nurse should provide age-appropriate activities for the child. d. The nurse should record accurate intake and output.

a. The nurse should monitor for decreased circulation every 4 hours.

The community health nurse is preparing a presentation which will illustrate the various forms of spina bifida for a health fair. Which explanation should the nurse use to explain spina bifida with meningocele? a. The spinal meninges protrude through the bony defect and form a cystic sac. b. There is no protrusion of the spinal cord, only soft-tissue inflammation occurs. c. There is a bony defect that occurs without soft-tissue involvement. d. There is protrusion of the spinal cord and meninges, with nerve roots embedded.

a. The spinal meninges protrude through the bony defect and form a cystic sac.

Parents are told their infant has a hypoplastic left heart. How would the nurse explain this condition to the family? a. This is a problem where the left side of the heart did not develop properly. b. This is a problem where the right side of the heart did not develop properly. c. The infant will have immediate surgery to completely correct the heart defect. d. There are no surgeries that can help the child live with this heart defect.

a. This is a problem where the left side of the heart did not develop properly.

A mother is asking for more information about her infant's patent ductus arteriosus (PDA). What would be included in the education? a. This is caused by an opening that usually closes by 1 week of age. b. This type of defect is caused by having a genetic predisposition for it. c. Your child may need multiple surgeries to correct this defect. d. An IV for fluids will be started immediately.

a. This is caused by an opening that usually closes by 1 week of age.

A nurse is taking care of an infant with diabetes insipidus. Which assessment data are most important for the nurse to monitor while the infant has a prescription for fluid restriction? a. Urine output. b. Oral mucosa. c. Oral intake. d. Vital signs.

a. Urine output.

The mother of a 13-year-old adolescent is concerned about her daughter getting cervical cancer later in life and asks the nurse if there are any ways to reduce the risk. Which would the nurse recommend? a. Vaccination for the human papillomavirus. b. Urging the daughter to not begin smoking. c. Insist that the daughter wear SPF 30 sunscreen while outside. d. A diet free from animal fats.

a. Vaccination for the human papillomavirus.

Which instructions should a nurse give to a client who has a history of urinary tract infections to prevent recurrence? Select all that apply. a. Wipe from front to back. b. Limit bathing to once a week. c. Use bubble bath to wash. d. Encourage fluids throughout the day. e. Finish all antibiotics prescribed.

a. Wipe from front to back. d. Encourage fluids throughout the day. e. Finish all antibiotics prescribed.

A nurse should recognize that which laboratory result would be most consistent with a diagnosis of diabetes mellitus? a. a fasting blood glucose greater than 126 mg/dl. b. a fasting blood glucose less than 126 mg/dl. c. proteinuria. d. glucose in the urine.

a. a fasting blood glucose greater than 126 mg/dl.

A client has just been admitted to the unit with a history of recent streptococcal infection, hematuria, and proteinuria. Based on these findings, the nurse suspects which condition? a. acute glomerulonephritis. b. prune belly syndrome. c. acute kidney injury. d. urinary tract infection.

a. acute glomerulonephritis.

Which problem-based nursing care plan will the nurse indicate as priority for the child following cardiac surgery for tetralogy of Fallot? a. altered cardiopulmonary tissue perfusion risk. b. fluid overload risk. c. acute parental anxiety. d. surgical site infection risk.

a. altered cardiopulmonary tissue perfusion risk.

A child with a primary growth hormone deficiency is to receive biosynthetic growth hormone. The nurse would explain to the child and parents that this hormone would be given at which frequency? a. daily. b. monthly. c. bi-monthly. d. weekly.

a. daily.

The nurse is assessing a 1-month-old girl who, according to the mother, doesn't eat well. Which assessment suggests the child has congenital hypothyroidism? a. enlarged tongue. b. tachycardia. c. frequent diarrhea. d. warm, moist skin.

a. enlarged tongue.

The labor and delivery nurse is caring for a mother who has demonstrated polyhydramnios upon delivery. The newborn displays copious, frothy bubbles of mucus in the mouth and nose, as well as drooling. The nurse is concerned that the infant has what disorder? a. esophageal atresia. b. hiatal hernia. c. gastroschisis. d. omphalocele.

a. esophageal atresia.

The nurse knows that the heads of infants and toddlers are large in proportion to their bodies, placing them at risk for what problem? a. head trauma. b. positional plagiocephaly. c. intracranial hemorrhaging. d. congenital hydrocephalus.

a. head trauma.

An infant with a femur fracture is placed in Bryant traction. What would the nurse include in the infant's plan of care? a. keeping the buttocks slightly elevated. b. wrapping the bandages from the ankle to the knee. c. removing the traction boot every 8 hours. d. provide range of motion to the unaffected extremity.

a. keeping the buttocks slightly elevated.

The nurse will teach parents of children with myelomeningocele to maintain an environment free of what element? a. latex. b. cat dander. c. alcohol gel. d. peanuts.

a. latex.

To prevent further sickle cell crisis, the nurse would advise the parents of a child with sickle cell anemia to: a. notify a health care provider if the child develops an upper respiratory infection. b. administer an iron supplement daily. c. encourage the child to participate in school activities, such as long-distance running. d. prevent the child from drinking an excess amount of fluids per day.

a. notify a health care provider if the child develops an upper respiratory infection.

A child with a seizure disorder is being admitted to the inpatient unit. When preparing the room for the child, what should be included? Select all that apply. a. padding for side rails. b. smelling salts. c. suction at bedside. d. oxygen gauge and tubing. e. tongue blade.

a. padding for side rails. c. suction at bedside. d. oxygen gauge and tubing.

A parent brings a 10-year-old child to the emergency room with reports of abdominal pain. The nurse performing a physical assessment notes the following symptoms: upper right quadrant pain that radiates to the back; fever; nausea; and abdominal distention. Which disease would the nurse suspect? a. pancreatitis. b. ulcerative colitis. c. Crohn disease. d. appendicitis.

a. pancreatitis.

The nurse is caring for a child diagnosed with Duchenne muscular dystrophy and notes the presence of a Gower sign on the assessment form. What action by the child would support this assessment? a. when on the floor, rising to the knees and pressing the hands against the ankles, knees, and thighs to stand. b. a short heel cord caused by walking on the toes. c. meeting motor milestones such as sitting, walking, and standing but at a later age than the average child. d. the presence of a waddling gait and difficulty climbing stairs.

a. when on the floor, rising to the knees and pressing the hands against the ankles, knees, and thighs to stand.

A child is in traction and is at risk for impaired skin integrity. Which intervention is most effective? a. Gently massage the child's back to stimulate circulation. b Inspect the child's skin for rashes, redness, irritation, or pressure injuries. c. Assess neurovascular status on the affected extremity once every shift. d. Keep the child's skin distal to the traction clean and dry.

b Inspect the child's skin for rashes, redness, irritation, or pressure injuries.

A 4-month-old has had a fever, vomiting, and loose watery stools every few hours for 2 days. The mother calls the physician's office and asks the nurse what she should do. Which response by the nurse is most appropriate? a. "Give a clear pediatric electrolyte replacement for the next few hours, then call back to report on how your child is doing." b. "Bring the child to the office today so we can evaluate her fluid balance and determine the best treatment." c. "Continue breastfeeding as you have been doing. The fluid from the breast milk is important to maintain fluid balance." d. "Do not give the child anything to drink for 4 hours. If the fever goes down and the loose stools stop, you can resume breastfeeding."

b. "Bring the child to the office today so we can evaluate her fluid balance and determine the best treatment."

The nurse is caring for a child recently fitted with braces on both legs due to cerebral palsy (CP). What would the nurse emphasize in the discharge teaching? a. "Please try and follow the therapist's on and off schedule." b. "Check the skin that is covered by the braces for redness and breakdown." c. "If the brace is painful, feel free to take it off." d. "It is very important to comply with the use of this brace."

b. "Check the skin that is covered by the braces for redness and breakdown."

The nurse helps position a child for a lumbar puncture. Which statement describes the correct positioning for this procedure? a. "The child will be placed in the prone position with the nurse holding the child still." b. "For a lumbar puncture, the child will be placed in a side-lying position with knees bent and neck flexed to assist with arching the back." c. "The child will be held by the mother on her lap with his back toward the health care provider." d. "When positioning the child, the nurse needs to assist the child to a side-lying position and keep his back as flat as much as possible."

b. "For a lumbar puncture, the child will be placed in a side-lying position with knees bent and neck flexed to assist with arching the back."

The student nurse is preparing a presentation on celiac disease. What information should be included? Select all apply. a. "Most children with celiac disease are diagnosed within the first year of life." b. "Gluten is found in most wheat products, rye, barley and possibly oats." c. "The entire family will need to eat a gluten-free diet." d. "The only treatment for celiac disease is a strict gluten-free diet." e. "Symptoms of celiac disease include diarrhea, steatorrhea, anemia, and dental disorders."

b. "Gluten is found in most wheat products, rye, barley and possibly oats." d. "The only treatment for celiac disease is a strict gluten-free diet." e. "Symptoms of celiac disease include diarrhea, steatorrhea, anemia, and dental disorders."

The boy has anemia and iron supplements that will be administered by his parents at home. Which statements by the child's parents indicate that further education is required? Select all that apply. a. "It's better if I give the iron with orange juice." b. "He may develop diarrhea." c. "I can give the iron mixed with chocolate milk." d. "If the iron is mixed in a drink, then he should drink it with a straw." e. "His urine may look dark."

b. "He may develop diarrhea." c. "I can give the iron mixed with chocolate milk."

The nurse is caring for a 2-year-old boy with an umbilical hernia and is teaching the mother about this condition. Which response from the mother indicates a need for further teaching? a. "I need to watch for pain, tenderness, or redness." b. "I can tape a quarter over the hernia to reduce it." c. "An incarcerated hernia is rare, but it can occur." d. "My son could have some appearance-related self-esteem issues."

b. "I can tape a quarter over the hernia to reduce it."

The nurse is caring for a child who has suffered a febrile seizure. While speaking with the child's parents, which statement by a parent indicates a need for further education? a. "When he gets his next set of immunizations, I need to make sure I give him some ibuprofen so he doesn't spike a fever." b. "I hate to think that I will need to be worried about my child having seizures for the rest of his life." c. "The next time he has a fever, I need to make sure I read the dosage on the acetaminophen bottle carefully." d. "I need to set an alarm to wake up and check his temperature during the night when he is sick."

b. "I hate to think that I will need to be worried about my child having seizures for the rest of his life."

The nurse is caring for a 12-year-old child with Crohn disease. What assessment finding will the nurse report to the health care provider when caring for the child? a. clear lung sounds. b. fever. c. no joint swelling. d. report of a headache.

b. fever.

During a visit to the clinic, the adolescent client with hypothyroidism tells the nurse that she takes her levothyroxine "whenever I think about it...sometimes I miss a dose, but not very often." What is the best response by the nurse? a. "If you forget a dose you can double up the next day. We just want your thyroid level to be maintained since you don't produce enough thyroid hormone." b. "I know it's hard to remember medicines, but it is really important for you to take it before breakfast each day to control your hypothyroidism." c. "Maybe you could do something to remind yourself to take the medication on a daily basis." d. "As long as you are missing multiple doses it should be fine. Just as long as you take the levothyroxine at some point each day."

b. "I know it's hard to remember medicines, but it is really important for you to take it before breakfast each day to control your hypothyroidism."

The parents of a 17-year-old adolescent diagnosed with bacterial meningitis tell the nurse, "We just do not understand how this could have happened. Our adolescent has always been healthy and just received a booster vaccine last year." How should the nurse respond? a. "Meningococcal conjugate vaccine covers only two types of bacterial meningitis." b. "I understand your frustration. Unfortunately, immunizations are not 100% effective in preventing the infection." c. "Your child may have been exposed to the type of meningitis that is not covered by the vaccine received." d. "Maybe your child's immune system is not strong enough to fight off the infection, even with having received the vaccine."

b. "I understand your frustration. Unfortunately, immunizations are not 100% effective in preventing the infection."

The nurse is discharging a client diagnosed with bacterial vaginosis. Which statement would indicate to the nurse that the client has a correct understanding of the discharge instructions? a. "I do not need to see my health care provider for this infection." b. "I will always use a condom with any further sexual encounters." c. "I do not have to worry about speeding this infection to my partner." d. "If I suspect anything, I will be sure to use soap and water after sex."

b. "I will always use a condom with any further sexual encounters."

The student nurse is caring for a child with the nursing diagnosis "Risk for fluid volume deficit related to inadequate oral intake." Which statement by the student would indicate a need for further education by the nursing instructor? a. "I will teach her mother to give her small drinks frequently." b. "I will make sure there is plenty of orange juice available. It's her favorite juice." c. "I will weigh her every morning at the same time." d. "I will monitor her IV line to help maintain her fluid volume."

b. "I will make sure there is plenty of orange juice available. It's her favorite juice."

The nurse is teaching an in-service program to a group of nurses on the topic of children diagnosed with sickle cell disease. The nurses in the group make the following statements. Which statement is most accurate regarding this condition? a. "The disease is most often seen in individuals of Asian decent." b. "If the trait is inherited from both parents the child will have the disease." c. "Males are much more likely to have the disease than females." d. "The trait or the disease is seen in one generation and skips the next generation."

b. "If the trait is inherited from both parents the child will have the disease."

The parent of a 3-week-old infant brings the infant in for an evaluation. During the visit, the parent tells the nurse that the infant is spitting up after feedings. Which response by the nurse would be most appropriate? a. "Thicken the formula by adding oat cereal." b. "Infants this age commonly spit up." c. "Your child might have an allergy." d. "Do not worry; you are just feeding your infant too much."

b. "Infants this age commonly spit up."

A couple is expecting a child. The fetus undergoes genetic testing and the couple discover the fetus has sickle cell disease. The couple ask the nurse how most commonly happens. Which statement is accurate for the nurse to provide? a. "Sickle cell disease is passed to a fetus when one of the parents has the gene." b. "Sickle cell disease is passed to a fetus when both parents have the gene." c. "Sickle cell diseas can be passed to the fetus in many ways. We will know more at birth." d. "Sickle cell disease occurs from a random genetic mutation."

b. "Sickle cell disease is passed to a fetus when both parents have the gene."

A 10-year-old child has been diagnosed with type 1 diabetes. The child is curious about the cause of the disease and asks the nurse to explain it. Which explanation will the nurse provide? a. "The pancreas inside your belly makes enough chemical called insulin, but your body does not want to use it to keep your blood sugar level normal." b. "Special cells in a part of your body called the pancreas cannot make a chemical called insulin, which helps control the sugar level in your blood." c. "The part of your body called the pancreas is broken and produces too much chemical called glucagon, which makes you really thirsty and have to go to the bathroom a lot." d. "The alpha and beta cells in your pancreas are fighting against each other; that is why your blood sugar stays high and you need insulin injection."

b. "Special cells in a part of your body called the pancreas cannot make a chemical called insulin, which helps control the sugar level in your blood."

The nurse is caring for a 14-year-old client scheduled for magnetic resonance imaging (MRI). The nurse explains the test to the child and family. Which information would be most appropriate to include in the explanation? a. "The MRI uses radiation to examine soft tissue and bony structures of the body." b. "The MRI uses radio waves and magnets to produce a computerized image of the body." c. "The MRI uses sound waves to create images that visualize body structures and locate masses." d. "The MRI is a nuclear scanning test to rule out cancer involving the bones or determine extent of bone involvement."

b. "The MRI uses radio waves and magnets to produce a computerized image of the body."

The nurse is providing child and family education prior to discharge following a cardiac catheterization. The nurse is teaching about signs and symptoms of complications. Which statement by the mother indicates a need for further teaching? a. "We need to avoid a tub bath for the next 3 days." b. "The feeling of the heart skipping a beat is common." c. "We need to watch for changes in skin color or difficulty breathing." d. "Strenuous activity should be limited for the next 3 days."

b. "The feeling of the heart skipping a beat is common."

The nurse knows that disorders of the pituitary gland depend on the location of the physiologic abnormality. In caring for a child that has issues with the anterior pituitary, the nurse knows that this child has issues with which hormone? a. vasopressin. b. growth hormone. c. oxytocin. d. antidiuretic hormone.

b. growth hormone.

The nurse is caring for a 10-year-old boy who plays on two soccer teams. He practices four days a week and his team travels to tournaments once a month. He has been diagnosed with a stress fracture in one of his vertebrae. Which instruction is most important to emphasize to the boy and his parents? a. "NSAIDs can help with pain control and inflammation." b. "You and your coaches need to understand that you cannot play soccer for at least six weeks." c. "You will need to see a physical therapist for stretching and strengthening exercises." d. "Ice will help reduce the inflammation."

b. "You and your coaches need to understand that you cannot play soccer for at least six weeks."

The pediatric nurse has digoxin ordered for each of five children. The nurse should withhold digoxin for which children? Select all that apply. a. 4-month-old child with an apical heart rate of 102 beats per minute. b. 16-year-old child with a heart rate of 54 beats per minute. c. 5-year-old child who developed vomiting and diarrhea, and is difficult to arouse. d. 2-year-old child whose digoxin level was 2.4 ng/ml from a blood draw this morning. e. 12-year-old child whose digoxin level was 0.9

b. 16-year-old child with a heart rate of 54 beats per minute. c. 5-year-old child who developed vomiting and diarrhea, and is difficult to arouse. d. 2-year-old child whose digoxin level was 2.4 ng/ml from a blood draw this morning.

The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of congenital aganglionic megacolon? a. A thickened, elongated muscle causes an obstruction at the end of the stomach. b. A partial or complete intestinal obstruction occurs. c. In this disorder the sphincter that leads into the stomach is relaxed. d. There are recurrent paroxysmal bouts of abdominal pain.

b. A partial or complete intestinal obstruction occurs.

A client with cancer is diagnosed with typhlitis. Which emergency intervention would the nurse perform? a. Monitor serum sodium levels. b. Administer broad-spectrum antibiotics intravenously. c. Administer diuretics. d. Maintain fluid restriction to below maintenance levels.

b. Administer broad-spectrum antibiotics intravenously.

The nurse is administering cyclophosphamide as ordered for a 12-year-old boy with nephrotic syndrome. Which instruction is most accurate regarding administration? a. Provide adequate hydration and encourage voiding. b. Administer in the morning; encourage fluids and voiding during and after administration. c. Encourage fluids, adequate food intake, and voiding before and after administration d. Administer in the evening on an empty stomach.

b. Administer in the morning; encourage fluids and voiding during and after administration.

A 4 y/o child has been admitted to the hospital w/ a diagnosis of pneumococcal pneumonia. The parents are extremely distraught over the child's condition & the fact that the child has not wanted to eat anything for the past 2 days. Which nursing approach would be most important to take to help alleviate the high anxiety level of the parents? a. Avoid telling the parents unnecessary facts regarding the child's prognosis. b. Allow the parents to remain w/ the child as much as possible. c. Encoura

b. Allow the parents to remain w/ the child as much as possible.

An 8 y/o girl presents with drooling & a complaint of painful swallowing. She has a high fever & is lethargic. On examination the nurse sees that her palatine tonsils are bright red & swollen. The girl's mother says that she has never had these symptoms before. A throat culture indicates a streptococcus infection. What is the course of treatment that the nurse would expect in this situation? a. Adenoidectomy. b. Antipyretic, analgesic, & antibiotic. c. Antipyretic & analgesic. d. Tonsillectomy.

b. Antipyretic, analgesic, & antibiotic.

The nurse is assessing an infant and notes brachial pulses of 2+ and femoral pulses of 1+. Which action will the nurse perform first? a. Apply appropriate oxygen device. b. Assess blood pressure in all extremities. c. Prepare for balloon angioplasty. d. Contact the health care provider.

b. Assess blood pressure in all extremities.

The nurse is caring for a 10-year-old boy with hemophilia. He asks the nurse for suggestions about appropriate physical activities. Which activity would the nurse most likely recommend? a. Soccer. b. Baseball. c. Football. d. Wrestling.

b. Baseball.

A child has been diagnosed with a basilar skull fracture. The nurse identifies ecchymosis behind the child's ear. This would be documented as: a. rhinorrhea. b. Battle sign. c. otorrhea. d. raccoon eyes.

b. Battle sign.

Pancreatic enzymes are part of the treatment in cystic fibrosis. When should the nurse administer the enzymes? a. Three times a day with water. b. Before meals and snacks with milk. c. At night after dinner. d. Once a day.

b. Before meals and snacks with milk.

A group of nursing students are studying information about childhood cancers in preparation for a class examination. They are reviewing how childhood cancers differ from adult cancers. The group demonstrates understanding of the information when they identify what location as an unlikely site for childhood cancer? a. Kidney. b. Bladder. c. Brain. d. Blood.

b. Bladder.

The nurse is collecting data on a 6-year-old child admitted with acute glomerulonephritis. Which vital sign would the nurse anticipate with this child's diagnosis? a. Pulse oximetry 93% on room air. b. Blood pressure 136/84. c. Respirations 24 per minute. d. Pulse rate 112 bpm.

b. Blood pressure 136/84.

A child is born with clubfoot (congenital talipes equinovarus). The child later receives a cast on the affected leg to correct the problem. Which measure should the nurse mention to the mother to ensure good circulation in the affected leg? a. Perform passive foot exercises. b. Check the infant's toes for coldness or blueness. c. Apply Denis Browne splints to the infant each night. d. Change the infant's diapers frequently.

b. Check the infant's toes for coldness or blueness.

A teenage girl asks why chemotherapy causes hair loss. Which response by the nurse is accurate? a. Hair is not a living tissue, and it is easily damaged by chemotherapy. b. Chemotherapy affects cancer cells and normal cells that multiply rapidly. c. Circulation to the head causes large doses of chemotherapy to reach the scalp. d. Hair is exposed to the sun, which increases sensitivity to chemotherapy.

b. Chemotherapy affects cancer cells and normal cells that multiply rapidly.

A nursing student compares and contrasts childhood and adult cancers. Which statement does so accurately? a. Adult cancers are more responsive to treatment than are those in children. b. Children's cancers, unlike those of adults, often are detected accidentally, not through screening. c. Little is known regarding cancer prevention in adults, although much prevention information is available for children. d. Environmental and lifestyle influences in children are strong, unlike those in adults.

b. Children's cancers, unlike those of adults, often are detected accidentally, not through screening.

A nurse on the pediatric floor is taking care of a 12-year-old child with diabetes insipidus (DI). Which fact would the nurse understand about this disease? a. DI can be managed by short-term treatment with hormone replacement medications. b. DI can be managed with vasopressin given as lifelong treatment. c. DI can cause anorexia if appropriate meals are not planned. d. DI requires strict fluid restrictions until it resolves.

b. DI can be managed with vasopressin given as lifelong treatment.

An adolescent is having an annual physical. The adolescent has a documented weight loss of 9 lb (4.08 kg). The parent states, "He eats constantly." Exam findings are normal overall, except that the child reports having trouble sleeping, and the child's eyeballs are noted to bulge slightly. Which interventions would the nurse perform based on these findings? a. Prepare the parent for a neurology consult. b. Discuss preparing for a thyroid function test. c. Explain why the child might need to schedule an eye exam. d. Explain the preparation for an 8-hour fasting blood glucose test.

b. Discuss preparing for a thyroid function test.

The nurse working on a pediatric floor understands the importance of diagnosing inborn errors of metabolism early. A child with a suspected problem must have blood urea nitrogen (BUN) and creatinine testing done. Which is the purpose of these two tests? a. Evaluate liver function. b. Evaluate renal function. c. Detect changes in amino acid patterns. d. Evaluate metabolism.

b. Evaluate renal function.

A parent brings a 2-year-old child to the health clinic with reports of diarrhea, vomiting, and abdominal pain. The father tells the nurse that he is a single parent and his child is enrolled in a local day care center. Based on this information, what gastrointestinal condition might the nurse suspect? a. Appendicitis. b. Gastroenteritis. c. Pancreatitis. d. Hirschsprung disease.

b. Gastroenteritis.

While administering a blood transfusion to a child with a hematologic disorder, the nurse notes the child develops urticaria and wheezing. Which collaborative interventions will the nurse begin? Select all that apply. a. Administer a diuretic. b. Give an antihistamine. c. Apply oxygen as needed. d. Obtain a blood culture. e. Discontinue the transfusion.

b. Give an antihistamine. c. Apply oxygen as needed. e. Discontinue the transfusion.

The type of fracture often seen in young children is one in which there is not complete ossification of the bone, and the bone bends and just partially breaks. What type of fracture is this? a. Epiphyseal. b. Greenstick. c. Spiral. d. Complete.

b. Greenstick.

A child is diagnosed with retinoblastoma in which there are three tumors 4, 5, and 7 disk diameters behind the equator. Using the Reese-Ellsworth staging classification, which describes the staging and prognosis for this condition? a. Group V, very unfavorable prognosis. b. Group II, favorable prognosis. c. Group IV, unfavorable prognosis. d. Group III, doubtful prognosis. e. Group I, very favorable prognosis.

b. Group II, favorable prognosis.

The parent contacts the health care provider because their preschool-age child has a temperature of 101.5°F (38.6°C). The child received outpatient chemotherapy 1 week ago. Which is the most appropriate response by the nurse? a. Ask whether any family members or other close associates are ill. b. Have the parent bring the child to the pediatric oncology clinic as soon as possible. c. Instruct the parent to immediately obtain and give the antibiotic that the oncologist calls in to the pharmacy. d. Instruct the parent to administer acetaminophen every 4 hours until the fever dissipates.

b. Have the parent bring the child to the pediatric oncology clinic as soon as possible.

A 10-year-old male presents with low-grade fever, nausea, and abdominal pain. The nurse examining him suspects appendicitis and checks for rebound tenderness in what quadrant? a. Upper right. b. Lower right. c. Upper left. d. Lower left.

b. Lower right.

The nurse is collecting data from a child who may have a seizure disorder. Which nursing observations suggest an absence seizure? a. Sudden, momentary loss of muscle tone, with a brief loss of consciousness. b. Minimal or no alteration in muscle tone, with a brief loss of responsiveness or attention. c. Muscle tone maintained and child frozen in position. d. Brief, sudden contracture of a muscle or muscle group.

b. Minimal or no alteration in muscle tone, with a brief loss of responsiveness or attention.

The nurse is caring for a 9-month-old with cryptorchidism noted on the medical record. In which manner will the nurse assess this condition? a. Note any bruising on the skin. b. Palpate the scrotum for the testes. c. Auscultate for bowel sounds. d. Assess the upper extremity strength.

b. Palpate the scrotum for the testes.

A nurse is assessing a 3-year-old child for possible bacterial meningitis. Which sign would indicate irritation of the meninges? a. Negative Kernig sign. b. Positive Kernig sign. c. Positive Chadwick sign. d. Negative Brudzinski sign.

b. Positive Kernig sign.

The nurse is caring for a child with idiopathic thrombocytopenic purpura with a platelet count of 24,000/mm3. Which health care provider prescription will the nurse question? a. Transfuse 1 unit of platelets. b. Provide ibuprofen as needed for pain. c. Administer prednisone orally. d. Give intravenous immunoglobulin (IVIG).

b. Provide ibuprofen as needed for pain.

In caring for the child with asthma, the nurse recognizes that bronchodilator medications are administered to children with asthma for which reason? a. Prevention of mild symptoms. b. Relief of acute symptoms. c. To stabilize the cell membranes. d. Management of chronic pain.

b. Relief of acute symptoms.

The nurse is caring for a child diagnosed with hydronephrosis. Which manifestation is consistent with complications of the disorder? a. hypothermia. b. hypertension. c. tachycardia. d. hypotension.

b. hypertension.

The nurse is caring for a 6-month-old infant with diarrhea and dehydration. The parent is concerned because the infant has some patches on the tongue. Which feature indicates a geographic tongue? a. There are also plaques on the buccal mucosa. b. Some patches are light in color and other patches are dark in color. c. The patches are thick, white plaques on the tongue. d. There are also white patches on the erupted teeth.

b. Some patches are light in color and other patches are dark in color.

An adolescent is diagnosed with hepatitis A. Which problem should be considered when planning care? a. The adolescent will be very irritable and perhaps require sedation. b. The adolescent will become fatigued easily. c. The adolescent's urine will be dark and infectious. d. Hypothermia is common.

b. The adolescent will become fatigued easily.

The nurse is caring for a child who is suspected to have a growth hormone deficiency. Which finding after further testing supports this diagnosis? a. Magnetic resonance imaging shows a brain tumor. b. The bone age is found to be two or more deviations below normal. c. Physical examination finds excessive foot and finger growth for age. d. Computed tomography identifies a tumor on the child's kidney.

b. The bone age is found to be two or more deviations below normal.

The nurse is taking a health history for a 3-year-old girl suspected of having pneumonia who presents with a fever, chest pain, and cough. Which information places the child at risk for pneumonia? a. The child was a postmaturity date infant. b. The child attends day care. c. The child is a triplet. d. The child has diabetes.

b. The child attends day care.

A nurse is providing teaching to a child receiving chemotherapy and the parents. The nurse determines that the teaching was successful when the parents state that they will contact the primary health care provider if which occurs? a. The child has a bruise on the arm. b. The child has redness or swelling at the central venous access site. c. The child has no appetite because of nausea. d. The child has increased urinary output or vomiting.

b. The child has redness or swelling at the central venous access site.

The nurse is caring for a child diagnosed with Legg-Calvé-Perthes disease (LCPD). What is the most important nursing intervention for the nurse to include in working with this child and his caregivers? a. The nurse should support the caregivers in restricting activity during the treatment. b. The nurse should help the caregivers to understand and help the child to effectively use the corrective devices. c. The nurse should be a contact person when the child is hospitalized. d. The nurse should provide information when the child or caregiver requests it

b. The nurse should help the caregivers to understand and help the child to effectively use the corrective devices.

The nurse is reviewing the causative organisms noted on laboratory reports. Which organism is transmitted solely by sexual contact? a. Borelli. b. Trichomonas. c. Bacillus. d. Cholera bacterium.

b. Trichomonas.

A child presents to the primary care setting with enuresis, nocturia, increased hunger, weight loss, and increased thirst. What does the nurse suspect? a. Syndrome of inappropriate diuretic hormone. b. Type 1 diabetes mellitus. c. Hypothyroidism. d. Diabetes insipidus.

b. Type 1 diabetes mellitus.

The nurse is preparing clients for diagnostic testing for cancer. Which test is used to differentiate a neuroblastoma from other tumors? a. Urinalysis. b. Urine catecholamine metabolites, homovanillic acid (HVA), and vanillylmandelic acid (VMA). c. Serum chemistries. d. Complete blood count (CBC) with differential.

b. Urine catecholamine metabolites, homovanillic acid (HVA), and vanillylmandelic acid (VMA).

A 6-week-old infant is diagnosed with pyloric stenosis. When taking a health history from the parent, which symptom would the nurse expect to hear described? a. Chronic diarrhea. b. Vomiting immediately after feeding. c. Vomiting about 2 hours after feeding. d. Refusal to eat.

b. Vomiting immediately after feeding.

The caregiver of a child with a history of ear infections calls the nurse and reports that her son has just told her his urine "looks funny." He also has a headache, and his mother reports that his eyes are puffy. Although he had a fever 2 days ago, his temperature is now down to 100℉ (37.8℃). The nurse encourages the mother to have the child seen by the care provider because the nurse suspects the child may have: a. rheumatic fever. b. acute glomerulonephritis. c. lipoid nephrosis (idiopathic nephrotic syndrome). d. a urinary tract infection.

b. acute glomerulonephritis.

A mother brings her 3-year-old son to the ER and tells the triage nurse that he has been vomiting blood. A medical history determines that the 3-year-old has no history of GI disturbances and his only symptoms are a slightly elevated fever and vomiting bright red blood. Based on these symptoms, what condition might the nurse suspect? a. GI tract obstruction. b. acute upper GI bleeding. c. gastroesophageal reflux. d. intussusception.

b. acute upper GI bleeding.

The parents of a 10-month-old child bring the infant to the emergency department after finding the infant face down in the bathtub. The parent states, "I just left the bathroom to answer the phone." Which assessments are priority for the nurse to complete? Select all that apply. a. signs of child abuse (child mistreatment). b. airway. c. circulation. d. respiratory status. e. vital signs. f. pupillary response. g. level of consciousness.

b. airway. c. circulation. d. respiratory status.

An infant is placed in Bryant traction. For Bryant traction to be effective, the infant must be positioned on the: a. stomach with both legs extended. b. back with hips up off the bed. c. back with hips flat on the bed. d. back with the injured hip flexed and the uninjured one extended.

b. back with hips up off the bed.

The nurse is reinforcing dietary teaching with the caregiver of a child diagnosed with celiac syndrome. Which foods would be permitted in the diet of the child with celiac syndrome? Select all that apply. a. rye bread. b. bananas. c. wheat bread. d. skim milk. e. applesauce.

b. bananas. d. skim milk. e. applesauce.

A child is scheduled for a urea breath test. The nurse understands that this test is being performed for which reason? a. determine esophageal contractility. b. detect Helicobacter pylori. c. confirm pancreatitis. d. evaluate gastric pH.

b. detect Helicobacter pylori.

The nurse develops a meal plan for a child with iron-deficiency anemia. Which meal would the nurse teach the parent has the highest amount of iron? a. chicken, corn, brown rice, and oranges. b. red meat, eggs, oatmeal, and dried fruit. c. pork, broccoli, white rice, and strawberries. d. tuna salad with eggs, whole wheat crackers, and blueberries.

b. red meat, eggs, oatmeal, and dried fruit.

A nurse is preparing a plan of care for an infant who has undergone surgery to repair a myelomeningocele. The nurse would include placing the infant in which positions postoperatively? Select all that apply. a. supine. b. right side lying. c. left side lying. d. prone. e. semi-Fowler.

b. right side lying. c. left side lying. d. prone.

The type of traction in which a pin, wire, tongs, or other device is surgically inserted through a bone is: a. Russell traction. b. skeletal traction. c. Buck extension traction. d. skin traction.

b. skeletal traction.

Dexamethasone is often prescribed for the child who has sustained a severe head injury. Dexamethasone is a(n): a. diuretic. b. steroid. c. anticonvulsant. d. antihistamine.

b. steroid.

The nurse is teaching the parents of a 15-year-old boy who is being treated for acute myeloid leukemia about the side effects of chemotherapy. For which symptoms should the parents seek medical care immediately? a. blisters, ulcers, or a rash appear. b. temperature of 101°F (38.3°C) or greater. c. difficulty or pain when swallowing. d. earache, stiff neck, or sore throat.

b. temperature of 101°F (38.3°C) or greater.

A newborn has been diagnosed with a congenital heart disease. Which congenital heart disease is associated with cyanosis? a. coarctation of aorta. b. tetralogy of Fallot. c. aortic stenosis. d. pulmonary stenosis.

b. tetralogy of Fallot.

The nurse is using the pediatric Glasgow Coma Scale to assess a child's level of consciousness. What would the nurse assess? Select all that apply. a. fontanels (fontanelles). b. verbal response. c. motor response. d. posture. e. eye opening.

b. verbal response. c. motor response. e. eye opening.

A 2-year-old client and the parents are at the office for a follow-up visit. The client has had excessive hormone levels in the recent blood work, and the parents question why this was not found sooner. How should the nurse respond? a. "Endocrine disorders are hard to detect and you are lucky that we have found it when we did." b. "Have there been signs and symptoms that you should have reported to the doctor?" c. "As endocrine functions become more stable throughout childhood, alterations become more apparent." d. "It takes time to determine the level of functioning of endocrine glands."

c. "As endocrine functions become more stable throughout childhood, alterations become more apparent."

A 4-week-old infant is diagnosed with acute bronchiolitis. The parent states, "I do not know how the baby got this!" How should the nurse respond? a. "Do any family members have history of asthma?" b. "Do you have air conditioning in your house?" c. "Has your infant been around any crowds?" d. "Do you have allergies in the family?"

c. "Has your infant been around any crowds?"

A 4-week-old infant is diagnosed with acute bronchiolitis. The parent states, "I do not know how the baby got this!" How should the nurse respond? a. "Do you have allergies in the family?" b. "Do any family members have history of asthma?" c. "Has your infant been around any crowds?" d. "Do you have air conditioning in your house?"

c. "Has your infant been around any crowds?"

The nurse has performed client education for a 15-year-old boy with Crohn disease and his parents regarding the cobblestone lesions in his small intestine. Which comment by the family indicates learning has occurred? a. "I have a lot of diarrhea every day because of how my small intestine is damaged." b. "I may end up with a colectomy because the disease is continuous from the beginning to the end of my intestines." c. "I have to be careful because I am prone to not absorbing nutrients." d. "It's unusual for someone my age to get Crohn disease."

c. "I have to be careful because I am prone to not absorbing nutrients."

The nurse is caring for a toddler taking ferrous sulfate for severe iron-deficiency anemia. Which report by the parent is most concerning? a. "My child takes ferrous sulfate after meals." b. "My child's stools are darker than usual." c. "I mix ferrous sulfate with milk in a bottle." d. "I brush my child's teeth once every day."

c. "I mix ferrous sulfate with milk in a bottle."

The nurse is auscultating the lungs of a lethargic, irritable 6-year-old boy and hears wheezing. The nurse will most likely include which teaching point if the child is suspected of having asthma? a. "We're going to go take a look at your lungs to see if there are any sores on them." b. "I'm going to hold your hand while the phlebotomist gets blood from your arm." c. "I'm going to have this hospital worker take a picture of your lungs." d. "I'm going to have the respirator

c. "I'm going to have this hospital worker take a picture of your lungs."

The nurse is providing education to a client newly diagnosed with asthma. Which statement by the parents indicates additional teaching is needed? a. "Our family dog will need to go live with a grandparent." b. "We will both enroll in smoking cessation classes." c. "It is okay for our child to do chores such as sweeping the floor." d. "We will keep an albuterol inhaler with our child at all times."

c. "It is okay for our child to do chores such as sweeping the floor."

The parents of a 5-year-old child with a cardiovascular disorder tell the nurse they don't understand why their child isn't gaining weight, "We make sure our child has 3 very nutritious meals every day." How should the nurse respond? a. "Are you sure you are making nutrient-dense foods?" b. "It's hard to get your child to eat enough at this age to maintain their weight since they are expending so much energy with the heart condition." c. "It's great you are providing nutritious meals, but small

c. "It's great you are providing nutritious meals, but small, frequent meals will tire your child less and promote weight gain."

The nurse is caring for a 6-year-old boy with myelomeningocele. The nurse is teaching the mother how to promote appropriate bowel elimination and avoid constipation. Which response from the mother indicates a need for further teaching? a. "He must have an adequate amount of fluid." b. "I can palpate his abdomen to assess for constipation." c. "My son's activity is too limited to stimulate his bowels." d. "I need to figure out his usual pattern for passing stool."

c. "My son's activity is too limited to stimulate his bowels."

An 8-year-old client is suffering from allergic rhinitis (hay fever). Which statement will the nurse include when providing education to the client's caregiver? a. "Penicillin is the treatment of choice. Be sure your child takes the entire prescribed amount." b. "Your child needs to avoid peanuts until further testing is completed." c. "Pollen is a cause of these symptoms. Allergy medicine may help your child." d. "When bathing, your child needs to use a mild soap, free of dye and fragrance."

c. "Pollen is a cause of these symptoms. Allergy medicine may help your child."

The parent of a 12-year-old child with Reye syndrome approaches the nurse wanting to know how this happened to the child, saying, "I never give my children aspirin!" What could the nurse say to begin educating the parent? a. "Aspirin in combination with the virus will make the brain swell and the liver fail." b. "Do not worry; you are in good hands. We have it under control now." c. "Sometimes it is hard to tell what products may contain aspirin." d. "Do you think that maybe your child took aspirin on his or her own?"

c. "Sometimes it is hard to tell what products may contain aspirin."

The nurse is educating parents of a male infant with Chiari type II malformation. Which statement about their child's condition is most accurate? a. "You won't need to change diapers often." b. "You'll see a big difference after the surgery." c. "Take your time feeding your baby." d. "Lay him down after feeding."

c. "Take your time feeding your baby."

The nurse is collecting data on a 2-year-old child admitted with a diagnosis of gastroenteritis. When interviewing the caregivers, which question is most important for the nurse to ask? a. "How long has your child been toilet trained?" b. "How many times a day does your child urinate?" c. "Tell me about the types of stools your child has been having." d. "What foods has your child eaten during the last few days?"

c. "Tell me about the types of stools your child has been having."

The caregiver of a 1-year-old boy calls the nurse, upset that his wife has just told him that their son is being given a hormone. His wife says that the pediatrician called it human chorionic gonadotropic hormone but that is all she understood. The nurse most accurately clarifies the caregiver's question by making which statement regarding the son's treatment? a. "Your child's testes have not dropped, so the hormone is being administered to avoid causing degeneration until they do." b. "Without the treatment your child's gonads will not reach normal size." c. "The doctor is hoping that the hormone will cause your son's undropped testes to move into their proper place." d. "Without the hormone your son will have fluid that will collect in his scrotum."

c. "The doctor is hoping that the hormone will cause your son's undropped testes to move into their proper place."

The parents of a 2-year-old toddler newly diagnosed with tricuspid atresia ask the nurse, "I do not understand why our toddler's fingertips are spread out and rounder than normal fingertips?" Which response by the nurse is best? a. "Increased cardiac workload from your toddler's heart defect affects various parts of the body, including the fingers." b. "This is a common complication of tricuspid atresia. Unfortunately, there is nothing we can do to treat it." c. "The low blood oxygen levels fro

c. "The low blood oxygen levels from the heart defect causes the lack of oxygen to the fingers, causing these changes."

The nurse is speaking with a parent of a child diagnosed with scoliosis. The parent states, "I hate to think about my child having to wear a huge brace to treat this disorder. My best friend growing up had to wear one and she hated it." What is the best response by the nurse? a. "Unfortunately, bracing is the only option for treating this disorder. I'm sure your child will get used to it after a few weeks." b. "The newer braces only have to be worn while the child is asleep and don't have to be worn at school." c. "The newer type of braces fit under the arms and are made to fit under clothing. They aren't nearly as big as they used to be." d. "Braces have been replaced with surgical intervention. Your child will only wear a brace for a few weeks after the surgery."

c. "The newer type of braces fit under the arms and are made to fit under clothing. They aren't nearly as big as they used to be."

The nurse is conducting a wellness examination of a 6-month-old infant. The parent points out some dimpling and skin discoloration in the infant's lumbosacral area. What is the nurse's best response? a. "Dimpling, skin discoloration, and abnormal patches of hair are often indicators of spina bifida occulta." b. "This is often an indicator of spina bifida occulta as opposed to spina bifida cystica." c. "This can be considered a normal variant with no indication of a problem; however, the doctor will want to take a closer look." d. "This could be an indicator of spina bifida; we need to evaluate this further."

c. "This can be considered a normal variant with no indication of a problem; however, the doctor will want to take a closer look."

The nurse has been teaching the parents of a child diagnosed with osteogenesis imperfecta about the use of bisphosphonates for this condition. What statement by a parent indicates a need for further education? a. "My child's risk for fractures will hopefully be decreased as by taking this medication." b. "This medication will help to increase bone mineral density." c. "This medication will cure my child of this disorder." d. "This medication doesn't prevent fractures from happening."

c. "This medication will cure my child of this disorder."

The nurse has told the 14-year-old adolescent with diabetes that the doctor would like to have a hemoglobin A1C test performed. Which comment by the client indicates that she understands what this test is for? a. "The normal level for my hemoglobin A1C is between 60 to 100 mg/dl." b. "That is the test that I take after I have fasted for at least 8 hours." c. "This will tell my doctor what my average blood glucose level has been over the last 2 to 3 months." d. "I monitor my own blood glucose every day at home. I don't see why the doctor would want this done."

c. "This will tell my doctor what my average blood glucose level has been over the last 2 to 3 months."

A 13-year-old adolescent is being treated for scoliosis with a brace. During the first follow-up appointment after the brace was initiated, which statement by the adolescent indicates the need for further instruction? a. "I wear a t-shirt under my brace." b. "I check my brace daily to make sure there is no damage or change to it." c. "When I get home from school, I look forward to taking off my brace for a few hours before I go to bed." d. "I leave my brace on for gym at school."

c. "When I get home from school, I look forward to taking off my brace for a few hours before I go to bed."

The nurse is speaking with the parents of a child recently diagnosed with hypothyroidism. Which statement by a parent indicates an understanding of symptoms of this disorder? a. "My son's nervousness may be a symptom of his hypothyroidism." b. "Most people with hypothyroidism have smooth, velvety skin." c. "When they get my son's thyroid levels normal, he won't be so tired." d. "Heat intolerance is a caused by low thyroid levels."

c. "When they get my son's thyroid levels normal, he won't be so tired."

The nurse is caring for a 13-year-old girl with suspected autoimmune hepatitis. The girl inquires about the testing required to evaluate the condition. How should the nurse respond? a. "You will most likely have viral studies." b. "You will most likely have an ultrasound evaluation." c. "You will most likely have a blood test to check for certain antibodies." d. "You will most likely be tested for ammonia levels."

c. "You will most likely have a blood test to check for certain antibodies."

A nurse is reinforcing the diagnosis of constitutional delay by the health provider to a 13-year-old male adolescent. Which is the best approach for this teen? a. "It really doesn't matter how tall your dad is. The physician just looks at your height to make this diagnosis." b. "If you think you want testosterone shots, then I will get them scheduled for you." c. "You will not need medication because your hormone levels are normal. I would be glad to discuss these findings with you." d. "I would be worried about your short stature too and get a second opinion."

c. "You will not need medication because your hormone levels are normal. I would be glad to discuss these findings with you."

The nurse is caring for children at a local hospital. Which child warrants immediate attention from the nurse? a. 2-year-old child with clubbing noted on the fingers. b. 6-month-old infant with edema on the face and presacral area. c. 1-week-old newborn whose oxygenation is not improving with oxygen. d. 1-year-old child with a temporal temperature of 101°F (38.3°C).

c. 1-week-old newborn whose oxygenation is not improving with oxygen.

A 10-year-old child is newly diagnosed with type 1 diabetes. The child's hemoglobin A1C level is being monitored. The nurse determines that additional intervention is needed with the child based on which result? a. 6.5%. b. 7.5%. c. 8.5%. d. 7.0%.

c. 8.5%.

The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurately related to the diagnosis of pyloric stenosis? a. In this disorder the sphincter that leads into the stomach is relaxed. b. A partial or complete intestinal obstruction occurs. c. A thickened, elongated muscle causes an obstruction at the end of the stomach. d. There are recurrent paroxysmal bouts of abdominal pain.

c. A thickened, elongated muscle causes an obstruction at the end of the stomach.

Prior to discharging an infant with congenital hypothyroidism to home with the parents, what should the nurse emphasize regarding the care that this child will need going forward? a. Administration of vitamin C until after growth is complete. b. Vitamin K administration until school age. c. Administration of levothyroxine indefinitely. d. An increased intake of calcium beginning immediately.

c. Administration of levothyroxine indefinitely.

The parents of a child who was diagnosed with diabetes insipidus ask the nurse, "How does this disorder occur?" When responding to the parents, the nurse integrates knowledge that a deficiency of which hormone is involved? a. Insulin. b. Thyroxine. c. Antidiuretic hormone. d. Growth hormone.

c. Antidiuretic hormone.

In understanding the development of the musculoskeletal system, the nurse recognizes that what is implanted in a gel-like substance during fetal life? a. Ligaments. b. Tendons. c. Cartilage. d. Joints.

c. Cartilage.

The nurse knows that which condition is caused by excessive levels of circulating cortisol? a. Turner syndrome. b. Graves disease. c. Cushing syndrome. d. Addison disease.

c. Cushing syndrome.

What is the most common debilitating disease of childhood among those of European descent? a. Asthma. b. Pneumonia. c. Cystic fibrosis. d. BPD.

c. Cystic fibrosis.

A newborn is diagnosed with the salt-losing form of congenital adrenogenital hyperplasia. On what should the nurse focus when assessing this client? a. Excessive cortisone secretion. b. Bleeding tendency. c. Dehydration. d. Hypoglycemia.

c. Dehydration.

The nurse is administering medications to the child with congestive heart failure (CHF). Large doses of what medication are used initially in the treatment of CHF to attain a therapeutic level? a. Ferrous sulfate. b. Albuterol sulfate. c. Digoxin. d. Spironolactone.

c. Digoxin.

The nurse assesses that the client is at risk for an infection related to chemotherapy-induced immunosuppression. What will the nurse include in the teaching plan for the child and parents to help reduce this risk? Select all that apply. a. Cheer up the environment with fresh flowers and plants. b. Encourage frequent contact with multiple visitors. c. Encourage frequent, thorough handwashing. d. Have the child sleep in a single bed and room. e. Provide a low-carbohydrate, low-protein diet.

c. Encourage frequent, thorough handwashing. d. Have the child sleep in a single bed and room.

An adolescent receiving chemotherapy has lost all hair and is sad about self-image. Which action should the nurse take to support this adolescent and involve the client in decision making? a. Refer the adolescent to a peer support group. b. Support the adolescent's choice of comfortable clothing. c. Encourage the adolescent to select hats or wigs to fit one's personality. d. Have a Child Life specialist work with the adolescent.

c. Encourage the adolescent to select hats or wigs to fit one's personality.

The caregivers of a child report that their child had a cold and complained of a sore throat. When interviewed further they report that the child has a high fever, is very anxious, and is breathing by sitting up and leaning forward with the mouth open and the tongue out. The nurse recognizes these symptoms as those seen with which disorder? a. Laryngotracheobronchitis. b. Tonsillitis. c. Epiglottitis. d. Spasmodic laryngitis.

c. Epiglottitis.

The pediatric nurse examines the radiographs of a client that indicate lesions on the bone. This finding is indicative of: a. Hodgkin disease. b. non-Hodgkin lymphoma. c. Ewing sarcoma. d. neuroblastoma.

c. Ewing sarcoma.

A toddler who is beginning to walk has fallen and hit his head on the corner of a low table. The caregiver has been unable to stop the bleeding and brings the child to the pediatric clinic. The nurse is gathering data during the admission process and notes several bruises and swollen joints. A diagnosis of hemophilia is confirmed. This child most likely has a deficiency of which blood factor? a. Factor X. b. Factor V. c. Factor VIII. d. Factor XIII.

c. Factor VIII.

During an assessment of an adolescent child, the nurse notes that the child has a protuberant tongue, fatigued appearance, poor muscle tone, and exophthalmos. What medical diagnosis would the nurse expect the child to have? a. Cushing disease. b. diabetes. c. Graves disease. d. syndrome of inappropriate antidiuretic hormone secretion (SIADH).

c. Graves disease.

The student nurse is developing a care plan for a child who suffered a fractured tibia and will have a cast on his lower leg for approximately 6 weeks. Which nursing diagnosis would be the priority for this client? a. Pain related to chronic inflammation of the lower leg. b. Deficient diversional activities related to a need for imposed activity restriction for 6 weeks. c. Impaired physical mobility related to a cast on the leg. d. Situational low self-esteem related to the use of a walker.

c. Impaired physical mobility related to a cast on the leg.

A nurse is reviewing blood work for a child with a cyanotic heart defect. What result would most likely be seen in a client experiencing polycythemia? a. Increased WBC. b. Decreased RBC. c. Increased RBC. d. Decreased WBC.

c. Increased RBC.

The nurse is administering 2 puffs of an albuterol sulfate inhaler to a 4-year-old. Which side effect would the nurse instruct the parent to most likely expect? a. Increased mucus expectoration. b. Increased nonproductive cough. c. Increased heart rate and restlessness. d. Drowsiness causing a nap.

c. Increased heart rate and restlessness.

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

c. It is difficult to keep the child awake.

The nurse is caring for a child diagnosed with low functioning parathyroid. Which is a treatment goal of a child with hypoparathyroidism? a. Assure the parents have a plan in place for periods of low glucose levels if noted. b. Provide the parents a specific dietary plan for high-phosphorus foods to be eaten. c. Maintain the child's calcium level at a normal level with calcium replacement as prescribed. d. Provide the child and parent with a referral to a pediatric gastrointestinal specialist.

c. Maintain the child's calcium level at a normal level with calcium replacement as prescribed.

A nurse suspects a child is experiencing cardiac tamponade after heart surgery. What would be the priority nursing intervention? a. Elevate the head of the bed. b. Observe vitals every two hours. c. Notify the doctor immediately. d. Administer epinephrine.

c. Notify the doctor immediately.

The nurse is caring for a teenager diagnosed with acute pancreatitis. Which order would the nurse question? a. serum amylase levels. b. nasogastric tube placed to suction. c. PO pain management. d. NPO.

c. PO pain management.

A nurse is caring for a child with Kawasaki disease. Which assessment finding would the nurse expect to see? a. Low blood pressure and decreased heart rate. b. Decreased heart rate and impalpable pulse. c. Peeling hands and feet; fever. d. Irritability and dry mucous membranes.

c. Peeling hands and feet; fever.

A nurse is providing care to a toddler with nephroblastoma and is being evaluated. Which nursing action would be most important? a. Preparing the child for chemotherapy. b. Preventing weight-bearing activities. c. Placing a "no abdominal palpation" sign above the child's bed. d. Restricting the child's visitors. e. Ensuring that the child be allowed nothing by mouth.

c. Placing a "no abdominal palpation" sign above the child's bed.

When reviewing the record of a child with tetralogy of Fallot, what would the nurse expect to discover? a. Leukopenia. b. Anemia. c. Polycythemia. d. Increased platelet level.

c. Polycythemia.

A parent brings an infant in for poor feeding and listlessness. Which assessment data would most likely indicate a coarctation of the aorta? a. Pulses weaker in upper extremities compared to lower extremities. b. Cyanosis with crying. c. Pulses weaker in lower extremities compared to upper extremities. d. Cyanosis with feeding.

c. Pulses weaker in lower extremities compared to upper extremities.

A 3-month-old boy is found to have undescended testes. The parents are concerned. What should the nurse anticipate as the next step for this client? a. Perform karyotyping to establish the client's gender. b. Administer low-dose human chorionic gonadotropin hormone. c. Reassess the client's testes at 6 months of age. d. Schedule emergency orchiopexy to correct the condition.

c. Reassess the client's testes at 6 months of age.

A nurse is caring for a 12-year-old girl who is recovering from surgery for removal of a brain tumor. Which intervention should the nurse implement to avoid increasing intracranial pressure? a. Apply saline eye drops, as prescribed. b. Place a sterile towel under wet dressings. c. Regulate the rate of IV fluid infusions carefully. d. Sponge the client's face.

c. Regulate the rate of IV fluid infusions carefully.

Which nursing diagnosis should the nurse identify as being the most appropriate for a child with idiopathic thrombocytopenic purpura? a. Risk for infection related to abnormal immune system. b. Risk for altered urinary elimination related to kidney impairment. c. Risk for bleeding related to insufficient platelet formation. d. Ineffective breathing pattern related to decreased white blood count.

c. Risk for bleeding related to insufficient platelet formation.

When providing care to a child with vesicoureteral reflux (VUR), which nursing diagnosis would be the priority? a. Activity intolerance. b. Excess fluid volume. c. Risk for infection. d. Imbalanced nutrition less than body requirements.

c. Risk for infection.

The nurse is caring for a 10-year-old boy with end-stage kidney disease (ESKD) with metabolic acidosis. What would the nurse expect to administer if ordered? a. Vitamin D. b. Erythropoietin. c. Sodium bicarbonate tablets. d. Ferrous sulfate.

c. Sodium bicarbonate tablets.

The nurse is caring for a 6-month-old infant who was admitted to the emergency department 24 hours ago with signs of severe diarrhea. The infant's rectal temperature is 104°F (40°C), with weak and rapid pulse and respirations. The skin is pale and cool. The child is on IV rehydration therapy, but the diarrhea is persisting. The infant has not voided since being admitted. Which is the priority nursing intervention? a. Feed the child a cracker. b. Administer IV potassium. c. Take a stool culture. d. Administer antibiotic therapy.

c. Take a stool culture.

A 14-year-old girl with a fractured leg is receiving instructions from the nurse on how to use crutches. Which intervention should the nurse implement to help prevent nerve palsy in the client? a. Assess the tips of the crutches to be certain the rubber tip is intact. b. Caution parents to clear articles such as throw rugs out of paths at home. c. Teach the client not to rest with the crutch pad pressing on the axilla. d. Be certain the child is walking with the crutches about 6 inches to the side of the foot.

c. Teach the client not to rest with the crutch pad pressing on the axilla.

The nurse is caring for a 5-month-old boy with an undescended left testis. What would the nurse identify as indicative of true cryptorchidism? a. Fluid detected in scrotal sac. b. Testis can briefly be brought into scrotum. c. Testis cannot be "milked" down inguinal canal. d. Venous varicosity detected along the spermatic cord.

c. Testis cannot be "milked" down inguinal canal.

A pediatric client is scheduled for an intravenous pyelogram (IVP) of the kidney this afternoon. Which situation would require immediate attention by the nurse? a. The child is diapered. b. The child's appetite is poor. c. The child does not have intravenous access. d. The child is unable to ambulate.

c. The child does not have intravenous access.

The nurse sees a 3-year-old child in the ambulatory setting for localized wheezing on auscultation. Which statement by the parent would be most important to report to the health care provider? a. The child received the pneumococcal vaccine series within his or her first year. b. The parent has supervised the child in the same room for the past 24 hours. c. The child was eating peanuts yesterday. d. The child has two cousins who have many allergies.

c. The child was eating peanuts yesterday.

When examining a child with congenital heart disease, an organ in the upper right quadrant of the abdomen can be palpated at 4 cm below the rib cage. What would most likely explain this assessment finding? a. The spleen size increases due to increased destruction of red blood cells. b. The spleen size increases due to frequent infection. c. The liver size increases in right-sided heart failure. d. The liver size increases due to cardiac medications.

c. The liver size increases in right-sided heart failure.

A 6-year-old boy has a moon-face, stocky appearance but with thin arms and legs. His cheeks are unusually ruddy. He is diagnosed with Cushing syndrome. What is the most likely cause of this condition in this child? a. Tumor of the thyroid. b. Tumor of the parathyroid. c. Tumor of the adrenal cortex. d. Tumor of the pancreas.

c. Tumor of the adrenal cortex.

The caregivers of an 8 y/o bring their child to the pediatrician & report that the child hasn't had breathing problems before, but since taking up lacrosse the child has been coughing & wheezing at the end of every practice and game. Their friend's child has often been hospitalized for asthma; they are concerned that their child has a similar illness. The nurse knows that because the problems seem to be directly related to exercise, it is likely that the child will be able to be treated w/: a.

c. a bronchodilator & mast cell stabilizers.

The nurse is planning care for a school-aged child recovering from being hit by a motor vehicle while riding a bicycle. For what will the nurse assess to determine the onset of disseminated intravascular coagulation (DIC) in this child? a. nausea and vomiting. b. blurred vision. c. bleeding from intravenous sites. d. sudden onset of knee pain.

c. bleeding from intravenous sites.

The student nurse is collecting data on a child diagnosed with cystic fibrosis and notes the child has a barrel chest and clubbing of the fingers. In explaining this manifestation of the disease, the staff nurse explains the cause of this symptom to be: a. decreased respiratory capacity. b. impaired digestive activity. c. chronic lack of oxygen. d. high sodium chloride concentration in the sweat.

c. chronic lack of oxygen.

After teaching a group of students about endocrine disorders, the instructor determines that the teaching was successful when the students identify insulin deficiency, increased levels of counterregulatory hormones, and dehydration as the primary cause of which condition? a. ketonuria. b. ketone bodies. c. diabetic ketoacidosis. d. glucosuria.

c. diabetic ketoacidosis.

The nurse is teaching a child with type 1 diabetes mellitus to administer insulin. The child is receiving a combination of short-acting and long-acting insulin. The nurse knows that the child has appropriately learned the technique when the child: a. administers the insulin into a doll at a 30-degree angle. b. wipes off the needle with an alcohol swab. c. draws up the short-acting insulin into the syringe first. d. administers the insulin intramuscularly into rotating sites.

c. draws up the short-acting insulin into the syringe first.

A child is admitted to the pediatric medical unit with the diagnosis of syndrome of inappropriate antidiuretic hormone (SIADH). The child experiences the typical signs and symptoms of this disorder. Which concern will the nurse include in care planning? a. delayed growth and development risk. b. altered nutrition risk. c. excess fluid volume risk. d. noncompliance because of difficulty coping.

c. excess fluid volume risk.

The nurse in a pediatric cardiovascular clinic is talking with the father of a 5-year-old child who underwent cardiac surgery for a heart defect at the age of 3. The father reports that the child has been having increased shortness of breath, tires easily after playing, and has been gaining weight. The nurse is aware that the child is most likely demonstrating symptoms of which acquired cardiovascular disorder? a. infective endocarditis. b. cardiomyopathy. c. heart failure. d. Kawasaki Disease.

c. heart failure.

Through which mechanism is Duchenne muscular dystrophy acquired? a. virus. b. environmental toxins. c. heredity. d. autoimmune factors.

c. heredity.

A child is diagnosed with hypoparathyroidism. Which electrolyte imbalance would the nurse most likely expect to address? a. hypomagnesemia. b. hyponatremia. c. hypocalcemia. d. hyperkalemia.

c. hypocalcemia.

The nurse is concerned about the pediatric client's immune system after taking corticosteroids. Which laboratory study is the nurse most correct to assess? a. basophils. b. eosinophils. c. leukocyte count. d. red blood count.

c. leukocyte count.

The nurse is caring for a child with rickets. Which diagnostic test result would the nurse expect to find in the child's medical record? a. high serum phosphate levels. b. x-ray confirmation of adequate bone shape. c. low serum calcium levels. d. low alkaline phosphate levels.

c. low serum calcium levels.

A child is diagnosed with rheumatic fever. For which medication will the nurse educate the caregivers? a. phenytoin. b. antiviral. c. nonsterioidal anti-inflammatory drugs (NSAIDs). d. insulin.

c. nonsterioidal anti-inflammatory drugs (NSAIDs).

The first method of choice for obtaining a urine specimen from a 3-year-old child with a possible urinary tract infection is: a. performing a suprapubic aspiration. b. placing a cotton ball in the underwear to catch urine. c. obtaining a clean catch voided urine. d. placing an indwelling urinary catheter.

c. obtaining a clean catch voided urine.

The child has been diagnosed with leukemia. Rank the following medications used to treat leukemia in order based on the stage of treatment. a. low doses of 6-mercaptopurine and methotrexate. b. chemotherapy through an intrathecal catheter. c. oral steroids and vincristine through an intravenous line. d. high-dose methotrexate and 6-mercaptopurine.

c. oral steroids and vincristine through an intravenous line. d. high-dose methotrexate and 6-mercaptopurine. a. low doses of 6-mercaptopurine and methotrexate. b. chemotherapy through an intrathecal catheter.

The nurse is caring for a 3-year-old girl who is cyanotic and breathing rapidly. Which intervention is best to relieve these symptoms? a. saline lavage. b. saline gargles. c. oxygen administration. d. suction.

c. oxygen administration.

The nurse is conducting a physical examination of a 9-month-old infant with a suspected neuromuscular disorder. Which finding would warrant further evaluation? a. absence of tonic neck reflex. b. presence of symmetrical spontaneous movement. c. presence of Moro reflex. d. absence of Moro reflex.

c. presence of Moro reflex.

The nurse is caring for a child with a broken wrist that has just been placed in a cast. The nurse would elevate the arm to: a. discourage infection. b. ensure proper bone alignment. c. prevent edema. d. promote healing.

c. prevent edema.

A nurse is reviewing the medical record of a child who has sustained a fracture. Documentation reveals a bowing deformity. The nurse interprets this fracture as: a. bone buckling due to compression. b. incomplete fracture. c. significant bending without actual breaking. d. bone that breaks into two pieces.

c. significant bending without actual breaking.

The caregiver of a child diagnosed with celiac disease tells the nurse that the child has large amounts of bulky stools and what looks like fat in the stools. The clinical manifestation this caregiver is describing is: a. currant jelly stools. b. severe diarrhea. c. steatorrhea. d. projectile stools.

c. steatorrhea.

A child is hospitalized with nephrotic syndrome. Which measurement is best for the nurse to determine the child's edema? a. urine output, every shift. b. abdominal circumference. c. weight, daily. d. amount of protein in the urine.

c. weight, daily.

If there is a foreign body in the larynx, how will the client present? a. speaks clearly. b. edematous. c. with stridor. d. quietly.

c. with stridor.

The nurse is teaching the mother of an infant with a temporary ileostomy about stoma care. What is the most important instruction to emphasize to the mother to avoid an emergency situation? a. "Gather all of your supplies before you begin." b. "You may need adhesive remover to ease pouch removal." c. "You must be meticulous in caring for the surrounding skin." d. "Call the doctor immediately if the stoma is not pink/red and moist."

d. "Call the doctor immediately if the stoma is not pink/red and moist."

The nurse is teaching an in-service program to a group of nurses on the topic of children diagnosed with rheumatic fever. The nurses in the group make the following statements. Which statement is most accurate regarding the diagnosis of rheumatic fever? a. "This disorder is caused by genetic factors." b. "Being up-to-date on immunizations is the best way to prevent this disorder." c. "The onset and progression of this disorder is rapid." d. "Children who have this diagnosis may ha

d. "Children who have this diagnosis may have had strep throat."

A community health nurse is conducting a parenting class on respiratory syncytial virus (RSV). What statement made by a parent indicates that the teaching has been successful? a. "Early initiation of antibiotics can lessen the severity of the infection." b. "RSV season occurs primarily April through September." c. "Infants are less affected by RSV than older children." d. "Exposure to second- or third-hand smoke increases the risk for developing RSV."

d. "Exposure to second- or third-hand smoke increases the risk for developing RSV."

A nurse who is caring for a 7-year-old is providing client education to the child and caregiver. Which response by the caregiver demonstrates to the nurse that the caregiver understands the diagnosis of type 1 diabetes mellitus? a. "Her body fights against the insulin." b. "We will just have our child exercise and take medicine to cure this." c. "I will just feed my child healthy foods and sign her up for more sports." d. "Her body doesn't have any insulin."

d. "Her body doesn't have any insulin."

The health care provider has just informed the parents of a 3-year-old that their child has leukemia. The mother begins crying and tells the nurse she does not want her baby to die. What is the nurse's best response? a. "Don't worry, the health care provider is very good at treating leukemia." b. "I don't blame you for being upset; any parent would be scared too." c. "You are very lucky to have caught it so early; that makes the treatments easier." d. "I know this is scary, but leukemia has a high cure rate in children these days."

d. "I know this is scary, but leukemia has a high cure rate in children these days."

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

d. "I should position him on his abdomen with knees bent."

Parents tell the nurse who is admitting their infant for a well-child exam that they recently saw a "white glow" in their child's left pupil. What is the nurse's best response? a. "Most parents mention a red color." b. "A plugged tear duct would not be unusual." c. "Has your baby been rubbing either eye?" d. "I will report this to the pediatrician."

d. "I will report this to the pediatrician."

The parents of a 6-year-old child with idiopathic thrombocytopenic purpura (ITP) ask the nurse, "What causes this disease?" Which response by the nurse would be most appropriate? a. "ITP occurs when the body's iron stores are depleted due to rapid physical growth, inadequate iron intake, inadequate iron absorption, or loss of blood." b. "ITP is a serious bleeding disorder characterized by a decreased, absent, or dysfunctional coagulation." c. "ITP is characterized by the loss of surface area on the red blood cell membrane." d. "ITP is primarily an autoimmune disease in that the immune system attacks and destroys the body's own platelets, for an unknown reason."

d. "ITP is primarily an autoimmune disease in that the immune system attacks and destroys the body's own platelets, for an unknown reason."

An adolescent with scoliosis is refusing to wear the prescribed body brace. Which instruction is best to progress the adolescent to the treatment goals? a. "It is important to prevent herniation of a spinal disk, which is painful." b. "It is important to prevent torticollis." c. "It is important to correct spinal curvature before it gets too bad, causing you problems." d. "It is important to wear the brace now to stabilize your spinal alignment, decreasing your symptoms."

d. "It is important to wear the brace now to stabilize your spinal alignment, decreasing your symptoms."

The nurse is reinforcing teaching with a group of caregivers of children diagnosed with iron-deficiency anemia. One of the caregivers tells the group, "I give my child ferrous sulfate." Which statement made by the caregivers is correct regarding giving ferrous sulfate? a. "We watch closely for any diarrhea since that usually happens when he takes ferrous sulfate." b. "I always give the ferrous sulfate with meals." c. "When I give my son ferrous sulfate I know he also needs potassium supplements." d. "My husband gives our daughter orange juice when she takes her ferrous sulfate, so she gets Vitamin C."

d. "My husband gives our daughter orange juice when she takes her ferrous sulfate, so she gets Vitamin C."

A mother asks the nurse why her infant who was born at 34 weeks' gestation is being prescribed ferrous sulfate. Which response by the nurse is most appropriate? a. "Ferrous sulfate helps improve red blood cell formation." b. "Infants with pyloric stenosis require ferrous sulfate." c. "Your infant may have been having excessive diarrhea." d. "Preterm infants are at risk for iron-deficiency anemia."

d. "Preterm infants are at risk for iron-deficiency anemia."

A child who has been having seizures is admitted to the hospital for diagnostic testing. The child has had laboratory testing and an EEG, and is scheduled for a lumbar puncture. The parents voice concern to the nurse stating, "I don't understand why our child had to have a lumbar puncture since the EEG was negative." What is the best response by the nurse? a. "A lumbar puncture is a routine test that is performed anytime someone has a seizure disorder." b. "Since the EEG was negative there must be some other cause for the seizures. The lumbar puncture is necessary to determine what the cause is." c. "I know it must be frustrating not having a diagnosis yet, but you have to be patient. Seizure disorders are difficult to diagnose." d. "The lumbar puncture can help rule out any infection in fluid surrounding the brain and spinal cord as the cause of the seizures."

d. "The lumbar puncture can help rule out any infection in fluid surrounding the brain and spinal cord as the cause of the seizures."

The caregiver of a child who has had a cast applied to the leg observes the nurse putting adhesive tape strips around the edge of the cast. The caregiver asks the nurse why she is doing this. The best response by the nurse would be: a. "These will help the cast look more attractive so the child won't feel self-conscious." b. "We put these on so the child will not pull the padding from under the cast." c. "In case the child has an accident and misses the bedpan, these can be changed to keep the area dry." d. "These make a smooth edge on the cast so the skin is better protected."

d. "These make a smooth edge on the cast so the skin is better protected."

The nurse is preparing a client for surgery and the client asks, "What does it mean when they say they are going to reduce my abdominal hernia?" Which response by the nurse is most appropriate? a. "All this means is that the herniated intestines are twisted and edematous, which is why you need surgery." b. "If you do not understand this, I need to cancel your surgery and have the health care provider come back." c. "The health care provider will remove about half of the herniated contents during the procedure." d. "This means the hernia contents will be manipulated back into your peritoneal cavity during surgery."

d. "This means the hernia contents will be manipulated back into your peritoneal cavity during surgery."

A nurse is teaching the parents of a child diagnosed with rheumatic fever about prescribed drug therapy. Which statement would indicate to the nurse that additional teaching is needed? a. "If she needs dental surgery, we might need additional medication." b. "She needs to take the drug for the full 14 days." c. "To prevent another episode, she'll need preventive antibiotic therapy for at least 5 years." d. "We can stop the penicillin when her symptoms disappear."

d. "We can stop the penicillin when her symptoms disappear."

The nurse working at the child community clinic must administer the influenza vaccine to the high-risk children first. Which child would she choose first? a. 22-month-old client who has a wound from touching a hot pan at home. b. 12-month-old client who is very healthy. c. 21-month-old client who has a cold. d. 23-month-old client who had heart surgery as an infant for a defect.

d. 23-month-old client who had heart surgery as an infant for a defect.

The nurse is preparing the room for a client admitted from the emergency department with suspected tuberculosis (TB). Which type of infection control precautions would the nurse anticipate? a. Contact precautions. b. Standard precautions. c. Droplet precautions. d. Airborne precautions.

d. Airborne precautions.

The nurse is preparing to send a child with cancer for a radiation treatment. Which medication should the nurse provide to premedicate the child for this procedure? a. Analgesic. b. Antineoplastic. c. Antipyretic. d. Antiemetic.

d. Antiemetic.

The nurse is providing preoperative care for a 7-year-old boy with a brain tumor, as well as his parents. Which intervention is a priority? a. Providing a tour of the intensive care unit. b. Educating the child and parents about shunts. c. Having the child talk to another child who has had this surgery. d. Assessing the child's level of consciousness.

d. Assessing the child's level of consciousness.

A child has been prescribed desmopressin acetate for the treatment of diabetes insipidus. The client and the parents ask the nurse how this drug works. What is the correct response by the nurse? a. Desmopressin acetate works to help your kidneys work more efficiently. b. Desmopressin acetate works on your pancreas to stimulate insulin production. c. Desmopressin acetate is a synthetic form of insulin used to lower your blood sugar. d. Desmopressin acetate is a synthetic antidiuretic hormone that will slow down your urine output.

d. Desmopressin acetate is a synthetic antidiuretic hormone that will slow down your urine output.

The nurse is observing a 3-year-old boy who is sitting and playing in the waiting area of his pediatrician's office. The nurse calls the boy and his mother back for the boy's appointment. The boy rolls onto his stomach and pushes himself to his knees. Then he presses his hands against his ankles, knees, and thighs, walking up the front of his body, to stand. Which condition should the nurse suspect in this client? a. Facioscapulohumeral muscular dystrophy. b. Juvenile arthritis. c. Congenital myotonic dystrophy. d. Duchenne muscular dystrophy.

d. Duchenne muscular dystrophy.

The nurse is caring for a child admitted with gastroesophageal reflux (GER). Which clinical manifestation would likely be seen in this child? a. Severe constipation with occasional ribbon-like stools. b. Forceful vomiting followed by the child being eager to eat again. c. Bouts of diarrhea with failure to gain weight. d. Effortless vomiting just after the child has eaten.

d. Effortless vomiting just after the child has eaten.

The nurse caring for a client in a body cast knows that immobility can cause contractures, loss of muscle tone, or fixation of joints. Which nursing interdisciplinary intervention is recommended to help prevent these adverse conditions? a. Check for a normal capillary refill of 3 to 5 seconds on a daily basis to ensure there in adequate arterial supply. b. Give the client large, frequent meals with decreased fiber and increased protein and Vitamin C. c. Encourage child to stifle cough and take shallow breaths to prevent ineffective breathing patterns. d. Encourage active and passive range-of-motion activities to prevent ineffective tissue perfusion.

d. Encourage active and passive range-of-motion activities to prevent ineffective tissue perfusion.

The nurse is teaching the caregivers of a child with cystic fibrosis. What is most important for the nurse to teach this family? a. Avoid overprotecting the child. b. Be sure the child exercises daily. c. Watch out for signs that family members are overly stressed. d. Encourage everyone in the family to use good handwashing techniques.

d. Encourage everyone in the family to use good handwashing techniques.

An 8-year-old with cystic fibrosis has had a noted decline on the growth chart. Which nursing intervention is best for maintaining adequate nutrition? a. Provide high caloric meals to the client's liking. b. Limit sodium to a 2 gram sodium restricted diet c. Delay pancreatic enzymes until food enters the small intestine. d. Encourage high calorie, high protein snacks.

d. Encourage high calorie, high protein snacks.

A nurse is performing postoperative care on a child with a ureteral stent. Which intervention will help manage bladder spasms? a. Apply antibiotic ointment to tube site. b. Increase low-fat foods. c. Allow tubes to dangle freely to encourage flow. d. Encourage high fluid intake.

d. Encourage high fluid intake.

A 15-year-old client diagnosed with von Willebrand disease has reached menarche. Based on this fact, what information is most important for the nurse to convey to the client? a. Occasional skipped periods can be expected. b. The duration of each period will be short. c. Bruising may occur in the perineal area. d. Expect menstrual bleeding to be heavy.

d. Expect menstrual bleeding to be heavy.

A toddler who is beginning to walk has fallen and hit his head on the corner of a low table. The caregiver has been unable to stop the bleeding and brings the child to the pediatric clinic. The nurse is gathering data during the admission process and notes several bruises and swollen joints. A diagnosis of hemophilia is confirmed. This child most likely has a deficiency of which blood factor? a. Factor X. b. Factor V. c. Factor XIII. d. Factor VIII.

d. Factor VIII.

A pediatric nurse is discharging a 1-month-old infant. The infant was diagnosed with congenital hypothyroidism on this admission and will be treated with levothyroxine. The nurse knows it is important to teach the parent about medication administration. Which process will the nurse include in the teaching? a. Crush the medication and put it in the full bottle of formula so it tastes better. b. Explain that this treatment is administered until the child is 3 years of age. c. Administer the medication every other day. d. Give the crushed medication in a syringe mixed with a small amount of formula.

d. Give the crushed medication in a syringe mixed with a small amount of formula.

A nurse is providing care to a hospitalized child diagnosed with cerebral palsy. The nursing is preparing the family for discharge. What action by the nurse will most ensure the family's success after discharge? a. Provide pamphlets that outline resources for cerebral palsy. b. Arrange for a home care nurse to visit the family weekly. c. Ask the family what they perceive as their greatest challenge. d. Have the family meet with a case manager before discharge.

d. Have the family meet with a case manager before discharge.

A child is diagnosed with hyperthyroidism. What finding would the nurse expect to assess? a. Facial edema. b. Weight gain. c. Constipation. d. Heat intolerance.

d. Heat intolerance.

A neonatal nurse teaches students how to recognize gastrointestinal disorders in infants. The nurse tells the students that failure of the newborn to pass meconium in the first 24 hours after birth may indicate what disease? a. Ulcerative colitis (UC). b. Short bowel syndrome (SBS). c. Gastroenteritis. d. Hirschsprung disease.

d. Hirschsprung disease.

The caregivers of a child just diagnosed with diabetes express concern that they won't remember the different signs and symptoms of hyperglycemia and hypoglycemia. As a result, they are afraid they won't handle an emergency correctly. What is the best initial response by the nurse to help ensure the child's safety? a. Give the caregivers educational pamphlets and videos about diabetes. b. Suggest that the child wear an insulin pump for continuous insulin administration. c. Repeat the signs and symptoms over and over until they seem to understand. d. Instruct them to treat the reaction as if it's hypoglycemia, which is more likely.

d. Instruct them to treat the reaction as if it's hypoglycemia, which is more likely.

The nurse is preparing the medication leucovorin to provide to a child who is currently receiving methotrexate for a brain tumor. What should the nurse explain to the child and parents regarding the purpose of this medication? a. It is an experimental drug to ensure resistance to infection during methotrexate therapy. b. It helps methotrexate enter leukemia cells the same as insulin helps glucose enter cells. c. It will encourage bone marrow to build new cells after methotrexate therapy. d. It prevents methotrexate that is not incorporated into leukemia cells from entering normal cells.

d. It prevents methotrexate that is not incorporated into leukemia cells from entering normal cells.

A school-aged child with cancer is receiving chemotherapy. Which nursing action would best promote the oral comfort of a child receiving chemotherapy? a. Encouraging the use of acidic fruit juices to decrease mouth organisms. b. Having the child solely eat or drink cold foods to reduce mucosal pain. c. Vigorously brushing the teeth and gums to remove secretions. d. Keeping the child's lips moist with petroleum jelly to prohibit cracking.

d. Keeping the child's lips moist with petroleum jelly to prohibit cracking.

A school-aged child is admitted to the hospital with a vaso-occlusive sickle cell crisis. Which measure in the child's care plan should be given priority? a. Encouraging the child to take deep breaths hourly. b. Beginning active range-of-motion exercises. c. Seeing that the child ingests a protein-rich diet. d. Maintaining fluids through an intravenous line.

d. Maintaining fluids through an intravenous line.

The nurse is performing an assessment on a child suspected of having an inguinal hernia. Which assessment technique(s) should be used to assess for the presence of the hernia? Select all that apply. a. Ask the child to hold the breath and grunt forcefully. b. Ask the child to inhale forcefully while the inguinal canal is palpated. c. Press the palm of one hand on the abdomen and then withdraw the hand. d. Palpate the inguinal canal and ask the child to turn the head and cough. e. Palpate the inguinal canal while the child blows up a balloon.

d. Palpate the inguinal canal and ask the child to turn the head and cough. e. Palpate the inguinal canal while the child blows up a balloon.

The caregivers of a child who was diagnosed with cystic fibrosis 5 months ago report that they have been following all of the suggested guidelines for nutrition, fluid intake, and exercise, but the child has been having bouts of constipation and diarrhea. The nurse tells the caregiver to increase the amount of which substance in the child's diet? a. Iodized salt. b. Saturated fat. c. Calories from protein. d. Pancreatic enzymes.

d. Pancreatic enzymes.

The nurse is caring for a child admitted with pyloric stenosis. Which clinical manifestation would likely have been noted in the child with this diagnosis? a. Explosive diarrhea. b. Severe abdominal pain. c. Frequent urination. d. Projectile vomiting.

d. Projectile vomiting.

The nurse is caring for a child who has been admitted with a diagnosis of asthma. What laboratory/diagnostic tool would likely have been used for this child? a. Purified protein derivative test. b. Sweat sodium chloride test. c. Blood culture and sensitivity. d. Pulmonary functions test.

d. Pulmonary functions test.

During the newborn examination, the nurse notes that an infant who is appropriate for gestational age by birth weight has a head circumference below the 10th percentile and the fontanels (fontanelles) are not palpable. What action would the nurse take? a. Document that the infant has microcephaly. b. Tell the parent the infant's brain is underdeveloped. c. Reassess the head circumference in 24 hours. d. Report the findings to the pediatric health care provider.

d. Report the findings to the pediatric health care provider.

The nurse is preparing a care plan for a child who has a seizure disorder. The child experiences tonic-clonic seizures. Which nursing diagnosis will the nurse identify as having the highest priority? a. Risk for ineffective tissue perfusion: cerebral. b. Risk for self-care deficit: bathing and dressing. c. Risk for delayed development. d. Risk for injury.

d. Risk for injury.

The nurse is discussing types of treatment used when working with children who have orthopedic disorders. Which form of treatment covers the lower part of the body, usually from the waist down, and either one or both legs while leaving the feet open? a. Internal fixation device. b. Stockinette. c. External fixation device. d. Spica cast.

d. Spica cast.

An adolescent has hepatitis B. What would be the most important nursing action? a. Close observation to detect cerebral hallucinations. b. Conscientious collection of stool for ova and parasites. c. Strict calculation of caloric and vitamin B intake. d. Strict enforcement of standard precautions.

d. Strict enforcement of standard precautions

A child with Addison disease has been admitted with a history of nausea and vomiting for the past 3 days. The client is receiving IV glucocorticoids. Which intervention will the nurse perform? a. Weigh daily. b. Monitor sodium and potassium levels. c. Measure intake and output. d. Take glucometer readings as ordered.

d. Take glucometer readings as ordered.

A 14-year-old girl visits her gynecologist and is found to have vaginal candidiasis. She is obese, claims to not be sexually active, and is not on oral contraceptive pills. Which intervention should be considered for this client? a. Prescription of an antibiotic. b. Prescription for oral contraceptive pills. c. Insertion of antifungal tablets or creams in the morning. d. Test her urine for glucose to rule out diabetes mellitus.

d. Test her urine for glucose to rule out diabetes mellitus.

The nurse is preparing a child suspected of having a thyroid disorder for a thyroid scan. What information regarding the child should the nurse alert the doctor or nuclear medicine department about? a. The child has had an MRI of their leg within the past 6 weeks. b. The child is taking a vitamin supplement. c. The child wears a medical alert bracelet for diabetes. d. The child is allergic to shellfish.

d. The child is allergic to shellfish.

The nurse sees a 3-year-old child in the ambulatory setting for localized wheezing on auscultation. Which statement by the parent would be most important to report to the health care provider? a. The child received the pneumococcal vaccine series within his or her first year. b. The child has two cousins who have many allergies. c. The parent has supervised the child in the same room for the past 24 hours. d. The child was eating peanuts yesterday.

d. The child was eating peanuts yesterday.

A school nurse finds a 10-year-old's blood pressure is over the 95th percentile. The nurse advises the parent to seek medical attention for the child. What outcome would the nurse expect? a. The child will probably need surgery. b. Advise the child go to the emergency room. c. This is a normal result for a child this age. d. The child will need the blood pressure checked two more times.

d. The child will need the blood pressure checked two more times.

Which goal of therapy would be appropriate for a nurse to establish with a client's family and a client who has a diagnosis of enuresis? a. The parent takes the client to the bathroom at night. b. The client wets only when involved in an activity. c. The child wakes up once during the night for a glass of water. d. The client remains continent throughout the night.

d. The client remains continent throughout the night.

A 2-year-old toddler is seen for acute laryngotracheobronchitis. What observation would lead the nurse to suspect airway occlusion? a. The cough is becoming harsher. b. The toddler states being tired and wanting to sleep. c. The nasal discharge is increasing. d. The respiratory rate is gradually increasing.

d. The respiratory rate is gradually increasing.

A parent asks if her newborn's undescended testicles will need surgery to repair. What is the best response by the nurse? There is a chance the testicles will descend on their own. a. Surgery is not needed for this type of problem. b. This problem needs to be corrected immediately in the newborn period. c. If the infant is having swelling or pain, then surgery will be performed. d. There is a chance the testicles will descend on their own.

d. There is a chance the testicles will descend on their own.

An elementary school child takes metformin three times each day. Which disorder would the school nurse expect the child to have? a. Type 1 diabetes mellitus. b. Inflammatory bowel disorder. c. Gastrointestinal reflux. d. Type 2 diabetes mellitus.

d. Type 2 diabetes mellitus.

In caring for a child with nephrotic syndrome, which intervention will be included in the child's plan of care? a. Increasing fluid intake by 50 ml per hour. b. Testing the urine for glucose levels regularly. c. Ambulating 3 to 4 times a day. d. Weighing on the same scale each day.

d. Weighing on the same scale each day.

The nurse is caring for a 2-year-old girl with suspected vulvovaginitis. The nurse suspects the cause as Candida albicans based on which finding? a. Foul yellow-gray discharge. b. Irritation of labia and vaginal opening. c. Thin gray vaginal discharge with fishy odor. d. White cottage cheese-like discharge.

d. White cottage cheese-like discharge.

A group of students is reviewing information about bone healing in children. The students demonstrate understanding of this information when they state: a. callus production is slower (but greater in amount) in children than in adults. b. the process of breaking down and forming new bone is decreased in children compared with adults. c. a fracture closer to the growth plate heals much slower than one in the metaphysis. d. a child's bones heal more quickly than those of an adult.

d. a child's bones heal more quickly than those of an adult.

The nurse is teaching the parents of a young client who has recently been diagnosed with diabetes insipidus about the disease. The child is not secreting enough of which hormone? a. adrenocorticotropic hormone (ACTH). b. thyroid stimulating hormone (TSH). c. luteinizing hormone (LH). d. antidiuretic hormone (ADH).

d. antidiuretic hormone (ADH).

The nurse assesses a child and finds that the child's pupils are pinpoint. What does this finding indicate? a. intracranial mass. b. seizure activity. c. brain stem herniation. d. brain stem dysfunction.

d. brain stem dysfunction.

A newborn is born with hypothyroidism. If it is not recognized and treated, what complication is likely? a. muscle spasticity. b. dehydration. c. blindness. d. cognitive impairment.

d. cognitive impairment.

Insulin deficiency, in association with increased levels of counter-regulatory hormones and dehydration, is the primary cause of: a. glucosuria. b. ketone bodies. c. ketonuria. d. diabetic ketoacidosis.

d. diabetic ketoacidosis.

The nurse is assessing a 10-year-old girl recently fitted with a cast on her wrist. Which assessment finding would alert the nurse to a possible infection? a. pallor of the fingers. b. delayed capillary refill. c. diminished pulse. d. drainage on the cast.

d. drainage on the cast.

Which nursing objective is most important when working with neonates who are suspected of having congenital hypothyroidism? a. encouraging fluid intake. b. promoting bonding. c. allowing rooming in. d. early identification.

d. early identification.

A nurse taking a health history of a newborn notes that there is a maternal history of polyhydramnios. What GI condition might this history precipitate? a. pyloric stenosis. b. hernia. c. cleft palate. d. esophageal atresia (EA).

d. esophageal atresia (EA).

After assessing a child, the nurse suspects coarctation of the aorta based on a finding of: a. bounding pulse. b. hepatomegaly. c. narrow pulse. d. femoral pulse weaker than brachial pulse.

d. femoral pulse weaker than brachial pulse.

The nurse is caring for a child with leukemia. Which nursing intervention would be the highest priority for this child? a. grouping nursing care. b. providing age-appropriate activities. c. encouraging the child to share feelings. d. following guidelines for reverse isolation.

d. following guidelines for reverse isolation.

An 18-month-old infant is brought to the emergency department with flu-like symptoms. The infant is diagnosed with pneumonia secondary to aspiration of stomach contents. The nurse explains to the parents that pneumonia is a condition that often occurs secondary to: a. inflammatory bowel disease. b. cystic fibrosis. c. Hirschsprung disease. d. gastroesophageal reflux disease.

d. gastroesophageal reflux disease.

The nurse is conducting a physical examination of an infant with suspected pyloric stenosis. Which finding indicates pyloric stenosis? a. perianal fissures and skin tags. b. sausage-shaped mass in the upper mid abdomen. c. abdominal pain and irritability. d. hard, moveable "olive-like mass" in the upper right quadrant.

d. hard, moveable "olive-like mass" in the upper right quadrant.

The parent reports that the health care provider said that the infant had a hernia but cannot remember which type. When recalling what the health care provider said, the parent said that a surgeon will repair it soon and there is no problem with the testes. Which hernia type is anticipated? a. diaphragmatic hernia. b. umbilical hernia. c. hiatal hernia. d. inguinal hernia.

d. inguinal hernia.

An infant has been born and diagnosed with a meningocele. Which action will the nurse incorporate into each contact with this infant? a. careful supine positioning. b. auscultation for bowel sounds. c. listening for a shrill cry. d. inspection of the cystic sac on the child's back for leakage.

d. inspection of the cystic sac on the child's back for leakage.

A nurse is assessing the skin of a 12-year-old with suspected right ventricular heart failure. Where should the nurse expect to note edema in this child? a. hands. b. face. c. presacral region. d. lower extremities.

d. lower extremities.

The nurse is reviewing the medical record of a child with a cleft lip and palate. When reviewing the child's history, what would the nurse identify as a risk factor for this condition? a. history of hypoxia at birth. b. preterm birth. c. maternal use of acetaminophen in third trimester. d. mother age 42 with pregnancy.

d. mother age 42 with pregnancy.

The nurse caring for an 18-month-old infant with Meckel diverticulum knows that the most common clinical manifestation of this condition is: a. ischemia. b. respiratory distress. c. dehydration. d. painless rectal bleeding.

d. painless rectal bleeding.

The nurse is assessing a child and notices pinpoint hemorrhages appearing on several different areas of the body. The hemorrhages do not blanch on pressure. The nurse documents this finding as: a. ecchymosis. b. purpura. c. poikilocytosis. d. petechiae.

d. petechiae.

A mother is alarmed because her 6-week-old boy has begun vomiting almost immediately after every feeding. In the past week, the vomiting has grown more forceful, with the vomit projecting several feet from his mouth. He is always hungry again just after vomiting. At the physician's office, the nurse holds the child and offers him a bottle. While he drinks, the nurse notes an olive-size lump in his right abdomen. Which condition should the nurse suspect in this child? a. appendicitis. b. peptic ulcer disease. c. gastroesophageal reflux. d. pyloric stenosis.

d. pyloric stenosis.

A 3-month-old is admitted with severe diarrhea. Yesterday, the infant weighed 11 pounds (5 kg). Today, this infant weighs 9 pounds, 8 ounces (4.3 kg). Based on this information the nurse documents that the infant has: a. malabsorption syndrome. b. risk for fluid volume deficit. c. failure to thrive. d. severe dehydration.

d. severe dehydration.

The nurse identifies a nursing diagnosis of Ineffective airway clearance related to inflammation and copious thick secretions. What action is the priority? a. administering analgesics as ordered. b. monitoring oxygen saturation by pulse oximeter. c. administering oxygen as ordered. d. suctioning secretions from the airway.

d. suctioning secretions from the airway.

The parents of a preschool-age child learn their child is diagnosed with Duchenne muscular dystrophy (DMD), based on the nurse noting a Gower sign during a well-child visit. How should the nurse explain Gower sign to these parents? a. the pelvis position during gait. b. muscle twitching present during a quick stretch. c. a waddling-type gait. d. the way the child stands up.

d. the way the child stands up.

The nurse cares for a 7-year-old child with new-onset seizure disorder. Which prescription will the nurse anticipate for this client? a. vagus nerve stimulation. b. ketogenic diet. c. frequent temperature assessment. d. use of anticonvulsant medications.

d. use of anticonvulsant medications.

The nurse measures the client's blood glucose level prior to breakfast. The measurement obtained is 130 mg/dl. The orders read to administer 2 units of Humalog insulin for a blood glucose of 100 to 150 mg/dl. How soon should the nurse ensure that the client eats breakfast after receiving insulin? a. within 5 minutes. b. within 2 hours. c. within 60 to 90 minutes. d. within 15 to 30 minutes.

d. within 15 to 30 minutes.