peds exam 2

1,2,4

. A school-age child is diagnosed with hand, foot, and mouth disease. Which should the nurse instruct the parent to do when caring for the patient at home? Select all that apply. 1. Provide bland foods and fluids. 2. Offer generous amounts of oral fluids. 3. Wash clothes with hot soapy water and bleach. 4. Use acetaminophen or ibuprofen for pain control. 5. Instruct to flush the mouth with an alcohol-based mouthwash.

3,5

A 17-year-old patient with influenza tells the nurse, "I can't believe I got sick. I've been taking vitamin C, vitamin D, echinacea, and some other herbal remedies to boost my immune system." Which should the nurse say in response to this patient? Select all that apply. 1. "You probably weren't taking enough of the supplements." 2. "Those supplements help with focus and attention, not disease prevention." 3. "The safe use of supplements and herbs has not been determined." 4. "The vitamins you were taking may have reduced the effectiveness of the herbs." 5. "The effectiveness of supplements and herbs against influenza has not been determined."

3. A high level of protein in the urine

A 6-year-old patient is brought to the pediatrician's office with symptoms of feeling ill, periorbital edema, weight gain, and anorexia. The nurse suspects nephrotic syndrome. Which laboratory value confirms the nurse's suspicion? 1. Serum sodium of 138 mEq/L 2. Serum potassium of 4.5 mEq/L 3. A high level of protein in the urine 4. Low serum levels of high-density lipoprotein (HDL) and low-density lipoproteins (LDLs)

2. Positive for nitrites

A 9-year-old male patient arrives at the emergency department with suprapubic tenderness, nausea, vomiting, and painful urination. Which laboratory result does the nurse expect from a urinalysis (UA)? 1. White blood cells: 15,000 cells/L 2. Positive for nitrites 3. Potassium: 3.5 to 5.0 mEq/L 4. Hematocrit: 37%

1,3,4,5

A grandmother brings a toddler to a pediatric clinic and states, ―I am worried that my grandchild is not getting adequate care.‖ The nurse is able to verify the child is underweight for height and age. Which findings will cause the nurse to initiate additional assessment? Select all that apply. 1. The grandmother cannot provide an adequate feeding history. 2. The toddler's weight for height is less than the 20th percentile. 3. The toddler repeatedly asks if the nurse will get some food. 4. The toddler's evaluation at birth indicates prematurity. 5. The mother is a single parent and lives alone with the toddler.

4. Serum potassium of 5.7 mEq/L

A high school male adolescent arrives at the emergency department following a fall sustained while rock climbing. The physician prescribes diagnostic tests to rule out acute kidney injury (AKI). Which diagnostic finding does the nurse report immediately to the health-care provider? 1. Serum creatinine level of 0.6 2. Hematocrit level of 38% 3. Serum blood urea nitrogen (BUN) of 20 mg/dL 4. Serum potassium of 5.7 mEq/L

4. "I am suggesting you and your parents see a doctor who can help."

A middle-school teacher notifies the school nurse of a student who sleeps in class, smells of alcohol, and exhibits behavior impairment. The student tells the nurse, "I drink too much and want to quit, but I keep failing." Which recommendation does the nurse make to the student? 1. "You may be the perfect candidate for attending alcoholics anonymous (AA) meetings." 2. "Many young people benefit from individual and group therapy." 3. "Maybe you need a few days at home to see if you can quit on your own." 4. "I am suggesting you and your parents see a doctor who can help."

1,2,5

A neonate is born with a 6-cm omphalocele, in which the stomach and intestines are contained within a sac of amnio, peritoneum, and Wharton's jelly outside of the abdomen. For which additional anomalies will the nurse assess? Select all that apply. 1. Neural tube defects 2. Cardiac defects 3. Rupture of the sac 4. Herniation of the brainstem 5. Exstrophy of the urinary bladder

3. Protect the defect with a nonadherent sterile saline dressing.

A neonate is born with gastroschisis. Which action will the nurse perform immediately? 1. Prepare to tell the mother her newborn has a life-threatening birth. 2. Promote nonnutritive sucking to fulfill the neonate's needs. 3. Protect the defect with a nonadherent sterile saline dressing. 4. Place an orogastric tube to decompress the neonate's intestines

1. Difficult to arouse

A new parent contacts the health-care provider's office to ask for guidance regarding a change in the infant's health. For which reason should the nurse direct the parent to seek immediate medical attention? 1. Difficult to arouse 2. Wetting six diapers a day 3. Breastfeeding every 3 hours 4. Sleeping for several hours in the afternoon

4. Purulent drainage

A nurse is caring for a school-age child who has inflammation of the right eye. Which finding, if present, would indicate to the nurse that the child has bacterial conjunctivitis rather than viral conjunctivitis? 1. Eye swelling 2. Red conjunctiva 3. Watery discharge 4. Purulent drainage

4. Seek medical attention immediately if a fever develops.

A nurse is providing discharge instructions for a 2-month-old infant who was treated for a urinary tract infection (UTI). Which instruction would the nurse emphasize as being most important? 1. Avoid putting on the baby's diaper too tight. 2. Keep all follow-up appointments. 3. Ensure the child completes the entire course of antibiotics. 4. Seek medical attention immediately if a fever develops.

1. Elevated serum bilirubin

A parent arrives at the family clinic seeking medical attention for their 14-year-old child. The child has a fever, malaise, nausea, and abdominal pain. Which finding should indicate to the nurse that the patient is experiencing hepatitis A? 1. Elevated serum bilirubin 2. Greater than 10% atypical lymphocytes 3. Presence of the virus in nasal secretions 4. Positive Paul-Bunnell heterophile antibody test

4. UTI

A parent brings a 12-month-old toddler to the pediatrician because the toddler cries a lot and then stops on her own. The parent has noticed a little blood in the diaper every time it is wet. Assessment reveals a temperature of 101.3°F (38.5°C). Which condition does the nurse anticipate after a UA? 1. Hypospadias 2. Henoch-Schönlein purpura (HSP) 3. Acute kidney injury 4. UTI

2. Hepatitis B

A parent brings a 2-month-old baby in for a routine wellness examination. Which vaccination should the nurse prepare to administer to this patient? 1. Hepatitis A 2. Hepatitis B 3. Inactivated poliovirus (IPV) 4. Measles, mumps, rubella

3. Tourette's syndrome is a disorder of complex motor and vocal tics that have been present for more than 1 year.

A parent brings a child who is 8 years of age to the pediatric clinic and tells the nurse, ―I think he has Tourette's syndrome. He recently began some eye-blinking and grimacing actions.‖ Which information does the nurse provide to help the parent distinguish between transient tic of childhood and Tourette's syndrome? 1. Vocal tics frequently become chronic in children with transient tic of childhood diagnosis. 2. Transient tic of childhood begins with a high level of tic activity and usually disappears completely by age 12. 3. Tourette's syndrome is a disorder of complex motor and vocal tics that have been present for more than 1 year. 4. Tourette's syndrome is a disorder of complex motor and vocal tics that develop between the ages of 3 and 8 years.

4. Allow the toddler to decide her own approach to the pool.

A parent brings a toddler to a pediatric clinic for advice about dealing with a fear of water. The parent shares that the toddler screams and throws a tantrum if anyone attempts to get her into a pool. The nurse also learns of an incident when the toddler was pushed into a pool. Which recommendation will the nurse make to help the toddler overcome this phobia? 1. Make sure the toddler has a safe flotation device. 2. Talk calmly as the toddler is taken slowly into the pool. 3. Plan recreation activities that do not involve water. 4. Allow the toddler to decide her own approach to the pool.

2. Initiate intravenous access.

A parent brings an 18-month-old toddler to the pediatric emergency department for abdominal pain and stool mixed with blood and mucus. The pain is recurring three to four times an hour. Which intervention will the nurse initiate first? 1. Assess laboratory results. 2. Initiate intravenous access. 3. Maintain strict intake and output. 4. Prepare for ultrasound studies.

1,3,5

A parent brings an adolescent who is 16 years of age to the pediatric clinic, because the patient is experiencing unusual sensations in the feet. The nurse learns the patient was diagnosed with type 1 diabetes mellitus as a toddler; glucose levels have always been erratic and difficult to control. Which assessment findings does the nurse expect based on the health history? Select all that apply. 1. Inability to identify a sharp or blunt sensation on the sole of the foot 2. Feet warm to the touch and capillary refill within normal limits 3. Problems with balance when standing without support 4. Toenails smooth in appearance and nail beds pink in color 5. Signs of weakness during neuromuscular checks to the lower legs

1,2

A parent brings an infant to the pediatric clinic and expresses concern about irritability and poor feeding, along with recent symptoms of flu lasting a few days. The nurse notices multiple raised mosquito bites on the infant. Which additional knowledge causes the nurse to suspect encephalitis? Select all that apply. 1. A recent local outbreak of West Nile fever 2. Bulging fontanels when in a quiet state 3. Signs of facial and eyelid weakness 4. Loss of deep tendon reflexes 5. Drooling instead of swallowing saliva

4. "Was the child exposed to anyone with a respiratory infection?"

A parent brings their school-age child to the clinic for a rash that developed over the face, trunk, and extremities. Which question should the nurse ask the parent when assessing the patient? 1. "Has the child been nauseated or has the child vomited?" 2. "How often is the child given acetaminophen, or Tylenol?" 3. "Has the child eaten any food that was not properly cooked?" 4. "Was the child exposed to anyone with a respiratory infection?"

4. Scarlet fever with strep throat

A parent brings their school-age child to the health-care provider's office for evaluation of a sore throat, fever, headache, and fine red rough rash over both arms and abdomen. For which health problem should the nurse plan care for this patient? 1. Bacterial meningitis 2. Tonsillitis 3. Epiglottitis 4. Scarlet fever with strep throat

1. "Your son may have developed conduct disorder (CD)."

A parent of an adolescent tells the nurse, "He had some bad habits as a child, but now he is in trouble with the law for destruction of property, stealing, and hurting animals. I think his oppositional defiant disorder (ODD) is getting worse." Which comment by the nurse is accurate? 1. "Your son may have developed conduct disorder (CD)." 2. "Increasing his ADHD medication may help." 3. "Right now he needs your feedback and support." 4. "There are lawyers that specifically help troubled teens."

3,4,5

A parent with a school-age child with mumps asks for information about the illness and treatment. Which information should the nurse provide? Select all that apply. 1. "There is no need to isolate the child." 2. "There are no laboratory tests to detect the mumps virus." 3. "Sometimes the complications of mumps involve the testicles and ovaries." 4. "Mumps are seen by observation of swelling around the ears and jaw." 5. "Provide food and drink that is nonirritating to the mouth and surrounding glands."

1,4,5

A patient who is 17 years old comes to his health-care provider for a sports physical. The nurse's visual assessment places the patient in high percentiles for both weight and height. Which additional assessments does the nurse expect to be conducted for a complete health evaluation? Select all that apply. 1. Body mass index 2. Bedtime cortisol levels 3. Glucose levels after meals 4. Lipid profile 5. Thyroid-stimulating hormone level

3. Strawberry tongue

A school-age child is brought to the clinic to be evaluated for a headache and stomachache. For which reason should the nurse prepare the patient to have a rapid strep test? 1. Coryza 2. Productive cough 3. Strawberry tongue 4. Jaundiced conjunctiva

3. Wear a mask when providing care.

A school-age patient with rubella is placed in droplet precautions. Which action should the nurse take when implementing these precautions? 1. Use a mask with a high-efficiency particulate air (HEPA) filter. 2. Instruct to cough into the hands. 3. Wear a mask when providing care. 4. Assign to a negative air pressure room.

1,2,3,5

A teacher in an elementary school voices concerns to the school nurse about a student in their second-grade class. The student has recently become withdrawn from adults but constantly tries to please the teacher. Today the teacher saw bruises around the student's neck. Which plan does the school nurse develop and implement? Select all that apply. 1. Talk to child alone in the school clinic about any pain or concerns. 2. Inspect the back, chest, and legs in the presence of the principal. 3. Report possible child abuse with assessment findings to proper authorities. 4. Call the parents and report that authorities have been notified of abuse. 5. Develop a trusting rapport with the child.

1. Ask if the student has been tested by a physician for seizure disorder.

A third-grade teacher discusses behavioral problems with a student. The teacher states, "He walks around class making horrible sucking noises. He does not respond to me." Which information does the nurse seek from the student's parents? 1. Ask if the student has been tested by a physician for seizure disorder. 2. Inquire if the student is either diagnosed or medicated for attention deficit-hyperactivity disorder (ADHD). 3. Ascertain if the student has experienced recent illness or a fever. 4. Suggest the student be screened for possible developmental delays.

4. "Have you been around anyone with a cold over the last 3 weeks?"

An adolescent develops a fever, cough, and a maculopapular rash. Which question should the nurse ask when completing the health history with this patient? 1. "Did you receive any vaccinations recently?" 2. "Do you usually eat cold pizza left on the counter overnight?" 3. "Do you forget to wash your hands after using the bathroom?" 4. "Have you been around anyone with a cold over the last 3 weeks?"

1,2,3,5

An adolescent is diagnosed with mononucleosis. Which teaching should the nurse provide to the parents when providing care at home? Select all that apply. 1. Encourage ample fluids. 2. Avoid all contact sports for 6 to 8 weeks. 3. Encourage rest with quiet activities and play. 4. Limit the amount of caloric intake until recovered. 5. Provide ibuprofen or acetaminophen for elevated temperature.

1. Bruising in the flank area

An adolescent who is 15 years of age is brought to the pediatric clinic because of bloody urine. Which additional finding during assessment will cause the nurse to consider AKI? 1. Bruising in the flank area 2. Tenderness in the lower back 3. Hesitation and pain with urination 4. Suprapubic swelling and pain

2,4

An adolescent who is 16 years of age is being discharged home after treatment for kidney stones. The nurse provides the patient and parents with written instructions for reference at home. Which information will the nurse expect to include? Select all that apply. 1. The patient is not on a restricted diet or fluid intake at this time. 2. All urine is to be strained and sediment kept for analysis. 3. The thiazide diuretic may be discontinued on discharge. 4. The patient and parents need to understand any medication regimen. 5. A metabolic workup is no longer necessary

4. A laboratory result reveals a positive hepatitis B e antigen (HBeAg).

An adult woman arrives in the emergency department following a spontaneous birth at home. The woman indicates that no prenatal care has been received. Which assessment finding about the woman causes the nurse greatest concern for the newborn? 1. A laboratory result reveals a positive hepatitis A anti-HAV-total. 2. The mother is emaciated and has indications of drug abuse. 3. The mother has no permanent address and denies having family. 4. A laboratory result reveals a positive hepatitis B e antigen (HBeAg).

3. "Be sure to keep the lesions covered until they crust over."

An older patient with weeping lesions caused by herpes zoster asks if a trip to visit small grandchildren can still occur this upcoming weekend. Which should the nurse say to the patient in response? 1. "There is no reason for you to cancel your trip." 2. "You should not travel until all of the lesions are healed." 3. "Be sure to keep the lesions covered until they crust over." 4. "As long as the lesions are kept uncovered, you can travel without any issues."

1,4,5

An urgent-care clinic nurse is preparing to discharge a 7-year-old child who tested positive for the COVID-19 virus. The child's symptoms are minor (cough, fever, and fatigue). Which statements made by the caregivers, show the need for more education. Select all that apply. 1. "We will give our child ibuprofen for fever and discomfort." 2. "We will use a cool-mist humidifier in our child's bedroom." 3. "We will seek medical help if our child's urinary output decreases." 4. "We are so thankful to know that our child will only have mild symptoms because they are so young." 5. "We want our family to get tested for COVID-19. We will request a polymerase chain reaction (PCR) test because it doesn't require a nasal swab."

2,4,5

During assessment of an average-weight 18-year-old female patient, the nurse asks about weight and eating habits. Which response from the patient does the nurse recognize as an indication of a possible eating disorder? Select all that apply. 1. "I know I shouldn't but I sometimes eat junk food when I'm stressed." 2. "I need to lose weight before school starts. I can't go to school looking like this." 3. "I can't eat vegetables. I've tried, but I can't." 4. "I don't like eating at school in front of people." 5. "No matter what I do, I can't seem to lose weight."

2. The diagnosis is usually an isolated anomaly.

Shortly after the birth of a male neonate, the parents are informed about the diagnosis of hypospadias. The physician explains that the neonate's urethral opening is located midpenile, and surgery will occur between the ages of 6 and 12 months. Which additional explanation does the nurse provide to the parents? 1. The neonate should be circumcised immediately. 2. The diagnosis is usually an isolated anomaly. 3. A ventral curvature of the penis is likely. 4. A pediatric surgeon will perform the surgery.

1,2,3,4

The neonatal intensive care unit (NICU) nurse is providing care for a neonate exhibiting manifestations of congenital Zika syndrome. Which distinct features does the nurse associate with the syndrome? Select all that apply. 1. Partially collapsed skull 2. Decreased brain tissue 3. Damage to the back of the eyes 4. Multiple joint contractures 5. Agitated body movement

1. Allow the child to complete each session of handwashing.

The nurse at a pediatric clinic is gathering assessment information on a school-age patient who is 9 years of age. The mother expresses concern about a recent habit of excessive handwashing to "get rid of all germs on my hands." Which recommendation by the nurse is appropriate? 1. Allow the child to complete each session of handwashing. 2. Assign tasks to the child that involves putting hands in water. 3. Interrupt the handwashing by moving the child away from the sink. 4. During the handwashing, ask the child about worries and concerns.

2,3,4,5

The nurse at a pediatric clinic notices a female high-school student has had extensive dental work and is currently exhibiting additional dental caries. The nurse also identifies the bilateral existence of Russell's sign. Based on these findings, for which comorbid manifestation will the nurse assess the student? Select all that apply. 1. Frequent absenteeism from school 2. Issues with overspending 3. Thoughts of suicide 4. Presence of cutting activity 5. Casual sexual encounters

3,4

The nurse in a neonatal nursery is mentoring a newly hired nurse. The new nurse expresses uncertainty about the use of probiotics in children. Which information does the nurse provide? Select all that apply. 1. Probiotics should be used only in children 12 years and older. 2. Probiotics may be taken after a course of antibiotics but should not be taken concurrently. 3. Probiotics have been shown to shorten the duration of acute infectious diarrhea from bacterial infection. 4. Lactobacillus rhamnosus GG (LGG) has been shown to help manage pain associated with IBS. 5. Probiotics are now considered the primary treatment for ulcerative colitis.

1. A hard mass is palpated in the mid-epigastrium.

The nurse in a pediatric clinic is assessing an infant 2 months of age. The parent states, "He always spits up, but it has become so much worse. Vomit goes everywhere." Which additional assessment will help the nurse identify a possible diagnosis for the infant? 1. A hard mass is palpated in the mid-epigastrium. 2. Vomiting occurs both before and after eating. 3. Weight is normal even with frequent vomiting. 4. Normal skin turgor is noted over the sternum

3. "Is the child urinating, and what color is the urine?"

The nurse in a pediatric clinic is gathering information from the parent of a toddler who has anorexia, generalized edema, and joint pain following a bout with strep throat. Which question(s) will most likely give the nurse information for a specific condition? 1. "What behavior did you see to indicate joint pain?" 2. "When and where did you first notice swelling?" 3. "Is the child urinating, and what color is the urine?" 4. "How were you managing the symptoms at home?"

2. Begin an age-appropriate weight loss program.

The nurse in a pediatric clinic is obtaining a health history on a child who is 9 years of age. The nurse learns the child exhibits a chronic cough, midsternal discomfort, and frequent sore throats without infection. Physical assessment indicates the child is on the 50th percentile on the height chart and on the 85th percentile for weight. Which recommendation does the nurse make? 1. Serve citrus juices instead of carbonated beverages. 2. Begin an age-appropriate weight loss program. 3. Initiate a practice of no eating or drinking after dinner. 4. Encourage lying on the left side after eating a meal.

3. Severe vomiting and diarrhea

The nurse in a pediatric clinic is obtaining information about a 7-month-old infant with GI symptoms. The parent informs the nurse that bloating, flatulence, and foul-smelling stools occurred with the introduction of wheat cereal. Which additional information will cause the nurse to initiate emergency care? 1. Dental enamel defects of the teeth 2. Presence of dermatitis herpetiformis 3. Severe vomiting and diarrhea 4. Weight loss indicated by thinness of extremities

1,4,5

The nurse in a pediatric clinic is performing a physical examination of a patient who is 8 years of age. The patient's weight is over the 95th percentile on the growth chart. The patient also expresses the presence of knee and abdominal pain. The patient's parent states, ―He will outgrow it; all my boys start off like this.‖ Which information does the nurse present to the parent? Select all that apply. 1. Obesity is related to the development of diabetes mellitus. 2. Being a social outcast can cause feelings of poor self-esteem. 3. Children with obesity are more likely to drop out of school. 4. There is a high risk for cardiac disease and hypertension. 5. Obesity adversely affects joint health and function.

3. Parental action is required for the onset of vomiting or severe abdominal pain.

The nurse in a pediatric clinic is working with a preschool patient and a parent about managing the child's functional constipation. Which is the most important information for the nurse to share? 1. The child is allowed to select a reward for having a bowel movement. 2. The child is informed of the treatments for constipation and/or impaction. 3. Parental action is required for the onset of vomiting or severe abdominal pain. 4. The parents expect the child to sit on the toilet for a period of time each day.

3. The child may have excessive interest in or attraction to fire.

The nurse in a pediatric emergency department is providing care for a school-age child with first and second-degree burns to the hands and arms. The parent states, "She is so fascinated with the color and movement of the flames; she just got too close." For which reason does the nurse recommend psychotherapy for this child? 1. The child is exhibiting an inability to recognize danger. 2. The child does not obey instructions to stay away from matches. 3. The child may have excessive interest in or attraction to fire. 4. The child is likely to repeat the behavior and cause worse injuries.

2,4

The nurse in a pediatric unit is providing care for a 2-month-old infant just diagnosed with spinal muscle atrophy. Which characteristics of the condition does the nurse expect to find during physical assessment? Select all that apply. 1. Hyperreflexia in deep tendons 2. Few spontaneous movements 3. Deep, rapid respirations 4. Fasciculations of the tongue 5. Proximal muscle atrophy

3. A scattered purpuric rash is found on the skin.

The nurse in the emergency department of a pediatric hospital is providing care for a toddler with a sudden high fever. The parent states, "She has been grumpy all day and I thought she just needed a nap." Which finding does the nurse recognize as an indication of an immediate medical emergency? 1. The toddler keeps eyes closed or covered at all times. 2. The nurse elicits a positive Brudzinski's sign. 3. A scattered purpuric rash is found on the skin. 4. The toddler cries when head and neck are moved.

4. Cover the defect with a sterile dressing moistened with warm sterile normal saline, using aseptic technique

The nurse in the newborn nursery is providing care for a neonate with an open spinal cord defect. The neonate will be transported to a pediatric surgery hospital as soon as possible. Which description of the nurse's care of the neonate is correct? 1. Using aseptic technique, place a sterile plastic bag around the defect and loosely tie it closed. 2. Place the newborn prone on a loose diaper and cover the defect with a second saline-moistened diaper. 3. Position the newborn on the side with a moistened dressing on the defect; wrap the defect and newborn in a blanket. 4. Cover the defect with a sterile dressing moistened with warm sterile normal saline, using aseptic technique

1. A liver transplant

The nurse is admitting an infant who is 3 months of age. The parents sought medical attention when the infant began passing pale-colored stools that are nearly white. The infant had been diagnosed with biliary atresia at birth and underwent corrective surgery. For which treatment will the nurse prepare the parents? 1. A liver transplant 2. A second corrective surgery 3. Initiating comfort care 4. Focusing on diet therapy

1. Explain to the parent that rapid development takes place in infancy and early childhood.

The nurse is assessing a 7-year-old child at a pediatric clinic. The nurse notices that several developmental milestones have been missed or are late during previous visits. The parent states, "I know she is a little slow, but she will catch up quickly." Which action by the nurse is warranted? 1. Explain to the parent that rapid development takes place in infancy and early childhood. 2. Suggest activities in the home that may improve mental and physical development. 3. Recommend that the child be placed in special classes aimed at promoting development. 4. Ask the parent detailed questions about the pregnancy, birth, and early childhood health.

3. Placing a small object in the palm inconsistently elicits a grasp.

The nurse is assessing an 8-month-old infant during a routine well-baby visit. During the neurological assessment, which finding is a reason for concern? 1. The infant starts to suck when the mouth is touched. 2. Toes fan out when the sole of the food is stroked upward. 3. Placing a small object in the palm inconsistently elicits a grasp. 4. A light puff of air in the face causes the eyes to close.

4. Assist the student to a quiet place and remain with the student.

The nurse is attending a high-school sports event when a student suddenly stands and shouts, "I need to get out of here—get me out!" Which intervention by the nurse is most appropriate at this time? 1. Attempt to calm the student with quiet breathing and relaxation. 2. Identify the events that led to the student's behaviors. 3. Look for the student's parents and ask about the behavior. 4. Assist the student to a quiet place and remain with the student.

1. Most commonly through bodily fluids, such as drinking from the cup of a person with the infection

The nurse is caring for a 15-year-old patient who has been diagnosed with mononucleosis. The patient asks how the infection was obtained. Which information should the nurse include when responding to the patient? 1. Most commonly through bodily fluids, such as drinking from the cup of a person with the infection 2. Eating contaminated food or drinking contaminated beverages 3. Eating meat that is raw or undercooked 4. Inhaling airborne germs, such as after someone coughs or sneezes

3. Insert an indwelling urinary catheter

The nurse is caring for a 6-month-old infant with a grade II vesicoureteral reflux (VUR). Which order will the nurse question? 1. Monitor vital signs 2. Monitor intake and output 3. Insert an indwelling urinary catheter 4. Administer ceftriaxone 50 mg/kg/day

4. Signs of gastroesophageal reflux and ways to treat

The nurse is caring for a family whose newborn son underwent surgery to correct a tracheoesophageal fistula. Which instruction will the nurse include in the family teaching? 1. Need to adhere to a gluten-free diet 2. Value of nonnutritive sucking before oral feedings 3. How to administer enteral feedings 4. Signs of gastroesophageal reflux and ways to treat

1. Incontinent of feces

The nurse is caring for a school-age patient diagnosed with hepatitis A. For which reason should the nurse begin implementing contact precautions for this patient? 1. Incontinent of feces 2. Evidence of dehydration 3. Development of dark urine 4. Severe nausea and vomiting

2. "Did your child feel strange and faint after standing up?"

The nurse is collecting information about a school-age patient brought to a pediatric clinic by a parent. The parent reports several incidences of syncope. Which assessment question helps the nurse to identify a possible diagnosis of vasovagal syncope? 1. "Has your daughter been diagnosed with diabetes mellitus?" 2. "Did your child feel strange and faint after standing up?" 3. "Was your child in a stressful situation before fainting?" 4. "Does your daughter have any cardiac conditions?"

4. The need and availability of parent training for behavior management

The nurse is counseling a parent of a child diagnosed with ADHD who has now also been diagnosed with ODD. The parent states, "I don't know what to do" Which information does the nurse provide for the parent? 1. The fact that 40% to 60% of children with ADHD also have ODD 2. The importance of not showing emotional reactions to the behaviors 3. How to remain consistent with consequences related to ODD behaviors 4. The need and availability of parent training for behavior management

1. Make a rocking horse or child-sized rocking chair available to the child.

The nurse is discussing a child's diagnosis of autism spectrum disorder (ASD) with the child's parents. The parents tell the nurse the child is completely resistant to any type of stimulation. The nurse suspects sensory processing disorder and will recommend which intervention? 1. Make a rocking horse or child-sized rocking chair available to the child. 2. Place colored lights and automated toys in the child's room. 3. Set specific times of day when the child is held and cuddled. 4. Child-appropriate music is played throughout the day.

2. The nurse validates the child is obese.

The nurse is gathering health information on a child who is 8 years of age. The parent reports the child is extremely difficult to wake in the morning. Which other information will prompt the nurse to recommend screening for a sleep disorder? 1. The bedroom is shared with a sibling. 2. The nurse validates the child is obese. 3. There is a TV in the child's bedroom. 4. It is difficult to get the child to bed.

4. The condition is congenital and causes blockage of the intestines.

The nurse is informing a new mother of the concern about her newborn who is 36 hours old and has not passed any meconium. The nurse shares a suspicion of Hirschsprung's disease. The mother asks the nurse multiple questions about the condition. Which information will the nurse provide? 1. Retained meconium is a source of severe infection in newborns. 2. A positive diagnosis indicates the newborn is terminally ill. 3. The absence of nerves in the colon also indicates mobility issues. 4. The condition is congenital and causes blockage of the intestines.

2. How often the student is taking medication

The nurse is performing a routine pediatric assessment on an 11-year-old student who is taking medication for attention deficit-hyperactivity disorder (ADHD). The parent reports disruptive behavior and acting out both at school and at home. The parent asks about a possible medication increase. Which information is the most important for the nurse to acquire from the student? 1. Whether the student is having problems sleeping 2. How often the student is taking medication 3. The student's weight and level of appetite 4. The student's perception of medication effects

3. "Do you ever remember feelings of being depressed or sad?"

The nurse is performing a well-baby check on an infant at 6 months of age. The mother shares that the infant sometimes seems unhappy. Which question is most important for the nurse to ask the mother? 1. "Is it easy to make the baby laugh if he seems unhappy?" 2. "Can you cheer him up by playing with his favorite toys?" 3. "Do you ever remember feelings of being depressed or sad?" 4. "Are you noticing any problems with him eating or sleeping?"

2,3,4,5

The nurse is performing an abdominal examination on a preschool-age child. When palpating the abdomen, which action will the nurse take? Select all that apply. 1. Instruct the child to lay supine, with the arms at the side and legs straight 2. Have the child place their hand on the nurse's during the examination 3. Use light palpation 4. Place their entire palm on the child's abdomen 5. Check for a hernia

1. Review lifestyle changes and diet modification with the adolescent.

The nurse is preparing teaching materials for an adolescent patient recently diagnosed with nonalcoholic fatty liver disease (NAFLD). The adolescent initially presented with right upper quadrant pain, obesity, and hepatomegaly. Which teaching will the nurse initially present? 1. Review lifestyle changes and diet modification with the adolescent. 2. Explain the care that is provided in the event acute liver failure occurs. 3. Discuss feelings the adolescent has related to the disease diagnosis. 4. Begin to introduce the probability for a liver transplant later in life.

2. All females of child-bearing age should take 0.4 mg of folic acid daily

The nurse is presenting a class to high school female students about decreasing the developmental risks related to pregnancy. Which information does the nurse consider to be most important? 1. Young women should begin taking 600 mg of calcium twice a day. 2. All females of child-bearing age should take 0.4 mg of folic acid daily 3. Early prenatal care is essential for a healthy pregnancy and baby. 4. Important fetal development occurs before pregnancy is suspected.

1. Initially, most drugs are obtained cost free from friends or family members.

The nurse is presenting a program to the parents of school-age children about prescription drug abuse among adolescents. Which information does the nurse provide to parents about preventing their children from abusing prescription drugs? 1. Initially, most drugs are obtained cost free from friends or family members. 2. The abused drugs are not commonly found in the normal household. 3. Adolescents are at great risk for life-threatening effects from prescription drugs. 4. Withdrawal from this type of drug can be managed by the adolescent's family

1,2,3,5

The nurse is providing care for a 10-year-old patient admitted for chronic kidney disease (CKD). The patient is diagnosed with CKD stage 3. Which nursing actions are most important for the nurse to include on the patient's plan of care? Select all that apply. 1. Arrange for hemodialysis. 2. Correct electrolyte imbalances. 3. Monitor blood pressure. 4. Prepare for renal replacement. 5. Obtain accurate daily intake and output (I&O) and weight.

2. Monitoring without surgical interventions

The nurse is providing care for a 2-month-old infant admitted to the hospital for testing because of a persistent low-grade fever. Laboratory tests and ultrasound of the abdomen confirm the presence of gallstones. Which procedure does the nurse expect to be prescribed for this infant? 1. Immediate preparation for abdominal surgery 2. Monitoring without surgical interventions 3. Endoscopic removal of stones and gallbladder 4. Placing the infant on low-fat, soy-based formula

2,3,5

The nurse is providing care for a 3-year-old toddler admitted with a diagnosis of nephrotic syndrome related to a recent upper respiratory infection. In preparation for discharge, which teaching does the nurse provide for the parents? Select all that apply. 1. Administration of prophylactic antibiotic medication 2. Reason for checking feet and lower legs for edema 3. Method to use when strictly monitoring daily weight 4. Suggestions about maintaining a low activity level 5. Provision of written material about diet and fluid restriction

4. Recent Escherichia coli infection

The nurse is providing care for a 4-year-old child whose admitting diagnosis is hemolytic uremic syndrome (HUS). Which patient history factor does the nurse expect to find in the patient's electronic health record? 1. Recent measles, mumps, rubella (MMR) immunization 2. Use of acyclovir in the past 14 days 3. Recent abdominal surgery 4. Recent Escherichia coli infection

4. Antibiotic therapy

The nurse is providing care for a 7-year-old child whose admitting diagnosis is poststreptococcal glomerulonephritis. The nurse expects which care to be prescribed for the child? 1. Hemodialysis 2. Nifedipine orally 3. Increase fluids 4. Antibiotic therapy

1. 14 mg

The nurse is providing care for a 9-year-old patient diagnosed with postinfectious glomerulonephritis. The nurse is aware of hypertension and a prescribed dose of nifedipine 0.5 mg/kg/dose every 4 hours. The patient weighs 63 pounds. Which dose does the nurse give every 4 hours? 1. 14 mg 2. 18 mg 3. 22 mg 4. 30 mg

2. Closely monitor the adolescent's bathroom behavior.

The nurse is providing care for a female adolescent at an in-patient facility for persons with eating disorders. The adolescent's current weight is less than 85% of ideal body weight. The adolescent appears to be unexpectedly agreeable with the interventions being implemented for weight gain. Which is an important intervention for the nurse to perform? 1. Eat with the client to demonstrate adequate intake. 2. Closely monitor the adolescent's bathroom behavior. 3. Allow the adolescent to select the flavor of nasogastric (NG) tube feedings. 4. Provide information about the effects of malnutrition on the body

3. The risk of acquiring second impact syndrome

The nurse is providing care for a pediatric patient who received a concussion while playing football. The patient had brief loss of consciousness and now reports a headache with a pain level of 6 on a 0 to 10 scale. The patient states, "My team plays again in five days and I should be better." Which information is vital for the patient and parents to understand? 1. A realistic time frame regarding complete recovery 2. Type of equipment to prevent a second head injury 3. The risk of acquiring second impact syndrome 4. The potential for long-term headaches

2,3,5

The nurse is providing care for a preschool child who is 4 years of age. The child is being treated for severe abuse that occurred in the home since the child was an infant. Which comments by the child indicate to the nurse a possible dissociative disorder? Select all that apply. 1. "Someday I will live with grandma." 2. "If it hurts, I will just go away." 3. "I have a friend who always stays with me." 4. "I want a really big lunch and dinner." 5. "I can be invisible if they get mad at me."

4. Offer verbal support and encourage the student to express feelings

The nurse is providing care for a student who was involved in a school violence incidence. The student becomes agitated and angry on the anniversary of the event. Which action by the nurse is most helpful to the student? 1. Administer the physician-prescribed dose of propranolol (Inderal). 2. Gently and quietly try to soothe the student verbally and physically. 3. Call for a psychotherapist to come and assist the student with posttraumatic stress disorder (PTSD). 4. Offer verbal support and encourage the student to express feelings

2. Possibility of oral aphthous ulcers

The nurse is providing care for an adolescent diagnosed with Crohn's disease. The nurse provides patient teaching regarding which manifestation of the condition? 1. Urgency to defecate 2. Possibility of oral aphthous ulcers 3. Episodic epigastric pain 4. Nocturnal awakening events

3. Establish nothing by mouth (NPO) status and prepare patient for surgery.

The nurse is providing care for an adolescent patient admitted with a diagnosis of nephrolithiasis. The patient's symptoms include flank pain, hematuria, and vomiting. The nurse notices an hourly output of 20 mL/hour. Patient's medical history includes UTIs, type 1 diabetes mellitus, and one kidney at birth. Which medical prescription does the nurse expect immediately from the physician? 1. Increase IV fluids to 125 mL/hour. 2. Cover blood glucose on a sliding scale. 3. Establish nothing by mouth (NPO) status and prepare patient for surgery. 4. Administer IV morphine 5 mg every 2 hours for pain.

4. Renal biopsy shows IgA deposition

The nurse is providing care to a school-age child admitted because of the presence of colicky abdominal pain, palpable purpura on the lower extremities, edema of the face and lips, and anorexia. The suspected diagnosis is HSP. Which diagnostic test result does the nurse expect to validate the diagnosis? 1. Elevated serum creatinine 2. Positive for proteinuria 3. Stool positive for occult blood 4. Renal biopsy shows IgA deposition

2. A "whoop" sound after coughing

The nurse is providing care to an 8-week-old infant who has symptoms of an upper respiratory infection. Which assessment finding should indicate to the nurse that the patient is experiencing pertussis? 1. An expiratory wheeze 2. A "whoop" sound after coughing 3. Three wet diapers each day 4. Bulging fontanelles

3. "I will observe my child for seizures, headache, fever and vomiting."

The nurse is providing discharge instructions for a father whose child had a ventriculoperitoneal shunt. Which statement by the parent indicates that teaching was effective? 1. "I will let my child resume swimming in 3 days." 2. "I'm so happy that my child wouldn't need any more shunt surgeries." 3. "I will observe my child for seizures, headache, fever and vomiting." 4. "I like that these sutures dissolve in 3 days."

1,2,5

The nurse is providing teaching to the parents of a preschool-age toddler diagnosed with CKD. Which information does the nurse cover regarding vaccinations for the toddler? Select all that apply. 1. Routine immunizations given to healthy children are administered. 2. Annual pneumococcal conjugate vaccinations are encouraged. 3. Live viral vaccinations such as varicella and MMR are appropriate. 4. Intranasal influenza vaccine are preferred for children with CKD. 5. Annual attenuated influenza vaccinations are recommended.

1. Low-protein diet

The nurse is reviewing the chart of an adolescent who is 17 years of age with a diagnosis acute kidney disease. Which dietary order is the nurse expecting to find in the electronic health record? 1. Low-protein diet 2. High-calorie diet 3. High-oxalate diet 4. Ketogenic diet

2,5

The nurse is visiting the home of a patient with hepatitis B who is 1 week postpartum. Which information should the nurse include when teaching this patient? Select all that apply. 1. "Hepatitis B is only transmitted through sexual contact." 2. "The baby may have contracted hepatitis B through the pregnancy." 3. "There are no medications appropriate for children with hepatitis B." 4. "After the baby has received treatment, there is no need for follow-up." 5. "The baby should have received the hepatitis B immunization and hepatitis B immune globulin."

4. "A dose should be given today with follow-up doses in 1 to 2 months, and the last in 6 months."

The nurse learns that a 16-year-old patient has not received the human papillomavirus vaccine (HPV-Gardasil). Which should the nurse explain to the patient at this time about the vaccination? 1. "The complete vaccine can be given today." 2. "You can wait a few years before needing the vaccination." 3. "A dose can be given today with the final dose in 6 months." 4. "A dose should be given today with follow-up doses in 1 to 2 months, and the last in 6 months."

3. After acute withdrawal some symptoms may become chronic.

The nurse works in a facility where treatment of adolescents with addiction issues is the focus. A 14-year-old patient is being admitted for treatment of cocaine dependence. Which information does the nurse provide relative to the patient's withdrawal? 1. Acute symptoms of withdrawal last for 2 to 3 weeks. 2. The patient will be sedated throughout most of the process. 3. After acute withdrawal some symptoms may become chronic. 4. Close monitoring is important due to life-threatening symptoms.

1. The new nurse states, "How can I hear bowel sounds when he cries?"

The pediatric nurse in a clinic is mentoring a newly hired nurse who has no experience in pediatrics. The new nurse is performing a physical assessment on an infant who is 1 month of age. Which observation will prompt the nurse to discuss assessment skills with the new nurse? 1. The new nurse states, "How can I hear bowel sounds when he cries?" 2. The new nurse keeps the sleeping infant covered for parts of the assessment. 3. The new nurse performs all observations before physical assessment. 4. The new nurse informs the attending parent about the assessment actions.

4. Manifestations of increased intracranial pressure

The pediatric nurse in an acute care facility is providing care for a patient who is 12 years of age with a history of sickle cell anemia. During this hospitalization, it is determined that the patient has experienced a stroke. Which teaching is most important for the nurse to provide to the patient and parents? 1. A need for intensive physical and speech therapies 2. Reasons to have a designated social worker 3. The necessity for an individualized education plan 4. Manifestations of increased intracranial pressure

2. Make an appointment with a physician for testing and evaluation

The pediatric nurse is examining the skin of a young child and notices eight café-au-lait spots between 1.5 and 3 inches in diameter on the body, along with axillary freckling. Which recommendation does the nurse make to the parent? 1. Refrain from having additional children without counseling. 2. Make an appointment with a physician for testing and evaluation. 3. Agree to blood testing of the child to identify a defect in the NF1 gene. 4. Arrange for psychological therapy to address self-esteem problems.

4. Performing urinary catheterization

The pediatric nurse receives a medical prescription to obtain a urine sample for culture from an infant 6 months of age diagnosed with a UTI. By which method will the nurse collect the sample? 1. Applying clean-catch techniques 2. Attaching an external urine bag 3. Catching urine in a sterile diaper 4. Performing urinary catheterization

4. The student is exhibiting signs of a respiratory infection.

The school nurse in a middle school is aware of a student who takes lithium for a bipolar disorder type 1. Which observation by the nurse will indicate a need for a laboratory test? 1. The student is exhibiting multiple signs of mania. 2. The student gets a bathroom pass during every class. 3. The student shoved other students at lunch and in the hall. 4. The student is exhibiting signs of a respiratory infection.

3. Walk with the child in the hallway and provide reassurance.

The school nurse is called to attend to a child who is 10 years of age. The teacher reports the child panicked when asked to present a verbal book report to the class. Which intervention will the nurse initiate with the child? 1. Take the child to the clinic and report the event to the parents. 2. Place the child on a clinic bed and allow some alone time. 3. Walk with the child in the hallway and provide reassurance. 4. Join the teacher in attempting to find the source of panic.

4. "Are you experiencing headache or vomiting?"

The school nurse is caring for a 12-year-old student who fell in the school gym while playing basketball. What is the most important question for the school nurse to ask? 1. "Where is the pain located?" 2. "What is the height from which you fell?" 3. "What part of your body is most affected?" 4. "Are you experiencing headache or vomiting?"

1. Protect the student from injury related to seizure movement.

The school nurse is present at a school assembly when a student falls to the floor with a seizure. Which intervention does the nurse initiate when providing care to the student during the seizure? 1. Protect the student from injury related to seizure movement. 2. Remove or loosen any tight clothing around the neck or waist. 3. Provide comfort and promote resting in a quiet environment. 4. If incontinent, cover the student with a blanket or sheet.

2. Seizures

When providing care for a child with cerebral palsy, it is most important that the nurse be aware that the child is at risk for which of the following? 1. Pain 2. Seizures 3. Motor delays 4. Cognitive delays