Peds Final

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SLE - which nursing dx would you NOT consider? 1. Diarrhea 2. Acute pain 3. Disturbed body image 4. Impaired skin integrity

1. Diarrhea?

A nurse is teaching the parents of a child diagnosed with a urinary tract infection secondary to vesicoureteral reflux. How should the nurse explain how the reflux contributes to the infection? 1. "It prevents complete emptying of the bladder." 2. "It causes urine backflow into the kidney." 3. "It results in painful bladder spasms." 4. "It causes painful urination."

1. "It prevents complete emptying of the bladder."

Which statements by the mother of a toddler should lead the nurse to suspect that the child is at risk for iron deficiency anemia? Select all that apply. 1. "He drinks over three cups of milk per day." 2. "I can't keep enough apple juice in the house; he must drink over 10 oz per day." 3. "He refuses to eat more than two different kinds of vegetables." 4. "He doesn't like meat, but he will eat small amounts of it." 5. "He sleeps 12 hours every night and takes a 2-hour nap."

1. "He drinks over three cups of milk per day." 2. "I can't keep enough apple juice in the house; he must drink over 10 oz per day."

The nurse is educating the parents and their 10-year-old child regarding home care for the child's diagnosis of acute glomerular nephritis. Which of the following statements by the child indicate that the child understood the teaching? Select all that apply. 1. "I can't eat any potato chips or other salty foods." 2. "I can't go to school for a week because I am contagious." 3. "I won't be able to go back to soccer practice for a long time." 4. "I'm going to have to go to the doctor's office a lot during the next few months." 5. "When I get home, I will have to stay in bed, except when I need to go to the bathroom."

1. "I can't eat any potato chips or other salty foods." 3. "I won't be able to go back to soccer practice for a long time." 4. "I'm going to have to go to the doctor's office a lot during the next few months."

A child with Kawasaki disease is to receive IV immune globulin on day 7 of the illness. A parent asks the nurse, "I am so scared. Will my child be cured after getting the medicine?" Which of the following responses by the nurse is appropriate? 1. "I cannot promise, but children have been shown to have the best results from the medicine when it is given before the 10th day of the illness." 2. "I am sure that your child will be fine. This medicine has been shown to work well for children with Kawasaki disease." 3. "I really do not know. We will find out more when your child has follow up testing in 1 or 2 days." 4. "I know that you are scared, but it is important for you to have faith in your doctors because they are doing all that they can do."

1. "I cannot promise, but children have been shown to have the best results from the medicine when it is given before the 10th day of the illness."

A 12-year-old with rheumatic fever has a history of long-tem aspirin use. Which statement by the client indicates that the nurse should notify the health care provider? 1. "I hear ringing in my ears." 2. "Is it alright to put lotion on my itchy skin?" 3. "My stomach hurts after I take that medicine." 4. "These pills make me cough."

1. "I hear ringing in my ears."

After teaching a group of parents about temper tantrums, the nurse knows the teaching has been effective when one of the parents states which of the following? 1. "I will ignore the temper tantrum." 2. "I should pick up the child during the tantrum." 3. "I'll talk to my daughter during the tantrum." 4. "I should put my child in time out."

1. "I will ignore the temper tantrum."

Which statement made by the mother of a child with cystic fibrosis should indicate to a nurse that the mother is in need of further teaching regarding the administration of pancreatic enzymes? 1. "I'll crush the capsules and mix with my child's food." 2. "The capsule can be broken and its contents sprinkled onto food." 3. "I may need to give more enzymes with larger meals." 4. "I will administer the enzymes 30 minutes after the meal."

1. "I'll crush the capsules and mix with my child's food."

A 12-year-old child has been diagnosed with group A strep pharyngitis. The primary health-care provider has ordered penicillin V 500 mg PO tid for 10 days. Which of the following questions is important for the nurse to ask the parents and the child before giving them the prescription? 1. "Is there any reason why you will not be able to take medicine 3 times a day for 10 days?" 2. "Would you rather get 1 shot or take 40 pills?" 3. "Have you ever had strep throat before?" 4. "Do you know of any other children in your school who have recently had sore throats?"

1. "Is there any reason why you will not be able to take medicine 3 times a day for 10 days?"

Which of the following statements by the mother of a toddler diagnosed with nephrotic syndrome indicates that the mother has understood the nurse's teaching about this disease? 1. "My child really likes chips and bologna. I guess we'll have to find something else." 2. "We'll have to encourage lots of liquids. Did you say about 4 liters every day?" 3. "We worry about the surgery. Do you think we should do direct donation of blood?" 4. "We understand the need for antibiotics. I just wish the antibiotics could be given by mouth."

1. "My child really likes chips and bologna. I guess we'll have to find something else."

Which statement by the mother of a child with Wilms' tumor tells the nurse that the mother understands what stage II tumor means? 1. "The tumor has extended beyond the kidney but was completely removed." 2. "Although the tumor was in the kidney, it has spread to the lung, liver, and bone." 3. "The tumor has extended outside the kidney to the lungs and the liver." 4. "The tumor was solely located in the kidney but it was totally removed."

1. "The tumor has extended beyond the kidney but was completely removed."

The parents of a 12-year-old girl ask why their non-sexually active daughter should receive the human papillomavirus (HPV) vaccine. The nurse should tell the parents: 1. "The vaccine is most effective against cervical cancer if given before becoming sexually active." 2. "Parents are never sure when their child might become sexually active." 3. "HPV is most common is teens and women in their late twenties." 4. "If your daughter is sexually assaulted, she may be exposed to HPV."

1. "The vaccine is most effective against cervical cancer if given before becoming sexually active."

An 8-year-old girl, who is complaining of a "really bad" sore throat and whose temperature is 102.2°F, is seen in the school nurse's office. The nurse has the child lie down in a room away from other children. Which of the following statements is most important for the nurse to convey when calling the child's parents? 1. "Your child should be seen by her primary care provider." 2. "Your child is very uncomfortable with a sore throat." 3. "Your child is crying and asking for mommy and daddy." 4. "Your child may be contagious to the other children."

1. "Your child should be seen by her primary care provider."

Four babies were delivered in the maternity unit during a 24-hour period. Which of the babies would the nurse most predict would exhibit cryptorchidism? 1. 34 weeks' gestation, 2,200 grams, Apgar 9/9 2. 37 weeks' gestation, 4,000 grams, Apgar 8/9 3. 39 weeks' gestation, 3,500 grams, Apgar 7/8 4. 42 weeks' gestation, 2,400 grams, Apgar 8/8

1. 34 weeks' gestation, 2,200 grams, Apgar 9/9

The nurse has admitted a child with tricuspid atresia. The nurse would expect which initial lab result? 1. A high hemoglobin 2. A low hematocrit 3. A high white blood cell count 4. A low platelet count

1. A high hemoglobin

When explaining the plan of care to the parents of an infant with an undescended testis, the nurse should tell the parents about which of the following as a nonsurgical treatment method? 1. A trial of human chorionic gonadotrophic hormone. 2. A trial of adrenocorticotropic hormone. 3. Frequent stimulation of the cremasteric reflex. 4. .Use of several warm baths each day.

1. A trial of human chorionic gonadotrophic hormone.

The nurse is providing care to a male infant who is diagnosed with hypospadias. Which clinical manifestation does the nurse anticipate when assessing this infant? 1. A urethral meatus that is located on the ventral surface of the penis 2. The presence of foreskin 3. A small opening or a fissure that extends the entire length of the penis 4. An opening on the dorsal surface of the penis

1. A urethral meatus that is located on the ventral surface of the penis

A recent history of which of the following should alert the nurse to gather additional information about the possibility of a urinary tract infection in a 2-year-old child who is exhibiting fever and fussiness? 1. Abdominal pain. 2. Swollen lymph glands. 3. Skin rash. 4. Back pain.

1. Abdominal pain.

A nurse would be most correct in withholding digoxin prescribed to an infant if heart rate falls below which parameter? 1. Below 100 bpm 2. Below 120 bpm 3. Below 140 bpm 4. Below 160 bpm

1. Below 100 bpm

Which development is necessary for toilet training readiness for a 2-year-old? Select all that apply. 1. Adequate neuromuscular development for sphincter control. 2. Appropriate chronological age. 3. Ability to communicate the need to use the toilet. 4. Desire to please the parents. 5. Ability to play with other 2-year-olds.

1. Adequate neuromuscular development for sphincter control. 3. Ability to communicate the need to use the toilet. 4. Desire to please the parents.

A school-age child visits a school nurse with complaints of dizziness and shaking. The nurse confirms that the child has a history of type 1 diabetes mellitus when the child becomes diaphoretic and begins to faint. What should be the nurse's first action? 1. Administer an injection of glucagon. 2. Activate EMS. 3. Squeeze glucose gel into the cheek. 4. Test the child's blood sugar.

1. Administer an injection of glucagon.

A school-age child visits a school nurse with complaints of dizziness and shaking. The nurse confirms that the child has a history of type 1 diabetes mellitus when the child becomes diaphoretic and begins to faint. What should be the nurse's first action? 1. Administer injection of glucagon 2. Activate EMS 3. Squeeze glucose gel into the cheek 4. Test the child's blood sugar

1. Administer injection of glucagon

During the nurse's initial assessment of a school-age child, the child reports a pain level of 6 out of 10. The child is lying quietly in bed watching television. Which action by the nurse is most appropriate? 1. Administer prescribed analgesic. 2. Ask the child's parents if they think the child is hurting. 3. Reassess the child in 15 minutes to see if the pain rating has changed. 4. Do nothing, since the child appears to be resting.

1. Administer prescribed analgesic.

An infant has been transferred from the ICU to the pediatric floor after undergoing surgery to cor- rect a heart defect. Which tasks can the nurse delegate to the licensed practical nurse (LPN)? Select all that apply. 1. Administering oral medications. 2. Administering I.V. morphine. 3. Obtaining vital signs. 4. Recording the input and output. 5. Administering blood products. 6. Morning hygiene. 7. Circulation checks. 8. Discharge teaching.

1. Administering oral medications. 3. Obtaining vital signs. 4. Recording the input and output. 6. Morning hygiene.

A 7-year-old child is hospitalized for a tonsillectomy. What are priority nursing actions when caring for this child after surgery? Select all that apply 1. Advancing diet as tolerated 2. Encouraging coughing to clear throat 3. Monitoring PT and PTT 4. Administering pain medication around the clock 5. Suctioning mouth and throat frequently

1. Advancing diet as tolerated 3. Monitoring PT and PTT 4. Administering pain medication around the clock

A 7-year-old child is hospitalized for a tonsillectomy. What are priority nursing actions when caring for this child after surgery? Select all that apply. 1. Advancing diet as tolerated. 2. Encouraging coughing to clear the throat. 3. Monitoring PT and PTT. 4. Administering pain medication around the clock. 5. Suctioning mouth and throat frequently.

1. Advancing diet as tolerated. 3. Monitoring PT and PTT. 4. Administering pain medication around the clock.

An infant in a newborn nursery is identified as having PKU. What is the best initial source of nutrients for an infant with this diagnosis? 1. Maternal breast milk 2. Pregestimil 3. Lofenalac 4. Isomil

1. Maternal breast milk

To determine if a blood pressure reading is normal, the nurse must know which information about the child? Select all that apply. 1. Age. 2. Body mass index (BMI). 3. Gender. 4. Height. 5. Occipital frontal circumference (OFC). 6. Weight.

1. Age. 3. Gender. 4. Height.

Which nursing intervention should a nurse perform on a young child suspected of having a diagnosis of acute epiglottitis whose oxygen saturation measures 93% on room air? 1. Allow the child to sit in a position of comfort 2. Provide small amounts of liquid orally via a syringe 3. Inspect the child's nares to assess degree of swelling 4. Apply 100% oxygen via mask

1. Allow the child to sit in a position of comfort

Which nursing intervention should a nurse perform on a young child suspected of having a diagnosis of acute epiglottitis whose oxygen saturation measures 93% on room air? 1. Allow the child to sit in a position of comfort. 2. Provide small amounts of liquid orally via a syringe. 3. Inspect the child's nares to assess degree of swelling. 4. Apply 100% oxygen via mask.

1. Allow the child to sit in a position of comfort.

Which would be an abnormal finding when doing a well-child checkup on a 1-week-old infant? 1. An audible "clunk" during the Ortolani test 2. Symmetrical gluteal folds when the infant is held upright 3. Negative Barlow test 4. Symmetrical knee height when the infant is supine

1. An audible "clunk" during the Ortolani test

Which would be an abnormal finding when doing a well-child checkup on a 1-week-old infant? 1. An audible "clunk" during the Ortolani test. 2. Symmetrical gluteal folds when the infant is held upright. 3. Negative Barlow test. 4. Symmetrical knee height when the infant is supine.

1. An audible "clunk" during the Ortolani test.

The nurse is admitting an infant diagnosed with supraventricular tachycardia. Which intervention is the priority for this infant? 1. Apply ice to the face. 2. Perform Valsalvas maneuver. 3. Administer a beta blocker. 4. Prepare for cardioversion.

1. Apply ice to the face.

A school nurse is creating an informational brochure for parents regarding the treatment of head lice. What form of treatment should the nurse caution against? 1. Applying repeated doses of permethrin for as long as it takes until the infestation clears 2. Washing all clothing and linens in hot water followed by drying them in a hot dryer 3. Wearing gloves when washing the child's hair or inspecting for nits 4. Removing nits daily from the child's hair with fine-tooth comb

1. Applying repeated doses of permethrin for as long as it takes until the infestation clears

A school nurse is creating an informational brochure for parents regarding the treatment of head lice. What form of treatment should the nurse caution against? 1. Applying repeated doses of permethrin for as long as it takes until the infestation clears. 2. Washing all clothing and linens in hot water followed by drying them in a hot dryer. 3. Wearing gloves when washing the child's hair or inspecting for nits. 4. Removing nits daily from the child's hair with a fine-tooth comb.

1. Applying repeated doses of permethrin for as long as it takes until the infestation clears.

The mother of a child with chronic renal failure who is receiving peritoneal dialysis at home asks the nurse what she can do if both inflow and drain times are increased. Which of the following instructions would be most appropriate for the nurse to include when responding to the mother? 1. Assess the child for constipation. 2. Decrease the amount of dialysate infused for each dwell. 3. Incorporate the increased inflow and drain times into the dialysis schedule. 4. Monitor the child for shoulder pain during inflow and drain times.

1. Assess the child for constipation.

A 10-year-old child hospitalized with acute poststreptococcal glomerulonephritis during the acute stage has elevated blood pressure and low urine output for 14 hours. The nurse should next: 1. Assess the child's neurologic status. 2. Encourage the child to drink more water. 3. Advise the child to eat a low-sodium breakfast. 4. Help the client to ambulate in the hallway.

1. Assess the child's neurologic status.

An 8-year-old child, who has a history of asthma, is seen in the office of the school nurse with coughing and wheezing. Which of the following actions should the nurse perform first? 1. Assess the child's peak expiratory flow. 2. Educate the child to avoid triggers. 3. Transport the child to the emergency department. 4. Notify the child's parents of his condition.

1. Assess the child's peak expiratory flow.

A nurse compares a child's height and weight with standard growth charts and finds the child to be in the 50th percentile for height and in the 45th percentile for weight. The nurse interprets these findings as indicating that the child is: 1. Average height and weight. 2. Overweight for height. 3. Underweight for height. 4. Abnormal in height.

1. Average height and weight.

A 6-month-old child is discharged with a urinary stent after a procedure to repair a hypospadias. The nurse should tell the parents to: 1. Avoid tub baths until the stent is removed. 2. Measure output in the urinary bag. 3. Avoid drinking fruit juice. 4. Clean the tip of the penis 3 times a day with soap and water.

1. Avoid tub baths until the stent is removed.

A nurse prepares to administer chelating agent to a child with lead poisoning. Which laboratory tests should be obtained prior to the administration of this agent? 1. BUN and creatinine 2. PT, PTT 3. Urine specific gravity 4. CBC

1. BUN and creatinine

As part of the preoperative teaching for the family of a child undergoing a tetralogy of Fallot repair, the nurse tells the family upon returning to the pediatric floor that the child may: 1. Be placed on a reduced sodium diet. 2. Have an activity restriction for several days. 3. Be assigned to an isolation room. 4. Have visits limited to a select few.

1. Be placed on a reduced sodium diet.

Which orders should a nurse question for a 5-month-old infant with hypoplastic left heart syndrome who is hospitalized awaiting the second stage of surgical repair? (Select all that apply). 1. Call physician for oxygen saturation below 85% 2. Daily weights 3. Hold digoxin (Lanoxin) for heart rate less than 80bpm 4. Strict I&O 5. Enfamil formula ad lib

1. Call physician for oxygen saturation below 85% 3. Hold digoxin (Lanoxin) for heart rate less than 80bpm 5. Enfamil formula ad lib

Which orders should a nurse question for a 5-month-old infant with hypoplastic left heart syndrome who is hospital- ized awaiting the second stage of surgical repair? Select all that apply. 1. Call physician for oxygen saturations below 85%. 2. Daily weights. 3. Hold digoxin (Lanoxin) for heart rate less than 80 beats per minute. 4. Strict I&O. 5. Enfamil formula ad lib.

1. Call physician for oxygen saturations below 85%. 3. Hold digoxin (Lanoxin) for heart rate less than 80 beats per minute. 5. Enfamil formula ad lib.

A child, in renal failure, is diagnosed with hyperkalemia. Which food choices will the nurse teach the parents and child to avoid? 1. Carrots and green, leafy vegetables 2. Chips, cold cuts, and canned foods 3. Spaghetti and meat sauce, breadsticks 4. Hamburger on a bun, cherry gelatin

1. Carrots and green, leafy vegetables

While suctioning a child with a tracheostomy tube in place, a nurse discovers that the suction catheter will not advance inside the tracheostomy tube and the child is becoming pale and anxious, with noticeable suprasternal retractions. What should be the nurse's priority action? 1. Change the tracheostomy tube at once 2. Instill normal saline into the tracheostomy tube and attempt to suction again 3. Obtain a pulse oximetry reading 4. Auscultate lung sounds

1. Change the tracheostomy tube at once

An infant in a newborn nursery is identified as having phenylketonuria (PKU). What is the best initial source of nutrients for an infant with this diagnosis? 1. Maternal breast milk. 2. Pregestimil. 3. Lofenalac. 4. Isomil.

1. Maternal breast milk.

While suctioning a child with a tracheostomy tube in place, a nurse discovers that the suction catheter will not advance inside the tracheostomy tube and the child is becoming pale and anxious, with noticeable suprasternal retractions. What should be the nurse's priority action? 1. Change the tracheostomy tube at once. 2. Instill normal saline into the tracheostomy tube and attempt suctioning again. 3. Obtain a pulse oximetry reading. 4. Auscultate lung sounds.

1. Change the tracheostomy tube at once.

A nurse is working with a nursing student in the care of a young child status post-appendectomy. The student checks the current order of IV gentamicin and discovers the ordered dose is above the safe dose range based on the child's weight. What should be the nurse's first action? 1. Check the child's recent lab work 2. Contact the physician 3. Order a hearing test 4. Obtain an order for BUN and creatinine

1. Check the child's recent lab work

A nurse is working with a nursing student in the care of a young child status post-appendectomy. The student checks the current order of IV gentamicin and discovers the ordered dose is above the safe dose range based on the child's weight. What should be the nurse's first action? 1. Check the child's recent lab work. 2. Contact the physician. 3. Order a hearing test. 4. Obtain an order for BUN and creatinine.

1. Check the child's recent lab work.

The mother of a child with a heart defect is questioning the nurse about the child's diuretic. When teaching the mother about the medication, what should the emphasis from the nurse? 1. Close monitoring of output 2. The digitalization process 3. The possibility that pulses in the child might be weak 4. The child's increased appetite

1. Close monitoring of output

After teaching the mother of a young child with a peritoneal catheter about the signs and symptoms of peritonitis, the nurse determines that the mother has understood the teaching when she identifies which of the following as an important sign? 1. Cloudy dialysate drainage return. 2. Distended abdomen. 3. Shortness of breath. 4. Weight gain of 3 lb in 2 days.

1. Cloudy dialysate drainage return.

A nurse enters the room of a child following the placement of a ventriculoperitoneal shunt. The child is sitting up in bed, crying, and has vomited a small amount on the bed linens. What are the priority nursing actions? Select all that apply 1. Complete a neurological assessment 2. Place the child in the supine position 3. Administer the antiemetic as ordered 4. Complete a pain assessment 5. Increase the child's IV rate

1. Complete a neurological assessment 3. Administer the antiemetic as ordered 4. Complete a pain assessment

A nurse enters the room of a child following the placement of a ventriculoperitoneal shunt. The child is sitting up in bed, crying, and has vomited a small amount on the bed linens. What are the priority nursing actions? Select all that apply. 1. Complete a neurological assessment. 2. Place the child in the supine position. 3. Administer the antiemetic as ordered. 4. Complete a pain assessment. 5. Increase the child's IV rate.

1. Complete a neurological assessment. 3. Administer the antiemetic as ordered. 4. Complete a pain assessment.

A hospitalized child is experiencing sickle cell vasoocclusive crisis. The child is currently receiving an intra- venous (IV) fluid bolus, pain medication every 4 hours, and warm compresses to the extremities per physician orders. During the midday assessment, the child reports no pain. Which action should a nurse take? 1. Continue to apply warm compresses per physician order. 2. Hold the next dosage of pain medication. 3. Hold the next round of warm compresses. 4. Contact the physician for a change in orders.

1. Continue to apply warm compresses per physician order.

A hospitalized child is experiencing sickle cell vaso-occlusive crisis. The child is currently receiving IV fluid bolus, pain medication Q4H, and warm compresses to the extremities per physician orders. During the midday assessment, the child reports no pain. Which action should a nurse take? 1. Continue to apply warm compresses per physician orders 2. Hold the next dosage of pain medication 3. Hold the next round of warm compresses 4. Contact the physician for a change in orders

1. Continue to apply warm compresses per physician orders

A child is admitted with acute exacerbation of asthma. A physician orders 100% oxygen via mask. Which physician order should be a nurse's next priority? 1. Continuous inhaled albuterol 2. IV Solu-Medrol 2mg/kg loading dose 3. IV fluids at maintenance rate 4. Chest x-ray

1. Continuous inhaled albuterol

A child is admitted with acute exacerbation of asthma. A physician orders 100% oxygen via mask. Which physician order should be a nurse's next priority? 1. Continuous inhaled albuterol. 2. IV Solu-Medrol 2 mg/kg loading dose. 3. IV fluids at maintenance rate. 4. Chest x-ray.

1. Continuous inhaled albuterol.

A child who has been diagnosed with chorea has been admitted to the pediatric unit with a diagnosis of rheumatic fever. Immediately prior to admission, the child's throat culture was positive for group A strep. Which of the following actions should the nurse perform when admitting the child? Select all that apply. 1. Cover the headboard with a soft material. 2. Put the child on droplet precautions. 3. Place a tracheostomy tray in the child's room. 4. Have the child perform active range of motion exercises. 5. Assess the child's apical heart rate for one full minute.

1. Cover the headboard with a soft material. 2. Put the child on droplet precautions. 5. Assess the child's apical heart rate for one full minute.

The nurse determines that interventions for decreasing fluid retention have been effective when the child with nephrotic syndrome demonstrates evidence of which of the following? 1. Decreased abdominal girth. 2. Increased caloric intake. 3. Increased respiratory rate. 4. Decreased heart rate.

1. Decreased abdominal girth.

An 18-month-old with a congenital heart defect is to receive digoxin twice a day. The nurse should instruct the parents about which of the following? 1. Digoxin enables the heart to pump more effectively with a slower and more regular rhythm. 2. Signs of toxicity include loss of appetite, vomiting, increased pulse, and visual disturbances. 3. Digoxin is absorbed better if taken with meals. 4. If the child vomits within 15 minutes of administration, the dosage should be repeated.

1. Digoxin enables the heart to pump more effectively with a slower and more regular rhythm.

The parents of a 9-month-old bring the infant to the clinic for a regular checkup. The infant has received no immunizations. Which of the following would be appropriate for the nurse to administer at this visit? 1. Diphtheria, tetanus, and acellular pertussis (DTaP); Haemophilus influenzae type B (Hib); inactivated poliomyelitis vaccine (IPV); and purified protein derivative (PPD). 2. DTaP; Hib; oral polio vaccine (OPV); and measles, mumps, and rubella (MMR). 3. PPD, MMR, hepatitis B (hepB), and OPV. 4. HepB, IPV, Hib, and varicella.

1. Diphtheria, tetanus, and acellular pertussis (DTaP); Haemophilus influenzae type B (Hib); inactivated poliomyelitis vaccine (IPV); and purified protein derivative (PPD).

A toddler with Kawasaki disease is to receive IV immune globulin. Which of the following actions must the nurse perform? Select all that apply. 1. Discard the immune globulin if it appears cloudy. 2. Check the expiration date of the immune globulin. 3. Secure the arm to the arm board with a clear shield. 4. Document the lot number of the infusion in the child's medical record. 5. Allow the refrigerated immune globulin to warm in the microwave for 1 full minute.

1. Discard the immune globulin if it appears cloudy. 2. Check the expiration date of the immune globulin. 3. Secure the arm to the arm board with a clear shield. 4. Document the lot number of the infusion in the child's medical record.

The nurse is performing the initial assessment of a child newly diagnosed Kawasaki disease. Which symptoms would the nurse expect to assess with this child? 1. Dry, swollen, fissured lips 2. Non-palpable lymph nodes 3. Conjunctivitis with exudates 4. Cyanosis of the hands and feet

1. Dry, swollen, fissured lips

The nurse and parents are planning for the discharge of a child with leukemia who is receiv- ing dactinomycin (actinomycin D) and vincristine (Oncovin). The nurse should teach the parents to: 1. Encourage increased fluid intake. 2. Keep the child out of the sun. 3. Monitor the child's heart rate. 4. Observe the child for drowsiness.

1. Encourage increased fluid intake.

The nurse teaches parents how to care for their child who has tympanostomy tubes inserted. Which actions by the parents indicate appropriate understanding of the teaching session? Select all that apply. 1. Encouraging the child to drink generous amounts of fluids 2. Administering a decongestant for one to two weeks following surgery 3. Restricting the child to quiet activities after surgery 4. Limiting diet to soft, bland foods 5. Avoiding getting water in ears during bath time

1. Encouraging the child to drink generous amounts of fluids 3. Restricting the child to quiet activities after surgery 5. Avoiding getting water in ears during bath time

An infant is admitted for probable pyloric stenosis. A physician orders IV fluid and makes the infant NPO pending surgical consult. The infant is crying vigorously and the parents express frustration that they cannot feed their baby even though the surgery is not yet definite. Which is the best action for the nurse to take now? 1. Explain to the parents that feeding an infant with pyloric stenosis can lead to electrolyte imbalances from possible vomiting 2. Offer the parents a pacifier for the infant 3. Place a call to the surgeon t find out how long it will be before the consult 4. Feed the infant a small amount of Pedialyte since the surgical repair for this condition will most likely not occur until the following day

1. Explain to the parents that feeding an infant with pyloric stenosis can lead to electrolyte imbalances from possible vomiting

An infant is admitted for probable pyloric stenosis. A physician orders IV fluids and makes the infant NPO pending a surgical consult. The infant is crying vigorously and the parents express frustration that they cannot feed their baby even though the surgery is not yet definite. Which is the best action for the nurse to take now? 1. Explain to the parents that feeding an infant with pyloric stenosis can lead to electrolyte imbalances from possible vomiting. 2. Offer the parents a pacifier for the infant. 3. Place a call to the surgeon to find out how long it will be before the consult. 4. Feed the infant a small amount of Pedialyte since the surgical repair for this condition will most likely not occur until the following day.

1. Explain to the parents that feeding an infant with pyloric stenosis can lead to electrolyte imbalances from possible vomiting.

A physician prescribes digoxin for a toddler with congestive heart failure. Before administering 1. First obtain an apical heart rate 2. Determine the serum potassium 3. Review the child's admission ECG 4. Mix the medication with a pleasant-tasting food

1. First obtain an apical heart rate

A physician prescribes digoxin (Lanoxin) for a toddler with congestive heart failure (CHF). Before administering the medication, it is most important for the nurse to: 1. First obtain an apical heart rate. 2. Determine the serum potassium. 3. Review the child's admission electrocardiogram (ECG). 4. Mix the medication with a pleasant-tasting food.

1. First obtain an apical heart rate.

An infant is admitted to a pediatric unit with labored breathing and moderate amounts of thick nasal secretions. What nursing intervention is most likely to improve the infant's oxygenation? 1. Frequent suctioning of the nares with a nasal olive 2. Providing supplemental oxygen via nasal cannula 3. Strict monitoring of oxygen saturation levels 4. Placing the child in an infant seat

1. Frequent suctioning of the nares with a nasal olive

An infant is admitted to a pediatric unit with labored breathing and moderate amounts of thick nasal secre- tions. What nursing intervention is most likely to improve the infant's oxygenation? 1. Frequent suctioning of the nares with a nasal olive. 2. Providing supplemental oxygen via nasal cannula. 3. Strict monitoring of oxygen saturation levels. 4. Placing the child in an infant seat.

1. Frequent suctioning of the nares with a nasal olive.

The nurse is preparing an educational session for sexually active adolescents. Which statements are appropriate for the nurse to include when educating about sexually transmitted infections (STIs)? Select all that apply. 1. Frequently diagnosed STIs include chlamydia, genital herpes, gonorrhea, human papillomavirus, trichomoniasis, and syphilis. 2. Your risk for contracting an STI can be decreased by using a condom when having sex. 3. Birth control pills are useful in decreasing your risk of contracting an STI. 4. Risk factors for pelvic inflammatory disease (PID) include multiple sexual partners, lack of barrier protection during intercourse, and history of an STI. 5. Pelvic inflammatory disease (PID) is an infection of the lower genital tract.

1. Frequently diagnosed STIs include chlamydia, genital herpes, gonorrhea, human papillomavirus, trichomoniasis, and syphilis. 2. Your risk for contracting an STI can be decreased by using a condom when having sex. 4. Risk factors for pelvic inflammatory disease (PID) include multiple sexual partners, lack of barrier protection during intercourse, and history of an STI.

A child with nephrotic syndrome has been prescribed prednisone. The nurse should monitor the child for which of the following medication side effects? 1. Gastric distress 2. Bradycardia 3. Hypoglycemia 4. Weight loss

1. Gastric distress

Discharge teaching for a 3-month-old infant with a cardiac defect who is to receive digoxin (Lanoxin) should include which of the following? Select all that apply. 1. Give the medication at regular intervals. 2. Mix the medication with a small volume of breast milk or formula. 3. Repeat the dose one time if the child vomits immediately after administration. 4. Notify the primary care provider of poor feeding or vomiting. 5. Make up any missed doses as soon as realized. 6. Notify the primary care provider if more than 2 consecutive doses are missed. 7. Keep medication in a safe place, preferably a locked cabinet. 8. Induce vomiting if there is an accidental overdose.

1. Give the medication at regular intervals. 4. Notify the primary care provider of poor feeding or vomiting. 6. Notify the primary care provider if more than 2 consecutive doses are missed. 7. Keep medication in a safe place, preferably a locked cabinet.

A school-age child has been seen in the pediatric clinic three times in the last two months for complaints of abdominal pain. Physical exam and all ordered lab work have been normal. Which question by the nurse would most likely help determine the etiology of the child's abdominal pain? 1. Have there been any changes in your child's school or home life recently? 2. How many meals does your child eat each day? 3. Are your child's immunizations up to date? 4. Has your child had any fevers or viral illnesses in the last three months?

1. Have there been any changes in your child's school or home life recently?

The school nurse is planning a smoking-prevention program for middle school students. Which intervention is most likely to be effective in preventing middle school children from smoking? 1. Having a local high school basketball star come to talk to the students about the importance of not smoking 2. Having the schools biology teacher demonstrate the pathophysiology of the effects of smoking tobacco on the body 3. Developing colorful posters with catchy slogans and placing them all over the school 4. Having a pledge campaign with prizes awarded, during which students sign contracts saying that they will not use tobacco products

1. Having a local high school basketball star come to talk to the students about the importance of not smoking

Which of the following initial physical findings indicate the development of carditis in a child with rheumatic fever? 1. Heart murmur. 2. Low blood pressure. 3. Irregular pulse. 4. Anterior chest wall pain.

1. Heart murmur.

A 12-year-old with leukemia will be taking vincristine. The nurse should encourage the child to eat what kind of diet? 1. High-residue. 2. Low-residue. 3. Low-fat. 4. High-calorie.

1. High-residue.

Which statement made by the mother of a child with cystic fibrosis should indicate to a nurse that the mother is in need of further teaching regarding the administration of pancreatic enzymes? 1. I'll crush the capsules and mix with my child's food 2. The capsule can be broken and its contents sprinkled onto food 3. I may need to give more enzymes with larger meals 4. I will administer the enzymes 30 minutes after the meal

1. I'll crush the capsules and mix with my child's food

A parent asks why it is recommended that the second dose of the measles, mumps, and rubella (MMR) vaccine be given at 4 to 6 years of age? The nurse should explain to the parent that the second dose is given at this age for what reason? 1. If the child reaches puberty and becomes pregnant when receiving the vaccine, the risks to the fetus are high. 2. The chance of contracting the disease is much lower at this age. 3. The dangers associated with a strong reaction to the vaccine are increased at this age. 4. A serious complication from the vaccine is swelling of the joints.

1. If the child reaches puberty and becomes pregnant when receiving the vaccine, the risks to the fetus are high.

The nurse admits a child with a ventricular septal defect (VSD) to the unit. Which nursing diagnosis for this child is the most appropriate? 1. Impaired Gas Exchange Related to Pulmonary Congestion Secondary to the Increased Pulmonary Blood Flow 2. Deficient Fluid Volume Related to Hyperthermia Secondary to the Congenital Heart Defect 3. Acute Pain Related to the Effects of a Congenital Heart Defect 4. Hypothermia Related to Decreased Metabolic State

1. Impaired Gas Exchange Related to Pulmonary Congestion Secondary to the Increased Pulmonary Blood Flow

The nurse educator is teaching a group of nursing students the pathophysiologic reasons related to genitourinary (GU) disorders in the pediatric population. Which statements are appropriate for the nurse educator to include in the teaching session? Select all that apply. 1. Incomplete organ development during fetal development is the cause of many GU disorders. 2. Improper placement of the urethra in vagina is one cause of GU disorders. 3. GU disorders in the pediatric population can be caused by hydronephrosis. 4. GU disorders in the pediatric population are not caused by infections. 5. Anatomic obstruction or incomplete nerve innervation can cause GU disorders.

1. Incomplete organ development during fetal development is the cause of many GU disorders. 3. GU disorders in the pediatric population can be caused by hydronephrosis. 5. Anatomic obstruction or incomplete nerve innervation can cause GU disorders.

After a child undergoes nephrectomy for a Wilms' tumor, the nurse should assess the child postoperatively for which early sign of a complication? 1. Increased abdominal distention. 2. Elevated blood pressure. 3. Increased respiratory rate. 4. Increased urine output.

1. Increased abdominal distention.

When teaching a class on home safety to new parents, on which type of exposure should a nurse focus as the primary cause of lead poisoning in children? 1. Ingesting paint dust or chips from an old home 2. Having a parent who works near lead products 3. Riding in a care that uses leaded gasoline 4. Chewing on pencils with lead tips

1. Ingesting paint dust or chips from an old home

When teaching a class on home safety to new parents on which type of exposure should a nurse focus as the primary cause of lead poisoning in children? 1. Ingesting paint dust or chips from an old home. 2. Having a parent who works near lead products. 3. Riding in a car that uses leaded gasoline. 4. Chewing on pencils with lead tips.

1. Ingesting paint dust or chips from an old home.

When teaching a class on home safety to new parents, on which type of exposure should a nurse focus as the primary cause of lead poisoning in children? 1. Ingesting paint dust or chips from an old home. 2. Having a parent who works near lead products. 3. Riding in a car that uses leaded gasoline. 4. Chewing on pencils with lead tips.

1. Ingesting paint dust or chips from an old home.

A parent asks the nurse about head lice (pediculosis capitis) infestation during a visit to the clinic. Which of the following symptoms should the nurse tell the parent is most common in a child infected with head lice? 1. Itching of the scalp. 2. Scaling of the scalp. 3. Serous weeping on the scalp surface. 4. Pinpoint hemorrhagic spots on the scalp surface.

1. Itching of the scalp.

The nurse is conducting an admission assessment for a preschool-age client in the emergency department. When using the resiliency theory, which findings place this client at risk? Select all that apply. 1. Loss of health insurance 2. No primary care provider 3. Incomplete immunizations 4. A grandmother who is able to room-in 5. High level language skills from the child

1. Loss of health insurance 2. No primary care provider 3. Incomplete immunizations

A school-aged child visits a school nurse and states that a family member has been behaving inappropriately by touching the child near the groin area. What should be the school nurse's priority action? 1. Make a report to the proper child protective authorities as mandated by law 2. Contact the child's parents to share what the child has reported 3. Question the child to determine all of the details of the inappropriate toughing 4. Provide the child with a safe and calm environment in which to continue the discussion

1. Make a report to the proper child protective authorities as mandated by law

A school-age child visits a school nurse and states that a family member has been behaving inappropriately by touching the child near the groin area. What should be the school nurse's priority action? 1. Make a report to the proper child protective authorities as mandated by law. 2. Contact the child's parents to share what the child has reported. 3. Question the child to determine all of the details of the inappropriate touching. 4. Provide the child with a safe and calm environment in which to continue the discussion.

1. Make a report to the proper child protective authorities as mandated by law.

The nurse is transferring a child who has had open heart surgery from the pediatric intensive care unit to the pediatric unit. The child's blood pressure has been fluctuating but has been stable during the last 2 hours. The nurse from the pediatric intensive care unit should include which of the following information in the report to the nurse on the pediatric unit? Select all that apply. 1. Medications being used. 2. Current vital signs. 3. Potential for blood pressure to drop. 4. Drip rate for the intravenous infusion. 5. Time of the most recent dose of pain medication.

1. Medications being used. 2. Current vital signs. 3. Potential for blood pressure to drop. 4. Drip rate for the intravenous infusion. 5. Time of the most recent dose of pain medication.

The nurse is providing care to a school-age client admitted to the emergency department following a motor vehicle crash. The client is exhibiting symptoms of hypovolemic shock. Which nursing interventions are appropriate for this client? Select all that apply. 1. Monitor hemoglobin and hematocrit. 2. Monitor liver enzymes. 3. Administer oxygen, as needed. 4. Administer a dextrose solution. 5. Monitor blood glucose.

1. Monitor hemoglobin and hematocrit. 3. Administer oxygen, as needed. 5. Monitor blood glucose.

A child is being sent home after a tonsillectomy. Which of the following actions should the nurse educate the parents to perform? 1. Monitor the child for excessive swallowing. 2. Place warm compresses around the child's neck. 3. Encourage the child to drink cold citrus juices. 4. Position the child supine for the next six hours.

1. Monitor the child for excessive swallowing.

A preschool-age client diagnosed with nephrotic syndrome is placed on prednisone for several weeks. Which teaching point is appropriate for the nurse to include in the teaching plan for this client? 1. Never stop the medication suddenly. 2. This drug is taken once a week on Sunday. 3. The child should always take the medication at night before bed. 4. This drug should be taken with meals.

1. Never stop the medication suddenly.

A school-age client diagnosed with nephrotic syndrome is severely edematous. The primary healthcare provider has placed the child on bed rest. Which nursing intervention is a priority for this client? 1. Reposition the child every two hours. 2. Monitor BP every 30 minutes. 3. Encourage fluids. 4. Limit visitors.

1. Reposition the child every two hours.

A child has had open heart surgery to repair a tetralogy of Fallot with a patch. The nurse should instruct the parents to: 1. Notify all health care providers before invasive procedures for the next 6 months. 2. Maintain adequate hydration of at least 10 glasses of water a day. 3. Provide for frequent rest periods and naps during the first 4 weeks. 4. Restrict the ingestion of bananas and citrus fruit.

1. Notify all health care providers before invasive procedures for the next 6 months.

A nurse is caring for a child with acute glomerulonephritis. Which nursing assessment should be the nurse's first priority when caring for this child? 1. Obtaining a daily weight 2. Palpating extremities frequently for edema 3. Assessing urine for hematuria 4. Obtaining the child's blood pressure every shift

1. Obtaining a daily weight

A nurse is caring for a child with acute glomerulonephritis. Which nursing assessment should be the nurse's first priority when caring for this child? 1. Obtaining a daily weight. 2. Palpating extremities frequently for edema. 3. Assessing urine for hematuria. 4. Obtaining the child's blood pressure every shift.

1. Obtaining a daily weight.

The nurse is performing an assessment on a child admitted to hospital with a probable diagnosis of nephrotic syndrome. Which assessment findings should the nurse expect to observe? Select all that apply. 1. Pallor 2. Edema 3. Anorexia 4. Proteinuria 5. Weight loss 6. Decreased serum lipids

1. Pallor 2. Edema 3. Anorexia 4. Proteinuria

An infant with tetralogy of Fallot is having a hypercyanotic episode (tet spell). Which nursing interventions are appropriate for the nurse to implement for this infant? Select all that apply. 1. Place the child in knee-chest position. 2. Draw blood for a serum hemoglobin. 3. Administer oxygen. 4. Administer morphine and propranolol intravenously as ordered. 5. Administer Benadryl as ordered.

1. Place the child in knee-chest position. 3. Administer oxygen. 4. Administer morphine and propranolol intravenously as ordered.

The nurse is planning interventions for the nursing diagnosis Deficient diversional activity for a school-age child. Which of the following activities should the nurse expect to include? 1. Playing a card game with someone the same age. 2. Putting together a puzzle with mother. 3. Playing video games with a 4-year-old. 4. Watching a movie with a younger brother.

1. Playing a card game with someone the same age.

The parents of a preschooler ask the nurse how to handle their child's temper tantrums. Which of the following should the nurse include in the teaching plan? Select all that apply. 1. Putting the child in "time-out." 2. Telling the child to go to his bedroom. 3. Ignoring the child. 4. Putting the child to bed. 5. Spanking the child. 6. Trying to reason with the child.

1. Putting the child in "time-out." 3. Ignoring the child.

Which condition in children and adolescents should a nurse identify as being associated with metabolic alkalosis? Select all that apply 1. Pyloric stenosis 2. Diabetes 3. Renal failure 4. Bulimia nervosa 5. Aspirin ingestion

1. Pyloric stenosis 4. Bulimia nervosa

Which conditions in children and/or adolescents should a nurse identify as being associated with metabolic alkalosis? Select all that apply. 1. Pyloric stenosis. 2. Diabetes. 3. Renal failure. 4. Bulimia nervosa. 5. Aspirin ingestion.

1. Pyloric stenosis. 4. Bulimia nervosa.

A 13-year-old has been admitted with a diagnosis of rheumatic fever and is on bed rest. He complains of a sore throat. His joints are painful and swollen. He has a red rash on his trunk and is experiencing aimless movements of his extremities. Temp: 100.4 -> 98.6, Respirations: 22-> 24, Apical HR: 110 -> 150, BP: 110/80 -> 120/85 1. Report the heart rate to the physician. 2. Apply lotion to the rash. 3. Splint the joints to relieve the pain. 4. Request an order for medication to treat the elevated temperature.

1. Report the heart rate to the physician.

1. Reposition the child every two hours.

During a well-child exam, the parents of a preschool-age child inform the nurse that they are thinking of buying a television for their childs bedroom and ask for advice as to whether this is appropriate. Which response by the nurse is the most appropriate? 1. Research has shown that children with a television in their bedroom spend significantly less time playing outside than other children, and physical inactivity in children has been linked to many chronic diseases such as obesity and type 2 diabetes. 2. Research has shown that watching educational television shows improves a child's performance in school. 3. Don't buy a television for your child's room; he is much too young for that. 4. It is okay for children to have a television in their room as long as you limit the amount of time they watch it to less than two hours per day.

1. Research has shown that children with a television in their bedroom spend significantly less time playing outside than other children, and physical inactivity in children has been linked to many chronic diseases such as obesity and type 2 diabetes.

The nurse is planning care for a child with hemolytic-uremic syndrome who has been anuric and will be receiving peritoneal dialysis treatment. The nurse should plan to implement which measure? 1. Restrict fluids as prescribed 2. Care for the arteriovenous fistula 3. Encourage foods high in potassium 4. Administer analgesics as prescribed

1. Restrict fluids as prescribed

A 13-year-old client diagnosed with beta-thalassemia is hospitalized for blood transfusion. What are the priority nursing diagnoses related to this child's care? Select all that apply 1. Risk for infection 2. Impaired elimination 3. Risk for injury 4. Disturbed body image 5. Chronic pain 6. Activity intolerance

1. Risk for infection 3. Risk for injury 4. Disturbed body image 6. Activity intolerance

A 13-year-old client diagnosed with beta-thalassemia is hospitalized for blood transfusion. What are the priority nursing diagnoses related to this child's care? Select all that apply. 1. Risk for infection. 2. Impaired elimination. 3. Risk for injury. 4. Disturbed body image. 5. Chronic pain. 6. Activity intolerance.

1. Risk for infection. 3. Risk for injury. 4. Disturbed body image. 6. Activity intolerance.

What assessment findings should a nurse expect in a child with acute post-streptococcal glomerulonephritis? Select all that apply 1. Severe hematuria 2. Pallor 3. Decreased urine specific gravity 4. Weight gain 5. Headache 6. Massive proteinuria

1. Severe hematuria 2. Pallor 4. Weight gain 5. Headache

What assessment findings should a nurse expect in a child with acute post-streptococcal glomerulonephritis? Select all that apply. 1. Severe hematuria. 2. Pallor. 3. Decreased urine specific gravity. 4. Weight gain. 5. Headache. 6. Massive proteinuria.

1. Severe hematuria. 2. Pallor. 4. Weight gain. 5. Headache.

A child is prescribed hemodialysis for the treatment of kidney failure. When providing care for this child, what will the nurse monitor for during the assessment? Select all that apply. 1. Shock 2. Hypotension 3. Infections 4. Migraines 5. Fluid overload

1. Shock 2. Hypotension 3. Infections

A child is admitted with infective endocarditis. Which nursing intervention is most appropriate for this child? 1. Start an intravenous line. 2. Place the child in contact isolation. 3. Place the child on seizure precautions. 4. Assist with a lumbar puncture.

1. Start an intravenous line.

A transfusion of packed red blood cells has been ordered for a 1-year-old with a sickle cell anemia. The infant has a 25 gauge I.V. infusing dextrose with sodium and potassium. Using the Situation, Background, Assessment, Recommendation (SBAR) method of communication, the nurse contacts the physician and recommends: 1. Starting a second I.V. with a 22 gauge catheter to infuse normal saline with the blood. 2. Using the existing I.V., but changing the fluids to normal saline for the transfusion. 3. Replacing the I.V. with a 22 gauge catheter to infuse the ordered fluids. 4. Starting a second I.V. with a 25 gauge catheter to infuse normal saline with the transfusion.

1. Starting a second I.V. with a 22 gauge catheter to infuse normal saline with the blood.

Which symptoms, if present in a child, should a nurse recognize as being characteristic of Kawasaki disease? (select all that apply) 1. Strawberry tongue 2. High fever 3. Irritability 4. Cough 5. Desquamation of the extremities 6. Elevated ESR

1. Strawberry tongue 2. High fever 3. Irritability 5. Desquamation of the extremities 6. Elevated ESR

Which symptom(s), if present in a child, should a nurse recognize as being characteristic of Kawasaki disease? Select all that apply. 1. Strawberry tongue. 2. High fever. 3. Irritability. 4. Cough. 5. Desquamation of the extremities. 6. Elevated ESR.

1. Strawberry tongue. 2. High fever. 3. Irritability. 5. Desquamation of the extremities. 6. Elevated ESR.

A mother has heard that several children have been diagnosed with mononucleosis. She asks the nurse what precautions should be taken to prevent this from occurring in her child. The nurse should instruct the mother to: 1. Take no particular precautionary measures. 2. Sterilize the child's eating utensils before they are reused. 3. Wash the child's linens separately in hot, soapy water. 4. Wear masks when providing direct personal care.

1. Take no particular precautionary measures.

In developing a plan of care for a hospitalized preschooler, a nurse recognizes that it is most essential to consider: 1. That the child may believe the hospitalization is a punishment 2. Ways to provide visitation from peers 3. How to improve play activities with other children 4. Ways to promote privacy and independence

1. That the child may believe the hospitalization is a punishment

In developing a plan of care for a hospitalized preschooler, a nurse recognizes that it is most essential to consider: 1. That the child may believe the hospitalization is a punishment. 2. Ways to provide visitation from peers. 3. How to incorporate play activities with other children. 4. Ways to promote privacy and independence.

1. That the child may believe the hospitalization is a punishment.

The oncologist caring for a child immediately postsurgery for Wilms' tumor reports: the child is in Stage III. The child will go through a series of chemotherapy. Based on the proposed therapy, which of the following patient-care goals should be included in the child's nursing care plan? Select all that apply. 1. The child will be free of infection. 2. The child will experience no tissue damage. 3. The child will have regular bowel movements. 4. The child will not complain of nausea and will not vomit. 5. The child will regress to the previous level of growth and development.

1. The child will be free of infection. 2. The child will experience no tissue damage. 3. The child will have regular bowel movements. 4. The child will not complain of nausea and will not vomit.

When providing client teaching to the caregivers of a young child with sickle cell disease, a nurse should stress that: 1. The child's diet should include whole grains and leafy green vegetables 2. Immunizations should be delayed until the child enters school 3. There is a 50% chance that the child's future offspring will have sickle cell anemia 4. The parents should request IV Demerol if the child is hospitalized with pain crisis

1. The child's diet should include whole grains and leafy green vegetables

When providing client teaching to the caregivers of a young child with sickle cell disease, a nurse should stress that: 1. The child's diet should include whole grains and leafy green vegetables. 2. Immunizations should be delayed until the child enters school. 3. There is a 50% chance that the child's future offspring will have sickle cell anemia. 4. The parents should request IV Demerol if the child is hospitalized with pain crisis.

1. The child's diet should include whole grains and leafy green vegetables.

When providing client teaching to the caregivers of a young child with sickle cell disease, a nurse should stress that: 1. The child's diet should include whole grains and leafy green vegetables. 2. Immunizations should be delayed until the child enters school. 3. There is a 50% chance that the child's future offspring will have sickle cell anemia. 4. The parents should request IV Demerol if the child is hospitalized with pain crisis.

1. The child's diet should include whole grains and leafy green vegetables.

A nurse is planning to teach a group of 10-year-old children about drug and alcohol prevention. Which characteristics of this age group are important for the nurse to consider when developing the teaching plan Select all that apply 1. These children are achievement oriented 2. They expect good behavior to be rewarded 3. Their problem-solving approach tends to be concrete and systematic 4. The central persons in their lives tend to be friends 5. These children are nearing puberty

1. These children are achievement oriented 2. They expect good behavior to be rewarded 3. Their problem-solving approach tends to be concrete and systematic 4. The central persons in their lives tend to be friends 5. These children are nearing puberty

A nurse is planning to teach a group of 10-year-old children about drug and alcohol prevention. Which characteristics of this age group are important for the nurse to consider when developing the teaching plan? Select all that apply. 1. These children are achievement-oriented. 2. They expect good behavior to be rewarded. 3. Their problem-solving approach tends to be concrete and systematic. 4. The central persons in their lives tend to be friends. 5. These children are nearing puberty.

1. These children are achievement-oriented. 2. They expect good behavior to be rewarded. 3. Their problem-solving approach tends to be concrete and systematic. 4. The central persons in their lives tend to be friends. 5. These children are nearing puberty.

Which of the following actions indicates that the parents of a 12-month-old with iron deficiency anemia understand how to administer iron supplements? Select all that apply. 1. They administer iron supplements in combination with fruit juice. 2. They administer iron supplements with meals. 3. They report dark stools. 4. They brush the child's teeth after administering the iron supplements. 5. They decrease dietary intake of foods fortified with iron.

1. They administer iron supplements in combination with fruit juice. 4. They brush the child's teeth after administering the iron supplements.

The school nurse is implementing a program to decrease bullying. Which interventions are appropriate for the school nurse to implement? Select all that apply. 1. Train teachers about the behaviors 2. Ensure adult supervision in the hallways 3. Teach children to report behaviors 4. Ensure that immunizations are up-to-date 5. Set up anti-hazing policies

1. Train teachers about the behaviors 2. Ensure adult supervision in the hallways 3. Teach children to report behaviors

While the nurse is conducting the history of a school-age child, the parents admit to owning firearms. Which safety measures are appropriate to include in the teaching plan for this family? Select all that apply. 1. Using a gun lock on all firearms in the house 2. Taking the child to a shooting range for lessons on how to use a gun properly 3. Storing the guns and ammunition in separate places 4. Keeping all the guns in a locked cabinet 5. Explaining the dangers of a gun to the child and telling her explicitly to never touch it

1. Using a gun lock on all firearms in the house 3. Storing the guns and ammunition in separate places 4. Keeping all the guns in a locked cabinet

A nurse is caring for a child with tetralogy of Fallot. Which assessment findings should the nurse expect? Select all that apply 1. Ventricular septal defect (VSD) 2. Atrial septal defect (ASD) 3. Overriding aorta 4. Pulmonic stenosis 5. Right ventricular hypertrophy 6. Patent ductus arteriosus (PDA) 7. Left-to-right shunting of blood 8. Aortic stenosis

1. Ventricular septal defect (VSD) 3. Overriding aorta 4. Pulmonic stenosis 5. Right ventricular hypertrophy 7. Left-to-right shunting of blood

A nurse is caring for a child with tetralogy of Fallot. Which assessment findings should the nurse expect? Select all that apply. 1. Ventricular septal defect (VSD). 2. Atrial septal defect (ASD). 3. Overriding aorta. 4. Pulmonic stenosis. 5. Right ventricular hypertrophy. 6. Patent ductus arteriosus (PDA). 7. Left-to-right shunting of blood. 8. Aortic stenosis

1. Ventricular septal defect (VSD). 3. Overriding aorta. 4. Pulmonic stenosis. 5. Right ventricular hypertrophy. 7. Left-to-right shunting of blood.

A mother states that she thinks her 9-month-old "is developing slowly." When assessing the infant's development, the nurse is also concerned because the infant should be demonstrating which of the following characteristics? 1. Vocalizing single syllables. 2. Standing alone. 3. Building a tower of two cubes. 4. Drinking from a cup with little spilling.

1. Vocalizing single syllables.

A nurse teaches a child with spina bifida how to perform urinary self-catheterization. Which steps should the nurse include in the teaching? Place each correct step in sequential order. 1. Wash hands. 2. Open latex catheter package. 3. Lubricate tip of catheter. 4. Wash catheter with soap and water. 5. Cleanse perineum with Betadine swabs.

1. Wash hands. 3. Lubricate tip of catheter. 4. Wash catheter with soap and water.

The nurse is teaching a group of adolescents about care for acne vulgaris. Which interventions will the nurse include in the teaching session? Select all that apply. 1. Wash skin with mild soap and water twice a day. 2. Use astringents and vigorous scrubbing. 3. Avoid picking or squeezing the lesions. 4. Apply tretinoin (Retin-A) liberally. 5. Avoid sun exposure if on tetracycline.

1. Wash skin with mild soap and water twice a day. 3. Avoid picking or squeezing the lesions. 5. Avoid sun exposure if on tetracycline.

A child is scheduled for a kidney transplant. The nurse completes the preoperative teaching to prepare the child and parents for the surgery and postoperative considerations. Which statement by the parents indicates understanding of the teaching session? 1. We know it's important to see that our child takes prescribed medications after the transplant. 2. Well be glad we won't have to bring our child in to see the doctor again. 3. Were happy our child won't have to take any more medicine after the transplant. 4. We understand our child won't be at risk anymore for catching colds from other children at school.

1. We know it's important to see that our child takes prescribed medications after the transplant.

The nurse teaches a group of parent's strategies to reduce the risk of lead exposure for their children. Which statements indicate an appropriate understanding of the content presented? Select all that apply. 1. We will provide our child with frequent snacks high in iron and calcium. 2. We will wash any surfaces that have peeling paint. 3. We will store leftovers in a ceramic pot. 4. We can continue to use our traditional-medicine treatment, azarcon, for any GI upset. 5. We will sand the windowsills to remove the lead-based paint.

1. We will provide our child with frequent snacks high in iron and calcium. 2. We will wash any surfaces that have peeling paint.

A nurse is assessing an infant who has coarctation of the aorta. Which of the following findings should the nurse expect? Select all that apply. 1. Weak femoral pulses. 2. Cool skin of lower extremities 3. Severe cyanosis 4. Clubbing of the fingers 5. Heart failure

1. Weak femoral pulses. 2. Cool skin of lower extremities 5. Heart failure

The nurse is closely monitoring the intake and output of an infant with heart failure who is receiving diuretic therapy. The nurse should use which most appropriate method to assess I/O? 1. Weighing the diapers 2. Inserting a urinary catheter 3. Comparing I/O 4. Measuring the amount of water added to formula

1. Weighing the diapers

Because of the risks associated with administration of factor VIII concentrate, the nurse should teach the child's family to recognize and report which of the following? 1. Yellowing of the skin. 2. Constipation. 3. Abdominal distention. 4. Puffiness around the eyes.

1. Yellowing of the skin.

A child with nephrosis is placed on prednisone. The dose is 2 mg/kg/day to be administered twice a day. The child weighs 25 lb. How many milligrams will the child receive at each dose? ________________________ mg.

11.3 mg

A 2-year-old child brought to the clinic by her parents is uncooperative when the nurse tries to look in her ears. Which of the following should the nurse try first? 1. Ask another nurse to assist. 2. Allow a parent to assist. 3. Wait until the child calms down. 4. Restrain the child's arms.

2. Allow a parent to assist.

The nurse has provided home instructions for a child being discharged after cardiac surgery. Which statement indicates need for further teaching? 1. "A balance of rest and exercise is important" 2. "I can apply lotion or powder to the incision if it is itchy" 3. "Activities in which my child could fall need to be avoided for 2 to 4 weeks" 4. "Large crowds of people need to be avoided for at least 2 weeks after surgery"

2. "I can apply lotion or powder to the incision if it is itchy"

The nurse reviews the record of a child who is suspected to have glomerulonephritis. Which statement by the child's parent should the nurse expect that is associated with this diagnosis? 1. "I'm so glad they didn't find protein in his urine" 2. "I noticed his urine was the color of coca-cola lately" 3. "His health care provider said his kidneys are working well" 4. "The nurse who admitted my child said his BP was low"

2. "I noticed his urine was the color of coca-cola lately"

A father of a child with a urinary tract infection calls the clinic and explains, "My wife and I are concerned because our child refuses to obey us concerning the preventions you told us about. Our child refuses to take the medication unless we buy a present. We don't want to use discipline because of the illness, but we're worried about the behavior." Which response by the nurse is best? 1. "I sympathize with your difficulties, but just ignore the behavior for now." 2. "I understand it's hard to discipline a child who is ill, but things need to be kept as normal as possible." 3. "I understand that things are difficult for you right now, but your child is ill and deserves special treatment." 4. "I understand your concern, but this type of behavior happens all the time; your child will get over it when feeling better."

2. "I understand it's hard to discipline a child who is ill, but things need to be kept as normal as possible."

After teaching the parents of a child newly diagnosed with leukemia about the disease, which of the following descriptions given by the mother best indicates that she understands the nature of leukemia? 1. "The disease is an infection resulting in increased white blood cell production." 2. "The disease is a type of cancer characterized by an increase in immature white blood cells." 3. "The disease is an inflammation associated with enlargement of the lymph nodes." 4. "The disease is an allergic disorder involving increased circulating antibodies in the blood."

2. "The disease is a type of cancer characterized by an increase in immature white blood cells."

The parents of a Hispanic American child who has been diagnosed with Wilms' tumor ask the nurse about the origin of the tumor. Which of the following information should the nurse provide the parents? 1. "Nephroblastoma is a cancer that originated in another part of your child's body." 2. "The tumor often starts growing in the kidney while the baby is still in the uterus." 3. "Wilms' tumor is especially prevalent in the Hispanic population." 4. "The cancer is often seen in children who live in areas near nuclear reactors."

2. "The tumor often starts growing in the kidney while the baby is still in the uterus."

A mother asks the nurse, "How did my children get pinworms?" The nurse explains that pinworms are most commonly spread by which of the following when contaminated? 1. Food. 2. Hands. 3. Animals. 4. Toilet seats.

2. Hands.

The mother of a child hospitalized with tetralogy of Fallot tells the nurse that the child's 3-year-old sibling has become quiet and shy and demonstrates more than a usual amount of genital curiosity since this child's hospitalization. The nurse should tell the mother: 1. "This behavior is very typical for a 3-year-old." 2. "This may be how your child expresses feeling a need for attention." 3. "This may be an indication that your child may have been sexually abused." 4. "This may be a sign of depression in your child."

2. "This may be how your child expresses feeling a need for attention."

The nurse completes postoperative discharge teaching to the parents of a child who had a tonsillectomy. Which statement by the parents indicates correct understanding of the teaching session? 1. "We will call the physician for any indication of ear pain." 2. "We will plan on administering acetaminophen (Tylenol) for pain." 3. "We will be sure to give our child adequate amounts of citrus juices." 4. "We will keep our child on bed rest for 10 days after the surgery."

2. "We will plan on administering acetaminophen (Tylenol) for pain."

After reading the vaccine information sheets, the parent of a 2-month-old infant is hesitant to consent to the recommended vaccinations. The nurse should first ask the parent: 1. "Did you know that vaccinations are required by law for school entry?" 2. "What personal beliefs or safety concerns do you have about vaccinations?" 3. "Would you prefer that fewer vaccines are given at a time?" 4. "Can you please sign this vaccine waiver form?"

2. "What personal beliefs or safety concerns do you have about vaccinations?"

While the nurse is examining the infant for presence of testes, the father paces around the room shaking his head. Which of the following would be the most appropriate response by the nurse? 1. "I'm sure everything will work out for the best, and he'll be fine." 2. "You seem upset; please tell me how you're feeling." 3. "Don't worry; his testes will probably descend on their own." 4. "Would you like to talk with a parent of a child who has the same problem?"

2. "You seem upset; please tell me how you're feeling."

An RN and LVN/LPN are working as a team on a pediatric unit. Which task should the RN perform rather than delegating to the LVN/LPN? 1. Obtain a 12-lead ECG on a 10-year-old. 2. Change the dressing and examine the decubitus ulcer of a preschooler. 3. Administer a gavage feeding to an infant with failure to thrive. 4. Check the blood sugar of a teen in DKA.

2. Change the dressing and examine the decubitus ulcer of a preschooler.

The neonatal cardiologist orders digoxin (Lanoxin) for a newborn in congestive heart failure. The baby weighs 7 lb 8 oz and is 21 inches long. The drug reference states: for full-term newborns, 8 to 10 mcg/kg/day in divided doses every 12 hr. Which of the following orders would be safe for the nurse to administer? 1. 10mcgPOevery12hr 2. 15mcgPOevery12hr 3. 20mcgPOevery12hr 4. 25mcgPOevery12hr

2. 15mcgPOevery12hr

When planning a 15-month-old toddler's daily diet with the parents, which of the following amounts of milk should the nurse include? 1. 1⁄2 to 1 cup. 2. 2 to 3 cups. 3. 3 to 4 cups. 4. 4 to 5 cups.

2. 2 to 3 cups.

The nurse notes that an infant stares at an object placed in her hand and takes it to her mouth, coos and gurgles when talked to, and sustains part of her own weight when held in a standing position. The nurse correctly interprets these findings as characteristic of an infant at which of the following ages? 1. 2 months. 2. 4 months. 3. 7 months. 4. 9 months.

2. 4 months.

Which child would be the best roommate for a 9-year-old child with myelodysplasia who is hospitalized for a foot infection? 1. A 13-year-old with juvenile idiopathic arthritis 2. A 10-year-old with a fractured femur 3. An 8-year-old status post-appendectomy 4. A 6-year-old with bacterial meningitis

2. A 10-year-old with a fractured femur

Which child would be the best roommate for a 9-year-old child with myelodysplasia who is hospitalized for a foot infection? 1. A 13-year-old with juvenile idiopathic arthritis. 2. A 10-year-old with a fractured femur. 3. An 8-year-old status post-appendectomy. 4. A 6-year-old with bacterial meningitis.

2. A 10-year-old with a fractured femur.

An infant is hospitalized following febrile seizure. When a nurse teaches the infant's family about the prevention of future seizures, what would be the nurse's best recommendation? 1. Place the child in a tepid bath during the next febrile illness 2. Administer antipyretic around the clock the next time the child has a fever 3. Contact the physician for antibiotics if the child becomes feverish again 4. Take the child's temperature frequently during the next illness

2. Administer antipyretic around the clock the next time the child has a fever

An infant is hospitalized following a febrile seizure. When a nurse teaches the infant's family about the pre- vention of future seizures, what would be the nurse's best recommendation? 1. Place the child in a tepid bath during the next febrile illness. 2. Administer antipyretics around the clock the next time the child has a fever. 3. Contact the physician for antibiotics if the child becomes feverish again. 4. Take the child's temperature frequently during the next illness.

2. Administer antipyretics around the clock the next time the child has a fever.

A 2-year-old child with nephrotic syndrome is admitted to the pediatric unit. The following orders have been written in the child's medical record. Which of the actions is highest priority for the nurse to perform? 1. Place child on alternating pressure mattress. 2. Administer intravenous albumin. 3. Weigh all wet diapers. 4. Administer oral antibiotics

2. Administer intravenous albumin.

The nurse is teaching the parent of a type 1 diabetic preschool-age client about management of the disease. Which teaching point is appropriate for the nurse to include in this session? 1. Allowing the client to administer all the insulin injections (middle school & up) 2. Allowing the client to choose which finger to stick for glucose testing 3. Allowing the client to draw up the insulin dose (middle school & up) 4. Allowing the client to test blood glucose (middle school & up)

2. Allowing the client to choose which finger to stick for glucose testing

When assessing a child after heart surgery to correct tetralogy of Fallot, which of the following should alert the nurse to suspect a low cardiac output? 1. Bounding pulses and mottled skin. 2. Altered level of consciousness and thready pulse. 3. Capillary refill of 2 seconds and blood pressure of 96/67 mm Hg. 4. Extremities warm to the touch and pale skin.

2. Altered level of consciousness and thready pulse.

In doing a child's admission assessment, which signs and symptom should a nurse recognize as most likely related to rheumatic fever? 1. Vomiting and diarrhea 2. Arthralgia and muscle weakness 3. Conjunctivitis and red, cracked lips 4. Bradycardia and hypotension

2. Arthralgia and muscle weakness

In doing a child's admission assessment, which signs and symptoms should a nurse recognize as most likely related to rheumatic fever? 1. Vomiting and diarrhea. 2. Arthralgia and muscle weakness. 3. Conjunctivitis and red, cracked lips. 4. Bradycardia and hypotension.

2. Arthralgia and muscle weakness.

A nurse is preparing to administer an unpleasant tasting liquid medication to a toddler. What is the best method for administering this medication? 1. Mix the medication with a cup of ice cream to mask the taste 2. Ask the child to choose between two types of fluids as a chaser 3. Request the parents hold the child firmly so the nurse can place the medication into the mouth 4. Offer the child a toy out of the toy box as a reward if the child agrees to take the medication

2. Ask the child to choose between two types of fluids as a chaser

A child with nephrosis is taking prednisone. The nurse should teach the caregivers to report which of the following adverse effects? Select all that apply. 1. Increased urinary output. 2. Hematemesis. 3. Respiratory infection. 4. Bleeding gums. 5. Vision problems.

2. Hematemesis. 3. Respiratory infection.

A nurse is preparing to administer an unpleasant-tasting liquid medication to a toddler. What is the best method for administering this medication? 1. Mix the medication with a cup of ice cream to mask the taste. 2. Ask the child to choose between two types of fluids as a chaser. 3. Request the parents hold the child firmly so the nurse can place the medication into the mouth. 4. Offer the child a toy out of the toy box as a reward if the child agrees to take the medication.

2. Ask the child to choose between two types of fluids as a chaser.

A child with status pose-Harrington rod placement for the correction of scoliosis is being cared for on the pediatric unit. The child suddenly experiences facial sweating and complaints of headache. A nurse notes also a slower heart rate on the monitor. What action should the nurse take first? 1. Call the surgeon immediately 2. Assess patency of the urinary catheter 3. Administer pain medication as ordered 4. Complete a neurological assessment

2. Assess patency of the urinary catheter

A child with status post-Harrington rod placement for the correction of scoliosis is being cared for on the pedi- atric unit. The child suddenly experiences facial sweating and complains of a headache. A nurse notes also a slower heart rate on the monitor. What action should the nurse take first? 1. Call the surgeon immediately. 2. Assess patency of the urinary catheter. 3. Administer pain medication as ordered. 4. Complete a neurological assessment.

2. Assess patency of the urinary catheter.

While preparing for an admission, a nurse hears the alarm sound on the cardiac monitor of a child in the next bed. The nurse views the screen and sees what appears to be v-fib. What is the best initial action by the nurse? 1. Call out for help 2. Assess the child 3. Begin chest compressions 4. Press the "code blue" button

2. Assess the child

While preparing for an admission, a nurse hears the alarm sound on the cardiac monitor of a child in the next bed. The nurse views the screen and sees what appears to be ventricular fibrillation. What is the best initial action by the nurse? 1. Call out for help. 2. Assess the child. 3. Begin chest compressions. 4. Press the "Code Blue" button.

2. Assess the child.

A child diagnosed with hypopituitarism is to begin receiving daily injections. At what time should a nurse instruct the child's parents to administer the injection each day? 1. Before breakfast 2. At bedtime 3. With lunch 4. Any time the child prefers

2. At bedtime

A child diagnosed with hypopituitarism is to begin receiving daily injections. At what time should a nurse instruct the child's parents to administer the injection each day? 1. Before breakfast. 2. At bedtime. 3. With lunch. 4. Any time the child prefers.

2. At bedtime.

A nurse is caring for a child diagnosed with SIADH. Which laboratory test would the nurse be least likely to obtain? 1. Urine specific gravity 2. Blood glucose 3. Serum sodium 4. Urine osmolality

2. Blood glucose

A nurse is caring for a child diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH). Which labo- ratory test would the nurse be least likely to obtain? 1. Urine specific gravity. 2. Blood glucose. 3. Serum sodium. 4. Urine osmolality.

2. Blood glucose.

A nurse is preparing to admit a child with possible obstructive uropathy. Which laboratory test should the nurse expect to draw on this child? 1. Platelet count 2. Blood urea nitrogen (BUN) and creatinine 3. Partial thromboplastin time (PTT) 4. Blood culture

2. Blood urea nitrogen (BUN) and creatinine

The nurse is teaching an adolescent with asthma how to use an inhaler. In which order should the nurse instruct the client to follow the steps from first to last? 1. Inhale through an open mouth. 2. Breathe out through the mouth. 3. Hold the breath for 5 to 10 seconds. 4. Press the canister to release the medication.

2. Breathe out through the mouth. 1. Inhale through an open mouth. 4. Press the canister to release the medication. 3. Hold the breath for 5 to 10 seconds.

The pediatric nurse is working with a parent who is suspected of Munchausen Syndrome by Proxy. Which action by the nurse is the priority? 1. Confront the parent with concerns of possible abuse. 2. Carefully document parent-child interactions. 3. Try to keep the parent separated from the child as much as possible. 4. Explain to the child that the parent is causing the illness and that the health team will prevent the child from being harmed.

2. Carefully document parent-child interactions.

When teaching the parents of a child with a ventricular septal defect who is scheduled for a cardiac catheterization, the nurse explains that this procedure involves the use of which of the following? 1. Ultra-high-frequency sound waves. 2. Catheter placed in the right femoral vein. 3. Cutdown procedure to place a catheter. 4. General anesthesia.

2. Catheter placed in the right femoral vein.

An RN and LVN are working as a team on a pediatric unit. Which task should the RN perform rather than delegating to the LVN? 1. Obtain a 12-lead ECG on a 10-year-old 2. Change the dressing and examine the decubitus ulcer of a preschooler 3. Administer a gavage feeding to an infant with failure to thrive 4. Check the blood sugar of a teen in DKA

2. Change the dressing and examine the decubitus ulcer of a preschooler

A parent brings a 5-year-old child to a vac- cination clinic to prepare for school entry. The nurse notes that the child has not had any vaccinations since 4 months of age. To determine the current evidence for best practices for scheduling missed vaccinations the nurse should: 1. Ask the primary care provider. 2. Check the website at the Center for Disease Control and Prevention (CDC). 3. Read the vaccine manufacturer's insert. 4. Contact the pharmacist.

2. Check the website at the Center for Disease Control and Prevention (CDC).

A mother asks the nurse if her child's iron deficiency anemia is related to the child's frequent infections. The nurse responds based on the understanding of which of the following? 1. Little is known about iron deficiency anemia and its relationship to infection in children. 2. Children with iron deficiency anemia are more susceptible to infection than are other children. 3. Children with iron deficiency anemia are less susceptible to infection than are other children. 4. Children with iron deficiency anemia are equally as susceptible to infection as are other children.

2. Children with iron deficiency anemia are more susceptible to infection than are other children.

An infant is hospitalized for congenital adrenal hyperplasia (CAH). Which medication should a nurse anticipate to be part of the child's treatment plan? 1. Insulin 2. Cortisone 3. Growth hormone 4. Thyroid hormone

2. Cortisone

An infant is hospitalized for congenital adrenal hyperplasia (CAH). Which medication should a nurse anticipate to be part of the child's treatment plan? 1. Insulin. 2. Cortisone. 3. Growth hormone. 4. Thyroid hormone.

2. Cortisone.

The nurse is caring for an infant with a diagnosis of bladder exstrophy. To protect the exposed bladder tissue, the nurse should plan which intervention? 1. Cover the bladder with petroleum jelly gauze 2. Cover the bladder with a non-adhering plastic wrap 3. Apply sterile distilled water dressings over the bladder mucosa 4. Keep the bladder tissue dry by covering it with dry sterile gauze

2. Cover the bladder with a non-adhering plastic wrap

A child recently had a heart transplant and the nurse teaches the parents the importance of administering cyclosporine A. Which statement by the parents indicates an appropriate understanding of the teaching session? 1. Cyclosporin A reduces serum-cholesterol level. 2. Cyclosporin A prevents rejection. 3. Cyclosporin A treats hypertension. 4. Cyclosporin A treats infections.

2. Cyclosporin A prevents rejection.

Laboratory findings indicate that a child with leukemia is also anemic. The nurse interprets this finding as most likely resulting from which of the following? 1. Inadequate dietary folic acid intake. 2. Decreased red blood cell production. 3. Increased destruction of red blood cells by lymphocytes. 4. Progressive replacement of bone marrow with scar tissue.

2. Decreased red blood cell production.

Which of the following diet plans would be appropriate for the nurse to discuss with the family of a child with acute renal failure? 1. High carbohydrate and protein. 2. High fat and carbohydrate. 3. Low fat and protein. 4. Low in carbohydrate and fat.

2. High fat and carbohydrate.

A nurse is performing discharge teaching with the parents of preschooler diagnosed with cystic fibrosis. What part of the teaching plan will best assist the parents to prevent future pulmonary infections in this child? 1. Teaching the parents proper administration of pancreatic enzymes 2. Emphasizing the need for regular and consistent chest physiotherapy 3. Stressing the need to seek prompt medical attention for increased work of breathing 4. Instructing the parents to monitor the child's daily fluid intake for adequacy

2. Emphasizing the need for regular and consistent chest physiotherapy

The parents of a child on sulfamethoxazole and trimethoprim (Bactrim) for a urinary tract infection report that the child has a red, blistery rash. The nurse should tell the parents to: 1. Apply lotion to the affected areas. 2. Discontinue the medicine and come for immediate further evaluation. 3. Use sunblock while on the medication. 4. Increase the child's fluid intake.

2. Discontinue the medicine and come for immediate further evaluation.

Parents of a 15-year-old state that he is moody and rude. The nurse should advise his parents to: 1. Restrict his activities. 2. Discuss their feelings with their child. 3. Obtain family counseling. 4. Talk to other parents of adolescents.

2. Discuss their feelings with their child.

After having a blood sample drawn, a 5-year-old child insists that the site be covered with a bandage. When the parent tries to remove the bandage before leaving the office, the child screams that all the blood will come out. The nurse encourages the parent to leave the bandage in place and tells the parent that the child: 1. Fears another procedure. 2. Does not understand body integrity. 3. Is expressing pain. 4. Is attempting to regain control.

2. Does not understand body integrity.

The nurse is teaching the parents of a child with sickle cell disease. To instruct them on how to prevent sickle cell crisis, she should include which instruction? 1. Restrict the child's fluid intake to less than 1 quart per day. 2. Drink at least 2 quarts of fluids per day. 3. Stay away from other teenagers. 4. Avoid physical activity.

2. Drink at least 2 quarts of fluids per day.

While assessing the penis of a child who has had surgery for repair of a hypospadias, the nurse observes the appearance of the penis. The nurse should report which aspect to the surgeon? 1. Swollen. 2. Dusky blue at the tip. 3. Somewhat misshapen. 4. Pink.

2. Dusky blue at the tip.

The mother of a toddler with nephrotic syndrome asks the nurse what can be done about the child's swollen eyes. Which measure should the nurse suggest? 1. Applying cool compresses to the child's eyes. 2. Elevating the head of the child's bed. 3. Applying eye drops every 8 hours. 4. Limiting the child's television watching.

2. Elevating the head of the child's bed.

A nurse is performing discharge teaching with the parents of a preschooler diagnosed with cystic fibrosis. What part of the teaching plan will best assist the parents to prevent future pulmonary infections in this child? 1. Teaching the parents proper administration of pancre- atic enzymes. 2. Emphasizing the need for regular and consistent chest physiotherapy. 3. Stressing the need to seek prompt medical attention for increased work of breathing. 4. Instructing the parents to monitor the child's daily fluid intake for adequacy.

2. Emphasizing the need for regular and consistent chest physiotherapy.

A father asks the nurse how he would know if his child had developed mononucleosis. The nurse explains that in addition to fatigue, which of the following would be most common? 1. Liver tenderness. 2. Enlarged lymph glands. 3. Persistent nonproductive cough. 4. A blush-like generalized skin rash.

2. Enlarged lymph glands.

The mother of a preschooler reports that her child creates a scene every night at bedtime. The nurse and the mother decide that the best course of action would be to do which of the following? 1. Allow the child to stay up later one or two nights a week. 2. Establish a set bedtime and follow a routine. 3. Encourage active play before bedtime. 4. Give the child a cookie if bedtime is pleasant.

2. Establish a set bedtime and follow a routine.

A 4-year-old has been scheduled for a cardiac catheterization. To help prepare the family the nurse should: 1. Advise the family to bring the child to the hospital for a tour a week in advance. 2. Explain that the child will need a large bandage after the procedure. 3. Discourage bringing favorite toys that might become associated with pain. 4. Explain that the child may get up as soon as the vital signs are stable.

2. Explain that the child will need a large bandage after the procedure.

The mother of a 4-year-old expresses concern that her child may be hyperactive. She describes the child as always in motion, constantly dropping and spilling things. Which of the following actions would be appropriate at this time? 1. Determine whether there have been any changes at home. 2. Explain that this is not unusual behavior. 3. Explore the possibility that the child is being abused. 4. Suggest that the child be seen by a pediatric neurologist.

2. Explain that this is not unusual behavior.

The nurse is teaching a group of mothers of infants about the benefits of immunization. Which immunization will the nurse teach to the mothers that can assist in preventing the life-threatening disease epiglottitis? 1. Measles, mumps, and rubella (MMR) 2. Haemophilus influenzae type B (HIB) 3. Hepatitis B 4. Polio

2. Haemophilus influenzae type B (HIB)

When developing the preoperative teaching plan for a 14-month-old child with an undescended testis who is scheduled to have surgery, which of the following methods is appropriate? 1. Telling the child that his penis and scrotum will be "fixed." 2. Explaining to the parents how the defect will be corrected. 3. Telling the child that he will not see any incisions after surgery. 4. Using an anatomically correct doll to show the child what will be "fixed."

2. Explaining to the parents how the defect will be corrected.

A 15-year-old has been admitted to the hospital with the diagnosis of acute lymphocytic leukemia. Which of the following signs and symptoms require the most immediate nursing intervention? 1. Fatigue and anorexia. 2. Fever and petechiae. 3. Swollen neck lymph glands and lethargy. 4. Enlarged liver and spleen.

2. Fever and petechiae.

A preschool-age client is diagnosed with acute glomerulonephritis and is admitted to the hospital. Which nursing diagnosis is most appropriate for this client? 1. Risk for Injury Related to Loss of Blood in Urine 2. Fluid-Volume Excess Related to Decreased Plasma Filtration 3. Risk for Infection Related to Hypertension 4. Altered Growth and Development Related to a Chronic Disease

2. Fluid-Volume Excess Related to Decreased Plasma Filtration

The nurse performing an admission assessment on a 2 yo child who has been diagnosed with nephrotic syndrome notes that which is the most common characteristic associated with this disease? 1. Hypertension 2. Generalized edema 3. Increased urinary output 4. Frank, bright red blood in the urine

2. Generalized edema

Which assessment findings would cause a nurse to withhold scheduled immunizations in a child? Select all that apply. 1. Current cold symptoms (e.g., runny nose, cough). 2. History of recent blood transfusion. 3. Currently taking corticosteroids. 4. Mild diarrhea without symptoms of dehydration. 5. Family history of penicillin allergy. 6. Positive for HIV.

2. History of recent blood transfusion. 3. Currently taking corticosteroids. 6. Positive for HIV.

Which assessment findings would cause a nurse to withhold scheduled immunizations in a child? Select all that apply 1. Current cold symptoms (e.g. runny nose, cough) 2. History of recent blood transfusions 3. Currently taking corticosteroids 4. Mild diarrhea without symptoms of dehydration 5. Family history of penicillin drug allergy 6. Positive for HIV

2. History of recent blood transfusions 3. Currently taking corticosteroids 6. Positive for HIV

The nurse is preparing to discharge an infant with a congenital heart defect. The infant will be cared for at home by the parents until surgery. Which items will the nurse include in the discharge teaching for this infant and family? Select all that apply. 1. Allow the infant to feed for 60 minutes. 2. Hold the infant at a 45 degree angle. 3. Encourage frequent hand hygiene. 4. Notify the health care provider for fever. 5. Pump the breasts and feed with a bottle if weight gain is an issue.

2. Hold the infant at a 45 degree angle. 3. Encourage frequent hand hygiene. 4. Notify the health care provider for fever. 5. Pump the breasts and feed with a bottle if weight gain is an issue.

A child is admitted to the pediatric unit with nephrotic syndrome. Which of the following laboratory results would the nurse expect to see? 1. Thrombocytopenia 2. Hypoalbuminemia 3. Neutropenia 4. Hypermagnesemia

2. Hypoalbuminemia

When developing the plan of care for a school-age child with acute poststreptococcal glomerulonephritis who has a fluid restriction of 1,000 mL/day, which of the following fluids should the nurse consider as most appropriate for the client's condition and effective for preventing excessive thirst? 1. Diet cola. 2. Ice chips. 3. Lemonade. 4. Tap water.

2. Ice chips.

The nurse is providing care to a toddler-age child. Which assessment finding is indicative of abuse? 1. Parents indicating that they did not see the event occur 2. Inconsistency of stories between caregivers 3. Bruising noted on the knees and shins 4. Acting out behavior of the child

2. Inconsistency of stories between caregivers

A nurse is caring for a child newly diagnosed with congenital heart disease. The nurse should monitor the child with the understanding that the earliest sign of heart failure is: 1. Audible lung crackles 2. Increased heart rate 3. Weight gain 4. Generalized edema

2. Increased heart rate

A nurse is caring for a child newly diagnosed with congenital heart disease. The nurse should monitor the child with the understanding that the earliest sign of heart failure is: 1. Audible lung crackles. 2. Increased heart rate. 3. Weight gain. 4. Generalized edema.

2. Increased heart rate.

A child, hospitalized with nephrotic syndrome, has been receiving corticosteroids for a week. What should the nurse recognize as early evidence that the child is responding well to treatment? 1. Decreased general edema 2. Increased urinary output 3. Improved general appetite 4. Hemoglobin and hematocrit within normal limits

2. Increased urinary output

A child, hospitalized with nephrotic syndrome, has been receiving corticosteroids for a week. What should the nurse recognize as early evidence that the child is responding well to treatment? 1. Decreased general edema. 2. Increased urinary output. 3. Improved general appetite. 4. Hemoglobin and hematocrit within normal limits.

2. Increased urinary output.

A child with hemophilia presents with a burning sensation in the knee and reluctance to move the body part. The nurse collaborates with the care team to provide factor replacement and: 1. Administer an aspirin-containing compound. 2. Institute Rest, Ice, Compression, and Elevation (RICE). 3. Begin physical therapy with active range of motion. 4. Initiate skin traction.

2. Institute Rest, Ice, Compression, and Elevation (RICE).

A child with type 1 diabetes is being prepared for discharge from a hospital. What should a nurse include as part of the teaching regarding diabetes care? 1. Expect hypoglycemic episodes to always occur after meals 2. Insulin dosage may need to be decreased during sports activities 3. The child should not self-administer injections until the teen years 4. Insulin should never be administered during febrile illnesses

2. Insulin dosage may need to be decreased during sports activities

A child with type 1 diabetes is being prepared for discharge from a hospital. What should a nurse include as part of the teaching regarding diabetes care? 1. Expect hypoglycemic episodes to always occur after meals. 2. Insulin dosage may need to be decreased during sports activities 3. The child should not self-administer injections until the teen years. 4. Insulin should never be administered during febrile illnesses.

2. Insulin dosage may need to be decreased during sports activities

A toddler with Kawasaki disease is being evaluated by a primary care clinic nurse 1 week following discharge. The nurse understands that it is a priority to instruct the parents to contact the clinic immediately if the child: 1. Throws frequent temper tantrums 2. Is exposed to someone with chickenpox 3. Experiences night terrors 4. Develops a low-grade fever

2. Is exposed to someone with chickenpox

A toddler with Kawasaki disease is being evaluated by a primary care clinic nurse 1 week following discharge. The nurse understands that it is a priority to instruct the parents to contact the clinic immediately if the child: 1. Throws frequent temper tantrums. 2. Is exposed to someone with chickenpox. 3. Experiences night terrors. 4. Develops a low-grade fever.

2. Is exposed to someone with chickenpox.

A client is attending a newborn discharge class and asks a nurse about the bump on the infant's head. Upon assessment, the neonate has a large, diffuse swelling on the left occiput that crosses the sagittal suture line. The nurse should explain to the mother that: select all that apply 1. This is a collection of blood under the skull bone of the infant 2. It is edematous swelling that overlies the periosteum 3. It leads to hyperbilirubinemia in the infant 4. It will require no treatment to resolve 5. It is caused by pressure on the fetal head before delivery

2. It is edematous swelling that overlies the periosteum 4. It will require no treatment to resolve 5. It is caused by pressure on the fetal head before delivery

A client is attending a newborn discharge class and asks a nurse about the bump on the infant's head. Upon assess- ment, the neonate has a large, diffuse swelling on the left occiput that crosses the sagittal suture line. The nurse should explain to the mother that: Select all that apply. 1. This is a collection of blood under the skull bone of the infant. 2. It is edematous swelling that overlies the periosteum. 3. It leads to hyperbilirubinemia in the infant. 4. It will require no treatment to resolve. 5. It is caused by pressure on the fetal head before delivery.

2. It is edematous swelling that overlies the periosteum. 4. It will require no treatment to resolve. 5. It is caused by pressure on the fetal head before delivery.

The nurse teaches parents that the anticholinergic drug oxybutynin is used to treat enuresis. The parents ask the nurse why the medication is being prescribed. Which response by the nurse is the most appropriate? 1. It's an antidepressant that is used to help the child relax. 2. It will help decrease the spasms sometimes associated with enuresis. 3. It has an antidiuretic effect, so your child can attend sleepovers. 4. It will slow the production of urine, so your child does not have to urinate as frequently.

2. It will help decrease the spasms sometimes associated with enuresis.

The toddler with nephrotic syndrome responds to treatment and is ready to go home. When helping the family plan for home care, which of the following instructions should the nurse include in the teaching? 1. Administer pain medication as needed. 2. Keep the child away from others with an infection. 3. Notify the physician if there is an increase in the child's urine output. 4. Administer acetaminophen (Tylenol) daily.

2. Keep the child away from others with an infection.

After teaching the parents about the urethral catheter placed after surgical repair of their son's hypospadias, the nurse determines that the teaching was successful when the mother states that the catheter in her child's penis accomplishes which of the following? 1. Decreases pain at the surgical site. 2. Keeps the new urethra from closing. 3. Measures his urine correctly. 4. Prevents bladder spasms.

2. Keeps the new urethra from closing.

The nurse is providing care to an adolescent child who is at risk for developing adult-onset cardiovascular disease. Which teaching points will decrease the adolescents risk? Select all that apply. 1. Encourage a decrease in smoking. 2. Limit fat intake to 20% to 35% of intake. 3. Encourage participation in vigorous exercise for at least 30 minutes. 4. Maintain a normal weight. 5. Include high-fat dairy products in the daily diet.

2. Limit fat intake to 20% to 35% of intake. 3. Encourage participation in vigorous exercise for at least 30 minutes. 4. Maintain a normal weight.

When developing the plan of care for a newly admitted 2-year-old child with the diagnosis of Kawasaki disease, which of the following should be the priority? 1. Taking vital signs every 6 hours. 2. Monitoring intake and output every hour. 3. Minimizing skin discomfort. 4. Providing passive range-of-motion exercises.

2. Monitoring intake and output every hour.

A 21⁄2-year-old child is in the hospital with Kawasaki disease. Which of the following actions by the nurse is important for the child's psychosocial care? 1. Place the child in a single-bedded room. 2. Make sure the child always has his transitional object with him. 3. Supply the child with board games for play. 4. Let the child see what he looks like in a surgical mask and cap.

2. Make sure the child always has his transitional object with him.

The mother tells the nurse that her 8-year-old child is continually telling jokes and riddles to the point of driving the other family members crazy. The nurse should explain this behavior is a sign of? 1. Inadequate parental attention. 2. Mastery of language ambiguities. 3. Inappropriate peer influence. 4. Excessive television watching.

2. Mastery of language ambiguities.

The primary health care provider orders pulse assessments through the night for a 12-year-old child with rheumatic fever who has a daytime heart rate of 120. The nurse explains to the mother that this is to evaluate if the elevated heart rate is caused by: 1. The morning digitalis. 2. Normal activity during waking hours. 3. A warmer daytime environment. 4. Normal variations in day and evening hours.

2. Normal activity during waking hours.

A nurse attempts to give a newborn infant the first bottle feeding. While sucking, the infant becomes cyanotic and soughs, and formula is seen coming out of the infant's nose. What should be the nurse's first action? 1. Auscultate the lungs 2. Suction the child's airway 3. Obtain an order for an x-ray 4. Contact the physician

2. Suction the child's airway

A 10-year-old with leukemia is taking immunosuppressive drugs. To maintain health the nurse should instruct the child and parents to: 1. Continue with immunizations. 2. Not receive any live attenuated vaccines. 3. Receive vitamin and mineral supplements. 4. Stay away from peers.

2. Not receive any live attenuated vaccines.

A nurse is conducting a daily weight on a pediatric client diagnosed with diabetes insipidus and notes the child has lost two pounds in 24 hours. Which action by the nurse is the most appropriate? 1. Continue to monitor the child. 2. Notify the healthcare provider regarding the weight loss. 3. Chart the weight and report the loss to the next shift. 4. Do nothing more than chart the weight, as this would be a normal finding.

2. Notify the healthcare provider regarding the weight loss.

An adolescent with a history of losing weight and fatigue is admitted to the hospital with a diagnosis of stage I chronic renal failure. The chart shows: Day 1 - intake 1850 mL, output 1550 mL Day 2 - intake 2200 mL, output 1150 mL Based on these findings, the nurse should: 1. Continue monitoring intake and output. 2. Notify the physician. 3. Restrict the client's fluids. 4. Increase the client's fluids.

2. Notify the physician.

When assessing for pain in a toddler, which of the following methods should be the most appropriate? 1. Ask the child about the pain. 2. Observe the child for restlessness. 3. Use a numeric pain scale. 4. Assess for changes in vital signs.

2. Observe the child for restlessness.

A child diagnosed with acute glomerulonephritis is in the playroom and experiences blurred vision and headache. Which action by the nurse is the most appropriate? 1. Check the urine to see if hematuria has increased. 2. Obtain a blood pressure on the child; notify the healthcare provider. 3. Reassure the child and encourage bed rest until the headache improves. 4. Obtain serum electrolytes and send a urinalysis to the lab.

2. Obtain a blood pressure on the child; notify the healthcare provider.

A 10-year-old with glomerulonephritis reports a headache and blurred vision. The nurse should immediately: 1. Put the client to bed. 2. Obtain the child's blood pressure. 3. Notify the physician. 4. Administer acetaminophen (Tylenol).

2. Obtain the child's blood pressure.

A nurse admits a teenager in sickle cell crisis to a pediatric unit. The child has an elevated heart rate but normal blood pressure, respiratory rate, and temperature. The child has an oxygen saturation of 98% on room air and rates pain in the extremities at an 8 on a 1-to-10 numeric pain rating scale. Which actions should the nurse perform at this time? Prioritize the nurse's actions by placing each correct intervention in priority order. 1. Administer oxygen. 2. Obtain the child's weight. 3. Administer IV fluids as ordered. 4. Monitor I&O. 5. Obtain an order for pain medication via PCA. 6. Apply cool, moist compresses to extremities.

2. Obtain the child's weight. 3. Administer IV fluids as ordered. 5. Obtain an order for pain medication via PCA. 4. Monitor I&O.

A nurse visits the home of a young child to administer the Denver II developmental assessment. The child is unable to perform several required items, and the parent expresses concern regarding the child's performance. What is the best way for the nurse to respond to the parent's concerns 1. Reassure the parent that the Denver II is not a measure of the child's IQ 2. Offer the parent some skill-building activities and explain that the child will be reassessed in 2 weeks 3. Advise the parent that the child's primary physician will be notified and will make any necessary referrals 4. Tell the parent that is not unusual for children to fail the Denver II

2. Offer the parent some skill-building activities and explain that the child will be reassessed in 2 weeks

A nurse visits the home of a young child to administer the Denver II developmental assessment. The child is unable to perform several required items, and the parent expresses concern regarding the child's performance. What is the best way for the nurse to respond to the parent's concerns? 1. Reassure the parent that the Denver II is not a measure of the child's IQ. 2. Offer the parent some skill-building activities and explain that the child will be reassessed in 2 weeks. 3. Advise the parent that the child's primary physician will be notified and will make any necessary referrals. 4. Tell the parent that it is not unusual for children to fail the Denver II.

2. Offer the parent some skill-building activities and explain that the child will be reassessed in 2 weeks.

A nurse is working with a nursing student in caring for an infant who has just returned from the surgical recovery area following a cleft lip repair. Which action by the nursing student should cause the nurse to intervene? 1. Placement of elbow restraints on the infant. 2. Offering the parents a regular bottle with which to feed the infant. 3. Positioning the infant in the semi-Fowler's position. 4. Advising the parents of a plan to administer pain medication around the clock.

2. Offering the parents a regular bottle with which to feed the infant.

A nurse is working with a nursing student in caring for an infant who has just returned from the surgical recovery area following cleft lip repair. Which action by the nursing student should cause the nurse to intervene? 1. Placement of elbow restraints on the infant 2. Offering the parents, a regular bottle with which to feed the infant 3. Positioning the infant in semi-fowler's position 4. Advising the parents of a plan to administer pain medication around the clock

2. Offering the parents, a regular bottle with which to feed the infant

When assessing a 2-year-old child with Wilms' tumor, the nurse should avoid? 1. Measuring the child's chest circumference. 2. Palpating the child's abdomen. 3. Placing the child in an upright position. 4. Measuring the child's occipitofrontal circumference.

2. Palpating the child's abdomen.

A school nurse is preparing to teach a group of teenagers how to prevent meningitis. What aspect of meningitis prevention should the nurse be certain to include in the presentation? 1. Getting a meningitis vaccine is the only way to guarantee prevention. 2. Refraining from sharing food and drinks is a good way to prevent meningitis infection. 3. Avoiding team sports is one way to stop the spread of meningitis infection. 4. Meningitis prevention methods should be employed whenever children are in crowds.

2. Refraining from sharing food and drinks is a good way to prevent meningitis infection.

A 3-year-old child is admitted to the pediatric unit for surgery. The child has a tumor in his left kidney. The child is to undergo surgery the next day. Which of the following primary health-care practitioner prescriptions is most important for the nurse to follow? 1. Maintain the child NPO after midnight. 2. Place a sign at the head of the bed stating, "Do not touch abdomen." 3. Send a urine specimen for a urinalysis. 4. Send a blood specimen for electrolyte analysis.

2. Place a sign at the head of the bed stating, "Do not touch abdomen."

Which of the following actions initiated by the parents of an 8-month-old indicates they need further teaching about preventing childhood accidents? 1. Placing a fire screen in front of the fireplace. 2. Placing a car seat in a front-seat, front-facing position. 3. Inspecting toys for loose parts. 4. Placing toxic substances out of reach or in a locked cabinet.

2. Placing a car seat in a front-seat, front-facing position.

After surgery to correct a tetralogy of Fallot, the child's parents express concern to the nurse that their 4-year-old child wants to be held more frequently than usual. The nurse recommends: 1. Introducing a new skill. 2. Play therapy. 3. Encouraging the behavior. 4. Having the volunteer hold the child.

2. Play therapy.

The school nurse develops a plan with an adolescent to provide relief of dysmenorrhea to aid in her development of which of the following? 1. Positive peer relations. 2. Positive self-identity. 3. A sense of autonomy. 4. A sense of independence.

2. Positive self-identity.

Which of the following foods should the nurse encourage the mother to offer to her child with iron deficiency anemia? 1. Rice cereal, whole milk, and yellow vegetables. 2. Potato, peas, and chicken. 3. Macaroni, cheese, and ham. 4. Pudding, green vegetables, and rice.

2. Potato, peas, and chicken.

Which of the following should the nurse expect to include in the plan of care for a child who is diagnosed with rheumatic fever and carditis and admitted to the hospital? 1. Ensuring continuous parental presence at the child's bedside. 2. Providing the child with periods of rest. 3. Encouraging participation in age-appropriate activities. 4. Advising the child to eat as much as possible.

2. Providing the child with periods of rest.

While working at a weekend free clinic, the nurse is assessing a toddler when the mother of the child confides that it has been very difficult providing for her family of four children on her limited budget. She is not sure that she has enough money to buy food for the rest of the month and the antibiotic that is needed for the child's ear infection. Which intervention would be the most beneficial for this family? 1. Giving the mother enough free samples of the antibiotic for the recommended course of treatment 2. Putting the mother in contact with a local agency that provides food on a regular basis to needy families and helps them access other resources in the community 3. Talking with the mother about the factors that increase a child's risk of acquiring an ear infection 4. Talking with the mother about the importance of a balanced diet in the growth and development of children and providing her with a list of inexpensive, nutritious foods

2. Putting the mother in contact with a local agency that provides food on a regular basis to needy families and helps them access other resources in the community

A school nurse is preparing to teach a group of teenagers how to prevent meningitis. What aspect of meningitis prevention should the nurse be certain to include in the presentation? 1. Getting a meningitis vaccine is the only way to guarantee prevention 2. Refraining from sharing food and drinks is a good way to prevent meningitis infection 3. Avoiding team sports is one way to stop the spread of meningitis infection 4. Meningitis prevention methods should be employed whenever children are in crowds

2. Refraining from sharing food and drinks is a good way to prevent meningitis infection

After doing well for a period of time, a child with leukemia develops an overwhelming infection. The child's death is imminent. Which of the following statements offers the nurse the best guide in making plans to assist the parents in dealing with their child's imminent death? 1. Knowing that the prognosis is poor helps prepare relatives for the death of children. 2. Relatives are especially grieved when a child does well at first but then declines rapidly. 3. Trust in health care personnel is most often destroyed by a death that is considered untimely. 4. It is more difficult for relatives to accept the death of an older child than that of a toddler.

2. Relatives are especially grieved when a child does well at first but then declines rapidly.

A 13-month-old has a febrile seizure one month after the administration of the chicken pox vaccine. The nurse should: 1. Recognize that the events are unrelated. 2. Report the event through the Vaccine Adverse Event Reporting System. 3. Explain to the parents that this is a rare but acceptable risk. 4. Report the incident through the vaccine manufacturer's hotline.

2. Report the event through the Vaccine Adverse Event Reporting System.

A diagnosis of hemophilia A is confirmed in an infant. Which of the following instructions should the nurse provide the parents as the infant becomes more mobile and starts to crawl? 1. Administer one-half of a children's aspirin for a temperature higher than 101° F (38.3° C). 2. Sew thick padding into the elbows and knees of the child's clothing. 3. Check the color of the child's urine every day. 4. Expect the eruption of the primary teeth to produce moderate to severe bleeding.

2. Sew thick padding into the elbows and knees of the child's clothing.

A 10-year-old child proudly tells the nurse that brushing and flossing her teeth is her responsibility. The nurse interprets this statement as indicating which of the following about the child? 1. She is too young to be given this responsibility. 2. She is most likely capable of this responsibility. 3. She should have assumed this responsibility much sooner. 4. She is probably just exaggerating the responsibility.

2. She is most likely capable of this responsibility.

A child with Kawasaki disease is receiving low dose aspirin. The mother calls the clinic and states that the child has been exposed to influenza. Which recommendations should the nurse make? Select all that apply. 1. Increase fluid intake. 2. Stop the aspirin. 3. Keep the child home from school. 4. Watch for fever. 5. Weigh the child daily.

2. Stop the aspirin. 4. Watch for fever.

A nurse attempts to give a newborn infant the first bottle feeding. While sucking, the infant becomes cyanotic and coughs, and formula is seen coming out of the infant's nose. What should be the nurse's first action? 1. Auscultate the lungs. 2. Suction the child's airway. 3. Obtain an order for an x-ray. 4. Contact the physician.

2. Suction the child's airway.

The mother tells the nurse she will be afraid to allow her child with hemophilia to participate in sports because of the danger of injury and bleeding. After explaining that physical fitness is important for children with hemophilia, which of the following activities should the nurse suggest as ideal? 1. Snow skiing. 2. Swimming. 3. Basketball. 4. Gymnastics.

2. Swimming.

Which of the following should the nurse include when completing discharge instructions for the parents of a 12-month-old child diagnosed with Kawasaki disease (KD) and being discharged to home? 1. Offer the child extra fluids every 2 hours for 2 weeks. 2. Take the child's temperature daily for several days. 3. Check the child's blood pressure daily until the follow-up appointment. 4. Call the physician if the irritability lasts for 2 more weeks.

2. Take the child's temperature daily for several days.

A child is admitted to the hospital unit with physical injuries. The nurse is taking the child's history. Which statement by the parent would arouse suspicion of abuse? 1. I did not realize that my baby was able to roll over yet, and I was just gone a minute to check on dinner when the baby rolled off of the couch and onto our tile floor. 2. The baby's 18-month-old brother was trying to pull the baby out of the crib and dropped the baby on the floor. 3. I placed the baby in the infant swing. His 6-year-old brother was running through the house and tripped over the swing, causing it to fall. 4. I was walking up the steps and slipped on the ice, falling while carrying my baby.

2. The baby's 18-month-old brother was trying to pull the baby out of the crib and dropped the baby on the floor.

A 1-year-old child is scheduled for surgery to correct hypospadias and chordee. The nurse explains to the parents that this is the preferred time for surgical repair based on which of the following? 1. At this age, the child will experience less pain. 2. The child is too young to have developed castration anxiety. 3. The child will not remember the surgical experience. 4. The repair is easier to perform after the child is toilet trained.

2. The child is too young to have developed castration anxiety.

The nurse is teaching the parents of a group of cardiac patients. Which teaching guideline will the nurse include for any child who has undergone cardiac surgery? 1. The child should be restricted from most play activities. 2. The child should be evaluated to determine if prophylactic antibiotics for dental, oral, or upper-respiratory-tract procedures are necessary. 3. The child should not receive routine immunizations. 4. The child can be expected to have a fever for several weeks following the surgery.

2. The child should be evaluated to determine if prophylactic antibiotics for dental, oral, or upper-respiratory-tract procedures are necessary.

A baby, exhibiting no obvious signs of congestive heart failure, has been diagnosed with a small ventricular septal defect. Which of the following information should the nurse explain to the baby's parents? 1. The baby will likely need open-heart surgery within a week. 2. The defect will likely close without therapy. 3. The defect likely developed early in the second trimester. 4. The baby will likely be placed on high-calorie formula.

2. The defect will likely close without therapy.

A recently divorced mother who must return to work is concerned about the effects of placing her child in day care full time. In counseling the mother, which factor does the nurse share as the most influential in determining whether or not day care has a positive or negative effect on the child? 1. The ratio of day-care workers to children 2. The closeness of the parent-child relationship 3. The amount of time that the children spend playing outside 4. The cleanliness of the facility

2. The closeness of the parent-child relationship

The parents of a neonate with hypospadias and chordee wish to have him circumcised. Which of the following explanations should the nurse incorporate into the discussion with the parents concerning the recommendation to delay circumcision? 1. The associated chordee is difficult to remove during circumcision. 2. The foreskin is used to repair the deformity surgically. 3. The meatus can become stenosed, leading to urinary obstruction. 4. The infant is too small to have a circumcision.

2. The foreskin is used to repair the deformity surgically.

An infant is brought to an emergency department with a chief complaint of nausea and vomiting. Which nursing assessment finding should indicate to a nurse that the infant's dehydration is severe? 1. The infant is lethargic with a urinary output of less than 1 mL/kg/hr 2. The infant has weak pulses, poor skin turgor, and cool, mottled skin 3. The infant has warm skin, increased pulses, and capillary refill of 2 seconds 4. The infant is irritable, with dry mucous membranes and increased respirations

2. The infant has weak pulses, poor skin turgor, and cool, mottled skin

An infant is brought to an emergency department with a chief complaint of nausea and vomiting. Which nursing assessment finding should indicate to a nurse that the infant's dehydration is severe? 1. The infant is lethargic with a urinary output of less than 1 mL/kg/hr. 2. The infant has weak pulses, poor skin turgor, and cool, mottled skin. 3. The infant has warm skin, increased pulse, and capillary refill of 2 seconds. 4. The infant is irritable, with dry mucous membranes and increased respirations.

2. The infant has weak pulses, poor skin turgor, and cool, mottled skin.

Which of the following outcomes indicates that the activity restriction necessary for a 7-year-old child with rheumatic fever during the acute phase has been effective? 1. Joints demonstrate absence of permanent injury. 2. The resting heart rate is between 60 and 100 bpm. 3. The child exhibits a decrease in chorea movements. 4. The subcutaneous nodules over the joints are no longer palpable.

2. The resting heart rate is between 60 and 100 bpm.

A child recently had a kidney transplant and is prescribed cyclosporine. The parents ask the nurse about the reason for the cyclosporine. Which reason will the nurse include in the response for why this medication is prescribed? 1. To boost immunity 2. To suppress rejection 3. To decrease pain 4. To improve circulation

2. To suppress rejection

A baby that was born 5 minutes earlier is tachypneic, tachycardic, and markedly cyanotic. A STAT echocardiogram confirms the presence of a cyanotic congenital cardiac defect. Which of the following defects would be consistent with the assessment findings? 1. Patent ductus arteriosus 2. Transposition of the great vessels 3. Atrial septal defect 4. Ventricular septal defect

2. Transposition of the great vessels

The parents of a child recently discharged with acute spasmodic laryngitis contact a nurse to report that the child continues to have croupy coughing spells a nighttime but is otherwise fine. What should the nurse recommend? 1. Contact the child's physician for another round of antibiotics 2. Treat the spasms by sitting in the bathroom while a hot shower runs 3. Bring the child back to the emergency department as soon as possible 4. Elevate the child's head at bedtime using pillows

2. Treat the spasms by sitting in the bathroom while a hot shower runs

The parents of a child recently discharged with acute spasmodic laryngitis contact a nurse to report that the child continues to have croupy coughing spells at nighttime but is otherwise fine. What should the nurse recommend? 1. Contact the child's physician for another round of antibiotics. 2. Treat the spasms by sitting in the bathroom while a hot shower runs. 3. Bring the child back to the emergency department as soon as possible. 4. Elevate the child's head at bedtime using pillows.

2. Treat the spasms by sitting in the bathroom while a hot shower runs.

A 15-year-old has been diagnosed with acute glomerulonephritis and has been in the hospital for 1 day. Which of the following findings requires immediate action? 1. Large amount of generalized edema. 2. Urine specific gravity of 1.030. 3. Large amount of albumin in the urine. 4. 24-hour output of 1,500 mL.

2. Urine specific gravity of 1.030.

A 7-year-old child has been diagnosed with rheumatic fever. Which of the following physical findings would the nurse expect to assess? 1. Vesicular rash over the face and chest 2. Warm and swollen knees and elbows 3. Palpable mass in the upper right quadrant of the abdomen 4. Yellow pigmentation of the sclerae of the eyes

2. Warm and swollen knees and elbows

What is the priority nursing diagnosis for an infant receiving treatment for hyperbilirubinemia? 1. Imbalanced body temperature. 2. Alteration in elimination. 3. Deficient fluid volume. 4. Interrupted family processes.

3. Deficient fluid volume.

The parents of a 2-year-old child ask a nurse how to best assist the child to accomplish developmental tasks at this age. What is the best response by the nurse? 1. "Make sure that the child's siblings insist that the child share toys at playtime." 2. "Since the child understands the word 'no,' use this word frequently to establish house rules." 3. "Ask grandparents and other child care providers to follow your home schedule as much as possible." 4. "Attend to the child quickly during temper tantrums by hugging and offering reassurance."

3. "Ask grandparents and other child care providers to follow your home schedule as much as possible."

The mother of a 6-month-old states that she started her infant on 2% milk. The nurse should first ask the mother: 1. "Do you think your baby will be fine with this milk?" 2. "Is it possible for you to switch your baby to whole milk?" 3. "Can you tell me more about the reason you switched your baby to 2% milk?" 4. "You cannot switch to 2% milk right now. Did your pediatrician tell you to do this?"

3. "Can you tell me more about the reason you switched your baby to 2% milk?"

The family of a 5-year-old, only child has just moved to a rural setting where the father has started a dental practice. At the well-child visit, the father expresses concern that his child seems prone to minor accidents such as, skinning his elbow and knees or falling off his scooter. The nurse tells the father: 1. "Only children use accidents as a way to seek parental attention." 2. "Children who live in the suburbs typically have more accidents." 3. "Children frequently have more accidents when families experience change." 4. "We see a relationship between accidents and parental education."

3. "Children frequently have more accidents when families experience change."

Which of the following questions should the nurse ask first when obtaining a history from the mother of a 10-year-old child with a fever, complaints of not feeling well, and swelling around the eyes? 1. "Has the child had a sore throat recently?" 2. "Is the child playing with friends as usual?" 3. "Does the child urinate as much as usual?" 4. "Is the urine pale in color?"

3. "Does the child urinate as much as usual?"

An Orthodox Jewish couple deliver a baby boy with hypospadias. The parents state, "We are so excited. We are planning the baby's bris (ritual circumcision) for next week. Which of the following responses by the nurse is appropriate? 1. "I know how happy you must be. I know that you will have a wonderful party." 2. "If you are comfortable sharing the information, what Hebrew name do you plan to give your baby next week?" 3. "I understand how important it is to have a bris, but the baby will not be able to be circumcised next week." 4. "Do you have a mohel to perform the bris? I know how hard it is to locate one who you feel you can trust."

3. "I understand how important it is to have a bris, but the baby will not be able to be circumcised next week."

The health care provider has ordered a sterile urine specimen on a 3-year-old boy with a history of recurrent urinary tract infections. The family is upset because the last time the child was catheterized the procedure was very painful and traumatic. The nurse should tell the family: 1. "I will request an order for a sedative to help him relax." 2. "I can't do anything to reduce the pain, but you can hold him during the procedure." 3. "I will get an order for a lidocaine-based lubricant to make the procedure more comfortable." 4. "I can apply a topical anesthetic 20 minutes before placing the catheter."

3. "I will get an order for a lidocaine-based lubricant to make the procedure more comfortable."

A nurse and nursing student are caring for a child who sustained a head injury as a result of a fall from a play structure. The nurse knows the nursing student is prepared to care for the child when the student states: 1. "I will be sure to let you know if the child's pupils become fixed and dilated." 2. "I will keep the child straight in the supine position." 3. "I will look for any changes in the child's respirations, pulse, or blood pressure." 4. "I will notify the physician if the child becomes sleepy."

3. "I will look for any changes in the child's respirations, pulse, or blood pressure."

During a clinic visit, the mother of an infant with hydrocele states that the infant's scrotum is smaller now than when he was born. After teaching the mother about the infant's condition, which of the following statements by the mother indicates that the teaching has been effective? 1. "I guess keeping his bottom up has helped." 2. "Massaging his groin area is working." 3. "It seems like the fluid is being reabsorbed." 4. "Keeping him quiet and in an infant seat has helped."

3. "It seems like the fluid is being reabsorbed."

After teaching the parents about the cause of ringworm of the scalp (tinea capitis), which of the following, if stated by the father, indicates successful teaching? 1. "It results from overexposure to the sun." 2. "It's caused by infestation with a mite." 3. "It's a fungal infection of the scalp." 4. "It's an allergic reaction."

3. "It's a fungal infection of the scalp."

A mother of a toilet-trained 3-year-old expresses concern over her child's bedwetting while hospitalized. The nurse should tell the mother: 1. "He was too immature to be toilet trained. In a few months he should be old enough." 2. "Children are afraid in the hospital and frequently wet their bed." 3. "It's very common for children to regress when they're in the hospital." 4. "This is normal. He probably received too much fluid the night before."

3. "It's very common for children to regress when they're in the hospital."

The charge nurse finds the mother of a child with a chronic bladder condition requiring clean intermittent catheterization (CIC) visibly upset. The mother states, "That other nurse said parents are not allowed to perform CIC in the hospital because of increased infection risk." The charge nurse should tell the parent: 1. "Your child is exposed to additional bacterial in the hospital that makes CIC unsafe." 2. "You can catheterize your child as long as you use sterile technique." 3. "You can use CIC on your child. I will talk with your nurse to clarify the policy." 4. "I can tell you are having a conflict with this nurse. I will switch assignments."

3. "You can use CIC on your child. I will talk with your nurse to clarify the policy."

The parent of an 18-year-old with chronic renal disease states, "My son has so many problems. I'm really worried that he will not get the right care if he gets sick at college." The nurse should tell the parent: 1. "I can have his records sent to the school's health center." 2. "Make sure your son always carries his nephrologist's phone number." 3. "Your son can make an e-health history to facilitate his care if he gets sick away from home." 4. "Your son is going to need to learn to manage his own disease."

3. "Your son can make an e-health history to facilitate his care if he gets sick away from home."

When discussing the onset of adolescence with parents, the nurse explains that it occurs at which of the following times? 1. Same age for both boys and girls. 2. 1 to 2 years earlier in boys than in girls. 3. 1 to 2 years earlier in girls than in boys. 4. 3 to 4 years later in boys than in girls.

3. 1 to 2 years earlier in girls than in boys.

What should be the expected weight of an infant 12 months of age whose birth weight was 3600g? 1. 5600g 2. 7200g 3. 11kg 4. 15kg

3. 11kg

When preparing an intramuscular injection for a 1-week-old infant, which needle would be the most appropriate for the nurse to select? 1. 18 G, 7/8 inch. 2.21G,1inch. 3. 25 G, 5/8 inch. 4. 25 G, 11/2 inch.

3. 25 G, 5/8 inch.

When preparing and IM injection for a 1-week-old infant, which needle would be the most appropriate for the nurse to select? 1. 18-gauge, 7/8 inch 2. 21-gauge, 1 inch 3. 25-gauge, 5/8 inch 4. 25-gauge, 1 ½ inch

3. 25-gauge, 5/8 inch

A child with type 1 diabetes is receiving insulin based on carbohydrate intake. The child's insulin-to-carbohydrate ratio is 15:1. Of the items listed on the child's lunch menu shown below, the child ate 2 slices of bread (15g each), a slice of cheese (free), a glass of milk (10g), a cup of soup (10g), and half of a banana (22g). How many units of insulin should the nurse administer based on the client's carbohydrate count? Round to the nearest whole number. 1. 2 units 2. 3 units 3. 4 units 4. 5 units

3. 4 units

A child with type 1 diabetes is receiving insulin based on carbohydrate intake. The child's insulin-to-carbohydrate ratio is 15:1. Of the items listed on the child's lunch menu shown below, the child ate 2 slices of bread, a slice of cheese, a glass of milk, a cup of soup, and half of a banana. How many units of insulin should the nurse administer based on the client's carbohydrate count? Round to the nearest whole number. Banana - 22 g Glass of low-fat milk - 10 g Bread slice - 15 g Cheese slice - Free Cup of soup - 10 g 1. 2 units. 2. 3 units. 3. 4 units. 4. 5 units.

3. 4 units.

After teaching a group of parents of pre-schoolers attending a well-child clinic about oral hygiene and tooth brushing, the nurse determines that the teaching has been successful when the parents state that children can begin to brush their teeth without help at which of the following ages? 1. 3 years. 2. 5 years. 3. 7 years. 4. 9 years.

3. 7 years.

When assessing an infant with an undescended testis, the nurse should be alert for which of the following? 1. Abnormal lower extremity reflexes. 2. A history of frequent emesis. 3. A bulging in the inguinal area. 4. Poor weight gain.

3. A bulging in the inguinal area.

A nurse performs a head-to-toe assessment on a newborn. Which finding should be of greatest concern to the nurse? 1. Capillary refill time of 2 seconds. 2. Transient mottling of the skin. 3. Irregular respirations. 4. Negative Babinski reflex.

4. Negative Babinski reflex.

A charge nurse is seated in front of a bank of cardiac monitors on a pediatric unit. There are four children receiving cardiac monitoring. Which finding should the charge nurse communicate at once to the child's nurse? 1. A heart rate of 50 in a 15-year-old adolescent who is sleeping 2. A heart rate of 190 in a 1-month-old infant who is crying 3. A heart rate of 160 in a 2-year-old child who is walking in the hallway 4. A heart rate of 75 in a 5-year-old child who is watching television

3. A heart rate of 160 in a 2-year-old child who is walking in the hallway

A charge nurse is seated in front of a bank of cardiac monitors on a pediatric unit. There are four children receiving cardiac monitoring. Which finding should the charge nurse communicate at once to the child's nurse? 1. A heart rate of 50 in a 15-year-old adolescent who is sleeping. 2. A heart rate of 190 in a 1-month-old infant who is crying. 3. A heart rate of 160 in a 2-year-old child who is walking in the hallway. 4. A heart rate of 75 in a 5-year-old child who is watching television.

3. A heart rate of 160 in a 2-year-old child who is walking in the hallway.

When explaining to the parents of a child with a hydrocele about the possible cause of the condition, the nurse bases this explanation on the interpretation that a hydrocele is most likely the result of which condition? 1. Blockage in the inguinal canal that allows fluid to accumulate in epididymis and ductus deferens. 2. Failure of the upper part of the processus vaginalis to atrophy, allowing accumulation of fluid in the testicle and the peritoneal cavity. 3. A patent processus vaginalis that results in the collection of fluid along the spermatic cord or tunica vaginalis of the testicle. 4. An obliterated processus vaginalis that allows fluid to accumulate in the scrotal sac.

3. A patent processus vaginalis that results in the collection of fluid along the spermatic cord or tunica vaginalis of the testicle.

When developing the teaching plan about illness for the mother of a preschooler, which of the following should the nurse include about how a preschooler perceives illness? 1. A necessary part of life. 2. A test of self-worth. 3. A punishment for wrongdoing. 4. The will of God.

3. A punishment for wrongdoing.

A mother calls the clinic to talk to the nurse. The mother states that a physician described her daughter as having 20/60 vision and she asks the nurse what this means. The nurse responds based on the interpretation that the child is experiencing which of the following? 1. A loss of approximately one-third of her visual acuity. 2. Ability to see at 60 feet what she should see at 20 feet. 3. Ability to see at 20 feet what she should see at 60 feet. 4. Visual acuity three times better than average.

3. Ability to see at 20 feet what she should see at 60 feet.

The nurse assesses a 6-month-old for vaccination readiness. Which finding would most likely indicate the need to delay administering the diphtheria, tetanus, and acellular pertussis (DTaP) vaccine? 1. A family history of sudden infant death syndrome (SIDS). 2. A fever of 38.5 °C following the 4-month vaccinations. 3. An acute bilateral ear infection. 4. Living with a family member who is immunosuppressed.

3. An acute bilateral ear infection.

A mother brings her 18-month-old to the clinic because the child "eats ashes, crayons, and paper." Which of the following information about the toddler should the nurse assess first? 1. Evidence of eruption of large teeth. 2. Amount of attention from the mother. 3. Any changes in the home environment. 4. Intake of a soft, low-roughage diet.

3. Any changes in the home environment.

The nurse caring for a 7-year-old child who has undergone a cardiac catheterization 2 hours ago finds the dressing and bed saturated with blood. The nurse should first: 1. Assess the vital signs. 2. Reinforce the dressing. 3. Apply pressure just above the catheter insertion site. 4. Notify the physician.

3. Apply pressure just above the catheter insertion site.

A clinic nurse prepares to perform a physical assessment on a preschool child. What are the appropriate actions for the nurse to take when preparing for and performing the examination? Prioritize the nurse's actions by placing each correct step in sequential order. 1. Allow child to keep underpants on. 2. Allow child to undress in private. 3. Ask child's preference for parental involvement. 4. Inspect ears, eyes, and mouth. 5. Proceed in head-to-toe direction. 6. Gain cooperation with bright objects as a distraction.

3. Ask child's preference for parental involvement. 1. Allow child to keep underpants on. 5. Proceed in head-to-toe direction. 4. Inspect ears, eyes, and mouth.

The parents of a 2-year-old child ask a nurse how to best assist the child to accomplish developmental tasks at this age. What is the best response by the nurse? 1. Make sure that the child's siblings insist that the child share toys at playtime 2. Since the child understands the word "no" use this word frequently to establish house rules 3. Ask grandparents and other child care providers to follow tour home schedule as much as possible 4. Attend to the child quickly during temper tantrums by hugging and offering reassurance

3. Ask grandparents and other child care providers to follow tour home schedule as much as possible

A child is seen in an emergency department following the ingestion of lighter fluid. Which nursing action is of the highest priority? 1. Induce vomiting 2. Determine the amount of poison ingested 3. Assess the respiratory system 4. Administer Mucomyst as ordered

3. Assess the respiratory system

A child is seen in an emergency department following the ingestion of lighter fluid. Which nursing action is of the highest priority at this time? 1. Induce vomiting. 2. Determine the amount of poison ingested. 3. Assess the respiratory system. 4. Administer Mucomyst as ordered.

3. Assess the respiratory system.

A high school student calls to ask the nurse for advice on how to care for a new navel piercing. Which response by the nurse is the most appropriate? 1. Apply warm soaks to the area for the first two days to minimize swelling. 2. Do not move or turn the jewelry for the first three days. 3. Avoid contact with another persons bodily fluids until the area is well healed. 4. Apply lotion to the area, rubbing gently, to prevent skin from becoming dry and irritated.

3. Avoid contact with another persons bodily fluids until the area is well healed.

When visiting the home of a school-age child who is dying, what would be the best action by a hospice nurse? 1. Speak softly (whisper) hen speaking in the child's presence 2. Provide as little interaction with the child as possible 3. Avoid correcting the child who is in denial about dying 4. Rely on the parents for pain assessment

3. Avoid correcting the child who is in denial about dying

When visiting the home of a school-age child who is dying, what would be the best action by a hospice nurse? 1. Speak softly (whisper) when speaking in the child's presence. 2. Provide as little interaction with the child as possible. 3. Avoid correcting the child who is in denial about dying. 4. Rely on the parents for pain assessment.

3. Avoid correcting the child who is in denial about dying.

The nurse collects a urine specimen preoperatively from a child with epispadias who is scheduled for surgical repair. When analyzing the results of urinalysis, which should the nurse most likely expect to note? 1. Hematuria 2. Proteinuria 3. Bacteriuria 4. Glucosuria

3. Bacteriuria

Which of the following meals would be most appropriate for a 15-year-old with glomerulonephritis with severe hypertension? 1. Egg noodles, hamburger, canned peas, milk. 2. Baked ham, baked potato, pear, canned carrots, milk. 3. Baked chicken, rice, beans, orange juice. 4. Hot dog on a bun, corn chips, pickle, cookie, milk.

3. Baked chicken, rice, beans, orange juice.

When teaching a preschool-age child how to perform coughing and deep-breathing exercises before corrective surgery for tetralogy of Fallot, which of the following teaching and learning principles should the nurse address first? 1. Organizing information to be taught in a logical sequence. 2. Arranging to use actual equipment for demonstrations. 3. Building the teaching on the child's current level of knowledge. 4. Presenting the information in order from simplest to most complex.

3. Building the teaching on the child's current level of knowledge.

Where is the best location for a nurse to auscultate a murmur created by pulmonic stenosis?

3. C (pulmonic valve)

A young girl is being discharged from the pediatric unit after a left nephrectomy for Stage 1 Wilms' tumor of the left kidney and the first round of chemotherapy. The nurse is providing the parents with discharge planning. Which of the following statements should the nurse include? 1. Child will need to restrict fluids for the rest of his or her life. 2. Child will require dialysis until a kidney for transplant is found. 3. Child will be able to live a normal life after the surgical site heals. 4. Child will have to take antirejection medications after surgery.

3. Child will be able to live a normal life after the surgical site heals.

A nurse is planning to teach a child safety class to a group of new parents. When preparing a lesson regarding car seats, what should the nurse recommend? 1. Children should be seated in the rear of the car until 6 years of age 2. Infants should face forward in an infant seat until 20 pounds 3. Children should face rear of the car until as close to 1 year of age as 4. Make sure to use the automobile air bags as these enhance the safety of car seats

3. Children should face rear of the car until as close to 1 year of age as

A nurse is planning to teach a child safety class to a group of new parents. When preparing a lesson regarding car seats, what should the nurse recommend? 1. Children should be seated in the rear of the car until 6 years of age. 2. Infants should face forward in an infant seat until 20 pounds. 3. Children should face the rear of the car until as close to 1 year of age as possible. 4. Make sure to use the automobile air bags as these enhance the safety of car seats.

3. Children should face the rear of the car until as close to 1 year of age as possible.

On assessment of a child admitted with a diagnosis of acute stage Kawasaki disease, the nurse expects to note which manifestation of the acute stage of the disease? 1. Cracked lips 2. Normal appearance 3. Conjunctival hyperemia 4. Desquamation of the skin

3. Conjunctival hyperemia

A 6-year-old child is admitted to the pediatric unit with a diagnosis of acute poststreptococcal glomerular nephritis. Which of the following toys/ activities would be most appropriate for the nurse to provide to the child? 1. Push and pull toy 2. Bean bags and target 3. Crayons and paper 4. Set of blocks

3. Crayons and paper

A 6-year-old child is admitted to the pediatric unit with a diagnosis of acute poststreptococcal glomerular nephritis. Which of the following toys/activities would be most appropriate for the nurse to provide to the child? 1. Push and pull toy 2. Bean bags and target 3. Crayons and paper 4. Set of blocks

3. Crayons and paper

The nurse needs to administer a medication to a preschool-age child. The medication is only available in tablet form. Which action by the nurse is the most appropriate? 1. Place the tablet on the child's tongue and give the child a drink of water. 2. Break the tablet in small pieces and ask the child to swallow the pieces one by one. 3. Crush the tablet and mix it in a teaspoon of applesauce. 4. Crush the table and mix it in a cup of juice.

3. Crush the tablet and mix it in a teaspoon of applesauce.

A 12-year-old with leukemia is receiving cyclophosphamide (Cytoxan). The nurse should assess for the adverse effect of: 1. Photosensitivity. 2. Ataxia. 3. Cystitis. 4. Cardiac arrhythmias.

3. Cystitis.

What us the priority nursing diagnosis for an infant receiving treatment for hyperbilirubinemia? 1. Imbalanced body temperature 2. Alteration in elimination 3. Deficient fluid volume 4. Interrupted family processes

3. Deficient fluid volume

In counseling an adolescent female about safe sex practices, which question is the most appropriate for the nurse to ask? 1. Do you and your boyfriend use a condom every time you have sex? 2. Do you have a boyfriend, and if so, are you sexually active? 3. Do you have one or more sexual partners? 4. Have you and your boyfriend ever had unprotected sex?

3. Do you have one or more sexual partners?

A parent brings a 4-month-old to the clinic for a regular well visit and expresses concern that the infant is not developing appropriately. Which findings in the infant would indicate the need for further developmental screening? 1. Has no interest in peek-a-boo games. 2. Does not turn front to back. 3. Does not babble. 4. Continues to have head lag.

3. Does not babble.

A 3-year-old child is hospitalized with multiple fractures as a result of a car accident. What is the best way for a nurse to assess this child's pain level? 1. Ask the child to rate pain using a numeric pain rating scale 2. Rely on vital sign measurements as a way to verify pain ratings 3. Employ the FACES pain scale with every nursing assessment 4. Try to have the child describe the pain's intensity and quality

3. Employ the FACES pain scale with every nursing assessment

A 3-year-old child is hospitalized with multiple fractures as a result of a car accident. What is the best way for a nurse to assess this child's pain level? 1. Ask the child to rate pain using a numeric pain rating scale. 2. Rely on vital sign measurements as a way to verify pain ratings. 3. Employ the FACES pain scale with every nursing assessment. 4. Try to have the child describe the pain's intensity and quality.

3. Employ the FACES pain scale with every nursing assessment.

While preparing to examine a 6-week-old infant's scrotal sac and testes for possible undescended testes, which of the following would be most important for the nurse to do? 1. Check the diaper for recent urination. 2. Give the infant a pacifier. 3. Ensure that the room is kept warm. 4. Tap lightly on the left inguinal ring.

3. Ensure that the room is kept warm.

While performing daily peritoneal dialysis and catheter exit site care with the mother of a child with chronic renal failure, which of the following would be an important step to emphasize to the mother? 1. Applying an occlusive dressing after cleaning the site. 2. Changing the dressing when the peritoneal space is dry. 3. Examining the site for signs of infection while cleaning the area. 4. Pulling on the catheter to hold taut while cleaning the skin.

3. Examining the site for signs of infection while cleaning the area.

The nurse discusses the eating habits of school-age children with their parents, explaining that these habits are most influenced by: 1. Food preferences of their peers. 2. Smell and appearance of foods offered. 3. Examples provided by parents at mealtimes. 4. Parental encouragement to eat nutritious foods.

3. Examples provided by parents at mealtimes.

The nurse reviews the record of a child just seen by a health care provider and diagnosed with suspected aortic stenosis. The nurse expects to note documentation of which clinical manifestation specifically found in this disorder? 1. Pallor 2. Hyperactivity 3. Exercise intolerance 4. GI disturbances

3. Exercise intolerance

A nurse assesses the respiratory status of an infant. Which findings should be of most concern to the nurse? 1. Tachypnea 2. Scattered rhonchi 3. Expiratory grunt 4. Abdominal breathing

3. Expiratory grunt

A nurse assesses the respiratory status of an infant. Which finding should be of most concern to the nurse? 1. Tachypnea. 2. Scattered rhonchi. 3. Expiratory grunt. 4. Abdominal breathing.

3. Expiratory grunt.

The nurse is preparing to discharge a toddler-age client who just had an orchiopexy. Which discharge instruction is appropriate for this client? 1. Information to the parents about the child's resuming normal vigorous activities 2. Discussion with the parents about the low incidence of testicular malignancy and no further need for any follow-up 3. Explanation to the parents about the need for loose, nonrestrictive clothing 4. Reassurance to the parents that infertility is not a future risk

3. Explanation to the parents about the need for loose, nonrestrictive clothing

The nurse is assisting with conscious sedation for a 6-year-old undergoing a bone marrow biopsy. The nurse's most important responsibility during the procedure is to: 1. Administer the topical anesthetic. 2. Keep the parents informed. 3. Monitor the client. 4. Record the procedure.

3. Monitor the client.

A 3-year-old child receiving chemotherapy after surgery for a Wilms' tumor has developed neutropenia. The parent is trying to encourage the child to eat by bringing extra foods to the room. Which food would not be appropriate for this child? 1. Fudge. 2. French fries. 3. Fresh strawberries. 4. A milk shake.

3. Fresh strawberries.

Which athletic activity can the nurse recommend for a school-age client with pulmonary-artery hypertension? 1. Cross-country running 2. Soccer 3. Golf 4. Basketball

3. Golf

To assess a 9-year-old's social development, the nurse asks the parent if the child: 1. Thinks independently. 2. Is able to organize and plan. 3. Has a best friend. 4. Enjoys active play.

3. Has a best friend.

A nurse and nursing student are caring for a child who sustained a head injury as a result of a fall from a play structure. The nurse knows the nursing student is prepared to care for the child when the student states: 1. I will be sure to let you know if the child's pupils become fixed and dilated 2. I will keep the child straight in the supine position 3. I will look for any changes in the child's respirations, pulse, or blood pressure 4. I will notify the physician if the child becomes sleepy

3. I will look for any changes in the child's respirations, pulse, or blood pressure

Which of the following medication orders to help relieve discomfort in a child with leukemia should the nurse question? 1. Acetaminophen (Tylenol). 2. Acetaminophen with codeine (Tylenol with Codeine). 3. Ibuprofen (Motrin). 4. Propoxyphene hydrochloride (Darvon).

3. Ibuprofen (Motrin).

When assessing a 2-year-old child brought by his mother to the clinic for a routine checkup, which of the following should the nurse expect the child to be able to do? 1. Ride a tricycle. 2. Tie his shoelaces. 3. Kick a ball forward. 4. Use blunt scissors.

3. Kick a ball forward.

The nurse assesses the child with chronic renal failure who is receiving peritoneal dialysis for edema. Which finding is expected for this child? 1. Absence of pulmonary crackles. 2. Increased dialysate outflow. 3. Normal blood pressure. 4. Pallor.

4. Pallor.

A child is admitted to the hospital unit with a diagnosis of minimal-change nephrotic syndrome (MCNS). Which clinical manifestations does the nurse anticipate when conducting the admission assessment? 1. Hematuria, bacteriuria, weight gain 2. Gross hematuria, albuminuria, fever 3. Massive proteinuria, hypoalbuminemia, edema 4. Hypertension, weight loss, proteinuria

3. Massive proteinuria, hypoalbuminemia, edema

An 18-year-old high school senior wishes to obtain birth control through her parents' insurance but does not want the information disclosed. The nurse tells the client that under the Health Information Portability and Accountability Act (HIPAA) parents: 1. Have the right to review a minor's medical records until high school graduation. 2. Have the right to review a minor's medical record if they are responsible for the payment. 3. May not view the medical record, but may learn of the visit through the insurance bill. 4. May not view the minor's medical record or the insurance bill.

3. May not view the medical record, but may learn of the visit through the insurance bill.

A newborn is suspected of having cystic fibrosis. As the child is being prepared for transfer to a pediatric hospital, the mother asks the nurse which symptoms made the practitioner suspect cystic fibrosis. Which response by the nurse is the most appropriate? 1. Steatorrheic stools 2. Constipation 3. Meconium ileus 4. Rectal prolapse

3. Meconium ileus

Initiation of which of the following immunizations is recommended prior to the adolescent entering college? 1. Diphtheria, tetanus, and acellular pertussis (DTaP). 2. Varicella. 3. Meningococcal. 4. Pneumococcal conjugate vaccine (PCV).

3. Meningococcal.

A nurse is caring for a newborn infant diagnosed with hypospadias. The parents ask when the surgical repair will be complete. The nurse knows that the most likely time for completion of the surgical repair will be: 1. Within the first month of life 2. Not until the child reaches puberty 3. Nearer the child's first birthday 4. Before the child begins school

3. Nearer the child's first birthday

A nurse is caring for a newborn infant diagnosed with hypospadias. The parents ask when the surgical repair will be complete. The nurse knows that the most likely time for completion of the surgical repair will be: 1. Within the first month of life. 2. Not until the child reaches puberty. 3. Nearer the child's first birthday. 4. Before the child begins school.

3. Nearer the child's first birthday.

The nurse explains to the parents of a 1-year-old child admitted to the hospital in sickle cell crisis that the local tissue damage the child has on admission is caused by which of the following? 1. Autoimmune reaction complicated by hypoxia. 2. Lack of oxygen in the red blood cells. 3. Obstruction to circulation. 4. Elevated serum bilirubin concentration.

3. Obstruction to circulation.

A school-age client admitted to the hospital because of decreased urine output and periorbital edema is diagnosed with acute poststreptococcal glomerulonephritis. Which of the following actions should receive the highest priority? 1. Assessing vital signs every 4 hours. 2. Monitoring intake and output every 12 hours. 3. Obtaining daily weight measurements. 4. Obtaining serum electrolyte levels daily.

3. Obtaining daily weight measurements.

A nurse is assessing the growth and development of a 14-year-old boy. He reports that his 13-year-old sister is 2 inches taller than he is. The nurse should advise the boy that the growth spurt in adolescent boys, compared with the growth spurt of adolescent girls: 1. Occurs at the same time. 2. Occurs 2 years earlier. 3. Occurs 2 years later. 4. Occurs 1 year earlier.

3. Occurs 2 years later.

Which of the following is the priority nursing diagnosis during a toddler's vasoocclusive sickle cell crisis? 1. Ineffective coping related to presence of a life-threatening disease. 2. Decreased cardiac output related to abnormal hemoglobin formation. 3. Pain related to tissue anoxia. 4. Excess fluid volume related to infection.

3. Pain related to tissue anoxia.

A parent asks, "Can I get head lice too?" The nurse indicates that adults can also be infested with head lice but that pediculosis is more common among school children, primarily for which of the following reasons? 1. An immunity to pediculosis usually is established by adulthood. 2. School-age children tend to be more neglectful of frequent handwashing. 3. Pediculosis usually is spread by close contact with infested children. 4. The skin of adults is more capable of resisting the invasion of lice.

3. Pediculosis usually is spread by close contact with infested children.

A nurse prepares to insert a nasogastric tube in a 10-month-old child. Which actions should the nurse take to complete this procedure? Prioritize the nurse's actions by placing each correct step in sequential order. 1. Aspirate gastric contents. 2. Have the child begin a bottle feeding. 3. Place child supine with head and neck elevated. 4. Inject 10 mL of air into the tube while auscultating the stomach. 5. Tape tube securely to infant's cheek. 6. Measure from the infant's earlobe to the area of the stomach.

3. Place child supine with head and neck elevated. 1. Aspirate gastric contents. 5. Tape tube securely to infant's cheek.

A 16-month-old child diagnosed with Kawa- saki disease (KD) is very irritable, refuses to eat, and exhibits peeling skin on the hands and feet. The nurse should do which of the following first? 1. Apply lotion to the hands and feet. 2. Offer foods the toddler likes. 3. Place the toddler in a quiet environment. 4. Encourage the parents to get some rest.

3. Place the toddler in a quiet environment.

To encourage autonomy in a 4-year-old, the nurse should instruct the mother to: 1. Discourage the child's choice of clothing. 2. Button the child's coat and blouse. 3. Praise the child's attempts to dress herself. 4. Tell the child when the combination of clothes is not appropriate.

3. Praise the child's attempts to dress herself.

In assessing the reflexes of a 15-month-old child, which finding would indicate that the child is experiencing normal development? 1. Positive Babinski reflex 2. Asymmetric tonic neck reflex 3. Positive patellar reflex 4. Presence of doll's eyes reflex

3. Positive patellar reflex

In assessing the reflexes of a 15-month-old child, which finding would indicate that the child is experiencing normal development? 1. Positive Babinski reflex. 2. Asymmetric tonic neck reflex. 3. Positive patellar reflex. 4. Presence of doll's eye reflex.

3. Positive patellar reflex.

An adolescent with chronic renal failure is scheduled to go home with a peritoneal dialysis catheter in place. When developing the discharge teaching plan for the client and family focusing on psychosocial needs, which of the following areas should be a top priority to include? 1. Advantages of limiting social activities and contacts for the first few months. 2. Not disclosing information about the peritoneal dialysis to people outside the family. 3. Possible effect on body image of the presence of an abdominal catheter. 4. Importance of relying on parents to do the dialysis and dressing changes.

3. Possible effect on body image of the presence of an abdominal catheter.

Which of the following structures should be closed by the time the child is 2 months old? 1. Anterior fontanelle 2. Sagittal suture 3. Posterior fontanelle 4. Coronal suture

3. Posterior fontanelle

A newborn arrives in a NICU with a myelomeningocele. A physician writes orders to keep the infant in the prone position. A nurse should know that the most important rationale behind this order is to: 1. Prevent infection 2. Promote circulation in the lower extremities 3. Prevent trauma to the meningeal sac 4. Promote comfort

3. Prevent trauma to the meningeal sac

A newborn arrives in a neonatal intensive care unit with a myelomeningocele. A physician writes orders to keep the infant in the prone position. A nurse should know that the most important rationale behind this order is to: 1. Prevent infection. 2. Promote circulation in the lower extremities. 3. Prevent trauma to the meningeal sac. 4. Promote comfort.

3. Prevent trauma to the meningeal sac.

When developing the discharge plan for a child who had a nephrectomy for a Wilms' tumor, the nurse identifies outcomes to prevent damage to the child's remaining kidney and accomplish which of the following? 1. Minimize pain. 2. Prevent dependent edema. 3. Prevent urinary tract infection. 4. Minimize sodium intake.

3. Prevent urinary tract infection.

When developing the discharge plan for a school-age child diagnosed with acute poststreptococcal glomerulonephritis, which instruction should the nurse plan to discuss? 1. Restricting dietary protein. 2. Monitoring pulse rate and rhythm. 3. Preventing respiratory infections. 4. Restricting foods high in potassium.

3. Preventing respiratory infections.

A nurse is planning care for a 12-year-old with rheumatic fever. The nurse should teach the parents to: 1. Observe the child closely. 2. Allow the child to participate in activities that will not tire him. 3. Provide for adequate periods of rest between activities. 4. Encourage someone in the family to be with the child 24 hours a day.

3. Provide for adequate periods of rest between activities.

An adolescent tells the school nurse that she would like to use tampons during her period. The nurse should first: 1. Assess her usual menstrual flow pattern. 2. Determine whether she is sexually active. 3. Provide information about preventing toxic shock syndrome. 4. Refer her to a specialist in adolescent gynecology.

3. Provide information about preventing toxic shock syndrome.

A 2-year-old tells his mother he is afraid to go to sleep because "the monsters will get him." The nurse should tell his mother to: 1. Allow him to sleep with his parents in their bed whenever he is afraid. 2. Increase his activity before he goes to bed, so he eventually falls asleep from being tired. 3. Read a story to him before bedtime and allow him to have a cuddly animal or a blanket. 4. Allow him to stay up an hour later with the family until he falls asleep.

3. Read a story to him before bedtime and allow him to have a cuddly animal or a blanket.

Concerned parents call the school nurse because of changes in their 15-year-old adolescents behavior. Which behavior would the nurse indicate as indicative of adolescent substance abuse? 1. Buying baggy, oversized clothing at thrift shops and dying her hair black 2. Becoming very involved with friends and in activities related to the basketball team that she is on; never seeming to be home; and, when she is home, preferring to be in her room with the door shut 3. Receiving numerous detentions lately from teachers for sleeping in class 4. Becoming very moody, dramatically crying and weeping one minute and then being cheerful and excited the next

3. Receiving numerous detentions lately from teachers for sleeping in class

A child diagnosed with Wilms' tumor undergoes successful surgery for removal of the diseased kidney. When the child returns to the room, the nurse should place the child in which position? 1. Modified Trendelenburg. 2. Sims'. 3. Semi-Fowler's. 4. Supine.

3. Semi-Fowler's.

A 6-year-old child with antistreptolysin antibodies and negative cultures is admitted to the pediatric unit with a diagnosis of acute poststreptococcal glomerular nephritis. It would be most appropriate for the nurse to admit the child into which of the following rooms? 1. Isolation room on droplet isolation with no roommate 2. Isolation room on droplet and contact isolation with a child with bronchiolitis 3. Regular patient room with 8-year-old child in traction for a broken femur 4. Regular patient room with 6-year-old child with diabetes for insulin control

3. Regular patient room with 8-year-old child in traction for a broken femur

A nurse assesses a child who is 12 hours status post-tonsillectomy and adenoidectomy. The child reports feeling nauseated and shows the nurse a moderate amount of red-tinged vomitus in the emesis basin. Which action should the nurse take first? 1. Administer an antiemetic as ordered 2. Offer the child ice chips as tolerated 3. Report the findings to the physician 4. Apply bilateral pressure to the child's neck

3. Report the findings to the physician

A nurse assesses a child who is 12 hours status post- tonsillectomy and adenoidectomy. The child reports feeling nauseated and shows the nurse a moderate amount of red-tinged vomitus in the emesis basin. Which action should the nurse take first? 1. Administer an antiemetic as ordered. 2. Offer the child ice chips as tolerated. 3. Report the findings to the physician. 4. Apply bilateral pressure to the child's neck.

3. Report the findings to the physician.

A child with myelomeningocele, corrected at birth, is now 5 years old. Which is the priority nursing diagnosis for a child with corrected spina bifida at this age? 1. Risk for Altered Nutrition 2. Risk for Impaired Tissue Perfusion—Cranial 3. Risk for Altered Urinary Elimination 4. Risk for Altered Comfort

3. Risk for Altered Urinary Elimination

When examining a toddler-age child during a well-child physical, which assessment is the priority? 1. Visual acuity 2. Helmet use 3. Risk of lead exposure 4. Whether household drinking water contains fluorine

3. Risk of lead exposure

Which of the following is appropriate language development for an 8-month-old? The child should be: 1. Saying "dada" and "mama" specifically ("dada" to father and "mama" to mother). 2. Saying three other words besides "mama" and "dada." 3. Saying "dada" and "mama" nonspecifically. 4. Saying "ball" when parents point to a ball.

3. Saying "dada" and "mama" nonspecifically.

The mother of a child asks a clinical nurse how to safety proof the home. What should the nurse recognize as the most effective means to prevent accidental poisoning? 1. Keep the Poison Control Center phone number near the phone 2. Store poisons in the garage rather than in the home 3. Scan the home from the child's eye level and remove accessible toxins 4. Tell children where toxic substances are kept and instruct them not to go there

3. Scan the home from the child's eye level and remove accessible toxins

The mother of a child asks a clinic nurse how to safety-proof the home. What should the nurse recognize as the most effective means to prevent accidental poisoning? 1. Keep the Poison Control Center phone number near the phone. 2. Store poisons in the garage rather than in the home. 3. Scan the home from the child's eye level and remove accessible toxins. 4. Tell children where toxic substances are kept and instruct them not to go there.

3. Scan the home from the child's eye level and remove accessible toxins.

The parent of a young child phones an advice nurse to report that the child is ill. The child has a reddish pinpoint rash most concentrated in axilla and groin areas, a high fever, flushed cheeks, and abdominal pain. The parent also reports that the child's tongue is a dark red with white spots. A nurse should recognize these symptoms as indicative of which infection? 1. Mumps 2. Measles 3. Scarlet fever 4. Varicella

3. Scarlet fever

The parent of a young child phones an advice nurse to report that the child is ill. The child has a reddish pin-point rash most concentrated in the axilla and groin areas, a high fever, flushed cheeks, and abdominal pain. The parent also reports that the child's tongue is dark red with white spots. A nurse should recognize these symp- toms as indicative of which infection? 1. Mumps. 2. Measles. 3. Scarlet fever. 4. Varicella.

3. Scarlet fever.

A 7-year-old child has been prescribed desmopressin (DDAVP) 20 mcg intranasal (10 mcg in each nostril) for nocturnal enuresis. Which of the following information regarding the medication should the nurse include in the parent/child teaching session? 1. Child must consume at least five cups of fluid each day. 2. Medication should be stored in the freezer between administrations. 3. Severe headaches with blurred vision should be reported to the prescribing practitioner. 4. Spray should be administered into the nostrils while the child is lying supine with head extended.

3. Severe headaches with blurred vision should be reported to the prescribing practitioner.

A mother tells the nurse that one of her children has chickenpox and asks what she should do to care for that child. When teaching the mother, the nurse should instruct the mother to help her child prevent: 1. Acid-base imbalance. 2. Malnutrition. 3. Skin infection. 4. Respiratory infection

3. Skin infection.

A child has been admitted to the hospital unit in congestive heart failure (CHF). Which symptom would the nurse anticipate upon assessment of the child? 1. Weight loss 2. Bradycardia 3. Tachycardia 4. Increased blood pressure

3. Tachycardia

The nurse is monitoring an infant with congenital heart disease closely for signs of heart failure. The nurse should assess the infant for which early sign of HF? 1. Pallor 2. Cough 3. Tachycardia 4. Slow and shallow breathing

3. Tachycardia

An adolescent with a history of surgical repair for an undescended testis comes to the clinic for a sports physical. Anticipatory guidance for the parents and adolescent should focus on which of the following as most important? 1. The adolescent's sterility. 2. The adolescent's future plans. 3. Technique for monthly testicular self-examinations. 4. Need for a lot of psychological support.

3. Technique for monthly testicular self-examinations.

The mother of a 2-year-old is concerned because the child's right eye seems to turn in toward his nose when he is tired. The nurse should: 1. Assure the mother that this is a normal event when the child is tired. 2. Advise the mother to continue to watch his eyes closely and if the problem persists to call the clinic. 3. Test the child with the cover-uncover test and refer the mother and child to an ophthalmologist if the test is abnormal. 4. Explain to the mother that the child will probably outgrow the weakness and she need not be concerned.

3. Test the child with the cover-uncover test and refer the mother and child to an ophthalmologist if the test is abnormal.

A nurse is educating the parents of a child with an atrial septal defect regarding the child's condition. Which of the following information would be appropriate for the nurse to provide? 1. The baby becomes cyanotic because the blood is flowing through a hole from the right side of the heart to the left side of the heart. 2. The baby has a murmur because there is a hole between the aorta and the pulmonary artery. 3. The baby's heart is working harder than a normal heart because some of its blood is reentering the pulmonary system. 4. The baby's heart rate is slowed because of the high number of red blood cells in the blood.

3. The baby's heart is working harder than a normal heart because some of its blood is reentering the pulmonary system.

When developing the discharge teaching plan for a child with chronic renal failure and the family, the nurse should emphasize restriction of which of the following nutrients? 1. Ascorbic acid. 2. Calcium. 3. Magnesium. 4. Phosphorus.

4. Phosphorus.

The nurse is planning care with the parents of a child who requires continuous peritoneal dialysis. Which finding should be discussed with the physician? 1. The family lives a long distance from the medical facility. 2. The child attends a large public school. 3. The child reports having a previous surgery for a ruptured appendix. 4. The family feels the child cannot self-regulate to wake at night and change bags.

3. The child reports having a previous surgery for a ruptured appendix.

The mother asks the nurse about her 9-year-old child's apparent need for between-meal snacks, especially after school. When developing a sound nutritional plan for the child with the mother, the nurse should advise the mother: 1. The child does not need to eat between-meal snacks. 2. The child should eat the snacks the mother thinks are appropriate. 3. The child should help with preparing his or her own snacks. 4. The child will instinctively select nutritional snacks.

3. The child should help with preparing his or her own snacks.

A 10-month-old looks for objects that have been removed from his view. The nurse should instruct the parents that: 1. Neuromuscular development enables the child to reach out and grasp objects. 2. The child's curiosity has increased. 3. The child understands the permanence of objects even though the child cannot see them. 4. The child is now able to transfer objects from hand to hand.

3. The child understands the permanence of objects even though the child cannot see them.

A nurse should suspect Hirschsprung's disease in a child who has which type of stooling pattern? 1. Pale gray stools. 2. Currant-jelly stools. 3. Loose, yellow stools. 4. Thin, ribbon-like stools.

4. Thin, ribbon-like stools.

A charge nurse is creating nursing assignments for a pediatric unit when one of the oncoming nurses calls to say, "Sorry, I'll be a few minutes late since I have a child home ill with the chickenpox." What type assignment would be most acceptable for the nurse who will be late? 1. Any assignment is fine as long as the nurse wears a mask 2. The nurse needs an assignment that does not include children with neutropenia 3. The nurse should not be given an assignment and should be called off 4. Any care assignment is acceptable, without restrictions

3. The nurse should not be given an assignment and should be called off

A charge nurse is creating nursing assignments for a pediatric unit when one of the oncoming nurses calls to say, "Sorry, I'll be a few minutes late since I have a child home ill with the chickenpox." What type of assignment would be most acceptable for the nurse who will be late? 1. Any assignment is fine as long as the nurse wears a mask. 2. The nurse needs an assignment that does not include children with neutropenia. 3. The nurse should not be given an assignment and should be called off. 4. Any care assignment is acceptable, without restrictions.

3. The nurse should not be given an assignment and should be called off.

The mother asks the nurse for advice about discipline for her 18-month-old. Which of the following should the nurse suggest that the mother use? 1. Structured interactions. 2. Spanking. 3. Reasoning. 4. Time out.

4. Time out.

Several high-school seniors are referred to the school nurse because of suspected alcohol misuse. When the nurse assesses the situation, what would be most important to determine? 1. What they know about the legal implications of drinking. 2. The type of alcohol they usually drink. 3. The reasons they choose to use alcohol. 4. When and with whom they use alcohol.

3. The reasons they choose to use alcohol.

A nursing student prepares to administer eye drops to a young child. What actions by the nursing student should cause a registered nurse to intervene? 1. The student positions the child supine with head extended 2. After administration, the student asks the child to close eyes and move them around 3. The student scheduled medication administration to occur just before lunchtime 4. Prior to administration, the student pulls the lower lid down, forming sac

3. The student scheduled medication administration to occur just before lunchtime

A nursing student prepares to administer eyedrops to a young child. What action by the nursing student should cause a registered nurse to intervene? 1. The student positions the child supine with head extended. 2. After administration, the student asks the child to close eyes and move them around. 3. The student schedules medication administration to occur just before lunchtime. 4. Prior to administration, the student pulls the lower lid down, forming a sac.

3. The student schedules medication administration to occur just before lunchtime.

The nurse should refer the parents of an 8-month-old child to a health care provider if the child is unable to: 1. Stand momentarily without holding onto furniture. 2. Stand alone well for long periods of time. 3. Stoop to recover an object. 4. Sit without support for long periods of time.

4. Sit without support for long periods of time.

The nurse is conducting a health promotion class for adolescents. In counseling an adolescent about lifestyle choices, what should the adolescent eliminate in order to decrease the risk of the most preventable cause of adult death? 1. Alcohol use 2. Obesity 3. Tobacco use 4. Cocaine use

3. Tobacco use

The physician orders a urinalysis for a child who has undergone surgical repair of a hypospadias. Which of the following results should the nurse report to the physician? 1. Urine specific gravity of 1.017. 2. Ten red blood cells per high-powered field. 3. Twenty-five white blood cells per high-powered field. 4. Urine pH of 6.0.

3. Twenty-five white blood cells per high-powered field.

Which response to hospitalization is a nurse most likely to observe in a 4-year-old child? 1. Fearfulness of loud noises and sudden movements 2. Frequent crying outbursts and agitation 3. Urinary frequency and fear of mutilation 4. Boredom or loneliness

3. Urinary frequency and fear of mutilation

Which response to hospitalization is a nurse most likely to observe in a 4-year-old child? 1. Fearfulness of loud noises and sudden movements. 2. Frequent crying outbursts and agitation. 3. Urinary frequency and fear of mutilation. 4. Boredom or loneliness.

3. Urinary frequency and fear of mutilation.

A child is receiving chemotherapy for the treatment of osteosarcoma. Which morning laboratory result must a nurse report immediately to the physician? 1. Absolute neutrophil count of 1200 2. Platelet count of 150,000 3. Urine dipstick positive for heme 4. WBC count of 4500

3. Urine dipstick positive for heme

A child is receiving chemotherapy for the treatment of osteosarcoma. Which morning laboratory result must a nurse report immediately to the physician? 1. Absolute neutrophil count of 1200. 2. Platelet count of 150,000. 3. Urine dipstick positive for heme. 4. WBC count of 4500.

3. Urine dipstick positive for heme.

When developing the discharge teaching plan for the parents of a child who has undergone a cardiac catheterization for ventricular septal defect, which of the following should the nurse expect to include? 1. Restriction of the child's activities for the next 3 weeks. 2. Use of sponge baths until the stitches are removed. 3. Use of prophylactic antibiotics before receiving any dental work. 4. Maintenance of a pressure dressing until a return visit with the physician.

3. Use of prophylactic antibiotics before receiving any dental work.

A child arrives in an emergency department with a chief complaint of asthma exacerbation. Which assessment information is most important for the nurse to obtain first? 1. Whether the child has been takin asthma medications as prescribed 2. When the child began having symptoms 3. Whether the child is able to speak in full sentences 4. The child's ABG levels

3. Whether the child is able to speak in full sentences

A child arrives in an emergency department with a chief complaint of asthma exacerbation. Which assessment information is most important for the nurse to obtain first? 1. Whether the child has been taking asthma medications as prescribed. 2. When the child began having symptoms. 3. Whether the child is able to speak in full sentences. 4. The child's ABG levels.

3. Whether the child is able to speak in full sentences.

A physician orders penicillin 200,000 units/kg/day IV Q6H for a child weighing 16kg. The penicillin on hand comes prepared in a concentration of 250,000 units/mL. In order to administer the correct dose, a nurse calculates that____mL of penicillin should be administered to the child. Fill in the blank.

3.2 mL

A physician orders penicillin 200,000 units/kg/day IV q6h for a child weighing 16 kg. The penicillin on hand comes prepared in a concentration of 250,000 units/mL. In order to administer the correct dose, a nurse calculates that _______ mL of penicillin should be administered to the child. Fill in the blank.

32 mL

A father brings his 4-week-old son to the clinic for a checkup, stating that he believes his son's testicle is missing. Which of the following explanations would be most appropriate? 1. "Although the testes should have descended by now, it is not a cause for worry." 2. "The testes often do not descend until age 6 months, but let's check to see whether the testes are present." 3. "The testes are present in the scrotal sac at birth, but surgery can remedy the situation." 4. "Although the testes normally descend by 1 year of age, I can understand your concern."

4. "Although the testes normally descend by 1 year of age, I can understand your concern."

A 10-year-old child is in the hospital on bedrest with a diagnosis of rheumatic fever complicated by carditis. When the nurse responds to the child's call bell, the child states, "I hate this! I want to get up and play!" Which of the following responses is appropriate for the nurse to make at this time? 1. "I know that you are unhappy, but you must stay in bed so that you can get better and go home." 2. "What if we make a deal and I promise to let you get up for 10 minutes every 2 hours if you are very good the rest of the day?" 3. "I am sure that I can get the doctor to let you go to the playroom for 1 to 2 hours this afternoon." 4. "I am so sorry that you are unhappy, but what if I contact the play lady and have her bring you a selection of video games to play with?"

4. "I am so sorry that you are unhappy, but what if I contact the play lady and have her bring you a selection of video games to play with?"

The nurse provides home care instructions to the parents of a child with heart failure regarding procedure for administration of digoxin. Which statement indicates need for further teaching? 1. "I will not mix with food" 2. "I will take my child's pulse before administering medication" 3. "If more than 1 dose is missed I will call the HCP" 4. "If my child vomits after med administration, I will repeat the dose"

4. "If my child vomits after med administration, I will repeat the dose"

Which of the following statements should the nurse use to describe to the parents why their child with leukemia is at risk for infections? 1. "Play activities are too strenuous." 2. "Vitamin C intake is reduced over a period of time." 3. "The number of red blood cells is inadequate for carrying oxygen." 4. "Immature white blood cells are incapable of handling an infectious process."

4. "Immature white blood cells are incapable of handling an infectious process."

The mother asks the nurse why her child's hemoglobin was normal at birth but now the child has S hemoglobin. Which of the following responses by the nurse is appropriate? 1. "The placenta bars passage of the hemoglobin S from the mother to the fetus." 2. "The red bone marrow does not begin to produce hemoglobin S until several months after birth." 3. "Antibodies transmitted from you to the fetus provide the newborn with temporary immunity." 4. "The newborn has a high concentration of fetal hemoglobin in the blood for some time after birth."

4. "The newborn has a high concentration of fetal hemoglobin in the blood for some time after birth."

Shortly after an infant is returned to his room following hydrocele repair, the infant's mother tells the nurse that the child's scrotum looks swollen and bruised. Which of the following responses by the nurse would be most appropriate? 1. "Let me see if the doctor has ordered aspirin for him. If he did, I'll get it right away." 2. "Why don't you wait in his room? Then you can ask me any questions when I get there." 3. "What you are describing is unusual after this type of surgery. I'll let the doctor know." 4. "This is normal after this type of surgery. Let's look at it together just to be sure."

4. "This is normal after this type of surgery. Let's look at it together just to be sure."

The parent of a 9-month-old infant is concerned that the infant's front soft spot is still open. The nurse should tell the parent: 1. "I will measure your baby's head to see if it is a normal size." 2. "Your infant will need to be referred for more testing." 3. "You should contact your physician immediately." 4. "This is normal because this soft spot usually closes between 12 and 18 months."

4. "This is normal because this soft spot usually closes between 12 and 18 months."

A child is admitted for treatment of lead poisoning. A nurse recognizes that the priority nursing diagnosis for this child is: 1. Alteration in comfort related to abdominal pain. 2. Alteration in nutrition related to pica. 3. Pain related to chelation therapy. 4. Alteration in neurologic functioning.

4. Alteration in neurologic functioning.

The nurse is checking peripheral perfusion to a child's extremity following a cardiac catheterization. Which assessment finding indicates adequate peripheral circulation to the affected extremity? 1. A capillary refill of greater than three seconds 2. A palpable dorsalis pedis pulse but a weak posterior tibial pulse 3. A decrease in sensation with a weakened dorsalis pedis pulse 4. A capillary refill of less than three seconds with palpable warmth

4. A capillary refill of less than three seconds with palpable warmth

The nurse is checking peripheral perfusion to a childs extremity following a cardiac catheterization. Which assessment finding indicates adequate peripheral circulation to the affected extremity? 1. A capillary refill of greater than three seconds 2. A palpable dorsalis pedis pulse but a weak posterior tibial pulse 3. A decrease in sensation with a weakened dorsalis pedis pulse 4. A capillary refill of less than three seconds with palpable warmth

4. A capillary refill of less than three seconds with palpable warmth

Which of the following beverages should the nurse plan to give a child with leukemia to relieve nausea? 1. Orange juice. 2. Weak tea. 3. Plain water. 4. A carbonated beverage.

4. A carbonated beverage.

A toddler is started on digoxin (Lanoxin) for cardiac failure. Which is the initial symptom the nurse would assess if the child develops digoxin (Lanoxin) toxicity? 1. Lowered blood pressure 2. Tinnitus 3. Ataxia 4. A change in heart rhythm

4. A change in heart rhythm

The school nurse is invited to attend a meeting with several parents who express frustration with the amount of time their adolescents spend in front of the mirror and the length of time it takes them to get dressed. The nurse explains that this behavior indicates: 1. An abnormal narcissism. 2. A method of procrastination. 3. A way of testing the parents' limit-setting. 4. A result of developing self-concept.

4. A result of developing self-concept.

When providing anticipatory guidance to the parents of a child with hemophilia, a nurse should stress that: 1. Active range-of-motions exercise should be used to treat sore joints 2. Aspirin should be given for minor bumps and bruises 3. Warm compresses should be applied to wounds to promote circulation 4. A soft toothbrush should be used to promote oral health

4. A soft toothbrush should be used to promote oral health

When providing anticipatory guidance to the parents of a child with hemophilia, a nurse should stress that: 1. Active range-of-motion exercise should be used to treat sore joints. 2. Aspirin should be given for minor bumps and bruises. 3. Warm compresses should be applied to wounds to promote circulation. 4. A soft toothbrush should be used to promote oral health.

4. A soft toothbrush should be used to promote oral health.

An LVN/LPN from an orthopedic unit is floated to a child health unit. In creating assignments, which child should the charge nurse avoid assigning to the LVN? 1. A 10-year-old in traction for a fractured femur 2. An 8-year-old child with Legg-Calve-Perthes disease 3. A 4-year-old with osteogenesis imperfecta 4. A teenager receiving chemotherapy for osteosarcoma

4. A teenager receiving chemotherapy for osteosarcoma

An LVN/LPN from an orthopedic unit is floated to a child health unit. In creating assignments, which child should the charge nurse avoid assigning to the LVN/LPN? 1. A 10-year-old in traction for a fractured femur. 2. An 8-year-old child with Legg-Calvé-Perthes disease. 3. A 4-year-old with osteogenesis imperfecta. 4. A teenager receiving chemotherapy for osteosarcoma.

4. A teenager receiving chemotherapy for osteosarcoma.

A child is admitted for treatment of lead poisoning. A nurse recognizes that the priority nursing diagnosis for the child is: 1. Alteration in comfort related to abdominal pain 2. Alteration in nutrition related to pica 3. Pain related to chelation therapy 4. Alteration in neurologic function

4. Alteration in neurologic function

4. Alteration in neurologic functioning.

Twelve hours after cardiac surgery, the nurse is assessing a 3-year-old who weighs 15 kg. The nurse should notify the surgeon about which of the following clinical finding? 1. A urine output of 60 mL in 4 hours. 2. Strong peripheral pulses in all four extremities. 3. Fluctuations of fluid in the collection chamber of the chest drainage system. 4. Alterations in levels of consciousness.

4. Alterations in levels of consciousness.

A nurse prepares to administer spironolactone (Aldactone)to an infant with congenital heart disease. The nurse understands that the main purpose of this medication is to: 1. Preserve the patent ductus arteriosus 2. Cause vasodilation of the blood vessels 3. Prevent the secretion of potassium 4. Block aldosterone, which leads to diuresis

4. Block aldosterone, which leads to diuresis

The nurse reviews the laboratory results for a child with a suspected diagnosis of rheumatic fever, knowing that which lab study would assist in confirming the diagnosis? 1. Immunoglobin 2. RBC Count 3. WBC count 4. Anti-strptolysin O titer

4. Anti-strptolysin O titer

A nurse is assessing a 1-day-old sleeping baby in the well-baby nursery. Which of the following assessments should the nurse report to the neonatologist? 1. Temperature 97.9°F 2. Blood pressure 77/46 3. Respiratory rate 52 4. Apical heart rate 179

4. Apical heart rate 179

The nurse is preparing to administer furosemide (Lasix) to a 3-year-old with a heart defect. The nurse verifies the child's identity by checking the arm band and: 1. Asking the child to state her name. 2. Checking the room number. 3. Asking the child to tell her birth date. 4. Asking the parent the child's name.

4. Asking the parent the child's name.

A young school-age client is in the playroom when the respiratory therapist arrives on the pediatric unit to give the child a scheduled breathing treatment. Which action by the nurse is the most appropriate? 1. Reschedule the treatment for a later time. 2. Show the respiratory therapist to the playroom so the treatment may be performed. 3. Escort the child to his room and ask the child-life specialist to bring toys to the bedside. 4. Assist the child back to his room for the treatment but reassure the child that he may return when the procedure is completed.

4. Assist the child back to his room for the treatment but reassure the child that he may return when the procedure is completed.

A clinic nurse has a follow-up appointment with and adolescent with JIA. What topic should be the nurse's top priority? 1. Sleep patterns 2. Participation in daily exercise 3. Information regarding JIA support groups 4. Avoidance of alcohol use

4. Avoidance of alcohol use

A clinic nurse has a follow-up appointment with an adolescent with juvenile idiopathic arthritis (JIA). What topic should be the nurse's top priority? 1. Sleep patterns. 2. Participation in daily exercise. 3. Information regarding JIA support groups. 4. Avoidance of alcohol use.

4. Avoidance of alcohol use.

After teaching a child with leukemia scheduled for a bone marrow aspiration about the procedure, the nurse determines that the teaching has been successful when the child identifies which of the following as the site for the aspiration? 1. Right lateral side of the right wrist. 2. Middle of the chest. 3. Distal end of the thigh. 4. Back of the hipbone.

4. Back of the hipbone.

A school nurse advises the dietary staff that a special lunch tray must be created for a student who has celiac disease. What recommendation should the nurse provide the dietary staff? 1. Make sure the student has a whole-grain bread roll each day 2. The child may have cake if the staff is celebrating someone's birthday 3. The child's pizza should be topped with a variety of vegetables 4. Beans and rice are suitable side dishes for this student

4. Beans and rice are suitable side dishes for this student

A school nurse advises the dietary staff that a special lunch tray must be created for a student who has celiac disease. What recommendation should the nurse provide to the dietary staff? 1. Make sure the student has a whole-grain bread roll each day. 2. The child may have cake if the staff is celebrating someone's birthday. 3. The child's pizza should be topped with a variety of vegetables. 4. Beans and rice are suitable side dishes for this student.

4. Beans and rice are suitable side dishes for this student.

A nurse is teaching the family of an 8-year-old boy with acute lymphocytic leukemia about appropriate activities. Which of the following activities should the nurse recommend? 1. Home schooling. 2. Restriction from participating in athletic activities. 3. Avoiding trips to the shopping mall. 4. Being treated as "normal" as much as possible.

4. Being treated as "normal" as much as possible.

A nurse prepares to administer spironolactone (Aldactone) to an infant with congenital heart disease. The nurse understands that the main purpose of this medication is to: 1. Preserve the patent ductus arteriosus. 2. Cause vasodilation of the blood vessels. 3. Prevent the secretion of potassium. 4. Block aldosterone, which leads to diuresis.

4. Block aldosterone, which leads to diuresis.

The nurse finds that an infant has stronger pulses in the upper extremities than in the lower extremities, and higher blood pressure readings in the arms than in the legs. Which assessment will the nurse perform next on this infant? 1. Pedal pulses 2. Pulse oximetry level 3. Hemoglobin and hematocrit values 4. Blood pressure of the four extremities

4. Blood pressure of the four extremities

A child is recovering from abdominal surgery removes the NG tube accidentally. A nurse replaces the NG tube and places it to a low wall suction. Two hours later, the nurse discovers that there is no drainage from the tube what should be the nurse's first action? 1. Ask the child to change positions 2. Place urgent call to the surgeon 3. Flush the tube with 10ml of sterile water 4. Check the suction mechanism and settings

4. Check the suction mechanism and settings

A child recovering from abdominal surgery removes the nasogastric tube accidentally. A nurse replaces the naso- gastric tube and places it to low wall suction. Two hours later, the nurse discovers that there is no drainage from the tube. What should be the nurse's first action? 1. Ask the child to change position. 2. Place an urgent call to the surgeon. 3. Flush the tube with 10 mL of sterile water. 4. Check the suction mechanism and settings.

4. Check the suction mechanism and settings.

The nurse is reviewing a treatment plan with the parents of a newborn with hypospadias. Which statement by the parents indicates their understanding of the plan? 1. Caution should be used when straddling the infant on the hip 2. Vital signs should be taken daily to check for bladder infection 3. Catheterization will be necessary when the infant does not void 4. Circumcision has been delayed to save tissue for surgical repair

4. Circumcision has been delayed to save tissue for surgical repair

A child hospitalized with hydrocephalus is being treated with an externalized ventricular drain (EVD). A nurse begins the afternoon assessment and discovers that the drain is positioned several inches below the child's ear level. What should be the nurse's priority action? 1. Raise the drain to the child's ear level. 2. Leave the drain as is and monitor the CSF drainage hourly. 3. Quickly elevate the head of the bed. 4. Clamp the drain and complete a neurological assessment.

4. Clamp the drain and complete a neurological assessment.

A child hospitalized with hydrocephalus is being treated with an externalized ventricular drain (EVD). A nurse begins the afternoon assessment and discovers that the drain is positioned several inches below the child's ear level. What should be the nurse's priority action? 1. Raise the drain to the child's ear level 2. Leave the drain as is and monitor the CSF drainage hourly 3. Quickly elevate the head of the bed 4. Clamp the rain and complete a neurological assessment

4. Clamp the rain and complete a neurological assessment

The nurse reads the new medications orders for a 4-year-old child with nephrotic syndrome on the chart below: D/C prednisolone 40 mg PO Daily Prednisolone 30 mg PO QOD The nurse should: 1. Discontinue the prednisolone 40 mg and give the 30 mg dose today. 2. Check the medication record first to see when the last dose of prednisolone was given. 3. Start the 30 mg dose tomorrow. 4. Contact the prescriber for clarification.

4. Contact the prescriber for clarification.

The parents of a newborn infant ask a nurse how to prevent future ear infections. What is the best advice the nurse should provide these parents? 1. Avoid crowds during the winter months 2. Allow the baby to bottle-feed in the supine position 3. Make sure the baby receives the DTaP vaccine as scheduled 4. Continue breastfeeding as close to the baby's first birthday as possible

4. Continue breastfeeding as close to the baby's first birthday as possible

The parents of a newborn infant ask a nurse how to prevent future ear infections. What is the best advice the nurse should provide these parents? 1. Avoid crowds during the winter months. 2. Allow the baby to bottle-feed in the supine position. 3. Make sure the baby receives the DTaP vaccine as scheduled. 4. Continue breastfeeding as close to the baby's first birthday as possible.

4. Continue breastfeeding as close to the baby's first birthday as possible.

A nurse visits the home of a toddler. With what aspect of the home environment would the nurse be most concerned? 1. Power cords plugged into capped electrical outlets 2. Presence of a television in the child's bedroom 3. A swimming pool located in the backyard 4. Cooking pot handle turned toward the front of the stove

4. Cooking pot handle turned toward the front of the stove

A nurse visits the home of a toddler. With what aspect of the home environment would the nurse be most concerned? 1. Power cords plugged into capped electrical outlets. 2. Presence of a television in the child's bedroom. 3. A swimming pool located in the backyard. 4. Cooking pot handle turned toward the front of the stove.

4. Cooking pot handle turned toward the front of the stove.

After emphasizing to an adolescent with renal failure the importance of maintaining a positive self-concept, which of the following behaviors by the adolescent should the nurse identify as an indicator that the plan is working? 1. Reports of headaches, abdominal pain, and nausea. 2. Insistence on making diet choices even if the foods chosen are restricted. 3. Verbalization of plans to quit all after-school activities when returning home. 4. Demonstration of desire to do the dressing changes and take care of the medications.

4. Demonstration of desire to do the dressing changes and take care of the medications.

When observing the parent instilling prescribed ear drops ordered twice a day for a toddler, the nurse decides that the teaching about positioning of the pinna for instillation of the drops is effective when the parent pulls the toddler's pinna in which of the following directions? 1. Up and forward. 2. Up and backward. 3. Down and forward. 4. Down and backward.

4. Down and backward.

A 2-year-old always puts his teddy bear at the head of his bed before he goes to sleep. The parents ask the nurse if this behavior is normal. The nurse should explain to the parents that toddlers use ritualistic patterns to: 1. Establish a sense of identity. 2. Establish control over adults in their environment. 3. Establish sequenced patterns of learning behavior. 4. Establish a sense of security.

4. Establish a sense of security.

A 14-year-old girl with sickle cell disease has her fourth hospitalization for sickle cell crisis. Her family is planning a ski vacation in the mountains. What should the nurse tell the parents? 1. Encourage them to go on the trip. 2. Go on the trip, but find a sitter for the 14-year-old. 3. Suggest the trip be postponed until next year. 4. Explain that the high altitude may cause a crisis.

4. Explain that the high altitude may cause a crisis.

The nurse is discharging an 8-month-old who weighs 15 lb from the hospital. The parents have put the child in the back seat of the car with the car seat facing the front. The nurse should: 1. Ask the parents to wait while obtaining the correct car seat. 2. Complete the discharge with the child sitting facing the front seat. 3. Give the parents a manual on proper car seat placement. 4. Explain the need for the rear-facing position and request assistance from a car seat technician.

4. Explain the need for the rear-facing position and request assistance from a car seat technician.

A child is seen in the emergency department. The nurse hears a high-pitched squeal every time the child inhales. The parent states that the child's fever is very high and, in addition, the child is gasping for breath and sitting in the tripod position. Which of the following actions would be appropriate for the nurse to perform at this time? 1. Provide the child with warm liquids to drink. 2. Inspect the throat with a flashlight and tongue blade. 3. Check the child's vital signs and lung fields. 4. Get immediate medical attention for the child.

4. Get immediate medical attention for the child.

The nurse provided discharge instructions to the parents of a 2 year old child who had an orchiopexy to correct cryptorchidism. which statement indicates a need for further instruction? 1. I'll check his temperature 2. I'll give him medication so he will be comfortable 3. I'll check his voiding to be sure there's no problem 4. I'll let him decide when to return to his play activities.

4. I'll let him decide when to return to his play activities.

A nurse is assessing the growth and development of a 10-year-old. What is the expected behavior of this child? 1. Enjoys physical demonstrations of affection. 2. Is selfish and insensitive to the welfare of others. 3. Is uncooperative in play and school. 4. Has a strong sense of justice and fair play.

4. Has a strong sense of justice and fair play.

Which question should the nurse ask the parents of a child suspected of having glomerulonephritis? 1. Did your child fall off a bike onto the handlebars 2. Has the child had persistent nausea and vomiting 3. Has the child been itching or had a rash anytime in the last week 4. Has the child had a sore throat or a throat infection in the last few weeks

4. Has the child had a sore throat or a throat infection in the last few weeks

A newborn baby is receiving digoxin (Lanoxin) and furosemide (Lasix) for congestive heart failure. Which of the following actions would be appropriate for the nurse to perform? 1. Hold digoxin if the apical heart rate is 170 bpm. 2. Hold digoxin for a digoxin level of 1 ng/mL. 3. Hold both the digoxin and furosemide for a weight increase of 5% in one day. 4. Hold both the digoxin and the furosemide for a potassium 3.2 mEq/L.

4. Hold both the digoxin and the furosemide for a potassium 3.2 mEq/L.

A nurse working in the nursery identifies a goal for a mother of a newborn to demonstrate positive attachment behaviors upon discharge. Which intervention would be least effective in accomplishing this goal? 1. Provide opportunities for the mother to hold and examine the newborn. 2. Engage the mother in the newborn's care. 3. Create an environment that fosters privacy for the mother and newborn. 4. Identify strategies to prevent difficulties in parenting.

4. Identify strategies to prevent difficulties in parenting.

A 12-month-old child with infantile eczema is seen at the clinic for several open lesions on the arms and legs. What should a nurse caution the child's parents against? 1. Initiating a diet free of milk products 2. The use of topical hydrocortisone cream 3. Adding cornstarch to bath water 4. Immunization during eczema exacerbation

4. Immunization during eczema exacerbation

A 12-month-old child with infantile eczema is seen at the clinic for several open lesions on the arms and legs. What should a nurse caution the child's parents against? 1. Initiating a diet free of milk products. 2. The use of topical hydrocortisone cream. 3. Adding cornstarch to bath water. 4. Immunization during eczema exacerbations.

4. Immunization during eczema exacerbations.

A nurse performs a head-to-toe assessment on a newborn. Which findings should be of greatest concern to the nurse? 1. Capillary refill time of 2 seconds 2. Transient mottling of the skin 3. Irregular respirations 4. Negative Babinski reflex

4. Negative Babinski reflex

A child diagnosed with tetralogy of Fallot becomes upset, crying and thrashing around when a blood specimen is obtained. The child's color becomes blue and the respiratory rate increases to 44 breaths/minute. Which of the following actions should the nurse do first? 1. Obtain an order for sedation for the child. 2. Assess for an irregular heart rate and rhythm. 3. Explain to the child that it will only hurt for a short time. 4. Place the child in a knee-to-chest position.

4. Place the child in a knee-to-chest position.

When developing the teaching plan for the parents of a 12-month-old infant with hypospadias and chordee repair, which of the following should the nurse expect to include as most important? 1. Assisting the child to become familiar with his dressings so he will leave them alone. 2. Encouraging the child to ambulate as soon as possible by using a favorite push toy. 3. Forcing fluids to at least 2,500 mL/day by offering his favorite juices. 4. Preventing the child from disrupting the catheters by using soft restraints.

4. Preventing the child from disrupting the catheters by using soft restraints.

A 7 year old child is seen in a clinic, and the health care provider documents a diagnosis of primary nocturnal enuresis. The nurse provides which information to the parents? 1. Primary nocturnal enuresis does not respond to treatment 2. Primary nocturnal enuresis is caused by a psychiatric problem 3. Primary nocturnal enuresis requires surgical intervention to improve the problem 4. Primary nocturnal enuresis is usually outgrown without therapeutic intervention

4. Primary nocturnal enuresis is usually outgrown without therapeutic intervention

The nurse judges that the mother understands the diet restrictions for her child with chronic renal failure who is receiving peritoneal dialysis when she reports providing a diet involving which of the following? 1. Sodium and water restrictions. 2. High protein and carbohydrates. 3. High potassium and iron. 4. Protein and phosphorus restrictions.

4. Protein and phosphorus restrictions.

A child has been diagnosed with Kawasaki disease. Which of the following signs and symptoms would the nurse expect to see? Select all that apply. 1. Diarrhea 2. Vertigo 3. Purpural rash over torso 4. Reddened and crusty eyes 5. Skin peeling from hands and feet

4. Reddened and crusty eyes 5. Skin peeling from hands and feet

A nurse is caring for a child with meningococcemia who is on a ventilator. This morning, the nurse finds the child's mother sitting at the bedside crying. The mother tells the nurse, "I thought it was the flu. This is my fault because I should have come to the hospital earlier." What is the best action by the nurse in response to the mother's statements? 1. Tell the mother not to worry since many parents and even physicians frequently mistake meningitis symptoms for other infectious conditions 2. Make a referral to social services 3. Call the child's father and explain that the mother needs emotional support from him 4. Remind the mother that she did seek proper treatment as soon as she became concerned, and review the special care the child is receiving now

4. Remind the mother that she did seek proper treatment as soon as she became concerned, and review the special care the child is receiving now

A nurse is caring for a child with meningococcemia who is on a ventilator. This morning, the nurse finds the child's mother sitting at the bedside, crying. The mother tells the nurse, "I thought it was the flu. This is my fault because I should have come to the hospital earlier." What is the best action by the nurse in response to the mother's statements? 1. Tell the mother not to worry since many parents and even physicians frequently mistake meningitis symptoms for other infectious conditions. 2. Make a referral to social services. 3. Call the child's father and explain that the mother needs emotional support from him. 4. Remind the mother that she did seek proper treatment as soon as she became concerned, and review the special care the child is receiving now.

4. Remind the mother that she did seek proper treatment as soon as she became concerned, and review the special care the child is receiving now.

A nurse performs a scoliosis screening at a local school. Which assessment findings by the nurse would least likely result in a scoliosis referral? 1. Unilateral rib hump noted when the child is bent forward 2. Asymmetrical hip height noted when the child is standing erect 3. Uneven wear noted on the bottom of the child's pant legs 4. Round shoulders noted when the child is standing erect

4. Round shoulders noted when the child is standing erect

A nurse performs a scoliosis screening at a local school. Which assessment finding by the nurse would least likely result in a scoliosis referral? 1. Unilateral rib hump noted when the child is bent forward. 2. Asymmetrical hip height noted when the child is standing erect. 3. Uneven wear noted on the bottom of the child's pant legs. 4. Rounded shoulders noted when the child is standing erect.

4. Rounded shoulders noted when the child is standing erect.

What is the most appropriate method to use when drawing blood from a child with hemophilia? 1. Use finger punctures for lab draws. 2. Be prepared to administer platelets for prolonged bleeding. 3. Apply heat to the extremity before venipunctures. 4. Schedule all labs to be drawn at one time.

4. Schedule all labs to be drawn at one time.

The toddler with nephrotic syndrome exhibits generalized edema. Which of the following measures should the nurse institute for this child with a nursing diagnosis of Impaired skin integrity related to edema? 1. Ambulate every shift while awake. 2. Apply lotion on opposing skin surfaces. 3. Apply powder to skinfolds. 4. Separate opposing skin surfaces with soft cloth.

4. Separate opposing skin surfaces with soft cloth.

An 8-year-old child is seen in the pediatrician's office for primary nocturnal enuresis. Which of the following nursing diagnoses should the nurse include in the child's nursing care plan? 1. Overflow Urinary Incontinence 2. Risk for Impaired Skin Integrity 3. Risk for Imbalanced Fluid Volume 4. Situational Low Self-Esteem

4. Situational Low Self-Esteem

A mother of two school-age children tells the nurse that her husband has recently been deployed overseas. The mother is concerned about the children's constant interest in watching TV news coverage of military activities overseas. Which suggestion from the nurse is the most appropriate? 1. Allow the children to watch as much television as they want. This is how they are coping with their father's absence. 2. It will just take some time to adjust to their father's absence, then everything will return to normal. 3. The less that you discuss this, the quicker the children will adjust to their father's absence. Try to keep them busy and use distractions to keep their mind off of it. 4. Spend time with your children and take cues from them about how much they want to discuss.

4. Spend time with your children and take cues from them about how much they want to discuss.

During hospitalization, a 10-year-old child with acute poststreptococcal glomerulonephritis and oliguria asks for food from home. After teaching the mother and child about diet, the nurse determines that the teaching had been effective when the mother brings in which food? 1. Pizza and cola. 2. Hamburger and fries. 3. Ice cream sundae. 4. Strawberries and kiwi.

4. Strawberries and kiwi.

Griseofulvin (Grisactin) was ordered to treat a child's ringworm of the scalp. The nurse instructs the parents to use the medication for several weeks for which of the following reasons? 1. A sensitivity to the drug is less likely if it is used over a period of time. 2. Fewer side effects occur as the body slowly adjusts to a new substance over time. 3. Fewer allergic reactions occur if the drug is maintained at the same level long-term. 4. The growth of the causative organism into new cells is prevented with long-term use.

4. The growth of the causative organism into new cells is prevented with long-term use.

The nurse is teaching the parents of an 8-month-old about what the child should eat. The nurse should include which of the following points in the teaching plan? 1. Items from all four food groups should be introduced to the infant by the time the child is 10 months old. 2. Solid foods should not be introduced until the infant is 10 months old. Iron deficiency rarely develops before 3. 12 months of age, so iron-fortified cereals should not be introduced until the infant is 12 months old. 4. The infant's diet can be changed from formula to whole milk when the infant is 12 months old.

4. The infant's diet can be changed from formula to whole milk when the infant is 12 months old.

A young child diagnosed with iron-deficiency anemia is prescribed a liquid iron supplement. A nurse provides the parents with instructions on administration and should be certain to advise them that: 1. The medication should be given along with the child's morning cereal breakfast 2. The child may experience some pale-colored stools 3. The child should be permitted to sip the medication from a medicine cup 4. The medication can be mixed with a small amount of fruit juice

4. The medication can be mixed with a small amount of fruit juice

A young child diagnosed with iron-deficiency anemia is prescribed a liquid iron supplement. A nurse provides the parents with instructions on administration and should be certain to advise them that: 1. The medication should be given along with the child's morning cereal breakfast. 2. The child may experience some pale-colored stools. 3. The child should be permitted to sip the medication from a medicine cup. 4. The medication can be mixed with a small amount of fruit juice.

4. The medication can be mixed with a small amount of fruit juice.

A nurse should suspect Hirschsprung's disease in a child who has which type of stooling pattern? 1. Pale gray stools. 2. Currant-jelly stools. 3. Loose, yellow stools. 4. Thin, ribbon-like stools.

4. Thin, ribbon-like stools.

A 1-day-old infant, born at 39 weeks' gestation, weighs 4 pounds, 7 ounces, at birth. A pediatrician diagnoses the neonate with intrauterine growth restriction. An RN observes the newborn to be irritable, difficult to console, restless, fist-sucking, and demonstrating a high-pitched, shrill cry. Based on these assessment data, the RN should: 1. Increase stimulation of the baby by handling the infant as much as possible 2. Schedule routine feeding times every 3 to 4 hours 3. Encourage stimulation by rubbing the infant's back and head 4. Tightly swaddle the infant in a flexed position

4. Tightly swaddle the infant in a flexed position

A 1-day-old infant, born at 39 weeks' gestation, weighs 4 pounds, 7 ounces at birth. A pediatrician diagnoses the neonate with intrauterine growth restriction (IGR). An RN observes the newborn to be irritable, difficult to console, restless, fist-sucking, and demonstrating a high-pitched, shrill cry. Based on these assessment data, the RN should: 1. Increase stimulation of the baby by handling the infant as much as possible. 2. Schedule routine feeding times every 3 to 4 hours. 3. Encourage stimulation by rubbing the infant's back and head. 4. Tightly swaddle the infant in a flexed position.

4. Tightly swaddle the infant in a flexed position.

During a home visit, the public health nurse assesses the peritoneal catheter exit site of a child with chronic renal failure. Which of the following findings should lead the nurse to formulate the nursing diagnosis Risk for infection? 1. Dialysate leakage. 2. Granulation tissue. 3. Increased time for drainage. 4. Tissue swelling.

4. Tissue swelling.

To assess the development of a 1-month-old, the nurse asks the parent if the infant is able to: 1. Smile and laugh out loud. 2. Roll from back to side. 3. Hold a rattle briefly. 4. Turn the head from side to side.

4. Turn the head from side to side.

Which symptoms are characteristic of a preschool-age client who is diagnosed with a urinary tract infection? 1. Foul-smelling urine, elevated blood pressure, and hematuria 2. Severe flank pain, nausea, headache 3. Headache, hematuria, vertigo 4. Urgency, dysuria, fever

4. Urgency, dysuria, fever

A baby is admitted to the newborn nursery with a chordee penis. The nurse carefully assesses the baby for which of the following signs/symptoms? 1. Blood-tinged urine 2. Constant dripping of urine from the urethra 3. Absence of urinary output 4. Urine flowing from the under surface of the penis

4. Urine flowing from the under surface of the penis

A child has been diagnosed with acute glomerular nephritis. Which of the following changes would the nurse expect to see in the child's laboratory reports? 1. Urine white blood cell count: elevated 2. Urine specific gravity: decreased 3. Urine creatinine clearance: decreased 4. Urine red blood cell count: elevated

4. Urine red blood cell count: elevated

Which of following should the nurse perform to help alleviate a child's joint pain associated with rheumatic fever? 1. Maintaining the joints in an extended position. 2. Applying gentle traction to the child's affected joints. 3. Supporting proper alignment with rolled pillows. 4. Using a bed cradle to avoid the weight of bed linens on joints.

4. Using a bed cradle to avoid the weight of bed linens on joints.

A toddler diagnosed with nephrotic syndrome has a nursing diagnosis of Excess fluid volume related to fluid accumulation in the tissues. Which measure should the nurse anticipate including in the child's plan of care? 1. Limiting visitors to 2 to 3 hours a day. 2. Maintaining strict bed rest. 3. Testing urine specific gravity every shift. 4. Weighing the child before breakfast.

4. Weighing the child before breakfast.

Early signs of dehydration 1. Dry mucous membranes 2. Low BP 3. High BP 4. Weight loss

4. Weight loss

A health care provider has prescribed oxygen as needed for an infant with heart failure. In which situation should the nurse administer the oxygen to the infant? 1. During sleep 2. When changing diapers 3. When mom is holding infant 4. When drawing blood for electrolyte testing

4. When drawing blood for electrolyte testing

An 8-month-old infant is seen in the well- child clinic for a routine checkup. The nurse should expect the infant to be able to do which of the following? Select all that apply. 1. Say "mama" and "dada" with specific meaning. 2. Feed self with a spoon. 3. Play peek-a-boo. 4. Walk independently. 5. Stack two blocks. 6. Transfer object from hand to hand.

6. Transfer object from hand to hand.

A nurse prepares to administer digoxin to an infant. Where is the most appropriate location for the nurse to assess the infant's heart rate? (diagram)

A (apical)

Name APETM

A: aortic area P: pulmonic area E: Erb's point T: Tricuspid area M: mitral area

Where should the nurse place the stethoscope on an infant to best auscultate bronchial breath sounds? (diagram)

B (top of the chest)

Where is the best location for a nurse to auscultate a murmur created by pulmonic stenosis? (diagram)

C (upper left area)

Vaccines not given to a 11-12 year old adolescent

DTap (Tdap given at age 11-12)

First line of tx for atopic dermatitis.

Emollients Corticosteroids

Post op cleft palate repair management

Keep in supine position

What do you teach adolescent about transmission of HIV?

Long incubation period

The nurse is caring for an infant with hypospadias. Identify the area where the nurse would assess for this condition.

Peds Final

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