Peds Final

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8 yo brought to clinic. Parent reports child has missed school for 3 wks & refuses to go back d/t "not feeling well." Which actions should nurse perform during initial interview w/ child? A. Ask child to describe what things were like right before not wanting to go to school B. Use a direct question & ask the child why going to school is no longer fun C. Tell the child it is okay not to like school but she has to go back

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

A 10-year-old girl is experiencing acute renal failure due to dehydration. The nurse is preparing to administer IV fluid. Which of the following interventions should the nurse take in caring for this child? A. Administer the IV fluid slowly B. Make sure the IV fluid contains potassium C. Increase oral intake of fluid D. Provide a diet high in protein and sodium

A 10-year-old who is receiving chemotherapy has received ondansetron before this therapy session. About an hour later, the child tells the nurse that his mouth feels really dry. The child has urinated several times and his skin turgor is normal. Which response by the nurse would be most appropriate? A. "The drug you got to help with the nausea can cause dry mouth." B. "Let me increase your intravenous fluids." C. "You might be having a severe allergic reaction. Are you itchy?" D. "This indicates an infection. We need to start antibiotics."

A 12-year-old boy arrives at the emergency room experiencing nausea, vomiting, headache, and seizures. He is diagnosed with bacterial meningitis. Other findings include a decrease in urine production, hyponatremia, and water intoxication. Which pituitary gland disorder would be most associated with these symptoms? A. Syndrome of inappropriate antidiuretic hormone B. Diabetes insipidus C. Hyposecretion of somatotropin D. Hypersecretion of somatotropin

A 12-year-old girl has recently begun menstruating and is well into puberty. She is visiting the doctor today for a routine physical examination. Which of the following findings should cause concern in the nurse? A. Vulvar irritation B. Irregular periods C. Breasts of slightly different sizes D. Supernumerary nipple

A 12yo has recurring nephrotic syndrome; which of the following areas of potential disturbances should be a prime consideration when planning ongoing nursing care? A. body image B. sexual maturation C. muscle coordination D. intellectual development

A 13-year-old girl has grown rapidly in height over the past 2 years and is taller than most of the boys in her class. She wonders when she will stop growing. What should the nurse tell her as a general guideline for the ages at which most girls stop growing? A. 16 to 17 years old B. 14 to 15 years old C. 18 to 19 years old D. 20 to 21 years old

A 15-year-old boy visits his primary care physician's office with fever, headache, and malaise, along with complaints of pain on chewing and pain in the jawline just in front of the ear lobe. The boy asks his mother to leave the exam room for a minute and then tells the nurse that he is also experiencing testicular pain and swelling. The nurse recognizes that this client most likely has which condition? A. Mumps B. Infectious mononucleosis C. Poliomyelitis D. Herpes zoster

A 17-year-old adolescent is found wandering around. The adolescent is confused, sweaty, and pale. Which test would the nurse expect to be performed first? A. Blood glucose level B. CT scan C. Arterial blood gases D. Blood cultures

A 4-month-old infant has been admitted for moderate to severe respiratory distress secondary to bronchiolitis. The infant has been suctioned, placed on oxygen via nasal cannula at 3 liters per minute, and is receiving IV fluid at 20 milliliters per hour via pump. After an hour, the infant's O2 saturation has increased from 86% to 92%. What action should the nurse take based on this assessment? A. Document the assessment findings and continue to monitor the infant. B. Notify the health care provider and anticipate weaning the infant from oxygen. C. Increase the oxygen to 4 liters and suction the infant as needed. D. Decrease the IV fluid rate and decrease the oxygen to 2 liters per minute.

A 4-month-old male infant is seen in the emergency room with clinical manifestations of moderate respiratory distress including nasal stuffiness, nasal flaring, tachypnea, and grunting. The infant's health history includes birth at 34 weeks' gestation, a temperature of 100.3°F (37.9°C) and a cough for 2 days. Based on this information, the triage nurse suspects the infant has developed which condition? A. Bronchiolitis B. Bronchitis C. Croup D. Tuberculosis

A 4-year-old child diagnosed with acute lymphoblastic leukemia (ALL) is receiving chemotherapy. The nurse is reviewing the child's most recent laboratory results. Which result should alert the nurse that the child is at risk for sepsis? A. absolute neutrophil count 300/L (0.30 109/L) B. white blood cell count 4900/L (4.9 109/L) C. red blood cell count 4.0 106/L (4.0 1012/L) D. hemoglobin 10.5 g/dL (105 g/L)

A 5-month-old infant being assessed was born at 32 weeks. The nurse doing the well-child check-up should compare the baby to what norms? A. The development of a 3-month-old B. The development of a 10-week-old C. The growth of a 2-month-old D. The growth of a 5-month-old

A 5-year-old girl who was already admitted to the hospital for an unrelated condition suddenly becomes irritable, restless and anxious. These may be early signs of respiratory distress in a child if accompanied by: A. tachypnea. B. retractions. C. cyanosis. D. clubbing of fingers

A 6-month-old child has developed skin irritation due to an allergic reaction. He has been prescribed a topical skin ointment. The nurse will consider which of the following before administering the drug? A. That the infant's skin has greater permeability than that of an adult B. That there is less body surface area to be concerned about. C. That there is decreased absorption rates of topical drugs in infants. D. That there is a lower concentration of water in an infant's body compared with an adult.

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

A child hospitalized with a diagnosis of asthma has received two albuterol nebulizer treatments back to back. The child reports feeling nervous. What action should the nurse take? A. Explain that this is a normal side effect to the medication in the nebulizer. B. Assure the child that there is nothing to be nervous about. C. Perform a fingerstick to check the glucose level. D. Ask the health care provider to change the nebulizer medication.

A child is refusing to use the potty and having accidents, even though he has achieved toilet training. This is an example of which type of behavior? A. Regression B. Positive redirection C. Desensitization D. Phobia

A child is to receive an oral corticosteroid as part of the treatment regimen for leukemia. After teaching the child and family about this drug, the nurse determines the need for additional teaching when they state: A. "We should administer the drug on an empty stomach." B. "We should check our son's urine for glucose." C. "He might develop a rounded face from this drug." D. "We will need to gradually decrease the dosage."

A child receiving chemotherapy is experiencing significant reduction in red blood cells secondary to myelosuppression. Which agent would the nurse most likely expect to be ordered? A. Epoetin alfa B. Filgrastim C. Sargramostim D. Gamma interferon

A child who is experiencing an exacerbation of asthma is brought to the emergency department by his parents. When reviewing the child's laboratory and diagnostic test results, which is consistent with the diagnosis? A. Hyperinflation of lungs on chest radiograph B. Increased peak expiratory flow rate C. Low arterial blood carbon dioxide level D. Decreased pulmonary function tests

A child with Addison's disease has been admitted with a history of nausea and vomiting for the past 3 days. The client is receiving IV glucocorticoids. Which intervention would the nurse implement? A. Take glucometer readings as ordered B. Measure intake and output C. Monitor sodium and potassium levels D. Weigh daily

A child with a suspected airway obstruction is brought to the emergency room. He produces a harsh, strident sound on inspiration (stridor). Where is the obstruction likely to be located, based on this information? A. In the larynx B. Lower trachea C. Bronchioles D. Pharynx

A child with attention deficit hyperactivity disorder (ADHD) is prescribed methylphenidate hydrochloride. What should the nurse instruct the parents regarding an adverse effect of this medication? A. Anorexia B. Sleepiness C. Garbled speech D. Rapid increase in height

A client with severe chronic anemia is receiving ongoing transfusion therapy. The nurse frequently assesses the client for what major complication of this therapy? A. Toxic iron overload B. Fibrin clots C. Chronic idiopathic thrombocytic purpura D. Vaso-occlusive crisis

A father and his 4-year-old son are waiting in an exam room when the nurse enters and greets them. Which activity that the nurse observes the boy doing would best demonstrate the primary developmental task of the preschool-age child, according to Erikson? A. Opening drawers in the room, pulling out supplies, and examining them B. Singing a song he learned at preschool C. Rough-housing with his father D. Reading a book

A father brings his 2-year-old son in for a well visit. The nurse assesses his growth since the last appointment. Which finding should concern the nurse? A. Total weight gain of 15 lb in the past year B. Increase in height of 5 inches in the past year C. Prominent abdomen D. Forward curve of the spine at the sacral area

A group of nursing students are reviewing information about neonatal screenings. The students demonstrate understanding of the information when the students identify which system of most consistently affected by metabolic disorders? A. Nervous system B. Cardiovascular system C. Gastrointestinal system D. Respiratory system

A new mother, when asked by a nurse, explains that her 4-month-old infant has been nursing regularly every 3 to 4 hours and seems satisfied. However, the mother recently introduced solid food in the form of unbuttered popcorn to the baby as a supplement, to "get her used to eating solid food." She felt that the popcorn would be safe because it is soft on the baby's gums. What should be the primary nursing diagnosis in this situation? A. Risk for aspiration related to feeding the infant an inappropriate food B. Imbalanced nutrition, less than body requirements, related to introduction of a low nutritive food C. Readiness for enhanced nutrition, related to the age of the infant D. Imbalanced nutrition, more than body requirements, related to introduction of a high-calorie food

A newborn was screened for hereditary metabolic disorder at 8 hours old. Which action by the nurse is most appropriate? A. Instruct the parent to have another screening in 1 to 2 weeks B. No further intervention is needed C. Repeat screening in 8 hours D. If the infant is premature, screening needs to be done every 8 hours for 48 hours

A nurse has completed discharge teaching with the parent of a child diagnosed with failure to thrive. Which statement by the parent indicates an understanding of the teaching? A. "I will need to mix formula a different way, so it has more calories per ounce." B. "Daycare should offer my infant one jar of baby food twice a day." C. "Switching to soy formula should help my infant gain weight." D. "My infant will catch up to friends in size once my infant starts elementary school."

A nurse has provided teaching to a school-aged child on early signs of an impending asthma attack. Which statement made by the child is the best indicator that the nurse's instruction was effective? A. "Chest tightness or feeling short of breath means I could have an attack." B. "Wheezing is an early sign that an attack is coming." C. "I could have an attack soon if I start to cough up mucus." D. "A lot of sneezing means I am about to have an attack."

A nurse is assessing a 12-year-old child diagnosed with a fractured wrist. The wrist has been in a cast for 3 weeks. Which statement made by the client requires intervention by the nurse? A. "Whenever I have pain I take the acetaminophen/oxycodone we have at home." B. "My mom makes me wrap my arm in a plastic bag when I shower." C. "My fingers are warm and I can wiggle them easily." D. "I use a hairdryer to blow cool air into the cast when my arm itches."

A nurse is assessing a school-aged child after a ventriculoperitoneal (VP) shunt replacement. Which of the following findings indicates a complication of this procedure? A. abdominal distention B. unequal peripheral pulses C. pinpoint pupils D. frontal bossing

A nurse is assessing a toddler who has measles (rubeola). Which of the following findings should the nurse expect? A. Koplik spots B. parotitis C. strawberry tongue D. paroxysmal coughing

A nurse is assessing an infant who has untreated congenital hypothyroidism. Which of the following manifestations should the nurse expect? A. constipation B. hyperreflexia C. oily skin D. hyperthermia

A nurse is assessing an infant who is at risk for increased intracranial pressure (ICP). Which of the following findings should indicate to the nurse that this complication is developing? A. high-pitched cry B. sunken fontanel C. tachycardia D. increased awake time

A nurse is caring for a 4-year-old child that will be undergoing a procedure to remove a mass from the abdomen. In order to help the child remain calm in preparation for getting an IV catheter placed, what intervention might the nurse implement? A. Allow the child to play with a procedure doll. B. Not discuss the procedure in front of the child. C. Distract the child with games and candy. D. Take the child to the playroom for coloring.

A nurse is caring for a child who has a possible intussusception. The parents of the child ask the nurse how the diagnosis is determined. Which of the following responses should the nurse make? A. an abdominal ultrasound will confirm the pocket in the intestine B. genotyping will be done to identify this condition C. a biopsy will be done on a small amt of tissue from the colon D. an upper GI series should identify the area involved

A nurse is caring for a child who has sickle cell anemia and is experiencing a vaso-occlusive crisis. Which of the following actions should the nurse take? A. admin ibuprofen B. limit daily fluid intake C. apply cold compresses to painful joints D. w/hold live virus immunizations

A nurse is caring for a child who is suspected to have Enterobius vermicularis. Which of the following actions should the nurse take? A. perform a tape test B. collect stool specimen for culture C. test the stool for occult blood D. initiate IV fluids

A nurse is caring for a child who just experienced a generalized seizure. Which of the following is the priority action for the nurse to take? A. maintain the child in a side-lying position B. loosen the child's restrictive clothing C. reorient the child to the environment D, note the time & characteristics of the child's seizure

A nurse is caring for a group of infants w/ congenital heart defects. For which of the following defects should the nurse expect to observe cyanosis? A. Transposition of the great arteries B. Ventricular septal defect C. Coarctation of the aorta D. Patent ductus arteriosus

A nurse is caring for a preschooler who needs an IV medication. Which action should the nurse take to prepare the child for the procedure? A. use role play activities B. provide child w/ detailed explanation of procedure C. Give child identical IV supplies to play w/

A nurse is caring for a pt who has suspected meningitis & a decreased LOC. Which of the following actions by the nurse is appropriate? A. Place the pt on NPO status B. Prepare the pt for a liver biopsy C. Position the pt dorsal recumbent D. Put the pt in a protective environment

A nurse is caring for a school aged child who has sickle cell anemia. Which of the following actions should the nurse plan to take to help decrease the risk for vaso-occlusive crisis? A. Provide adequate fluid intake throughout the day B. Provide O2 at 2L/min via nasal cannula C. Admin a blood transfusion D. give ibuprofen to manage pain

A nurse is caring for a school-aged child who has sickle cell anemia & was admitted for a vaso-occlusive crisis. Which should the nurse report to Dr ASAP? A. slurred speech B. hemoglobin 9 C. hematuria D. pain level 7 on FACES scale

A nurse is caring for a school-aged child who is having a tonic-clonic seizure. Which of the following actions should the nurse perform first? A. position the child on his side B. measure the child's VS C. loosen any restrictive clothing D. check the child for head injuries

A nurse is caring for an infant who has tetralogy of Fallot and is experiencing a hypercyanotic episode. Which of the following actions should the nurse take? A. place infant in a knee-chest position B. initiate a fluid restriction C. provide O2 by nasal cannula D. admin acetaminophen

A nurse is caring for an infant who is experiencing dehydration. Which of the following assessments is the nurse's priority? A. .measure the pt's Wt daily B. check for tears C. palpate the fontanel D. assess skin turgor

A nurse is carrying on a conversation with a 7-year-old girl during an office visit. Which of the following is an example of the level of language development the nurse should expect in this child? A. Difficulty understanding the concept of "half past" in reference to time B. Ability to carry on an adult conversation C. Inability to speak in full sentences D. Fascination with bathroom language

A nurse is conducting a presentation for a community parent group about respiratory conditions in children. The nurse determines that the teaching was successful when the group identifies which of the following as one of the most common conditions seen during early childhood? A. Croup B. Bronchiolitis C. Asthma D. Pneumonia

A nurse is planning care for a 4yo who has nephrotic syndrome. Which of the following actions should the nurse take? A. provide through skin care B. test for blood type & cross-match C. allow ample hydrating fluids D. maintain a low-carbohydrate diet

A nurse is planning care for a toddler who has acute gastroenteritis & was recently admitted. Which of the following should the nurse plan to provide for the child? A. oral rehydration solution B. bananas/applesauce C. chicken/beef broth D. hypertonic IV soultion

A nurse is providing care to a child with hemophilia who is experiencing muscle and joint involvement related to the bleeding. Which would the nurse include as an adjunctive measure to control bleeding? A. Compression B. Heat C. Exercise D. Lowering extremities

A nurse is providing teaching about home care to the parent of a child who has a newly applied fiberglass leg cast. Which of the following statements should the nurse include? A. monitor the color of his toes every 4 hours for 24 hours B. he can scratch the skin inside the cast with a small wooden ruler C. expect the cast to remain damp for 72 hours D. you can take him swimming and give baths as usual

A nurse is providing teaching to an adolescent who has a fiberglass arm cast. Which of the following instructions should the nurse include in the teaching? A. Place a plastic bag over the cast when showering B. Insert a dull knitting needle into the cast to rub itchy skin C. exercise fingers every 8 hr for the first 24 hr D. Draw on the cast using magic marker

A nurse is providing teaching to an adolescent who was recently diagnosed with type 1 DM.. Which of the following insulin injection sites should the nurse recommend that the client use during basketball competitions? A. hip B. upper arm C. thigh D. lower leg

A nurse is providing teaching to the parent of a child who is having an EEG. Which of the following responses should the nurse include in the teaching? A. "decaffinated beverages should be offered on the morning of the procedure" B. "don't wash your child's hair the night before the procedure" C. "withhold all foods the morning of the procedure" D. "give your child an analgesic the night before the procedure"

A nurse is providing teaching to the parent of an infant who has developmental hip dysplasia and a new prescription for a Pavlik harness. Which of the following parent statements indicates an understanding of the teaching? A. "I will apply the harness over a t-shirt and knee socks" B. "I will put my baby's diaper over the harness" C. "I will make the required harness adjustments as my baby grows" D. "I will apply powder around the harness buckles each day"

A nurse is providing teaching to the parents of a school-aged child who has type 1 DM about managing hypoglycemia. Which of the following responses by a parent indicates and UNDERSTANDING of the teaching? A. I will make sure she drinks 240 mL (8oz) of milk as soon as possible B. I will give her 2 units of regular insulin C. I will insist that she lie down to rest for 30 min D. I will check her urine for glucose twice daily

A nurse is teaching parents of a 2-year-old child about discipline and limit setting. When describing the use of time out, the nurse would inform the parents that the maximum duration of time out should be how many minutes per each year of age? A. 1 minute B. 30 seconds C. 90 seconds D. 2 minutes

A nurse is working with the local community on promoting physical fitness for children. The nurse encourages the community to develop programs that meet the needs of the school-aged child for physical activity, based on the understanding that this age group requires how much physical activity daily? A. 60 minutes B. 15 minutes C. 30 minutes D. 90 minutes

A panicked mother calls the health care provider's office and reports that her 5-year-old has a high fever and just had a seizure. The mother asks the nurse what she should do. Which is the nurse's best response? A. Report to the emergency room for medical evaluation B. Immerse the child in a bathtub of tepid water C. Administer oral acetaminophen per package directions D. Remove any heavy clothing and cover with a thin sheet

A parent brings a newly adopted 8-year-old child to the clinic for an initial well-child visit. At the end of the visit, the nurse provides the parent with information on normal developmental milestones for 8-year-old children. What information should the nurse include? A. Peer relationships begin to influence a child's perception of oneself. B. The child is more likely to take frustrations out on others. C. The child will use magical thinking to cope with problems. D. The child's thinking becomes more abstract.

A parent brings the 4-year-old child for a check-up. Which finding would concern the nurse? A. Resting pulse rate of 120 B. Ectomorphic body type C. No increase in appetite compared with that in toddler years D. Weight gain of 5 lb (2.27 kg) in the past year

A parent calls the health care provider's office and tells the nurse that the 2-year-old child has had diarrhea off and on for the past few days. The parent asks if he or she should be concerned about this. What is the best response by the nurse? A. "Tell me more about what your child is experiencing." B. "As long as your child is active, there is nothing to worry about." C. "You should take your child to the emergency department." D. "Bring your child to our office this afternoon and we will check the child."

A school health nurse is supporting a 15-year-old young woman with acne. What is a common myth related to acne in adolescent populations? A. Diet plays a significant role in acne production. B. Do not pick or squeeze acne lesions because it will just increase symptoms. C. Excessive face washing is not necessary to prevent lesions from forming. D. Makeup may increase lesion formation.

A school nurse has finished teaching a group of 16-year-old students about high-risk behaviors that may affect their physical and psychosocial health. Which statement made by a student would indicate a need for additional education? A. "Social networking sites are safe as long as I keep my personal information private." B. "Abstinence is the only way to prevent pregnancy and sexually transmitted infections." C. "Illicit drugs are not regulated by the FDA and may contain dangerous chemicals." D. "We need to pay close attention to friends who isolate themselves or withdraw from our peer group."

A school nurse is assisting with field day activities at a high school when a teenager experiences a head injury and begins having a tonic-clonic seizure. Which is the most appropriate initial action by the school nurse? A. Stay with child and instruct someone to call 911. B. Notify the parent to come pick the child up from school. C. Clear the area and offer the child comfort and reassurance. D. Look in the child's file for emergency contact information.

A school-age child with a supracondylar fracture of the humerus has been placed in a partial cast with the elbow region wrapped with an elastic bandage. What should the nurse explain to the parents and child regarding the reason for this type of casting approach? A. Ensures edema does not press on the nerves B. Keeps the bones of the forearm in alignment C. Provides additional stability until the bone heals

After teaching a group of nursing students about developmental milestones for children, between the ages of 1 to 4 years, the instructor determines that the teaching was successful when the students identify which of the following as a gross motor developmental milestone that occurs between 2 to 3 years of age? A. Jumping in place B. Riding a tricycle C. Climbing D. Standing on one foot with help

After teaching a group of students about medications commonly used for neuromuscular disorders, the nursing instructor determines that the teaching was successful when the students identify which agent as a centrally acting skeletal muscle relaxant? A. Baclofen B. Prednisone C. Lorazepam D. Botulin toxin

An 11-year-old boy has recently been prescribed methylphenidate. The mother calls the pediatrician's office to speak with the advanced practice pediatric nurse practitioner. This mother has been extremely resistant to medication and insists that the medication is not working. How should the nurse respond? A. "Tell me what makes you think the medication is not working" B. "Do you want to try a different medication?" C. "Are you sure you are administering it properly" D. "Do you want to increase the dosage?"

An 8-year-old boy and his father visit the pediatrician's office with reports of a sudden onset of abdominal pain and reddish-brown urine. A urinalysis shows 4+ protein. On taking the boy's health history, the nurse learns that he had strep throat a little over a week ago. Which condition should the nurse suspect? A. Acute glomerulonephritis B. Kidney agenesis C. Polycystic kidney D. Nephrosis

An 8-year-old child is being treated for tonic-clonic seizures. What should the nurse emphasize when teaching the parents about this disorder? A. The child should maintain an active lifestyle. B. Immediately provide medication if a seizure begins. C. Have the child carry a padded tongue blade with her at all times. D. Ensure quiet time late in the day, when seizure activity is most likely to occur.

An adolescent is recovering from surgery, radiation, and chemotherapy following a diagnosis of Ewing sarcoma. Which statement by the family indicates that reteaching is needed? A. "Our child is looking forward to playing football again." B. "We will remind our child to care for the skin following radiation." C. "Our child's friends shaved their heads in solidarity to show their support." D. "We will watch for signs of infection and report it to our health care provider."

An anxious 12-year-old girl receives an injection from the nurse and sighs with relief when it is done. After a moment of reflection, the girl asks the nurse, "Is it hard to give someone an injection?" This girl's question is evidence that she has developed which cognitive skill? A. Decentering B. Accommodation C. Conservation D. Class inclusion

An emergency room nurse is at the nurses' station when a child's parent runs into the hallway shouting, "Someone help! My child is shaking all over!" The nurse quickly responds and enters the room to find the child having a seizure. Which action should the nurse perform next? A. Begin timing the seizure and note the child's behaviors. B. Restrain the child and pad the side rails of the bed. C. Insert a tongue blade between the child's teeth. D. Suction the child to prevent aspiration of gastric contents.

An infant with poor feeding is suspected of having a congenital heart defect. The parents are asking why a chest x-ray is necessary in their infant. What is the best response from the nurse? A. It will determine if the heart is enlarged. B. It will determine disturbances in heart conduction. C. It will show if blood is being shunted. D. This image will clarify the structures within the heart

Beta-adrenergic agonists such as albuterol are given to Reggie, a child with asthma. Such drugs are administered primarily to do which of the following? A. Dilate the bronchioles B. Reduce secondary infections C. Decrease postnasal drip D. Reduce airway inflammation

Diabetes insipidus a disorder of the posterior pituitary resulting in deficient secretion of which hormone? A. Antidiuretic hormone B. Adrenocorticotropic hormone C. Thyroid stimulating hormone D. Luteinizing hormone

During a well-child visit, a nurse is providing teaching on child safety to the parent of a 9-year-old child. Which statement made by the parent indicates a need for additional teaching? A. "No one smokes in our home, so I have not discussed it with my child." B. "I am acquainted with my child's friends and their parents." C. "I have set screen time limits on all my child's electronic devices." D. "My child is good about sitting in the back seat and wearing a seat belt."

During the assessment of a preschooler, the nurse notes that the child has abnormal dryness and thickening of the conjunctiva and dry and scaly skin. Which vitamin deficiency does the nurse suspect this child is experiencing? A. Vitamin A B. Vitamin B C. Vitamin D D. Vitamin E

Linda, a 14-year-old, and her mother are in the office. As Linda goes to the bathroom, her mother stops the nurse and asks about the changes that Linda is going through. She would like to talk to her about sex and the changes but she is unsure of how to do this. As the nurse, which of the following would be appropriate for you to suggest? A. Promote open lines of communication, encourage listening, don't lecture, and share family values. B. Discuss with the adolescent the experiences that you had so that she can connect on a personal level. C. Encourage her to talk to her peers and teachers in health class about any concerns that she has. D. Do not initiate any conversation; let the teen come and seek you out for any advice and answers.

Nurse is assessing an 18 mo during a well-child exam. Which of the following findings should the nurse report? A. Unable to remove his shoes B. Unable to draw a plus sign C. Unable to jump off a step D. Unable to turn 1 pg of a book at a time

Nursing students correctly label the group of cells whose job is to ingest, engulf, and neutralize pathogens as: A. macrophages. B. immunogens. C. immunoglobins. D. red blood cells.

Patty calls the hospital nursing hotline and asks, "My 8-week-old daughter cries 8 hours a day, and she is hard to console, is that normal?" What should the nurse's response be to this mother? A. "Let me ask you some more questions to see if there are symptoms of colic." B. "Yes, infants cry all the time at that age." C. "No, call your doctor." D. "Yes, maybe she is just tired."

Performing a neuro exam on a 15 mo. Which should the nurse expect? A. (-) Babinski reflex B. Presence of Moro reflex C. Absence of corneal reflexes D. (+) Palmar grasp

Teaching parent of 3 yo toddler about promoting sleep. What should nurse include? A. Follow a nightly routine & established bedtime B. Encourage active play before bed C. Let the child remain awake until tired enough to sleep

Teaching parents of preschool-aged child about Tx of pinworms. Which indicates an UNDERSTANDING of the Tx? A. I will give my child a dose of albendazole today & again in 2 wks B. I will collect specimens immediately after my child has a BM C. I will give my child a tub bath twice a day D. I will place my child's bed linens in a sealed plastic bag for 7 days

The mother of a 10-year-old child diagnosed with rubella asks what can be done to help her child feel better during her illness. What information can be provided? A. Encourage rest and relaxation. B. Antibiotic therapy may be initiated. C. Antiviral medications can be prescribed. D. Range of motion to prevent contractures

The mother of a 6-month-old child calls the clinic triage nurse and states, "I'm worried that my baby is falling behind. He just doesn't do the same things other babies his age are doing." Which of the following behaviors reported by the mother should the nurse recognize as a sign of developmental delay? A. Head lags when pulled to sitting position B. Sits leaning forward on both hands C. Able to roll from back to front D. Grasps food with whole hand

The nurse is assessing a 10-year-old girl with acute lymphoblastic leukemia. What information would lead the nurse to suspect that the cancer has infiltrated the central nervous system? A. Child reports of facial palsy and vision problems B. Observing petechiae, purpura, or unusual bruising C. Noting adventitious breath sounds during auscultation D. Palpation of abdomen reveals enlarged liver and spleen

The nurse is assessing a 5-year-old child. Which assessment finding would be documented as abnormal? A. Inability to state address. B. Inability to count to 20. C. Can recall a part of a story. D. Can explain how an item is used.

The nurse is assessing a 6-month-old child. The mother asks when the soft area in her child's head will go away. What is the best response by the nurse? A. "The area is called the anterior fontanel and typically closes anytime up to 18 months of age." B. "Soft spots on the child's head should have closed by now." C. "The area is called a fontanel. They remain open to allow for rapid brain growth in the first months of life." D. "The soft spots may stay open until your child is two or three years old."

The nurse is assessing a school-aged child with sickle-cell anemia. Which assessment finding is consistent with this child's diagnosis? A. Slightly yellow sclera B. Enlarged mandibular growth C. Increased growth of long bones D. Depigmented areas on the abdomen

The nurse is assessing the neuromusculoskeletal system of a newborn. What is an abnormal assessment finding? A. Sluggish deep tendon reflexes B. Full range of motion in extremities C. Absence of hypotonia D. Lack of purposeful muscular control

The nurse is assessing the speech development of an 8-year-old child. Which finding should the nurse document as consistent with the child's chronological age? A. Talks through thoughts and feelings B. Understands simple questions and commands C. Uses negative phrases D. Imitates new words

The nurse is caring for a 12-year-old girl with nephrotic syndrome. The girl confides that she feels like a "freak" compared to her peers because of her weight, edema, and moon face. Which response by the nurse would be most appropriate? A. "Let's put you in touch with some other girls who are also having the same body changes." B. "Luckily, this is just a temporary, unfortunate part of your condition; you need to accept it." C. "Your real friends do not care about your appearance and just want you to get well." D. "You are beautiful in your own way; what matters is what is on the inside."

The nurse is caring for a 14-year-old client with sickle cell anemia hospitalized for acute splenic sequestration. For which condition should the nurse monitor? A. Shock B. Hypoglycemia C. Hemorrhagic stroke D. Cardiomegaly

The nurse is caring for a 14-year-old client with sickle cell anemia who is receiving treatment with hydroxyurea. Which consideration should the nurse take into account for this client? A. Assess for signs of infection. B. Educate about potential confusion with hydrocodone. C. Monitor for constipation. D. Alert to side effects of drowsiness, confusion, and sedation

The nurse is caring for a 14-year-old client with sickle cell anemia with a prescription for oxycodone as needed for pain. Which nutritional consideration should the nurse take into account when instructing the client on how to use the medication? A. Increasing fluid and fiber intake B. Increasing protein intake C. Increasing fruits and vegetables in the diet D. Increasing foods high in carbohydrates

The nurse is caring for a 2-year-old diagnosed with bacterial pneumonia. The child has been placed in a mist tent. In caring for the child, it is important for the nurse to: A. monitor the child regularly for signs of cyanosis. B. avoid contact with the mist if the nurse is a sexually active female of childbearing age. C. use contact transmission precautions. D. check for hyperthermia related to enclosure in the tent

The nurse is caring for a 3-year-old girl who has just undergone a ventriculostomy. Which of the following would the nurse include in this child's plan of care to manage increased intracranial pressure (ICP)? A. Use pillows to support the child when lying on her side B. Support the parents in starting a ketogenic diet C. Pad the side rails on the bed D. Teach her to do deep breathing techniques

The nurse is caring for a 5-year-old child. The child's parent reports that the parent and child are constantly fighting about the child's choice of clothing. The child insists on selecting ones own clothes. The parent is tired of the power struggle and is embarrassed by the child's mismatched apparel. The parent asks for guidance. How should the nurse respond? A. "Offer two or three coordinated outfits and let the child choose." B. "Lay the clothes out in the order in which they are to be put on." C. "Only give your child clothes that are easy to put on." D. "Remind your child of the importance of dressing appropriately."

The nurse is caring for a 5-year-old girl. During a routine wellness examination, the mother tells the nurse that the girl's father has enrolled her in a mini pom-pom cheering squad. The girl dislikes it immensely, but her father doesn't want the girl to be a "quitter." The mother asks for some guidance. How should the nurse respond? A. "Bad experiences can cause her to avoid other similar activities" B. "Tell your husband that requiring her to continue is inappropriate" C. "Your daughter may not be able to keep up with the instructions" D. "This may not suit your child's temperament or her physical abilities"

The nurse is caring for a child with type 1 diabetes. The child is currently nauseated, sweaty, and has clammy skin. Which nursing intervention would take priority? A. Obtain a glucose reading. B. Check the child's temperature. C. Administer a dose of ondansetron. D. Provide the child with a cup of orange juice

The nurse is caring for a child with type 1 diabetes. The child's morning blood glucose was 112 mg/dl (6.22 mmol/l). The child has insulin aspart, regular insulin, and insulin glargine prescribed. Which action by the nurse is best? A. Administer the prescribed dose of insulin glargine. B. Give a dose of insulin aspart 30 minutes after the child's first meal. C. Provide a dose of regular insulin 15 minutes before the first meal. D. Hold each insulin type until blood glucose is checked later in the day.

The nurse is conducting a routine physical examination of a newborn to screen for developmental dysplasia of the hip. The nurse correctly assesses the infant by placing the infant: A. In a prone position, noting asymmetry of the thigh or gluteal folds. B. With both legs extended and observes the hip and knee joint relationship. C. With both legs extended and observes the feet. D. In a supine position with both legs extended and observes the tibia/fibula.

The nurse is conducting an assessment of a 5-year-old client. During the assessment, the nurse notes that the child does not maintain eye contract or speak. The nurse suspects an autism spectrum disorder. Which additional finding would help support the nurse's suspicion? A. The child constantly opens and closes the hands. B. The child is highly active and inattentive. C. The child has a slight decrease in head circumference. D. The child has a long face and prominent jaw

The nurse is developing a plan of care for a 7-year-old child with type 1 diabetes. The child reports participating in athletics at 1300 each day. Which step will be part of the plan? A. Checking glucose levels more frequently B. Postponing lunch until after athletic practice C. Reducing the nighttime dose of insulin glargine D. Increasing the morning dose of insulin isophane

The nurse is doing an in-service training on clinical manifestations seen in communicable diseases. Which skin condition best describes erythema? A. Redness of the skin produced by congestion of the capillaries B. Small, circumscribed, solid elevation of the skin C. Discolored skin spot not elevated at the surface D. Small elevation of epidermis filled with a viscous fluid

The nurse is performing an assessment for a 17-year-old client during an annual exam. Which assessment finding should the nurse anticipate based on the client's stage of growth and development? A. Pushes the limits of authority B. Has friends primarily of the same gender C. Feels ready to leave the safety of home D. Grows closer to parents

The nurse is performing an assessment on a 14-year-old client who has chronic pain from sickle cell anemia. Which consideration should the nurse take into account while assessing the client's pain? A. Differentiating acute pain from chronic pain B. Anticipating a higher rating on the numeric pain scale C. Using a different pain scale for the client's acute pain D. Adjusting the client's pain rating to correct for chronic pain

The nurse is performing an assessment on a 14-year-old client with sickle cell anemia during an annual exam. Which finding requires further follow-up by the nurse? A. The client reports having a difficult time making friends at a new high school. B. The client has become more distant from the parents. C. The client pushes the limits of authority. D. The client feels conflicted about leaving the safety of the home

The nurse is preparing a discharge teaching plan for the parents of an 8-year-old girl with leukemia. Which instruction would be the priority? A. Calling the doctor if the child gets a sore throat B. Keeping a written copy of the treatment plan C. Writing down phone numbers and appointments D. Using acetaminophen if the child needs an analgesic

The nurse is preparing an 18-month-old for discharge following treatment for dehydration secondary to diarrhea. What instruction would the nurse most likely include in the discharge teaching? A. "Encourage a bland diet." B. "Implement clear liquids." C. "Provide plenty of 100% fruit juice." D. "Offer flavored gelatin if hungry."

The nurse is preparing teaching materials for a family whose child is prescribed somatropin for a growth hormone deficiency. What should the nurse instruct the parents about the administration of this medication? A. This medication must be given by injection. B. This medication must be given in the morning before school. C. Hip or knee pain is an expected adverse effect of this medication. D. This medication does not interact with any other types of medication.

The nurse is preparing to post a sign above the crib of an infant with a Wilms tumor. Which statement should the nurse post immediately? A. "Do not palpate abdomen." B. "No intramuscular injections." C. "No milk or milk products allowed." D. "No blood sampling in lower extremities

The nurse is preparing to teach a 15-year-old client about health maintenance and safety relevant to the client's stage of growth and development. Which action should the nurse take to facilitate the teaching? A. Meeting with the client independently of the parents B. Encouraging the parents to manage health concerns C. Anticipating the client's ability to look at future needs D. Allowing the client to solve complex problems independently

The nurse is providing anticipatory guidance to the mother of a 9-month-old girl during a well-baby visit. Which topic would be most appropriate? A. Advising how to create a toddler-safe home B. Warning about small objects left on the floor C. Cautioning about putting the baby in a walker D. Instructing on safety procedures during baths

The nurse is providing education to parents of a child with a blood pressure in the 90th percentile. What would be included in the intervention strategies? A. The nurse would review the child's 24-hour diet recall. B. The child should not be allowed to participate in sports. C. Blood pressures should be measured daily. D. Beta blocker education should be given to the parents.

The nurse is providing teaching to a child on the benefits of getting an insulin pump. Which statement made by the child demonstrates an understanding of this teaching? A. "I will give myself fewer injections with an insulin pump." B. "Insulin glargine will be used to provide steady glucose control." C. "A sensor in the pump will detect the carbohydrates I consume." D. "The pump will check my blood sugar automatically and transmit it to my phone."

The nurse is reinforcing teaching with a group of caregivers related to the nutritional needs of the infant. One caregiver asks why the 6-month-old infant needs to have solid foods when breast milk is such a good source of nutrition. What would be the best response by the nurse? A. "Milk will not fully provide the child's needs for iron, which is found in solid foods." B. "By this age the child becomes interested in trying new skills." C. "The extrusion reflex must be developed and feeding solid foods will help the child to develop this reflex." D. "Breastfeeding will become painful when the child gets more teeth, so the infant needs to eat solid foods."

The nurse is reviewing the dosing instructions for hydroxyurea with a 14-year-old client with sick cell anemia. Which topic should the nurse review with the client to ensure the therapy's effectiveness? A. Compliance B. Weight C. Hydration D. Hand hygiene

The nurse is speaking with the parents of a school-aged child recently diagnosed with diabetes mellitus regarding the differences between hypoglycemia and hyperglycemia. Which statement by a parent indicates a need for further teaching? A. "If I notice changes in my son like tearfulness or irritability, his blood sugar may be high." B. "When my son's breath smells fruity, it almost always indicates high blood sugar." C. "If my son says he feels shaky, his blood sugar may be low." D. "Dry flushed skin may be a sign if high blood sugar."

The nurse is teaching a group of parents about head lice. Which statement is essential to include during the presentation? A. Head lice are becoming very resistant to treatment. B. Send your child to school even if you suspect head lice, but have the school nurse check the child. C. Discourage the children from going to sleepovers. D. Wash the bed linens in hot water to kill the lice.

The nurse is teaching the parent of a child with chronic renal failure on high-potassium foods that should be restricted. Which foods will the nurse include in this teaching? . A. Bananas, carrots, nuts, and milk B. Peaches, broccoli, and red meat C. Oranges, potatoes, wheat, and bran D. Spinach, chicken, fish, and green beans

The nurse is teaching the parents of a child with varicella about the disorder. The nurse determines that the teaching was successful when the parents state which of the following? A. "We will make sure to remind him not to scratch the lesions." B. "We can give him aspirin for fever." C. "We should put him in a warm bath if he is itchy." D. "We can use salt solutions to help heal his oral lesions."

The nurse is teaching the preschooler's parents injury prevention. Which method would the nurse advise for the parents as the best way to enforce injury prevention? A. Repetition and reinforcement B. Safety rules C. Adequate supervision D. Constant vigilance

The parent of a child with mumps on one side of the face is concerned that the disease can develop on the other side in the future. How should the nurse respond to the mother about this concern? A. The child is immune to further attacks of the disease. B. It does not matter because mumps in adulthood is not serious. C. The child should receive active immunization against mumps. D. There is nothing that can be done to prevent another attack of mumps in the future.

The parent of a four year-old child has expressed concern that the child is wetting her bed several times each week. What should the nurse teach the parent? A. Bed wetting is not an unexpected behavior at this age B. The child's fluid intake should be limited after 3:00 p.m. C. The parents should try to dialogue with the child about possible causes and solutions D. The parents should provide incentives for keeping the bed dry

The parents of a 5-year-old have just found out that their child has head lice. Which statement by the parents would support the nursing diagnosis of deficient knowledge? A. "I can't believe it. We're not unclean, poor people." B. "We'll have to get that special shampoo." C. "Everybody in the house will need to be checked." D. "That explains his complaints of itching on his neck."

The parents of an 8-month-old boy voice concern to the nurse that their child is not developing motor skills as he should. What question would be appropriate for the nurse to ask in determining if their fears are warranted? A. "Does he move a toy back and forth from one hand to the other when you give it to him?" B. "Does he place toys into a box or container and take them out?" C. "Is he able to drink with a cup by himself?" D. "Is he able to hold a pencil and scribble on paper?"

Well child assessment on a 4 yo. Which findings should the nurse expect? A. child able to hop on 1 foot B. Child able to build tower of up to 6 blocks C. Child able to name days of week D. Child able to identify left & right

When assessing a child and his parents during a well-child visit, the nurse determines that the child is experiencing night terrors. Which of the following would the nurse be most likely to suggest to assist the parents in dealing with this issue.? A. Allowing the episode to take its course B. Waking the child up during the episode C. Allowing the child roam about without supervision D. Talking to the child while the episode is occurring

When caring for children with respiratory issues in relationship to the anatomy and physiology of the child's respiratory system, it is important to recognize which of the following? A. The diameter of the child's trachea is about the size of the child's little finger. B. As soon as the child is born, respiratory passages needed during fetal life close. C. Full development of the lungs and respiratory organs involved does not occur until the child is an adolescent. D. The newborn uses the thoracic muscles to breathe, and as they grow they begin using the abdominal muscles to breathe

When describing play by the school-aged child to a group of nursing students, the instructor would emphasize the need for which of the following? A. Rules B. Recreation C. Physical activity D. Ritualism

When describing the negative feedback system that controls endocrine function, the nurse explains that a decreased secretion of which correlates with a decrease in blood glucose levels? A. Insulin B. Glucagon C. Adrenocorticotropic hormone D. Glycogen

When teaching about Turner's syndrome, what should the nurse include? A. Timing and use of growth hormone B. Use of hormone therapy to prevent infertility C. Long-term effects of decreased intellectual ability D. Treatment for gynecomastia

Where would you admin an IM injection for a 2 mo? A. vastus lateralis B. doesogluteal C. deltoid D. abdomen 2" from umbilicus

Which developmental milestone would the nurse expect an 11-month-old infant to have achieved? A. Sitting independently B. Walking independently C. Building a tower of four cubes D. Turning a doorknob

Which nursing intervention is priority when caring for a child with HIV? A. Administer prescribed medications. B. Assist the child with daily activities. C. Assess pain after invasive procedures. D. Review laboratory CD4 counts daily.

Which of the following instructions would Nurse Courtney include in a teaching plan that focuses on initial prevention for Sheri who is diagnosed with rheumatic fever? A. Treating streptococcal throat infections with an antibiotic B. Giving penicillin to patients with rheumatic fever C Using corticosteroid to reduce inflammation D Providing an antibiotic before dental work

Which type of diet should be included in the plan of care for a child diagnosed with Addison disease? A. High-protein, low-carbohydrate, high-sodium diet B. High-protein, high-carbohydrate, low-sodium diet C. Low-calorie, low-carbohydrate, low-sodium diet D. Low-calorie, low-cholesterol, low-saturated fat diet

You are administering the following vaccines to a 6 yo: DTaP, MME, and varicells; which should you also plan to administer A. IPV B. Hib C. PCV D. HBV

A 2-year-old child is admitted to the hospital with a fever, vomiting, and diarrhea. The nurse has completed an assessment and is creating a plan of care. What important consideration is necessary to the child's plan of care? A. Fluid loss is slower in a child than an adult. B. Children require more fluid intake than adults to maintain fluid balance. C. The presence of fever will lessen the child's fluid loss. D. Insensible water loss will not affect the child's outcome.

A 2-year-old child is hospitalized with a diagnosis of severe dehydration. The child has had several episodes of watery diarrhea and has vomited three times since admission. The child has a temperature of 104°F (40°C). The parents are worried that the child has not eaten anything or urinated since the day before. What should be the priority focus of the child's care? A. Febrile state B. Fluid status C. Parental education D. Urine output

A 3-month-old infant is hospitalized with a diagnosis of bronchiolitis. The nurse is creating a plan of care for the infant. Which intervention is a priority? A. Provide parental teaching on the antibiotics the infant will need to take at home. B. Administer oxygen to maintain the infant's oxygen saturation at or above 92%. C. Allow the parents to remain by the infant's side throughout the hospitalization. D. Keep the infant NPO until the condition has resolved.

A 6-month-old girl is seen with retinoblastoma. When taking a health history from her father, which symptom would you expect him to report he has noticed? A. The infant always keeps her eyes tightly closed. B. He has noticed one pupil appears white. C. His daughter tugs and pulls at one ear. D. His daughter's eye appears to be protruding

A child in the clinic has a fever and reports a sore neck. Upon assessment the nurse finds a swollen parotid gland. The nurse suspects which infectious disease? A. Measles B. Mumps C. Whooping cough D. Scabies

A child who was Dx w/ Hirschsprung's Dz has a fever & watery explosive diarrhea. Which of the following would the nurse do first? A. administer an antidiarrheal B. notify the physician immediately C. monitor the child every 30 mins D. nothing these are common findings

A community health nurse is conducting a home visit with the family of a 6-month-old child diagnosed with developmental delay. Which statement by the parent indicates the need for further teaching? A. "My infant is drinking iron-fortified formula thickened with rice cereal." B. "My infant loves to play marbles with an older sibling." C. "The car seat is in the back seat facing backward." D. "My infant has an appointment for immunizations next week."

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

A community health nurse is conducting a seminar offered to parents of young infants. During the teaching session, a parents asks, "When is the appropriate time to introduce solid food into the infant's diet?" What is the nurse's best response? A. "You should offer solid foods around 2 to 3 months of age." B. "Infants may begin eating pureed foods at age 4 to 6 months." C. "Infants are ready to eat solid foods once they have triple their birth weight." D. "Pureed foods may be offered upon eruption of the first tooth."

A family is caring for their son who is suffering from tetralogy of Fallot. Which of the following are defects associated w/ this congenital heart condition? A. Aorta exits from the right ventricle, pulmonary artery exits from the left ventricle, and two noncommunicating circulations B. Ventricular septal defect, overriding aorta, pulmonic stenosis (PS), and right ventricular hypertrophy C. Coarctation of aorta, aortic valve stenosis, mitral valve stenosis, and patent ductus arteriosus D. Tricuspid valve atresia, atrial septal defect, ventricular septal defect, and hypoplastic right ventricle

A nurse is admitting a child who has acute lymphocytic leukemia. Which of the following lab values should the nurse expect? A. platelets 500,000 mm^3 B. RBCs 2.5 million/uL C. WBCs 4,000/mm^3 D. Hct 60%

A nurse is assessing a 6yo who began Tx for pneumococcal pneumonia 4 days ago. Which of the following is an indication the Tx is effective? A. dullness w/ chest percussion B. HR 118 bpm C. conjunctival discharge D. RR 28 bpm

A nurse is assessing a client diagnosed with a fractured arm that has a long arm cast in place. The nurse notes that the client's fingers are cool and have a moderate amount of edema with a capillary refill of 3 to 4 seconds. Based on this information, the nurse suspects the client has developed what complication? A. Infection B. Compartment syndrome C. Neuropathy D. Skin breakdown

A nurse is assessing an infant who has acute gastroenteritis. Which of the following findings should the nurse identify as the priority? A. decreased skin turgor B. capillary refill 5 seconds C. heart rate 150/min D. dry mucous membranes

A nurse is assessing, Maria, an 11-year-old female. During the assessment, the nurse notices that the girl's breasts have begun to develop. Based on an understanding of adolescent growth and development, the nurse would anticipate that Maria would most likely begin to menstruate within which time period? A. 1 year B. 2 years C. 3 years D. 4 years

A nurse is caring for a 2-year-old child who has a heart defect and is scheduled for cardiac catheterization. Which of the following actions should the nurse take? A. place on NPO status for 12hr prior to the procedure B. check for iodine or shellfish allergies prior to the procedure C. elevate the affected extremity following the procedure D. limit fluid intake following the procedure

A nurse is caring for a 9-year-old child experiencing a severe asthma exacerbation with a dry hacking cough and wheezing. The child's pulse oximeter reading is 88% (0.88). What is the nurse's priority in caring for the child? A. Suction the nasopharynx. B. Administer oxygen as prescribed. C. Auscultate the lungs. D. Educate the family on the plan of care.

A nurse is caring for a child who has acute glomerulonephritis. Which of the following actions should the nurse take? A. maintain the child on strict bed rest B. check the child's BP every 4 hr C. administer albumin to the child every 8 hr D. provide the child w/ a low-carbohydrate diet

A nurse is caring for a child who has been in Buck's traction for 2 days. Which of the following actions should the nurse take to prevent complications? A. manually move the weights to the floor when the child is experiencing pain B. check for pulses in the affected leg Q4hr C. cleanse the pins Q12hr D. inform the parents to discourage visitors

A nurse is caring for a child who has had watery diarrhea for the past 3 days. Which of the following is an appropriate action for the nurse to take? A. offer chicken broth B. initiate oral rehydration Thx C. start hypertonic IV solution D. keep NPO until the diarrhea subsides

A nurse is caring for a school-aged child who begins to have a tonic-clonic seizure when leaving the bathroom. Which of the following actions should the nurse take first? A. obtain a portable suction machine & suction tubing B. ease the child to the floor in Sims' position C. time the length of the sizure D. notify the child's parents

A nurse is caring for a toddler who has a Wilms' tumor. Which of the following actions should the nurse take? A. palpate the child's abdo to ID the size of the tumor B. prepare the child for surgery C. teach the parents about dialysis D. obtain a 24-hr urine specimen from the child

A nurse is caring for a toddler who has gastroenteritis caused by Salmonella. Which of the following is the priority action for the nurse? A. weigh the child B. initiate contact precautions C. establish a skin care routine D. obtain a recent food history

A nurse is caring for an infant admitted with a diagnosis of bronchiolitis. After completing an assessment, the nurse creates a plan of care for the infant. Which client goal would be priority in the plan of care? A. The infant will attain oxygen saturation of 90% on room air. B. The infant's airway will remain clear and free of mucus. C. The infant's breathing will be less labored. D. The infant will have decreased nasal stuffiness.

A nurse is caring for an infant whose screening test reveals that he might have sickle cell disease. Which of the following tests should be performed to distinguish if the infant has the trait or the disease? A. sickle solubility test B. hemoglobin eletrophoresis C. complete blood count D. transcranial doppler

A nurse is caring for an infant with spinal muscle atrophy (SMA) type 1. What will the nurse note when assessing the child? A. Spastic upper and lower extremities B. Narrow chest and protuberant abdomen C. Enlarged head with low-set ears D. Lusty cry with voracious appetite

A nurse is obtaining the history from a parent of a child who experiences absence seizures. Which of the following would the nurse expect the mother to describe? A. Brief, sudden onset with muscles that become tense B. Loss of motor activity accompanied by a blank stare C. Sudden, brief jerking motions of a muscle group D. Loss of muscle tone and loss of consciousness

A nurse is preparing to administer iron dextran IM to a school-age child who has iron deficiency anemia. Which of the following actions by the nurse is appropriate? A. admin the dose in the deltoid muscle B. use the Z-track method when administering the dose C. avoid injecting more than 2mL w/ each dose D. massage the injection site for 1 min after administering the dose

A nurse is providing care for a 4-year-old child being treated for acute lymphoblastic leukemia (ALL). The nurse is performing an assessment on the child. The child says, "You have to do this on Pinky, too." The child has no visitors at the moment. What is the most appropriate response by the nurse? A. Gently explain to the child that there is no one else in the room. B. Recognize that engaging in magical thinking is the child's way of coping. C. Report the child's comment to the health care provider. D. Tell the child that nurses can only provide care to real people.

A nurse is providing care in the emergency department for a 12-year-old child who is diagnosed with a buckle fracture of the left ulna. The child is accompanied by a parent who asks the nurse why the child's hand is so swollen. What is the nurse's best response? A. "Believe it or not, it is the pain caused by the break that results in soft tissue swelling." B. "When a bone breaks, it causes an inflammatory response which results in swelling around the injured area." C. "Pain fibers in the nerves surrounding the broken bone can cause the tissues to swell." D. "The flexibility of a child's bones makes them more susceptible to swelling when broken."

A nurse is providing care to a 12-year-old child diagnosed with a fractured radius that has been placed in a cast. The nurse has completed an assessment. Which assessment finding requires the nurse to intervene? A. Ability to wiggle fingers B. Fingers cool and dry C. Capillary refill less than 2 seconds D. Hand pink in color

A nurse is providing care to a 13-year-old child during a routine well-child visit. The nurse has completed an initial assessment of the client. What assessment finding should the nurse refer for evaluation? A. Weight in the 50th percentile B. Height 51 in (130 cm) C. Presence of pubic hair D. Presence of an "Adam's apple

A nurse is providing care to a 4-year-old child hospitalized with a diagnosis of acute lymphoblastic leukemia (ALL). The nurse has completed an assessment. Which finding should the nurse consider most concerning? A. Blood pressure 90/54 mm Hg B. Absolute neutrophil count = 400 mm3 (0.4 109/L) C. Poor appetite D. Temperature 101.2° F (38.4° C)

A nurse is providing care to a pregnant adolescent client who lives on a reservation in the Navajo Nation. During a prenatal visit, the client states, "I think it is important to incorporate tribal medicine into my plan of care." What is the nurse's best response? A. "Your tribe elders will emphasize the importance of practicing traditional medicine." B. "Perhaps you can discuss herbal remedies provided by the tribe's Medicine Man with your healthcare provider." C. "Your father should come to the next visit, because he will guide you regarding childrearing and feeding practices." D. "It will be important for you to maintain a balance between yin and yang during this pregnancy to continue leading a healthy life."

A nurse is providing care to a toddler with nephroblastoma and is being evaluated. Which nursing action would be most important? A. Restricting the child's visitors B. Placing a "no abdominal palpation" sign above the child's bed C. Ensuring that the child be allowed nothing by mouth D. Preparing the child for chemotherapy

A nurse is providing teaching to a 13yo who has type 1 DM. Which of the following patient statements indicates an understanding of DM management? A. I will need to avoid snacks between meals B. I should check my blood glucose levels more often when I am sick C. I will need to limit my exercise to 1 hr per day D. I should consume 30g of simple carbs if I feel shaky

A nurse is reading a journal article about adolescents and major causes of injuries in this age group. The nurse demonstrates understanding of this information by identifying which situation as the major cause of adolescent injuries? A. Drowning B. Motor vehicle crashes C. Violence D. Suicide

A nurse is reviewing the health records of several 4-month-old infants who were seen in the pediatric office today. Which infant behavior will require referral for further evaluation of growth and development? A. Reaches for nearby objects B. Unable to support head C. Cannot sit without assistance D. Rolls from prone to supine position

A nurse is reviewing the lab report of a 2yo who has diarrhea & has been vomiting for 24 hr. Which of the following findings should the nurse report to the provider? A. Hct 40% B. potassium 2.5 C. serum creatinine 0.4 D. BUN 6

A nurse is reviewing the lab report of a toddler who is receiving chemo for leukemia. Which of the following should the nurse report to the Dr? A. platelets 150,000 B. Hgb 6 C. WBC 6,000 D. potassium 4.5

A nurse is reviewing the lab results of a child who has experienced diarrhea for the past 24 hr. Which of the following values for urine specific gravity should the nurse expect? A. 1.010 B. 1.035 C. 1.020 D. 1.005

A nurse is reviewing the laboratory results of a preschool child diagnosed with leukemia. The child is receiving chemotherapy and corticosteroids as part of the treatment regimen. What intervention is most important for the nurse to include in the child's plan of care? A. Offer mouth care before meals. B. Assess the temperature every 2 hours. C. Monitor intake and output. D. Administer an antiemetic as prescribed.

A nurse is teaching a teen who has type 1 DM about managing hypoglycemia. Which of the following statements should the nurse include in the teaching? A. You should drink 8 oz of a regular soft drink B. You should drink 4 oz of orange juice C. You should take 2 glucose tablets D. You should take 3 tsp of sugar

A nurse is teaching the parents of a 26-month-old toddler about toddler safety. A parent asks about the best way to keep the toddler safe in the car. The toddler weighs 28 lb. (12.7 kg). Which is the nurse's best response? A. "The best place for your toddler to ride is in the back seat of the car." B. "Your toddler should ride in a rear-facing seat that is appropriate for the child's height and weight." C. "A front-facing car seat is appropriate for your toddler." D. "A booster seat strapped to the back seat is appropriate for your toddler."

A nurse is teaching the parents of a 3yo who has persistent otitis media about prevention. Which of the following statements by the parents indicates an understanding of the teaching? A. my child should not play around others who have ear infections B. we should not smoke around our child C. my child should not swim this summer D. I will encourage my child to blow his nose forcefully when he has a cold

A nurse is teaching the parents of a toddler who has enterobiasis about managing this parasitic disease. Which of the following pieces of information should the nurse include in the teaching? A. you should encourage your child to take a tub bath daily B. you should keep your child's fingernails trimmed short C. you should dress your child in a 2-piece outfit at bedtime D. you should expect your child not to have a recurrence of the parasitic disease

A nurse is visiting a couple to follow-up on their 5-week-old newborn who was diagnosed with a congenital heart anomaly at birth. When the nurse arrives, the mother is in the process of nursing the newborn. What is the best way for the nurse to proceed? A. Ask the mother to end the feeding session so the visit can begin. B. Wait for the mother to finish nursing the newborn. C. Perform assessments that can be done while the newborn is feeding. D. Tell the mother that the visit will need to be rescheduled

A parent calls the health care provider's office concerned about the 2-year-old child who has had one episode of vomiting and three episodes of diarrhea. The parent asks the nurse what to do for the child. The nurse tells the parent to begin oral rehydration therapy. What instruction should the nurse include for the parent? A. "You can rehydrate your child by offering sips of chicken broth." B. "Over-the-counter solutions such as Pedialyte can be used to rehydrate your child." C. "Water and/or milk are the best fluids to rehydrate your child." D. "Give your child as much water and fruit juice as tolerated."

A parent has brought a 12-year-old child to the clinic for a well-child visit. The nurse is reviewing the child's medical record and health history. Which immunization should the nurse anticipate administering during this visit? A. Rotavirus B. Meningococcal C. Poliovirus D. Measles, mumps, and rubella

A parent has brought a 12-year-old child to the pediatrician for a well-child visit. During a discussion on bicycle safety, the parent says "I heard that a child's bones are more flexible than an adult. Is that why they break so easily?" The nurse's response should include what characteristic of the pre-adolescent bone structure? A. The bones are less flexible than adults because the bone plates have fused by age 12. B. A child's bones have a greater degree of bend before breaking, due in part to the decreased mineral content of the bone. C. Growth plates are located at the ends of bones and normally close by the time the child reaches age 10. D. Adults have more cartilage and collagen in their bones, which make them more susceptible to breakage.

A pediatric clinic nurse is reviewing the charts of the children who were seen that day. The nurse is concerned that one of the toddlers requires referral for not meeting developmental milestones. Which toddler should the nurse refer for follow-up on appropriate developmental milestones? A. 18-month-old who feeds self finger foods B. 28-month-old who has a 5- to 10-word vocabulary C. 30-month-old who entertains self by scribbling on paper D. 36-month-old who can say his name and age

A young client arrives at the clinic with a rash on the trunk and flexor surfaces of the extremities. The parent informs the nurse that the rash started a day before on the exterior surfaces of the extremities; 2 days before, the child had a really bad rash on the face. The health care provider diagnoses the child with erythema infectiosum. The nurse tells the parent that this is also known as: A. enterovirus. B. fifth disease. C. rosacea. D. pityriasis rosea

An 8-year-old child diagnosed with asthma is being taught how to use a spacer with an albuterol inhaler. What is the best way for the nurse to evaluate the child's understanding of how to use the spacer? A. Guide the child step by step through the process. B. Have the child attach the spacer to the inhaler and use it. C. Have the child verbalize how to use the spacer. D. Attach the spacer to the inhaler, then have the child to use it.

An adolescent comes into the emergency department with a foot wound. Upon assessment, the nurse learns that the patient is a runaway and has been living on the streets. Which is the most appropriate care for the nurse to provide to the client at this time? A. Recommend returning to live with parents. B. Treat the wound and provide wound care supplies. C. Discuss the importance of a diet high in protein and vitamin C. D. Explain how the wound needs to be flushed with water every 4 hours.

An adolescent who is depressed states, "Nothing ever seems to be right in my life." Which would be the most appropriate response by the nurse? A. "Things will be better when you go off to college." B. "You are feeling sad right now. It's a hard time." C. "Try to look at the bright side of things." D. "Being a teenager is hard work."

Assessment on 6 mo. Which reflex should you expect to find? A. stepping B. Babinski C. extrusion D. Moro

At a community center, the nurse is teaching about child developmental milestones for 6-month-old infants. Which statement by a participant is most concerning? A. "Babies this age like to play with others and are generally happy." B. "We expect that our 6-month-old infants will have head lag." C. "It may get noisy in the room for 6-month-old infants; they are learning to babble." D. "Close monitoring is necessary as these babies explore with their hands and mouths."

Bryce is a child diagnosed with coarctation of aorta. While assessing him, Nurse Zach would expect to find which of the following? A. Squatting posture B. Absent or diminished femoral pulses C. Severe cyanosis at birth D cyanotic ("tet") episodes

In diagnosing seizure disorder, which of the following is the most beneficial? A. skull radiographs B. EEG C. Brain scan D. lumbar puncture

Nurse is assessing a 9 mo during a well-child visit. Which indicates the child has a developmental delay? A. Creeping on hands & knees B. Inability to vocalize vowel sounds C. Using a crude pincer grasp D. Standing by holding onto a support

Nurse is caring for an 18 yo who is up to date on immunizations & planning on attending college. Which should the nurse recommend prior to moving to a dorm? A. Pneumococcal polysaccharide B. Menigococcal polysaccharide C. Rotovirus D. Herbes zoster

Nurse provides a teaching session to nursing staff regarding osteosarcoma. Which statement indicates a need for information? A. The femur is the most common site of this sarcoma B. The child does not experience pain at the primary tumor site C. Limping if a weight bearing limb is affected is a clinical manifestation D. The symptoms of the disease in the early stage are almost always attributed to normal growing pains

The emergency department nurse is caring for a client with cystic fibrosis who is dyspneic and has a productive cough. Place in order the nursing interventions performed upon arrival to improve breathing. (1) Notify respiratory therapy. (2) Assess respiratory status. (3) Obtain oxygen saturation reading. (4) Place in bed in a semi-Fowler's position. (5) Place on oxygen at 2 liters. (6)Instruct on energy conservation measures A. 1, 2, 3, 4, 5, 6 B. 2, 4, 3, 5, 1, 6 C. 4, 2, 6, 3, 1, 5 D. 6, 5, 4, 2, 3, 1

The infant weighs 7 lb 4 oz (3,248 g) at birth. If the infant is following a normal pattern of growth, what would be the expected weight for this child at the age of 12 months? A. 14 lb 8 oz (6.6 kg) B. 21 lb 12 oz (9.9 kg) C. 25 lb (11.3 kg) D. 28 lb 4 oz (12.8 kg)

The mother of a 1-month-old infant voices concern about her baby's respirations. She states they are rapid and irregular. Which information should the nurse provide? A. The normal respiratory rate for an infant at this age is between 20 and 30 breaths per minute. B. The respirations of a 1-month-old infant are normally irregular and periodically pause. C. An infant at this age should have regular respirations. D. The irregularity of the infant's respirations are concerning; I will notify the physician.

The nurse caring for a toddler immediately after a fall from a grocery cart will avoid moving which body area as the child is examined? A. Lower extremities B. Head and neck C. Torso D. Clavicle

The nurse is admitting a 12-month-old to the medical unit. During the admission process the parents tell the nurse that their child is very advanced because he says "ball" when he picks up a football. How should the nurse respond? A. "He really isn't any more advanced than most 12-month-old children." B. "That is great that he is recognizing objects and is able to name them. He is right on target for language skills." C. "If he were advanced in language skills he would be putting several words together to form short sentences." D. "Parents usually think their child is far more advanced than other children."

The nurse is assessing a child who is experiencing acute splenic sequestration secondary to sickle cell disease. The nurse would identify which of the following as the priority? A. Pain relief B. Emergent transfusion C. Antibiotic administration D. Oxygen administration

The nurse is assessing the gross and fine motor development of an 8-year-old child during an annual exam. Which finding requires further follow-up by the nurse? A. Has just learned to ride a bike without training wheels B. Is able to run and jump, but has difficulty skipping C. Can throw a football, but cannot make it spiral D. Plays hopscotch during recess at school

The nurse is caring for a 14-year-old client who has been newly prescribed hydroxyurea therapy. Which action should the nurse take to increase adherence to the prescribed therapy? A. Explaining the benefits of avoiding costly health care B. Reviewing the therapeutic effects of the medication C. Recommending a pill case for daily medications D. Suggesting the use of a medication diary to track doses

The nurse is caring for a 14-year-old client who has undergone genetic testing for sickle cell disease and was found to be a carrier. Which information should the nurse review with the client when discussing the results of the test? A. "You will need to take care to watch for symptoms and complications and protect yourself from the disease." B. "You are a carrier and may not have any symptoms or complications of the disease." C. "You may develop symptoms or complications of the disease, but they will be less severe." D. "You are a carrier of the gene, but you will not develop any symptoms or complications of the disease."

The nurse is caring for a 6-month-old infant who is in foster care and diagnosed with organic failure to thrive. Which statement by the foster parent indicates a need for additional teaching? A. "We may need to thicken the formula with rice cereal to decrease reflux." B. "Offering enough calories would have prevented this problem." C. "The inability to absorb nutrients has prevented the infant from gaining weight." D. "Switching to a hypoallergenic formula may help with achieving the target weight."

The nurse is caring for a 7-year-old child diagnosed with type 1 diabetes. Which statement made by the child is accurate regarding blood glucose monitoring? A. "My parents will do this for me at home." B. "I will need to use the side of my fingertip to get blood." C. "The school nurse will create a schedule to check my glucose at school." D. "The most important time to have my glucose checked is in the morning."

The nurse is caring for a 7-year-old child newly diagnosed with type 1 diabetes. The child is receiving an insulin infusion. The last blood glucose reading was 414 mg/dl (23.0 mmol/l) one hour ago. Upon recheck, the blood glucose reading is 325 mg/dl (18.0 mmol/l). Which action by the nurse would be best? A. Recheck the blood glucose in one hour. B. Adjust the insulin regimen as prescribed. C. Check the blood glucose at a different site. D. Encourage the child to drink a cup of orange juice.

The nurse is caring for a child with history of asthma who presents to the emergency department with wheezing, tachypnea, and dyspnea. What will the nurse do first? A. Ask what may have triggered the attack. B. Place the child in high-Fowler's position. C. Assess the child's pulse oximetry reading. D. Apply oxygen via nasal cannula at 2 liters

The nurse is evaluating outcomes for teaching provided to the mother of a school-age child with an itchy rash. Which outcome indicates that teaching has been effective? A. Mother applies hot compresses to itchy skin areas every few hours B. Child drinks a glass of water every 1 to 2 hours throughout the day C. Child showers in hot water and uses soap on the rash every morning D. Child wearing long denim pants and a long-sleeve shirt while playing outside

The nurse is performing an assessment on an 8-year-old child during an annual well-child visit. Which finding requires further follow-up by the nurse? A. Shares concerns about the future B. Focuses more on self than on others C. Time spent reading increased by 30 to 60 minutes since last exam D. Has learned how to ride a bicycle

The nurse is providing discharge teaching regarding medication compliance to an adolescent diagnosed with epilepsy since infancy. Based on knowledge of the psychosocial impact of chronic illness on children in this age group, which response should the nurse anticipate? A. "I spend a lot of time with my parents who are active participants in my care." B. "None of my friends have to take medicine everyday like I do." C. "I am not concerned with what others think about me at school." D. "My parents are supportive of my decision to stop taking seizure medications."

The nurse is providing discharge teaching to the family of a child recently diagnosed with epilepsy. Which statement by the child's parent indicates a need for additional teaching? A. "Because our child has had three seizures, our child is now considered epileptic." B. "Our child may experience an aura, or perceptual disturbance, after the seizure." C. "It is important that we note if our child is having clonic, atonic, or tonic movements." D. "The postictal state may last minutes to hours and involve an alteration in consciousness."

The nurse is providing discharge teaching to the parents of a 7-year-old child. Which statement made by the parents demonstrates an understanding of parenting tips for a child this age? A. "Rules should be set without consequences." B. "I should teach my child how to make healthy food choices." C. "My child should be able to read his or her own bedtime stories." D. "I should pack my child's lunch for school as much as possible."

The nurse is reviewing laboratory values on four clients. Which client should the nurse assess first? A. Glycosylated hemoglobin of 9.5% (0.095) B. Nighttime glucose of 60 mg/dl (3.3 mmol/l) C. Fasting blood glucose of 130 mg/dl (7.0 mmol/l) D. Two-hour postprandial glucose of 250 mg/dl (13.9 mmol/l)

The nurse is reviewing safe swimming practices with the parents of an 8-year-old child during an annual exam. What statement by the parents requires further follow-up by the nurse? A. "I keep close by when my child is near water, even if we are not swimming." B. "I let my older children watch my little ones when they swim." C. "My child has never had the chance to learn how to swim." D. "Even if my child was a strong swimmer, supervision is still important."

The nurse performing an admission assessment on a 2yo who has be Dx w/ nephrotic syndrome notes that which most common characteristic is associated w/ this syndrome? A. hypertension B, generalized edema C. increased UOP D. frank, bright red blood in urine

The nurse receives the shift report of multiple pediatric clients. Which pediatric client will the nurse see first? A. an infant whose parents report difficulty feeding with a temperature of 100.1°F (38°C) B. a toddler with tetralogy of Fallot squatting quietly in the corner of the room C. a child with history of hypertension and a current blood pressure of 130/90 mm Hg D. an adolescent with coarctation of the aorta with reports of coughing and coryza

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 Dx? A. his pediatrician said his kidneys are working well B. I noticed his urine was the color of cola lately C. I'm so glad they didn't find any protein in his urine D. the nurse who admitted my child said his BP was low

The nurse working in a health care provider's office is caring for a child with type 1 diabetes who has an elevated blood glucose despite taking insulin. The child presents with a sore throat, runny nose, and a cough. Which statement made by the nurse is most appropriate? A. "The insulin may have expired and is less effective." B. "You will need to check your glucose more often while you are sick." C. "Decrease your carbohydrate intake until your glucose levels are lower." D. "I recommend proceeding to the emergency room for further examination."

The parent of an infant being treated for bronchiolitis is visibly upset and tearful. The parent states "I am so afraid for my infant. Is there something I could have done to prevent this from happening?" Which is the best response for the nurse to make? A. "Please do not cry. I doubt you did anything to cause your infant to get sick." B. "This must be very difficult for you. Let's talk about risk factors related to bronchiolitis." C. "That does not matter now. It is more important that we focus on getting your infant well." D. "There was nothing you could have done to prevent this. We will do everything we can to make your infant well again."

The young child has been diagnosed with Guillain-Barré syndrome and it is progressing in a classic manner. Rank the following sequence of events in the order that they typically occur. (1). The child is having difficulty producing facial expressions. (2). The child states that it is difficult to move his legs. (3). The child reports numbness and tingling in his toes. (4). The child states that it is difficult to move his arms. A. 1, 2, 3, 4 B. 2, 3, 4, 1 C. 3, 4, 1, 2 D. 4, 3, 2, 1

What would be most effective in helping promote initiative and nutritional health for a preschooler? A. Giving the child a high carbohydrate snack after preschool B. Allowing the child to spread soft cheese on crackers C. Encouraging the child to cut up small pieces of apple for a snack D. Praising the child for cleaning his large plate of food

When assessing the oral cavity of a 2 1/2-year-old toddler, which finding is expected? A. 12 deciduous teeth B. 20 deciduous teeth C. 16 deciduous and 2 permanent teeth D. 6 deciduous and 12 permanent teeth

When providing support and education to the family of a child who is diagnosed with a serious genetic abnormality, what would be the priority? A. Assisting with scheduling follow-up visits B. Establishing a trusting relationship C. Teaching the family what to expect D. Using measures to promote growth and development

Which diagnostic measure is most accurate in detecting neural tube defects? A. Flat plate of the lower abdomen after the 23rd week of gestation B. Significant level of alpha-fetoprotein present in amniotic fluid C. Amniocentesis for lecithin-sphingomyelin (L/S) ratio D. Presence of high maternal levels of albumin after 12th week of gestation

Which is an appropriate toy for a 3 yo? A. Jump rope B. Coloring book & crayons C. checkers game D, Jack in the box

Which nursing intervention is the priority for the immobilized child in an acute care setting? A. Ambulate the child up and down the hall twice a day. B. Offer age-appropriate toys and diversional activities. C. Take the child to the playroom at least once a day. D. Encourage active and passive range of motion exercises once a day.

Which of the following parameters would the nurse monitor to evaluate the effectiveness of thickened feedings for an infant w/ gastroesophageal reflux? A. urine B. vomiting C. weight D. stools

Which reaction should the nurse expect from an 8 mo? A. gives a social smile B. turns away when the nurse approaches C. reaches out to be held D. responsive & alert as you come closer

Which statement best describes the difference between an infant's respiratory tract and that of an adult? A. The infant's respiratory tract has more alveoli than the adult. B. The trachea and bronchi have smaller lumens in the infant. C. Because of the location of an infant's trachea airway obstruction is less likely. D. Adults have more soft tissue surrounding the trachea than infants.

Which type of play would the nurse use to prepare a preschooler for upcoming surgery to reduce the stress of the event? A. Associative play B. Dramatic play C. Onlooker play D. Cooperative play

Which would be a nutritional goal for a preschool client? A. Eat everything on the plate. B. Introduce new food gradually and include variety. C. Reduce messiness and spills. D. Let the child eat only what the child wants.

A 10yo child w/ hemophilia A has slipped on the ice & bumped his knee. The nurse should prepare to admin what? A. Injection of factor X B. IV infusion of iron C. IV infusion of factor VIII D. IM injection of iron using Ztrack method

A 12-year-old child tells the school nurse, "I do not understand why my parents will not allow me to go to concerts without chaperones like some of my friends' parents. I feel like a baby compared to my friends." How will the nurse respond? A. "Your parents are right. Twelve years old is too young to be attending concerts without a chaperone." B. "I'm sure your parents are just very worried that you could get into trouble attending concerts at a young age." C. "Have you given any thought to why they don't let you go without a chaperone? Let's talk about some of the reasons they feel this way." D. "You are so young that you have plenty of time to go to concerts alone. Your parents just care about you."

A 2-year-old child is brought to the pediatric clinic with reports of decreased urine output and fever over the past 3 days. As the nurse begins an assessment, the child is crying and moving about in the parent's arms. Which action should the nurse take first? A. Ask the parent to place the child on the exam table. B. Request a prescription for an antipyretic. C. Ask the parent when the child voided last. D. Use the FLACC scale to assess the child for pain.

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

A 6-month-old infant is admitted with a diagnosis of bacterial meningitis. The nurse would place the infant in which room? A. A room with a 12-month-old infant with a urinary tract infection B. A room with an 8-month-old infant with failure to thrive C. A private room near the nurses' station D. A two-bed room in the middle of the hall

A child diagnosed with leukemia will receive chemotherapy as part of the treatment regimen. The nurse is providing teaching to the family about chemotherapy. Which statement by the family indicates that the teaching was effective? A. "Chemotherapy treatments for leukemia are usually completed within 4 to 6 weeks." B. "Once the first treatment is administered, the remaining treatments can be administered as an outpatient." C. "We can expect our child to experience hair loss, vomiting, and loss of appetite." D. "Side effects from these medications are usually minimal."

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

A child is brought to the school nurse after injuring a wrist in a fall. The child presents with pain rated 9 on a scale of 1 to 10. The affected wrist has moderate edema and bruising, and the child has difficulty moving the wrist. Based on this information, what is the nurse's priority in providing care? A. Administer an analgesic. B. Call 911 for an ambulance. C. Immobilize the wrist. D. Apply ice to the wrist.

A child is hospitalized because of persistent vomiting. The nurse should monitor the child closely for which problem? A. diarrhea B. metabolic acidosis C. metabolic alkalosis D. hyperactive bowel sounds

A child with sickle cell disease is brought to the emergency department by his parents. He is in excruciating pain. A vaso-occlusive crisis is suspected and analgesia is prescribed. Which of the following would the nurse least likely expect to be ordered? A. Morphine B. Nalbuphine C. Meperidine D. Hydromorphone

A child with spastic cerebral palsy is to receive botulin toxin. The nurse prepares the child for administration of this drug by which route? A. Oral B. Subcutaneous injection C. Intramuscular injection D. Intravenous infusion

A community health nurse is doing a home assessment of a family with a 2-year-old child. During the assessment, the nurse identifies a potential safety hazard. Which finding should the nurse discuss with the family? A. Covered electrical outlets B. Window blinds with turn handles C. Can of peanuts on the table D. Tub full of toys in the corner

A community health nurse is teaching a class on safety for parents of preschoolers. Which statement by one of the parents indicates a need for additional teaching? A. "If there is a gun in the home, it should be stored unloaded in a locked container out of the reach of children." B. "When giving my child medication, I should not refer to it as candy." C. "If my child is separated from me while we are out, my child should seek help from any responsible adult." D. "We do not allow visitors to smoke in or around our home."

A group of 10-year-old girls have formed a "girls only" club. It is only open to girls who still like to play with dolls. How should this behavior be interpreted? A. poor peer relationships B. encouragement for bullying and sexism C. appropriate social development D. immaturity for this age group

A health care provider prescribes acetaminophen 12 mg/kg PO for a child hospitalized with a diagnosis of a fracture of a left lower extremity. The child weighs 90 lb (40 kg). The pharmacy dispenses one 650-mg dose. What action should the nurse take? A. Administer one-half of the dose to the child. B. Administer the entire 650 mg to the child. C. Call the pharmacy and review the prescription with the pharmacist. D. Call the health care provider to confirm the prescription

A high-school football player has been diagnosed as having osteosarcoma of the femur. The parents are angry because they told the adolescent not to play football. Which health teaching points would the nurse include in the teaching plan for the adolescent and parents? A. Osteosarcoma often follows trauma, such as a football injury. B. You can expect some discoloration of the leg following chemotherapy. C. Football injuries do not contribute to the development of a tumor. D. Tumor growth is related to your dislike of milk

A lumbar puncture is performed on a child suspected to have bacterial meningitis & CSF is obtained for analysis. The nurse reviews the results of the CSF analysis & determines that which results would verify the Dx? A. clear CSF, decreased pressure, elevated protein level B. clear CSF, elevated protein, decreased glucose levels C. cloudy CSF, elevated protein, decreased glucose levels D. cloudy CSF, decreased protein, decreased glucose levels

A mother is concerned that her 2-year-old child is having seizures. He holds his breath until he passes out when he wants something his mother does not want him to have. How should the nurse respond to this mother's concern? A. Seizures rarely occur in toddlers. B. With seizures, cyanosis rarely develops. C. Seizures are not provoked; temper tantrums are. D. Seizures typically occur with fever; temper tantrums do not.

A new mother reports that she is exhausted and that the little sleep she gets is determined by her baby. Which suggestion should the nurse prioritize to help the mother establish healthy sleeping patterns in her infant? A. Put the baby to bed at various times of the evening. B. Let the baby cry during the night and she will eventually fall back to sleep. C. Use the crib for sleeping only, not for play activities. D. Wake the baby from afternoon naps after 1 hour to ensure she is sleepy by nighttime.

A nurse in an emergency department is caring for a toddler who is in acute respiratory distress. Which of the following findings should alert the nurse to the possibility of epiglottis? A. lethargy B. spontaneous coughing C. drooling D. hoarseness

A nurse in the pediatric clinic has completed an assessment on a 5-week-old newborn seen for a well visit. Which finding should be documented by the nurse as abnormal? A. Lifts and turn head to side B. Recognizes voices of caregivers C. Legs are straight and floppy D. Bats at objects that are of interest

A nurse is assessing a 6mo infant who was recently admitted w/ acute vomiting & diarrhea. Which of the following findings indicates the infant has moderate dehydration? A. bulging anterior fontanel B. bradycardia C. tachypnea D. polyuria

A nurse is assessing a child with persistent fever, fatigue, and joint pain for 3 days. The parent denies that anyone else in the family is or has been ill, or that the child has been exposed to illness outside the family. Based on this information, what would be an appropriate action for the nurse take next? A. Notify the health care provider. B. Document the findings as a viral infection. C. Assess the child's skin for any rashes or lesions. D. Check the child's immunization schedule.

A nurse is assessing a toddler who has gastroenteritis. Which of the following findings indicates the toddler is experiencing severe dehydration? A. slight thirst B. capillary refill of 3 seconds C. deep, rapid respirations D. decreased tear production

A nurse is assessing physical growth of a 6-month-old child during a well-child check-up. Which data should the nurse be most concerned about? A. Head circumference in the 19th percentile B. Length in the 27th percentile C. Weight in the 4th percentile D. Body mass index (BMI) in the 8th percentile

A nurse is caring for a 6mo infant who has intussusception. Which of the following actions should the nurse take? A. prepare to administer high-dose steroids B. give the child magnesium hydroxide PO C. prepare the child for a barium enema D. inform the parents that the child will need a colostomy

A nurse is caring for a child who has glomerulonephritis. Which of the following actions should the nurse take? A. monitor the child's BP twice a day B. maintain the child on bed rest for 3 days C. weigh the child once each day D. increase the child's daily intake of sodium

A nurse is caring for a child who is postop following surgical removal of a Wilms' tumor. Which of the following assessments is an indication to continue NPO status? A. abdo girth 1cm larger than yesterday B. report of pain at the op site C. absent bowel sounds D. passing of flatus every 30 mins

A nurse is caring for a school-age child who has glomerulonephritis. The child has decreased UOP & a BP of 160/78 & is receiving hydralazine. Which of the following lunch choices should the nurse recommend? A. 1 hot dog, 22 potato chips, 120 ml (4oz) of oj B. 1 sandwich w/ lettuce, tomato & 4 slices of bacon, a small apple and 240 mL (8oz) of milk C. 3 oz grilled chicken, 1 cup of pear slices, and 120 mL (4oz) of apple juice D. 1 cup of cottage cheese, a small banana & 240 mL (8 oz) of soda

A nurse is caring for a school-aged child who had an arm cast applied 8 hours ago. Which of the following findings should alert the nurse to a complication related to the casting? A. the child reports a pain level of 5/10 B. the child's hands are cool bilaterally C. the child reports tightness at the wrist D. the child's grasp is weak

A nurse is caring for an adolescent who has a new Dx of osteosarcoma. Which of the following actions should the nurse take? A. ensure that the teen has a referral for a psychiatrist visit B. prepare a teaching plan to educate the teen in detail about his Dx & Tx C. spend time w/ the teen to answer any questions he can have D. perform a mental status exam to assess the teen's thought patterns

A nurse is caring for an infant who has gastroenteritis & is dehydrated. Which of the following characteristics places the infant at higher risk of electrolyte imbalances compared to an adult client? A. less extracellular fluid B. reduced body surface area C. longer intestinal tract D. decreased rate of metabolism

A nurse is planning care for an infant who is scheduled to have a lumbar puncture. Which of the following actions should the nurse include in the plan of care? A. cleanse the thoracic area of the infant's back w/ an antiseptic solution B. apply a eutectic mixture of local anesthetic cream just before the procedure begins C. restrain the infant during the procedure to prevent movement D. position the infant w/ his head extended & chin raised

A nurse is providing care for a toddler hospitalized with vomiting, diarrhea, and fever for several days. The nurse has created a plan of care related to fluid volume deficit. Which intervention is most important for the nurse to implement? A. Perform daily weights. B. Send a serum potassium level. C. Assess the child's circulation. D. Provide parental teaching

A nurse is providing discharge teaching for the parent of a newborn who is prescribed a Pavlik harness for developmental dysplasia of the hip. Which of the following responses indicates an understanding of the teaching? A. I should apply powder to the folds of skin on my baby's knees and thighs B. I should adjust the straps on the harness once a week as my baby grows C. I should lightly massage my baby underneath the straps once a day D. I should place my baby's diaper over the straps of the harness

A nurse is providing teaching to a school-aged child about medications the child will use to manage asthma. Which medication should the nurse teach the child to use when acute symptoms occur? A. Montelukast B. Prednisone C. Albuterol D. Theophylline

A nurse is providing teaching to a school-aged child who just had a fiberglass cast application following a lower-extremity fracture. Which of the following instructions should the nurse give the child and his parents about care during the first 48 hr? A. "Use a toothbrush to scratch under the cast if your skin itches" B. "Avoid moving your leg and the joints above and below the cast" C. "Keep the cast above the level of your heart" D. "Clean soil from the cast with soapy water"

A nurse is providing teaching to the mother of an infant who has a prescription for digoxin. Which of the following instructions should the nurse include? A. "do not offer your baby fluids after giving the medication" B. "digoxin increases your baby's heart rate" C. "give the correct dose of medication at regularly scheduled times" D. "if your baby vomits a dose, you should repeat the dose to ensure that he gets the correct amount"

A nurse is reviewing the lab reports of a child w/ acute nephrotic syndrome who has been receiving prednisone by mouth for the past wk. Which of the following findings should the nurse report to the provider? A. serum sodium 142 B. serum potassium 4 C. WBC count 3,000 D. platelet count 298,000

A nurse is reviewing the lab values for a 6mo who has acute renal failure. Which of the following findings should the nurse expect? A. BUN 5 mg/dL B. Creatinine 0.2 mg/dL C. Sodium 125 mEq/L D. Potassium 4.2 mEq/L

A nurse is teaching a school-age child who has a new diagnosis of type 1 diabetes mellitus. Which of the following statements should the nurse make? A. "If you take too much insulin, drink a sugar-free cola" B. "You will need to decrease your insulin dosage when you become a teenager" C. "You can use a vial of insulin for up to 30 days" D. "Stop taking your insulin if you are vomiting"

A nurse is teaching about clinical manifestations of tracheomalacia to the parent of an infant who had tracheoesophageal fistula repair as a newborn. Which of the following findings should the nurse include in the teaching? A. absence of bowel sounds B, neck contortions C. barking cough D. projectile vomiting

A nurse is teaching parents about erythema infectiosum and describing the progression of the disease from earliest to latest. Place the following manifestations in the order in which the nurse would describe them. (1) Intense red rash on the face (2)Rash on the flexor surfaces of extremities and trunk (3)Rash on extremity extensor surfaces (4) Fever and headache (5) Lace-like lesion appearance A. 5, 4, 3, 2, 1 B. 1, 2, 3, 4, 5 C. 4, 1, 3, 2, 5 D. 2, 4, 3, 5, 1

A nurse is teaching the parent of a school-age child who has DM how to recognize DKA. Which of the following findings should the nurse identify as a manifestation of this complication? A. slow heart rate B. protruding eyeballs C. deep, rapid respirations D. decreased urinary output

A nurse is teaching the parents of an infant who has mild gastroesophageal reflux (GER). Which of the following instructions about feeding therapies should the nurse recomment? A. apply the infant's diaper snugly prior to feedings B. administer nasogastric feedings C. thicken feedings w/ rice cereal D. place the infant in a lateral position for 1 hr after feedings

A nurse is working with a preceptor in a well-baby clinic that deals with children aged birth to 12 years old. During the routine physical assessment of a 2-year-old, the nurse identifies which finding as being abnormal for this age group? A. heart rate of 92 beats/min, regular B. respiration rate of 20 bpm, abdominal breathing noted C. blood pressure of 116/80 mm Hg D. wears diapers since not potty trained

A parent brings the 2-month-old newborn to the clinic for a well-child visit. Which statement made by the parent should raise concerns in the nurse regarding safety? A. "I always put the newborn down on the back for a nap or at bedtime." B. "If I need to warm the bottle, I place it in a pan of warm water." C. "We cannot afford a crib right now, so the newborn sleeps with me." D. "The newborn is so active; I have to keep one hand on the newborn while on the changing table."

A parent brings the 2-year-old child to the clinic for a well-child visit. The nurse performs an assessment and notes that the child is pale and the anterior fontanel is sunken. What action should the nurse take next? A. Continue the assessment and document the findings. B. Notify the health care provider of the findings. C. Ask the parent if the child has shown any signs of illness recently. D. Ask the parent about the child's growth and development

A parent brings the infant to a community health clinic for the first time since giving birth on the Navajo Reservation 6 months ago. What is a priority topic for discussion during this visit? A. Infant food preferences B. Enrollment in a daycare program C. Catch-up schedule for immunizations D. Dental referral

A school nurse is developing educational materials for a school health fair that will be attended by 16-year-old students. Which information should the nurse include related to growth and development for this age group? A. Hair growth in the pubic area will begin. B. Breast enlargement in girls will slow or stop. C. Height and weight are close to that of an adult. D. Growth spurts are complete.

A toddler's mother reports that her child will only eat peanut butter and jelly sandwiches for several days in a row. The child will then refuse to eat them for several weeks. Which term would the nurse use to document this behavior? A. Physiologic anorexia B. Echolalia C. Food jag D. Egocentrism

An 18-month-old child is admitted with signs of increased intracranial pressure. What should the nurse observe when assessing this patient? A. Numbness of fingers and decreased temperature B. Increased pulse rate and decreased blood pressure C. Increased temperature and decreased respiratory rate D. Decreased level of consciousness and increased respiratory rate

An 8-year-old child with no past medical history is brought to the emergency department after experiencing a tonic-clonic seizure at soccer practice. The child's parent states, "I cannot believe my child has epilepsy." What is the nurse's best response? A. "Try not to worry; epilepsy is easily treated for most children." B. "Your child can still do normal things just like other children." C. "This seizure may or may not mean that your child has epilepsy." D. "Your child has had only one seizure; I doubt it will happen again."

An adolescent has recently been diagnosed with epilepsy. To help the client adjust to the new diagnosis, the nurse must consider which characteristic of psychosocial development common to this age group? A. Desire to cultivate a close relationship with parents B. Decision-making process that is highly analytical C. Fear of being viewed as different by peer group D. Constant focus on consequences of actions

An adolescent is brought to the emergency department by the parents after being found unresponsive but breathing. The client's neurological assessment is within defined limits upon admission. The nurse should incorporate which principle of growth and development into the care of this client? A. Parents should remain with the client throughout all assessments and testing. B. The client should be taken to a private room, away from the parents, until all evaluations are complete. C. Parents should step out of the client's room for the nurse to perform a head-to-toe assessment. D. The client should be asked if he or she would like for the parents to remain in the room throughout all evaluations.

An infant failed to pass meconium w/in the 1st 24hrs after birth; this may indicate which of the following? A. celiac disease B. intussusception C. Hirschsprung's disease D. abdominal-wall defect

An infant is being treated for bronchiolitis. The infant's parent asks the nurse why this condition has such an adverse effect on the infant's breathing. The nurse's response is based on which fact? A. Infants are obligate mouth breathers and have smaller tongues. B. Infants have cylindrical tracheas and longer necks than adults. C. Infants have a cartilaginous trachea and smaller bronchi than adults. D. Infants have a smaller number of bronchioles and alveoli than adults.

An infant is diagnosed with bronchiolitis. The nurse is teaching the parent of how to use a bulb suction to clear the infant's airway. What is the best way for the nurse to evaluate the effectiveness of the teaching? A. Guide the parent step by step through the procedure. B. Have the parent verbalize each step of the procedure. C. Observe the parent as he/she suctions the infant. D. Provide the parent with written instructions of the procedure.

An otherwise healthy 18-month-old child with a history of febrile seizures is in the well-child clinic. Which statement by the father would indicate to the nurse that additional teaching should be done? A. "I have ibuprofen available in case it's needed." B. "My child will likely outgrow these seizures by age 5." C. "I always keep phenobarbital with me in case of a fever." D. "The most likely time for a seizure is when the fever is rising."

Assessing 7 yo psychosocial development. Which finding should nurse recognize as an indicator for FURTHER eval? A. Child prefers same sex playmates B. Child is competitive when playing board games C. Child complains daily about going to school D. Child enjoys spending time alone

Assessing a 30 mo at a well child visit. Which finding requires FURTHER assessment? A. primary dentition is complete B. unable to hop on 1 foot C. birth weight is tripled D. able to state first & last name

During a well-child checkup, the mother of a 5-year-old girl reports her daughter seems much smaller than her 2 older children did at this same age. A review of the medical record reveals that the child is 44 inches tall and weighs 42 pounds. What information should be included in the response by the nurse? A. "Your daughter is within normal limits for her weight but she is slightly shorter in stature than other children her age." B. "Your daughter is within the acceptable range for her height but she is significantly smaller in weight for her age." C. "Your daughter is slightly taller than other children her age but her weight is normal." D. "The weight of your daughter at this time is with normal limits for her age but she is moderately taller than other children her age."

Expected G&D of school aged children. A. 7yo prefers to play w/ children of different gender B. 6yo should understand the concept of cause & effect C. 6 yo should be able to count 13 coins D. 8yo should be able to wash their own hair independently

For which child's behavior should the nurse identify as being characteristic of separation anxiety disorder? A. An 8-month-old who cries when left with strangers B. A 7-year-old who withdraws from contact with all strangers C. An 8-year-old who will not stay overnight at a friend's house D. A 10-year-old who reports headaches if there is to be a test in school

Fred is a 12-year-old boy diagnosed with pneumococcal pneumonia. Which of the following would Nurse Nica expect to assess? A. Mild cough B. Slight fever C. Chest pain D. Bulging fontanel

In the emergency room, the nurse is assessing a toddler who is currently being treated for a radius fracture and has a history of multiple fractures. The assessment reveals short stature, blue sclera, and no bruising or swelling at the fracture site. The nurse suspects: A. Child abuse. B. Attention deficit/hyperactivity disorder. C. Osteogenesis imperfecta. D. Lack of parental supervision.

Significance of playing peek-a-boo with an 8mo? A. Hand-eye coordination B. Sense of trust C. Object permanence D. Egocentrism

Talking to a parent of 4mo about G&D. Which indicates that the parent NEEDS further teaching? A. I need to remind my older kids to keep small objects out of the baby's reach B. I let my baby play on her stomach when she is awake & I am watching C. My baby loves to play w/ pillows in her crib

The adoptive parents of a child who is 7 years old and HIV positive are concerned about telling their child about his condition. What information can be provided by the nurse? A. The child should not have information about their health provided at this age. B. Children at this age should have full disclosure of their condition. C. When providing health information to a child of this age it should be simplistic and at the child's level of understanding. D. Once a child is apprised of their health concerns they do not normally experience any after affects.

The mother of a 3-month-old baby is concerned because the child is not able to sit independently. How should the nurse respond to this mother's concern? A. Most babies sit steadily at 3 months. B. Most babies sit steadily at 4 months. C. Most babies do not sit steadily until 8 months. D. Sitting ability and the age of first tooth eruption are correlated.

The nurse assesses a 2-year-old toddler for a normal checkup. The client is accompanied by a parent. Which action is appropriate for the assessment? A. Ask the toddler to rate the pain on a scale from 1 to 10. B. Begin with a brief animated video that explains the purpose of an assessment. C. Let the toddler play with a stethoscope before auscultating breath sounds. D. Instruct the child to move from the parent's lap to the examination table.

The nurse assesses a toddler who is hospitalized with a diagnosis of dehydration with vomiting and diarrhea for 3 days. Which assessment finding requires immediate intervention by the nurse? A. Urine output of 1 ml/kg/hr B. Weight loss of 8 oz (2.3 kg) over 7 days C. Lethargy D. Temperature of 102°F (38.9°C)

The nurse has completed an education program on normal communication abilities in the preschool child. Which statement by a participant indicates a need for further education? A. "It is normal that my 4-year-old asks so many questions." B. "I'm glad to know that is normal that my 4-year-old cannot count to 10 yet." C. "I'm concerned that my 5-year-old can only count to 20." D. "I'm concerned that my 5-year-old cannot say his name and address."

The nurse is assessing a 4-year-old child. Which assessment finding would the nurse identify as being of the highest concern? A. Hops on one foot. B. Copies capital letters. C. Stands on one foot for about 3 seconds. D. Draws a person with 4 body parts.

The nurse is assessing a 6-week-old infant in the clinic. Which characteristic represents normal language development for this age? A. Cooing B. Laughing out loud C. Babbling D. Producing noises when spoken to

The nurse is collecting data on a 5-year-old child admitted with the diagnosis of congestive heart failure. Which clinical manifestation observed during the physical assessment would be consistent with this diagnosis? A. Jerking movements of the arms and legs B. Scissoring of the legs with toes pointed down C. Failure to gain weight D. Spooning of the finger nails

The nurse is completing the physical assessment of a 12-year-old child who has a series of bruises in various stages of healing. When asked about the bruises the child appears frightened and offers inconsistent accounts about how the child got the bruises. The nurse suspects abuse. Which initial action of the nurse is most appropriate? A. Take photographs of the bruises. B. Ask the child to provide a written statement of how he or she got the bruises. C. Document the bruises and any statements made by the child relating to them. D. Interview the child's parents about the origin of the bruises

The nurse is doing an in-service training on clinical manifestations seen in communicable diseases. Which best describes a macule? A. Redness of the skin produced by congestion of the capillaries B. Small, circumscribed, solid elevation of the skin C. Discolored skin spot not elevated at the surface D. Small elevation of epidermis filled with a viscous fluid

The nurse is instructing the parents of a child with sickle cell anemia on safety precautions. What should the nurse emphasize during this teaching? A. Suggest the child participate in sports activities without restriction. B. Treat upper respiratory infections with over-the-counter medication. C. Ensure a consistent and daily intake of adequate fluids to prevent dehydration. D. Remind to avoid immunizations to prevent the introduction of bacteria into the body.

The nurse is monitoring an infant with congenital heart disease closely for signs of HF. The nurse should assess the infant for which early sign of HF? A. pallor B. cough C. tachycardia D. slow & shallow breathing

The nurse is performing a physical assessment on an 11-year-old child. Which assessment finding indicates an abnormal finding at this age? A. Dry skin B. Tanner stage III C. Striae distensae on hips D. Respiratory rate of 22 breaths/min

The nurse is providing anticipatory guidance to a mother to help promote healthy sleep for her 3-week-old baby. Which recommended guideline might be included in the teaching plan? A. Place the baby on a soft mattress with a firm, flat pillow for the head. B. Place the head of the bed near the window to provide fresh air, weather permitting. C. Place the baby on his or her back when sleeping. D. If the baby sleeps through the night, wake him or her up for the night feeding

The nurse is providing dietary education to a 7-year-old child with type 1 diabetes. Which statement by the child demonstrates an understanding of his or her dietary needs? A. "It is better if I eat 2 to 3 large meals a day." B. "I will not be able to participate in school sports." C. "I need to count my carbohydrates for each meal." D. "As long as I give myself the right dose of insulin, I can eat whatever I want."

The nurse is providing education to a teen mother about her 20-month-old daughter's growth. The teen says her daughter seems to have such a big head. What information should the nurse include in the response? A. Some children have large heads but that does not signal a problem. B. Explain that the child looks normal. C. Share that the heads of children at this age are large in proportion to the rest of their body. D. Teach the mother that this larger head than body appearance will be this way until the child is about 6 years old.

The nurse is weighing a 2-month-old newborn during a clinic visit. The newborn weighs 6 lb 5 oz (2948 g). At birth, the newborn weighed 5 lb 13 oz (2637 g). What should the nurse document regarding the newborn's weight? A. The newborn has gained an adequate amount of weight for age. B. Weight gain is slightly under what it should be at this age. C. Weight gain is inadequate and indicates failure to thrive. D. The number of feedings per day is needed to determine the adequacy of weight gain.

The nurse takes a call from a concerned mother whose infant received routine immunizations the day before and now has a temperature of 101oF (38.3oC), is fussy and pulling at the injection site. The mother wants to know what she should do. Which is the best response from the nurse to this mother? A. "You need to bring the baby to the emergency department to be sure he is not having an allergic reaction." B. "All babies have similar reactions but you should call back if he is still fussy in 24 hours." C. "This is a common reaction. Give your child acetaminophen, cuddle him, and apply a cool compress to the injection site." D. "You can give your child ice cold fluids and cover the injection site so that he doesn't scratch the site and get it infected."

The parent of child who has been diagnosed with acute lymphoblastic leukemia (ALL) approaches the nurse's station asking to speak to the child's nurse. The parent is visibly upset and confides in the nurse concerns about the child's condition. What is the best action for the nurse to take? A. Assure the parent that the child's treatment is going well. B. Call the health care provider and recommend a family conference. C. Ask the parent to talk more about his or her concerns about the child's condition. D. Tell the parent to be careful not to show fear in front of the child

The parents of a 10-year-old boy report they are having problems with their son. The child's mother reports her son is not a talented athlete but her husband continues to encourage him to play and try to excel. The child's father reports sports will help his son build character. What response by the nurse is most appropriate? A. "Encouraging involvement in sports can build valuable skills for a child." B. "Although your son is not a talented athlete, continue to encourage him to try." C. "Perhaps another pursuit would be better suited for your son." D. "It is important not to let him quit without trying."

The parents of a child with a history of seizures who has been taking phenytoin (Dilantin) ask the nurse why it's difficult to maintain therapeutic plasma levels of this medication. Which statement by the nurse would be most accurate? A. "A drop in the plasma drug level will lead to a toxic state." B. "The capacity to metabolize the drug becomes overwhelmed over time." C. "Small increments in dosage lead to sharp increases in plasma drug levels." D. "Large increments in dosage lead to a more rapid stabilizing therapeutic effect."

What should be included in the teaching plan for a child with type 1 diabetes mellitus who is going home on insulin therapy? A. Children show an increased need for insulin during the first months after glucose control is established. B. Once glucose control is established, there will never be a need for an increase in the amount of insulin administered. C. It is absolutely normal for the growing child to require an increase in insulin; this does not mean his/her condition is getting worse. D. All children should be on at least two types of insulin to establish glucose control.

What will be the nurse's next action after noting dimpling and a tuft of hair located in the lumbosacral area of the preschool child during examination? A. Snip the tuft of hair off close to the skin for hygienic reasons B. Move on to other assessments without calling attention to the difference C. Record and refer the finding for follow-up to the pediatrician D. Inspect for precocious hair growth in the genital and underarm areas

When interviewed by the school nurse, a 13-year-old adolescent female states she has a boyfriend and that her parents do not talk about sex with her. She says is confused about the facts and wants to know the truth. Which approach would best address this adolescent's concerns? A. Explain that a discussion about sex is best handled by her parents and she should go home and ask them. B. Offer to provide her some brochures to help her better understand how her body works. C. Sit down with her and openly discuss her concerns and questions in an honest, straightforward manner. D. Refer the adolescent to a local health department for sexual counseling and pregnancy prevention.

Which of the following times should the nurse advise the parent to perform the tape test for pinwoms A. STAT after she has a BM B. after being on a clear diet for 24 hours C. STAT after child wakes in AM D. after soaking for 20 mins in warm bath

Which piece of equipment is most helpful in determining airway obstruction in the client with asthma? A. A nebulizer B. An inhaler C. A peak flow meter D. An incentive spirometer

A 15-year-old male complains of persistent scrotal pain, edema, and nausea since being hit in the groin by a baseball 3 hours ago. Which is the priority action by the nurse? A. Applying an ice pack to alleviate the pain B. Documenting the swelling and discoloration C. Administering pain medications as ordered D. Ensuring that the teen is assessed by the physician immediately

A 6-month-old girl weighs 14.7 pounds (6.7 kg) during a scheduled check-up. Her birth weight was 8 pounds (3.6 kg). What is the priority nursing intervention? A. Talking about solid food consumption B. Discouraging daily fruit juice intake C. Increasing the number of breast-feedings D. Discussing the child's feeding patterns

A 7yo was Dx w/ minimal-change nephrotic syndrome; which of the following Sxs are characteristics of this? A. hypertension, edema, hematuria B. hypertension, edema, proteinuria C. gross hematuria, fever, proteinuria D. poor appetiie, edema, proteinura

A child is admitted to the hospital with a diagnosis of dehydration. The family is originally from the Middle East and practices the Islamic faith. While conducting the admission assessment, the nurse notices that whenever questions are asked, only the father answers. What action should the nurse take? A. Explain to the father that the mother needs to be involved in the assessment as well. B. Ask the mother if she would feel more comfortable with an interpreter present. C. Realize that the father is very controlling and the mother is intimidated by him. D. Continue to direct questions to both parents with the understanding that in this culture, the father makes healthcare decisions

A client has been admitted to the general pediatric unit at a children's hospital for epileptic seizures. During the admission assessment, the client's parent states, "We have had some trouble getting all our medications from the pharmacy since we lost our health insurance coverage a few months ago." What is the nurse's best response? A. "You should really find a way to get your child's seizure medications; they are really important." B. "Have you considered giving half a dose every day, so each refill lasts longer?" C. "I know they are expensive; maybe you could try an alternative therapy to help with managing your child's seizures." D. "There may be a prescription assistance program available to help. Would you like for me to contact a case manager for you?"

A clinic nurse is developing a plan of care with the parent of a formula-fed infant diagnosed with nonorganic failure to thrive. The parent states, "I do not understand how my infant has been diagnosed with failure to thrive." What is the nurse's best response? A. "Your infant's body has been unable to absorb the nutrients from the foods the infant has been eating." B. "Illnesses leading to malabsorption can lead to nonorganic failure to thrive." C. "Your infants reflux has caused the infant to lose weight, which led to the diagnosis." D. "When formula is mixed inappropriately it may lead to nonorganic failure to thrive."

A clinic nurse is providing teaching to the parent of a 1mo who has gastroesophageal reflux. Which of the following statements by the parent indicates an understanding of the teaching? A. I will give lansoprazole 30 min after my baby's feedings B. I will lay my baby on her side after feedings C. I will give my baby a bottle just before bedtime D. I will add rice cereal to my baby's feedings

A nurse has provided care to several 2-year-old toddlers in the pediatric clinic. In reviewing the children's growth and development, which toddler should the nurse refer for evaluation? A. Has a temper tantrum in the waiting room B. Prefers reaching for things with left hand C. Carries several blocks to the exam room D. Consistently walks on the tiptoes

A nurse in an ED is assessing a child who is experiencing an acute asthma exacerbation. Which of the following findings is the priority for the nurse to report to the provider? A. excessively prolonged expiration B. increased diaphoresis C. increased production of frothy sputum D. sudden decrease in wheezing

A nurse is assessing a preschooler who has HIV. Which of the following manifestations should the nurse expect? A. generalized petechiae B. jaundice C. obesity D. chronic diarrhea

A nurse is assessing a school-aged child who has acute glomerulonephritis. Which of the following manifestations should the nurse expect? A. hypokalemia B. decreased BP C. increased urine vol D. periorbital edema

A nurse is assessing a toddler who has AIDS. Which of the following findings is an indication of an opportunistic infection? A. Koplik spots B. peripheral neuropathy C. chancre D. candidiasis

A nurse is assessing an adolescent who has sustained a broken tibia. Following the application of a fiberglass cast, the adolescent reports pain and a tingling feeling in the limb. Which of the following actions should the nurse take first? A. give the adolescent ibuprofen B. elevate the adolescent's leg on pillows C. place an ice pack on the cast D. assess for manifestations of circulatory impairment

A nurse is caring for a 4mo infant who has meningitis. Which of the following findings is associated w/ this Dx? A. depressed anterior fontanel B. constipation C. presence of the rooting reflex D. high-pitched cry

A nurse is caring for a 5yo child who has a fever & begins to have a seizure. Which of the following actions should the nurse take? A. give acetaminophen 240 mg PO immediately following the seizure B. sponge the child's skin w/ a mixture of cold water & rubbing alcohol C. administer rectal diazepam if the seizure lasts longer than 2 mins D. place the child in a side-lying position

A nurse is caring for a 6mo infant & has moderate dehydration. Which of the following findings should the nurse expect? A. absent tears B. Wt loss >10% C. lethargy D. dry mucous membranes

A nurse is caring for a child who has suspected nephrotic syndrome. Which of the following lab values should the nurse expect? A. platelets 120,000 B. sodium 160 C. Hgb 9 D. cholesterol 700

A nurse is caring for a child who has tetralogy of Fallot. Which of the following lab values should the nurse expect to find? A. Platelet count of 20,000 B. WBC 4,000 C. Thyroid stimulation hormone 7.0 D. RBC 6.8 million

A nurse is caring for a school-aged child who has acute post-streptococcal glomerulonephritis. Which of the following manifestations should the nurse expect? A. hypotension B. elevated serum lipid levels C. decreased serum potassium levels D. hematuria

A nurse is caring for a10-year-old child diagnosed with severe asthma. The health care provider has prescribed intravenous methyl-prednisolone. Based on this information, the nurse should be alert for what potential adverse effect? A. Nasal congestion B. Nervousness C. Decreased inflammation D. Hyperglycemia

A nurse is caring for an adolescent diagnosed with a fractured radius. The fracture is casted in a short cast from below the elbow down to the hand with fingers and thumb exposed. Which client goal has priority for the nurse's plan of care? A. Maintain a pain rating of 3 on a scale of 1 to 10. B. The client verbalizes an understanding of cast care. C. The family verbalizes measures to prevent fractures. D. Capillary refill is maintained at less than 2 seconds.

A nurse is caring for an infant newly admitted for suspected bronchiolitis. The infant's parent is very upset and states "I am so worried about my infant. What can you do to help my infant?" What is the nurse's best response? A. "There is no need to worry; we care for cases like this all the time." B. "I know this is hard for you but do not worry. We will be able to discharge your infant in a few days." C. "No worries; having you hold the infant is very helpful. The infant will be back at home in no time." D. "I know it is difficult to see your infant like this. We will suction your infant and give oxygen to make the infant comfortable.

A nurse is planning care for a child who has meningococcal meningitis. Which of the following isolation precautions should the nurse plan to implement? A. airborne precautions B. contract precautions C. protective environment D. droplet precautions

A nurse is preparing discharge instructions for the parents of a toddler who has been hospitalized for dehydration. The nurse notes that the parents' primary language is not the dominant one, although they can speak the dominant language. What is the best way for the nurse to ensure the parents fully understand the discharge instructions? A. Provide the instructions verbally in the dominant language and in writing in both the parents' primary language and the dominant language. B. Ask the parents to bring their teenage nephew who speaks, reads, and understands the dominant language well. C. Enlist the help of an unlicensed assistive personnel who speaks the parents' primary language to translate. D. Call client services to enlist the help of an interpreter who speaks the parents' primary language.

A nurse is preparing to administer an enema to a 10mo infant. Which of the following actions should the nurse plan to take? A. administer the enema using room-temperature tap water B. insert the tubing 7.5 cm (3in) into the rectum C. position the infant sitting upright on a bedpan while administering the enema D. hold the infant's buttocks together after administering the fluid

A nurse is preparing to obtain an antistreptolysin O (ASO) titer from a child who has acute glomerulonephritis. The child's parent asks the nurse to explain the purpose of the test. Which of the following responses should the nurse provide? A. the test determines the level of antibiotics in your child's blood B. the test tells us if your child ever had measles C. the test verifies the amount of albumin in your child's blood D. the test shows us if your child had a recent strep infections

A nurse is providing care for an 8-year-old child diagnosed with a severe asthma exacerbation. The child is receiving oxygen therapy, albuterol nebulizer treatments, and intravenous methylprednisolone. Based on this information, which laboratory result should the nurse monitor? A. Calcium B. Sodium C. Magnesium D. Glucose

A nurse is providing care to a 12-year-old child who has injured an arm while playing football. The client states, "I cannot believe I did this! Does this mean I will not be able to play for the rest of the season?" Which response by the nurse is most therapeutic? A. "It is hard to say, but it is not unusual for kids to break bones while playing sports." B. "Do not worry, we will take an x-ray and get you back on the field in no time." C. "There is a possibility that your arm is broken and that you will have to sit out the rest of the season." D. "I know this is hard for you, but we will not know when you can play again until we know for sure if your arm is broken."

A nurse is providing care to an adolescent client diagnosed with a fractured humerus. The client has a long arm cast in place. The nurse has completed an assessment. Which assessment finding requires the nurse to contact the health care provider? A. Pain rating of 5 out of 10 B. Mild itching under the cast C. Capillary refill of 1 second D. Pale, dusky nail beds

A nurse is providing discharge instructions to the parents of a child who has received chemotherapy treatments. The nurse is discussing infection prevention. Which statement by the parents indicates additional teaching is needed? A. "Good personal hygiene, especially hand washing, will help to prevent infection." B. "I will remind the pediatrician that my child cannot receive any live vaccines right now." C. "We will make sure our child is not exposed to anyone with a contagious illness." D. "My child has mouth sores from the chemotherapy, so I will take a rectal temperature if needed."

A nurse is providing discharge teaching on cast care to the family of a 12-year-old child diagnosed with a fractured arm. What is the best way for the nurse to evaluate the effectiveness of the teaching? A. Ask the family if they have questions about the instructions. B. Provide the family with step-by-step written instructions. C. Ask the family if they understand the instructions. D. Have the family describe how to care for a cast.

A nurse is providing teaching to a 12yo who is recovering from an acute episode of hemophilia A. Which of the following statements should the nurse include in the teaching? A. Have your parent stretch & move your legs for you B. Apply heat to joints that become painful, stiff & swollen C. Take aspirin at the first sign of a HA D. You will be able to participate in physical exercises

A nurse is reviewing lab findings of an adolescent who has acute renal failure. Which of the following findings should the nurse expect? A. hypokalemia B. hypercalcemia C. decreased plasma creatinine level D. metabolic acidosis

A nurse is reviewing the morning lab results of an infant who is receiving digoxin & furosemide for the Tx of HF. Which of the following findings should the nurse report to dr? A. Sodium 140 B. Calcium 10.2 C. Chloride 100 D. Potassium 3.2

A nurse is teaching the parents of an infant who has congenital hypothyroidism. Which of the following directions should the nurse provide? A. your child will need to take estrogen daily when she reaches puberty B. your child will need monthly blood coagulation studies C. your child will need surgery to remove the diseased thyroid D. your child will need to take thyroid hormone replacement for her entire life

A parent brings the 7-week-old newborn to the emergency department because the newborn has been "too sleepy" and "just does not seem right." After completing a health history and assessment, the nurse suspects that the newborn may have developed congestive heart failure. Which statement made by the parent best supports the nurse's suspicion? A. "My other kids did not sleep as much at this age as this newborn does." B. "When my newborn breathes, he or she makes a grunting noise." C. "When I nurse the newborn, he or she only takes a little before falling asleep." D. "The newborn seems most comfortable when I hold him or her up on my shoulder."

A parent brings the infant in for a wellness visit. During the visit, the parent tells the nurse "I remember our conversation about me stopping smoking. I have cut down a lot and only smoke outside on the porch." What is the best response for the nurse to make? A. "I am glad to hear about the changes you have made. Keep up the good work!" B. "You should stop smoking completely! You are still putting your baby at risk." C. "It is not enough to just smoke outside. The smoke is still in your clothes when you come inside." D. "I am glad to hear about these positive changes. However, we need to talk about this more."

A parent has brought the 2-year-old child to the emergency department. The child exhibits the following clinical manifestations: very lethargic, moaning, and barely opens the eyes when called by name. The parent states that the child vomited dinner and had two episodes of vomiting and diarrhea the night before. The nurse suspects the child is dehydrated and performs an assessment. Which finding is most indicative of dehydration? A. Temperature of 102.5°F (39.1°C) B. Capillary refill less than 3 seconds C. Lethargy D. Sticky mucous membranes

A preschool child is hospitalized with a diagnosis of leukemia and is receiving chemotherapy treatments. The child wants to go to the playroom but the recent laboratory results prohibit this. What is the best action for the nurse to take? A. Gently explain to the child the reason the child cannot go to the playroom. B. Ask the parents to bring a sibling or friend in to play with the child. C. Arrange a play date with another child on the unit who has the same diagnosis. D. Enlist the help of a child life specialist to find an activity the child can work on in his or her room.

An acute care nurse is developing a plan of care for an adolescent admitted with new-onset seizures. Which intervention should the nurse implement for this client? A. Administer medication via rectal route at onset of seizure. B. Call the health care provider for a seizure lasting longer than 15 minutes. C. Restrain the child's limbs to prevent bodily injury. D. Pad side rails of bed and have suction equipment readily available.

During a complete physical assessment of a preteen boy, the nurse correctly recognizes which finding as being the first change of puberty? A. Increase in height B. Deepening voice C. Development of axillary hair D. Testicular enlargement

In developing a plan of care for the child diagnosed with rheumatic fever, the nursing intervention that takes highest priority for this child is to: A. position the child to relieve joint pain. B. monitor the C-reactive protein and ESR levels. C. provide age-appropriate diversional activities. D. promote rest periods and bed rest

Nurse in an ED caring for an 8yo who is up to date w/ current immunization recommendations & has a deep puncture injury. Which should the nurse anticipate administering? A. Diptheria, tetanus & acellular pertussis (DTaP) B. Single injection of tetanus immune globulin (TIG) mixed w/ pediatric tetanus booster (DT) C. Tetanus, diptheria & axellular pertussis (Tdap) D. Adult tetanus booster (Td)

Nurse teaching parent of 1 mo infant who has gastroesophageal reflux. Which statement by the parent indicates an UNDERSTANDING of the Tx? A. I will give lansoprazole 30 min before fedding B. I will lay her on the side after feeding C. I will give her a bottle just before bedtime D. I will add rice cereal to my baby's feedings

Other than providing direct care to children, what is the major role of nurses in the care of nearly all children with neuromuscular disorders? A. Consoling parents B. Teaching children self-care C. Helping with specialized equipment D. Coordinating care by specialists

Parents usually ask when their child can return to school after having chickenpox. The correct answer would be: A. not until all lesions have completely faded. B. as soon as the temperature is normal. C. 10 days after the initial lesions appear. D. as soon as all lesions are crusted.

Preschooler admitted for Tx of measles. Which activities should the nurse include? A. making a model airplane B. playing video games in playroom C. pulling a wagon w/ toys in hallway D. putting together a puzzle w/ lg pieces

The clinic nurse reviews the record of an infant and notes that the PCP has documents a Dx of suspected Hirschusprung's disease. The nurse reviews the assessment findings documented, knowing that which sign most likely led the mom to seek health care for the infant? A. diarrhea B. projectile vomiting C. regurgitation of feedings D. foul-smelling ribbon-like sttols

The mother of a an 8-year-old boy with mumps tells the nurse that she does not understand how her son could have gotten mumps since he was immunized according to her physician's recommendations. What is the best response by the nurse? A. "I am sure it must be frustrating. Where did you have the immunizations performed?" B. "I am wondering if your physician followed the immunization schedule correctly?" C. "Are you sure your child received an immunization for mumps?" D. "While immunizations are highly effective they aren't 100% effective at preventing infectious diseases."

The mother of a toddler is frustrated because no matter what she asks of the child, the response is "no." What can the nurse suggest to the mother to assist with this problem? A. Pretend she does not hear the child. B. Ask no further questions to the child. C. Tell the child to never to say "no" again. D. Give the child secondary, not primary, choices.

The nurse has just completed an assessment on a child who voices an interest in how things are made and who needs support when they are not successful. The child further reports he is involved in clubs and sports outside the home. The nurse is aware that this child is in which of Erikson's states of development? A. Initiative versus guilt B. Autonomy versus shame and doubt C. Trust versus mistrust D. Industry versus inferiority

The nurse has received morning report on a group of pediatric clients. Which pediatric client will the nurse see first? A. an infant with rhinorrhea, coughing, and oxygen saturation of 92% B. a toddler with a temperature of 100.1°F (38°C), and a harsh, barking cough C. a preschool child with crackles in the right lower lobe and chest pain D. a school-age child with dysphagia, drooling, and a hoarse voice

The nurse is administering digoxin as ordered and the child vomits the dose. What should the nurse do next? A. Contact the physician. B. Offer a snack and administer another dose. C. Immediately administer another dose. D. Administer next dose as ordered in 12 hours

The nurse is assessing a 3-year-old child. Which assessment finding would the nurse identify as abnormal? A. Builds a tower of 10 cubes. B. Pedals tricycle without assistance. C. Unscrews a bolt on a toy. D. Falls when bending over to touch toes

The nurse is assessing a child w/ pyloric stenosis; she is likely to note which of the following? A. "currant jelly" stools B. regurgitation C. steatorrhea D. projectile vomiting

The nurse is assessing the social and emotional development of an 8-year-old child during an annual exam. Which finding requires further follow-up by the nurse? A. Developing hobbies B. Thinking about the future C. Giving attention to friendships D. Appearance affecting self-esteem

The nurse is caring for a 12-month-old child diagnosed with an autism spectrum disorder. What information from the mother during the health history should the nurse identify as being consistent with the disorder? A. The child speaks in complete sentences. B. The child sleeps at least 12 out of every 24 hours. C. The child responds warmly to the father but not to the mother. D. The child constantly stares at a rotating wheel on the crib mobile.

The nurse is caring for a child and notes periorbital edema on the left eye with urticaria. Which action by the nurse is priority? A. Administer a corticosteroid. B. Ask if the child has allergies. C. Evaluate fluid volume status. D. Assess lung sounds bilaterally.

The nurse is caring for a chronically ill adolescent client. What can the nurse do to maintain stimulation and support the client's sense of identity while hospitalized? A. Plan activities around scheduled rest periods. B. Explain food choices appropriate to the prescribed diet. C. Teach the name and indications for use of all medications. D. Encourage communicating with friends through social media.

The nurse is caring for a school-age child with varicella. What should the nurse observe about the rash that is associated with this infection? A. Dark red color B. Noticeable crusts but no pruritus C. Dark red, macular, very pruritic lesions D. Various stages of lesions present at the same time

The nurse is caring for an 11-year-old child. According to Erikson's stages of development, which finding is expected for a client this age? A. Developing a sense of self B. Establishing independence C. Planning and achieving goals D. Increased interaction with peers

The nurse is monitoring the CD4 count of an infant who has contracted HIV from the mother in utero. The nurse is concerned that treatment with antiretroviral therapy is not effective when noting which CD4 level? A. 1900/mm3 B. 1700/mm3 C. 1500/mm3 D. 1300/mm3

The nurse is preparing to care for a child with a Dx of intussusception. The nurse reviews the child's record and expects to note which sign of this disorder documented? A. watery diarrhea B. ribbon like stools C. profuse projectile vomiting D. bright red blood and mucus in the stools

The nurse is providing care for a 16-year-old client recently admitted for recurrent seizures. The adolescent will remain hospitalized for at least 1 week for evaluation and treatment. What action should the nurse take to foster psychosocial development during this hospitalization? A. Restrict visitation from friends and family to prevent embarrassment for the client. B. Suggest the client's grandparents visit daily. C. Contact the client's teachers and request that schoolwork be emailed to the hospital. D. Encourage the client to invite friends to visit as often as possible.

The nurse is providing discharge teaching to an adolescent newly diagnosed with epilepsy characterized by tonic-clonic seizures. Which statement by the client indicates an understanding of the teaching? A. "I will probably have lots of energy and tremors right before I have a seizure." B. "My friends may not even notice when I have a seizure because it involves a blank stare." C. "I can participate in activities like swimming and driving just like my friends." D. "Disorientation and confusion are common feelings immediately following a seizure."

The nurse is providing discharge teaching to the parents of a child who has nephrotic syndrome. Which of the following instructions should the nurse include in the teaching? A. restrict the child's potassium intake B. administer acetaminophen to the child twice daily C. weigh the child once each week D. keep the child away from people who have an infection

The nurse is providing teaching to the parents of a child with varicella. Which statement indicates that the parents have understood the instructions? A. "We should apply alcohol to the lesions every four hours." B. "If he has a fever, we can give him some aspirin." C. "The lesions should eventually form soft crusts that drain." D. "We need to make sure that he washes his hands frequently."

The nurse is reviewing safety concerns with the parents of a 7-year-old child. Which statement made by the parents is correct? A. "We will hide our firearms from our child." B. "It is okay if the bike helmet is loose fitting." C. "A shoulder belt is okay in the car when it covers the neck." D. "Our child will use a life jacket when swimming in the lake."

The nurse knows that disorders of the pituitary gland depend on the location of the physiologic abnormality. Caring for a child who has issues with the anterior pituitary, the nurse would expect the child to have issues with which hormone? A. Vasopressin B. Antidiuretic hormone C. Oxytocin D. Growth hormone

The parent of a 2-month-old newborn tells the nurse, "My relative says that I hold my newborn too much and that I should not pick the newborn up every time he or she cries. My relative says the newborn will become spoiled if I keep doing that. I am not sure what to do." What is the nurse's best response? A. "Your relative is right. The newborn will not learn to soothe oneself if you pick the newborn up every time he or she cries." B. "That is an old wives' tale. You cannot spoil a newborn that young." C. "You know your newborn has different cries for different things. Not every cry means something is wrong." D. "Holding your newborn and tending to him or her whenever he or she cries helps the newborn to build trust. You are doing the right thing.

The parent of a 5-year-old child calls the doctor's office to seek advice about proper nutrition for her child. Which statement by the mother indicates that further teaching is needed? A. "I give her three meals a day and some snacks in between if she gets hungry." B. "We offer her the same foods we are eating, just in smaller portions." C. "She loves fruit, so I give her 1 cup each day." D. "Since she doesn't like vegetables, we no longer serve them to her."

When assessing a child for the probable cause of acute bronchiolitis, the nurse focuses on which factor? A. Bacterial infections B. Environmental allergies C. Prenatal complications D. Viral infections

When assessing a infant born at 32 weeks' gestation, which finding would lead the nurse to suspect that the newborn has a patent ductus arteriosus (PDA)? A. Weak, thready pulse B. Decreased pulse rate C. High diastolic arterial pressure D. Continuous murmur on auscultation

Which is an example of the nonpharmacological strategy of thought-stopping for chronic pain management? A. assemble puzzle B. talk about a recent pleasurable event C. tighten & then relax each body part D. repeat memorized facts about the painful event

Which of the following disorders leads to cyanosis from deoxygenated blood entering the systemic arterial circulation? A Aortic stenosis (AS) B Coarctation of aorta C Patent ductus arteriosus (PDA) D Tetralogy of Fallot

A 7-year-old child is rushed into the emergency room after being stung by a yellow jacket. The child is nauseated and vomiting and is experiencing itching and swelling on the arm where stung. The is having trouble breathing. Which type of hypersensitivity response is the child experiencing? A. Type I: anaphylaxis B. Type II: cytotoxic response C. Type III: immune complex D. Type IV: cell-mediated hypersensitivity

The nurse has completed an education session with parents of children diagnosed with food allergies. Which statement by a parent would indicate a need for additional education? A. "I will make sure my daughter always has her EpiPen® with her all the time." B. "If we need to use the EpiPen® we will need to notify her physician's office the next business day." C. "I have found a website that makes medical alert bracelets in my daughter's favorite color." D. "The grey part of the EpiPen® should never be removed until right before we use it."

The nurse is providing teaching about food substitutions when cooking for the child with an allergy to eggs. Which response indicates a need for further teaching? A. "I must not feed my child eggs in any form." B. "I can use the egg white when baking, but not the yolk." C. "1 tsp yeast and 1/4 cups warm water is a substitute in baked goods." D. "1.5 Tbsp each water and oil plus 1 tsp baking powder equals one egg in a recipe."

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