Senior Seminar Peds Quiz #4

A 1-month-old infant is seen in a clinic and is diagnosed with developmental dysplasia of the hip. On assessment, the nurse understands that which finding should be noted in this condition? 1. Limited range of motion in the affected hip 2. An apparent lengthened femur on the affected side 3. Asymmetrical adduction of the affected hip when the infant is placed supine with the knees and hips flexed 4. Symmetry of the gluteal skinfolds when the infant is placed prone and the legs are extended against the examining table

1. Limited range of motion in the affected hip

The nurse notes documentation that a child is exhibiting an inability to flex the leg when the thigh is flexed anteriorly at the hip. Which condition does the nurse suspect? 1. Meningitis 2. Spinal cord injury 3. Incracranial bleeding 4. Decreased cerebral blood flow

1. Meningitis

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

2. Cover the bladder with a nonadhering plastic wrap

A 10-year-old child with asthma is treated for acute exacerbation in the ED. The nurse caring for the child should monitor for which sign, knowing that it indicates a worsening of the condition? 1. Warm, dry skin 2. Decreased wheezing 3. Pulse rate of 90 bpm 4. RR of 18 br/min

2. Decreased wheezing

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

2. Generalized edema

A mother brings her 3-week-old infant to a clinic for a PKU rescreening blood test. The test indicates a serum phenylalanine level of 1 mg/dL. The nurse reviews this result and makes which interpretation? 1. It is positive 2. It is negative 3. It is inconclusive 4. It requires rescreening at age 6 weeks

2. It is negative

The nurse is caring for an infant with bronchiolitis, and diagnostic tests have confirmed respiratory syncytial virus (RSV). On the basis of this finding, which is the most appropriate nursing action? 1. Initiate strict enteric precautions 2. Move the infant to a room with another child with RSV 3. Leave the infant in the present room because RSV is not contagious 4. Inform the staff that they must wear a mask, gloves, and a gown when caring for the child

2. Move the infant to a room with another child with RSV

A child undergoes surgical removal of brain tumor. During the postop period, the nurse notes that the child is restless, the pulse rate is elevated, and the blood pressure has decreased significantly from the baseline value. The nurse suspects that the child is in shock. Which is the most appropriate nursing action? 1. Place the child in the supine position 2. Notify the HCP 3. Place the child in the Trendelenburg position 4. Increase the flow rate of the IV fluids

2. Notify the HCP

The nurse is monitoring a child for bleeding after surgery for removal of a brain tumor. The nurse checks the head dressing for the presence of blood and notes a colorless drainage on the back of the dressing. Which intervention should the nurse perform immediately? 1. Reinforce the dressing 2. Notify the HCP 3. Document the findings and continue to monitor 4. Circle the area of drainage and continue to monitor

2. Notify the HCP

The nurse is reviewing the lab results for a child scheduled for a tonsillectomy. The nurse determines that which lab value is most significant to review? 1. Creatainine level 2. PT time 3. Sedimentation rate 4. BUN level

2. PT time

The mother of a 6-year-old child arrives at a clinic because the child has been experiencing itchy, red, and swollen eyes. The nurse notes a discharge from the eyes and sends a culture to the lab for analysis. Chlamydial conjunctivitis is diagnosed. On the basis of this diagnosis, the nurse determines that which requires further investigation? 1. Possible trauma 2. Possible sexual abuse 3. Presence of an allergy 4. Presence of a respiratory infection

2. Possible sexual abuse

The nurse admits a child to the hospital with a diagnosis of pyloric stenosis. On assessment, which data would the nurse expect to obtain when asking the parent about the child's symptoms? 1. Watery diarrhea 2. Projectile vomiting 3. Increased urine output 4. Vomiting large amounts of bile

2. Projectile vomiting

The nurse is assisting a HCP examining a 3-week-old infant with developmental dysplasia of the hip. What test or sign should the nurse expect the HCP to assess? 1. Babinski's sign 2. The Moro reflex 3. Ortolani's maneuver 4. The palmar-plantar grasp

3. Ortolani's maneuver

The nurse is caring for a child after a tonsillectomy. The nurse monitors the child, knowing that which finding indicates the child is bleeding? 1. Frequent swallowing 2. A decreased pulse rate 3. Complaints of discomfort 4. An elevation in BP

1. Frequent swallowing

The nurse analyzes the lab values of a child with leukemia who is receiving chemo. The nurse notes that the platelet count is 19,500 mm3. On the basis of this lab result, which intervention should the nurse include in the plan of care? 1. Initiate bleeding precautions 2. Monitor closely for signs of infection 3. Monitor the temp every 4 hours 4. Initiate protective isolation precautions

1. Initiate bleeding precautions

Antibiotics are prescribed for a child with otitis media who underwent a myringotomy with insertion of tympamostomy tubes. The nurse provides discharge instructions to the parents regarding the administration of the antibiotics. Which statement, if made by the parents, indicates understanding of the instructions provided? 1. "Administer the antibiotics until they are gone." 2. "Administer the antibiotics if the child has a fever." 3. "Administer the antibiotics until the child feels better." 4. "Begin to taper the antibiotics after 3 days of a full course."

1. "Administer the antibiotics until they are gone."

The home care nurse provides instructions regarding basic infection control to the parent of an infant with HIV infection. Which statement, if made by the parent, indicates the need for further instruction? 1. "I will clean up any spills from the diaper with diluted alcohol." 2. "I will wash baby bottles, nipples, and pacifiers in the dishwasher." 3. "I will be sure to prepare foods that are high in calories and high in protein." 4. "I will be sure to wash my hands carefully before and after caring for my infant."

1. "I will clean up any spills from the diaper with diluted alcohol."

An infant of a mother infected with HIV is seen in the clinic each month and is being monitored for symptoms indicative of HIV infection. With knowledge of the most common opportunistic infection of children infected with HIV, the nurse assesses the infant for which sign? 1. Cough 2. Liver failure 3. Watery stool 4. Nuchal rigidity

1. Cough

The mother of a 3-year-old child arrives at a clinic and tells the nurse that the child has been scratching the skin continuously and has developed a rash. The nurse assesses the child and suspects the presence of scabies. The nurse bases this suspicion on which finding noted on assessment of the child's skin? 1. Fine grayish red lines 2. Purple-colored lesions 3. Thick, honey-colored crusts 4. Clusters of fluid-filled vesicles

1. Fine grayish red lines

The mother of a 4-year-old child tells the pediatric nurse that the child's abdomen seems to be swollen. During further assessment, the mother tells the nurse that the child is eating well and that the activity level of the child is unchanged. The nurse, suspecting the possibility of Wilms' tumor, should avoid which during the physical assessment? 1. Palpating the abdomen for a mass 2. Assessing the urine for the presence of hematuria 3. Monitoring the temp for the presence of fever 4. Monitoring the BP for the presence of HTN

1. Palpating the abdomen for a mass

The clinic nurse reads the results of a tuberculin skin test on a 3-year-old child. The results indicate an area of induration measuring 10 mm. The nurse should interpret these results as which finding? 1. Positive 2. Negative 3. Inconclusive 4. Definitive and requiring a repeat test

1. Positive

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

1. Restrict fluids as prescribed

The nurse provides home care instructions to the parents of a child with celiac disease. The nurse should teach the parents to include which food item in the child's diet? 1. Rice 2. Oatmeal 3. Rye toast 4. Wheat bread

1. Rice

The clinic nurse is reviewing the health care provider's prescription for a child who has been diagnosed with scabies. Lindane has been prescribed for the child. The nurse questions the prescription if which is noted in the child's record? 1. The child is 18 months old 2. The child is being bottle-fed 3. A sibling is using Lindane for the treatment of scabies 4. The child has a history of frequent respiratory infections

1. The child is 18 months old

After a tonsillectomy, a child begins to vomit bright red blood. The nurse should take which initial action? 1. Turn the child to the side 2. Administer the prescribed antiemetic 3. Notify the HCP 4. Maintain NPO status

1. Turn the child to the side

The nurse is monitoring a 3-year-old child for signs and symptoms of increased ICP after a craniotomy. The nurse plans to monitor for which early sign or symptom of increased ICP? 1. Vomiting 2. Bulging anterior fontanel 3. Increasing head circumference 4. Complaints of a frontal headache

1. Vomiting

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

1. Weighing the diapers

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

3. Bacteriuria

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

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

A 4-year-old child sustains a fall at home. After an x-ray examination, the child is determined to have a fractured arm and a plaster cast is applied. The nurse provides instructions to the parents regarding care for the child's cast. Which statement by the parents indicates a need for further instruction? 1. "The cast may feel warm as the cast dries." 2. "I can use lotion or powder around the cast edges to relieve itching." 3. "A small amount of white shoe polish can touch up a solid white cast." 4. "If the cast becomes wet, a blow drier set on the cool setting may be used to dry the cast."

2. "I can use lotion or powder around the cast edges to relieve itching."

The nurse is caring for a 4-year-old child with HIV infection. The nurse should expect which statement that is aligned with the psychosocial expectations of this age? 1. "Being sick is scary." 2. "I know it hurts to die." 3. "I know I will be healthy soon." 4. "I know I am different than other kids."

2. "I know it hurts to die."

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

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

The nurse provides a teaching session to the nursing staff regarding osteosarcoma. Which statement by a member of the nursing staff indicates a need for information? 1. "The femur is the most common site of this sarcoma." 2. "The child does not experience pain at the primary tumor site." 3. "Limping, if a weight-bearing limb is affected, is a clinical manifestation." 4. "The symptoms of the disease in the early stage are almost always attributed to normal growing pains."

2. "The child does not experience pain at the primary tumor site."

The nursing student is presenting a clinical conference and discusses the cause of b-thalassemia. The nursing student informs the group that a child at greatest risk of developing this disorder is which of these? 1. A child of Mexican descent 2. A child of Mediterranean descent 3. A child whose intake of iron is extremely poor 4. A breast-fed child of a mother with chronic anemia

2. A child of Mediterranean descent

The nurse is instructing the parents of a child with iron deficiency anemia regarding the administration of a liquid oral iron supplement. Which instruction should the nurse tell the parents? 1. Administer the iron at mealtimes 2. Administer the iron through a straw 3.Mix the iron with cereal to administer 4. Add the iron to formula for easy administration

2. Administer the iron through a straw

A 4-year-old child is admitted to the hospital for abdominal pain. The mother reports that the child has been pale and excessively tired and is bruising easily. On physical examination, lymphadenopathy and hepatosplenomegaly are noted. Diagnostic studies are being performed because acute lymphocytic leukemia is suspected. The nurse determines that which lab result confirms the diagnosis? 1. Lumbar puncture showing no blast cells 2. Bone marrow biopsy showing blast cells 3. Platelet count of 350,000 mm3 4. WBC count 4500 mm3

2. Bone marrow biopsy showing blast cells

An infant with a diagnosis of hydrocephalus is scheduled for surgery. Which is the priority nursing intervention in the preop period? 1. Test the urine for protein 2. Reposition the infant frequently 3. Provide a stimulating environment 4. Assess BP every 15 minutes

2. Reposition the infant frequently

The nurse is preparing to care for a child after a tonsillectomy. The nurse documents on the plan of care to place the child in which position? 1. Supine 2. Side-lying 3. High Fowler's 4. Trendelenburg

2. Side-lying

After a tonsillectomy, the nurse reviews the HCP's postop prescriptions. Which prescription should the nurse question? 1. Monitor for bleeding 2. Suction every 2 hours 3. Give no milk or milk products 4. Give clear, cool liquids when awake and alert

2. Suction every 2 hours

The day care nurse is observing a 2-year-old child and suspects that the child may have strabismus. Which observarion made by the nurse indicates the presence of this condition? 1. The child has difficulty hearing 2. The child consistently tilts the head to see 3. The child does not respond when spoken to 4. The child consistently turns the head to hear

2. The child consistently tilts the head to see

The ED nurse is caring for a child diagnosed with epiglottitis. In assessing the child, the nurse should monitor for which indication that the child may be experiencing airway obstruction? 1. The child exhibits nasal flaring and bradycardia 2. The child is leaning forward, with the chin thrust out 3. The child has a low-grade fever and complains of a sore throat 4. The child is leaning backward, supporting himself or herself with the hands and arms

2. The child is leaning forward, with the chin thrust out

The clinic nurse is instructing the parent of a child with HIV infection regarding immunizations. The nurse should provide which instruction to the parent? 1. The hepatitis B vaccine will not be given to the child 2. The inactivated influenza vaccine will be given yearly 3. The varicella vaccine will be given before 6 months of age 4. A Western blot test needs to be performed and the results evaluated before immunizations

2. The inactivated influenza vaccine will be given yearly

The nurse is providing medication instructions to a parent. Which statement by the parent indicates a need for further instruction? 1. "I should cuddle my child after giving the medication." 2. "I can give my child a frozen juice bar after he swallows the medication 3. " I should mix the medication in the baby food and give it when I feed my child." 4. "If my child does not like the taste of the medicine, I should encourage him to pinch his nose and drink the medication through a straw."

3. " I should mix the medication in the baby food and give it when I feed my child."

The mother of a hospitalized 2-year-old child with viral laryngotracheobronchitis (croup) asks the nurse why the HCP did not prescribe antibiotics. Which response should the nurse make? 1. "The child may be allergic to antibiotics." 2. "The child is too young to receive antibiotics." 3. "Antibiotics are not indicated unless a bacterial infection is present." 4. "The child still has the maternal antibodies from birth and does not need antibiotics."

3. "Antibiotics are not indicated unless a bacterial infection is present."

A 6-year-old child with HIV infection has been admitted to the hospital for pain management. The child asks the nurse if the pain will ever go away. The nurse should make which best response to the child? 1. "The pain will go away if you lie still and let the medicine work." 2. "Try not to think about it. The more you think it hurts, the more it will hurt." 3. "I know it must hurt, but if you tell me when it does, I will try to make it hurt a little less." 4. "Every time it hurts, press on the call button and I will give you something to make the pain go all away."

3. "I know it must hurt, but if you tell me when it does, I will try to make it hurt a little less."

Parents bring their 2-week-old infant to a clinic for treatment after a diagnosis of clubfoot made at birth. Which statement by the parents indicates a need for further teaching regarding this disorder? 1. "Treatment needs to be started as soon as possible." 2. "I realize my infant will require follow-up care until fully grown." 3. "I need to bring my infant back to the clinic in 1 month for a new cast." 4. "I need to come to the clinic every week with my infant for the casting."

3. "I need to bring my infant back to the clinic in 1 month for a new cast."

The nurse is providing instructions to the parents of a child with scoliosis regarding the use of a brace. Which statement by the parents indicates a need for further instruction? 1. "I will encourage my child to perform prescribed exercises." 2. "I will have my child wear soft fabric clothing under the brace." 3. "I should apply lotion under the brace to prevent skin breakdown." 4. "I should avoid the use of powder because it will cake under the brace."

3. "I should apply lotion under the brace to prevent skin breakdown."

The nurse prepares a teaching plan for the mother of a child diagnosed with bacterial conjunctivitis. Which, if stated by the mother, indicates a need for further teaching? 1. "I need to wash my hands frequently." 2. "I need to clean the eye as prescribed." 3. "It is okay to share towels and washcloths." 4. "I need to give the eye drops as prescribed."

3. "It is okay to share towels and washcloths."

The school nurse has provided an instructional session about impetigo to parents of the children attending the school. Which statement, if made by a parent, indicates a need for further instruction? 1. "It is extremely contagious." 2. "It is most common in humid weather." 3. "Lesions most often are located on the arms and chest." 4. "It might show up in an area of broken skin, such as an insect bite."

3. "Lesions most often are located on the arms and chest."

A 6-year-old child with leukemia is hospitalized and is receiving combination chemo. Lab results indicate that the child is neutropenic, and protective isolation procedures are initiated. The grandmother of the child visits and brings a fresh bouquet of flowers picked from her garden, and asks the nurse for a vase for the flowers. Which response should the nurse provide to the grandmother? 1. "I have a vase in the utility room, and I will get it for you." 2. "I will get the vase and wash it well before you put the flowers in it." 3. "The flowers from your garden are beautiful, but should not be placed in the child's room at this time." 4. "When you bring the flowers into the room, place them on the bedside stand as far away from the child as possible."

3. "The flowers from your garden are beautiful, but should not be placed in the child's room at this time."

The parents of a child with juvenile idiopathic arthritis call the clinic nurse because the child is experiencing a painful exacerbation of the disease. The parents ask the nurse if the child can perform range-of-motion exercises at this time. The nurse should make which response? 1. "Avoid all exercise during painful periods." 2. "Range-of-motion exercises must be performed every day." 3. "have the child perform simple isometric exercises during this time." 4. "Administer additional pain meds before performing range-of-motion exercises."

3. "have the child perform simple isometric exercises during this time."

Sulfisoxazole, 1 g orally twice daily, is prescribed for an adolescent with a urinary tract infection. The medication label reads "500-mg tablets." The nurse has determined that the dosage prescribed is safe. The nurse administers how many tablets perdose to the adolescent? 1. 1/2 tablet 2. 1 tablet 3. 2 tablets 4. 3 tablets

3. 2 tablets

A pediatric client with ventricular septal defect repair is placed on a maintenance dosage of digoxin. The dosage is 8 mcg/kg.day, and the client's weight is 7.2 kg. The HCP prescribes the digoxin to be given 2x daily. The nurse prepares how many mcg of digoxin to administer to the client at each dose? 1. 12.6 mcg 2. 21.4 mcg 3. 28.8 mcg 4. 32.2 mcg

3. 28.8 mcg

The parents of a child recently diagnosed with cerebral palsy ask the nurse about the limitations of the disorder. The nurse responds by explaining that the limitations occur as a result of which pathophysiological process? 1. An infectious disease of the CNS 2. An inflammation of the brain as a result of a viral illness 3. A chronic disability characterized by impaired muscle movement and posture 4. A congenital condition that results in moderate to severe intellectual disabilities

3. A chronic disability characterized by impaired muscle movement and posture

The nurse is monitoring a child with burns during treatment for burn shock. Which assessment provides the most accurate guide to determine the adequacy of fluid resuscitation? 1. Skin Turgor 2. Level of edema at burn site 3. Adequacy of capillary filling 4. Amount of fluid tolerated in 24 hours

3. Adequacy of capillary filling

A child has fluid volume deficit. The nurse performs an assessment and determines that the child is improving and the deficit is resolving if which finding is noted? 1. The child has no tears 2. Urine specific gravity is 1.035 3. Cap refill is less than 2 seconds 4. Urine output is less than 1 mL/kg/hour

3. Cap refill is less than 2 seconds

The nurse reviews the record of a newborn infant and notes that a diagnosis of esophageal atresia with tracheoesophageal fistula is suspected. The nurse expects to note which most likely sign of this condition documented in the record? 1. Incessant crying 2. Coughing at night time 3. Choking with feedings 4. Severe projectile vomiting

3. Choking with feedings

A lumber puncture is performed on a child suspected to have bacterial meningitis, and CSF is obtained for analysis. The nurse reviews the results of the CSF analysis and determines that which results would verify the diagnosis? 1. Clear CSF, decreased pressure, and elevated protein level 2. Clear CSF, elevated protein, and decreased glucose levels 3. Cloudy CSF, elevated protein, and decreased glucose levels 4. Cloudy CSF, decreased protein, and decreased glucose levels

3. Cloudy CSF, elevated protein, and decreased glucose levels

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

3. Conjunctival hyperemia

The mother of a 6-year-old child who has type 1 DM calls a clinic nurse and tells the nurse that the child has been sick. The mother reports that she checked the child's urine and it was positive for ketones. The nurse should instruct the mother to take which action? 1. Hold the next dose of insulin 2. Come to the clinic immediately 3. Encourage the child to drink liquids 4. Administer an additional dose of regular insulin

3. Encourage the child to drink liquids

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

3. Exercise intolerance

The nurse is caring for a newborn with a suspected diagnosis of inperforate anus. The nurse monitors the infant, knowing that which is a clinical manifestation associated with this disorder? 1. Bile'stained fecal emesis 2. The passage of currant jelly-like stools 3. Failure to pass meconium stool in the first 24 hours after birth 4. Sausage-shaped mass palpated in the upper right abdominal quadrant

3. Failure to pass meconium stool in the first 24 hours after birth

A 10-year-old child with hemophilia A has slipped on the ice and bumped his knee. The nurse should prepare to administer which prescription? 1. Injection of factor X 2. IV infusion of iron 3. IV infusion of factor VIII 4. IM injection of iron using the Z-track method

3. IV infusion of factor VIII

An infant has just returned to the nursing unit after surgical repair of a cleft lip on the right side. The nurse should place the infant in which best position at this time? 1. Prone position 2. On the stomach 3. Left lateral position 4. Right lateral position

3. Left lateral position

A child is hospitalized because of persistent vomiting. The nurse should monitor the child closely for which problem? 1. Diarrhea 2. Metabolic acidosis 3. Metabolic alkalosis 4. Hyperactive bowel sounds

3. Metabolic alkalosis

The nurse is assigned to care for an 8-year-old child with a diagnosis of a basilar skull fracture. The nurse reviews the HCP's prescriptions and should contact the HCP to question which prescription? 1. Obtain daily weight 2. Provide clear liquid intake 3. Nasotracheal suction as needed 4. Maintain a patent IV line

3. Nasotracheal suction as needed

The nurse is reviewing the record of a child with increased ICP and notes that the child has exhibited signs of decerebrate posturing. On assessment of the child, the nurse expects to note which characteristic of this type of posturing? 1. Flaccid paralysis of all extremities 2. Adduction of the arms at the shoulders 3. Rigid extension and pronation of the arms and legs 4. Abnormal flexion of the upper extremities and extension and adduction of the lower extremities

3. Rigid extension and pronation of the arms and legs

The nurse is providing home care instructions to the parents of a 10-year-old child with hemophilia. Which sport activity should the nurse suggest for this child? 1. Soccer 2. Basketball 3. Swimming 4. Field hockey

3. Swimming

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

3. Tachycardia

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

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

A child with rheumatic fever will be arriving to the nursing unit for admission. On admission assessment, the nurse should ask the parents which question to elicit assessment information specific to the development of rheumatic fever? 1. "Has the child complained of back pain?" 2. "Has the child complained of headaches?" 3. "Has the child had any nausea or vomiting?" 4. "Did the child have a sore throat or fever within the last 2 months?"

4. "Did the child have a sore throat or fever within the last 2 months?"

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

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

The nurse provides home care instructions to the parent of a child with AIDS. Which statement by the parent indicates the need for further teaching? 1. "I will wash my hands frequently." 2. "I will keep my child's immunizations up to date." 3. "I will avoid direct unprotected contact with my child's bodily fluids." 4. "I can send my child to day care if he has a fever, as long as it is a low-grade fever."

4. "I can send my child to day care if he has a fever, as long as it is a low-grade fever."

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

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

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

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

The mother with HIV infection brings her 10-month-old infant to the clinic for a routine checkup. The HCP has documented that the infant is asymptomatic for HIV infection. After the checkup, the mother tells the nurse that she is so pleased that the infant will not get HIV infection. The nurse should make which most appropriate response to the mother? 1. "I am so pleased also that everything has turned out fine." 2. "Because symptoms have not developed, it is unlikely that your infant will develop HIV infection." 3. "Everything looks great, but be sure to return with your infant next month for the scheduled visit." 4. "Most children infected with HIV develop symptoms within the first 9 months of life, and some become symptomatic sometime before they are 3 years old."

4. "Most children infected with HIV develop symptoms within the first 9 months of life, and some become symptomatic sometime before they are 3 years old."

The clinic nurse is providing instructions to a parent of a child with cystic fibrosis regarding the immunization schedule for the child. Which statement should the nurse make to the parent? 1. "The immunization schedule will need to be altered." 2. "The child should not receive any hepatitis vaccines." 3. "The child will receive all of the immunizations except for the polio series." 4. "The child will receive the recommended basic series of immunizations along with a yearly influenza vaccination."

4. "The child will receive the recommended basic series of immunizations along with a yearly influenza vaccination."

The nurse provides home care instructions to the parents of a child hospitalized with pertussis who is in the convalescent stage and is being prepared for discharge. Which statement by a parent indicates a need for further instruction? 1. "We need to encourage our child to drink fluids." 2. "Coughing spells may be triggered by dust or smoke." 3. "Vomiting may occur when our child has coughing episodes." 4. "We need to maintain droplet precautions and a quiet environment for at least 2 weeks."

4. "We need to maintain droplet precautions and a quiet environment for at least 2 weeks."

A HCP's prescription reads "ampicillin sodium 125 mg IV every 6 hours." The medication label reads "when reconstituted with 7.4 mL of bacteriostatic water, the final concentration is 1 g/7.4 mL." The nurse prepares to draw up how many mL to administer 1 dose? 1. 1.1 mL 2. 0.54 mL 3. 7.425 mL 4. 0.925 mL

4. 0.925 mL

Penicillin G procaine, 1,000,000 units IM, is prescribed for a child with an infection. The medication label reads "1,200,000 units per 2 mL." The nurse has determined that the dose prescribed is safe. The nurse administers how many mLs per dose to the child? 1. 0.8 mL 2. 1.2 mL 3. 1.4 mL 4. 1.7 mL

4. 1.7 mL

A child is receiving a series of the hep B vaccine and arrives at the clinic with his parent for the second dose. Before administering the vaccine, the nurse should ask the child and parent about a history of a severe allergy to which substance? 1. Eggs 2. Penicillin 3. Sulfonamides 4. A previous dose of hep B vaccine or component

4. A previous dose of hep B vaccine or component

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

4. Anti-streptolysin O titer

An infant receives a DTaP immunization at a well-baby clinic. The parent returns home and calls the clinic to report that the infant has developed swelling and redness at the site of injection. Which intervention should the nurse suggest to the parent? 1. Monitor the infant for a fever 2. Bring the infant back to the clinic 3. Apply a hot pack to the injection site 4. Apply a cold pack to the injection site

4. Apply a cold pack to the injection site

A topical corticosteroid is prescribed by the HCP for a child with atopic dermatitis (eczema). Which instruction should the nurse give the parent about applying the cream? 1. Apply the cream over the entire body 2. Apply a thick layer of cream to affected areas only 3. Avoid cleansing the area before application of the cream 4. Apply a thin layer of cream and rub it into the area thoroughly

4. Apply a thin layer of cream and rub it into the area thoroughly

Permethrin is prescribed for a child with a diagnosis of scabies. The nurse should give which instruction to the parents regarding the use of this treatment? 1. Apply the lotion to areas of the rash only 2. Apply the lotion and leave it on for 6 hours 3. Avoid putting clothes on the child over the lotion 4. Apply the lotion to cool, dry skin at least 30 minutes after bathing

4. Apply the lotion to cool, dry skin at least 30 minutes after bathing

An adolescent client with type 1 DM is admitted to the ED for treatment of DKA. Which assessment findings should the nurse expect to note? 1. Sweating and tremors 2. Hunger and HTN 3. Cold, clammy skin and irritability 4. Fruity breath odor and decreasing level of consciousness

4. Fruity breath odor and decreasing level of consciousness

A new parent expresses concern to the nurse regarding SIDS. She asks the nurse how to position her new infant for sleep. In which position should the nurse tell the parent to place the infant? 1. Side or prone 2. Back or prone 3. Stomach with the face turned 4. Back rather than on the stomach

4. Back rather than on the stomach

A mother arrives at the ED with her 5-year-old child and states that the child fell off a bunk bed. A head injury is suspected. The nurse checks the child's airway status and assesses the child for early and late signs of increased intracranial pressure. Which is a late sign of increased ICP? 1. Nausea 2. Irritability 3. Headache 4. Bradycardia

4. Bradycardia

The nurse is preparing to care for a child with a diagnosis of intussusception. The nurse reviews the child's record and expects to note which sign of this disorder documented? 1. Watery diarrhea 2. Ribbon-like stools 3. Profuse projectile vomiting 4. Bright red blood and mucus in the stools

4. Bright red blood and mucus in the stools

A child is placed in skeletal traction for treatment of a fractured femur. The nurse creates a plan of care and should include which intervention? 1. Ensure that all ropes are outside the pulleys 2. Ensure that the weights are resting lightly on the floor 3. Restrict diversional and play activities until the child is out of traction 4. Check the HCP's prescriptions for the amount of weight to be applied

4. Check the HCP's prescriptions for the amount of weight to be applied

A HCP prescribes an IV solution of D5 1/2 NS with 40 mEq of potassium chloride for a child with hypotonic dehydration. The nurse performs which priority assessment before administering this IV prescription? 1. Obtains a weight 2. Takes the temp 3. Takes the BP 4. Checks the amount of urine output

4. Checks the amount of urine output

A parent brings her 4-month-old infant to a well-baby clinic for immunizations. The child is up to date with the immunization schedule. The nurse should prepare to administer which immunizations to this infant? 1. Varicella, hep B vaccine 2. DTaP; MMR; IPV 3. MMR Hib, DTaP 4. DTaP, Hib, IPV, PCV, RV

4. DTaP, Hib, IPV, PCV, RV

A child with b-thalassemia is receiving long-term blood transfusion therapy for the treatment of the disorder. Chelation therapy is prescribed as a result of too much iron from the transfusions. Which medication should the nurse anticipate to be prescribed? 1. Fragmin 2. Meropenem 3. Metoprolol 4. Deferoxamine

4. Deferoxamine

A school-aged child with type 1 DM has soccer practice and the school nurse provides instructions regarding how to prevent hypoglycemia during practice. Which should the school nurse tell the child to do? 1. Eat twice the amount normally eaten at lunchtime 2. Take half the amount of prescibed insulin on practice days 3. Take the prescribed insulin at noontime rather than in the morning 4. Eat a small box of raisins or drink a cup of orange juice before soccer practice

4. Eat a small box of raisins or drink a cup of orange juice before soccer practice

The mother of an 8-year-old child being treated for right lower lobe pneumonia at home calls the clinic nurse. The mother tells the nurse that the child complains of discomfort on the right side and that ibuprofen is not effective. Which instruction should the nurse provide to the mother? 1. Increase the dose of ibuprofen 2. Increase the frequency of ibuprofen 3. Encourage the child to lie on the left side 4. Encourage the child to lie on the right side

4. Encourage the child to lie on the right side

The clinic nurse instructs parents of a child with sickle cell anemia about the precipitating factors related to sickle cell crisis. Which, if identified by the parents as a precipitating factor, indicates the need for further instruction? 1. Stress 2. Trauma 3. Infection 4. Fluid overload

4. Fluid overload

The clinic nurse review the record of an infant and notes that the HCP has documented a diagnosis of suspected Hirschsprung's disease. The nurse reviews the assessment findings documented in the record, knowing that which sign most likely led the mother to seek health care for the infant? 1. DIarrhea 2. Projectile vomiting 3. Regurgitation of feedings 4. Foul-smelling ribbon-like stools

4. Foul-smelling ribbon-like stools

A child with laryngotracheobronchitis (croup) is placed in a cool mist tent. The mother becomes concerned because the child is frightened, consistently crying and trying to climb out of the tent. Which is the most appropriate nursing action? 1. Tell the mother that the child must stay in the tent 2. Place a toy in the tent to make the child feel more comfortable 3. Call the HCP and obtain a prescription for a mild sedative 4. Let the mother hold the child and direct the cool mist over the child's face

4. Let the mother hold the child and direct the cool mist over the child's face

The nurse is planning care for a child with acute bacterial meningitis. Based on the mode of transmission of this infection, which precautionary intervention should be included in the plan of care? 1. Maintain enteric percautions 2. Maintain neutropenic precautions 3. No precautions are required as long as antibiotics have been started 4. Maintain respiratory isolation precautions for at least 24 hours after the initiation of antibiotics

4. Maintain respiratory isolation precautions for at least 24 hours after the initiation of antibiotics

A child with type 1 DM is brought to the ED by the mother, who states that the child has been complaining of abdominal pain and has been lethargic. DKA is diagnosed. Anticipating the plan of care, the nurse prepares to administer which type of IV infusion? 1. Potassium infusion 2. NPH insulin infusion 3. 5% dextrose infusion 4. Normal saline infusion

4. Normal saline infusion

A child has a right femur fracture caused by a motor vehicle crash and is placed in skin traction temporarily until surgery can be performed. During assessment, the nurse notes that the dorsalis pedis pulse is absent on the right foot. Which action should the nurse take? 1. Administer an analgesic 2. Release the skin traction 3. Apply ice to the extremity 4. Notify the HCP

4. Notify the HCP

A child who has undergone spinal fusion for scoliosis complains of abdominal discomfort and begins to have episodes of vomiting. On further assessment, the nurse notes abdominal distention. On the basis of these findings, the nurse should take which action? 1. Administer an antiemetic 2. Increase the IV fluids 3. Place the child in a Sims' position 4. Notify the HCP

4. Notify the HCP

The nurse analyzes the lab results of a child with hemophilia. The nurse understands that which result will most likely be abnormal in this child? 1. Platelet count 2. Hct level 3. Hgb level 4. Partial thromboplastin time

4. Partial thromboplastin time

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

4. Primary nocturnal enuresis is usually outgrown without therapeutic intervention

A child is diagnosed with Reye's syndrome. The nurse creates a nursing care plan for the child and should include which intervention in the plan? 1. Assessing hearing loss 2. Monitoring urine output 3. Changing body position every 2 hours 4. Providing a quiet atmosphere with dimmed lighting

4. Providing a quiet atmosphere with dimmed lighting

Lab studies are performed for a child suspected to have iron deficiency anemia. The nurse reviews the lab results, knowing that which result indicates this type of anemia? 1. Elevated Hgb level 2. Decreased reticulocyte count 3. Elevated RBC count 4. RBCs that are microcytic and hypochromic

4. RBCs that are microcytic and hypochromic

The nurse has just administered ibuprofen to a child with a temp of 102F. The nurse should also take which action? 1. Withhold oral fluids for 8 hours 2. Sponge the child with cold water 3. Plan to administer salicylate in 4 hours 4. Remove excess clothing and blankets from the child

4. Remove excess clothing and blankets from the child

The nurse creates a plan of care for a child at risk for tonic-clonic seizures. In the plan of care, the nurse identifies seizure precautions and documents that which item(s) need to be placed at the child's bedside? 1. Emergency cart 2. Tracheostomy set 3. Padded tongue blade 4. Suctioning equipment and oxygen

4. Suctioning equipment and oxygen

A diagnosis of Hodgkin's disease is suspected in a 12-year-old child. Several diagnostic studies are performed to determine the presence of this disease. Which diagnostic test result will confirm the diagnosis of Hodgkin's disease? 1. Elevated vanillylmandelic acid urinary levels 2. The presence of blast cells in the bone marrow 3. The presence of EBV in the blood 4. The presence of Reed-Sternberg cells in the lymph nodes

4. The presence of Reed-Sternberg cells in the lymph nodes

The nurse provides feeding instructions to a parent of an infant diagnosed with GERD. Which instruction should the nurse give to the parent to assist in reducing the episodes of emesis? 1. Provide less frequent, larger feedings 2. Burp the infant less frequently during feedings 3. Thin the feedings by adding water to the formula 4. Thicken the feedings by adding rice cereal to the formula

4. Thicken the feedings by adding rice cereal to the formula

The nurse prepares to administer an IM injection to a 4-month-old infant. The nurse selects which best site to administer the injection? 1. Ventrogluteal 2. Lateral deltoid 3. Rectus femoris 4. Vastus lateralis

4. Vastus lateralis

A HCP has prescribed O2 as needed for an infant with HF. In which situation should the nurse administer the O2 to the infant? 1. During sleep 2. When changing the infant's diapers 3. When the mother is holding the infant 4. When drawing blood for electrolyte level testing

4. When drawing blood for electrolyte level testing

The school nurse is performing pediculous capitis (head lice) assessments. Which assessment finding indicates that a child has a "positive" head check? 1. Maculopapular lesions behind the ears 2. Lesions in the scalp that extend to the hairline or neck 3. White flaky particles throughout the entire scalp region 4. White sacs attached to the hair shafts in the occipital area

4. White sacs attached to the hair shafts in the occipital area

A HCP prescribes lab studies for an infant of a woman positive for HIV. The nurse anticipates that which lab study will be prescribed for the infant? 1. Chest x ray 2. Western blot 3. CD4+ cell count 4. p24 antigen assay

4. p24 antigen assay