Pediatric Nursing Practice 219 Questions with Verified Answers,100% CORRECT

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Pediatric Nursing Practice 219 Questions with Verified Answers What is the recommended serving size of vegetables for a toddler? a. 1 tablespoon. b. 1 teaspoon. c. 1/2 teaspoon. d. 1... /2 tablespoon. - CORRECT ANSWERS a The nurse is providing emergency care for an unconscious child who presents with a head injury sustained in a fall. Which is the highest nursing priority? a. Establish an airway. b. Assess neurological status. c. Stabilize the spine. d. Obtain vital signs. - CORRECT ANSWERS a he vital signs of a 4-year-old child with polyuria are: BP 80/40, Pulse 118, and Respirations 24. The child's pedal pulses are present with a volume of +1, and no edema is observed. What action should the nurse implement first? a. Insert an indwelling urinary catheter. b. Start an IV infusion of normal saline. c. Send a specimen to the lab for urinalysis. d. Document the child's vital signs and pulses. - CORRECT ANSWERS b The nurse is assessing a 2-year-old child. What behavior indicates that the child's language development is within normal limits? a. Is able to name four colors. b. Can count five blocks. c. Is capable of making a three word sentence. d. Half of child's speech is understandable. - CORRECT ANSWERS c At 8 a.m. the unlicensed assistive personnel (UAP) informs the charge nurse that a female adolescent client with acute glomerulonephritis has a blood pressure of 210/110. The 4 a.m. blood pressure reading was 170/88. The client reports to the UAP that she is upset because her boyfriend did not visit last night. What action should the nurse take first? a. Give the client her 9 a.m. prescription for an oral diuretic early. b. Administer PRN prescription of nifedipine (Procardia) sublingually. - CORRECT ANSWERS b During administration of a blood transfusion, a child complains of chills, headache, and nausea. Which action should the nurse implement? a. Start another IV of dextrose solution and stay with the child. b. Continue the transfusion and monitor the child's vital signs. c. Stop the infusion immediately and notify the healthcare provider. d. Slow the transfusion and assess for cessation of symptoms. - CORRECT ANSWERS c The nurse is preparing a health teaching program for parents of toddlers and preschoolers and plans to include information about prevention of accidental poisonings. It is most important for the nurse to include which instruction? a. Tell children they should not taste anything but food. b. Store all toxic agents and medicines in locked cabinets. c. Provide special play areas in the house and restrict play in other areas. d. Punish children if they open cabinets that contain household che - CORRECT ANSWERS b What preoperative nursing intervention should be included in the plan of care for an infant with pyloric stenosis? a. Monitor for signs of metabolic acidosis. b. Estimate the quantity of diarrhea stools. c. Place in a supine position after feeding. d. Observe for projectile vomiting. - CORRECT ANSWERS d Which measurements should be used to accurately calculate a pediatric medication dosage? Select all that apply. a. Child's height and weight. b. Adult dosage of medication. c. Body surface area of child. d. Average adult's body surface area. e. Average pediatric dosage of medication. f. Nomogram determined mathematical constant. - CORRECT ANSWERS a,c,f The nurse is assessing the neurovascular status of a child in Russell's traction. Which finding should the nurse report to the healthcare provider? a. Pale bluish coloration of the toes. b. Skin is warm and dry to the touch. c. Toes are wiggled upon command. d. Capillary refill less than 3 seconds. - CORRECT ANSWERS a The mother of a preschool-aged child asks the nurse if it is all right to administer bismuth subsalicylate (Pepto Bismol, Bismylate) to her son when he "has a tummy ache." After reminding the mother to check the label of all over-the-counter drugs for the presence of aspirin, which instruction should the nurse include when replying to this mother's question? a. If the child's tongue darkens, discontinue the Pepto Bismol immediately. b. Do not give if the child has chickenpox, the flu, or any - CORRECT ANSWERS b A 12-month-old boy is admitted with a respiratory infection and possible pneumonia. He is placed in a mist tent with oxygen. Which nursing intervention has the greatest priority for this infant? a. Give small, frequent feedings of fluids. b. Accurately chart observations regarding breath sounds. c. Have a bulb syringe readily available to remove secretions. d. Encourage older siblings to visit. - CORRECT ANSWERS c The nurse is assessing a two-month-old in preparation for surgery for coarctation of the aorta repair. Which best describes the pathophysiology of coarctation of the aorta? a. Acyanotic defect, increased pulmonary blood flow. b. Cyanotic defect, obstructed blood flow from ventricles. c. Acyanotic defect, obstructed blood flow from ventricles. d. Cyanotic defect, decreased pulmonary blood flow. - CORRECT ANSWERS c The emergency department nurse is assessing a three-month-old infant suspected to be a victim of "shaken baby syndrome". Which type of intracranial hemorrhage is caused by tearing of a meningeal artery that causes an inward expansion of blood from the inner surface of the skull? a. Subarachnoid. b. Epidural. c. Subdural. d. Intracerebral. - CORRECT ANSWERS b The nurse recognizes signs that a 9-month-old toddler may be living in an abusive home. Which action is the priority for the nurse? a. Encourage the child to speak freely. b. Report the suspected abuse to local authorities. c. Document from head to feet, the physical signs of abuse. d. Test the child for sexually-transmitted diseases. - CORRECT ANSWERS b The nurse is caring for a client with gastroesophageal reflux disease (GERD) who has not responded to conventional medical treatments. The nurse should anticipate the need for which surgical intervention? a. Nissen fundoplication. b. Esophagectomy. c. Heller myotomy. d. Whipple procedure. - CORRECT ANSWERS a Which class of antiinfective drugs is contraindicated for use in children under 8 years of age? a. Aminoglycosides. b. Tetracyclines. c. Penicillins. d. Quinolones. - CORRECT ANSWERS b A 6-month-old infant with congestive heart failure (CHF) is receiving digoxin elixir. Which observation by the nurse warrants immediate intervention? a. Apical heart rate of 60. b. Sweating across the forehead. c. Doesn't suck well. d. Respiratory rate of 30 breaths per minute. - CORRECT ANSWERS a A 2-year-old child with gastro-esophageal reflux has developed a fear of eating. What instruction should the nurse include in the parents' teaching plan? a. Invite other children home to share meals. b. Accept that he will eat when he is hungry. c. Reward the child with a nap after eating. d. Consistently follow a set mealtime routine. - CORRECT ANSWERS d A 16-year-old is brought to the Emergency Center with a crushed leg after falling off a horse. The adolescent's last tetanus toxoid booster was received eight years ago. What action should the nurse take? a. Dispense a tetanus antitoxin. b. Prepare human tetanus immune globulin. c. Administer tetanus toxoid booster. d. Delay the tetanus toxoid booster until due. - CORRECT ANSWERS c The parents of a 3-week-old infant report that the child eats well but, vomits after each feeding. What information is most important for the nurse to obtain? a. Description of vomiting episodes in past 24 hours. b. Number of wet diapers in last 24 hours. c. Feeding and sleep schedule. d. Amount of formula consumed during the past 24 hours. - CORRECT ANSWERS a Which restraint should be used for a toddler after a cleft palate repair? a. Clove hitch. b. Mummy. c. Elbow. d. Jacket. - CORRECT ANSWERS c As part of the physical assessment of children, the nurse observes and palpates the fontanels. Which child's fontanel finding should be reported to the healthcare provider? a. A 6-month-old with failure to thrive that has a closed anterior fontanel. b. A 24-month-old with gastroenteritis that has a closed posterior fontanel. c. A 2-month-old with chickenpox that has an open posterior fontanel. d. A 28-month-old with hydrocephalus that has an open anterior fontanel. - CORRECT ANSWERS a A premature newborn girl, born 24 hours ago, is diagnosed with a patent ductus arteriosus (PDA) and placed under an oxygen hood at 35%. The parents visit the nursery and ask to hold her. Which response should the nurse provide to the parents? a. "Studies have shown that handling a sick newborn is not good for the baby and upsets the parents." b. "The oxygen hood is holding the baby's oxygen level just at the point which is needed. You may stroke and talk to her." c. "Since your baby has bee - CORRECT ANSWERS b Which immunosuppressive medication is used to manage the symptoms of systemic lupus erythematosus (SLE) in the pediatric population? a. Otezla. b. Quinine. c. Methotrexate. d. Mefloquine. - CORRECT ANSWERS c The nurse is caring for a client with a suspected diagnosis of celiac disease. In order to confirm this diagnosis, the nurse should prepare the client for which examination? a. Magnetic resonance imaging scan. b. Fluoroscopy with barium contrast. c. Computerized tomography scan. d. Endoscopy with small bowel biopsy. - CORRECT ANSWERS d The nurse is reviewing an electronic medical record (EMR) of a four-year-old child who is scheduled for an outpatient cardiac catheterization. The child has midazolam prescribed pre-procedure to alleviate anxiety. Which prescription should the nurse seek further clarification from the healthcare provider? a. Parents may administered the medication just prior to coming to hospital. b. The child may have clear liquids up to two hours prior to administration of medicine. c. The child is to be - CORRECT ANSWERS a A child with cystic fibrosis is having stools that float and are foul smelling. Which descriptive term should the nurse use to document the finding? a. Diarrhea. b. Rhinorrhea. c. Galactorrhea. d. Steatorrhea. - CORRECT ANSWERS d A 4-year-old boy was admitted to the emergency room with a fractured right ulna and a short arm cast was applied. When preparing the parents to take the child home, which discharge instruction has the highest priority? a. "Call the healthcare provider immediately if his nail beds appear blue." b. "Check his fingers hourly for the first 48 hours to see that he is able to move them without pain." c. "Be sure your child's arm remains above his heart for the first 24 hours." d. "Take his temp - CORRECT ANSWERS a The mother of a 6-month-old asks the nurse when her baby will get the first measles, mumps, and rubella (MMR) vaccine. Based on the recommended childhood immunization schedule published by the Centers for Disease Control, which response is accurate? a. 3 to 6 months. b. 12 to 15 months. c. 18 to 24 months. d. 4 to 6 years. - CORRECT ANSWERS b The nurse is teaching the parents of a 5-year-old child with cystic fibrosis about respiratory treatments. Which statement indicates to the nurse that the parents understand? a. Perform postural drainage before starting the aerosol therapy. b. Give respiratory treatments when the child is coughing a lot. c. Administer aerosol therapy followed by postural drainage before meals. d. Ensure respiratory therapy is done daily during any respiratory infection. - CORRECT ANSWERS c In developing a teaching plan for a 5-year-old child with diabetes, which component of diabetic management should the nurse plan for the child to manage first? a. Food planning and selection. b. Administering insulin injections. c. Process of glucose testing. d. Drawing up the correct insulin dose. - CORRECT ANSWERS c The nurse is providing anticipatory guidance to a group of new parents. How should the nurse explain the sequence in the development of fine and gross motor skills? a. Development predictably occurs from the head to the toes. b. The distal part of the body develops first, followed by the proximal. c. For right-handed dominance, the right side of body develops first, then left. d. The central portion of the body develops after peripheral growth. - CORRECT ANSWERS a The nurse is providing pre-operative teaching for a 12-year old child who will have a tonsillectomy in the morning. Which statement by the child best demonstrates the expected level of understanding about the concept of illness? a. "I need to save my tonsils in case I want them back in my mouth." b. "Tonsils were important for my immunity and infection prevention when I was a baby." c. "When I wake up my throat will hurt but I can eat all the ice cream I want and then I go home." d. "My f - CORRECT ANSWERS d The nurse is assessing a 2-year-old child at the pediatrician's office. The child's history is significant for prenatal brain trauma and low Apgar scores. The child exhibits hypertonia of the extremities, poor speech intonation, and is failing to meet expected motor skills milestones. Which disorder should the nurse suspect? a. Guillain-Barré syndrome. b. Spina bifida. c. Muscular dystrophy. d. Cerebral palsy. - CORRECT ANSWERS d The nurse is developing a plan of care for a 3-year-old who is scheduled for a cardiac catheterization. To assist in decreasing anxiety for the child on the day of the procedure, which intervention is best for the nurse to implement? a. Reassure the parents that 3-year-olds are cooperative and therefore are less likely to be anxious. b. Obtain a video film of a cardiac catheterization to show to the child prior to the procedure. c. Give the child a ride on a gurney to visit the cardiac cath - CORRECT ANSWERS c A 2-year-old child with Down syndrome is brought to the clinic for his regular physical examination. The nurse knows which problem is frequently associated with Down syndrome? a. Congenital heart disease. b. Fragile X chromosome. c. Trisomy 13. d. Pyloric stenosis. - CORRECT ANSWERS a The mother of a 4-year-old child asks the nurse what she can do to help her other children cope with their sibling's repeated hospitalizations. Which is the best response that the nurse should offer? a. Inform the parent that the other children are too young to visit the hospital. b. Suggest that the other children visit a grandmother until the sibling returns home. c. Ask the mother if the children ask when the sibling will be discharged. d. Encourage the mother to have the children visi - CORRECT ANSWERS d Which behavior would the nurse expect a two-year-old child to exhibit? a. Build a house with blocks. b. Ride a tricycle. c. Display possessiveness of toys. d. Look at a picture book for 15 minutes. - CORRECT ANSWERS c The nurse is having difficulty communicating with a hospitalized 6-year-old child. Which approach by the nurse is most helpful in establishing communication? a. Engage the child through drawing pictures. b. Suggest that the parent read a book to the child. c. Provide paper and pencil for the child to keep a diary. d. Ask the parent if the child is always uncommunicative. - CORRECT ANSWERS a A preschool-age child who is hospitalized for hypospadias repair is most strongly influenced by which behavior? a. Ability to communicate verbally. b. Response to separation from family. c. Concern for body integrity. d. Socialization with other children. - CORRECT ANSWERS c When discussing discipline with the mother of a 4-year-old child, the nurse should include which guideline? a. Parental control should be consistent. b. Children as young as 4 years rarely need reprimand or punishment. c. Withdrawal of approval is effective. d. Parents should enforce rigid rules to be followed without question. - CORRECT ANSWERS a Which action by the nurse is most helpful in communicating with a preschool-aged child? a. Speak clearly and directly to the child. b. Use a doll to play and communicate. c. Approach when a parent is not present. d. Play a board game with the child. - CORRECT ANSWERS b A 6-year-old is admitted to the pediatric unit after falling off a bicycle. Which intervention should the nurse implement to assist the child's adjustment to hospitalization? a. Explain hospital schedules to the child, such as mealtimes. b. Use terms, such as "honey" and "dear," to show a caring attitude. c. Provide a list of rules that limits visitation of siblings in the hospital. d. Orient the parents to the hospital unit and refreshment areas. - CORRECT ANSWERS a What clinical manifestation is the nurse likely to observe in a child with human immunodeficiency virus (HIV)? a. Petechiae. b. Visual disturbances. c. Bruising. d. Oral candidiasis. - CORRECT ANSWERS d A school nurse presented a parent-approved lesson about "Prevention transmitting Herpes Simplex Virus 2" (HSV-2) to a group of adolescent students. Which statement from one of the students would demonstrate a proper understanding of the lesson? a. There is currently no cure for HSV-2. b. Condoms are 100% effective in protecting again HSV-2. c. HSV-2 cannot be passed through vaginal secretions. d. When no lesions are visibly, the HSV-2 cannot be passed on. - CORRECT ANSWERS a The nurse is counseling a teenage girl who was recently diagnosed with gonorrhea. The nurse should inform the client that untreated gonorrhea may lead to which complication? a. Pelvic inflammatory disease. b. Gastrointestinal bleeding. c. Renal failure. d. Pyelonephritis. - CORRECT ANSWERS a A school nurse is assessing rashes on a child's lower shins and forearms that appear streaked and inflamed and are blistered with clear oozing substance present. The child reports that it is painful. Based on these signs and symptoms, what most likely caused this condition? a. Shellfish. b. Penicillin elixir. c. Laundry detergent. d. Poison ivy or oak. - CORRECT ANSWERS d Upon inspection, a nurse visualizes a blade of grass clipping stuck under the right upper eyelid of a teenage client complaining of eye pain, increased tear production, and redden sclera. What should the nurse use to remove the grass clipping? a. Moist gauze pad. b. Dry cotton swab. c. Plastic tweezer. d. Irrigation solution. - CORRECT ANSWERS a A 3-year-old client with sickle cell anemia is admitted to the Emergency Department with abdominal pain. The nurse palpates an enlarged liver, an x-ray reveals an enlarged spleen, and a CBC reveals anemia. These findings indicate which type of crisis? a. Aplastic. b. Sequestration. c. Hyperhemolytic. d. Vaso-occlusive. - CORRECT ANSWERS b Which menu selection by a child with celiac disease indicates to the nurse that the child understands necessary dietary considerations? a. Oven-baked potato chips and cola. b. Peanut butter and banana sandwich. c. Oatmeal-raisin cookies and milk. d. Graham crackers and fruit juice. - CORRECT ANSWERS a A female teenager is taking oral tetracycline HCL (Achromycin V) for acne vulgaris. What is the most important instruction for the nurse to include in this client's teaching plan? a. "Use sunscreen when lying by the pool." b. "Cleanse the skin at least 4 times a day." c. "Take the medication with a glass of milk." d. "Menstrual periods may become irregular." - CORRECT ANSWERS a When assessing a child with asthma, the nurse should expect intercostal retractions during a. inspiration. b. coughing. c. apneic episodes. d. expiration. - CORRECT ANSWERS a During discharge teaching of a child with juvenile rheumatoid arthritis, the nurse should stress to the parents the importance of obtaining which diagnostic testing? a. Hearing tests. b. Eye exams. c. Chest x-rays. d. Fasting blood glucose tests. - CORRECT ANSWERS b A 3-month-old infant develops oral thrush. Which pharmacologic agent should the nurse plan to administer for treatment of this disorder? a. Nystatin (Mycostatin). b. Nitrofurantoin (Macrodantin). c. Norfloxacin (Noroxin). d. Neomycin sulfate (Mycifradin). - CORRECT ANSWERS a The nurse must prevent a 2-year-old with severe eczema on the face, neck, and scalp from scratching the affected areas. Which nursing intervention is most effective in preventing further excoriation due to the pruritis? a. Obtain gloves for the child's hands. b. Apply finger cots on the child's fingers. c. Place elbow restraints on the child's arms. d. Apply soft restraints to the child's wrists. - CORRECT ANSWERS c A 2-year-old child recently diagnosed with hemophilia A is discharged home. What information should the nurse include in a teaching plan about home care? a. Minimize interactive play with other children to lessen chances for injury. b. Give low-dose children's chewable aspirin in orange flavor for joint discomfort. c. Use a firm and dry toothbrush to clean teeth at least twice per day. d. Apply pressure and ice for bleeding while elevating and resting the extremity. - CORRECT ANSWERS d A six-year-old client, who received a kidney transplant presents with signs including fever, decreased urine output, and tenderness over the transplanted organ. Laboratory results reveal an elevated serum creatinine level. This presentation is likely due to which cause? a. Immunosuppression medications. b. Obstructive uropathy. c. Transplant rejection. d. Nephrotic syndrome. - CORRECT ANSWERS c The parents of a 13-year-old male client are concerned that he may not have started puberty. The client's stage of puberty is assessed using the Tanner scale of development. Which type of test is performed to determine this child's Tanner stage? a. Orchidometry. b. Radiological examination. c. Bone densitometry. d. Muscle mass calculation. - CORRECT ANSWERS a The nurse is caring for an 8-year-old child who is recovering from major burn injuries sustained in a house fire. The client has become increasingly lethargic and difficult to awaken. The following vital signs were obtained: T 96°.2 F (35.7°C), BP 100/72, P 132, and RR 36. Which complication should the nurse suspect? a. Hypothermia. b. Early sepsis. c. Acute renal failure. d. Hypovolemia. - CORRECT ANSWERS b The nurse is assigned to care for an irritable and fatigue 11-year-old child who has been unable to gain weight despite excessive consumption of calories. While talking to the client, the nurse noticed the child appeared to be restless and demonstrated a slight tremor, and possessed physical characteristics of bulging eyes, and a goiter. Which condition should the nurse suspect? a. Hypoparathyroidism. b. Hyperthyroidism. c. Hyperparathyroidism. d. Hypothyroidism. - CORRECT ANSWERS b The nurse is caring for a pediatric client with a skin infection. A honey-colored crusted exudate is seen overlying the infected area. This appearance is consistent with which condition? a. Impetigo. b. Ringworm. c. Scarlet fever. d. Rubella. - CORRECT ANSWERS a The nurse applied 6 lpm of oxygen via a non-rebreather mask to a ten-year-old child with a history of asthma in the emergency department and began a nebulizer treatment. The child upon arrival had a respiratory rate of 32 breathes per minute, SpO2 of 86% on room air; substernal and intercostal retractions; and audible expiratory and inspiratory wheezing audible three feet away. After the nebulizer treatment, the nurse noted the audible wheezing had lessen and the lower lobes of the lungs were ab - CORRECT ANSWERS d A child who is recovering from surgery for removal of a Wilms tumor develops abdominal pain and distension, absence of bowel sounds, and vomiting. Which complication should the nurse suspect? a. Intestinal obstruction. b. Abdominal peritonitis. c. Pyloric stenosis. d. Infectious gastritis. - CORRECT ANSWERS a While performing the initial physical examination of a newborn, the nurse elicits a positive Ortolani test. Which skeletal defect does this indicate? a. Septic arthritis. b. Legg-Calve-Perthes disease. c. Developmental dysplasia of the hip. d. Slipped capital femoral epiphysis. - CORRECT ANSWERS c A three-year-old toddler has recently developed a rash on the trunk and buttocks. Which question should the nurse asked the child's parent first? a. Has your child been swimming in a pool lately? b. Have you changed your laundry detergent lately? c. Has your child's dietary habits been altered lately? d. Have you applied sunscreen on your child's skin lately? - CORRECT ANSWERS b The nurse is performing an assessment on a three-year-old near drowning victim. The client presents with abnormal involuntary muscle contractions that cause rigid flexion in the upper extremities, extension of the legs, and plantar flexed feet. How should the nurse document this finding? a. Decorticate posturing. b. Cervical dystonia. c. Cranial dystonia. d. Decerebrate posturing. - CORRECT ANSWERS a The nurse is reviewing the lab values for an eight-year-old client and notes that the child's absolute neutrophil count (ANC) is below 500 cells/mm3. Which nursing intervention should the nurse implement first? a. Transfer the child to a negative pressure room. b. Notify the healthcare provider of the laboratory result. c. Initiate reverse isolation precautions for this child. d. Call the lab and request a "stat" unit of platelets. - CORRECT ANSWERS c A pediatric client is placed on a drug regimen for management of aplastic anemia. What should the nurse identify as the expected outcome of this treatment? a. Replace clotting factors. b. Increase intravascular volume. c. Restore bone marrow function. d. Increase iron levels in the blood. - CORRECT ANSWERS c A mother is worried that her three-year-old toddler may have inherited hemophilia because the toddler has few scattered bruises on thier body from playing on the playground and the father of the baby has hemophilia. What is the most common inheritance pattern in clients with hemophilia? a. X-linked recessive. b. X-linked dominant. c. Y-linked recessive. d. Y-linked dominant. - CORRECT ANSWERS a A 3-year-old client being treated for sepsis has begun bleeding from multiple sites. The nurse's assessment reveals widespread petechiae and bleeding from the nose, mouth, and rectum. Laboratory results reveal a prolonged prothrombin time (PT), elevated d-dimer, and low platelet count. Which disorder should the nurse suspect? a. Von Willebrand disease. b. Disseminated intravascular coagulation. c. Hemophilia type A. d. Hypoplastic anemia. - CORRECT ANSWERS b Which treatment regimen reduces the risk of pneumococcal infection in a pediatric client with sickle cell anemia? a. Annual flu shot. b. Penicillin prophylaxis. c. Vitamin E supplementation. d. Tdap vaccination series. - CORRECT ANSWERS b A teenager is admitted to the hospital diagnosed with anorexia nervosa. Which condition should the nurse evaluate the client for? a. Osteoarthritis. b. Cardiac arrhythmia. c. Asthma. d. Bowel ischemia. - CORRECT ANSWERS b A 12-year-old client presents suddenly with signs of shock; weak and rapid pulse; bronchoconstriction and laryngeal edema. What should the nurse suspect is the cause of this presentation? a. Bronchial asthma. b. Anaphylaxis. c. Bronchiolitis. d. Respiratory distress syndrome. - CORRECT ANSWERS b The nurse is assessing a four year old victim who was an improperly restrained passenger of a high speed impact motor vehicle collision. The victim presents with a falling blood pressure, poor capillary refill, low central venous pressure, tachycardia and bruising noted upper left quadrant of the abdomen. Which condition should the nurse suspect? a. Neurogenic shock. b. Cardiogenic shock. c. Hypovolemic shock. d. Distributive shock. - CORRECT ANSWERS c A pediatric client is admitted with sepsis and a high-grade fever following an episode of gastritis. The nurse's assessment reveals cool skin; normal pulse and blood pressure; decreased urinary output; and a diminished mental state. Which term describes this stage of septic shock? a. Hyperdynamic. b. Normodynamic. c. Macrodynamic. d. Hypodynamic. - CORRECT ANSWERS b The nurse is counseling the parents of a child with adrenocortical insufficiency. The nurse should educate the parents about the signs and symptoms of which condition that can occur as a result of prolonged hydrocortisone therapy? a. Gastric ulcers. b. Weight loss. c. Drowsiness. d. Decreased blood pressure. - CORRECT ANSWERS a Which action should the nurse take when caring for a child with epiglottitis? a. Examine the throat with tongue depressor. b. Set up emergency airway equipment at bedside. c. Place the child in supine position. d. Perform a throat culture. - CORRECT ANSWERS b Which intervention should the nurse implement to assist a child and the family to reduce the risk of an asthma exacerbation? a. Help them recognize triggers. b. Encourage peak pulmonary flow measurement. c. Demonstrate use of MDI spacer. d. Provide emergency treatment plan. - CORRECT ANSWERS a A child with cystic fibrosis (CF) is experiencing recurrent lung infections. Which lung condition is this client likely to develop? a. Pleurisy. b. Bronchiectasis. c. Bronchiolitis. d. Asthma. - CORRECT ANSWERS b The nurse is assessing an agitated three-year-old child who is leaning forward with their chin thrust out, mouth open, and tongue protruded with copious amount of drooling present. The client's vital signs are tympanic temperature of 103.1°F (39.5°C), pulse of 110 beats per minute and respiratory rate of 28 per minute. Which condition should the nurse suspect? a. Croup. b. Bronchiolitis. c. Acute epiglottitis. d. Gastroesophageal reflux. - CORRECT ANSWERS c Which medication is administered to premature infants to reduce the severity of symptoms associated with respiratory syncytial virus (RSV) infection? a. Respaire. b. Singulair. c. Menomune. d. Synagis. - CORRECT ANSWERS d An alert child has been treated for a submersion injury (near drowning). Which complication should the nurse anticipate? a. Hypertension. b. Edema. c. Oliguria. d. Hypothermia. - CORRECT ANSWERS d Which information about a child's seizure episode is most important for the nurse to document? a. Classification. b. Duration. c. Etiology. d. Expected outcome. - CORRECT ANSWERS b Intracranial pressure (ICP) monitoring is required for a child with a severe brain injury. To obtain the most accurate readings, a catheter is inserted into which area of the brain? a. Subdural space. b. Epidural space. c. Lateral ventricle. d. Anterior fontanel. - CORRECT ANSWERS c A child diagnosed with HIV is being enrolled in a new school. Who has the right to inform the school of this child's HIV status? a. Doctors or nurses. b. Social workers. c. Parents or legal guardians. d. Child welfare department. - CORRECT ANSWERS c The nurse is preparing to collect a fingerstick blood glucose from a 2 year old client. Which pain relief intervention would work best? a. Telling jokes. b. Singing songs. c. Guided imagery. d. Massage therapy. - CORRECT ANSWERS b A five-year-old client who had been prescribed amoxicillin, presents to the clinic with urticaria. Which medication is recommended for initial treatment of this condition? a. Epinephrine. b. Diphenhydramine. c. Ibuprofen. d. Doxepin. - CORRECT ANSWERS b The nursing interventions for a 4-year-old victim of a scald burn of maintaining correct body alignment and function; frequent position changes; braced extremities; and active and passive range of motion are primarily implemented to prevent which complication from severe burns? a. Contractures. b. Pneumonia. c. Decubitus ulcers. d. Deep vein thrombosis. - CORRECT ANSWERS a The nurse is developing a nursing care plan (NCP) for a 5-year-old child who is newly diagnosed with Legg-Calve-Perthes disease. Which nursing outcome would be the most appropriate for this client? a. The client is smiling while quietly coloring pictures. b. The client has gained 2 pounds (0.9 kg) since admission. c. The client is able to put full weight bearing on affected limb. d. The client has been able to maintain a steady normal glucose level . - CORRECT ANSWERS a Which action should the nurse perform during preoperative management of a child with intestinal bleeding? a. Record appearance of blood in stools. b. Apply abdominal compression wrap. c. Begin fluid replacement therapy. d. Measure body weight every 6 hours. - CORRECT ANSWERS a Which information is important for the nurse to include when educating the parents of a two-month-old with gastroesophageal reflux disease (GERD)? a. The child should sleep in the supine position. b. The child's condition should improve over time. c. The child's oral cavity should be cleaned before each feeding. d. The child should be fed while in the prone position. - CORRECT ANSWERS b A three-year-old child who is lethargic, vomiting and complaining of abdominal pain is being assessed for acetominophen poisoning. Which medication is used for treatment of acetaminophen poisoning? a. Deferoxamine. b. Vitamin K. c. N-acetylcysteine. d. Sodium bicarbonate. - CORRECT ANSWERS c Why is meperidine (Demerol) contraindicated for pain relief in clients with sickle cell disease? a. It is ineffective. b. It can cause GI ulcers. c. It is too sedating. d. It can induce seizures. - CORRECT ANSWERS d A child has been diagnosed with chicken pox and the nurse teaches the parent not to give the child aspirin. Which condition may result when a child with chickenpox is given aspirin? a. Reye's syndrome. b. Huntington's chorea. c. Raynaud syndrome. d. Purpura disorder. - CORRECT ANSWERS a Which type of visual impairment is corrected by increasing visual stimulation to the weaker eye, by patching the stronger eye? a. Myectopia b. Strabismus. c. Ophritis d. Anisometropia. - CORRECT ANSWERS b A child with cataracts has an increased risk for developing which condition? a. Amblyopia. b. Glaucoma. c. Hyperopia. d. Myopia. - CORRECT ANSWERS a During a routine well-child exam, the nurse observes that a 12-month-old child is unable to pronounce any simple words or syllables. Which possible cause should the child be evaluated for first? a. Brain injury. b. Hearing loss. c. Autism. d. Apraxia of speech. - CORRECT ANSWERS b A 10-year-old client was brought to the emergency department due to collapsing and experiencing jerky motor movements after being hit in the forehead with a baseball. Upon examination, the child's pupils appear widely dilated and reactive bilaterally. Based on this finding, which condition should the nurse suspect the client experienced? a. Seizure. b. Nerve damage. c. Hydrocephalus. d. Subdural hematoma. - CORRECT ANSWERS a The school nurse is reviewing the electronic health record of a child diagnosed with conductive hearing loss who is unable to understand conversational speech, experiences difficulty with classroom discussion, and is enrolled in speech therapy. Which classification of hearing impairment does the child have? a. Slight. b. Mild to moderate. c. Moderately severe. d. Severe. - CORRECT ANSWERS c A child is being treated with penicillin for bacterial pneumonitis. The nurse teaches the parent to monitor for signs of an allergic reaction to the new medication. Which sign is the parent most likely to observe? a. Skin rash. b. Nasal congestion. c. Diarrhea. d. Vomiting. - CORRECT ANSWERS a Which information is important for the nurse to include when providing discharge teaching to the parents of a child with Kawasaki disease? a. Live immunizations should be deferred for 11 months. b. Associated arthritis symptoms will persist for life. c. Passive range of motion exercises are generally ineffective. d. Warm packs can be used to ease pain of peeling skin. - CORRECT ANSWERS a A 12-month-old client is being discharged with a body spica cast. Which information should the nurse include in the parents' discharge teaching plan? a. Foul odor from cast may indicate infection or skin breakdown. b. Pillows should not be placed under cast. c. The child can be safely transported in a stroller. d. Use pillows to elevate the child's head. - CORRECT ANSWERS a A twelve-year-old with a left big toe infection which is non-responsive to current oral antibiotic therapy is being evaluated for possible osteomyelitis. Which diagnostic imaging modality is the most sensitive for detecting osteomyelitis? a. Radiography. b. Fluoroscopy. c. Computed tomography (CT). d. Magnetic resonance imaging (MRI). - CORRECT ANSWERS d A 12-year-old athlete reports severe ankle pain and an audible "popping" sound in the ankle after a fall at soccer practice. The nurse upon inspection observes moderate swelling, bruising, and joint instability. Initial radiographs of the ankle appear normal. Which type of injury should the nurse suspect? a. Strain. b. Sprain. c. Fracture. d. Dislocation. - CORRECT ANSWERS b The nurse is caring for a 2-week-old infant, who was just diagnosed with developmental dysplasia of the hip (DDH). Which treatment should the nurse expect to be implemented for this client? a. Pavlik harness. b. Fixed abduction brace. c. Closed reduction surgery. d. Open reduction surgery. - CORRECT ANSWERS a The nurse assigning care for a 5-year-old child with otitis media is concerned about the child's increasing temperature over the past 24 hours. Which statement is accurate and should be considered when planning care for the remainder of the shift? a. An RN should be assigned to take temperatures frequently. b. Tympanic and oral temperatures are equally accurate. c. The PN should take rectal temperatures on this child. d. The pediatrician should decide how to assess the temperature. - CORRECT ANSWERS b A 5-month-old is admitted to the hospital with vomiting and diarrhea. The pediatrician prescribes dextrose 5% and 0.25% normal saline with 2 mEq KCl/100 ml to be infused at 25 ml/hour. Prior to initiating the infusion, the nurse should obtain which assessment finding? a. Frequency of emesis in the last 8 hours. b. Serum BUN and creatinine levels. c. Current blood sugar level. d. Appearance of the stool. - CORRECT ANSWERS b The nurse receives a lab report stating a child with asthma has a theophylline level of 15 mcg/dl. What action will the nurse take? a. Pass the information on in the report. b. Notify the healthcare provider because the value is high. c. Repeat the lab study because the value is too high. d. Hold the next dose of theophylline. - CORRECT ANSWERS a The nurse reviews the latest laboratory results for a child who received chemotherapy last week and identifies a reduced neutrophil count. Which nursing diagnosis has the highest priority for this child? a. Risk for infection. b. Risk for hemorrhage. c. Altered skin integrity. d. Disturbance in body image. - CORRECT ANSWERS a The nurse is caring for a 12-year-old with Syndrome of Inappropriate Antidiuretic Hormone (SIADH). This child should be carefully assessed for which complication? a. Poor skin turgor resulting from dehydration. b. Changes in level of consciousness. c. Premature aging as the disease progresses. d. Severe edema from an excess of water and sodium. - CORRECT ANSWERS b A mother is visiting her one-month-old infant who was delivered at 27-weeks gestation and is currently in the neonatal intensive care unit (NICU). Which is the best way for the nurse to encourage parent-infant bonding? a. Educate the parents about well-baby care. b. Invite the parents to participate in diaper changes. c. Facilitate frequent but short parent visits. d. Demonstrate bottle feeding techniques to parents. - CORRECT ANSWERS b Which is recognized as a contributing factor to the development of anorexia nervosa in adolescents? a. Complaisant parenting. b. Peer pressure. c. Rigid family rules. d. Dropping out of high school. - CORRECT ANSWERS c The nurse is assessing the chest tube output of a 10 kilogram child status-post cardiac surgery. How many milliliters of drainage in one hour is a sign of possible postoperative hemorrhage? a. 10. b. 20. c. 40. d. 50. - CORRECT ANSWERS d The nurse is admitting an infant diagnosed with gastroenteritis with frequent episodes of diarrhea. Which complication can diarrhea can lead to? a. Acid-base imbalance with acidosis. b. Acid-base imbalance with alkalosis. c. Intestinal obstruction. d. Intestinal perforation. - CORRECT ANSWERS a The nurse is giving preoperative instructions to a 14-year-old female client who is scheduled for surgery to correct a spinal curvature. Which statement by the client best demonstrates that learning has taken place? a. "I will read all the literature you gave me before surgery." b. "I have had surgery before when I broke my wrist in a bike accident, so I know what to expect." c. "All the things people have told me will help me take care of my back." d. "I understand that I will be in a body cas - CORRECT ANSWERS d To take the vital signs of a 4-month-old child, which order will give the most accurate results? a. Respiratory rate, heart rate, then rectal temperature. b. Heart rate, rectal temperature, then respiratory rate. c. Rectal temperature, heart rate, then respiratory rate. d. Rectal temperature, respiratory rate, then heart rate. - CORRECT ANSWERS a During routine screening at a school clinic, an otoscope examination of a child's ear reveals a tympanic membrane that is pearly gray, slightly bulging, and not movable. What action should the nurse take next? a. No action required, as this is an expected finding for a school-aged child. b. Ask the child if he/she has had a cold, runny nose, or any ear pain lately. c. Send a note home advising the parents to have the child evaluated by a healthcare provider as soon as possible. d. Call the pare - CORRECT ANSWERS b Which restraint should be used for a toddler after a cleft palate repair? a. Clove hitch. b. Mummy. c. Elbow. d. Jacket. - CORRECT ANSWERS c What preoperative nursing intervention should be included in the plan of care for an infant with pyloric stenosis? a. Monitor for signs of metabolic acidosis. b. Estimate the quantity of diarrhea stools. c. Place in a supine position after feeding. d. Observe for projectile vomiting. - CORRECT ANSWERS d A six-month-old returns from surgery with elbow restraints in place. What nursing care should be included when caring for any restrained child? a. Keep restraints on at all times. b. Remove restraints one at a time and provide range of motion exercises. c. Remove all restraints simultaneously and provide play activities. d. Renew the healthcare provider's prescription for restraints every 72 hours. - CORRECT ANSWERS b A 2-year-old child with Down syndrome is brought to the clinic for his regular physical examination. The nurse knows which problem is frequently associated with Down syndrome? a. Congenital heart disease. b. Fragile X chromosome. c. Trisomy 13. d. Pyloric stenosis. - CORRECT ANSWERS a When assessing a child with asthma, the nurse should expect intercostal retractions during a. inspiration. b. coughing. c. apneic episodes. d. expiration. - CORRECT ANSWERS a When planning the care for a child who has had a cleft lip repair, the nurse knows that crying should be minimized because it a. increases salivation. b. increases the respiratory rate. c. leads to vomiting. d. stresses the suture line. - CORRECT ANSWERS d A full-term infant is admitted to the newborn nursery. After careful assessment, the nurse suspects that the infant may have an esophageal atresia. Which symptoms is this newborn likely to have exhibited? a. Choking, coughing, and cyanosis. b. Projectile vomiting and cyanosis. c. Apneic spells and grunting. d. Scaphoid abdomen and anorexia. - CORRECT ANSWERS a Which behavior would the nurse expect a two-year-old child to exhibit? a. Build a house with books. b. Ride a tricycle. c. Display possessiveness of toys. d. Look at a picture book for 15 minutes. - CORRECT ANSWERS c The mother of a preschool-aged child asks the nurse if it is all right to administer Pepto Bismol to her son when he "has a tummy ache." After reminding the mother to check the label of the over-the-counter drugs for the presence of aspirin, which instruction should the nurse include when replying to this mother's question? a. If the child's tongue darkens discontinue the Pepto Bismol immediately. b. Do not give if the child has chickenpox, the flu, or any other viral illness. c. Avoid the use - CORRECT ANSWERS b The nurse observes a 4-year-old boy in a daycare setting. Which behavior should the nurse consider normal for this child? a. Has a temper tantrum when told he must share his toys. b. Plays by himself most of the day. c. Demonstrates aggressiveness by boasting when telling a story. d. Begins to cry and is fearful when separated from his parents. - CORRECT ANSWERS c A burned child is brought to the emergency room. In estimating the percentage of the body burned, the nurse uses a modified "Rule of Nines." Which part of a child's body is calculated as a larger percentage of total body surface than an adult's? a. Head and neck. b. Arms and chest. c. Legs and abdomen. d. Back and abdomen. - CORRECT ANSWERS a The nurse receives a lab report stating a child with asthma has a theophylline level of 15 mcg/dl. What action will the nurse take? a. Pass the information on in the report. b. Notify the healthcare provider because the value is high. c. Repeat the lab study because the value is too high. d. Hold the next dose of theophylline. - CORRECT ANSWERS a A 12-month-old boy is admitted with a respiratory infection and possible pneumonia. He is placed in a mist tent with oxygen. Which nursing intervention has the greatest priority for this infant? a. Give small, frequent feedings of fluids. b. Accurately chart observations regarding breath sounds. c. Have a bulb syringe readily available to remove secretions. d. Encourage older siblings to visit. - CORRECT ANSWERS c All of the following interventions can be used to evaluate the effectiveness of nursing and medical interventions used to treat diarrhea. Which intervention is least useful in the nurse's evaluation of a 20-month-old child? a. Weighing diapers. b. Assessing fontanels. c. Checking skin turgor. d. Observing mucous membranes for moisture. - CORRECT ANSWERS b A 5-month-old is admitted to the hospital with vomiting and diarrhea. The pediatrician prescribes dextrose 5% and 0.25% normal saline with 2 mEq KCl/100 ml to be infused at 25 ml/hr. Prior to initiating the infusion, the nurse should obtain which assessment finding? a. Frequency of emesis in the last 8 hours. b. Serum BUN and creatinine levels. c. Current blood sugar levels. d. Appearance of the stool. - CORRECT ANSWERS b The nurse is assigning care for a 4-year-old child with otitis media and is concerned about the child's increasing temperature over the past 24 hours. When planning care for this child, it is important for the nurse to consider that a. only an RN should be assigned to monitor this child's temperature. b. a tympanic measurement of temperature will provide the most accurate reading. c. the licensed practical nurse should be instructed to obtain rectal temperatures on this child. d. the healthcare - CORRECT ANSWERS b The nurse is assessing an 8-month-old child who has a medical diagnosis of Tetrology of Fallot. Which symptom is this client most likely to exhibit? a. Bradycardia. b. Machinery murmur. c. Weak pedal pulses. d. Clubbed fingers. - CORRECT ANSWERS d As part of the physical assessment of children, the nurse observes and palpates the fontanels. Which child's fontanel finding should be reported to the healthcare provider? a. A 6-month-old with failure to thrive that has a closed anterior fontanel. b. A 24-month-old with gastroenteritis that has a closed posterior fontanel. c. A 2-month-old with chickenpox that has an open posterior fontanel. d. A 28-month-old with hydrocephalus that has an open anterior fontanel. - CORRECT ANSWERS a A preschool-age child who is hospitalized for hypospadias repair is most strongly influenced by which behavior? a. Ability to communicate verbally. b. Response to separation from family. c. Concern for body integrity. d. Socialization with other children. - CORRECT ANSWERS c An infant is born with a ventricular septal defect (VSD) and surgery is planned to correct the defect. The nurse recognizes that surgical correction is designed to achieve which outcome? a. Stop the flow of unoxygenated blood into systemic circulation. b. Increase the flow of unoxygenated blood to the lungs. c. Prevent the return of oxygenated blood to the lungs. d. Reduce peripheral tissue hypoxia and nailbed clubbing. - CORRECT ANSWERS c A three-month old boy weighing 10 lbs 15 oz has an axillary temperature of 98.9 F. The nurse determines the daily caloric need for this child is approximately a. 400 calories per day. b. 500 calories per day. c. 600 calories per day. d. 700 calories per day. - CORRECT ANSWERS c The nurse is preparing a health teaching program for parents of toddlers and preschoolers and plans to include information about prevention of accidental poisonings. It is most important for the nurse to include which instruction? a. Tell children they should not taste anything but food. b. Store all toxic agents and medicines in locked cabinets. c. Provide special play areas in the house and restrict play in other areas. d. Punish children if they open cabinets that contain household chemicals - CORRECT ANSWERS b A 6-month-old infant with congestive heart failure (CHF) is receiving digoxin elixir. Which observation by the nurse warrants immediate intervention? a. Apical heart rate of 60. b. Sweating across the forehead. c. Doesn't suck well. d. Respiratory rate of 30 breaths per minute. - CORRECT ANSWERS a At 8 a.m. the unlicensed assistive personnel (UAP) informs the charge nurse that a female adolescent client with acute glomerulonephritis has a blood pressure of 210/110. The 4 a.m. blood pressure reading was 170/88. The client reports to the UAP that she is upset because her boyfriend did not visit last night. What action should the nurse take first? a. Give the client her 9 a.m. prescription for an oral diuretic early. b. Administer PRN prescription of nifedipine (Procardia) sublingually. c. - CORRECT ANSWERS b A premature newborn girl, born 24 hours ago, is diagnosed with a patent ductus arteriosus (PDA) and placed under an oxygen hood at 35%. The parents visit the nursery and ask to hold her. Which response should the nurse provide to the parents? a. "Studies have shown that handling a sick newborn is not good for the baby and upsets the parents." b. "The oxygen hood is holding the baby's oxygen level just at the point which is needed. You may stroke and talk to her." c. "Since your baby has been do - CORRECT ANSWERS b The nurse is developing a plan of care for a 3-year-old who is scheduled for a cardiac catheterization. To assist in decreasing anxiety for the child on the day of the procedure, which intervention is best for the nurse to implement? a. Reassure the parents that 3-year-olds are cooperative and therefore are less likely to be anxious. b. Obtain a video film of a cardiac catheterization to show to the child prior to the procedure. c. Give the child a ride on a gurney to visit the cardiac catheter - CORRECT ANSWERS c When taking the health history of a child, the nurse knows that which finding is an early indication of hypothyroidism in children? a. Hyperactive behavioral traits. b. Delay in the eruption of permanent teeth. c. Slow sexual development, but within normal range. d. Cessation of growth in a child that had been normal. - CORRECT ANSWERS d The nurse is teaching a 12-year-old male adolescent and his family about taking injections of growth hormone for idiopathic hypopituitarism. Which adverse symptoms, commonly associated with growth hormone therapy, should the nurse plan to describe to the child and his family? a. Polyuria and polydipsia. b. Lethargy and fatigue. c. Increased facial hair. d. Facial bone structure changes. - CORRECT ANSWERS a The nurse is caring for a 12-year-old with Syndrome of Inappropriate Antidiuretic Hormone (SIADH). This child should be carefully assessed for which complication? a. Poor skin turgor resulting from dehydration. b. Changes in level of consciousness. c. Premature aging as the disease progresses. d. Severe edema from an excess of water and sodium. - CORRECT ANSWERS b A 4-year-old girl continues to interrupt her mother during a routine clinic visit. The mother appears irritated with the child and asks the nurse, "is this normal behavior for a child this age?" The nurse's response should be based on which information? a. Children need to retain a sense of initiative without impinging on the rights and privileges of others. b. Negative feelings of doubt and shame are characteristic of 4-year-old children. c. Role conflict is a common problem of children this a - CORRECT ANSWERS a The mother of a 2-year-old boy consults the nurse about her son's increased temper tantrums. The mother states, "Yesterday he threw a fit in the grocery store, and I did not know what to do. I was so embarrassed. What can I do if this occurs again?" Which recommendation is best for the nurse to provide this mother? a. Paddle him gently as soon as the behavior is initiated. b. Immediately put him in "time-out." c. Quietly remind him that others are watching him. d. Walk away from him and ignore - CORRECT ANSWERS d A 14-year-old female client tells the nurse that she is concerned about the acne she has recently developed. Which recommendation should the nurse provide? a. Remove all blackheads and follow with an alcohol scrub. b. Use medicated cosmetics only to help hide the blemishes. c. Wash the hair and skin frequently with soap and hot water. d. Encourage her to see a dermatologist as soon as possible. - CORRECT ANSWERS c During discharge teaching of a child with juvenile rheumatoid arthritis, the nurse should stress to the parents the importance of obtaining which diagnostic testing? a. Hearing tests. b. Eye exams. c. Chest x-rays. d. Fasting blood glucose tests. - CORRECT ANSWERS b A hospitalized 16-year-old male refuses all visits from his classmates because he is concerned about his distorted appearance. To increase the client's social interaction, what intervention is best for the nurse to initiate? a. Encourage the client to use a hand-held video game that is popular with all his friends. b. Assign a 25-year-old female nursing student to offer support to the client. c. Arrange for an Internet connection in the client's room for email communication. d. Encourage the cl - CORRECT ANSWERS c The nurse is assessing a 2-year-old. What behavior indicates that the child's language development is within normal limits? a. Is able to name four colors. b. Can count five blocks. c. Is capable of making a three word sentence. d. Half of child's speech is understandable. - CORRECT ANSWERS c When evaluating the effectiveness of interventions to improve the nutritional status of an infant with gastro-esophageal reflex, which intervention is most important for the nurse to implement? a. Record weight daily. b. Assess for signs of anemia. c. Document sleeping patterns. d. Teach parenting skills. - CORRECT ANSWERS a Which menu selection by a child with celiac disease indicates to the nurse that the child understands necessary dietary considerations? a. Oven-baked potato chips and cola. b. Peanut butter and banana sandwich. c. Oatmeal-raisin cookies and milk. d. Graham crackers and fruit juice. - CORRECT ANSWERS a The parents of a 3-week-old infant report that the child eats well but vomits after each feeding. What information is most important for the nurse to obtain? a. Description of vomiting episodes in past 24 hours. b. Number of wet diapers in last 24 hours. c. Feeding and sleep schedule. d. Amount of formula consumed during the past 24 hours. - CORRECT ANSWERS a A 3-month-old infant develops oral thrush. Which pharmacologic agent should the nurse plan to administer for treatment of this disorder? a. Nystatin (Mycostatin). b. Nitrofurantoin (Macrodantin). c. Norfloxacin (Noroxin). d. Neomycin sulfate (Mycifradin). - CORRECT ANSWERS a Which class of antiinfective drugs is contraindicated for use in children under 8 years of age? a. Aminoglycosides. b. Tetracyclines. c. Penicillins. d. Quinolones. - CORRECT ANSWERS b A female teenager is taking oral tetracycline HCL (Achromycin V) for acne vulgaris. What is the most important instruction for the nurse to include in this client's teaching plan? a. "Use sunscreen when lying by the pool." b. "Cleanse the skin at least 4 times a day." c. "Take the medication with a glass of milk." d. "Menstrual periods may become irregular." - CORRECT ANSWERS a The mother of a 6-month-old asks the nurse when her baby will get the first measles, mumps, and rubella (MMR) vaccine. Based on the recommended childhood immunization schedule published by the Centers for Disease Control, which response is accurate? a. 3 to 6 months. b. 12 to 15 months. c. 18 to 24 months. d. 4 to 6 years. - CORRECT ANSWERS b Preoperative nursing care for a child with Wilms' tumor should include which intervention? a. Gently percuss the abdomen for evidence of trapped air. b. Observe the abdomen for any noticeable discolorations. c. Apply cold compresses to the abdomen to reduce edema. d. Put a sign on the bed reading, "DO NOT PALPATE ABDOMEN." - CORRECT ANSWERS d A 4-year-old boy was admitted to the emergency room with a fractured right ulna and a short arm cast was applied. When preparing the parents to take the child home, which discharge instruction has the highest priority? a. "Call the healthcare provider immediately if his nail beds appear blue." b. "Check his fingers hourly for the first 48 hours to see that he is able to move them without pain." c. "Be sure our child's arm remains above his heart for the first 24 hours." d. "Take his temperature - CORRECT ANSWERS a An 18-month-old is admitted to the hospital with possible Hirschsprung's disease. When obtaining a nursing history, the nurse asks about bowel habits. What description of the disease? a. Foul-smelling and fatty. b. Bile-colored and watery. c. Semi-solid and yellow. d. Ribbon-like and brown. - CORRECT ANSWERS d The nurse must prevent a 2-year-old with severe eczema on the face, neck, and scalp from scratching the affected areas. Which nursing intervention is most effective in preventing further excoriation due to the pruritis? a. Obtain gloves for the child's hands. b. Apply finger cots on the child's fingers. c. Place elbow restraints on the child's arms. d. Apply soft restraints to the child's wrists. - CORRECT ANSWERS c The nurse assigning care for a 5-year-old child with otitis media is concerned about the child's increasing temperature over the past 24 hours. Which statement is accurate and should be considered when planning care for the remainder of the shift? a. An RN should be assigned to take temperatures frequently. b. Tympanic and oral temperatures are equally accurate. c. The PN should take rectal temperatures on this child. d. The pediatrician should decide how to assess the temperature. - CORRECT ANSWERS b A 3-year-old boy is brought to the emergency room because he swallowed an entire bottle of children's vitamin pills. Which intervention should the nurse implement first? a. Insert N/G tube for gastric lavage. b. Determine the child's pulse and respirations. c. Assess the child's level of consciousness. d. Administer an IV D5/0.25 NS as prescribed. - CORRECT ANSWERS b A 2-year-old child with gastro-esophageal reflux has developed a fear of eating. What instruction should the nurse include in the parents' teaching plan? a. Invite other children home to share meals. b. Accept that he will eat when he is hungry. c. Reward the child with a nap after eating. d. Consistently follow a set mealtime routine. - CORRECT ANSWERS d A 6-month-old boy and his mother are at the healthcare provider's office for a well-baby check-up and routine immunizations. The healthcare provider recommends to the mother that the child receive an influenza vaccine. What medications should the nurse plan to administer today? a. The routine immunizations and schedule another appointment to administer the influenza vaccine. b. All the immunizations with the influenza vaccine given at a separate site from any other injection. c. The influenza v - CORRECT ANSWERS b The nurse is assessing a 13-year-old girl with suspected hyperthyroidism. Which question is most important for the nurse to ask her during the admission interview? a. "Have you lost any weight in the last month?" b. "Are you experiencing any type of nervousness?" c. "When was the last time you took your Synthroid?" d. "Are you having any problems with your vision?" - CORRECT ANSWERS b The nurse is planning care for school-aged children at a community care center. Which activity is best for the children? a. Building model airplanes. b. Playing follow-the-leader. c. Stringing large and small beads. d. Playing with Playdough and clay. - CORRECT ANSWERS b Surgery is being delayed for an infant with undescended testes. In collaboration with the healthcare provider and the family, which prescription should the nurse anticipate? a. A trial of adrenocorticotrophic hormone injections. b. Frequent stimulation of the cremasteric reflex. c. A trial of human chronic gonadotrophic hormone. d. Frequent warm baths to gently dilate the scrotal area. - CORRECT ANSWERS c A 3-year-old client with sickle cell anemia is admitted to the Emergency Department with abdominal pain. The nurse palpates an enlarged liver, an x-ray reveals an enlarged spleen, and a CBC reveals anemia. These findings indicate with type of crisis? a. Aplastic. b. Sequestration. c. Hyperhemolytic. d. Vaso-occlusive. - CORRECT ANSWERS b To assess the effectiveness of an analgesic administered to a 4-year old, what intervention is best for the nurse to implement? a. Use a happy-face/sad-face pain scale. b. Ask the mother if she thinks the analgesic is working. c. Assess for changes in the child's vital signs. d. Teach the child to point to a numeric pain scale. - CORRECT ANSWERS a In developing a teaching plan for a 5-year-old child with diabetes, which component of diabetic management should the nurse plan for the child to manage first? a. Food planning and selection. b. Administering insulin injections. c. Process of glucose testing. d. Drawing up the correct inulin dose. - CORRECT ANSWERS c A 17-year-old male student reports to the school clinic one morning for a scheduled health exam. He tells the nurse that he just finished football practice and is on his way to class. The nurse assesses his vital signs: temperature 100 F, pulse 80, respirations 20, and blood pressure 122/82. What is the best action for the nurse to take? a. Tell the student to proceed to his regularly scheduled class. b. Call the parent and suggest re-taking the student's temperature at home. c. Give the studen - CORRECT ANSWERS a The vital signs of a 4-year-old child with polyuria are: BP 80/40, Pulse 118, and Respirations 24. The child's pedal pulses are present with a volume of +1, and no edema is observed. What action should the nurse implement first? a. Insert an indwelling urinary catheter. b. Start an IV infusion of normal saline. c. Sen a specimen to the lab for urinalysis. d. Document the child's vital signs and pulses. - CORRECT ANSWERS b A 3-week-old newborn is brought to the clinic for follow-up after a home birth. The mother reports that her child bottle feeds for 5 minutes only and then falls asleep. The nurse auscultates a loud murmur characteristic of a ventricular septal defect (VSD), and finds the newborn is acyanotic with a respiratory rate of 64 breaths per minute. What instruction should the nurse provide the mother to ensure the infant is receiving adequate intake? (Select all that apply.) a. Monitor the infant's wei - CORRECT ANSWERS a, b, d, e When discussing discipline with the mother of a 4-year-old child, the nurse should include with guideline? a. Parental control should be consistent. b. Children as young as 4 years rarely need reprimand or punishment. c. Withdrawal of approval is effective. d. Parents should entice rigid rules to the followed without question. - CORRECT ANSWERS a Which action by the nurse is most helpful in communicating with a preschool-aged child? a. Speak clearly and directly to the child. b. Use a doll to play and communicate. c. Approach when a parent is not present. d. Play a board game with the child. - CORRECT ANSWERS b The nurse is having difficulty communicating with a hospitalized 6-year-old child. Which approach by the nurse is most helpful in establishing communication? a. Engage the child through drawing pictures. b. Suggest that the parent read a book to the child. c. Provide paper and pencil for the child to keep a diary. d. Ask the parent if the child is always uncommunicative. - CORRECT ANSWERS a A child falls on the playground and is brought to the school nurse with a small laceration on the forearm. Which action should the nurse implement first? a. Slowly pour hydrogen peroxide over the open wound. b. Apply ice to the area before rinsing with cold water. c. Wash the wound gently with mild soap and water. d. Gently cleanse with a sterile pad using povidone-iodine. - CORRECT ANSWERS c A 6-year-old is admitted to the pediatric unit after falling off a bicycle. Which intervention should the nurse implement to assist the child's adjustment to hospitalization? a. Explain hospital schedules to the child, such as mealtimes. b. Use terms, such as "honey" and "dear," to show a caring attitude. c. Provide a list of rules that limits visitation of siblings in the hospital. d. Orient the parents to the hospital unit and refreshment areas. - CORRECT ANSWERS a A 16-year-old is brought to the Emergency Center with a crushed leg after falling off a horse. The adolescent's last tetanus toxoid booster was received eight years ago. What action should the nurse take? a. Dispense a tetanus antitoxin. b. Prepare human tetanus immune globulin. c. Administer tetanus toxoid booster. d. Delay the tetanus booster until due. - CORRECT ANSWERS c A child with cystic fibrosis is having stools that float and are foul smelling. Which descriptive term should the nurse use to document the finding? a. Diarrhea. b. Rhinorrhea. c. Galactorrhea. d. Steatorrhea. - CORRECT ANSWERS d The clinic nurse is taking the history for a new 6-month-old client. The mother reports that she took a great deal of aspirin while pregnant. Which assessment should the nurse obtain? a. Type of reaction to loud noises. b. Any surgeries on the ears since birth. c. Drainage from the infant's ears. d. Number of ear infections since birth. - CORRECT ANSWERS a The nurse is giving a liquid iron preparation to a 3-year-old child. Which technique should the nurse implement to engage the child's cooperation? a. Use a colorful straw. b. Mix the medication in water. c. Administer the medication using an oral syringe. d. Ask the pharmacy to provide an enteric tablet. - CORRECT ANSWERS a The nurse is teaching a mother to give 4 mL of a liquid antibiotic to a 10-month-old infant. Which statement by the parent indicates a need for further teaching? a. "I will give this antibiotic to my child until it is finished." b. "Using a teaspoon will help me measure this correctly." c. "I will call the clinic if my child develops a rash or itching." d. "My baby should begin to feel better within a few days." - CORRECT ANSWERS b Which growth and development characteristic should the nurse consider when monitoring the effects of a topical medication for an infant? a. A lower sensitivity reactions to skin irritants. b. A thin stratum corneum that increases topical absorption. c. A smaller percentage of muscle mass. d. A greater body surface area that requires larger dosages. - CORRECT ANSWERS b A 2-year-old child recently with hemophilia A is discharged home. What information should the nurse include in a teaching plan about home care? a. Minimize interactive play with other children to lessen chances for injury. b. Give low-dose children's chewable aspirin in orange flavor for joint discomfort. c. Use a firm and dry toothbrush to clean teeth at least twice per day. d. Apply pressure and ice for bleeding while elevating and resting the extremity. - CORRECT ANSWERS d A nurse provides the parents with information on health maintenance for their child with sickle cell disease. Which information reflected by the parents indicates understanding of the child's care? a. Daily iron supplements should be given. b. Plenty of fluids should be consumed daily. c. Immunizations should be delayed for a few years. d. Protective equipment should be worn for contact sports. - CORRECT ANSWERS b The nurse reviews the latest laboratory results for a child who received chemotherapy last week and identifies a reduces neutrophil count. Which nursing diagnosis has the highest priority for this child? a. Risk for infection. b. Risk for hemorrhage. c. Altered skin integrity. d. Disturbance in body image. - CORRECT ANSWERS a During administration of a blood transfusion, a child complains of chills, headache, and nausea. Which action should the nurse implement? a. Start another IV of dextrose solution and stay with the child. b. Continue the transfusion and monitor the child's vital signs. c. Stop the infusion immediately and notify the healthcare provider. d. Sow the transfusion and assess for cessation of symptoms. - CORRECT ANSWERS c The nurse is teaching the parents of a 5-year-old with cystic fibrosis about respiratory treatments. Which statement indicates to the nurse that the parents understand? a. "Perform postural drainage before starting the aerosol therapy." b. "Give respiratory treatments when the child is coughing a lot." c. "Administer aerosol therapy followed by postural drainage before meals." d. "Ensure respiratory therapy is done during any respiratory infection." - CORRECT ANSWERS c The nurse is assessing the neurovascular status of a child in Russell's traction. Which finding should the nurse report to the healthcare provider? a. Pale bluish coloration of the toes. b. Skin is warm and dry to the touch. c. Toes are wiggled upon command. d. Capillary refill less than 3 seconds. - CORRECT ANSWERS a A child is rescued from a burning house and brought to the emergency room with partial-thickness burns on the face and chest. Which action should the nurse implemented first? a. Insert an indwelling urinary catheter. b. Administer IV pain medication. c. Collect blood specimen for laboratory studies. d. Assess the child's respiratory status. - CORRECT ANSWERS d The mother of a 4-year-old child asks the nurse what she can do to help her other children cope with their sibling's hospitalizations. Which is the best response that the nurse should offer? a. Inform the parent that the child is too young to visit the hospital. b. Suggest that the child visit a grandmother until the sibling returns home. c. Ask the mother if the child asks when the sibling will be discharged. d. Encourage the mother to have the children visit the hospitalized sibling. - CORRECT ANSWERS d Which finding in a 19-year-old female client should trigger further assessment by the nurse? A. menstruation has not occurred B. reports no tetanus immunization since childhood C. denies having any wisdom teeth D. history of painful, inward growth on bottom of foot - CORRECT ANSWERS a A 15-year-old girl tells the school nurse that all of her friends have started their periods and she feels abnormal because she has not. Which response is best for the nurse provide? a. Refer the adolescent to the healthcare provider for a pregnancy screen. b. Schedule a conference with her parents to recommend hormone therapy. c. Explain that menarche varies and occurs between the ages of 12 and 18 years. d. Suggest that she use diversions to help her not worry about delayed menarche. - CORRECT ANSWERS c Which measurements should be used to accurately calculate a pediatric medication dosage? (Select all that apply.) a. Child's height and weight. b. Adult dosage of medication. c. Body surface area of child. d. Average adult's body surface area. e. Average pediatric dosage of medication. f. Nomogram determined mathematical constant. - CORRECT ANSWERS a, c, f A 17-year-old male student reports to the school clinic one morning for a scheduled health exam. He tells the nurse that he just finished football practice and is on his way to class. The nurse assesses his vital signs: temperature 100 F, pulse 80, respirations 20, and blood pressure 122/82. What is the best action for the nurse to take? a. Tell the student to proceed directly to his regularly scheduled class. b. Call the parent and suggest re-taking the student's temperature at home. c. Give t - CORRECT ANSWERS a When evaluating the effectiveness of interventions to improve the nutritional status of an infant with gastro-esophageal reflux, which intervention is most important for the nurse to implement? a. Record weight daily. b. Assess for signs of anemia. c. Document sleeping patterns. d. Teach parenting skills. - CORRECT ANSWERS a A 6-month-old infant with congestive heart failure (CHF) is receiving digoxin elixir. Which observation by the nurse warrants immediate intervention? a. Apical heart rate of 60. b. Sweating across the forehead. c. Doesn't suck well. d. Respiratory rate of 30 breaths per minute. - CORRECT ANSWERS a The clinic nurse is taking the history for a new 6-month-old client. The mother reports that she took a great deal of aspirin while pregnant. Which assessment should the nurse obtain? a. Type of reaction to loud noises. b. Any surgeries on the ears since birth. c. Drainage from the infant's ears. d. Number of ear infections since birth. - CORRECT ANSWERS a Which measurements should be used to accurately calculate a pediatric medication dosage? (Select all that apply.) a. Child's height and weight. b. Adult dosage of medication. c. Body surface area of child. d. Average adult's body surface area. e. Average pediatric dosage of medication. f. Nomogram determined mathematical constant. - CORRECT ANSWERS a, c, f In developing a teaching plan for a 5-year-old child with diabetes, which component of diabetic management should the nurse plan for the child to manage first? a. Food planning and selection. b. Administering insulin injections. c. Process of glucose testing. d. Drawing up the correct insulin dose. - CORRECT ANSWERS c Which class of antiinfective drugs is contraindicated for use in children under 8 years of age? a. Aminoglycosides. b. Tetracyclines. c. Penicillins. d. Quinolones. - CORRECT ANSWERS b The nurse is having difficulty communicating with a hospitalized 6-year-old child. Which approach by the nurse is most helpful in establishing communication? a. Engage the child through drawing pictures. b. Suggest that the parent read a book to the child. c. Provide paper and pencil for the child to keep a diary. d. Ask the parent if the child is always uncommunicative. - CORRECT ANSWERS a The mother of a preschool-aged child asks the nurse if it is all right to administer Pepto Bismol to her son when he "has a tummy ache." After reminding the mother to check the label of all over-the-counter drugs for the presence of aspirin, which instruction should the nurse include when replying to this mother's question? a. If the child's tongue darkens, discontinue the Pepto Bismol immediately. b. Do not give if the child has chickenpox, the flu, or any other viral illness. c. Avoid the use - CORRECT ANSWERS b An infant is born with a ventricular septal defect (VSD) and surgery is planned to correct the defect. The nurse recognizes that surgical correction is designed to achieve with outcome? a. Stop the flow of unoxygenated blood into systemic circulation. b. Increase the flow of unoxygenated blood to the lungs. c. Prevent the return of oxygenated blood to the lungs. d. Reduce peripheral tissue hypoxia and nailbed clubbing. - CORRECT ANSWERS c When discussing discipline with the mother of a 4-year-old child, the nurse should include which guideline? a. Parental control should be consistent. b. Children as young as 4 years rarely need reprimand or punishment. c. Withdrawal of approval is effective. d. Parents should enforce rigid rules to be followed without question. - CORRECT ANSWERS a To assess the effectiveness of an analgesic administered to a 4-year-old, what intervention is best for the nurse to implement? a. Use a happy-face/sad-face pain scale. b. Ask the mother if she thinks the analgesic is working. c. Assess for changes in the child's vital signs. d. Teach the child to point to a numeric pain scale. - CORRECT ANSWERS a Which growth and development characteristic should the nurse consider when monitoring the effects of a topical medication for an infant? a. A lower sensitivity reactions to skin irritants. b. A thin stratum corneum that increases topical absorption. c. A smaller percentage of muscle mass. d. A greater body surface area that requires larger dosages. - CORRECT ANSWERS b During routine screening at a school clinic, an otoscope examination of a child's ear reveals a tympanic membrane that is pearly gray, slightly bulging, and not movable. What action should the nurse take next? a. No action required, as this is an expected finding for a school-aged child. b. Ask the child if he/she has had a cold, runny nose, or any ear pain lately. c. Send a note home advising the parents to have the child evaluated by a healthcare provider as soon as possible. d. Call the pare - CORRECT ANSWERS b All of the following interventions can be used to evaluate the effectiveness of nursing and medical interventions used to treat diarrhea. Which intervention is least useful in the nurse's evaluation of a 20-month-old child? a. Weighing diapers. b. Assessing fontanels. c. Checking skin turgor. d. Observing mucous membranes for moisture. - CORRECT ANSWERS b At 8 a.m. the unlicensed assistive personnel (UAP) informs the charge nurse that a female adolescent client with acute glomerulonephritis has a blood pressure of 210/110. The 4 a.m. blood pressure reading was 170/88. The client reports to the UAP that she is upset because her boyfriend did not visit last night. What action should the nurse take first? a. Give the client her 9 a.m. prescription for an oral diuretic early. b. Administer PRN prescription of nifedipine (Procardia) sublingually. c. - CORRECT ANSWERS b A 2-year-old child recently diagnosed with hemophilia A is discharged home. What information should the nurse include in a teaching plan about home care? a. Minimize interactive play with other children to lessen chances for injury. b. Give low-dose children's chewable aspirin in orange flavor for joint discomfort. c. Use a firm and dry toothbrush to clean teeth at least twice per day. d. Apply pressure and ice for bleeding while elevating and resting the extremity. - CORRECT ANSWERS d The nurse is assessing a 13-year-old girl with suspected hyperthyroidism. Which question is most important for the nurse to ask her during the admission interview? a. "Have you lost any weight in the last month?" b. "Are you experiencing any type of nervousness?" c. "When was the last time you took your Synthroid?" d. "Are you having any problems with your vision?" - CORRECT ANSWERS b A 2-year-old child with Down syndrome is brought to the clinic for his regular physical examination. The nurse knows which problem is frequently associated with Down syndrome? a. Congenital heart disease. b. Fragile X chromosome. c. Trisomy 13. d. Pyloric stenosis. - CORRECT ANSWERS a The nurse s teaching a mother to give 4 mL of a liquid antibiotic to a 10-month-old infant. Which statement by the parent indicates a need for further teaching? a. "I will give this antibiotic to my child until it is finished." b. "Using a teaspoon will help me measure this correctly." c. "I will call the clinic if my child develops a rash or itching." d. "My baby should begin to feel better within a few days." - CORRECT ANSWERS b [Show More]

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