Practice Pediatrics Exam 84 Questions with Verified Answers,100% CORRECT

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Practice Pediatrics Exam 84 Questions with Verified Answers The nurse is giving preoperative instructions to a 14-year-old female client who is scheduled tor surgery to correct a spinal curvature. ... Which statement by the client best demonstrates that learning has taken place? A "l 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 nave told me will help me take care of my back." D "l understand that I will be in a body cast an - CORRECT ANSWER D Outcome of learning is best demonstrated when the client not only verbalizes an understanding but can also provide a return demonstration (D). A 14-year-old may or may not follow through with (A), and there is no measurement of that learning. Having previous surgery (8) may help the client understand the surgical process, but wrist surgery is very different from spinal surgery and emergency surgery is different from elective surgery. In (C), the client may be saying what the nurse wants to near, without expressing any real understanding of what to do after surgery 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 ANSWER A The respiratory rate should be taken first (A) in infants, since touching them or performing unpleasant procedures usually makes them cry, elevating the heart rate and making respirations difficult to count Rectal temperature is the most invasive procedure, and is most likely to precipitate crying, so should be done last (C and D). 3. 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. A. No action required, as this is an expected finding tor 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 nave the child evaluated by a healthcare provider as soon as possible. D Call the - CORRECT ANSWER B More information is needed to interpret these findings The tympanic membrane is normally pearly gray, not bulging, and moves when the client blows against resistance or a small puff of air is blown into the ear canal. Since this child's findings are not completely normal, further assessment of history and related signs and symptoms is indicated tor accurate interpretation of the findings. (A, C, and D) are inappropriate actions based on the data obtained from the otoscope examination. 4. Which restraint should be used tor a toddler after a cleft palate repair? A Glove. B Mummy. C Elbow. D Jacket - CORRECT ANSWER C Elbow restraints prevent children from bending their arms and bringing their hands to the oral surgical site. (A) restrains the hands, but the child can bend and bring their head to their hands. (B) is used during procedures. (D) restrains the body torso and is not appropriate. 5. What preoperative nursing intervention should be included in the plan of care tor an infant with pyloric stenosis? A Monitor tor signs of metabolic acidosis. B Estimate the quantity of diarrhea stools. C Place in a supine position after feeding. D Observe tor projectile vomiting. - CORRECT ANSWER D Projectile vomiting (D), which contributes to metabolic alkalosis (A), is the classic sign of pyloric stenosis. (B) is not indicated. (C) is dangerous, due to the potential tor aspiration with frequent vomiting. A six-month-old returns from surgery with elbow restraints in place. What nursing care should be included when caring tor 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 tor restraints every 72 hours. - CORRECT ANSWER B Removing restraints one at a time (B) is safer than removing all of them at once (C). The child needs to exercise and should not be kept in restraints at all times (A). The renewal of the healthcare provider's prescription varies with hospitals (D), and it does not really answer the question. A 2-year-old child with Down syndrome is brought to the clinic tor 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 ANSWER A Congenital heart disease (A) is the most common associated detect in children with Down syndrome. (C) might have seemed possible since Down syndrome is a trisomal chromosomal abnormality of chromosome 21. (3) is a sex-linked abnormality also causing mental retardation. (D) is not associated with Down syndrome. When assessing a child with asthma, the nurse should expect intercostal retractions during A inspiration. B coughing. C apneic episodes. D expiration - CORRECT ANSWER A Intercostal retractions result from respiratory effort to draw air into restricted airways (A). When planning the care tor 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 ANSWER D Prevention of stress on the lip suture line (D) is essential for optimum healing and the cosmetic appearance of a cleft lip repair. Although crying also causes (A, B, and C), these conditions do not create a problem tor the child with a cleft lip repair. 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 Scapnoid abdomen and anorexia. - CORRECT ANSWER A (A) includes the "3 Cs" of esophageal atresia caused by the overflow of secretions into the trachea. (B) is characteristic of pyloric stenosis in the infant. (C) could be due to prematurity or sepsis, and grunting is a sign of respiratory distress. (D) is characteristic of diaphragmatic hernia. 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 tor 15 minutes. - CORRECT ANSWER C Two-year-old children are egocentric and unable to share with other children. (A, B, and D) are behaviors of a preschooler. The mother of a preschool-aged child asks the nurse it it is all right to administer Pepto Bismol to her son when he "has a tummy acne:' After reminding the mother to check the label of all over-the-counter drugs tor the presence of aspirin, which instruction should the nurse include when replying to this mothers question? A It the child's tongue darkens, discontinue the Pepto Bismol immediately. B Do not give it the child has chickenpox, the flu, or any other viral illness. C Avoid the use of - CORRECT ANSWER B Pepto Bismol contains aspirin and there is the potential of Reye's syndrome. (A) is a common effect of Pepto Bismol and does not warrant discontinuation. Pepto Bismol can be used by children (C). Pepto Bismol does not cause rebound hyperacidity (D), which is a complication of antacids containing calcium. The nurse observes a 4-year-old boy in a daycare setting. Which behavior should the nurse consider normal tor this child? A Has a temper tantrum when told he must snare 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 tearful when separated from his parents. - CORRECT ANSWER C Four-year-old children are aggressive in their behavior and enjoy "tale telling" (C). Behaviors in (A and D) are typical of toddlers. The play of a preschooler is cooperative, so playing alone (B) is not typical. 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 ANSWER A A child's head and neck are proportionately larger to their body than an adults (A). The standard "Rule of Nines" is inaccurate tor determining burned body surface areas with children, and must be modified tor use with children. Specially designed charts tor children are commonly used to determine body surface area involvement (a, C, and D) are not proportionately different 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 ANSWER A The therapeutic level of theopnylline is 10 to 20 mcg/dl, so the child's level is within the therapeutic range. This information evaluates the prescribed therapy and should be communicated in the nurse's report (A). (B, C, and D) would be inappropriate actions in view of the laboratory finding. 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 tor 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 ANSWER C A patent airway has the highest priority. Humidification will liquefy the nasal secretions thereby increasing the amount of secretions and making (C) the highest priority. (A) maintains hydration and prevent tiring, but an open airway has a higher priority! (3) is important tor evaluation of therapy. When asked "priority" questions, REMEMBER MASLOW' Physical needs usually have a nigher priority than psychosocial needs (D) and an open airay is the highest physiological need 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 tor moisture. - CORRECT ANSWER B All of these interventions evaluate fluid status in infants. But, now old is this child? Posterior fontanel closes at 2 months and anterior fontanel closes by 18 months of age Remember normal growth and development! 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 KCI/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 ANSWER B Regardless of a client's age, adequate renal function must be present before adding potassium to IV fluids (B). (A) is important in determining the need for fluid replacement. (C) is not indicated. (D) is useful information, but will not impact administration of the prescribed IV solution. The nurse is assigning care tor 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 tor this child, it is important tor 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 pr - CORRECT ANSWER B A tympanic membrane sensor [s an excellent site because 50th the eardrum and hypothalamus (temperature-regulating center) are perfused by the same circulation. The sensor is unaffected by cerumen and the presence of suppurative or unsuppurative otitis media does not effect measurement RULE OF THUMB: for management—sterile procedures should be assigned to licensed personnel. Management skills will be tested on the NCLEX An RN is not required (A). Rectal temperature measurement (C) is less accurate because of the possibility of stool in the rectum. (D) is unnecessary. 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 ANSWER D Tetrology of Fallot, a congenital heart disease detect, causes clubbing of fingers and toes (D) due to tissue hypoxia. Tachycardia, not (A), is a manifestation of classic sign of ventricular septal detect (C) is characteristic of coarctation of the aorta. 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 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 28-month-old with hydrocephalus that has an open anterior fontanel - CORRECT ANSWER A At six months of age the anterior fontanel should be open, and it should not be closed until approximately 18 months of age. (3 and C) are normal findings. A child with hydrocephalus may have a delayed closing or the fontanel (D). A preschool-age child who is hospitalized tor hypospadias repair IS most strongly influenced by which behavior? A Ability to communicate verbally. B Response to separation from family. C Concern tor body integrity. D Socialization with other children. - CORRECT ANSWER C The preschoolers major stressor is concern for his body integrity (C). He tears that his "insides will leak out." A child undergoing surgery to his genitalia is even more concerned about body integrity. The preschooler is quite verbal, so comprehension of the words he uses or nears may be inaccurate, while his imagination and fears may fantasize the reality (A). (B) is a concern tor all children, but of most concern to the toddler. (D) is not a prime concern in this situation. An infant is born with a ventricular septal detect (VSD) and surgery is planned to correct the detect 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 low 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 ANSWER C Closure of VSDs stops oxygenated blood from being shunted from the left ventricle to the right ventricle (C). VSDs are acyanotic defects, which means that no oxygenated blood enters the systemic circulation (A and B). (D) is common with Tetrology of Fallot, which is a cyanotic defect. A three-month old boy weighing 10 lbs 15 oz has an axillary temperature of 98.9 E The nurse determines the daily caloric need tor 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 ANSWER C 10 lbs 15 oz = 10.9 lbs. Convert lbs to kg by dividing pounds by 2.2; 10.9/2.2 = 4.954 kg, rounded to 5 kg. An infant requires 108 calories/kg/day (108 x 5 = 540 calories/day). However, this infant requires 10% more calories because he has one degree temperature elevation. 10% of 540 is 54 and 540 + 54 = 594. This infant will require approximately 600 calories/day Tough question! You know that 400 calories are too few and 700 are too much, and a temperature elevation necessitates consumption of more calories, so choose the higher of the two choices left! The nurse is preparing a health teaching program tor parents of toddlers and preschoolers and plans to include information about prevention of accidental poisonings. It is most important tor 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 f they open cabinets that contain household chemicals. - CORRECT ANSWER B The only reliable way to prevent poisonings in young children is to make them inaccessible (B). Teaching children not to taste is important (A), but ineffective tor young children. (C and D) will not control a child's curiosity. 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 ANSWER A A heart rate of 60 (A) is much lower than normal for a a-month-old and warrants immediate intervention. The normal heart rate for a 6-month-old is 80 to 150 apical when awake and a rate of 70 while sleeping is considered within normal limits. (B and C) are expected symptoms of heart failure in an infant (D) is within normal limits for an infant At 8 a.m. the unlicensed assistive personnel (LIA?) informs the charge nurse that a female adolescent client with acute glomerulonepnritis 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 tor an oral diuretic early. B Administer PRN prescription of nitedipine (Procardia) sublingually C Not - CORRECT ANSWER B Sublingual Procardia (B) lowers blood pressure very quickly, and this should be done first (A) may also be done, but oral diuretics do not work as rapidly as the sublingual antihypertensive. When notifying the healthcare provider, the first thing he/she will want to know is f the PRN antihypertensive has been administered (C). (D) does not consider the seriousness of this finding. The nurse should stay with the client until the blood pressure is reduced. 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 tor me baby and upsets the parents." B "Tne 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 doing - CORRECT ANSWER B The baby is at 35% which is much more than room air (21%) and at this time the baby should not be moved from under the hood. The nurse should otter the parents an alternative such as to stroke and reassure the infant (B). Holding sick babies benefits the infant and the parents (A). The first consideration now has to be the infant's oxygenation. The nurse should not take the baby out from under the hood without a prescription from the healthcare provider, as this could severely compromise the infant A PO2 of 35% cannot be readily achieved with "blow by" oxygen (D). The nurse is developing a plan of care tor a 3-year-old who is scheduled tor a cardiac catheterization. To assist in decreasing anxiety tor the child on the day of the procedure, which intervention is best tor 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 snow to the child prior to the procedure. C Give the child a ride on a gumey to visit the cardiac catheterizat - CORRECT ANSWER C Familiarizing the child and mother with the department (C) will help decrease anxiety of the child and mother (who may have more anxiety than the child). Three is a difficult age to undergo a procedure that requires cooperation Restraints and possibly sedation may be required (A). At three, the child is too young to understand why this must be done, and (3) is not indicated. (D) is also not indicated because is likely to be interpreted as painful. 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 ANSWER D Since the thyroid gland is responsible tor metabolism, for hypothyroidism in children. The child with hypothyroidism they are late signs (not early indications) and are signs more of growth (D) which was previously within normal range, is the most common sign is likely to be HYPOactive, not (A). Although (B and C) may occur with hypothyroidism, often associated with a lack of growth hormone. The nurse is teaching a 12-year-old male adolescent and his family about taking injections of growth hormone tor idiopathic hypopituitarisrn. 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 ANSWER A Signs and symptoms of diabetes or hyperglycemia (A) need to be reported. Those receiving growth hormone should be monitored to detect elevated blood sugars and glucose intolerance. (3) is associated with any number of health alterations, Out is not associated with the growth hormone therapy. (C and D) are normal changes that occur with 12-year-old males. The nurse is caring for a 12-year-old with Syndrome of Inappropriate Antidiuretic Hormone (SIADH). This child should be carefully assessed tor 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 ANSWER B The child must be monitored for signs and symptoms of hyponatremia, which creates secondary central nervous system alterations such as changes in level of consciousness, seizure, and coma/ Fluid overload occurs with SIADH, not (A) (which occurs with diabetes insipidus)_ (C) is caused by hypersecretion of growth hormone, not SIADH. (D) is not found in children with SIADH because edema is caused by an excess of 50th water and sodium. 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 tor 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 age. - CORRECT ANSWER A Children aged 3 to 6 are in Erickson's "Initiative vs. Guilt" stage, which is characterized by vigorous, intrusive behavior, enterprise, and strong imagination. At this age, children develop a conscience and must learn to retain a sense of initiative without impinging on the rights of others (A). (B) describes the "Autonomy vs. Shame and Doubt," stage (1 to 3 years of age). (C) describes an adolescent (12 to 18 years of age), the "Identity vs. Role Contusion" stage (D) describes a child 6 to 12 years of age, the "Industry vs. Inferiority" stage. 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 f this occurs again?" Which recommendation is best tor 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 the b - CORRECT ANSWER D The best approach tor a toddler is to ignore the attention-seeking behavior (D). The parent should be somewhat nearby, within view of the child but should avoid reinforcing the behavior in any way. Tantrums can sometimes be avoided by talking to the child before the situation occurs. (A, B, and C) would all provide attention tor the inappropriate behavior. 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 one,' to help hide the blemishes. C Wash the hair and skin frequently with soap and not water. D Encourage her to see a dermatologist as soon as possible. - CORRECT ANSWER C Washing the hair and skin with soap and hot water (C) removes oil and debris from the skin and helps prevent and treat acne. Oily skin is especially bothersome during adolescence when hormones cause enlargement of sebaceous glands and increased glandular secretions which predispose the teenager to acne. (A) is contraindicated. Cosmetics ("medicated" or not) should be used sparingly to avoid turner blocking sebaceous gland ducts (D) might be indicated at a later time, it healthcare recommendations are not successful. 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 ANSWER B Visual changes leading to blindness can occur in children with JRA_ Regular eye exams (B) can help to prevent this complication. (A, C, and D) are not routinely necessary tor management of JRA_ 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 tor 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 tor an Internet connection in the client's room tor email communication. D Encourage the client - CORRECT ANSWER C Body image and peer acceptance are key concerns for the adolescent. (C) allows for social interaction without face to face contact thus protecting his self-image while also promoting social interaction. (A) does not promote social interaction. (B) does not encourage interaction with his own peer group, which is of greater importance. (D) does not respect the client's concern about his body image. 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 tour colors. B Can count five blocks. C Is capable of making a three word sentence. D Half of child's speech is understandable. - CORRECT ANSWER C A toddler 1 to 3 years old is capable of making two to three word sentences. Other options listed represent different age levels. 39. When evaluating the effectiveness of interventions to improve the nutritional status of an Infant with gastro-esophageal reflux, which intervention is most important tor the nurse to implement? A. Record weight daily B Assess tor signs of anemia. C Document sleeping patterns. D. Teach parenting skills. - CORRECT ANSWER A The most definitive measure of improved nutrition in an infant is obtaining the child's daily weight (A). (B, C, and D) may also be useful, but they are not as definitive as a daily weight measurement 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 ANSWER A Celiac disease causes an intolerance to the protein gluten found in oats, rye, wheat, and barley. The child should avoid any products containing these ingredients to avoid symptoms such as diarrhea. (A) is the selection which avoids all of these ingredients. (B, C, and D) contain gluten in one form or another. The parents of a 3-week-old infant report that the child eats well but vomits after each feeding. What information is most important tor 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 ANSWER A A description of the vomiting episodes (A) will assist the nurse in determining the reason tor the symptoms, which may be helpful in developing a plan of care for this infant. (B and C) provide related information Out are not as helpful as (A). (D) may be related to the vomiting, but the nurse should first obtain a better description of the vomiting episodes. A 3-month-old infant develops oral thrush. Which pharmacologic agent should the nurse plan to administer tor treatment of this disorder? A Nystatin (Mycostatin). B Nitroturantoin (Macrodantin). C Nortloxacin (Noroxin). D Neomycin sulfate (Mycifradin). - CORRECT ANSWER A Nystatin (Mycostatin) (A) is an antifungal drug that is effective in treating thrush, an oral fungal infection (B, C, and D) are not indicated tor the treatment of oral thrush. Which class of antiinfectlve drugs is contraindicated tor use in children under 8 years of age? A Aminoglycosides. B Tetracyclines C Penicillins D Quinolones - CORRECT ANSWER B Tetracyclines (B) cause enamel hypoplasia and tooth discoloration in children under 8 years of age. (A, C, and D) are not contraindicated in children. A female teenager is taking oral tetracycline HCL (Acnromycin V) tor acne vulgaris_ What is the most important instruction tor 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 ANSWER A Photosensitivity is a common side effect of tetracycline HCL (Achromycin V) therapy. Severe sunburn can occur with minimal sun exposure. Clients should be instructed to avoid sunlight and to use sunscreen (A). (B and D) are not related to tetracycline HCL (Achromycin V) therapy. Dairy products (C) interfere with the absorption of tetracyclines. The mother of a a-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 tor 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 ANSWER B The first measles, mumps. and rubella (MMR) vaccine should be given no sooner than 12 months of age, and ideally between 12 and 15 months of age (B). (A) should not receive the MMR vaccine due to tne presence of matemal antibodies. MMR is not routinely administered at (C), but other immunizations, such as DTaP and Hepatitis B may be given at that time. The second dose of MMR is routinely administered at (D), provided that at least 4 weeks have elapsed since the first dose, and it 50th doses were administered beginning at or after 12 months. Preoperative nursing care tor a child with Wilms' tumor should include which intervention? A Gently percuss the abdomen tor evidence of trapped air. B Observe the abdomen tor 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 ANSWER D Prevention of abdominal palpation (D) minimizes the risk of rupturing the encapsulated tumor and subsequent metastasis. (A) is unnecessary, and this action could traumatize the tumor in the same manner as palpation. (B and C) are incorrect since the abdomen is not discolored and cold compresses are not indicated. 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 it ms nail beds appear blue." B. Check his fingers hourly tor 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 tor the first 24 hours." D. "Take his temperature e - CORRECT ANSWER A Cyanosis (A) indicates impaired circulation to fingers and should be reported immediately. Although the actions described in (A, C, and D) may be indicated, they are implemented rather excessively—and might tend to frighten the parents. It is not necessary to check the child's ability to move his fingers hourly for two days (B). Elevating the arm above the heart helps to decrease swelling, but (C) is stated in a frightening way. It is not necessary to take the child's temperature q4h (D) unless indicated by other symptoms. 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 tatty. B Bile-colored and watery. C Semi-solid and yellow D Ribbon-like and brown - CORRECT ANSWER D Hirschsprung's disease is a mechanical obstruction caused by inadequate motility in a part of the intestines. The condition results from failure of ganglion cells to migrate craniocaudally along the GI tract during gestation. The lack of peristalsis in the affected bowel segment causes constipation and small diameter, brown-colored stools (D). (A) is associated with cystic fibrosis. (B) is common in gastroenteritis. (C) is normal in breastfed neonates The nurse must prevent a 2-year-old with severe eczema on the face: neck, and scalp from scratching the affected area. Which nursing intervention is most effective in preventing further excoriation due to the pruritis? A Obtain gloves tor 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 ANSWER C Elbow restraints (C) prevent arm flexion and scratching of involved areas, but do not inhibit use of the hands for play activities. (A and B) can be easily removed by the child and would restrict hand movement (D) would be ineffective in preventing the child from scratching because the upper body could be moved within reach of restrained hands, and would also create the greatest restriction of hand movement 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 tor 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 RN should take rectal temperatures on this child. D The pediatrician should decide now to assess the temperature. - CORRECT ANSWER B A tympanic membrane sensor approximates core temperatures because the hypothalamus and eardrum are pertused by the same circulation. Tympanic readings obtained using proper technique correlated moderately to strongly with oral temperatures in recent research studies The sensor is unaffected by cerumen or the presence of suppurative or unsuppurative otitis media. An RN is not required to take the child's temperature, but must assess readings received from assistive personnel (A). Although rectal readings are highly accurate (C), such an invasive procedure is unnecessary. (D) is not required. 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 NG tube tor gastric lavage. B Determine the child's pulse and respirations. C Assess the child's level of consciousness. D. Administer an IV 05/0.25 NS as prescribed. - CORRECT ANSWER B The most important principle in dealing with a poisoning is to treat the child first, not the poison. Initiate immediate lite support measures with assessment of vital signs in particular, respirations. Inserting an airway or initiating mechanical ventilation may be necessary. Assessment and identification of the poison should occur prior to (A). (C and D) should occur after assessing the airway. A 2-year-old child with gastro-esophageal reflux has developed a tear 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 ANSWER D A 2-year-old child is comforted by consistency (D). (A) is contraindicated because two-year-olds may participate in parallel activities with other children but are too young to feel comfort and support by the presence of other children when anxious or afraid. (B) may or may not be true and does not address the child's fears. The child with reflux should remain upright at least two hours after eating (C) to reduce symptoms. A 6-month-old boy and his mother are at the healthcare provider's office tor 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 vacci - CORRECT ANSWER B At 6-months of age. the routine immunizations include Hepatitis B, DTaP, Hib (Haemophilus influenza type b) , PCV (Pneumococcal), IPV (inactivated poliovirus) and influenza. The influenza vaccine should be given at a separate site from any other injection Scheduling a return visit (A, B, or C) increases the risk that the mother will not bring the child back for the immunizations. The nurse is assessing a 13-year-old girl with suspected hyperthyroidism. wnicn question is most important tor 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 syntnroid?" D "Are you having any problems with your vision?" - CORRECT ANSWER B Assessing the client's physiological state upon admission is a priority, and nervousness, apprehension, hyperexcitability, and palpitations are signs of hyperthyroidism (B). Weight loss (even with a hearty appetite) (A) occurs in those with hyperthyroidism, but assessing the client's neurological state has a nigher priority. Hormone replacement is not administered to a client who is already producing too much thyroid (C). The client may have exopthalmus (bulging eyes) but hyperthyroidism does not cause vision problems (D). The nurse is planning care tor school-aged children at a community care center. Which activity is best tor the children? A Building model airplanes. B Playing follow-the-leader. C Stringing large and small beads. D. Playing with Playdough and clay. - CORRECT ANSWER B School aged children strive for independence and productivity (Erikson's Industry vs. Interiority) and enjoy individual and group activities related to real-lite situations, such as playing follow-the-leader. (A) is an individual activity that could contribute to feelings of interiority and inadequacy if the task is too complex. Although school-aged children enjoy crafts, (C and D) are more appropriate for pre-school children. Surgery is being delayed tor 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 chorionic gonadotropnic hormone. D Frequent warm baths to gently dilate the scrotal area. - CORRECT ANSWER C A trial of HCG (human cnorionic gonadotropnic hormone) (C) may aid in testicular descent, but does not replace surgical repair tor true undescended testes. Undescended testes (cryptorchidism) may be found in the inguinal canal due to exaggerated cremasteric reflex. (A) is not indicated. Stimulation of the cremasteric reflex causes the testes to ascend rather than descend in the scrotum (D) may relax the cremasteric muscle, but may not cause the testes to descend. A 3-year-old client with sickle cell anemia is admitted to the Emergency Department with abdominal pain. The nurse palpates an enlarged, an x-ray reveals an enlarged spleen, and a CBC reveals anemia. These findings indicate which type of crisis? A Aplastic. B Sequestratiom C Hypernemolytic. D Vaso-occlusive. - CORRECT ANSWER B The findings support a sequestration crisis (B), where blood pools in the spleen, and is characterized by abdominal pain and anemia. (A and C) crises produce anemia but no abdominal pain or splenic enlargement (D) crisis may produce abdominal pain, but no splenic enlargement or exacerbation of anemia. To assess the effectiveness of an analgesic administered to a 4-year-old, what intervention is best tor the nurse to implement? A. Use a happy-face/sad-face pain scale. B. Ask the mother it she thinks the analgesic is working. C. Assess tor changes in the child's vital signs. D. Teach the child to point to a numeric pain scale. - CORRECT ANSWER A A 4-year-old can readily identity with simple pictures (A) to snow the nurse how he/she is feeling. (B) could be used to validate what the child is telling the nurse via the "faces" pain scale, but it is best to elicit the child's assessment of his/her pain level. (C) may not accurately reflect the effectiveness of pain medication as they can also be affected by other variables, such as tear. (D) requires abstract number skills beyond the level of a 4-year-old In developing a teaching plan tor a 5-year-old child with diabetes, which component of diabetic management should the nurse plan tor 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 ANSWER C Developmentally, a 5-year-old has the cognitive and psychomotor skills to use a glucometer (C) and to read the number (it is especially helpful it the nurse presents this activity as a game). (A, B, and D) require more advanced cognitive and psychomotor skills and have greater potential tor errors. A 17-year-old male student reports to the school clinic one morning tor 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 tor 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 the - CORRECT ANSWER A This student has just completed football practice, and increased muscle activity increases body neat production. A temperature of 100 F is normal for this student at this time. The student should attend class (A) since no further nursing action is required. (3) would alarm the parents unnecessarily. (C) would provide a false reading of body temperature. (D) is unnecessary since these findings are within normal limits. The vital signs of a A-year-old child with polyuria are: SP 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 tor urinalysis. D. Document the child's vital signs and pulses. - CORRECT ANSWER B The current vital sign readings and the decreased peripheral pulse volume indicate that the child experiencing fluid volume deficit due to the polyuria, so the priority action is to restore fluid volume. (A) is useful in obtaining a precise urine output measure, but is a lower priority than restoring fluid volume at this time. (C) is not indicated based on the current assessment data, and (D) does not recognize the need for action to combat the fluid volume deficit immediately. A 3-week-old newborn is brought to the clinic tor follow-up after a home birth The mother reports that her child bottle feeds tor 5 minutes ID: 6974861285 only and then falls asleep The nurse auscultates a loud murmur characteristic of a ventricular septa' detect (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 - CORRECT ANSWER A.B.D.E. Correct responses are (A, B, D, and E). Neonates who have VSD may fatigue quickly during feeding and ingest inadequate amounts. They should be monitored tor weight gain and at least 6 wet diapers per day (A). A one-month old infant should ingest 2 to 4 ounces of formula per feeding and progress to about 30 ounces per day by 4-months of age Due to fatigue, the infant should rest, but teed at least every 2 hours to ensure adequate intake (D). A softer (preemie) nipple or a larger slit in the nipple (E) helps to reduce the sucking effort and energy expenditure, thus allowing the infant to ingest more with less effort. Antibiotic prophylaxis is recommended for infants with VSDs, but should not be mixed in a bottle of formula (C) because it is difficult to ensure that the total dose is consumed. 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 ANSWER A Discipline should be a positive and necessary component of childrearing that is started in infancy and should teach socially acceptable behavior, help children protect themselves from danger, and channel undesirable behavior into constructive activity. Misbehavior may result from inconsistent rules or messages, so parental attention should be clear, reasonable, and consistent (A). (B and C) are not helpful to the child. Children need boundaries that are firm but not rigid (D). Which action by the nurse is most helptul 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 ANSWER B Communicating through play with a doll (B) or other toy gives time tor the child to feel comfortable with a stranger. (A) may frighten some children and is usually not as effective as (B). To provide security and comfort, preschool-aged children should be approached when a parent is present, not (C). (D) is too advanced tor a preschooler 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 ANSWER A Drawing pictures (A) is a valuable form of non-verbal communication. As the nurse and child look at the drawings, a verbal story can be told that projects the child's thinking. (8) may distract the child, but does not establish communication with the nurse. (C) is useful tor an older child who is able to write. (D) is important, Out engaging the child is more effective in establishing communication patterns. 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 ANSWER C A small, superficial laceration to the skin should be washed gently with mild soap and water (C) for several minutes, followed by thorough rinsing. (A and D) are antiseptics that can be traumatic (painful) when cleaning fresh, open wounds. Applying ice (3) may reduce or prevent further edema, but the wound should be washed with mild soap and water first. 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 snow 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 ANSWER A Altered daily schedules and loss of rituals are upsetting to children and increase separation anxiety, and active sensitivity to the needs of children can minimize the negative effects of hospitalization. Explaining the hospital schedules (A) and establishing an individual schedule familiarizes the child to the hospital environment and decreases anxiety. (B) depersonalizes the child who should be addressed by name. Family and sibling visitation should be recommended and encouraged without limitation (C). Although (D) should be implemented, the direct involvement of the school-aged child incorporates the child's sense of initiate and cooperation. A 16-year-old is brought to the Emergency Center with a crushed leg after falling off a horse. The adolescents 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 ANSWER C After the completion of the initial tetanus immunization schedule, the recommended booster tor an adolescent or adult is every ten years or less it a traumatic injury occurs that is contaminated by dirt feces, soil or saliva. such as puncture or crushing injuries, avulsions, wounds from missiles, burns, or frostbite. The adolescent's injury is considered a contaminated wound requiring prophylactic therapy, so the tetanus toxoid booster should be administered (C). (A, B, and D) are not indicated. 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 ANSWER D Steatorrhea (D) is defined as stools with an abnormally high tat content that are usually foul smelling and float on water. (A, B, and C) do not describe this finding. The clinic nurse is taking the history tor 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 ANSWER A Ototoxicity diminishes nearing acuity and ca uses symptoms of tinnitus and vertigo in older children who can express subjective symptoms, so assessing an infant's reaction to loud noises (A) helps to determine an infant's risk for a nearing deficit related to a history of the mother taking an ototoxic drug, such as aspirin, while pregnant (a, C, and D) are not associated with exposure to aspirin in utero The nurse is giving a liquid iron preparation to a 3-year-old child. wnicn 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 ANSWER A A liquid iron preparation administered through a straw may help the child to accept the medication since young children consider drinking from a colorful straw tun (A). (B) may cause staining of the child's teeth. (C) is often used if the child is uncooperative. (D) is ineffective and should be requested from the healthcare provider. 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 "l 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 ANSWER B The prescribed medication is 4 ml per dosage and is measured with the most accuracy using a syringe, so if the parent uses a teaspoon (3), which is equivalent to 5 ml, further teaching is indicated. (A, C, and D) indicate correct understanding and require no further intervention by the nurse. Which growth and development characteristic should the nurse consider when monitoring the effects of a topical medication tor 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 ANSWER B Infants have a thin outer skin layer (stratum corneum), so the nurse should monitor the infant tor a prompt onset and response to the application of topical medication (A, C, and D) are unrelated to topical medication administration 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 tor injury. B. Give low-dose children's chewable aspirin in orange flavor tor joint discomfort. C. Use a firm and dry toothbrush to clean teeth at least twice per day. D. Apply pressure and ice tor bleeding while elevating and resting the extremity - CORRECT ANSWER D Hemophilia, a blood disorder, causes joint bleeding which is treated with rest, ice, compression, and elevation (RICE) (D). (A, B, and C) are inaccurate. A nurse provides the parents with information on health maintenance tor 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 tor a fewyears. D. Protective equipment should be worn for contact sports. - CORRECT ANSWER B Adequate fluid intake (B) decreases the viscosity of the blood which affects the incidence of vasocclusive crisis (A and D) are not commonly indicated for a child with sickle cell disease. A routine immunization schedule (C) is recommended for a children with SCD because of their increased susceptibility to infection that predisposes to sickling phenomena. The nurse reviews the latest laboratory results tor a child who received chemotherapy last week and identities a reduced neutrophil count. Which nursing diagnosis has the highest priority tor this child? A. Risk tor Infection. B. Risk tor hemorrhage. C. Altered skin integrity. D. Disturbance in body image. - CORRECT ANSWER A Chemotherapy (CT) suppresses phagocytotic neutrophils and places the child at risk tor infection (A), which is the priority nursing diagnosis. (B , C, and D) may be related to the care of a child receiving CT are not related to neutropenia_ 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 tor cessation of symptoms. - CORRECT ANSWER C The child is exhibiting signs of a reaction to the blood transfusion. The blood transfusion should be stopped immediately and the healthcare provider notified (C). After the transfusion is discontinued, IV access should be maintained (A) with fluids that do not introduce any more cellular products. (B and D) place the child at risk tor further blood reactions. The nurse is teaching the parents Ota 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 daily during any respiratory infection. - CORRECT ANSWER C Postural drainage tor a child with cystic fibrosis is most effective when performed after nebulization and before meals (C) or at least 1 hour after eating to prevent nausea and vomiting. Postural drainage uses gravity to promote mucous removal after nebulization (A) treatments which open the airways. Pulmonary toileting or respiratory treatments should be given 3 to 4 times daily, not episodically (B and D). 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 ANSWER A Russell's skin traction is used for fractures of the femur in young children and adolescents whose growth plates remain open and is applied to the lower leg using moleskin and elastic wrap bandages, which can compress the peroneal nerve and arteries that supply the toot. Assessment of adequate circulation, movement, and sensation of the toes and skin distal to the application is made to identity compromised blood flow, so cyanosis (A) should be reported immediately. (B, C, and D) are normal findings. 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 tor laboratory studies. D. Assess the child's respiratory status. - CORRECT ANSWER D Assessing the aimay and the respiratory status is the highest priority (D) since burns to the face and chest place the child at risk for smoke inhalation injury and compromised airway. (A, B, and C) are implemented after (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 repeated 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 it the child asks when the sibling discharged D. Encourage the mother to have the children visit the hospitalized sibling. - CORRECT ANSWER D Needs of a sibling will be better met with factual information and contact with the ill child, so sibling visitation should be encouraged (D). Parents are experts on their children and should determine when their children are old enough to visit (A) in the hospital. Separation from family and home (B) may intensity tear and anxiety. Children may have difficulty expressing questions (C), so the support of parents and other caregivers are needed to help alleviate their fears. Which finding in a 19-year-old female client should trigger turtner 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 toot. - CORRECT ANSWER A Menstruation is an expected secondary sex characteristic that occurs with pubescence and typically occurs by age 18, so (A) should prompt further investigation to determine the cause of this primary amenorrhea. Children receive tetanus as part of the DPT childhood immunization series, and a booster is not typically given until age 16 (B). Wisdom teeth are the third molar teeth of the permanent dentition and are the last to erupt, so (C) is a normal finding. (D) describes a plantar surface wart, harmless but painful because of the pressure with walking or standing. 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 tor the nurse provide? A. Refer the adolescent to the healthcare provider tor 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 ANSWER C The nurse should provide a factual and reassuring explanation that focuses on individual variations of menarche, which can normally occur between 12 and 18 years of age (C). (A) does not address the adolescent's concern and is judgmental Menarche is influenced by hereditary, general health, and nutritional status, so (B) is not indicated. (D) dismisses the adolescent's concerns and does not offer factual information. 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 ANSWER A.C.F. Correct selections are (A, C, and F). The most accurate calculations of pediatric dosages use the child's height and weight (A). The child's BSA is calculated using the square root of weight in kg times height in cm divided by 3600 or the square root of weight in lb times height in inches divided by 3131 (C), then the child's BSA is multiplied by the recommended published dose per BSA. The nomogram (F) is used to plot the child's height and weight, and the point at which they intersect is the BSA mathematical constant used to calculate the child's dose. (B, D, and E) are not used to calculate pediatric dosages. [Show More]

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