Pediatric Nursing Exam FINAL 140 Questions with Verified Answers The nurse is caring for a 4-year-old child immobilized by a fractured hip. Which complications should the nurse monitor? a. Hypocal... cemia b. Decreased metabolic rate c. Positive nitrogen balance d. Increased production of stress hormones - CORRECT ANSWER B What effect does immobilization have on the cardiovascular system? a. Venous stasis b. Increased vasopressor mechanism c. Normal distribution of blood volume d. Increased efficiency of orthostatic neurovascular reflexes - CORRECT ANSWER A A young girl has just injured her ankle at school. In addition to calling the child's parents, the most appropriate immediate action by the school nurse is to: a. Apply ice. b. Observe for edema and discoloration. c. Encourage child to assume a comfortable position. d. Obtain parental permission for administration of acetaminophen or aspirin. - CORRECT ANSWER A What would cause a nurse to suspect that an infection has developed under a cast? a. Complaint of paresthesia b. Increased respirations c. Cold toes d. "Hot spots" felt on cast surface - CORRECT ANSWER D The nurse is teaching the parents of a 7-year-old child who has just had a cast applied for a fractured arm with the wrist and elbow immobilized. Which instructions should be included in the teaching? a. Swelling of the fingers is to be expected for the next 48 hours. b. Immobilize the shoulder to decrease pain in the arm. c. Allow the affected limb to hang down for 1 hour each day. d. Elevate casted arm when resting and when sitting up. - CORRECT ANSWER D The nurse is teaching a family how to care for their infant in a Pavlik harness to treat developmental dysplasia of the hip. What should be included? a. Apply lotion or powder to minimize skin irritation. b. Remove the harness several times a day to prevent contractures. c. Return to the clinic every 1 to 2 weeks. d. Place a diaper over harness, preferably using a superabsorbent disposable diaper that is relatively thin. - CORRECT ANSWER C The primary method of treating osteomyelitis is: a. Joint replacement. b. Bracing and casting. c. Intravenous antibiotic therapy. d. Long-term corticosteroid therapy. - CORRECT ANSWER C Which medication is usually tried first when a child is diagnosed with juvenile idiopathic arthritis (JIA)? a. Aspirin b. Corticosteroids c. Cytotoxic drugs such as methotrexate d. Nonsteroidal antiinflammatory drugs (NSAIDs) - CORRECT ANSWER D What is most descriptive of the therapeutic management of osteosarcoma? a. Treatment usually consists of surgery and chemotherapy. b. Amputation of the affected extremity is rarely necessary. c. Intensive irradiation is the primary treatment. d. Bone marrow transplantation offers the best chance of long-term survival. - CORRECT ANSWER A An important nursing consideration when caring for a child with juvenile idiopathic arthritis (JIA) is to: a. Apply ice packs to relieve stiffness and pain. b. Administer acetaminophen to reduce inflammation. c. Teach child and family the correct administration of medications. d. Encourage range-of-motion exercises during periods of inflammation. - CORRECT ANSWER c Which interaction is part of the discharge plan for a school-age child with osteomyelitis who is receiving home antibiotic therapy? a. Instructions for a low-calorie diet b. Arrangements for tutoring and schoolwork c. Instructions for a high-fat, low-protein diet d. Instructions for the parent to return the child to team sports immediately - CORRECT ANSWER B Discharge planning for the child with juvenile arthritis includes the need for: a. Routine ophthalmologic examinations to assess for visual problems. b. A low-calorie diet to decrease or control weight in the less mobile child. c. Avoiding the use of aspirin to decrease gastric irritation. d. Immobilizing the painful joints, which are the result of the inflammatory process. - CORRECT ANSWER A When assessing the child with osteogenesis imperfecta, the nurse should expect to observe: a. Discolored teeth. b. Below-normal intelligence. c. Increased muscle tone. d. Above-average stature. - CORRECT ANSWER A Kristin, age 10 years, sustained a fracture in the epiphyseal plate of her right fibula when she fell off of a tree. When discussing this injury with her parents, the nurse should consider which statement? a. Healing is usually delayed in this type of fracture. b. Growth can be affected by this type of fracture. c. This is an unusual fracture site in young children. d. This type of fracture is inconsistent with a fall. - CORRECT ANSWER B A nurse is conducting discharge teaching for parents of an infant with osteogenesis imperfecta (OI). Further teaching is indicated if the parents make which statement? a. "We will be very careful handling the baby." b. "We will lift the baby by the buttocks when diapering." c. "We're glad there is a cure for this disorder." d. "We will schedule follow-up appointments as instructed." - CORRECT ANSWER C The nurse is caring for an infant with developmental dysplasia of the hip. Which clinical manifestations should the nurse expect to observe (Select all that apply)? a. Positive Ortolani sign b. Unequal gluteal folds c. Negative Babinski's sign d. Trendelenburg's sign e. Telescoping of the affected limb f. Lordosis - CORRECT ANSWER A,B A clinic nurse is conducting a staff in-service for other clinic staff regarding the signs and symptoms of a rhabdomyosarcoma tumor. Which should be included in the teaching session (Select all that apply)? a. Bone fractures b. Abdominal mass c. Sore throat and ear pain d. Headache e. Ecchymosis of conjunctiva - CORRECT ANSWER B,C,E The nurse is caring for a preschool child with a cast applied recently for a fractured tibia. Which assessment findings indicate possible compartment syndrome (Select all that apply)? a. Palpable distal pulse b. Capillary refill to extremity of <3 seconds c. Severe pain not relieved by analgesics d. Tingling of extremity e. Inability to move extremity - CORRECT ANSWER C,D,E Which of the following is a physiologic effect of immobilization on children? a. Metabolic rate increases. b. Increased joint mobility can lead to contractures in a short time. c. Bone calcium increases, releasing excess calcium into the body (hypercalcemia). d. Venous stasis can lead to thrombi or emboli formation. - CORRECT ANSWER D Which statement is true concerning osteogenesis imperfecta? A. It is easily treated. B. It is an inherited disorder. C. Later-onset disease usually runs a more difficult course. D. Braces and exercises are of no therapeutic value. - CORRECT ANSWER B An appropriate nursing intervention when caring for the child with chronic osteomyelitis is to: A. provide active range-of-motion exercises for the affected extremity. B. administer antibiotics with meals. C. encourage frequent ambulation. D. move and turn the child carefully and gently to minimize pain. - CORRECT ANSWER D Major goals of the therapeutic management of juvenile idiopathic arthritis are to: A. prevent joint discomfort and regain proper alignment. B. prevent loss of joint function and achieve cure. C. prevent physical deformity and preserve joint function. D. prevent skin breakdown and relieve symptoms. - CORRECT ANSWER C Spastic cerebral palsy is characterized by: a. Hypertonicity and poor control of posture, balance, and coordinated motion. b. Athetosis and dystonic movements. c. Wide-based gait and poor performance of rapid, repetitive movements. d. Tremors and lack of active movement. - CORRECT ANSWER A The most common problem of children born with a myelomeningocele is: a. Neurogenic bladder. b. Intellectual impairment. c. Respiratory compromise. d. Cranioschisis. - CORRECT ANSWER A Which problem is most often associated with myelomeningocele? a. Hydrocephalus b. Biliary atresia c. Craniosynotosis d. Esophageal atresia - CORRECT ANSWER A A current recommendation to prevent neural tube defects is the supplementation of: a. Vitamin A throughout pregnancy. b. Multivitamin preparations as soon as pregnancy is suspected. c. Folic acid for all women of childbearing age. d. Folic acid during the first and second trimesters of pregnancy. - CORRECT ANSWER C How much folic acid is recommended for women of childbearing age? a. 0.1 mg b. 0.4 mg c. 1.5 mg d. 2 mg - CORRECT ANSWER B The nurse is caring for a neonate born with a myelomeningocele. Surgery to repair the defect is scheduled the next day. The most appropriate way to position and feed this neonate is to place him: a. Prone and tube feed. b. Prone, turn head to side, and nipple feed. c. Supine in infant carrier and nipple feed. d. Supine, with defect supported with rolled blankets, and nipple feed. - CORRECT ANSWER B The nurse is talking to a parent with a child who has a latex allergy. Which statement by the parent would indicate a correct understanding of the teaching? a. "My child will have an allergic reaction if he comes in contact with yeast products." b. "My child may have an upset stomach if he eats a food made with wheat or barley." c. "My child will probably develop an allergy to peanuts." d. "My child should not eat bananas or kiwis." - CORRECT ANSWER D Latex allergy is suspected in a child with spina bifida. Appropriate nursing interventions include: a. Avoiding using any latex product. b. Using only nonallergenic latex products. c. Administering medication for long-term desensitization. d. Teaching the family about long-term management of asthma. - CORRECT ANSWER A Which finding should cause the nurse to suspect a diagnosis of spastic cerebral palsy? a. Tremulous movements at rest and with activity b. Sudden jerking movement caused by stimuli c. Writhing, uncontrolled, involuntary movements d. Clumsy, uncoordinated movements - CORRECT ANSWER B Therapeutic management of a child with tetanus includes the administration of: a. Nonsteroidal antiinflammatory drugs (NSAIDs) to reduce inflammation. b. Muscle stimulants to counteract muscle weakness. c. Bronchodilators to prevent respiratory complications. d. Antibiotics to control bacterial proliferation at the site of injury. - CORRECT ANSWER D What is the most appropriate nursing response to the father of a newborn infant with myelomeningocele who asks about the cause of this condition? a. "One of the parents carries a defective gene that causes myelomeningocele." b. "A deficiency in folic acid in the father is the most likely cause." c. "Offspring of parents who have a spinal abnormality are at greater risk for myelomeningocele." d. "There may be no definitive cause identified." - CORRECT ANSWER D The nurse is preparing to admit a newborn with myelomeningocele to the neonatal intensive care nursery. Which describes this newborn's defect? a. Fissure in the spinal column that leaves the meninges and the spinal cord exposed b. Herniation of the brain and meninges through a defect in the skull c. Hernial protrusion of a saclike cyst of meninges with spinal fluid but no neural elements d. Visible defect with an external saclike protrusion containing meninges, spinal fluid, and nerves - CORRECT ANSWER D The nurse is admitting a child with Werdnig-Hoffmann disease (spinal muscular atrophy type 1). Which signs and symptoms are associated with this disease? a. Spinal muscular atrophy b. Neural atrophy of muscles c. Progressive weakness and wasting of skeletal muscle d. Pseudohypertrophy of certain muscle groups - CORRECT ANSWER C The nurse is caring for an infant with myelomeningocele scheduled for surgical closure in the morning. Which interventions should the nurse plan for the care of the myelomeningocele sac? a. Open to air b. Covered with a sterile, moist, nonadherent dressing c. Reinforcement of the original dressing if drainage noted d. A diaper secured over the dressing - CORRECT ANSWER B The nurse is admitting a school-age child with suspected Guillain-Barré syndrome (GBS). Which nursing intervention is a priority in the care for this child? a. Monitoring intake and output b. Assessing respiratory efforts c. Placing on a telemetry monitor d. Obtaining laboratory studies - CORRECT ANSWER B Which statement best describes the infant's physical development? a. Anterior fontanel closes by age 6 to 10 months. b. Binocularity is well established by age 8 months. c. Birth weight doubles by age 5 months and triples by age 1 year. d. Maternal iron stores persist during the first 12 months of life. - CORRECT ANSWER C The nurse is assessing a 6-month-old healthy infant who weighed 7 pounds at birth. The nurse should expect the infant to now weigh approximately: a. 10 pounds. b. 15 pounds. c. 20 pounds d. 25 pounds. - CORRECT ANSWER B By what age does the posterior fontanel usually close? a. 6 to 8 weeks b. 10 to 12 weeks c. 4 to 6 months d. 8 to 10 months - CORRECT ANSWER A At which age can most infants sit steadily unsupported? a. 4 months b. 6 months c. 8 months d. 10 months - CORRECT ANSWER C In terms of fine motor development, the infant of 7 months should be able to: a. Transfer objects from one hand to the other. b. Use thumb and index finger in a crude pincer grasp. c. Hold a crayon and make a mark on paper. d. Release cubes into a cup. - CORRECT ANSWER A Which behavior indicates that an infant has developed object permanence? a. Recognizes familiar face such as the mother b. Recognizes familiar object such as a bottle c. Actively searches for a hidden object d. Secures objects by pulling on a string - CORRECT ANSWER C In terms of gross motor development, what would the nurse expect a 5-month-old infant to do? a. Roll from abdomen to back. b. Roll from back to abdomen. c. Sit erect without support d. Move from prone to sitting position. - CORRECT ANSWER A By what age should the nurse expect that an infant will be able to pull to a standing position? a. 6 months b. 8 months c. 9 months d. 11 to 12 months - CORRECT ANSWER C A parent asks the nurse "At what age do most babies begin to fear strangers?" The nurse responds that most infants begin to fear strangers at age: a. 2 months. b. 4 months. c. 6 months d. 12 months. - CORRECT ANSWER C An appropriate play activity for a 7-month-old infant to encourage visual stimulation is: a. Playing peek-a-boo. b. Playing pat-a-cake. c. Imitating animal sounds d. Showing how to clap hands. - CORRECT ANSWER A Which information could be given to the parents of a 12-month-old child regarding appropriate play activities for this age? a. Give large push-pull toys for kinesthetic stimulation. b. Place cradle gym across crib to facilitate fine motor skills. c. Provide child with finger paints to enhance fine motor skills. d. Provide stick horse to develop gross motor coordination - CORRECT ANSWER A The best play activity to provide tactile stimulation for a 6-month-old infant is to: a. Allow to splash in bath. b. Give various colored blocks. c. Play music box, tapes, or CDs d. Use infant swing or stroller. - CORRECT ANSWER A At what age should the nurse expect an infant to begin smiling in response to pleasurable stimuli? a. 1 month b. 2 months c. 3 months d. 4 months - CORRECT ANSWER B A mother tells the nurse that she is discontinuing breastfeeding her 5-month-old infant. The nurse should recommend that the infant be given: a. Skim milk. b. Whole cow's milk. c. Commercial iron-fortified formula d. Commercial formula without iron. - CORRECT ANSWER C When is the best age for solid food to be introduced into the infant's diet? a. 2 to 3 months b. 4 to 6 months c. when birth weight has tripled d. When tooth eruption has started - CORRECT ANSWER D The nurse should teach parents that which age is safe to give infants whole milk instead of commercial infant formula? a. 6 months b. 9 months c. 12 months d. 18 months - CORRECT ANSWER C The nurse expects which characteristic of fine motor skills in a 5-month-old infant? A. Strong grasp reflex B. Neat pincer grasp C. Able to build a tower of two cubes D. Able to grasp object voluntarily - CORRECT ANSWER D The nurse educator instructs a nursing student that according to Erikson, infancy is concerned with acquiring a sense of: A. trust. B. industry. C. initiative. D. separation. - CORRECT ANSWER A Which factor is most important in predisposing toddlers to frequent infections such as otitis media, tonsillitis, and upper respiratory tract infections? a. Respirations are abdominal. b. Pulse and respiratory rates are slower than those in infancy. c. Defense mechanisms are less efficient than those during infancy. d. Short, straight internal ear/throat structures and large tonsil/adenoid lymph tissue are present. - CORRECT ANSWER D A parent of an 18-month-old boy tells the nurse that he says "no" to everything and has rapid mood swings. If he is scolded, he shows anger and then immediately wants to be held. The nurse's best interpretation of this behavior is that: a. This is normal behavior for his age. b. This is unusual behavior for his age. c. He is not effectively coping with stress. d. He is showing he needs more attention. - CORRECT ANSWER A Two toddlers are playing in a sandbox when one child suddenly grabs a toy from the other child. The best interpretation of this behavior is that: a. This is typical behavior because toddlers are aggressive. b. This is typical behavior because toddlers are egocentric. c. Toddlers should know that sharing toys is expected of them. d. Toddlers should have the cognitive ability to know right from wrong. - CORRECT ANSWER B A parent asks the nurse about how to respond to negativism in toddlers. The most appropriate recommendation is to: a. Punish the child. b. Provide more attention. c. Ask child not always to say "no." d. Reduce the opportunities for a "no" answer. - CORRECT ANSWER D Steven, 16 months old, falls down a few stairs. He gets up and "scolds" the stairs as if they caused him to fall. This is an example of which of the following? a. Animism b. Ritualism c. Irreversibility d. Delayed cognitive development - CORRECT ANSWER When completing the health assessment for a 2-year-old child, the nurse should expect the child to: A. engage in parallel play. B. fully dress self with supervision. C. have a vocabulary of at least 500 words. D. be one third of the adult height. - CORRECT ANSWER A Which accomplishment would the nurse expect of a healthy 3-year-old child? a. Jump rope b. Ride a two-wheel bicycle c. Skip on alternate feet d. Balance on one foot for a few seconds - CORRECT ANSWER D In terms of fine motor development, what could the 3-year-old child be expected to do? a. Tie shoelaces. b. Use scissors or a pencil very well. c. Draw a person with seven to nine parts. d. Copy (draw) a circle. - CORRECT ANSWER D What is descriptive of the preschooler's understanding of time? a. Has no understanding of time b. Associates time with events c. Can tell time on a clock d. Uses terms like "yesterday" appropriately - CORRECT ANSWER B The nurse is caring for a hospitalized 4-year-old boy, Ryan. His parents tell the nurse that they will be back to visit at 6 PM. When Ryan asks the nurse when his parents are coming, the nurse's best response is: a. "They will be here soon." b. "They will come after dinner." c. "Let me show you on the clock when 6 PM is." d. "I will tell you every time I see you how much longer it will be." - CORRECT ANSWER B Which type of play is most typical of the preschool period? a. Solitary b. Parallel c. Associative d. Team - CORRECT ANSWER C Which characteristic best describes the language of a 3-year-old child? a. Asks meanings of words b. Follows directional commands c. Can describe an object according to its composition d. Talks incessantly, regardless of whether anyone is listening - CORRECT ANSWER D When is a child with chickenpox considered to be no longer contagious? a. When fever is absent b. When lesions are crusted c. 24 hours after lesions erupt d. 8 days after onset of illness - CORRECT ANSWER B According to Erikson, the primary psychosocial task of the preschool period is developing a sense of: A. identity. B. intimacy. C. initiative. D. industry. - CORRECT ANSWER C Which statement accurately describes physical development during the school-age years? a. The child's weight almost triples. b. A child grows an average of 2 inches per year. c. Few physical differences are apparent among children at the end of middle childhood. d. Fat gradually increases, which contributes to the child's heavier appearance. - CORRECT ANSWER B Generally the earliest age at which puberty begins is: a. 13 years in girls, 13 years in boys. b. 11 years in girls, 11 years in boys. c. 10 years in girls, 12 years in boys. d. 12 years in girls, 10 years in boys. - CORRECT ANSWER C What is descriptive of the play of school-age children? a. Individuality in play is better tolerated than at earlier ages. b. Knowing the rules of a game gives an important sense of belonging. c. They like to invent games, making up the rules as they go. d. Team play helps children learn the universal importance of competition and winning. - CORRECT ANSWER B In girls, the initial indication of puberty is: a. Menarche. b. Growth spurt. c. Growth of pubic hair. d. Breast development. - CORRECT ANSWER D The mean age of menarche in the United States is: a. 11.5 years b. 12.5 c. 13.5 years d. 14 years - CORRECT ANSWER A According to Erikson, the psychosocial task of adolescence is developing: a. Intimacy b. Identity. c. Initiative. d. Independence. - CORRECT ANSWER B According to Piaget, the adolescent is in the fourth stage of cognitive development, or period of: a. Formal operations. b. Concrete operations c. Conventional thought. d. Postconventional thought. - CORRECT ANSWER A The parents of a 14-year-old girl express concerns about the number of hours their daughter spends with her friends. The nurse explains that peer relationships become more important during adolescence because: a. Adolescents dislike their parents. b. Adolescents no longer need parental control. c. They provide adolescents with a feeling of belonging. d. They promote a sense of individuality in adolescents. - CORRECT ANSWER C A 14-year-old boy and his parents are concerned about bilateral breast enlargement. The nurse's discussion of this should be based on knowing that: a. This is usually benign and temporary. b. This is usually caused by Klinefelter's syndrome. c. Administration of estrogen effectively reduces gynecomastia. d. Administration of testosterone effectively reduces gynecomastia - CORRECT ANSWER A The nurse is explaining Tanner staging to an adolescent and her mother. Which statement best describes Tanner staging? a. Predictable stages of puberty that are based on chronologic age b. Staging of puberty based on the initiation of menarche and nocturnal emissions c. Predictable stages of puberty that are based on primary and secondary sexual characteristics d. Staging of puberty based on the initiation of primary sexual characteristics - CORRECT ANSWER C The parents of a 15-year-old girl are concerned that their adolescent spends too much time looking in the mirror. Which statement is the most appropriate for the nurse to make? a. "Your teenager needs clearer and stricter limits about her behavior." b. "Your teenager needs more responsibility at home." c. "During adolescence this behavior is not unusual." d. "The behavior is abnormal and needs further investigation." - CORRECT ANSWER C A nurse is teaching adolescent boys about pubertal changes. The first sign of pubertal change seen with boys is: a. Testicular enlargement. b. Facial hair. c. Scrotal enlargement. d. Voice deepens. - CORRECT ANSWER A A child has recently been admitted to the hospital. The child's parents have not yet arrived at the hospital. What behavior is the child exhibiting that leads the nurse to believe the child is exhibiting the stage of protest? The child: A. Screams and hits the nurse. B. Is withdrawn from others. C. Has the habit of bed-wetting. D. Sits in a corner with a toy. - CORRECT ANSWER The nurse is preparing to administer a vaccine to a child. The child is refusing to take the vaccination because of fear of bleeding. What should the nurse do in this situation? A. Tell the child he or she can pick the bandage color. B. Tell the child bleeding will stop in a few seconds. C. Request a staff member sit beside the child. D. Give a favorite toy to the child for distraction. - CORRECT ANSWER A Which type of croup is always considered a medical emergency? a. Laryngitis b. Epiglottitis c. Spasmodic croup d. Laryngotracheobronchitis (LTB) - CORRECT ANSWER B A child has a chronic, nonproductive cough and diffuse wheezing during the expiratory phase of respiration. This suggests: a. Asthma. b. Pneumonia. c. Bronchiolitis. d. Foreign body in the trachea. - CORRECT ANSWER A It is now recommended that children with asthma who are taking long-term inhaled steroids should be assessed frequently because they may develop: a. Cough. b. Osteoporosis. c. Slowed growth. d. Cushing's syndrome. - CORRECT ANSWER C The earliest recognizable clinical manifestation of cystic fibrosis (CF) is: a. Meconium ileus. b. History of poor intestinal absorption. c. Foul-smelling, frothy, greasy stools. d. Recurrent pneumonia and lung infections. - CORRECT ANSWER A Cystic fibrosis (CF) is suspected in a toddler. Which test is essential in establishing this diagnosis? a. Bronchoscopy b. Serum calcium c. Urine creatinine d. Sweat chloride test - CORRECT ANSWER D In providing nourishment for a child with cystic fibrosis (CF), which factor should the nurse keep in mind? a. Diet should be high in carbohydrates and protein. b. Diet should be high in easily digested carbohydrates and fats. c. Most fruits and vegetables are not well tolerated. d. Fats and proteins must be greatly curtailed. - CORRECT ANSWER A The parent of a toddler calls the nurse, asking about croup. What is a distinguishing manifestation of spasmodic croup? a. Wheezing is heard audibly. b. It has a harsh, barky cough. c. It is bacterial in nature. d. The child has a high fever. - CORRECT ANSWER B Which information should the nurse teach workers at a day care center about respiratory syncytial virus (RSV)? a. RSV is transmitted through particles in the air. b. RSV can live on skin or paper for up to a few seconds after contact.c. RSV can survive on nonporous surfaces for about 60 minutes. d. Frequent hand washing can decrease the spread of the virus. - CORRECT ANSWER D Which vitamin supplements are necessary for children with cystic fibrosis? a. Vitamin C and calcium b. Vitamins B6 and B12 c. Magnesium d. Vitamins A, D, E, and K - CORRECT ANSWER D Why do infants and young children quickly have respiratory distress in acute and chronic alterations of the respiratory system? a. They have a widened, shorter airway. b. There is a defect in their sucking ability. c. The gag reflex increases mucus production. d. Mucus and edema obstruct small airways. - CORRECT ANSWER D The nurse is assessing a child with acute epiglottitis. Examining the child's throat by using a tongue depressor might precipitate which symptom or condition? a. Inspiratory stridor b. Complete obstruction c. Sore throat d. Respiratory tract infection - CORRECT ANSWER When caring for a child after a tonsillectomy, the nurse should: A. Watch for continuous swallowing. B. Encourage gargling to reduce discomfort. C. Position the child on the back for sleeping. D. Apply warm compresses to the throat - CORRECT ANSWER A A 4-year-old girl is brought to the emergency room. She has a "froglike" croaking sound on inspiration, is agitated, and is drooling. She insists on sitting upright. The nurse should: A. Examine her oral pharynx and report to the physician. B. Make her lie down and rest quietly. C. Auscultate her lungs and make preparations for placement in a mist tent. D. Notify the physician immediately and be prepared to assist with a tracheostomy or intubation - CORRECT ANSWER D A 4-year-old boy needs to use a metered-dose inhaler to treat asthma. He cannot coordinate the breathing to use it effectively. The nurse should suggest that he use a: A. Spacer. B. Nebulizer. C. Peak expiratory flow meter. D. Trial of chest physiotherapy. - CORRECT ANSWER A Cystic fibrosis may affect singular or multiple systems of the body. The primary factor responsible for possible multiple clinical manifestations is: A. Atrophic changes in the mucosal wall of intestines. B. Hypoactivity of the autonomic nervous system. C. Hyperactivity of the sweat glands. D. Mechanical obstruction caused by increased viscosity of mucous gland secretions. - CORRECT ANSWER D Which type of dehydration results from water loss in excess of electrolyte loss? a. Isotonic dehydration b. Hypotonic dehydration c. Isosmotic dehydration d. Hypertonic dehydration - CORRECT ANSWER D The viral pathogen that frequently causes acute diarrhea in young children is: a. Giardia organisms. b. Shigella organisms. c. Rotavirus. d. Salmonella organisms. - CORRECT ANSWER C Therapeutic management of the child with acute diarrhea and dehydration usually begins with: a. Clear liquids. b. Adsorbents such as kaolin and pectin. c. Oral rehydration solution (ORS). d. Antidiarrheal medications such as paregoric. - CORRECT ANSWER C Therapeutic management of most children with Hirschsprung's disease is primarily: a. Daily enemas. b. Low-fiber diet. c. Permanent colostomy. d. Surgical removal of affected section of bowel. - CORRECT ANSWER D A 4-month-old infant has gastroesophageal reflux disease (GERD) but is thriving without other complications. What should the nurse suggest to minimize reflux? a. Place in Trendelenburg position after eating. b. Thicken formula with rice cereal. c. Give continuous nasogastric tube feedings. d. Give larger, less frequent feedings. - CORRECT ANSWER B The nurse is caring for a neonate with a suspected tracheoesophageal fistula. Nursing care should include: a. Elevating the head but giving nothing by mouth. b. Elevating the head for feedings. c. Feeding glucose water only. d. Avoiding suctioning unless the infant is cyanotic. - CORRECT ANSWER A Which clinical manifestation would most suggest acute appendicitis? a. Rebound tenderness b. Bright red or dark red rectal bleeding c. Abdominal pain that is relieved by eating d. Abdominal pain that is most intense at McBurney's point - CORRECT ANSWER D When caring for a child with probable appendicitis, the nurse should be alert to recognize that a sign of perforation is: a. Bradycardia. b. Anorexia. c. Sudden relief from pain. d. Decreased abdominal distention. - CORRECT ANSWER C The nurse is caring for a boy with probable intussusception. He had diarrhea before admission but, while waiting for administration of air pressure to reduce the intussusception, he passes a normal brown stool. The most appropriate nursing action is to: a. Notify the practitioner. b. Measure abdominal girth. c. Auscultate for bowel sounds. d. Take vital signs, including blood pressure. - CORRECT ANSWER A What is characterized by a chronic inflammatory process that may involve any part of the gastrointestinal (GI) tract from mouth to anus? a. Crohn's disease b. Meckel's diverticulum c. Ulcerative colitis d. Irritable bowel syndrome - CORRECT ANSWER A What is used to treat moderate-to-severe inflammatory bowel disease? a. Antacids b. Corticosteroids c. Antibiotics d. Antidiarrheal medications - CORRECT ANSWER B Which description of a stool is characteristic of intussusception? A. Ribbon-like stools B. "Currant jelly" stools C. Hard stools positive for guaiac D. Loose, foul-smelling stools - CORRECT ANSWER B The nurse is caring for a school-age girl who has had a cardiac catheterization. The child tells the nurse that her bandage is "too wet." The nurse finds the bandage and bed soaked with blood. The most appropriate initial nursing action is to: a. Notify the physician. b. Apply a new bandage with more pressure. c. Place the child in the Trendelenburg position. d. Apply direct pressure above the catheterization site - CORRECT ANSWER D Which defect results in increased pulmonary blood flow? a. Pulmonic stenosis b. Tricuspid atresia c. Atrial septal defect d. Transposition of the great arteries - CORRECT ANSWER C Which structural defects constitute tetralogy of Fallot? a. Pulmonic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy b. Aortic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy c. Aortic stenosis, atrial septal defect, overriding aorta, left ventricular hypertrophy d. Pulmonic stenosis, ventricular septal defect, aortic hypertrophy, left ventricular hypertrophy - CORRECT ANSWER A An 8-month-old infant has a hypercyanotic spell while blood is being drawn. The nurse's first action should be to: a. Assess for neurologic defects. b. Place the child in the knee-chest position. c. Begin cardiopulmonary resuscitation. d. Prepare the family for imminent death. - CORRECT ANSWER B Parents of a 3-year-old child with congenital heart disease are afraid to let their child play with other children because of possible overexertion. The nurse's reply should be based on knowing that: a. The child needs opportunities to play with peers. b. The child needs to understand that peers' activities are too strenuous. c. Parents can meet all the child's needs. d. Constant parental supervision is needed to avoid overexertion. - CORRECT ANSWER A A common, serious complication of rheumatic fever is: a. Seizures. b. Cardiac arrhythmias. c. Pulmonary hypertension. d. Cardiac valve damage. - CORRECT ANSWER D What is an expected assessment finding in a child with coarctation of the aorta? a. Orthostatic hypotension b. Systolic hypertension in the lower extremities c. Blood pressure higher on the left side of the body d. Disparity in blood pressure between the upper and lower extremities - CORRECT ANSWER D A nurse is teaching nursing students the physiology of congenital heart defects. Which defect results in decreased pulmonary blood flow? a. Atrial septal defect b. Tetralogy of Fallot c. Ventricular septal defect d. Patent ductus arteriosus - CORRECT ANSWER B The nurse is talking to a parent of an infant with heart failure about feeding the infant. Which statement about feeding the child is correct? a. "You may need to increase the caloric density of your infant's formula." b. "You should feed your baby every 2 hours." c. "You may need to increase the amount of formula your infant eats with each feeding." d. "You should place a nasal oxygen cannula on your infant during and after each feeding." - CORRECT ANSWER A An accurate description of anemia is: a. Increased blood viscosity. b. Depressed hematopoietic system. c. Presence of abnormal hemoglobin. d. Decreased oxygen-carrying capacity of blood. - CORRECT ANSWER A When teaching the mother of a 9-month-old infant about administering liquid iron preparations, the nurse should include that: a. They should be given with meals. b. They should be stopped immediately if nausea and vomiting occur. c. Adequate dosage will turn the stools a tarry green color. d. Preparation should be allowed to mix with saliva and bathe the teeth before swallowing. - CORRECT ANSWER C Which statement most accurately describes the pathologic changes of sickle cell anemia? a. Sickle-shaped cells carry excess oxygen. b. Sickle-shaped cells decrease blood viscosity. c. Increased red blood cell destruction occurs. d. Decreased red blood cell destruction occurs. - CORRECT ANSWER C Which clinical manifestation should the nurse expect when a child with sickle cell anemia experiences an acute vaso-occlusive crisis? a. Circulatory collapse b. Cardiomegaly, systolic murmurs c. Hepatomegaly, intrahepatic cholestasis d. Painful swelling of hands and feet, painful joints - CORRECT ANSWER D A school-age child is admitted in vaso-occlusive sickle cell crisis. The child's care should include: a. Correction of acidosis. b. Adequate hydration and pain management. c. Pain management and administration of heparin. d. Adequate oxygenation and replacement of factor VIII. - CORRECT ANSWER B Chelation therapy is begun on a child with -thalassemia major. The purpose of this therapy is to: a. Treat the disease. b. Eliminate excess iron. c. Decrease the risk of hypoxia. d. Manage nausea and vomiting. - CORRECT ANSWER B In which condition are all the formed elements of the blood simultaneously depressed? a. Aplastic anemia b. Sickle cell anemia c. Thalassemia major d. Iron deficiency anemia - CORRECT ANSWER A As related to inherited disorders, which statement is descriptive of most cases of hemophilia? a. Autosomal dominant disorder causing deficiency in a factor involved in the blood-clotting reaction b. X-linked recessive inherited disorder causing deficiency of platelets and prolonged bleeding c. X-linked recessive inherited disorder in which a blood-clotting factor is deficient d. Y-linked recessive inherited disorder in which the red blood cells become moon shaped - CORRECT ANSWER C What is most descriptive of the pathophysiology of leukemia? a. Increased blood viscosity occurs. b. Thrombocytopenia (excessive destruction of platelets) occurs. c. Unrestricted proliferation of immature white blood cells (WBCs) occurs. d. The first stage of the coagulation process is abnormally stimulated. - CORRECT ANSWER C An acquired hemorrhagic disorder that is characterized by excessive destruction of platelets is: a. Aplastic anemia. b. Thalassemia major. c. Disseminated intravascular coagulation. d. Idiopathic thrombocytopenic purpura. - CORRECT ANSWER D A common clinical manifestation of Hodgkin's disease is: a. Petechiae. b. Bone and joint pain. c. Painful, enlarged lymph nodes. d. Enlarged, firm, nontender lymph nodes. - CORRECT ANSWER D Which immunization should not be given to a child receiving chemotherapy for cancer? a. Tetanus vaccine b. Inactivated poliovirus vaccine c. Diphtheria, pertussis, tetanus (DPT) d. Measles, rubella, mumps - CORRECT ANSWER D A 12 year old boy seen in the clinic, and a diagnosis of Hodgkin's disease is suspected . Which diagnostic test results confirm the diagnosis of Hodgkin's disease? A . Elevated vanillylmandelic acid urinary level. B. The presence of blast cells in the bone marrow C. The presence of Epsetin-Barr virus in the blood. D. The presence of Reed-Sternberg cells in the lymph nodes - CORRECT ANSWER D A child is diagnosed with Wilms' tumor. During assessment, the nurse in charge expects to detect: a. Gross hematuria b. Dysuria c. Nausea and vomiting d. An abdominal mass - CORRECT ANSWER D The pediatric nurse understands that the most common cancer found in children is: A. Non-hodgkin's lymphoma B. Acute lymphocytic leukemia C. Chronic lymphocytic leukemia D. Ewing's sarcoma" - CORRECT ANSWER B What should the nurse recommend to prevent urinary tract infections in young girls? a. Wearing cotton underpants b. Limiting bathing as much as possible c. Increasing fluids; decreasing salt intake d. Cleansing the perineum with water after voiding - CORRECT ANSWER A Therapeutic management of nephrosis includes: a. Corticosteroids. b. Antihypertensive agents. c. Long-term diuretics. d. Increased fluids to promote diuresis. - CORRECT ANSWER A A child is admitted with acute glomerulonephritis. The nurse would expect the urinalysis during this acute phase to show: a. Bacteriuria and hematuria. b. Hematuria and proteinuria. c. Bacteriuria and increased specific gravity. d. Proteinuria and decreased specific gravity. - CORRECT ANSWER B What should the nurse include in a teaching plan for the parents of a child with vesicoureteral reflux? a. The importance of taking prophylactic antibiotics b. Suggestions for how to maintain fluid restrictions c. The use of bubble baths as an incentive to increase bath time d. The need for the child to hold urine for 6 to 8 hours - CORRECT ANSWER A The most common cause of acute renal failure in children is: a. Pyelonephritis. b. Tubular destruction. c. Urinary tract obstruction. d. Severe dehydration. - CORRECT ANSWER D A preschool child is being admitted to the hospital with dehydration and a urinary tract infection (UTI). Which urinalysis result should the nurse expect with these conditions? a. WBC <1; specific gravity 1.008 b. WBC <2; specific gravity 1.025 c. WBC >2; specific gravity 1.016 d. WBC >2; specific gravity 1.030 - CORRECT ANSWER D [Show More]
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