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STUDYING MATERIAL
A nurse is caring for an adolescent following a lumbar puncture. which of the following actions should the nurse take?
- initiate NPO status for the adolescent
- place the adolescent in a supine position
- place a moist, warm pack on the adolescents lower back
- apply a eutectic mixture of local anesthetics to the adolescent's puncture site - ANSWERS-Place the adolescent in supine position (The nurse should place the adolescent in a supine position for 30 minutes to an 1 hour following a lumbar puncture to decrease the risk of a post Dural puncture headache) A nurse is assessing a child who is receiving IV chemotherapy. assessment findings include extravasation of the tissues surrounding the IV insertion site. In which order should the nurse take the following actions?
- Remove IV line
- Elevate the extremity
- Stop the infusion - Notify the provide r - ANSWERS-Stop the infusion Elevate the extremity Notify the provider Remove the IV line A nurse is discussing the causes of chronic diarrhea with a client. which of the following conditions is caused by malabsorption
- Celiac disease
- Ulcerative colitis
- Hirschsprung's disease
- Crohn's disease
- ANSWERS-Celiac Disease
(the nurse should recognize that celiac disease causes chronic diarrhea due to malabsorption. other malabsorption conditions include short bowel syndrome, lactose intolerance, and congenital enzyme deficiency) A nurse is caring for an 8 year old child who has sickle cell anemia. which of the following actions should the nurse take?
- Apply cool compresses to the painful area
- Initiate contact isolation precautions
- Give the child flavored popsicles
- Administer phytonadione
- ANSWERS-Give the child flavored popsicles ( A nurse is caring for a toddler who has a fever, a high pitched cry, irritability, and vomiting. which of the following actions should the nurse take?
- Administer 81 mg of aspirin to the toddler
- Give the toddler a cold bath
- Place the toddler in a supine position
- Pad the rails of the toddler's bed
- ANSWERS-Pad the rails of the toddler's bed ( A Nurse is teaching the guardian of a preschooler. The guardian states that the preschooler has had an imaginary playmate for about 3 months. which of the following pieces of information should the nurse give to guardian?
- children commonly begin having imaginary friends when they reach school age
- Notify your provider if the imaginary friend persists longer than 6 months
- Have your child take responsibility for actions if he tries to blame the imaginary friend - Set limits by not allowing your child to have the imaginary friend present during family meals
- ANSWERS-Have your child take responsibility or actions if he tries to blame the imaginary friend Maintaining hydration with a child who has sickle cell anemia is important to prevent sickling. children often accept flavored popsicles as a source of fluid When caring for a toddler who has manifestations of bacterial meningitis, the nurse should implement seizure precautions, which includes padding the side rails of the bed)
(A 4 month old infant can recognize herself and will also attempt to play with the baby in the mirror. a mirror is a bright object that provides appropriate visual stimulation for this age group. For the infants safety, however, the mirror must be unbreakable) A nurse is planning care for an adolescent who has sickle cell anemia and is experiencing a vaso occlusive crisis. which of the following interventions should the nurse include in the plan?
- Apply cold compresses to the child's extremities
- Administer meperidine every 4 hr until the crisis has resolved
- Maintain the child on bed rest
- Decrease the child's fluid intake for 8 hours
- ANSWERS-Maintain the child on bed rest (The nurse should maintain bed rest for this child who is experiencing a vaso occlusive crisis to minimize energy expenditure and avoid additional oxygen needs A nurse is planning care for a 3 month old infant who has an ileostomy. which of the following interventions should the nurse include in the plan?
- Avoid laying the infant on his abdomen
- avoid tucking the appliance into the infants diaper
- check the bag for stool every 4 hours
- Replace the appliance every 3 days
- ANSWERS-Check the bag for stool every 4 hours (the nurse should check the bag for stool every 4 hours or less to prevent the bag from overfilling and leaking stool from an ileostomy is acidic and can cause excoriation of the skin) A nurse is caring for an infant who has gastroenteritis and is dehydrated. which of the following characteristics places the infant at a higher risk of electrolyte imbalances compared to an adult client? - Less extracellular fluid
- Reduced body surface area
- Longer intestinal tract
- Decreased rate of metabolism
- ANSWERS-Longer intestinal tract ( a nurse is caring for a child who has tetralogy of Fallot. which of the following laboratory values should the nurse expect to find? Compared to adults or older children, infants have a longer intestinal tract. this results in greater fluid losses, especially through diarrhea)
- Platelet count of 20,000/mm^
- WBC 4,000/mm^
- Thyroid stimulating hormone 7.0 microunits/mL
- RBC 6.8 million/uL
- ANSWERS-RBC 6.8 million/uL (A child who has tetralogy of Fallot experiences cyanosis; therefore, the body responds by increasing RBC production (polycythemia) in an attempt to supply oxygen to all body parts) A nurse is teaching an adolescent about various strategies for chironic pain management. which of the following activities should the nurse use as an example of the nonpharmacological strategy of thought stopping?
- Assemble a puzzle
- Discuss a recent pleasurable event
- Tighten and then relax each body part
- Repeat memorized facts about the painful event
- ANSWERS-Repeat memorized facts about the painful event (Having the adolescent repeat memorized facts about the painful event is an example of the non pharmacological pain management strategy of thought stopping. Thoughts such as the pain will be gone soon or ill be home by this time tomorrow can help the adolescent control the pain. after listing the facts, the nurse should then have the adolescent condense and memorize the facts to repeat them whenever pain occurs. A nurse is reviewing recommended immunizations with the guardian of a 2 month old infant. which of the following statements should the nurse make?
- your baby can receive the varicella vaccine at 6 months of age
- your baby can start the pneumococcal vaccine now
- Your baby should receive the flu vaccine before 6 months of age
- you baby can start eh measles, mumps, and rubella vaccine
- ANSWERS-Your baby can start eh pneumococcal vaccine now (The infant can receive the first dose of the pneumococcal vaccine now, with 2 additional doses at 4 months and 12 months of age) A nurse is caring for an infant who has pertussis. which of the following actions should the nurse take?
- assess for edema of the extremities
- apply warm compresses to the neck area
- initiate airborne precautions
- maintain a cardiorespiratory monitor
- have your parent stretch and mover your legs for you - apply heat to joints that become painful, stiff, and swollen.
- take aspirin at the first sign of a headache
- you will be able to participate in physical exercises
- ANSWERS-You will be able to participate in physical exercises (physical exercise is important for the maintenance of joint mobility and muscle strengthen. participation in non contact sports and the use of protective equipment such as knee pads are encouraged, although high impact athletic activities such as karate should be avoided) A school nurse is assessing a child who has been stung by a bee. the childes hand is swelling and the nurse notes that the child is allergic to insect stings. which of the following findings should the nurse expect if the child develops anaphylaxis
- Bradycardia
- Nausea
- Hypertension
- Urticaria
- Stridor
- ANSWERS-Nausea, Urticaria, and stridor (A common gastrointestinal response to excessive histamine release is nausea. A common skin manifestation of excessive histamine release is hives, also known as urticaria. A serious, life threatening response to excessive histamine release is airway narrowing, which presents as dyspnea and stridor) A nurse is developing a health education program for the parents of school aged females. which of the following pieces of information regarding sexual maturation should the nurse include
- hgihe4r body fat content is associated with earlier onset of menarche
- pubic hair is typically present prior to breast development
- ovulation begins after sexual maturation is complete
- menarche signals the beginning of puberty
- ANSWERS-higher body fat content is associated with earlier onset of menarche (the nurse should inform the parents that the onset of menarche is expected to occur around 10.5 to 15.5 years of age. females who have a higher body fat content have been shown to have earlier onset of menarche) A nurse in the emergency department is caring for a 2-year-old child who was found by his parents crying and holding a container of toilet bowl cleaner. The
child's lips are edematous and inflamed, and he is drooling. Which of the following is the priority action by the nurse? Remove the child's contaminated clothing. Check the child's respiratory status. Administer an antidote to the child. Establish IV access for the child. Rationale: The nurse should apply the ABC priority-setting Check the child's respiratory status. A nurse is teaching a parent of a 12-month old child about development during the toddler years. Which of the following statements should the nurse include? "Your child should be referring to himself using the appropriate pronoun by 18 months of age." "A toddler's interest in looking at pictures occurs at 20 months of age." C. "A toddler should have davtime control of his bowel and bladder by 24 months of age. d. "Your child should be able to scribble spontaneously using a crayon at the age of 15 months." d. "Your child should be able to scribble spontaneously using a crayon at the age of 15 months." A nurse is caring for a toddler and is preparing to administer 0.9% sodium chloride 100 mL IV to infuse over 4 hr. The drop factor of the manual IV tubing is 60 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) 25 GTT
- A nurse in a pediatric clinic is assessing a toddler at a well-child visit. Which of the following actions should the nurse take? a. Perform the assessment in a head to toe sequence. b. Minimize physical contact with the child initially. c. Explain procedures using medical terminology. d. Stop the assessment if the child becomes uncooperative. b. Minimize physical contact with the child initially.
- A nurse is caring for an 18-year-old adolescent who is up-to-date on immunizations and is planning to attend college. The nurse should inform the client that he should receive which of the following immunizations prior to moving into a campus dormitory? a. Pneumococcal polysaccharide b. Meningococcal polysaccharide c. Rotavirus d. Herpes zoster b. Meningococcal polysaccharide
- A nurse is teaching the parent of a toddler about home safety. Which of the following statements by the parent indicates an understanding of the teaching? a. "I lock my medications in the medicine cabinet."
- A nurse is assessing a 6-month-old infant at a well-child visit. Which of the following findings indicates the need for further assessment? a. Grabs feet and pulls them to her mouth b. Posterior fontanel is closed c. Legs remain crossed and extended when supine d. Birth weight has doubled Legs remain crossed and extended when supine
- A nurse is observing a mother who is playing peek-a-boo with her 8-month-old child. The mother asks if this game has any developmental significance. The nurse should inform the mother that peek-a-boo helps develop which of the following concepts in the child? a. Hand-eye coordination b. Sense of trust c. Object permanence d. Egocentrism Object permanence
- A nurse is caring for a 15-month-old toddler who requires droplet precautions. Which of the following actions should the nurse take? a. Have the toddler wear a disposable gown when in the unit's playroom. b. Wear sterile gloves when changing the toddler's diapers. c. Wear a mask when assisting the toddler with meals. d. Ask visitors to wear an N-95 mask when entering the room. Wear a mask when assisting the toddler with meals.
- A nurse at a pediatric clinic is assessing a 5-month-old infant during a wellchild visit. Which of the following findings should the nurse report to the provider? a. Head lags when pulled from a lying to a sitting position b. Absence of startle and crawl reflexes c. Inability to pick up a rattle after dropping it d. Rolls from back to side Head lags when pulled from a lying to a sitting position
- A nurse is planning to collect a specimen from a male infant using a urine collection bag. Which of the following actions should the nurse take? a.Wash and dry the infant's genitalia and perineum thoroughly. b. Apply a small coating of water-soluble lubricant to the skin of the infant's perineal area. c. Avoid placing the scrotum inside the collection bag. d. Wait several hours after positioning the device before checking it. Wash and dry the infant's genitalia and perineum thoroughly.
- A nurse in a pediatric clinic is caring for a 3-year-old child who has a blood lead level of 3 mcg/dL. When teaching the toddler's parents about the correlation of nutrition with lead poisoning, which of the following information is appropriate for the nurse to include in the teaching?
a. Decrease the child's vitamin C intake until the blood lead level decreases to zero. b. Administer a folic acid supplement to the child each day. c. Give pancreatic enzymes to the child with meals and snacks. d. Ensure the child's dietary intake of calcium and iron is adequate. Ensure the child's dietary intake of calcium and iron is adequate.
- A nurse is planning care for a 10-month-old infant who has suspected failure to thrive (FTT). Which of the following interventions should the nurse include in the plan of care? (Select all that apply.) a. Observe the parents' actions when feeding the child. b. Maintain a detailed record of food and fluid intake. c. Follow the child's cues as to when food and fluids are provided. d. Sit beside the child's high chair when feeding the child. e. Play music videos during scheduled meal times. Observe the parents' actions when feeding the child. b. Maintain a detailed record of food and fluid intake.
- A nurse is assessing a 7-year-old child's psychosocial development. Which of the following findings should the nurse recognize as requiring further evaluation? a. The child prefers playmates of the same sex. b. The child is competitive when playing board games. c. The child complains daily about going to school. d. The child enjoys spending time alone. The child complains daily about going to school.
- A nurse is providing education to the parent of a toddler who is about to receive her first dose of the MMR (measles, mumps and rubella) immunization. Which of the following statements by the parent indicates an understanding of the teaching? a. "I am not going to let my child play with other children for 2 days." b. "I will need to return in 2 weeks for my child to receive the varicella immunization." c. "I can give my child acetaminophen for discomfort associated with the immunization." "I can give my child acetaminophen for discomfort associated with the immunization."
- A nurse is providing teaching to the parents of a 4-year-old child about fine motor development. Which of the following tasks should the nurse include in the teaching as an expected finding for this age group? a. Copies a circle b. Cuts foods using a table knife c. Begins writing in cursive d. Prints first and last name clearly Copies a circle
b. The child is interested in what happens to his body after death. c. The child recognizes that death is permanent. d. The child believes his thoughts can cause death. e. The child thinks death is a punishment. a. The child views death as similar to sleep. b. The child is interested in what happens to his body after death. e. The child thinks death is a punishment.
- A nurse is teaching the parent of an infant about home safety. Which of the following information should the nurse include? a. Use a wheeled infant walker. b. Place soft pillows around the edge of the infant's crib. c. Position the car seat so it is rear-facing. d. Secure a safety gate at the top and bottom of the stairs. e. Maintain the water heater temperature at 49° C (120° F). c. Position the car seat so it is rear-facing. d. Secure a safety gate at the top and bottom of the stairs. e. Maintain the water heater temperature at 49° C (120° F).
- A nurse is caring for an adolescent who is receiving pain medication via a PCA pump. When the nurse assess the client's pain at 0800, the client describes the pain as a 3 on a scale of 1 to 10. At 100, the client describes the pain as a 5. The nurse discovers the client has not pushed the button to deliver medication in the past 2 hr. Which of the following actions should the nurse take? a. Ask the provider to discontinue the PCA so the nurse can administer PRN pain medication. b. Suggest the client's parent push the button for the client if the parent thinks the adolescent is having pain. c. Reevaluate the client in 1 hr since a pain level of 5 is acceptable on a scale of 1 to 10. Reinforce teaching with the client about how to push the button to deliver themed. Reinforce teaching with the client about how to push the button to deliver themed.
- A nurse is assessing a 12-month-old male infant's vital signs during a wellchild visit. The infant is in the 90th percentile of height. Which of the following findings should the nurse report to the provider? a. Heart rate 175/min b. Respiratory rate 26/min c. Blood pressure 88/40 mm Hg) d. Temperature 37.6° C (99.7° F Heart rate 175/min
- A nurse is teaching the parent of a 12-month-old infant about nutrition. Which of the following statements by the parent indicates a need for further teaching? a. "I can give my baby 4 ounces of juice to drink each day." b. "I will offer my baby dry cereal and chilled banana slices as snacks."
c. "I am introducing my baby to the same foods the family eats." d. "My infant drinks at least 2 quarts of skim milk each day." "My infant drinks at least 2 quarts of skim milk each day."
- A nurse is assisting a provider during a femoral venipuncture on a toddler. The nurse should place the child in which of the following positions? a. Side-lying b. Semi-recumbent c. Flexed sitting d. Supine Supine
- A nurse is assessing a 9-month-old infant during a well-child visit. Which of the following findings indicates that the infant has a developmental delay? a. Creeps on hands and knees b. Inability to vocalize vowel sounds c. Uses crude pincer grasp d. Stands by holding onto support Inability to vocalize vowel sounds
- A nurse is preparing to administer a liquid medication to an infant. Which of the following actions should the nurse take? a. Administer the medication while the infant is supine. b. Give the medication at the side of the infant's mouth. c. Add the medication to a full bottle of the infant's formula. d. Administer the medication slowly while holding the nares closed. Give the medication at the side of the infant's mouth.
- A nurse on a pediatric unit is reviewing the health record of a client who is demonstrating increasing levels of stress after admission. The nurse should identify which of the following findings as a risk factor for a stress-related reaction to hospitalization? a. Age 10 b. First hospitalization c. Male gender d. Calm, quiet demeanor c. Male gender
- A nurse in the emergency department is caring for a 12-year-old child who has ingested bleach. Which of the following statements by the nurse indicated an understanding of this ingestion? a. "The absence of oral burns excludes the possibility of esophageal burns." b. "Treatment focuses on neutralization of the chemical." c. "Injury by a corrosive liquid is more extensive than by a corrosive solid." d. "Immediate administration of activated charcoal is warranted." "Injury by a corrosive liquid is more extensive than by a corrosive solid."
- A nurse is caring for a child who has a bacterial endocarditis. The child is scheduled to receive moderate term antibiotic therapy and requires a peripherally inserted central catheter (PICC). Which of the following statements should the nurse include when teaching the child's parent? a. "The PICC line will last several weeks with proper care."
A nurse is caring for a school-age child who has primary nephrotic syndrome and is taking prednisone. Following I week of treatment, which of the following manifestations indicates to the nurse that the medication is effective? a Decreased edema Increased abdominal girth Decreased appetite Increased protein in the urine a Decreased edema
- A nurse is receiving change-of-shift report for four children. Which of the following children should the nurse assess first? a. A toddler who has a concussion and an episode of forceful vomiting b. An adolescent who has infective endocarditis and reports having a headache c. An adolescent who was placed into halo traction 1 hr ago and reports pain as 6 on a scale of 0 to 10 d. A school-age child who has acute glomerulonephritis and brown-colored urine A toddler who has a concussion and an episode of forceful vomiting
- A nurse is providing dietary teaching to the guardian of a school-age child who has cystic fibrosis. Which of the following statements should the nurse make? a. "You should offer your child high-protein meals and snacks throughout the day." b. "You should decrease your child's dietary fat intake to less than 10% of their caloric intake." c. "You should restrict your child's calorie intake to 1,200 per day." d. "You should give your child a multivitamin once weekly." "You should offer your child high-protein meals and snacks throughout the day." A nurse is providing discharge teaching to the guardians of a toddler who had lower leg cast applied 24 hr ago. The nurse should instruct the guardians to report which of the following finding to the provider? a. Capillary refill time less than 2 seconds b. Restricted ability to move the toes c. Swelling of the casted foot when the leg is dependent d. Pedal pulse +3 bilateral b. Restricted ability to move the toes ) A nurse in an emergency department is auscultating the lungs of an adolescent who is experiencing dyspnea. The nurse should identify the sound as which of the following? a. Wheezes b. Crackles c. Pleural friction rub d. Rhonchi a. Wheezes ) A nurse is caring for a preschooler who has congestive heart failure. The nurse observes wide QRS complexes and peaked T waves on the cardiac monitor. Which of the following prescriptions should the nurse clarify with the provider? a. Furosemide
b. Captopril c. Regular insulin d. Potassium chloride d. Potassium chloride
- A nurse is planning an educational program for school-age children and their parents about bicycle safety. Which of the following information should the nurse plan to include? a. The child should be able to stand on the balls of their feet when sitting on the bike. b. The child should ride their bike 2 feet to the side of other bike riders. c. The child should wear dark-colored clothing with a fluorescent stripe when riding at night. d. The child should ride the bike facing traffic when it is necessary to ride in the street. The child should be able to stand on the balls of their feet when sitting on the bike.
- A nurse is an emergency department is caring for a school-age child who has epiglottitis. Which of the following actions should the nurse take? a. Obtain a throat culture from the child. b. Monitor the child's oxygen saturation. c. Put a warm mist humidifier in the child's room. d. Place the child in the supine position Monitor the child's oxygen saturation.
- A nurse in an emergency department is caring for a school-age child who has sustained a minor superficial burn from fireworks on their forearm. Which of the following actions should the nurse take? a. Administer the tetanus toxoid vaccine if more than 1 year since the prior dose. b. Apply an antimicrobial ointment to the affected area. c. Leave the burn area open to air. d. Place an ice pack on the affected area. Apply an antimicrobial ointment to the affected area.
- A nurse in a providers office is caring for a school-age child who has varicella. The parents asks the nurse when their child will no longer be contagious. Which of the following responses should the nurse make? a. "When your child no longer has an increased temperature." b. "Three days after you first noticed the rash appear on your child." c. "When your child's lesions are crusted, usually 6 days after they appear." d. "Two to three weeks, when your child's lesions completely disappear." "When your child's lesions are crusted, usually 6 days after they appear." A nurse is providing discharge teaching to the parent of a school-age child who has moderate persistant asthma. Which of the following instructions should the nurse include? a. "You should give your child their salmeterol inhaler every 4 hours when they are having an acute episode of wheezing."
- A nurse is caring for a 1-month-old infant who is breastfeeding and requires a heel stick. Which of the following actions should the nurse take to minimize the infants pain? a. Use a manual lancet to obtain the heel blood sample. b. Apply an ice pack to the infant's heel prior to obtaining the sample. c. Allow the mother to breastfeed while the sample is being obtained. d. Apply a topical lidocaine cream prior to obtaining the sample. Allow the mother to breastfeed while the sample is being obtained.
- A nurse is assessing an adolescent who received a sodium polystyrene sulfonate enema. Which of the following findings indicates effectiveness of the medication? a. Reports an absence of nausea and vomiting b. Reports experiencing an onset of loose stools within 15 min of administration c. Serum potassium level 4.1 mEq/L d. Blood pressure 86/52 mm Hg Serum potassium level 4.1 mEq/L ) A charge nurse is preparing to make a room assignment for a newly admitted school- age child. Which of the following considerations is the nurses priority? a. Length of stay b. Treatment schedule c. Disease process d. Self-care ability c. Disease process A nurse is assessing the pain level of a 3-year-old toddler. Which of the following pain assessment scales should the nurse use? a. FACES b. Numeric c. CRIES d. Visual analog a. FACES A nurse is preparing to administer ibuprofen 5 mg/kg every 6 hr PRN for a temperatures above 38.0 C (100.5 F) to an infant who weighs 17.6 lb. Available is ibuprofen oral suspension 100mg/5mL. How many mL should the nurse administer to the infant per dose? i) 2 mL A nurse is assessing a 6-month-old infant during a well-child visit. Which of the following findings should the nurse report to the provider? a. Presence of a central incisor tooth b. Presence of strabismus c. Presence of an open anterior fontanel d. Presence of external cerumen b. Presence of strabismus
- A school nurse is caring for a child following tonic-clonic seizure. Which of the following actions should the nurse take first? a. Check the child for a head injury. b. Observe for oral bleeding.
c. Check the child's respiratory rate. d. Observe for extremity weakness. c. Check the child's respiratory rate.
- A nurse is planning developmental activities for a newly admitted 10-year-old child who has neutropenia. Which of the following actions should the nurse plan to take? a. Provide the child with a book about adventure. b. Arrange frequent visits from family members and peers. c. Give the child a large-piece puzzle. d. Use puppets to entertain the child. Provide the child with a book about adventure.
- A nurse in a health department is caring for an emancipated adolescent who has an STI and is unaccompanied by a guardian. Which of the following actions should the nurse take? a. Have the adolescent sign a consent form for treatment. b. Instruct the adolescent to return with a guardian. c. Obtain consent from the adolescent's guardian over the phone. d. Treat the adolescent without a consent form. Have the adolescent sign a consent form for treatment.
- A nurse is assessing an 8-year-old child who has early indications of shock. After establishing an airway and stabilizing the childs respirations, which of the following actions should the nurse take next? a. Insert an indwelling urinary catheter. b. Measure weight and height. c. Initiate IV access. d. Maintain ECG monitoring. Initiate IV access.
- A nurse is performing hearing screenings for children at a community health fair. Which of the following children should the nurse refer to a provider for a more extensive hearing evaluation? a. An 18-month-old toddler who has unintelligible speech b. A 3-month-old infant who has an exaggerated startle response A 4-year-old preschooler who prefers playing with others rather than alone d. An 8-month-old infant who is not yet making babbling sounds d. An 8-month-old infant who is not yet making babbling sounds A nurse is providing discharge teaching to the guardian of a school-age child who has undergone a tonsillectomy. Which of the following statements by the guardian indicates an understanding the teaching? a. "My child can resume usual activities since this was just an outpatient surgery." b. "My child will be able to drink the chocolate milkshake I promised to get for them tonight." c. "I will notify the doctor if I notice that my child is swallowing frequently." d. "I will have my child gargle with warm salt water to relieve their sore throat."
