The parents of a child with meningitis and multiple seizures ask 1. CP is diagnosed based on clinical characteristics and developmental findings. It is not
if the child will likely develop cerebral palsy (CP). Select the diagnosed with any type of radiological examination.
nurse's best response. 2. Although most cases of CP occur in the neonatal period, some children can develop CP
1. "When your child is stable, she'll undergo computed at a later age.
tomography (CT) and magnetic resolution imaging (MRI). The 3. The child will be given a chance to recover and will be monitored closely before a
physicians will be able to let you know if she has CP." diagnosis is made.
2. "Most children do not develop CP at this late age." 4. Although many children develop CP after having complications of meningitis, many do
3. "Your child will be closely monitored after discharge, and a not. Although the parents should not be given false hope, they should not be led to lose
developmental specialist will be able to make the diagnosis." hope for a complete recovery.
4. "Most children who have had complications following TEST-TAKING HINT: The test taker should be led to answer 3 because it explains the
meningitis develop some amount of CP." process and does not state that the child definitely will or will not develop CP.
The nurse is caring for a 2-month-old infant who is at risk for 1. The nurse cannot assume that the child will have speech difficulties. Speech therapy
cerebral palsy (CP) due to extreme low birth weight and does not guarantee vocalization at a developmentally appropriate age.
prematurity. His parents ask why a speech therapist is involved 2. Although speech therapy will assist with babbling at a later age, its primary purpose is to
in his care. Select the nurse's best response. assist with feeding.
1. "Your baby is likely to have speech problems because of his 3. It is important to involve speech therapy to strengthen tongue and jaw movements
early birth. to assist with feeding. The infant whois at risk for CP may have weakened
Involving the speech therapist now will ensure vocalization at a and uncoordinated tongue and jaw
developmentally appropriate age." movements.
2. "The speech therapist will help with tongue and jaw 4. Members of a multidisciplinary team become involved in a child’s care based on specific
movements to assist with babbling." needs, not hospital routine.
3. "The speech therapist will help with tongue and jaw TEST-TAKING HINT: The test taker should immediately eliminate answer 4 because it
movements to assist with feeding." does not consider the child’s individual needs.
4. "Many members of the health-care team are involved in your
child's care so that we will know if there are any unmet needs."
The nurse prepares baclofen for a child with cerebral palsy (CP) 1. Baclofen is not given for postoperative pain control.
who just had her hamstrings surgically released. The child's 2. Baclofen is not given for seizures.
parents ask what the medication is for. Select the nurse's best 3. Baclofen is given to help control the spasms associated with CP.
response. 4. Baclofen is not given for bladder control.
1. "It is a medication that will help decrease the pain from her TEST-TAKING HINT: The test taker needs to be familiar with the medication baclofen.
surgery."
2. "It is a medication that will prevent her from having seizures."
3. "It is a medication that will help control her spasms."
4. "It is a medication that will help with bladder control."
,The parents of a 12-month-old with cerebral palsy (CP) ask the 1. Sign language may help the child with CP communicate and ultimately decrease
nurse if they should teach their child sign language because he frustration. Children with CP may have difficulty verbalizing because of weak tongue
has not begun to vocalize. The nurse bases the response on and jaw muscles. They may be able to have sufficient motor skills to communicate
the knowledge that sign language: with their hands.
1. May be a very beneficial way to help children with CP 2. Sign language does not cause confusion and may help reinforce vocabulary and
communicate. vocalization.
2. May cause confusion and further delay vocalization. 3. CP is manifested differently in all children; therefore, generalizations cannot be made.
3. Is difficult to learn for most children with CP. 4. The earlier sign language is taught, the more it will be beneficial.
4. Is beneficial to learn, but it would be best to wait until the TEST-TAKING HINT: The test taker can immediately eliminate answer 3 because it
child is older. makes a generalization. All forms of language are beneficial and well tolerated by
children, especially young children.
The parents of a child with cerebral palsy (CP) are learning how 1. The food should be placed far back in the mouth to avoid tongue thrust.
to feed their child and avoid aspiration. The nurse would 2. The child should be placed in an upright position.
question which of the following when reviewing the teaching 3. Soft and blended foods minimize the risk of aspiration.
plan? 4. Allowing the child time to feed minimizes the risk of aspiration.
1. Place the food on the tip of the tongue. TEST-TAKING HINT: The test taker should consider which methods will decrease the
2. Place the child in an upright position during feedings. risk of aspiration. Answers 2, 3, and 4 all decrease the risk of choking and should be
3. Feed the child soft and blended foods. eliminated.
4. Feed the child slowly.
The parent of an infant diagnosed with a neuroblastoma asks 1. Neuroblastoma is not always cured and can be fatal depending on the stage at
the nurse what the prognosis is. The nurse's best response is: diagnosis, site of origin, and the age of the child.
1. Excellent, because a neuroblastoma is always cured. 2. Infants younger than 1 year have the best prognosis.
2. Excellent, because infants with a neuroblastoma have the 3. Infants younger than 1 year have the best prognosis.
best prognosis. 4. Although the prognosis varies with the site of origin, infants have the most favorable
3. Poor, because infants with a neuroblastoma rarely survive. outcome.
4. Variable, depending on the site of origin. TEST-TAKING HINT: The question requires the test taker to be familiar with the
prognosis of neuroblastoma.
The parent of a child with neuroblastoma asks the nurse what 1. Although abdominal fullness is often seen, difficulty urinating is not a common symptom.
the typical signs and symptoms are at first. Select the nurse's 2. Bone manifestations are a sign of bone metastasis, which is not seen in the early stages
best answer. of neuroblastoma.
1. "Most children complain of abdominal fullness and difficulty 3. The signs and symptoms vary depending on where the tumor is located, but
urinating." typical symptoms include weight loss, abdominal distention, and fatigue.
2. "Many children in the early stages of a neuroblastoma have 4. The signs and symptoms vary according to the location of the tumor. Generally, hunger
joint pain and walk with a limp." and weight gain are not seen.
3. "The signs and symptoms vary depending on where the TEST-TAKING HINT: The test taker should eliminate answer 2 because bone
tumor is located, but typical symptoms include weight loss, metastases are a late sign, and the test taker is looking for initial signs.
abdominal distention, and fatigue."
4. "The signs and symptoms are fairly consistent regardless of
the location of the tumor. They include fatigue, hunger, weight
gain, and abdominal fullness."
,The nurse is caring for a child receiving radiation therapy for a 1. Not all children who receive radiation
brain tumor. The parents ask if their child will likely have any experience learning disabilities.
learning disabilities. Select the nurse's best answer. 2. Younger children tend to experience more learning difficulties than do older children.
1. "All children who receive radiation have some amount of 3. Although variable, younger children tend to experience more learning difficulties
learning disability. As long as they receive extra tutoring, they than do older children.
usually do well in school." 4. Although variable, younger children tend to experience more learning difficulties than do
2. "Because your child is so young, she will likely do well and older children.
have no problems in the future." TEST-TAKING HINT: The test taker should be familiar with radiation therapy. The test
3. "Response varies with each child, but younger children who taker should be led to answers 3 and 4 because they both state that difficulties are
receive radiation tend to have some amount of learning variable.
disability later in life."
4. "Response varies with each child, but younger children who
receive radiation tend to have fewer problems later in life than
older children."
A child involved in a motor vehicle accident (MVA) is currently 1. The cervical collar should not be removed. In addition to the methylprednisolone
on a backboard with a cervical collar in place. The child is (Medrol), ranitidine (Zantac) should be administered to prevent gastric ulcer formation.
diagnosed with a cervical fracture. Which would the nurse 2. All forms of spinal stabilization should be continued while methylprednisolone
expect to find in the child's plan of care? (Medrol) and ranitidine (Zantac) are administered.
1. Remove the cervical collar, keep the backboard in place, and 3. The backboard and cervical collar should not be removed until after the halo traction has
administer high-dose methylprednisolone (Medrol). been applied.
2. Continue with all forms of spinal stabilization and administer 4. The cervical collar should not be removed.
high-dose methylprednisolone (Medrol) and ranitidine (Zantac). TEST-TAKING HINT: The test taker should be familiar with spinal cord injuries. The
3. Remove the backboard and cervical collar and prepare for test taker should eliminate any answer stating the cervical collar be removed, such
halo tractionplacement. as 1, 3, and 4.
4. Remove the cervical collar and backboard, place the child on
spinal precautions, and administer high-dose
methylprednisolone (Medrol) and ranitidine (Zantac).
, The parent of a newborn asks, "Will my baby spit out the 1. Swallowing is a reflex in neonates; infants younger than 6 weeks cannot voluntarily
formula if it is too hot or too cold?" Which is the nurse's best control swallowing.
response? 2. Swallowing is a reflex in neonates; infants younger than 6 weeks cannot voluntarily
1. "Babies have a tendency to reject hot fluids but not cold control swallowing.
fluids, which could result in abdominal discomfort." 3. The infant is not capable of selectively rejecting fluid because swallowing is a reflex until
2. "Babies have a tendency to reject cold fluids but not hot 6 weeks.
fluids, which could result in esophageal burns." 4. Swallowing is a reflex in infants younger than 6 weeks.
3. "Your baby would most likely spit out formula that was too TEST-TAKING HINT: Swallowing is a reflex that is present until the age of 6 weeks.
hot, but your baby could swallow some of it, which could result The test taker should eliminate answers 1, 2,and 3 because they suggest that the
in a burn." infant is capable of selectively rejecting fluids.
4. "Your baby is too young to be physically capable of spitting
out fluids and will automatically swallow anything."
A 4-month-old has had vomiting and diarrhea for 24 hours. The 1. The information obtained from a urinalysis of an infant is not as helpful as serum
infant is fussy, and the anterior fontanel is sunken. The nurse electrolytes. The infant has limited ability to concentrate urine, so the specific gravity is not
notes the infant does not produce tears when crying. Which usually affected.
task will help confirm the diagnosis of dehydration? 2. The information obtained from a urinalysis of an infant is not as helpful as serum
1. Urinalysis obtained by bagged specimen. electrolytes. The infant has limited ability to concentrate urine, so the specific gravity is not
2. Urinalysis obtained by sterile catheterization. usually affected. A urinalysis does not need to be obtained by catheterization.
3. Analysis of serum electrolytes. 3. The analysis of serum electrolytes offers the most information and assists with
4. Analysis of cerebrospinal fluid. the diagnosis of dehydration.
4. Although critical in diagnosing meningitis, a lumber puncture and analysis of
cerebrospinal fluid are not done to confirm dehydration.
TEST-TAKING HINT: Infants have limited ability to concentrate urine, so answers 1
and 2 can be eliminated immediately.
if the child will likely develop cerebral palsy (CP). Select the diagnosed with any type of radiological examination.
nurse's best response. 2. Although most cases of CP occur in the neonatal period, some children can develop CP
1. "When your child is stable, she'll undergo computed at a later age.
tomography (CT) and magnetic resolution imaging (MRI). The 3. The child will be given a chance to recover and will be monitored closely before a
physicians will be able to let you know if she has CP." diagnosis is made.
2. "Most children do not develop CP at this late age." 4. Although many children develop CP after having complications of meningitis, many do
3. "Your child will be closely monitored after discharge, and a not. Although the parents should not be given false hope, they should not be led to lose
developmental specialist will be able to make the diagnosis." hope for a complete recovery.
4. "Most children who have had complications following TEST-TAKING HINT: The test taker should be led to answer 3 because it explains the
meningitis develop some amount of CP." process and does not state that the child definitely will or will not develop CP.
The nurse is caring for a 2-month-old infant who is at risk for 1. The nurse cannot assume that the child will have speech difficulties. Speech therapy
cerebral palsy (CP) due to extreme low birth weight and does not guarantee vocalization at a developmentally appropriate age.
prematurity. His parents ask why a speech therapist is involved 2. Although speech therapy will assist with babbling at a later age, its primary purpose is to
in his care. Select the nurse's best response. assist with feeding.
1. "Your baby is likely to have speech problems because of his 3. It is important to involve speech therapy to strengthen tongue and jaw movements
early birth. to assist with feeding. The infant whois at risk for CP may have weakened
Involving the speech therapist now will ensure vocalization at a and uncoordinated tongue and jaw
developmentally appropriate age." movements.
2. "The speech therapist will help with tongue and jaw 4. Members of a multidisciplinary team become involved in a child’s care based on specific
movements to assist with babbling." needs, not hospital routine.
3. "The speech therapist will help with tongue and jaw TEST-TAKING HINT: The test taker should immediately eliminate answer 4 because it
movements to assist with feeding." does not consider the child’s individual needs.
4. "Many members of the health-care team are involved in your
child's care so that we will know if there are any unmet needs."
The nurse prepares baclofen for a child with cerebral palsy (CP) 1. Baclofen is not given for postoperative pain control.
who just had her hamstrings surgically released. The child's 2. Baclofen is not given for seizures.
parents ask what the medication is for. Select the nurse's best 3. Baclofen is given to help control the spasms associated with CP.
response. 4. Baclofen is not given for bladder control.
1. "It is a medication that will help decrease the pain from her TEST-TAKING HINT: The test taker needs to be familiar with the medication baclofen.
surgery."
2. "It is a medication that will prevent her from having seizures."
3. "It is a medication that will help control her spasms."
4. "It is a medication that will help with bladder control."
,The parents of a 12-month-old with cerebral palsy (CP) ask the 1. Sign language may help the child with CP communicate and ultimately decrease
nurse if they should teach their child sign language because he frustration. Children with CP may have difficulty verbalizing because of weak tongue
has not begun to vocalize. The nurse bases the response on and jaw muscles. They may be able to have sufficient motor skills to communicate
the knowledge that sign language: with their hands.
1. May be a very beneficial way to help children with CP 2. Sign language does not cause confusion and may help reinforce vocabulary and
communicate. vocalization.
2. May cause confusion and further delay vocalization. 3. CP is manifested differently in all children; therefore, generalizations cannot be made.
3. Is difficult to learn for most children with CP. 4. The earlier sign language is taught, the more it will be beneficial.
4. Is beneficial to learn, but it would be best to wait until the TEST-TAKING HINT: The test taker can immediately eliminate answer 3 because it
child is older. makes a generalization. All forms of language are beneficial and well tolerated by
children, especially young children.
The parents of a child with cerebral palsy (CP) are learning how 1. The food should be placed far back in the mouth to avoid tongue thrust.
to feed their child and avoid aspiration. The nurse would 2. The child should be placed in an upright position.
question which of the following when reviewing the teaching 3. Soft and blended foods minimize the risk of aspiration.
plan? 4. Allowing the child time to feed minimizes the risk of aspiration.
1. Place the food on the tip of the tongue. TEST-TAKING HINT: The test taker should consider which methods will decrease the
2. Place the child in an upright position during feedings. risk of aspiration. Answers 2, 3, and 4 all decrease the risk of choking and should be
3. Feed the child soft and blended foods. eliminated.
4. Feed the child slowly.
The parent of an infant diagnosed with a neuroblastoma asks 1. Neuroblastoma is not always cured and can be fatal depending on the stage at
the nurse what the prognosis is. The nurse's best response is: diagnosis, site of origin, and the age of the child.
1. Excellent, because a neuroblastoma is always cured. 2. Infants younger than 1 year have the best prognosis.
2. Excellent, because infants with a neuroblastoma have the 3. Infants younger than 1 year have the best prognosis.
best prognosis. 4. Although the prognosis varies with the site of origin, infants have the most favorable
3. Poor, because infants with a neuroblastoma rarely survive. outcome.
4. Variable, depending on the site of origin. TEST-TAKING HINT: The question requires the test taker to be familiar with the
prognosis of neuroblastoma.
The parent of a child with neuroblastoma asks the nurse what 1. Although abdominal fullness is often seen, difficulty urinating is not a common symptom.
the typical signs and symptoms are at first. Select the nurse's 2. Bone manifestations are a sign of bone metastasis, which is not seen in the early stages
best answer. of neuroblastoma.
1. "Most children complain of abdominal fullness and difficulty 3. The signs and symptoms vary depending on where the tumor is located, but
urinating." typical symptoms include weight loss, abdominal distention, and fatigue.
2. "Many children in the early stages of a neuroblastoma have 4. The signs and symptoms vary according to the location of the tumor. Generally, hunger
joint pain and walk with a limp." and weight gain are not seen.
3. "The signs and symptoms vary depending on where the TEST-TAKING HINT: The test taker should eliminate answer 2 because bone
tumor is located, but typical symptoms include weight loss, metastases are a late sign, and the test taker is looking for initial signs.
abdominal distention, and fatigue."
4. "The signs and symptoms are fairly consistent regardless of
the location of the tumor. They include fatigue, hunger, weight
gain, and abdominal fullness."
,The nurse is caring for a child receiving radiation therapy for a 1. Not all children who receive radiation
brain tumor. The parents ask if their child will likely have any experience learning disabilities.
learning disabilities. Select the nurse's best answer. 2. Younger children tend to experience more learning difficulties than do older children.
1. "All children who receive radiation have some amount of 3. Although variable, younger children tend to experience more learning difficulties
learning disability. As long as they receive extra tutoring, they than do older children.
usually do well in school." 4. Although variable, younger children tend to experience more learning difficulties than do
2. "Because your child is so young, she will likely do well and older children.
have no problems in the future." TEST-TAKING HINT: The test taker should be familiar with radiation therapy. The test
3. "Response varies with each child, but younger children who taker should be led to answers 3 and 4 because they both state that difficulties are
receive radiation tend to have some amount of learning variable.
disability later in life."
4. "Response varies with each child, but younger children who
receive radiation tend to have fewer problems later in life than
older children."
A child involved in a motor vehicle accident (MVA) is currently 1. The cervical collar should not be removed. In addition to the methylprednisolone
on a backboard with a cervical collar in place. The child is (Medrol), ranitidine (Zantac) should be administered to prevent gastric ulcer formation.
diagnosed with a cervical fracture. Which would the nurse 2. All forms of spinal stabilization should be continued while methylprednisolone
expect to find in the child's plan of care? (Medrol) and ranitidine (Zantac) are administered.
1. Remove the cervical collar, keep the backboard in place, and 3. The backboard and cervical collar should not be removed until after the halo traction has
administer high-dose methylprednisolone (Medrol). been applied.
2. Continue with all forms of spinal stabilization and administer 4. The cervical collar should not be removed.
high-dose methylprednisolone (Medrol) and ranitidine (Zantac). TEST-TAKING HINT: The test taker should be familiar with spinal cord injuries. The
3. Remove the backboard and cervical collar and prepare for test taker should eliminate any answer stating the cervical collar be removed, such
halo tractionplacement. as 1, 3, and 4.
4. Remove the cervical collar and backboard, place the child on
spinal precautions, and administer high-dose
methylprednisolone (Medrol) and ranitidine (Zantac).
, The parent of a newborn asks, "Will my baby spit out the 1. Swallowing is a reflex in neonates; infants younger than 6 weeks cannot voluntarily
formula if it is too hot or too cold?" Which is the nurse's best control swallowing.
response? 2. Swallowing is a reflex in neonates; infants younger than 6 weeks cannot voluntarily
1. "Babies have a tendency to reject hot fluids but not cold control swallowing.
fluids, which could result in abdominal discomfort." 3. The infant is not capable of selectively rejecting fluid because swallowing is a reflex until
2. "Babies have a tendency to reject cold fluids but not hot 6 weeks.
fluids, which could result in esophageal burns." 4. Swallowing is a reflex in infants younger than 6 weeks.
3. "Your baby would most likely spit out formula that was too TEST-TAKING HINT: Swallowing is a reflex that is present until the age of 6 weeks.
hot, but your baby could swallow some of it, which could result The test taker should eliminate answers 1, 2,and 3 because they suggest that the
in a burn." infant is capable of selectively rejecting fluids.
4. "Your baby is too young to be physically capable of spitting
out fluids and will automatically swallow anything."
A 4-month-old has had vomiting and diarrhea for 24 hours. The 1. The information obtained from a urinalysis of an infant is not as helpful as serum
infant is fussy, and the anterior fontanel is sunken. The nurse electrolytes. The infant has limited ability to concentrate urine, so the specific gravity is not
notes the infant does not produce tears when crying. Which usually affected.
task will help confirm the diagnosis of dehydration? 2. The information obtained from a urinalysis of an infant is not as helpful as serum
1. Urinalysis obtained by bagged specimen. electrolytes. The infant has limited ability to concentrate urine, so the specific gravity is not
2. Urinalysis obtained by sterile catheterization. usually affected. A urinalysis does not need to be obtained by catheterization.
3. Analysis of serum electrolytes. 3. The analysis of serum electrolytes offers the most information and assists with
4. Analysis of cerebrospinal fluid. the diagnosis of dehydration.
4. Although critical in diagnosing meningitis, a lumber puncture and analysis of
cerebrospinal fluid are not done to confirm dehydration.
TEST-TAKING HINT: Infants have limited ability to concentrate urine, so answers 1
and 2 can be eliminated immediately.
