a nurse is planning care for a child who has severe diarrhea. which of the following
actions is the nurse priority? - Assess fluid balance
A nurse is caring for a toddler who's parent states that the child has a mass in his
abdominal area and his urine is a pink color. Which of the following actions is the
nurse's priority? - Instruct the parent to avoid pressing on the abdominal area
A nurse is caring for a child who has acute glomerulonephritis. Which of the following
actions is the nurse's priority? - Check the Childs weight daily
A nurse is caring for a child who has a suspected diagnosis of bacterial meningitis.
Which of the following is the nurse's priority? - Administer antibiotics when available
A nurse is collecting data from an adolescent. Which of the following represents the
greatest risk for suicide? - Active psychiatric disorder (Mark, mental problems, patients
mind is unstable)
A nurse is collecting data from an infant who has otitis media (middle ear infection). The
nurse should expect which of the following findings? - Tugging on the affected ear lobe
A nurse is reinforcing reaching with a parent of a 1 month old infant who is to undergo
the initial surgery to treat Hirschsprung's disease (a ganglionic megacolon, part of the
colon isn't connected to the nerves or not functioning, so there will be an increase size
of the colon and stool gets stuck in there). Which of the following statements should
indicate to the nurse that the parent understanding the goal of surgery? - "I'm glad that
the ostomy is only temporary " (1st there going to cut the nonfunctioning of the colon,
and then apply temporary colostomy, after a couple of months they will suture it
together)
A nurse is caring for an infant who is 1 day postoperative following surgical repair of a
cleft lip. Which of the following actions should the nurse take? - Apply an antibiotic
ointment to the suture site
A nurse is reinforcing discharge instructions with a parent of a child who has cystic
fibrosis. Which of the following statements by the parent indicates an understanding of
the teaching? - "I will make sure my child washes her hands before eating"
A nurse working at a clinic speaks on the telephone with a parent of a 2-monthold
infant. The parent tells the nurse that the infant has projectile vomiting followed by
hunger after meals. Which of the following response by the nurse is appropriate? -
"Bring your infant into the clinic today to be seen"
, A nurse is caring for a 4 year old child who is 2 days postoperative following the
insertion of a ventriculoperitoneal shunt. Which of the following findings should the
nurse identify as the priority . (causes icp hydrocephalus) - lethargy (high pitched cry,
respiratory changes, bradycardia, wide pulse pressure, irritability
a nurse is caring for a child following an open reduction and internal fixation of a
fractured femur and application of a cast. The cast has a window cut in it for viewing of
the incision. Which of the following actions should the nurse take first? - Perform
neurovascular checks of the affected extremity (check for infection, color, capillary refill,
redness)
A nurse is an urgent care clinic is assisting with the care of a toddler who ingested 30
tablets of aspirin. Which of the following substances should the nurse administer to the
toddler? - Activated charcoal (can work with toxin, poison. Given through ng tube
absorbs toxins)
A nurse is caring for a 3 year old client who has persistent otitis media. To help identify
contributing factors, the nurse should ask the parents which of the following questions?
- Does anyone smoke in the same house as your daughter? (smoking can cause
irritation, cause mucus in respiratory and causes otitis media?) (otitis media is purulent
color)
A nurse is collecting data from a 2 year old toddler who has AIDS. The nurse should
inspect inside the toddler mouth for which of the following opportunistic infections
(fungus infections is usually opportunistic infections)? - Candidiasis (also called oral
thrush)
A nurse is caring for a 4 year old child who has dehydration. Which of the following
findings should the nurse identify as the priority? - Potassium 2.5 mEq/L
A nurse is caring for a child who Is postoperative following the insertion of a
ventriculorperitoneal shunt. The nurse should place the child in which of the following
positions? - On the nonoperative side
A nurse is caring for an infant who is dehydrated and requires IV therapy. The nurse
should monitor the infant response to therapy by performing which of the following
actions? - weighing the infants at the same time everyday
A nurse is caring for a preschool age child who has croup. Which of the following
findings should the nurse report to the provider? - Drooling (that could mean it can
mean there's an epiglottitis causes obstruction of the airway)
A nurse is collecting data from an infant who has hypertrophic pyloric stenosis. Which of
the following findings should the nurse expect? - Projectile vomiting