Exam 2: Study Guide:NR 328 Exam 2 Study Guide: Updated
Solution
The nurse is caring for a child with a Wilms tumor. Which assessment findings does the nurse anticipate?
Select all that apply. - ANSWER:-Abdominal Mass
-Hypertension
-Hematuria
The nurse is caring for a 5-year-old who will be undergoing surgery for removal of a neuroblastoma on
the adrenal gland. Which are appropriate ways to help the child cope with their fear of the procedure?
Select all that apply. - ANSWER:-Offer a tour of the facility prior to the procedure
-Offer choices when possible
-Answer questions honestly
-Ensure the child knows why they are having the surgery
-Ask the child to explain back what will happen at the hospital
The nurse is caring for a client receiving chemotherapy who is experiencing nausea and vomiting. The
highest priority nursing diagnosis for the nurse to address is ____________________. The action the
nurse should take is to administer the client's prescribed ______________________. - ANSWER:Fluid
and electrolyte imbalance
Ondansetron
The nurse is caring for a 4-year-old who is receiving chemotherapy and is experiencing nausea and
vomiting. Which is the best nursing action to address the problem? - ANSWER:Allow the child to choose
what to eat for meals
The nurse is caring for a toddler who is recovering from surgery to remove a cancerous tumor. Which
assessment finding best indicates the child's pain is decreasing? - ANSWER:Increased interest in play
The nurse is caring for a client being treated for acute lymphocytic leukemia (ALL). The client's white
blood cell count is 7,000 cells/mm³. A priority nursing diagnosis for this client is risk for infection. Which
outcome best indicates the client remains infection-free? - ANSWER:Temperature remains within normal
range
The nurse is caring for a pediatric client who is undergoing chemotherapy treatment for acute
lymphoblastic leukemia (ALL). The planned treatment is intermittent and may last up to two years.
Which intravenous line should the nurse advocate for the client? - ANSWER:Implanted port
The nurse is caring for a child diagnosed with a Wilms tumor. Prior to treatment, the client is at highest
risk for __________ which could cause __________. - ANSWER:trauma to the tumor
, spread of the cancer
Which cancer is most common in pediatrics? - ANSWER:Leukemia
The nurse is caring for a child who will be having abdominal surgery. Which nursing action(s) does the
nurse anticipate performing prior to surgery? Select all that apply. - ANSWER:-Request services from
child life specialist.
-Administer prescribed intravenous fluids.
-Administer prescribed preoperative antibiotics.
-Prepare surgical consent and witness informed consent.
The nurse is caring for a child who just returned to the pediatric unit after having an abdominal surgery.
Which nursing action(s) does the nurse anticipate performing? Select all that apply. - ANSWER:Assess
surgical wound and/or dressing.
Administer pain medication as prescribed.
Assess for return of bowel sounds.
Monitor vital signs per post-operative protocol.
Advance oral intake as tolerated.
The nurse is caring for a 6-year-old child who is 4 hours post-operative from a ruptured appendectomy.
Ibuprofen was administered 2 hours ago and the child rates pain as 1 out of 10. The child's intake
includes water, crackers, a cup of gelatin, and a bottle of juice. Review the health care provider's orders. -
ANSWER:Saline lock the intravenous line.
Which client experiencing constipation is at the most risk for serious complications? - ANSWER:A 2-day-
old newborn who has never had a bowel movement
The nurse is providing education for the parent of a 2-month-old infant who is newly diagnosed with
gastroesophageal reflux. Which statement by the parent indicates additional education is needed? -
ANSWER:"I will lay the baby down on their stomach to sleep to reduce reflux."
The nurse is caring for a postoperative 15-year-old client who had an appendectomy with drain
placement for a ruptured appendix. Which action should the nurse perform first? - ANSWER:Administer
pain medication for pain rating of 4/10.
The nurse is admitting a 2-month-old infant prior to a surgical intervention for pyloric stenosis. The
parent reports the infant has not had a wet diaper since the evening before. The nurse assesses the
infant has a sunken anterior fontanelle and is tachycardic. Which is the most important order the nurse
should request from the health care provider? - ANSWER:An order for intravenous fluids
mechanical obstruction from inadequate motility of intestine - ANSWER:Hirschsprung's disease
thickened obstruction between stomach and duodenum - ANSWER:pyloric stenosis
alteration in frequency, consistency, or ease of passing stool - ANSWER:constipation
Solution
The nurse is caring for a child with a Wilms tumor. Which assessment findings does the nurse anticipate?
Select all that apply. - ANSWER:-Abdominal Mass
-Hypertension
-Hematuria
The nurse is caring for a 5-year-old who will be undergoing surgery for removal of a neuroblastoma on
the adrenal gland. Which are appropriate ways to help the child cope with their fear of the procedure?
Select all that apply. - ANSWER:-Offer a tour of the facility prior to the procedure
-Offer choices when possible
-Answer questions honestly
-Ensure the child knows why they are having the surgery
-Ask the child to explain back what will happen at the hospital
The nurse is caring for a client receiving chemotherapy who is experiencing nausea and vomiting. The
highest priority nursing diagnosis for the nurse to address is ____________________. The action the
nurse should take is to administer the client's prescribed ______________________. - ANSWER:Fluid
and electrolyte imbalance
Ondansetron
The nurse is caring for a 4-year-old who is receiving chemotherapy and is experiencing nausea and
vomiting. Which is the best nursing action to address the problem? - ANSWER:Allow the child to choose
what to eat for meals
The nurse is caring for a toddler who is recovering from surgery to remove a cancerous tumor. Which
assessment finding best indicates the child's pain is decreasing? - ANSWER:Increased interest in play
The nurse is caring for a client being treated for acute lymphocytic leukemia (ALL). The client's white
blood cell count is 7,000 cells/mm³. A priority nursing diagnosis for this client is risk for infection. Which
outcome best indicates the client remains infection-free? - ANSWER:Temperature remains within normal
range
The nurse is caring for a pediatric client who is undergoing chemotherapy treatment for acute
lymphoblastic leukemia (ALL). The planned treatment is intermittent and may last up to two years.
Which intravenous line should the nurse advocate for the client? - ANSWER:Implanted port
The nurse is caring for a child diagnosed with a Wilms tumor. Prior to treatment, the client is at highest
risk for __________ which could cause __________. - ANSWER:trauma to the tumor
, spread of the cancer
Which cancer is most common in pediatrics? - ANSWER:Leukemia
The nurse is caring for a child who will be having abdominal surgery. Which nursing action(s) does the
nurse anticipate performing prior to surgery? Select all that apply. - ANSWER:-Request services from
child life specialist.
-Administer prescribed intravenous fluids.
-Administer prescribed preoperative antibiotics.
-Prepare surgical consent and witness informed consent.
The nurse is caring for a child who just returned to the pediatric unit after having an abdominal surgery.
Which nursing action(s) does the nurse anticipate performing? Select all that apply. - ANSWER:Assess
surgical wound and/or dressing.
Administer pain medication as prescribed.
Assess for return of bowel sounds.
Monitor vital signs per post-operative protocol.
Advance oral intake as tolerated.
The nurse is caring for a 6-year-old child who is 4 hours post-operative from a ruptured appendectomy.
Ibuprofen was administered 2 hours ago and the child rates pain as 1 out of 10. The child's intake
includes water, crackers, a cup of gelatin, and a bottle of juice. Review the health care provider's orders. -
ANSWER:Saline lock the intravenous line.
Which client experiencing constipation is at the most risk for serious complications? - ANSWER:A 2-day-
old newborn who has never had a bowel movement
The nurse is providing education for the parent of a 2-month-old infant who is newly diagnosed with
gastroesophageal reflux. Which statement by the parent indicates additional education is needed? -
ANSWER:"I will lay the baby down on their stomach to sleep to reduce reflux."
The nurse is caring for a postoperative 15-year-old client who had an appendectomy with drain
placement for a ruptured appendix. Which action should the nurse perform first? - ANSWER:Administer
pain medication for pain rating of 4/10.
The nurse is admitting a 2-month-old infant prior to a surgical intervention for pyloric stenosis. The
parent reports the infant has not had a wet diaper since the evening before. The nurse assesses the
infant has a sunken anterior fontanelle and is tachycardic. Which is the most important order the nurse
should request from the health care provider? - ANSWER:An order for intravenous fluids
mechanical obstruction from inadequate motility of intestine - ANSWER:Hirschsprung's disease
thickened obstruction between stomach and duodenum - ANSWER:pyloric stenosis
alteration in frequency, consistency, or ease of passing stool - ANSWER:constipation
