1. A nurse in an Administer epinephrine IM
emer- gency
department is Rationale: When using the urgent vs. non-urgent approach to
caring for a school- client care, the nurse should determine that the priority action is
age child who is administering epi- nephrine IM to the child. During an
experienc- ing an anaphylactic reaction, histamine re-
anaphylactic re-
action. Which of the fol- lease causes bronchoconstriction and vasodilation. This is an
emergency
lowing is the priority ac- because ultimately it causes decreased blood return to the
heart.
tion by the nurse?
2. A nurse in a pedi- Apply supplemental oxygen
atric emergency
de- partment is Rationale: According to the medical record and chest x-ray
planning report, the adolescent could potentially have a pneumothorax.
care for an Also according to the medical record and chest x-ray report, the
adolescent. Based adolescent's oxygen saturation level is decreasing, which indicates
on the informa-
hypoxia. Therefore, the nurse should plan to administer
tion in the
supplemental oxygen.
adolescent's
medical record,
which
of the following actions
should the nurse Prepare for chest tube insertion
plan
to take?
Select all that apply.
3. A nurse in an emer- gency
department is caring for a school-age
child who has epiglotti-
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Rationale: According to the medical
record and chest x-ray report, the
adolescent could potentially have
a pneumothorax. A pneumothorax
is the presence of air in the
pleural cavity, which results in
decreased lung expansion. The
adolescent could experience
dyspnea, tachypnea,
tachycardia, hypoxia, and pain. This
requires prompt intervention by the
provider, such as the placement of
a chest tube into the thoracic
cavity to remove air and fluid from
the pleural space, if present,
allowing the lung to re-expand.
Monitor the child's oxygen
saturation
Rationale: The nurse should monitor
the child's oxygen saturation level
because the child is experiencing
acute respiratory distress and it is
necessary to determine if the child
is responding to treatment.
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tis. Which of the has heart failure and a new
follow- ing actions prescription for digoxin twice dai- ly.
should the nurse Which of the follow- ing instructions
take? should
4. A nurse is
provid- ing
teaching about
play activities for
so- cial
development to
the guardians of
a
preschooler. Which
of the following play
activ- ities should
the nurse
recommend for the
child?
5. A nurse is receiving
change-of-shift
report for four
children. Which of
the following chil-
dren should the
nurse see first?
6. A nurse is
providing teaching
to the par- ents of
a preschooler who
, RN Pediatric Nursing Online Practice T e s t .
the nurse should see this child first.
"Brush the child's teeth after giving the medication."
Playing dress-up Rationale: The nurse should instruct the parents to brush the
child's teeth after administering digoxin to prevent tooth decay
Rationale: The nurse should instruct caused by the medication, which comes as a sweetened liquid to
the guardians that at the preschool enhance the taste.
age, play should focus on social,
mental, and physical
development.
Therefore, playing dress-up is a
recommended play activity for this
child.
A school-age child who has
sickle cell anemia and reports
decreased vision in the left eye
Rationale: When using the urgent
vs. non-urgent approach to client
care, the nurse should determine
the priority finding is a report of
decreased vision in the left eye.
This finding indicates that the child
is experiencing a vaso-occlusive
crisis and should be reported to the
provider immediately. Therefore,