NUR 254 Exam 4|Questions and Answers | 2025 Update | 100% Correct-Galen College of Nursing

INUN 20U, IVUIN 204, INUN 24U LA+ a vociowia % GALEN T i Faculty Name: Barbara Franklin Co 2 or NURSING Program: Assoclate of Science Degree in Nursing = ] b : | Exam Cover Sheet Course Number: NUR 254 Section: 03005 Course Name: Concepts of Nursing: The Childbearing/Child Caring Family Exam Name: Exam 4 a Test Form: A T EERAEET e VELT Term Exam Administered: 21 Winter Time Allowed for Completion (minutes): 75 Number of Exam Items: 50 Points per Exam Item: 2 Materials Supplied: none BETEENNInO TN « Students may write on the exam booklet (if available) but you must record your response(s) on the ScantronA® sheet. The ScantronA® sheet will be considered your final answer(s) for exam items. « Students must use a #2 pencil for recording responses + Students should choose the best response(s) to each item. ltems left blank will be counted a that you have answered every question before tumning in your exam. Fill in the circie completely, thoroughly. s Incorrect. There Is no penalty for guessing so be sure It you change your answer, erase your first answer Please remember that academic dishonesty includes, but is not restricted to the following, and may result in dismissal from the College: . Copying from or collaborating with another student during an exam. . Selling, buying or illegally obtaining part or all of an exam. . Discussing the test with any student that has not yet taken the exam. . Taking or allowing another person to take an exam or complete an assignment . Using unauthorized materials during an exam. B wWN - Please refer to the Academic Integrity Code published in your course syllabus for complete information Student Signature Student Print Name = Page 1/ 1%N . disorderv(ADHD)~at~arschoo|.w‘ s shguld = a. Completes projects quickly. b. Prefers detailed tasks. === c. Refrains from volunteering. ( .} Grabs items from others without thinking. ud 2. The nurse is caring for an infant who is having an active seizure. Which of the following actions should the nurse perform when caring for the infant during a seizure? a. Place the infant in the prone position inside the crib. b. Suction any secretions out of the infant's mouth. can, Swaddle the infant to keep them warm and safe. : d” Remove any items out of the crib that can harm the infant.. 3. The nurse is screening infants for signs of cerebral palsy. Which findings from the box below should the nurse recognize as early signs of cerebral palsy? 1. Poorhead control/lag after fi & ’ @ n 1 month. 2. Feeding difficulties. «8uFailuretosmileby 2 months= 4. Persistent Moro reflex 5. Rigid arms or legs: A 296 b. . 3,4,5. ?:, ] v1|’12:,|5.0 1% 2,4,5. ¥ {d 4. The nurse is admitting a toddler who is being hospitalized following a near-drowning accident/submersion injury. The toddler is spontaneously breathing but is unconscious. Which of the following actions should the nurse perform first? '( 3) Administer oxygen via face mask. //- ‘b7 Implement seizure precautions. L c. Notify spiritual advisor of parents’ choice. d. Obtain arterial blood gases (ABGs). Page 2/13 OV INUN £04, INUN 20 LAl 4 a velaiun a Thq nurse is asses§ing a 6-year-old child for manifestations of autism spectrum disorder (ASD). Which of the following manifestations should the nurse expect to observe in this child? a. Continuous eye contact. ’ oq 3 b. Increased imitation of others, F . Interest in various activities. 0 ‘Verbal development delay: 6. Thenurseis caring for a child who has increased intracranial pressure (ICP) and is in stable cg_rlig’i?tion. Which of the following interventions should the nurse implement to decrease ICP in the chi a. Increase the number of visitors inside the child's room. Administer hypotonic intravenous (1V) fluids. Keep the child positioned midline on the bed. d. Administer opioids for pain control. 7. Thenurseis caring for a child who had a ventricular shunt placement 24 hours ago. The child is sitting up in bed crying and has vomited a small amount on the bed linens. Whick, of the following actions should the nurse take first? ‘a Perform a neurologic assessment. b. Obtain a complete metabolic panel (CMP) specimar c. Comfort the child while the linens are changes. d. Inspect the incision site for infection. 8. The nurse is caring for a child who is hospitalized for 24-hour observation follewing a head injury. Which of the following actions by the nurse is the priority? a. Assess for neck stiffness. b. Lower the television sound. @ Checking pupil reaction every 4 hours. d. Restrict visitation to 1 person at a time. ) . 9. Thenurse is assessing a child who is in a coma and notes decorticate posturing. Which of the following findings should the nurse expect the child to demonstrate? a. Rigid extension with head arched back, arms extended by the sides, and legs extended. Rigid flexion with elbows, wrists and fingers flexed, and legs extended and rotated/inward. 7 Abnormal flexion of upper and lower extremities. d. Abnormal extension of the upper extremities and flexion of lower extremities. 0 135" Paae 3/1: =— 10. 1. 12. 13. The nurse wurse is is caring cari for a child i who is i §uspected ofha f having lumbar still pending, Whigh of the following ac == - pio-Adminlstermorphinessilfate: LRI E | ; @) Assessing neurological status every 2 to 4 hours. »z d. The nurse is caring for a child who has Reye's syndrome. Which of the following should the nurse bacterialmeningiis, meningitis. The The rosuls resul of he fions the priority? et - v ~ Dectease noxiousolfactory stimuli: Maintain a lighted environment. include in the child's plan of care? a. 9 The nurse preceptor is discussing Down's syndrome with a newly hired nurse. Which of the following v Change the child’s body position every 2 hours. Assess the child for diplopia in both eyes. Administer salicylates for increased temperature every 4 hours as needed (PRN). Provide the child a quiet atmosphere with dimmed lighting: clinical manifestations identified by the newly hired nurse indicates teaching has been effective? a. b. fcl) 1 The nurse is caring for an 8-yearparent. The nurse reviews the inf Large nose. Strawberry tongue. Wide space between big and second toes. Hypoflexibility. actions? 00 1o YT ED/Notes Laboratory R P S T R P A T AR 2 esults PSRRI P O O SR (AT T ATT I History L e I IR T pain range 8-year-old female Diagnosis: Rule out back VS: Within acceptable White blood cell (WBC) Count: 10/mm? X-ray: No visible abnormalities 6th visit to the ED in 6 months. Unable to verify any illness or concern during previous visits. Parent states, ‘I have a very sickly child who needs medical attention.” Explain the child will be able to go home shortly. Apply 2 L of oxygen via face mask. Notify child protective services (CPS). Ask the parent if they have a history of abuse. old child who was brought to the emergency department (ED) by a ormation in the chart below and performs which of the following Page 4/13A °X | /u, INUN 204, INUN LU LAGIH %+ G VGIDIUIL a W / The npwly hired nurse is caring for a newborn who has a myelomeningocele sac. Which of the ) following interventions performed by the newly hired nurse requires immediate intervention? / a. Using latex-free medical products. AL Cn bg'o%‘h"s’r(W s / b. Changing the dressing every 4 hours to keep the sac from drying out. N C Refraining from placing a diaper on the newborn. -0 S’Zéfl 1Keeping the newborn in the supine position unless feeding. 15. The nurse is caring for a child who has just died due to a chronic illness. Which of the following is an appropriate response to the grieving family? a. “You should feel relief for your child.” b. “Your child isn't feeling pain anymore." ? *| am very sorry; | will miss your child very much.” “I know how you feel: completely lost.” 16. The nurse has attended a continuing education conference on preschool-age children’s reaction to death. It indicates a correct understanding of the conference if the nurse states that preschool-age children a. understand death is permanent. ™ b. show more grief to a significant family member’s death. === @ imagine the deceased person is sleeping. d. are very interested in funerals and burials. 17. The nurse preceptor is discussing Wilm’s tumors with a newly hired nurse. The newly hired nurse asks, “Why should we avoid palpating the child’s abdomen?” Which of the following responses by the nurse preceptor is appropriate? 'a:) & ! fi 3 ‘I “This will increase the occurrence of emesis that will l%fhydrg}n.“ ’ ! “This will increase the risk of infection and prolong surgery.” “This will increase pain and require opioids for treatment.” “This will increase the chance of spreading cancer cells to otherarsas.’ « 18. The newly hired nurse is talking with the nurse preceptor about the prevention of iron-deficiency anemia in infants. Which of the following statements by the newly hired nurse is correct regarding prevention of this condition? 2 a. ‘“lron-fortified infant cereal éhould be introduced to infants at 10 months.” N b. ‘“Iron-fortified commercial formula should be given for the first 6 months of life.” @ “Whole cow’s milk should not be given until 1 year of age with limited daily intake.A “Ferrous sulfate drops are contraindicated in infants less than 6 months of age." Page 5/ 1%19, The nurse is admittinga child whohas vaso-occlusive sickle el crisis. Which of the following ., we Nterventions should the nurse anticipate being the ch!'dfimmuumfiww == :2-=-Conoctionotalikaiosis-and reductionotonergy expenditire e ——— T b Electiolyls feplacament and administration of heparin T T /€= Globulins and factor VIIl replacement. g (~d./ Oxygenation and rest. 20. The nurse is providing a teaching session to health care staff regarding osteosarcoma. Which of the following statements by a staff member indicates a need for additional teaching? "% “The sternum is the most common site of this sarcoma:” X )‘ ii_()'r_1ildren typically experience pain at the primary tumor site.” (QZ, _Ascommon clinical manifestation is limping if a weight-bearing limb is affected.” d. “Inthe early stage, the symptoms of this disease are usually attributed to normal growing pains.” % 21, The nurse is caring for a child at the end of life. The parents ask the nurse if there are any signs of approaching death. Which physical signs from the box below indicate the child is approaching death? Bradycardia. Decreased blood pressure. Body feels warm. Increased appetite. Slurred speech. Increased thirst. 4,5, 6. 3,4,5. 1,4,6. k2, 5. Lo TWwloaswNs 22. The nurse is caring for a 5-year-old child who has sickle cell disease. An assessment of the child includes the following: respirations (R) of 10 and unarousable. The child is currently on intravenous (IV) fluids and continuous IV morphine sulfate. Based on the assessment information, which of the following actions should the nurse take first? a Increase the IV fluids to decrease vaso-occlusion. b. Obtain arterial blood gas (ABG) readings to check for respiratory acidosis. c. Perform a sternal rub on the client. - Administer naloxone to'reverse the effect of the mo;phin‘e’f Page6 /13| )/V oy VUM 204, INUN UM LAGIT% Q VEILDIUN a i . The nurse is caring for a child who has leukemia with a white blood cell (WBC) count < 1,000 mm?. i Whig{ of the following should the nurse include in the child’s plan of care? Require the child to wash their hands when they go in and out of the room. Use aseptic techniques for any procedures. Administer-an influenza vaccinations d. Allow the child to play with other children who do not have a fever. 24, The nurse is speaking with a parent of a toddler. The parent asks the nurse what reaction is expected from their child regarding the impending death of a grandparent. The nurse should state that children in this age group @ imagine the deceased person to stillbe alive. 2 Dbelieve their thoughts caused the death. C. are very interested in funerals and burials. d. unaccepting of their own death. 25. The nurse is assessing a child who has anemia. Which of the following assessment findings should the nurse expect to observe? Pallor. r b. Painful swelling of the hands. . c. Anenlarged abdomen. d. Visual disturbances. 26. The nurse is caring for a child who has retinoblastoma and is returning from an enucleation procedure. The parents are concerned about their child’s appearance after the procedure. Which of the following statements is correct for the nurse to inform the parents? a. “The implanted sphere will need to be removed and cleaned daily.” F @ “A sphere is surgically implanted to maintain the shape of the'eyeball." ¢. “Moderate drainage will come from the affected socket initially.” d. “The eye pad dressing is left open to air in the evenings.” 27. The nurse is providing discharge instructions to the parents of a child who had surgical resection of a neuroblastoma 4 days ago. Which of the following statements by the parents indicates teaching has been effective? a. “Anincrease in temperature is expected after surgery.” b. “I will need to begin slowly reintroducing my child into social interaction.” e “Wewill provide pain relief using:pain: st.” d. “Aprotective helmet will need to be worn until the incision is healed.” Page 7/ 1% i26. Thenurseis talking with the parents of an adolescent. The nurse explains to the parents that ) oy, dolescents have trouble dealing,with death scents, .. fiawaa&“m ' Lnl:fibbnsidex;mm&be:bmbanc;mmemmngwlb ——— b have trouble understanding what happensitotheir bodyafter daath =~ g7y are the most likely to accept their own deathor cessation of life. fl have a need to participate in ritualism during the dying process. - 29. Thenurseis teaching staff members about caring for a child who has hemophilia. Which clinical manifestations from the box below identified by a staff member indicate a correct understanding of ihe teaching? Excessive bleeding; Growth retardation. Hyperkalemia. Hemarthrosis. Cosntant hematuria. Increased bruising. 1,2,3,4. 1,4,5. N 1,46 ) 1,2,8;5; QT R loos N~ 30. The nurse is caring for a 4-year-old child who is 36 hours postoperative following removal of 2 Wilm's tumor. Which of the following requires immediate follow-up by the nurse? White blood cell (WBC) count of 15 mms. Temperature (T) of 100.4° F that occurs 1'tima'in a 24-hour period. 7 Incision site is pink at the edges. ¢ d. Bowel sounds present in all 4 quadrants. ol c‘?fli * e/ | 31, The mother of a 6-year-old child who has diabetes mellitus (type 1) that her child is ill and is concerned about the effect this may have Which of the following instructions should the nurse provide to the calls the clinic nurse and reports on the child’s glucose levels. mother? “Administer an additional dose of insulin the next time your child eats a meal.” “Refrain from giving your child the next regularly scheduled dose of insulin.” “You should schedule an appointment with your primary health care provider.” 'jd) “Follow your scheduled insulin plan and check glucose more often.” a. b. c. 32. Anurse is providing discharge instructions to the parents of a child who has precocious puberty. Which of the following should the nurse include in the teaching? a. Consider having the child attend a same-sex school. /;E:) Importance of following up with the dietician referral. © Encourage clothing appropriate for theif age group. d. The need for lifelong gonadotropin-releasing agonist treatment. Page 8/13| ~ ‘ JU, 1NN 9 WURN cu LAalii =+ a versiun a & Thenurse wgrking in a community clinic is teaching the mother of an infant who was recently L diagnosed with congennal‘ yroidismthich of the following instructions should the nurse give the mother about the administration of levothyroxine? “Infants typically stay on this medication until adolescent age.” a “Dissolve the madication and pu tin a full bottle of formul, disgui etaste” — oy 62 :: : : CrIEhed madicakassa-smallamount of formula and'give before giving a bottle." ) @ T8 medication 1 nour after a feeding.” f} - 34. The nurse s preparing 1o izach an educational class on spine abnormalities. Which of the following abnormalities identified by the darkened areas in the images below represents scoliosis? 2| CIf [ ai - 3 i @ 4. c_ 1 d’ 2 35. The school nurse is teaching parents about pediculosis capitis. Which of the following should the nurse include in the teaching plan? Pediculosis capitis may look like white flaky particles on the scalp. Children should be instructed to avoid close physical contact after treatment. Check the nape of the neck if an infestation is suspected. Infested bed linens should be replaced with newly purchased linens. 36. A nurse is caring for a child who has a freshly applied cast to the right arm. Which of the following actions performed by the nurse requires immediate intervention? a. Observing the fingers on the right arm for edema. b. Elevating the child’s right arm with a pillow. c. _ Picking up the cast with the palms of the hands. Usingiatheated hair dryer to circulate air. Pace 9/1: -S - . 7 e et i =y -~ . ‘ ] A hip Spica cast about care . 37 The nurse is teaching the parents of a 2-year-old child wh.° ik oo 2 o Management when c?ischarged home. Which of the following statements parents indicates ., ; o need forRN 3further teaching? y s " . i Wé:céhblgcé{)u}"childion*our ng:*==- -. = 3* b. “Awagon with side rails can be used instead of a stroller when moving around.” 2 7€) Our child canistand in the cast while we SUpport them.” d. "We should use a super-absorbent diaper tucked beneath the perineal area.” 38. The nurse is caring for a 5-year-old child who was bitten on the leg by a dog. After cleansing the area with soap and water, which of the following actions should the nurse take next? ,:9/ Apply a clean pressure dressing. “b. Report the bite to the local health department. ¢. Administer epinephrine. d. Test for Lyme disease. 39. Which of the following statements by a parent indicates the need for further instructions? —_— < ,V a. ‘l'have to keep my infant in this harness for 6 toT2 weeks.” B-)“A- 0. "l'will keep my infant in the harness 24 hours a day unless directed otherwise by my doctor.” c. ‘I'have to take my infant back to the doctor every 1 to 2 weeks to check on the harness and the position of the hips.” ’}_:3? *1 will loosen the straps when bathing my infant so all areas of the skin can be cleansed:” Nei ) The nurse is giving discharge instructions to the parents of an infant who is in a Pavlik harpss. | e w 40. The nurse is teaching the parent of a toddler about animal bite prevention. Which of tfie following statements by the parent indicates a correct understanding of the teaching? a. ‘“I'should be able to trust my child around our pet if I'm not present.” b. “lwill teach our child to gently move our pet if it is eating.” (’cT: ‘I will keep our child away from our pet when it is sleeping.” d "I can let my child lie by our pet when it is feeling sick.” 41. The nurse is discussing types of insulin with a child who is newly diagnosed with diabetes meliites (type 1) and their parent. Which of the following types of insulin reach the blood within 2 to 6 hours? @ Intermediate-acting. b. Short-acting (regular). ! c. Long-acting. ! d. Rapid-acting. Page 10/ 1345, /" A nurse is caring for a child wh g coay INUN LU LAGHI S @ veisiu) o syndrome. Which of the fo!i;-w%ng has assectmirt a new cast r?gi ége left leg and is ; at risk ’ for compartment syndrome? NSO. SN tes that the child may y h have compartment SPSNEITUSN Presewe 5a. Strong P pedal pulse pulse. OU< &W E" un Deoel ‘V'j ~3% Ve Looseness of the cast, Foot is reddish in color. Burning sensation, @ Provide pain medication, b. Provide activities for distraction. @ Encourage peer visitation. d. Encourage frequent resting. The nurse is caring for the following assigned clients. Which client should the nurse follow up with first? a. The client who had a closed reduction 4 hours ago and is reporting a pain level of 6 on a scale of 0 (no pain) to 10 (severe pain). b. The client who had a plaster cast applied 12 hours £¢0 ana nas an indentation noted in the cast. c. The client who is scheduled to have a repair of a torn krige ligament in 2 hours and needs to go to the bathroom. @ The client who is in'skeletal traction and has warmth, rednecs, 2nd pain in the affected leg. The nurse is teaching a group of pregnant female clients anoct pheny!ketonuria (PKU) and its clinical manifestations. Which clinical manifestations from the box below should the nurse include in the teaching? 1. Frequent 1vomiting. 2. High piercing cry. «Barlrritability. 4, Decreased energy. 5u-Erratic behavior. 6. Focused attention. a 1,4,586. @135 c. 1,24 d - 1,2 3,6. Pane11 /1% 1VI LUV, IVUTN €Ul 1IN £U°T LARTTE ST U VEIDIVET @ 46. 47. 49. ={F1=-Relyplagla=sss The nurse’ is discussing diabetes mellites (type i1) with aa child i and and etheir parentsarnt. Whchcia manifestations,from the box below should include TRTITR LT m——e 21 Welght gain =+ 5. RS I e 3. Poor wound &~ ; healing. 0 . Increased energy. . Hyperglycemia .o~ Focused attention. R T ST- 1,2,3,6. - ¥ 1{.3;45] L el 2o Q2020 D lo o & The nurse manager is providing an in-service to nursing staff about juvenile idiopa(hic arthritis. Which of the following statements by a staff member indicates a need for additional teaching? a. 'Thereis no cure for juvenile idiopathic arthritis.” b. “The nurse should be aware of alterations in growth and development in children who have juvenile idiopathic arthritis.” c. “Physical challenges facing children with juvenile idiopathic arthritis are pain and exercising.” /d.) “Juvenile idiopathic arthritis tends to disappear after-age 15." A nurse is caring for a newborn who requires testing for phenylketonuria (PKL). Which of the following actions performed by the nurse requires immediate intervention? <, ?é}/ Obtaining a blood sample from the umbilical cord. %E./ b. Refraining from “layering” the blood sample. c. Collecting the blood sample using a pipette. d. Using fresh heel blood for the sample. The nurse is caring for a client who has a fracture of the right femur with a newly applied cast. Which of the following assessment findings should the nurse report to the primary health care provider (PHCP) immediately? a. Anunrelenting pain that is unrelieved by pain medication. b) The affected extremity is pale with sensation present. The capillary refill is 2 seconds. A 3+ pedal pulse in the affected extremity. / ~ 8 o Page 12/13’ / NN LVL, INUN UM LA 2t a velovil a | o& fif/ The nurse working in a clinic is instructing the parent of a child who has atopic dermatitis (eczema) about the administration of a topical corticosteroid. When instructing the parent about how to apply the cream, it is appropriate for the nurse to instruct the parent to apply a. the cream to the affected area within 10 minutes of completing a tepid bath. b. the cream to the affected area after cleansing with water. a thick layer of cream to the affected areas and allow it to be absorbed. @ a thin layer of cream and rub it into the affected arza. /7 Paae 13/17