NR 328 Exam 1 Preparation - TestBank Resource Questions

1. Question: The clinic nurse is reviewing statistics on infant mortality for the United States versus other countries. Compared with other countries that have a population of at least 25 million, the nurse makes which determination? 2. Question: Which is the leading cause of death in infants younger than 1 year in the United States? 3. Question: What is the major cause of death for children older than 1 year in the United States? 4. Question: In addition to injuries, what are the leading causes of death in adolescents ages 15 to 19 years? 5. Question: The nurse is planning a teaching session to adolescents about deaths by unintentional injuries. Which should the nurse include in the session with regard to deaths caused by injuries? 6. Question: What do mortality statistics describe? 7. Question: The nurse should assess which age group for suicide ideation since suicide in which age group is the third leading cause of death? 8. Question: Parents of a hospitalized toddler ask the nurse, “What is meant by family-centered care?” The nurse should respond with which statement? 9. Question: The nurse is describing clinical reasoning to a group of nursing students. Which is most descriptive of clinical reasoning? 10. Question: Evidence-based practice (EBP), a decision-making model, is best described as which? 11. Question: Which best describes signs and symptoms as part of a nursing diagnosis? 12. Question: The nurse is talking to a group of parents of school-age children at an after-school program about childhood health problems. Which statement should the nurse include in the teaching? 13. Question: The nurse is planning care for a hospitalized preschool-aged child. Which should the nurse plan to ensure atraumatic care? 14. Question: Which situation denotes a nontherapeutic nurse–patient–family relationship? 15. Question: The nurse is aware that which age group is at risk for childhood injury because of the cognitive characteristic of magical and egocentric thinking? 16. Question: The school nurse is assessing children for risk factors related to childhood injuries. Which child has the most risk factors related to childhood injury? 17. Question: The school nurse is evaluating the number of school-age children classified as obese. The nurse recognizes that the percentile of body mass index that classifies a child as obese is greater than which? 18. Question: The nurse is teaching parents about the types of behaviors children exhibit when living with chronic violence. Which statement made by the parents indicates further teaching is needed? 19. Question: The nurse is evaluating research studies according to the GRADE criteria and has determined the quality of evidence on the subject is moderate. Which type of evidence does this determination indicate? 20. Question: An adolescent patient wants to make decisions about treatment options, along with his parents. Which moral value is the nurse displaying when supporting the adolescent to make decisions? 21. Question: The nurse manager is compiling a report for a hospital committee on the quality of nursing-sensitive indicators for a nursing unit. Which does the nurse manager include in the report? MULTIPLE RESPONSE 1. Question: Which responsibilities are included in the pediatric nurse’s promotion of the health and well-being of children? (Select all that apply.) 2. Question: The nurse is conducting a teaching session for parents on nutrition. Which characteristics of families should the nurse consider that can cause families to struggle in providing adequate nutrition? (Select all that apply.) 3. Question: The nurse is preparing to complete documentation on a patient’s chart. Which should be included in documentation of nursing care? (Select all that apply.) 4. Question: Which actions by the nurse demonstrate overinvolvement with patients and their families? (Select all that apply.) 5. Question: Which are included in the evaluation step of the nursing process? (Select all that apply.) 6. Question: Which should the nurse teach to parents regarding oral health of children? (Select all that apply.) 7. Question: The school nurse is explaining to older school children that obesity increases the risk for which disorders? (Select all that apply.) 8. Question: The nurse is reviewing the Healthy People 2020 leading health indicators for a child health promotion program. Which are included in the leading health indicators? (Select all that apply.) 9. Question: Which actions by the nurse demonstrate clinical reasoning? (Select all that apply.) COMPLETION 1. Question: The nurse is determining if a newborn is classified in the low birth weight (LBW) category of less than 2500 g. The newborn’s weight is 5 lb, 4 oz. What is the newborn’s weight in grams? Record your answer in a whole number. MATCHING 1. Question: The nursing process is a method of problem identification and problem solving that describes what the nurse actually does. Match each step of the nursing process with its definition. 2. Question: Ethical dilemmas arise when competing moral considerations underlie various alternatives. Match each competing moral value with its definition. MULTIPLE CHOICE 1. Question: Children are taught the values of their culture through observation and feedback relative to their own behavior. In teaching a class on cultural competence, the nurse should be aware that which factor may be culturally determined? 2. Question: The nurse is aware that if patients’ different cultures are implied to be inferior, the emotional attitude the nurse is displaying is what? 3. Question: Which term best describes the sharing of common characteristics that differentiates one group from other groups in a society? 4. Question: After the family, which has the greatest influence on providing continuity between generations? 5. Question: The nurse is planning care for a patient with a different ethnic background. Which should be an appropriate goal? 6. Question: The nurse discovers welts on the back of a Vietnamese child during a home health visit. The child’s mother says she has rubbed the edge of a coin on her child’s oiled skin. The nurse should recognize this as what? 7. Question: A Hispanic toddler has pneumonia. The nurse notices that the parent consistently feeds the child only the broth that comes on the clear liquid tray. Food items, such as Jell-O, Popsicles, and juices, are left. Which statement best explains this? 8. Question: How is family systems theory best described? 9. Question: Which family theory is described as a series of tasks for the family throughout its life span? 10. Question: Which family theory explains how families react to stressful events and suggests factors that promote adaptation to these events? 11. Question: Which type of family should the nurse recognize when the paternal grandmother, the parents, and two minor children live together? 12. Question: Which type of family should the nurse recognize when a mother, her children, and a stepfather live together? 13. Question: Which is an accurate description of homosexual (or gay-lesbian) families? 14. The nurse is teaching a group of new nursing graduates about identifiable qualities of strong families that help them function effectively. Which quality should be included in the teaching? 15. When assessing a family, the nurse determines that the parents exert little or no control over their children. This style of parenting is called which? 16. When discussing discipline with the mother of a 4-year-old child, which should the nurse include? 17. Which is a consequence of the physical punishment of children, such as spanking? 18. The parents of a young child ask the nurse for suggestions about discipline. When discussing the use of time-outs, which should the nurse include? 19. A 3-year-old child was adopted immediately after birth. The parents have just asked the nurse how they should tell the child that she is adopted. Which guideline concerning adoption should the nurse use in planning a response? 20. Children may believe that they are responsible for their parents’ divorce and interpret the separation as punishment. At which age is this most likely to occur? 21. A parent of a school-age child tells the school nurse that the parents are going through a divorce. The child has not been doing well in school and sometimes has trouble sleeping. The nurse should recognize this as what? 22. A mother brings 6-month-old Eric to the clinic for a well-baby checkup. She comments, “I want to go back to work, but I don’t want Eric to suffer because I’ll have less time with him.” Which is the nurse’s most appropriate answer? 23. A foster parent is talking to the nurse about the health care needs for the child who has been placed in the parent’s care. Which statement best describes the health care needs of foster children? 24. The nurse is planning to counsel family members as a group to assess the family’s group dynamics. Which theoretic family model is the nurse using as a framework? 25. The nurse is reviewing the importance of role learning for children. The nurse understands that children’s roles are primarily shaped by which members? 26. The nurse is caring for an adolescent hospitalized for asthma. The adolescent belongs to a large family. The nurse recognizes that the adolescent is likely to relate to which group? 27. The nurse is explaining different parenting styles to a group of parents. The nurse explains that an authoritative parenting style can lead to which child behavior? 28. Parents of a preschool child ask the nurse, “Should we set rules for our child as part of a discipline plan?” Which is an accurate response by the nurse? 29. The nurse is discussing issues that are important with parents considering a cross-racial adoption. Which statement made by the parents indicates further teaching is needed? 30. The school nurse understands that children are impacted by divorce. Which has the most impact on the positive outcome of a divorce? 31. The nurse is discussing parenting in reconstituted families with a new stepparent. The nurse is aware that the new stepparent understands the teaching when which statement is made? MULTIPLE RESPONSE 1. The nurse is presenting a staff development program about understanding culture in the health care encounter. Which components should the nurse include in the program? (Select all that apply.) 2. The parents of a 5-year-old child ask the nurse how they can minimize misbehavior. Which responses should the nurse give? (Select all that apply.) 3. Which describe the feelings and behaviors of early preschool children related to divorce? (Select all that apply.) 4. Which describe the feelings and behaviors of adolescents related to divorce? (Select all that apply.) 5. The nurse is teaching parents about the effects of media on childhood obesity. The nurse realizes the parents understand the teaching if they make which statements? (Select all that apply.) MATCHING Culture characterizes a particular group with its values, beliefs, norms, patterns, and practices that are learned, shared, and transmitted from one generation to another. Match the terms used to describe groups with shared values, beliefs, norms, patterns, and practices. MULTIPLE CHOICE 1. The nurse is seeing an adolescent and the parents in the clinic for the first time. Which should the nurse do first? 2. Which is considered a block to effective communication? 3. Which is the single most important factor to consider when communicating with children? 4. Because children younger than 5 years are egocentric, the nurse should do which when communicating with them? 5. The nurse’s approach when introducing hospital equipment to a preschooler who seems afraid should be based on which principle? 6. When the nurse interviews an adolescent, which is especially important? 7. The nurse is preparing to assess a 10-month-old infant. He is sitting on his father’s lap and appears to be afraid of the nurse and of what might happen next. Which initial actions by the nurse should be most appropriate? 8. An 8-year-old girl asks the nurse how the blood pressure apparatus works. The most appropriate nursing action is which? 9. The nurse is having difficulty communicating with a hospitalized 6-year-old child. Which technique should be most helpful? 10. Which data should be included in a health history? 11. The nurse is taking a health history of an adolescent. Which best describes how the chief complaint should be determined? 12. The nurse is interviewing the mother of an infant. The mother reports, “I had a difficult delivery, and my baby was born prematurely.” This information should be recorded under which heading? 13. Where in the health history does a record of immunizations belong? 14. The nurse is taking a sexual history on an adolescent girl. Which is the best way to determine whether she is sexually active? 15. When doing a nutritional assessment on a Hispanic family, the nurse learns that their diet consists mainly of vegetables, legumes, and starches. The nurse should recognize that this diet is which? 16. Which parameter correlates best with measurements of total muscle mass? 17. The nurse is preparing to perform a physical assessment on a 10-year-old girl. The nurse gives her the option of her mother staying in the room or leaving. This action should be considered which? 18. With the National Center for Health Statistics criteria, which body mass index (BMI)–for-age percentiles should indicate the patient is at risk for being overweight? 19. Rectal temperatures are indicated in which situation? 20. What is the earliest age at which a satisfactory radial pulse can be taken in children? 21. The nurse needs to take the blood pressure of a small child. Of the cuffs available, one is too large and one is too small. The best nursing action is which? 22. Where is the best place to observe for the presence of petechiae in dark-skinned individuals? 23. During a routine health assessment, the nurse notes that an 8-month-old infant has a significant head lag. Which is the most appropriate action? 24. The nurse has just started assessing a young child who is febrile and appears ill. There is hyperextension of the child’s head (opisthotonos) with pain on flexion. Which is the most appropriate action? 25. During a funduscopic examination of a school-age child, the nurse notes a brilliant, uniform red reflex in both eyes. The nurse should recognize that this is which? 26. Which explains the importance of detecting strabismus in young children? 27. Which is the most frequently used test for measuring visual acuity? 28. The nurse is testing an infant’s visual acuity. By which age should the infant be able to fix on and follow a target? 29. During an otoscopic examination on an infant, in which direction is the pinna pulled? 30. What is an appropriate screening test for hearing that the nurse can administer to a 5-year-old child? 31. What is the appropriate placement of a tongue blade for assessment of the mouth and throat? 32. When assessing a preschooler’s chest, what should the nurse expect? 33. When auscultating an infant’s lungs, the nurse detects diminished breath sounds. What should the nurse interpret this as? 34. Which type of breath sound is normally heard over the entire surface of the lungs except for the upper intrascapular area and the area beneath the manubrium? 35. The nurse is assessing a child’s capillary refill time. This can be accomplished by doing what? 36. Which heart sound is produced by vibrations within the heart chambers or in the major arteries from the back-and-forth flow of blood? 37. Examination of the abdomen is performed correctly by the nurse in which order? 38. Superficial palpation of the abdomen is often perceived by the child as tickling. Which measure by the nurse is most likely to minimize this sensation and promote relaxation? 39. During examination of a toddler’s extremities, the nurse notes that the child is bowlegged. The nurse should recognize that this finding is which? 40. The nurse is caring for a non–English-speaking child and family. Which should the nurse consider when using an interpreter? 41. Which action should the nurse implement when taking an axillary temperature? 42. The nurse is aware that skin turgor best estimates what? 43. The Asian parent of a child being seen in the clinic avoids eye contact with the nurse. What is the best explanation for this considering cultural differences? MULTIPLE RESPONSE 1. The nurse is performing an otoscopic examination on a child. Which are normal findings the nurse should expect? (Select all that apply.) 2. The nurse is assessing breath sounds on a child. Which are expected auscultated breath sounds? (Select all that apply.) 3. The nurse is performing an oral examination on a preschool child. Which strategies should the nurse use to encourage the child to open the mouth for the examination? (Select all that apply.) 4. Which are effective auscultation techniques? (Select all that apply.) 5. The nurse is assessing heart sounds on a school-age child. Which should the nurse document as abnormal findings if found on the assessment? (Select all that apply.) 6. The nurse understands that blocks to therapeutic communication include what? (Select all that apply.) MULTIPLE CHOICE 1. Which is the most consistent and commonly used data for assessment of pain in infants? 2. Children as young as age 3 years can use facial scales for discrimination. What are some suggested anchor words for the preschool age group? 3. What is an important consideration when using the FACES pain rating scale with children? 4. What describes nonpharmacologic techniques for pain management? 5. Which nonpharmacologic intervention appears to be effective in decreasing neonatal procedural pain? 6. A 6-year-old child has patient-controlled analgesia (PCA) for pain management after orthopedic surgery. The parents are worried that their child will be in pain. What should your explanation to the parents include? 7. Which drug is usually the best choice for patient-controlled analgesia (PCA) for a child in the immediate postoperative period? 8. A child is in the intensive care unit after a motor vehicle collision. The child has numerous fractures and is in pain that is rated 9 or 10 on a 10-point scale. In planning care, the nurse recognizes that the indicated action is which? 9. The parents of a preterm infant in a neonatal intensive care unit are concerned about their infant experiencing pain from so many procedures. The nurse’s response should be based on which characteristic about preterm infants’ pain? 10. A preterm infant has just been admitted to the neonatal intensive care unit. The infant’s parents ask the nurse about anesthesia and analgesia when painful procedures are necessary. What should the nurse’s explanation be? 11. A bone marrow aspiration and biopsy are needed on a school-age child. The most appropriate action to provide analgesia during the procedure is which? 12. What is a significant common side effect that occurs with opioid administration? 13. The nurse is caring for a child receiving a continuous intravenous (IV) low-dose infusion of morphine for severe postoperative pain. The nurse observes a slower respiratory rate, and the child cannot be aroused. The most appropriate management of this child is for the nurse to do which first? 14. The nurse is teaching a staff development program about levels of sedation in the pediatric population. Which statement by one of the participants should indicate a correct understanding of the teaching? 15. The nurse is planning to administer a nonopioid for pain relief to a child. Which timing should the nurse plan so the nonopioid takes effect? 16. The nurse is planning pain control for a child. Which is the advantage of administering pain medication by the intravenous (IV) bolus route? 17. The nurse is teaching the parents of a child with recurrent headaches methods to modify behavior patterns that increase the risk of headache. Which statement by the parents indicates understanding the teaching? 18. Which is a complication that can occur after abdominal surgery if pain is not managed? 19. A burn patient is experiencing anxiety over dressing changes. Which prescription should the nurse expect to be ordered to control anxiety? 20. A cancer patient is experiencing neuropathic cancer pain. Which prescription should the nurse expect to be ordered to control anxiety? MULTIPLE RESPONSE 1. Which are components of the FLACC scale? (Select all that apply.) 2. The nurse is using the CRIES pain assessment tool on a preterm infant in the neonatal intensive care unit. Which are the components of this tool? (Select all that apply.) 3. Which coanalgesics should the nurse expect to be prescribed for pruritus? (Select all that apply.) 4. V BA child receiving chemotherapy is experiencing mucositis. Which prescriptions should the nurse plan to administer for initial treatment? (Select all that apply.) COMPLETION 1. A health care provider prescribes promethazine (Phenergan), 9 mg IV every 6 to 8 hours as needed for pruritus. The medication label states: “Promethazine 25 mg/1 mL.” The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer using two decimal places. 2. A health care provider prescribes diphenhydramine (Benadryl), 1 mg/kg PO every 4 to 6 hours as needed for pruritus. The child weighs 10 kg. The medication label states: “Diphenhydramine 12.5 mg/5 mL.” The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer in a whole number. 3. A health care provider prescribes hydroxyzine (Atarax), 0.6 mg/kg PO every 4 to 6 hours as needed for pruritus. The medication label states: “Hydroxyzine 10 mg/5 mL.” The child weighs 20 kg. The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer in a whole number. 4. A child receiving morphine sulfate (Morphine) is experiencing respiratory depression. A health care provider prescribes naloxone (Narcan), 0.5 mcg/kg IV in 2-minute increments until breathing improves. The medication label states: “Naloxone 400 mcg/1 mL.” The child weighs 40 kg. The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer using two decimal places. 5. A health care provider prescribes haloperidol (Haldol), 0.15 mg/kg IV every 4 to 6 hours as needed for confusion. The medication label states: “Haloperidol 2 mg/1 mL.” The child weighs 30 kg. The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer rounding to one decimal place. 6. A health care provider prescribes Kytril (granisetron), 10 mcg/kg IV every 4 to 6 hours as needed for nausea. The medication label states: “Kytril 100 mcg/1 mL.” The child weighs 15 kg. The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer to one decimal place. 7. A health care provider prescribes OxyContin (oxycodone), 3 mg PO every 4 to 6 hours as needed for pain. The medication label states: “OxyContin 5 mg/1 mL.” The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer using one decimal place. 8. A health care provider prescribes acetaminophen (Tylenol) gtt, 10 mg/kg/dose PO every 4 to 6 hours as needed for pain. The infant weighs 8 kg. The medication label states: “Acetaminophen 80 mg/0.8 mL.” The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer to one decimal place. 9. A health care provider prescribes naproxen (Naprosyn), 7 mg/kg PO every 12 hours for pain. The child weighs 25 kg. The medication label states: “Naproxen 125 mg/5 mL.” The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer in a whole number. 10. A health care provider prescribes choline magnesium trisalicylate (Trilisate), 15 mg/kg PO every 8 to 12 hours as needed for pain. The child weighs 10 kg. The medication label states: “Choline magnesium trisalicylate 500 mg/5 mL.” How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer to one decimal place. 11. A health care provider prescribes ibuprofen (Motrin), 5 mg/kg PO every 6 to 8 hours as needed for pain. The child weighs 8 kg. The medication label states: “Ibuprofen 100 mg/5 mL.” The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer in a whole number. MATCHING Complementary and alternative medicine therapies are grouped into five classes. Match the complementary or alternative therapy to its classification. MULTIPLE CHOICE 1. Pertussis vaccination should begin at which age? 2. A mother tells the nurse that she does not want her infant immunized because of the discomfort associated with injections. What should the nurse explain? 3. A 4-month-old infant comes to the clinic for a well-infant checkup. Immunizations she should receive are DTaP (diphtheria, tetanus, acellular pertussis) and IPV (inactivated poliovirus vaccine). She is recovering from a cold but is otherwise healthy and afebrile. Her older sister has cancer and is receiving chemotherapy. Nursing considerations should include which? 4. Which serious reaction should the nurse be alert for when administering vaccines? 5. Which muscle is contraindicated for the administration of immunizations in infants and young children? 6. Which is described as an elevated, circumscribed skin lesion that is less than 1 cm in diameter and filled with serous fluid? 7. Which vitamin supplementation has been found to reduce both morbidity and mortality in measles? 8. What does impetigo ordinarily results in? 9. What often causes cellulitis? 10. Lymphangitis (streaking) is frequently seen in what? 11. What is most important in the management of cellulitis? 12. What causes warts? 13. What is the primary treatment for warts? 14. Herpes zoster is caused by the varicella virus and has an affinity for which? 15. Treatment for herpes simplex virus (type 1 or 2) includes which? 16. What should the nurse explain about ringworm? 17. When giving instructions to a parent whose child has scabies, what should the nurse include? 18. Which is usually the only symptom of pediculosis capitis (head lice)? 19. The school reviewed the pediculosis capitis (head lice) policy and removed the “no nit” requirement. The nurse explains that now, when a child is found to have nits, the parents must do which before the child can return to school? 20. The nurse should know what about Lyme disease? 21. The nurse is teaching a nursing student about standard precautions. Which statement made by the student indicates a need for further teaching? 22. The nurse is preparing an airborne infection isolation room for a patient. Which communicable disease does the patient likely have? 23. An infant with respiratory syncytial virus (RSV) is being admitted to the hospital. The nurse should plan to place the infant on which precaution? 24. The nurse is administering the first hepatitis A vaccine to an 18-month-old child. When should the child return to the clinic for the second dose of hepatitis A vaccination? 25. The nurse is preparing to administer a measles, mumps, rubella, and varicella (MMRV) vaccine. Which is a contraindication associated with administering this vaccine? 26. An immunocompromised child has been exposed to chickenpox. What should the nurse anticipate to be prescribed to the exposed child? 27. The clinic nurse is instructing parents about caring for a toddler with ascariasis (common roundworm). Which statement made by the parents indicates a need for further teaching? 28. The nurse is assessing a child suspected of having pinworms. Which is the most common symptom the nurse expects to assess? 29. A child has been diagnosed with giardiasis. Which prescribed medication should the nurse expect to administer? 30. A child has been diagnosed with scabies. Which statement by the parent indicates understanding of the nurse’s teaching about scabies? 31. An 18-month-old child has been diagnosed with pediculosis capitis (head lice). Which prescription should the nurse question if ordered for the child? 32. A child has been diagnosed with cat scratch disease. The nurse explains which characteristics about this disease? MULTIPLE RESPONSE 1. The nurse is planning care for a child with chickenpox (varicella). Which prescribed supportive measures should the nurse plan to implement? (Select all that apply.) 2. The nurse is planning care for an infant with candidiasis (moniliasis) diaper dermatitis. Which topical ointments may be prescribed for the patient? (Select all that apply.) 3. The nurse is conducting discharge teaching to an adolescent with a methicillin-resistant staphylococcus aureus (MRSA) infection. What should the nurse include in the instructions? (Select all that apply.) 4. The clinic nurse is reviewing the immunization guidelines for hepatitis B. Which are true of the guidelines for this vaccine? (Select all that apply.) 5. The nurse is planning to administer immunizations to a 6-month-old infant. Which interventions should the nurse implement to minimize local reactions from the vaccines? (Select all that apply.) 6. The nurse is preparing to admit a 5-year-old child who developed lesions of varicella (chickenpox) 3 days ago. Which clinical manifestations of varicella should the nurse expect to observe? (Select all that apply.) 7. The nurse is preparing to admit a 1-year-old child with pertussis (whooping cough). Which clinical manifestations of pertussis should the nurse expect to observe? (Select all that apply.) 8. The nurse is preparing to admit a 2-year-old child with rubella (German measles). Which clinical manifestations of rubella should the nurse expect to observe? (Select all that apply.) 9. The clinic nurse is assessing a child with bacterial conjunctivitis (pink eye). Which assessment findings should the nurse expect? (Select all that apply.) 10. The clinic nurse is assessing a child with a heavy ascariasis lumbricoides (common roundworm) infection. Which assessment findings should the nurse expect? (Select all that apply.) MATCHING Match the key immunization terms to their meanings. MULTIPLE CHOICE 1. A 16-year-old girl comes to the pediatric clinic for information on birth control. The nurse knows that before this young woman can be examined, consent must be obtained from which source? 2. The nurse needs to take the blood pressure of a preschool boy for the first time. What action would be best in gaining his cooperation? 3. A 4-year-old girl is admitted to outpatient surgery for removal of a cyst on her back. Her mother puts the hospital gown on her, but the child is crying because she wants to leave on her underpants. What is the most appropriate nursing action at this time?? 4. Using knowledge of child development, what approach is best when preparing a toddler for a procedure? 5. The nurse is preparing a 9-year-old boy before obtaining a blood specimen by venipuncture. The child tells the nurse he does not want to lose his blood. What approach is best by the nurse? 6. A bone marrow biopsy will be performed on a 7-year-old girl. She wants her mother to hold her during the procedure. How should the nurse respond? 7. A 6-year-old child needs to drink 1 L of GoLYTELY in preparation for a computed tomography scan of the abdomen. To encourage the child to drink, what should the nurse do? 8. A toddler is being sent to the operating room for surgery at 9 AM. As the nurse prepares the child, what is the priority intervention? 9. A 5-year-old child returns from the pediatric intensive care unit after abdominal surgery. The orders state to monitor vital signs every 2 hours. On assessment, the nurse observes that the child’s heart rate is 20 beats/min less than it was preoperatively. What should be the nurse’s next action? 10. A 10-year-old child requires daily medications for a chronic illness. Her mother tells the nurse that the child continually forgets to take the medicine unless reminded. What nursing action is most appropriate to promote adherence to the medication regimen? 11. A 7-year-old is identified as being at risk for skin breakdown. What intervention should the nursing care plan include? 12. A 6-year-old boy is hospitalized for intravenous antibiotic therapy. He eats very little on his “regular diet” trays. He tells the nurse that all he wants to eat is pizza, tacos, and ice cream. What nursing action is the most appropriate? 13. A 14-year-old adolescent is hospitalized with cystic fibrosis. What nursing note entry represents best documentation of his breakfast meal? 14. A child, age 7 years, has a fever associated with a viral illness. She is being cared for at home. What is the principal reason for treating fever in this child? 15. A critically ill child has hyperthermia. The parents ask the nurse to give an antipyretic such as acetaminophen. How should the nurse respond to the parents? 16. The nurse gives an injection in a patient’s room. How should the nurse dispose of the needle? 17. A child who has cystic fibrosis is admitted to the pediatric unit with methicillin-resistant Staphylococcus aureus (MRSA) infection. The nurse recognizes that in addition to a private room, the child is placed on what precautions? 18. An 11-month-old hospitalized boy is restrained because he is receiving intravenous (IV) fluids. His grandmother has come to stay with him for the afternoon and asks the nurse if the restraints can be removed. What nurse’s response is best? 19. A nurse must do a venipuncture on a 6-year-old child. What consideration is important in providing atraumatic care? 20. A 2-year-old child is being admitted to the hospital for possible bacterial meningitis. When preparing for a lumbar puncture, what should the nurse do? 21. Frequent urine tests for specific gravity are required on a 6-month-old infant. What method is the most appropriate way to collect small amounts of urine for these tests? 22. A child has a central venous access device for intravenous (IV) fluid administration. A blood sample is needed for a complete blood count, hemogram, and electrolytes. What is the appropriate procedure to implement for this blood sample? 23. The nurse has just collected blood by venipuncture in the antecubital fossa. What should the nurse do next? 24. An appropriate method for administering oral medications that are bitter to an infant or small child should be to mix them with which? 25. The practitioner has ordered a liquid oral antibiotic for a toddler with otitis media. The prescription reads 1 1/2 tsp four times per day. What should the nurse consider in teaching the mother how to give the medicine? 26. Guidelines for intramuscular administration of medication in school-age children include what standard? 27. What is an advantage of the ventrogluteal muscle as an injection site in young children? 28. When teaching a mother how to administer eye drops, where should the nurse tell her to place them? 29. What is the best method to verify the placement of a nasogastric tube before each use? 30. Parents are being taught how to feed their infant using a newly placed gastrostomy tube (G-tube). What is essential information for the parents to receive? 31. What is a priority intervention for an infant with a temporary colostomy for Hirschsprung disease? 32. A 1-month-old infant is admitted to the hospital. The infant’s mother is 17 years old and single and lives with her parents. Who signs the informed consent for the 1-month-old infant? 33. A preschool child needs a dressing change. To prepare the child, what strategy should the nurse implement? 34. The nurse on a pediatric unit is writing guidelines for age-specific preparation of children for procedures based on developmental characteristics. What guideline is accurate? 35. A laboratory technician is performing a blood draw on a toddler. The toddler is holding still but crying loudly. The nurse should take which action? 36. At which age should a nurse keep teaching time short (5 minutes)? 37. The nurse is preparing to give acetaminophen (Tylenol) to a child who has a fever. What nursing action is appropriate? 38. The nurse is administering an IM injection into a vastus lateralis muscle of a 6-month-old infant. What should the length of the needle and amount to be given be? 39. The nurse needs to start an intravenous (IV) line on an 8-year-old child to begin administering intravenous antibiotics. The child starts to cry and tells the nurse, “Do it later, okay?” What action should the nurse take? 40. The nurse is preparing to administer a liquid medication by a nasogastric feeding tube. What is the first thing the nurse should do? 41. To facilitate the administration of an oral medication to a preschool-age child, what action should the nurse take? 42. A 2-year-old child has to receive Rocephin IM injections every 12 hours. What nursing intervention should be implemented for the child? 43. When checking the intravenous (IV) site on a child, the nurse should take which action? MULTIPLE RESPONSE 1. The nurse is caring for a 12-year-old child who is on fall precautions secondary to seizures. What interventions should be included in the child’s care plan? (Select all that apply.) 2. What methods should the nurse use to measure compliance to a treatment plan? (Select all that apply.) 3. What interventions should the nurse implement to prevent a pressure ulcer in a critically ill child? (Select all that apply.) 4. The nurse is preparing to obtain a nasal washing from a child. What equipment should the nurse gather for the procedure? (Select all that apply.) 5. The clinic nurse is teaching parents about when to call the office immediately for a child with a fever. What should the nurse include in the teaching session? (Select all that apply.) 6. What strategies should the nurse implement to assist in feeding a sick child? (Select all that apply.) 7. What disease processes require contact isolation? (Select all that apply.) 8. What disease processes require airborne precautions? (Select all that apply.) 9. What are the advantages of an implanted port (Port-a-Cath)? (Select all that apply.) 10. What play activities should the nurse implement to encourage fluid intake for a child? (Select all that apply.) MULTIPLE CHOICE 1. What respiratory condition or disease results in both increased compliance and increased resistance? 2. How much oxygen is contained in ambient air (room air)? 3. During a respiratory assessment, the nurse notes a sinking in of soft tissues relative to the cartilaginous and bony thorax. What is the term for this finding? 4. What test measures the amount of air inhaled and exhaled during any respiratory cycle? 5. What is the best explanation for using pulse oximetry on young children to determine oxygen saturation? 6. It is important to make certain that sensory connectors and oximeters are compatible because incompatible wiring can cause which condition? 7. What test should the nurse do as a precautionary measure before doing an arterial puncture to obtain an arterial blood sample? 8. Arterial blood gases have just been drawn on a child. What should the nurse do next? 9. The continuous administration of mist, or aerosolized water, for the treatment of inflammatory conditions of the airways is a common practice that functions in which manner? 10. When is bronchial (postural) drainage generally performed? 11. What nursing consideration is most important in the care of a child on a mechanical ventilator? 12. What intervention is necessary when weaning a child from the ventilator? 13. The nurse must suction a 6-month-old infant with a tracheostomy. What intervention should be included? 14. A 3-year-old child with a tracheostomy will soon be discharged. What recommendation should the nurse share with the family? 15. The nurse is planning home care for a 2-year-old child with a tracheostomy. What recommendation should be included? 16. Respiratory failure can result from many causes. What condition is a specific primary cause of inefficient gas transfer? 17. The nurse is caring for a child with a tracheostomy. What clinical manifestation should the nurse recognize as an early sign of impending respiratory distress or failure? 18. Cardiopulmonary resuscitation is begun on a toddler. What pulse is usually palpated because it is the most central and accessible? 19. What medication is considered to be the most useful in treating cardiac arrest? 20. Effective cardiopulmonary resuscitation (CPR) on a 5-year-old child should include what technique? 21. A series of subdiaphragmatic abdominal thrusts (the Heimlich maneuver) is recommended for airway obstruction in children older than which age? 22. The mother of a toddler yells to the nurse, “Help! He is choking to death on his food!” The nurse determines that lifesaving measures are necessary based on which finding? 23. The nurse is caring for a 4-year-old child who is receiving 2 L of oxygen per nasal cannula. What disadvantage should the nurse consider when planning care for the child? 24. A 5-month-old infant is in respiratory distress. What should the nurse expect to find? 25. A child is in uncompensated respiratory acidosis. What should the nurse expect the arterial blood gas to be? 26. A child is in uncompensated respiratory alkalosis. What should the nurse expect the arterial blood gas to be? 27. A child is in uncompensated metabolic alkalosis. What should the nurse expect the arterial blood gas to be? 28. A child is in uncompensated metabolic acidosis. What should the nurse expect the arterial blood gas to be? 29. A nurse is calculating the correlation of Pao2 with Sao2 according to the oxyhemoglobin dissociation curve. What parameter should indicate that the Pao2 is less than 50 to 60 mm Hg? 30. The nurse is reviewing factors that affect lung development. What factor delays surfactant production and maturation of alveolar cells? 31. The nurse is caring for a child in respiratory distress. What is an early but less obvious sign of respiratory failure? 32. The nurse is caring for a child on oxygen being delivered by a nasal cannula. What is the advantage of delivering oxygen in this manner? 33. The nurse is evaluating arterial blood gas results. What condition can cause an increase in PCO2? 34. The nurse is evaluating arterial blood gas results. What condition can cause an increase in HCO3? 35. The nurse is analyzing an arterial blood gas of pH, 7.30; PCO2, 50; and HCO3, 29. What result should the nurse document for this blood gas? 36. The nurse is analyzing an arterial blood gas of pH, 7.50; PCO2, 50; and HCO3, 29. What result should the nurse document for this blood gas? 37. The nurse is analyzing an arterial blood gas of pH, 7.29; PCO2, 30; and HCO3, 20. What result should the nurse document for this blood gas? 38. The nurse is analyzing an arterial blood gas of pH, 7.50; PCO2, 30; and HCO3, 20. What result should the nurse document for this blood gas? MULTIPLE RESPONSE 1. What conditions can produce hyperventilation? (Select all that apply.) 2. What condition or disease decreases lung compliance? (Select all that apply.) 3. The nurse is caring for an intubated child on mechanical ventilation. What interventions should the nurse implement to prevent ventilator-assisted pneumonia (VAP)? (Select all that apply.) 4. The nurse recognizes that oxygen mist tents are rarely used for a child with respiratory distress. What are reasons for not using an oxygen mist tent? (Select all that apply.) COMPLETION 1. The nurse is participating in a code blue on a 12-year-old child in a full respiratory arrest. The child weighs 110 lb. The health care provider has ordered an initial dose of epinephrine hydrochloride (1:10,000) given intravenously. Calculate the correct initial dose of epinephrine in mg. Record your answer using one decimal place. 2. The nurse is calculating the amount of expected urinary output for a 24-hour period on an intubated young child who weighs 22 lb. The nurse recognizes the formula to be used is 2 ml/kg/hr. What is the expected 24-hour urinary output for this child in milliliters? Record your answer below in a whole number. 3. The nurse is calculating the amount of expected urinary output for a 24-hour period on an intubated young child who weighs 33 lb. The nurse recognizes the formula to be used is 2 ml/kg/hr. What is the expected 24-hour urinary output for this child in milliliters? Record your answer below in a whole number. MULTIPLE CHOICE 1. Why are cool-mist vaporizers rather than steam vaporizers recommended in the home treatment of respiratory infections? 2. Decongestant nose drops are recommended for a 10-month-old infant with an upper respiratory tract infection. Instructions for nose drops should include which information? 3. The parent of an infant with nasopharyngitis should be instructed to notify the health professional if the infant shows signs or symptoms of which condition? 4. It is important that a child with acute streptococcal pharyngitis be treated with antibiotics to prevent which condition? 5. When caring for a child after a tonsillectomy, what intervention should the nurse do? 6. What statement best represents infectious mononucleosis? 7. Parents bring their 15-month-old infant to the emergency department at 3:00 AM because the toddler has a temperature of 39° C (102.2° F), is crying inconsolably, and is tugging at the ears. A diagnosis of otitis media (OM) is made. In addition to antibiotic therapy, the nurse practitioner should instruct the parents to use what medication? 8. An 18-month-old child is seen in the clinic with otitis media (OM). Oral amoxicillin is prescribed. What instructions should be given to the parent? 9. An infant’s parents ask the nurse about preventing otitis media (OM). What information should be provided? 10. Chronic otitis media with effusion (OME) differs from acute otitis media (AOM) because it is usually characterized by which signs or symptoms? 11. A 4-year-old girl is brought to the emergency department. She has a “froglike” croaking sound on inspiration, is agitated, and is drooling. She insists on sitting upright. The nurse should intervene in which manner? 12. The nurse is assessing a child with croup in the emergency department. The child has a sore throat and is drooling. Examining the child’s throat using a tongue depressor might precipitate what condition? 13. The mother of a 20-month-old boy tells the nurse that he has a barking cough at night. His temperature is 37° C (98.6° F). The nurse suspects mild croup and should recommend which intervention? 14. The nurse encourages the mother of a toddler with acute laryngotracheobronchitis to stay at the bedside as much as possible. What is the primary rationale for this action? 15. An infant with bronchiolitis is hospitalized. The causative organism is respiratory syncytial virus (RSV). The nurse knows that a child infected with this virus requires what type of isolation? 16. An infant has been diagnosed with staphylococcal pneumonia. Nursing care of the child with pneumonia includes which intervention? 17. What consideration is most important in managing tuberculosis (TB) in children? 18. A toddler has a unilateral foul-smelling nasal discharge and frequent sneezing. The nurse should suspect what condition? 19. The nurse is caring for a child with acute respiratory distress syndrome (ARDS) associated with sepsis. What nursing action should be included in the care of the child? 20. The nurse is caring for a child with carbon monoxide (CO) poisoning associated with smoke inhalation. What intervention is essential in this child’s care? 21. What diagnostic test for allergies involves the injection of specific allergens? 22. What statement is the most descriptive of asthma? 23. What condition is the leading cause of chronic illness in children? 24. A child has a chronic cough and diffuse wheezing during the expiratory phase of respiration. This suggests what condition? 25. A child with asthma is having pulmonary function tests. What rationale explains the purpose of the peak expiratory flow rate? 26. Children who are taking long-term inhaled steroids should be assessed frequently for what potential complication? 27. One of the goals for children with asthma is to maintain the child’s normal functioning. What principle of treatment helps to accomplish this goal? 28. What drug is usually given first in the emergency treatment of an acute, severe asthma episode in a young child? 29. Cystic fibrosis (CF) may affect single or multiple systems of the body. What is the primary factor responsible for possible multiple clinical manifestations in CF? 30. What is the earliest recognizable clinical manifestation(s) of cystic fibrosis (CF)? 31. What tests aid in the diagnosis of cystic fibrosis (CF)? 32. A child with cystic fibrosis (CF) receives aerosolized bronchodilator medication. When should this medication be administered? 33. A child with cystic fibrosis is receiving recombinant human deoxyribonuclease (DNase). What statement about DNase is true? 34. The parent of a child with cystic fibrosis (CF) calls the clinic nurse to report that the child has developed tachypnea, tachycardia, dyspnea, pallor, and cyanosis. The nurse should tell the parent to bring the child to the clinic because these signs and symptoms are suggestive of what condition? 35. Pancreatic enzymes are administered to the child with cystic fibrosis. What nursing consideration should be included in the plan of care? 36. The nurse is giving discharge instructions to the parents of a 5-year-old child who had a tonsillectomy 4 hours ago. What statement by the parent indicates a correct understanding of the teaching? 37. A child is admitted with acute laryngotracheobronchitis (LTB). The child will most likely be treated with which? 38. A 6-year-old child has had a tonsillectomy. The child is spitting up small amounts of dark brown blood in the immediate postoperative period. The nurse should take what action? 39. A 3-year-old child is experiencing pain after a tonsillectomy. The child has not taken in any fluids and does not want to drink anything, saying, “My tummy hurts.” The following health care prescriptions are available: acetaminophen (Tylenol) PO (orally) or PR (rectally) PRN, ice chips, clear liquids. What should the nurse implement to relieve the child’s pain? 40. A 1-year-old child has acute otitis media (AOM) and is being treated with oral antibiotics. What should the nurse include in the discharge teaching to the infant’s parents? 41. What do the initial signs of respiratory syncytial virus (RSV) infection in an infant include? 42. The nurse is caring for a 1-month-old infant with respiratory syncytial virus (RSV) who is receiving 23% oxygen via a plastic hood. The child’s SaO2 saturation is 88%, respiratory rate is 45 breaths/min, and pulse is 140 beats/min. Based on these assessments, what action should the nurse take? 43. A 5-year-old child is admitted with bacterial pneumonia. What signs and symptoms should the nurse expect to assess with this disease process? 44. An infant with a congenital heart defect is to receive a dose of palivizumab (Synagis). What is the purpose of this? 45. A 3-year-old is brought to the emergency department with symptoms of stridor, fever, restlessness, and drooling. No coughing is observed. Based on these findings, the nurse should be prepared to assist with what action? 46. A 3-year-old child woke up in the middle of the night with a croupy cough and inspiratory stridor. The parents bring the child to the emergency department, but by the time they arrive, the cough is gone, and the stridor has resolved. What can the nurse teach the parents with regard to this type of croup? 47. A 3-month-old infant is admitted to the pediatric unit for treatment of bronchiolitis. The infant’s vital signs are T, 101.6° F; P, 106 beats/min apical; and R, 70 breaths/min. The infant is irritable and fussy and coughs frequently. IV fluids are given via a peripheral venipuncture. Fluids by mouth were initially contraindicated for what reason? 48. A child is in the hospital for cystic fibrosis. What health care provider’s prescription should the nurse clarify before implementing? 49. A 6-year-old child is in the hospital for status asthmaticus. Nursing care during this acute period includes which prescribed interventions? 50. In providing nourishment for a child with cystic fibrosis (CF), what factors should the nurse keep in mind? 51. A quantitative sweat chloride test has been done on an 8-month-old child. What value should be indicative of cystic fibrosis (CF)? 52. A preschool child has asthma, and a goal is to extend expiratory time and increase expiratory effectiveness. What action should the nurse implement to meet this goal? 53. A school-age child has asthma. The nurse should teach the child that if a peak expiratory flow rate is in the yellow zone, this means that the asthma control is what? 54. A family requires home care teaching with regard to preventative measures to use at home to avoid an asthmatic episode. What strategy should the nurse teach? 55. A school-age child with cystic fibrosis takes four enzyme capsules with meals. The child is having four or five bowel movements per day. The nurse’s action in regard to the pancreatic enzymes is based on the knowledge that the dosage is what? 56. A term infant is delivered, and before delivery, the medical team was notified that a congenital diaphragmatic hernia (CDH) was diagnosed on ultrasonography. What should be done immediately at birth if respiratory distress is noted? 57. A child has a streptococcal throat infection and is being treated with antibiotics. What should the nurse teach the parents to prevent infection of others? 58. What medication is contraindicated in children post tonsillectomy and adenoidectomy? MULTIPLE RESPONSE 1. The nurse is preparing a staff education program about pediatric asthma. What concepts should the nurse include when discussing the asthma severity classification system? (Select all that apply.) 2. The nurse is caring for a newborn with suspected congenital diaphragmatic hernia. What of the following findings would the nurse expect to observe? (Select all that apply.) 3. What interventions can the nurse teach parents to do to ease respiratory efforts for a child with a mild respiratory tract infection? (Select all that apply.) 4. A tonsillectomy or adenoidectomy is contraindicated in what conditions? (Select all that apply.) 5. The clinic nurse is administering influenza vaccinations. Which children should not receive the live attenuated influenza vaccine (LAIV)? (Select all that apply.) 6. The nurse is preparing to admit a 7-year-old child with acute laryngotracheobronchitis (LTB). What clinical manifestations should the nurse expect to observe? (Select all that apply.) 7. The nurse is preparing to admit a 3-year-old child with acute spasmodic laryngitis. What clinical features of hepatitis B should the nurse recognize? (Select all that apply.) 8. A child is diagnosed with active pulmonary tuberculosis. What medications does the nurse anticipate to be prescribed for the first 2 months? (Select all that apply.) 9. The nurse is interpreting a tuberculin skin test. If the nurse finds a result of an induration 5 mm or larger, in which child should the nurse document this finding as positive? (Select all that apply.) 10. The nurse is preparing to admit a 7-year-old child with pulmonary edema. What clinical manifestations should the nurse expect to observe? (Select all that apply.) COMPLETION 1. The nurse is calculating the amount of expected urinary output for a 24-hour period on a child with bacterial pneumonia who weighs 22 lb. The nurse recognizes the formula to be used is 1 ml/kg/hr. What is the expected 24-hour urinary output for this child in milliliters? Record your answer below in a whole number. 2. The nurse is calculating the amount of expected urinary output for a 24-hour period on a child with laryngotracheobronchitis who weighs 33 lb. The nurse recognizes the formula to be used is 1 ml/kg/hr. What is the expected 24-hour urinary output for this child in milliliters? Record your answer below in a whole number. 3. The health care provider prescribes ceftazidime (Fortaz) 75 mg per intravenous piggy back (IVPB) every 8 hours for a child with cystic fibrosis. The pharmacy sends the medication to the unit in a 100-ml bag with directions to run the medication over 30 minutes. What milliliters per hour will the nurse set the intravenous pump to run the medication over 30 minutes? Fill in the blank and record your answer in a whole number. 4. The health care provider prescribes vancomycin 200 mg per intravenous piggy back (IVPB) every 6 hours for a child with cystic fibrosis. The pharmacy sends the medication to the unit in a 150-ml bag with directions to run the medication over 120 minutes. What milliliters per hour will the nurse set the intravenous pump to run the medication over 120 minutes? Fill in the blank and record your answer in a whole number.