1. A nurse is assessing the pain level of a 3 year old toddler. Which of the following assessment scales should the
nurse use?
a. FACES
b. Numeric
c. CRIES
d. Visual analog)
faces
(The nurse should use the FACES pain rating scale for pediatric clients who are 3 years old and older. This scale
allows the toddler to point to the face that depicts their current level of pain. The nurse can then determine the
need for pain)
2. A nurse is planning an educational program to teach parents about protecting their children from sunburns. Which
of the following instructions should the nurse plan to include?
a. "allow your child to play outside during the hours between 10:00am and 2:00pm."
b. "choose a waterproof sunscreen with a minimum SPF of 15."
c. "dress you child in loose weave polyester fabric prior to sun exposure."
d. "reapply sunscreen every 4 hours.")
b waterproof suscreen
3. A nurse is performing hearing screenings for children at a community health fair. Which of the following children
should the nurse refer to a provider for a more extensive hearing evaluation?
a. an 18 month old toddler who has unintelligible speech
b. a 3 month old infant who has exaggerated startle response
, c. a 4 year old preschooler who prefers playing with others rather than alone
d. an 8 month old infant who is not yet making babbling sounds)
8 mo old infant
(The nurse should refer an infant who is not making babbling sounds by the age of 7 months to a provider for a
more extensive evaluation of hearing.)
4. A nurse in an emergency department is assessing a 3 month old infant who has rotavirus and is experiencing
acute vomiting and diarrhea. Which of the following manifestations should the nurse identify as an indication that
the infant has moderate to severe dehydration?
a. HR 124
b. increased tear production
c. sunken anterior fontanel
d. capillary refill 2 seconds)
sunken anterior fontanelle
(The nurse should recognize that a sunken anterior fontanel is an indication of moderate to severe dehydration
due to the acute loss of fluid.)
5. A nurse is providing teaching to the family of a school-age child who has juvenile idiopathic arthrisis. Which of
the following instructions should the nurse include in the teaching?
a. "limit movement of the child's large joints"
b. "encourage the child to perform independent self-care."
c. "provide the child with a soft mattress for sleeping."
d. "schedule a 2 hour daily nap for the child in the afternoon.")
B independent self care
(The nurse should teach the family the importance of encouraging the child to perform independent self-care.
This will minimize the child's pain while maximizing mobility. Encouraging and praising the child's efforts for
independence will also increase their self-esteem)
(limit movements if SATA)
6. A nurse is planning care for a school age child who has a tunneled central venous access device. Which of the
following interventions should the nurse include in the plan?
, a. use sterile scissors to remove the dressing from the site
b. irrigate each lumen weekly with 10 ml of 0.9% sodium chloride solution when not in use
c. access the site suing a noncoring angle needle
d. use a semipermeable transparent depressing to cover the site)
semipermeable transparent dressing
7. A nurse is providing anticipatory guidance to the parent of a toddler. Which of the following expected behavior
characteristics of toddlers should the nurse include?
a. controls impulsive feelings
b. understands right from wrong
c. easily separates from parents for long periods of time
d. expresses likes and dislikes)
expresses likes and dislikes
(This is the time in life when a toddler is developing autonomy and self-concept. They will try to assert
themselves and frequently refuse to comply. The parent should allow the child to have some control, but also set
limits for them so they learn from their behavior and learn to control their actions.)
8. A nurse is providing discharge teaching to the parent of a school age child who has moderate persistent asthma.
Which of the following instructions should the nurse include?
a. "you should give your child their salmeterol inhaler every 4 hours when they are having an acute episode of
wheezing."
b. "you should monitor your child's weight weekly while they are receiving inhaled corticosteroids therapy."
c. "pulmonary function tests will be performed every 12-24 months to evaluate how your child is responding to
therapy."
d. "when using the peak expiratory flow meter, record your child's average of three readings.")
C pulmonary function test
9. A nurse is assessing an adolescent who received a sodium polystyrene sulfonate enema. Which of the following
findings indicates effectiveness of the medication?
a. reports an absence of nausea and vomiting
b. reports experiencing an onset of loose stools within 15 minutes of administration
c. serum potassium level 4.1 mEq/L
d. blood pressure 86/52 mm Hg)
nurse use?
a. FACES
b. Numeric
c. CRIES
d. Visual analog)
faces
(The nurse should use the FACES pain rating scale for pediatric clients who are 3 years old and older. This scale
allows the toddler to point to the face that depicts their current level of pain. The nurse can then determine the
need for pain)
2. A nurse is planning an educational program to teach parents about protecting their children from sunburns. Which
of the following instructions should the nurse plan to include?
a. "allow your child to play outside during the hours between 10:00am and 2:00pm."
b. "choose a waterproof sunscreen with a minimum SPF of 15."
c. "dress you child in loose weave polyester fabric prior to sun exposure."
d. "reapply sunscreen every 4 hours.")
b waterproof suscreen
3. A nurse is performing hearing screenings for children at a community health fair. Which of the following children
should the nurse refer to a provider for a more extensive hearing evaluation?
a. an 18 month old toddler who has unintelligible speech
b. a 3 month old infant who has exaggerated startle response
, c. a 4 year old preschooler who prefers playing with others rather than alone
d. an 8 month old infant who is not yet making babbling sounds)
8 mo old infant
(The nurse should refer an infant who is not making babbling sounds by the age of 7 months to a provider for a
more extensive evaluation of hearing.)
4. A nurse in an emergency department is assessing a 3 month old infant who has rotavirus and is experiencing
acute vomiting and diarrhea. Which of the following manifestations should the nurse identify as an indication that
the infant has moderate to severe dehydration?
a. HR 124
b. increased tear production
c. sunken anterior fontanel
d. capillary refill 2 seconds)
sunken anterior fontanelle
(The nurse should recognize that a sunken anterior fontanel is an indication of moderate to severe dehydration
due to the acute loss of fluid.)
5. A nurse is providing teaching to the family of a school-age child who has juvenile idiopathic arthrisis. Which of
the following instructions should the nurse include in the teaching?
a. "limit movement of the child's large joints"
b. "encourage the child to perform independent self-care."
c. "provide the child with a soft mattress for sleeping."
d. "schedule a 2 hour daily nap for the child in the afternoon.")
B independent self care
(The nurse should teach the family the importance of encouraging the child to perform independent self-care.
This will minimize the child's pain while maximizing mobility. Encouraging and praising the child's efforts for
independence will also increase their self-esteem)
(limit movements if SATA)
6. A nurse is planning care for a school age child who has a tunneled central venous access device. Which of the
following interventions should the nurse include in the plan?
, a. use sterile scissors to remove the dressing from the site
b. irrigate each lumen weekly with 10 ml of 0.9% sodium chloride solution when not in use
c. access the site suing a noncoring angle needle
d. use a semipermeable transparent depressing to cover the site)
semipermeable transparent dressing
7. A nurse is providing anticipatory guidance to the parent of a toddler. Which of the following expected behavior
characteristics of toddlers should the nurse include?
a. controls impulsive feelings
b. understands right from wrong
c. easily separates from parents for long periods of time
d. expresses likes and dislikes)
expresses likes and dislikes
(This is the time in life when a toddler is developing autonomy and self-concept. They will try to assert
themselves and frequently refuse to comply. The parent should allow the child to have some control, but also set
limits for them so they learn from their behavior and learn to control their actions.)
8. A nurse is providing discharge teaching to the parent of a school age child who has moderate persistent asthma.
Which of the following instructions should the nurse include?
a. "you should give your child their salmeterol inhaler every 4 hours when they are having an acute episode of
wheezing."
b. "you should monitor your child's weight weekly while they are receiving inhaled corticosteroids therapy."
c. "pulmonary function tests will be performed every 12-24 months to evaluate how your child is responding to
therapy."
d. "when using the peak expiratory flow meter, record your child's average of three readings.")
C pulmonary function test
9. A nurse is assessing an adolescent who received a sodium polystyrene sulfonate enema. Which of the following
findings indicates effectiveness of the medication?
a. reports an absence of nausea and vomiting
b. reports experiencing an onset of loose stools within 15 minutes of administration
c. serum potassium level 4.1 mEq/L
d. blood pressure 86/52 mm Hg)
