NCSBN Practice Questions & Answers
(NCSBN) 100% Guarantee Pass
A 1 year-old child is receiving temporary total parental nutrition (TPN) through
a central venous line. This is the first day of TPN therapy. Although all of the
following nursing actions must be included in the plan of care of this child,
which one would be a priority at this time?
A. Use aseptic technique during dressing changes
B. Check results of liver enzyme tests
C. Maintain central line catheter integrity
D. Monitor serum glucose levels - ------------ANS: D
Hyperglycemia may occur during the first day or two as the child adapts to the
high-glucose load of the TPN solution. Thus, a priority nursing responsibility is
blood glucose testing.
A 2-year-old child has just been diagnosed with cystic fibrosis. The child's
parent asks the nurse what the most important concerns are at this time.
Which is the appropriate response from the nurse?
A. "Thick, sticky secretions from the lungs are a constant challenge."
B. "Cystic fibrosis results in nutritional concerns that can be dealt with."
C. "You will work with a team of experts and have access to a support group."
D. "There is a high probability of life-long complications." - ------------ANS: A
The primary factor, and the one responsible for many of the clinical
manifestations of cystic fibrosis, is mechanical obstruction caused by the
increased viscosity of mucous gland secretions.Because of the increased
viscosity of bronchial mucus, there is greater resistance to ciliary action
(probably secondary to infection and ciliary destruction), a slower flow rate of
mucus and incomplete expectoration, which also contributes to the mucus
obstruction. This retained mucus serves as an excellent medium for bacterial
growth. Reduced oxygen-carbon dioxide exchange causes variable degrees
of hypoxia, hypercapnia and acidosis.In severe cases, progressive lung
involvement, compression of pulmonary blood vessels and progressive lung
dysfunction frequently lead to pulmonary hypertension, cor pulmonale,
respiratory failure and death. Pulmonary complications are present in almost
all children with cystic fibrosis, but the onset and extent of involvement are
variable.
,A 3 year-old child has findings that may suggest a neuroblastoma. While
listening to the concerns of the parents, which finding is consistent with this
diagnosis and requires follow-up by the health care provider?
A. "He seems to be getting weaker and weaker and is sometimes unsteady on
his feet."
B. "We keep having to buy him larger size pants because he's growing so big
around the waist."
C. "He doesn't seem to be going to the bathroom as much and his urine is
dark yellow in color."
D. "Our child has been quieter than normal lately and has lost weight." -
------------ANS: B
One of the most common signs of neuroblastoma is increased abdominal girth
due to the mass or tumor in the abdomen. The mass can cause pain and/or a
feeling of fullness and the pressure may affect the child's bladder or bowel.
Although the child with a neuroblastoma may not want to eat (which can lead
to weight loss), this finding could have many causes. A more significant
finding would be if the parents reported that child keeps outgrowing clothing or
that clothing is tight around the abdomen.
A 4 month-old infant is being given digoxin. The client's blood pressure is
92/78 mm Hg; resting pulse is 78 BPM; respirations are 28 BPM; and the
serum potassium level is 4.8 mEq/L (4.8 mmol/L). The client is irritable and
has vomited twice since the morning dose of digoxin. Which finding is most
indicative of digoxin toxicity?
A. Irritability
B. Vomiting
C. Bradycardia
D. Dyspnea - ------------ANS: C
The most common sign of digoxin toxicity in children is bradycardia which is a
heart rate below 100 BPM in an infant. Normal resting heart rate for infants
1-11 months-old is 100-160 BPM.
A 10-month old infant is admitted with a diagnosis of bacterial meningitis.
Several hours after admission, during a planning conference, which of the
actions suggested to the registered nurse (RN) by the practical nurse (PN)
would be appropriate to add to the plan of care?
,A. Provide an over-the-crib protective top
B. Measure head circumference
C. Initiate droplet precautions
D. Provide passive range of motion - ------------ANS: B
In meningitis, assessment of neurological signs should be done frequently.
Head circumference is measured because subdural effusions and obstructive
hydrocephalus can develop as a complication of meningitis. The client would
have already been placed on droplet precautions and had a crib top applied to
the bed when he was admitted to the unit.
A 12 year-old pediatric cancer client is distraught about the alopecia that
occurred after the last chemotherapy treatment. Which nursing interventions
are appropriate for this side effect of chemotherapy? (Select all that apply.)
A. Practice and teach thorough hand washing
B. Administer prescribed antiemetic medication before nausea is too severe
C. Encourage visits from friends before discharge from the hospital
D. Allow the child to choose a cap, scarf, wig or other head cover to use -
------------ANS: C,D
Alopecia is the loss of hair, which is a frequent side effect of certain types of
chemotherapy. Although it is not life-threatening, the body image change is
difficult for many individuals, particularly children and adolescents.
Encouraging visits from friends before discharge helps the young client and
friends adjust. Wearing preferred forms of head cover-ups increases comfort
and decreases embarrassment. The other options are proper interventions for
chemotherapy, but do not help the client with hair loss.
A 15 month-old child comes to the clinic for a follow-up visit after
hospitalization for treatment of Kawasaki disease and treatment involving
immunoglobulins. The nurse should recognize which scheduled
immunizations will be delayed?
A. Inactivated polio vaccine (IPV)
B. Haemophilus Influenzae Type b (Hib)
C. Mumps, measles, rubella (MMR)
D. Diptheria, tetanus, pertussis (DTaP) - ------------ANS: C
Medical management of Kawasaki involves administration of
immunoglobulins. Measles, mumps, rubella (MMR) is a live virus vaccine.
Following administration of immunoglobulins, live vaccines should be held due
to possible interference with the body's ability to form antibodies.
, A 16 month-old child has just been admitted to the hospital. As the nurse
assigned to this child enters the hospital room for the first time, the toddler
runs to the mother, clings to her and begins to cry. What should be an initial
action by the nurse?
A. Arrange to change client care assignments
B. Explain that the child needs extra attention
C. Discuss the appropriate use of "time-out"
D. Explain that this behavior is expected - ------------ANS: D
During normal development, fear of strangers becomes prominent and begins
around age 6 to 8 months-old. Such behaviors include clinging to parent,
crying and turning away from the stranger. These fears and behaviors extend
into the toddler period. In the toddler period, separation anxiety is at its peak.
As the child ages the behavior has a tendency to wane.
A 52 year-old postmenopausal woman asks the nurse how frequently she
should have a mammogram. How should the nurse respond?
A. "Unless you had previous problems, every two years is best."
B. "Your health care provider will advise you about your risks and the
frequency."
C. "Yearly mammograms are advised for any women over 35."
D. "Once a woman reaches 50, she should have a mammogram yearly." -
------------ANS: D
The American Cancer Society recommends a screening mammogram by age
40, every one to two years for women 40 to 49, and every year from age 50
onward. If there are family or personal health risks, other more frequent and
additional assessments may be recommended.
A 57 year-old male client has a hemoglobin of 10 g/dL (6.21 mmol/L) and a
hematocrit of 32% (0.32). What would be the most appropriate follow-up by a
home care nurse?
A. Ask the client if the client has noticed any bleeding or dark stools
B. Call 911 and send the client to the emergency department
C. Refer the client to schedule an appointment with a hematologist
D. Schedule a repeat hemoglobin and hematocrit in one month -
------------ANS: A
(NCSBN) 100% Guarantee Pass
A 1 year-old child is receiving temporary total parental nutrition (TPN) through
a central venous line. This is the first day of TPN therapy. Although all of the
following nursing actions must be included in the plan of care of this child,
which one would be a priority at this time?
A. Use aseptic technique during dressing changes
B. Check results of liver enzyme tests
C. Maintain central line catheter integrity
D. Monitor serum glucose levels - ------------ANS: D
Hyperglycemia may occur during the first day or two as the child adapts to the
high-glucose load of the TPN solution. Thus, a priority nursing responsibility is
blood glucose testing.
A 2-year-old child has just been diagnosed with cystic fibrosis. The child's
parent asks the nurse what the most important concerns are at this time.
Which is the appropriate response from the nurse?
A. "Thick, sticky secretions from the lungs are a constant challenge."
B. "Cystic fibrosis results in nutritional concerns that can be dealt with."
C. "You will work with a team of experts and have access to a support group."
D. "There is a high probability of life-long complications." - ------------ANS: A
The primary factor, and the one responsible for many of the clinical
manifestations of cystic fibrosis, is mechanical obstruction caused by the
increased viscosity of mucous gland secretions.Because of the increased
viscosity of bronchial mucus, there is greater resistance to ciliary action
(probably secondary to infection and ciliary destruction), a slower flow rate of
mucus and incomplete expectoration, which also contributes to the mucus
obstruction. This retained mucus serves as an excellent medium for bacterial
growth. Reduced oxygen-carbon dioxide exchange causes variable degrees
of hypoxia, hypercapnia and acidosis.In severe cases, progressive lung
involvement, compression of pulmonary blood vessels and progressive lung
dysfunction frequently lead to pulmonary hypertension, cor pulmonale,
respiratory failure and death. Pulmonary complications are present in almost
all children with cystic fibrosis, but the onset and extent of involvement are
variable.
,A 3 year-old child has findings that may suggest a neuroblastoma. While
listening to the concerns of the parents, which finding is consistent with this
diagnosis and requires follow-up by the health care provider?
A. "He seems to be getting weaker and weaker and is sometimes unsteady on
his feet."
B. "We keep having to buy him larger size pants because he's growing so big
around the waist."
C. "He doesn't seem to be going to the bathroom as much and his urine is
dark yellow in color."
D. "Our child has been quieter than normal lately and has lost weight." -
------------ANS: B
One of the most common signs of neuroblastoma is increased abdominal girth
due to the mass or tumor in the abdomen. The mass can cause pain and/or a
feeling of fullness and the pressure may affect the child's bladder or bowel.
Although the child with a neuroblastoma may not want to eat (which can lead
to weight loss), this finding could have many causes. A more significant
finding would be if the parents reported that child keeps outgrowing clothing or
that clothing is tight around the abdomen.
A 4 month-old infant is being given digoxin. The client's blood pressure is
92/78 mm Hg; resting pulse is 78 BPM; respirations are 28 BPM; and the
serum potassium level is 4.8 mEq/L (4.8 mmol/L). The client is irritable and
has vomited twice since the morning dose of digoxin. Which finding is most
indicative of digoxin toxicity?
A. Irritability
B. Vomiting
C. Bradycardia
D. Dyspnea - ------------ANS: C
The most common sign of digoxin toxicity in children is bradycardia which is a
heart rate below 100 BPM in an infant. Normal resting heart rate for infants
1-11 months-old is 100-160 BPM.
A 10-month old infant is admitted with a diagnosis of bacterial meningitis.
Several hours after admission, during a planning conference, which of the
actions suggested to the registered nurse (RN) by the practical nurse (PN)
would be appropriate to add to the plan of care?
,A. Provide an over-the-crib protective top
B. Measure head circumference
C. Initiate droplet precautions
D. Provide passive range of motion - ------------ANS: B
In meningitis, assessment of neurological signs should be done frequently.
Head circumference is measured because subdural effusions and obstructive
hydrocephalus can develop as a complication of meningitis. The client would
have already been placed on droplet precautions and had a crib top applied to
the bed when he was admitted to the unit.
A 12 year-old pediatric cancer client is distraught about the alopecia that
occurred after the last chemotherapy treatment. Which nursing interventions
are appropriate for this side effect of chemotherapy? (Select all that apply.)
A. Practice and teach thorough hand washing
B. Administer prescribed antiemetic medication before nausea is too severe
C. Encourage visits from friends before discharge from the hospital
D. Allow the child to choose a cap, scarf, wig or other head cover to use -
------------ANS: C,D
Alopecia is the loss of hair, which is a frequent side effect of certain types of
chemotherapy. Although it is not life-threatening, the body image change is
difficult for many individuals, particularly children and adolescents.
Encouraging visits from friends before discharge helps the young client and
friends adjust. Wearing preferred forms of head cover-ups increases comfort
and decreases embarrassment. The other options are proper interventions for
chemotherapy, but do not help the client with hair loss.
A 15 month-old child comes to the clinic for a follow-up visit after
hospitalization for treatment of Kawasaki disease and treatment involving
immunoglobulins. The nurse should recognize which scheduled
immunizations will be delayed?
A. Inactivated polio vaccine (IPV)
B. Haemophilus Influenzae Type b (Hib)
C. Mumps, measles, rubella (MMR)
D. Diptheria, tetanus, pertussis (DTaP) - ------------ANS: C
Medical management of Kawasaki involves administration of
immunoglobulins. Measles, mumps, rubella (MMR) is a live virus vaccine.
Following administration of immunoglobulins, live vaccines should be held due
to possible interference with the body's ability to form antibodies.
, A 16 month-old child has just been admitted to the hospital. As the nurse
assigned to this child enters the hospital room for the first time, the toddler
runs to the mother, clings to her and begins to cry. What should be an initial
action by the nurse?
A. Arrange to change client care assignments
B. Explain that the child needs extra attention
C. Discuss the appropriate use of "time-out"
D. Explain that this behavior is expected - ------------ANS: D
During normal development, fear of strangers becomes prominent and begins
around age 6 to 8 months-old. Such behaviors include clinging to parent,
crying and turning away from the stranger. These fears and behaviors extend
into the toddler period. In the toddler period, separation anxiety is at its peak.
As the child ages the behavior has a tendency to wane.
A 52 year-old postmenopausal woman asks the nurse how frequently she
should have a mammogram. How should the nurse respond?
A. "Unless you had previous problems, every two years is best."
B. "Your health care provider will advise you about your risks and the
frequency."
C. "Yearly mammograms are advised for any women over 35."
D. "Once a woman reaches 50, she should have a mammogram yearly." -
------------ANS: D
The American Cancer Society recommends a screening mammogram by age
40, every one to two years for women 40 to 49, and every year from age 50
onward. If there are family or personal health risks, other more frequent and
additional assessments may be recommended.
A 57 year-old male client has a hemoglobin of 10 g/dL (6.21 mmol/L) and a
hematocrit of 32% (0.32). What would be the most appropriate follow-up by a
home care nurse?
A. Ask the client if the client has noticed any bleeding or dark stools
B. Call 911 and send the client to the emergency department
C. Refer the client to schedule an appointment with a hematologist
D. Schedule a repeat hemoglobin and hematocrit in one month -
------------ANS: A
