RN PEDIATRIC NURSING ONLINE
PRACTICE 2023 B
A6nurse6is6caring6for6a6preschool-age6child.6
For6each6assessment6finding,6click6to6specify6if6the6finding6is6consistent6with6nightmares6
or6sleep6terrors.6Each6finding6may6support6more6than616disease6process.
-6Impulsivity
-6Daytime6alertness
-6Child's6responsiveness6to6guardian
-6Child's6description6of6the6dream.
-6Child's6return6to6sleeping
-6Child's6concentration
-6Timing6of6child's6crying6-6ans--Nightmares:
-6Child's6concentration
-6Daytime6alertness
-6Impulsivity
-6Timing6of6child's6crying
Rationale:6When6analyzing6cues,6the6nurse6should6recognize6that6manifestations6of6nigh
tmares6include6awakening6during6the6night6after6a6scary6dream.6Nightmares6are6a6sleep6
disturbance6after6the6dream6is6over.6The6child6might6be6crying,6fearful6of6returning6to6sle
ep,6&6believe6the6dream6is6real.6Sleep6disturbances6cause6interruptions6in6the6sleep-
wake6cycle6&6can6cause6impaired6concentration,6daytime6fatigue,6&6impulsive6behaviors.
Sleep6Terrors:
-6Child's6return6to6sleeping
-6Child's6concentration
-6Daytime6alertness
-6Impulsivity
-6Child's6responsiveness6to6guardian
Rationale:6When6analyzing6cues,6the6nurse6should6recognize6that6manifestations6of6slee
p6terrors6include6partial6awakening6during6a6deep6sleep.6Sleep6terrors6are6sleep6disturba
nces6that6cause6a6child6to6exhibit6behaviors6such6as6thrashing,6screaming,6moaning,6&6d
iaphoresis6that6disappear6once6the6child6awakens.6The6child6does6not6remember6the6epi
sode6&6is6not6comforted6by6others6during6the6disturbance.6The6child6usually6falls6asleep6
easily6afterwards.6Sleep6terrors6cause6interruptions6in6the6sleep-
wake6cycle6&6can6cause6impaired6concentration,6daytime6fatigue,6&6impulsive6behaviors.
A6nurse6is6caring6for6a6toddler6who6has6acute6otitis6media6&6a6temperature6of6406C6(1046
F).6After6administering6acetaminophen,6which6of6the6following6actions6should6the6nurse6p
lan6to6take6to6reduce6the6toddler's6temperature?
,-6Apply6a6cooling6blanket6to6the6toddler.
-6Dress6the6toddler6in6minimal6clothing.
-6Give6the6toddler6a6tepid6bath.
-6Administer6diphenhydramine6to6the6toddler.6-6ans---
6Dress6the6toddler6in6minimal6clothing.
Rationale:6The6nurse6should6recognize6that6dressing6the6toddler6in6minimal6clothing6will6
expose6the6skin6to6air6&6maximize6heat6evaporation6from6the6skin,6thus6reducing6the6tod
dler's6temperature.
A6nurse6on6a6pediatric6unit6is6caring6for6a6school-age6child.
After6reviewing6the6information6in6the6child's6medical6record,6which6of6the6following6findin
gs6should6the6nurse6report6to6the6provider?
6Select6the646findings6that6the6nurse6should6report6to6the6provider.
-6Arterial6blood6gases
-6Cardiovascular6assessment
-6WBC6count
-6Hemoglobin
-6O26saturation6level
-6Respiratory6assessment6-6ans---6Arterial6blood6gases
Rationale:6The6child's6ABGs6indicate6respiratory6alkalosis,6which6is6associated6with6com
plications6of6asthma,6such6as6hyperventilation6&6hypoxia.6Therefore,6the6nurse6should6re
port6these6findings6to6the6provider.
-6WBC6count
Rationale:6The6child's6WBC6count6is6above6the6expected6reference6range,6which6could6b
e6an6indication6of6infection6or6inflammation.6Therefore,6the6nurse6should6report6this6findin
g6to6the6provider.
-6O26saturation6level
Rationale:6The6child's6O26saturation6is6below6the6expected6reference6range6despite6the6
use6of6supplemental6O2.6Therefore,6the6nurse6should6report6this6finding6to6the6provider.
-6Respiratory6assessment
Rationale:6The6child's6respiratory6assessment6indicates6increased6respiratory6distress,6a
s6evidenced6by6the6presence6of6retractions,6tachypnea,6&6increased6wheezing.6Therefor
e,6the6nurse6should6report6this6finding6to6the6provider.
A6nurse6is6caring6for6a6preschooler6who6has6congestive6heart6failure.6The6nurse6observe
s6wide6QRS6complexes6&6peaked6T6waves6on6the6cardiac6monitor.6Which6of6the6followin
g6prescriptions6should6the6nurse6clarify6with6the6provider?
-6Furosemide
-6Captopril
, -6Regular6insulin
-6Potassium6chloride6-6ans---6Potassium6chloride
Rationale:6The6nurse6should6identify6that6a6child6who6has6congestive6heart6failure6can6de
velop6electrolyte6imbalances,6such6as6hyperkalemia6or6hypokalemia.6The6nurse6should6i
dentify6that6the6child6is6exhibiting6manifestations6of6hyperkalemia6&6contact6the6provider6
about6the6administration6of6potassium6chloride,6which6can6increase6the6severity6of6hyper
kalemia.
A6nurse6is6caring6for6a6toddler.
Complete6the6diagram6by6dragging6from6the6choices6below6to6specify6what6condition6the6
client6is6most6likely6experiencing,626actions6the6nurse6should6take6to6address6that6conditi
on,6&626parameters6the6nurse6should6monitor6to6assess6the6client's6progress.
Potential6Condition:
-6Cystic6fibrosis
-6Otitis6media
-6Diabetes6insipidus
-6Gastroesophageal6reflux
Actions6To6Take:
-6Educate6guardian6about6sweat6chloride6testing.
-6Assess6the6toddler's6tympanic6membranes.
-6Anticipate6the6performance6of6a6water6deprivation6test.
-6Prepare6the6toddler6for6chest6physiotherapy.
-6Request6a6prescription6for6cimetidine.
Parameters6To6Monitor:
-6Stools
-6Hearing
-6Enuresis
-6Regurgitation
-6O26saturation6level6-6ans--Potential6Condition:
-6Cystic6fibrosis
Actions6To6Take:
-6Educate6guardian6about6sweat6chloride6testing.
-6Prepare6the6toddler6for6chest6physiotherapy.
Parameters6To6Monitor:
-6Stools
-6O26saturation6level
Rationale:6Upon6recognizing6&6analyzing6client6findings,6the6nurse's6priority6hypothesis6i
s6that6the6toddler6is6most6likely6experiencing6cystic6fibrosis6&6that6is6it6important6to6gener
PRACTICE 2023 B
A6nurse6is6caring6for6a6preschool-age6child.6
For6each6assessment6finding,6click6to6specify6if6the6finding6is6consistent6with6nightmares6
or6sleep6terrors.6Each6finding6may6support6more6than616disease6process.
-6Impulsivity
-6Daytime6alertness
-6Child's6responsiveness6to6guardian
-6Child's6description6of6the6dream.
-6Child's6return6to6sleeping
-6Child's6concentration
-6Timing6of6child's6crying6-6ans--Nightmares:
-6Child's6concentration
-6Daytime6alertness
-6Impulsivity
-6Timing6of6child's6crying
Rationale:6When6analyzing6cues,6the6nurse6should6recognize6that6manifestations6of6nigh
tmares6include6awakening6during6the6night6after6a6scary6dream.6Nightmares6are6a6sleep6
disturbance6after6the6dream6is6over.6The6child6might6be6crying,6fearful6of6returning6to6sle
ep,6&6believe6the6dream6is6real.6Sleep6disturbances6cause6interruptions6in6the6sleep-
wake6cycle6&6can6cause6impaired6concentration,6daytime6fatigue,6&6impulsive6behaviors.
Sleep6Terrors:
-6Child's6return6to6sleeping
-6Child's6concentration
-6Daytime6alertness
-6Impulsivity
-6Child's6responsiveness6to6guardian
Rationale:6When6analyzing6cues,6the6nurse6should6recognize6that6manifestations6of6slee
p6terrors6include6partial6awakening6during6a6deep6sleep.6Sleep6terrors6are6sleep6disturba
nces6that6cause6a6child6to6exhibit6behaviors6such6as6thrashing,6screaming,6moaning,6&6d
iaphoresis6that6disappear6once6the6child6awakens.6The6child6does6not6remember6the6epi
sode6&6is6not6comforted6by6others6during6the6disturbance.6The6child6usually6falls6asleep6
easily6afterwards.6Sleep6terrors6cause6interruptions6in6the6sleep-
wake6cycle6&6can6cause6impaired6concentration,6daytime6fatigue,6&6impulsive6behaviors.
A6nurse6is6caring6for6a6toddler6who6has6acute6otitis6media6&6a6temperature6of6406C6(1046
F).6After6administering6acetaminophen,6which6of6the6following6actions6should6the6nurse6p
lan6to6take6to6reduce6the6toddler's6temperature?
,-6Apply6a6cooling6blanket6to6the6toddler.
-6Dress6the6toddler6in6minimal6clothing.
-6Give6the6toddler6a6tepid6bath.
-6Administer6diphenhydramine6to6the6toddler.6-6ans---
6Dress6the6toddler6in6minimal6clothing.
Rationale:6The6nurse6should6recognize6that6dressing6the6toddler6in6minimal6clothing6will6
expose6the6skin6to6air6&6maximize6heat6evaporation6from6the6skin,6thus6reducing6the6tod
dler's6temperature.
A6nurse6on6a6pediatric6unit6is6caring6for6a6school-age6child.
After6reviewing6the6information6in6the6child's6medical6record,6which6of6the6following6findin
gs6should6the6nurse6report6to6the6provider?
6Select6the646findings6that6the6nurse6should6report6to6the6provider.
-6Arterial6blood6gases
-6Cardiovascular6assessment
-6WBC6count
-6Hemoglobin
-6O26saturation6level
-6Respiratory6assessment6-6ans---6Arterial6blood6gases
Rationale:6The6child's6ABGs6indicate6respiratory6alkalosis,6which6is6associated6with6com
plications6of6asthma,6such6as6hyperventilation6&6hypoxia.6Therefore,6the6nurse6should6re
port6these6findings6to6the6provider.
-6WBC6count
Rationale:6The6child's6WBC6count6is6above6the6expected6reference6range,6which6could6b
e6an6indication6of6infection6or6inflammation.6Therefore,6the6nurse6should6report6this6findin
g6to6the6provider.
-6O26saturation6level
Rationale:6The6child's6O26saturation6is6below6the6expected6reference6range6despite6the6
use6of6supplemental6O2.6Therefore,6the6nurse6should6report6this6finding6to6the6provider.
-6Respiratory6assessment
Rationale:6The6child's6respiratory6assessment6indicates6increased6respiratory6distress,6a
s6evidenced6by6the6presence6of6retractions,6tachypnea,6&6increased6wheezing.6Therefor
e,6the6nurse6should6report6this6finding6to6the6provider.
A6nurse6is6caring6for6a6preschooler6who6has6congestive6heart6failure.6The6nurse6observe
s6wide6QRS6complexes6&6peaked6T6waves6on6the6cardiac6monitor.6Which6of6the6followin
g6prescriptions6should6the6nurse6clarify6with6the6provider?
-6Furosemide
-6Captopril
, -6Regular6insulin
-6Potassium6chloride6-6ans---6Potassium6chloride
Rationale:6The6nurse6should6identify6that6a6child6who6has6congestive6heart6failure6can6de
velop6electrolyte6imbalances,6such6as6hyperkalemia6or6hypokalemia.6The6nurse6should6i
dentify6that6the6child6is6exhibiting6manifestations6of6hyperkalemia6&6contact6the6provider6
about6the6administration6of6potassium6chloride,6which6can6increase6the6severity6of6hyper
kalemia.
A6nurse6is6caring6for6a6toddler.
Complete6the6diagram6by6dragging6from6the6choices6below6to6specify6what6condition6the6
client6is6most6likely6experiencing,626actions6the6nurse6should6take6to6address6that6conditi
on,6&626parameters6the6nurse6should6monitor6to6assess6the6client's6progress.
Potential6Condition:
-6Cystic6fibrosis
-6Otitis6media
-6Diabetes6insipidus
-6Gastroesophageal6reflux
Actions6To6Take:
-6Educate6guardian6about6sweat6chloride6testing.
-6Assess6the6toddler's6tympanic6membranes.
-6Anticipate6the6performance6of6a6water6deprivation6test.
-6Prepare6the6toddler6for6chest6physiotherapy.
-6Request6a6prescription6for6cimetidine.
Parameters6To6Monitor:
-6Stools
-6Hearing
-6Enuresis
-6Regurgitation
-6O26saturation6level6-6ans--Potential6Condition:
-6Cystic6fibrosis
Actions6To6Take:
-6Educate6guardian6about6sweat6chloride6testing.
-6Prepare6the6toddler6for6chest6physiotherapy.
Parameters6To6Monitor:
-6Stools
-6O26saturation6level
Rationale:6Upon6recognizing6&6analyzing6client6findings,6the6nurse's6priority6hypothesis6i
s6that6the6toddler6is6most6likely6experiencing6cystic6fibrosis6&6that6is6it6important6to6gener
