RN PEDIATRIC NURSING ONLINE
PRACTICE 2023 A
A6nurse6in6an6emergency6department6is6caring6for6a6school-
age6child6who6is6experiencing6an6anaphylactic6reaction.6Which6of6the6following6is6the6pri
ority6action6by6the6nurse?6-6ans--Administer6epinephrine6IM6
Rationale:6When6using6the6urgent6vs.6non-
urgent6approach6to6client6care,6the6nurse6should6determine6that6the6priority6action6is6adm
inistering6epinephrine6IM6to6the6child.6During6an6anaphylactic6reaction,6histamine6release
6causes6bronchoconstriction6and6vasodilation.6This6is6an6emergency6because6ultimately6
it6causes6decreased6blood6return6to6the6heart.
A6nurse6in6a6pediatric6emergency6department6is6planning6care6for6an6adolescent.6Based6
on6the6information6in6the6adolescent's6medical6record,6which6of6the6following6actions6sho
uld6the6nurse6plan6to6take?
Select6all6that6apply.6-6ans--Apply6supplemental6oxygen
Rationale:6According6to6the6medical6record6and6chest6x-
ray6report,6the6adolescent6could6potentially6have6a6pneumothorax.6Also6according6to6the6
medical6record6and6chest6x-
ray6report,6the6adolescent's6oxygen6saturation6level6is6decreasing,6which6indicates6hypox
ia.6Therefore,6the6nurse6should6plan6to6administer6supplemental6oxygen.
Prepare6for6chest6tube6insertion
Rationale:6According6to6the6medical6record6and6chest6x-
ray6report,6the6adolescent6could6potentially6have6a6pneumothorax.6A6pneumothorax6is6th
e6presence6of6air6in6the6pleural6cavity,6which6results6in6decreased6lung6expansion.6The6a
dolescent6could6experience6dyspnea,6tachypnea,6tachycardia,6hypoxia,6and6pain.6This6r
equires6prompt6intervention6by6the6provider,6such6as6the6placement6of6a6chest6tube6into6t
he6thoracic6cavity6to6remove6air6and6fluid6from6the6pleural6space,6if6present,6allowing6the6
lung6to6re-expand.
A6nurse6in6an6emergency6department6is6caring6for6a6school-
age6child6who6has6epiglottitis.6Which6of6the6following6actions6should6the6nurse6take?6-
6ans--Monitor6the6child's6oxygen6saturation
,Rationale:6The6nurse6should6monitor6the6child's6oxygen6saturation6level6because6the6chil
d6is6experiencing6acute6respiratory6distress6and6it6is6necessary6to6determine6if6the6child6i
s6responding6to6treatment.
A6nurse6is6providing6teaching6about6play6activities6for6social6development6to6the6guardia
ns6of6a6preschooler.6Which6of6the6following6play6activities6should6the6nurse6recommend6f
or6the6child?6-6ans--Playing6dress-up
Rationale:6The6nurse6should6instruct6the6guardians6that6at6the6preschool6age,6play6shoul
d6focus6on6social,6mental,6and6physical6development.6Therefore,6playing6dress-
up6is6a6recommended6play6activity6for6this6child.
A6nurse6is6receiving6change-of-
shift6report6for6four6children.6Which6of6the6following6children6should6the6nurse6see6first?6-
6ans--A6school-
age6child6who6has6sickle6cell6anemia6and6reports6decreased6vision6in6the6left6eye
Rationale:6When6using6the6urgent6vs.6non-
urgent6approach6to6client6care,6the6nurse6should6determine6the6priority6finding6is6a6report
6of6decreased6vision6in6the6left6eye.6This6finding6indicates6that6the6child6is6experiencing6a
6vaso-
occlusive6crisis6and6should6be6reported6to6the6provider6immediately.6Therefore,6the6nurs
e6should6see6this6child6first.
A6nurse6is6providing6teaching6to6the6parents6of6a6preschooler6who6has6heart6failure6and6
a6new6prescription6for6digoxin6twice6daily.6Which6of6the6following6instructions6should6the6
nurse6include6in6the6teaching?6-6ans--
"Brush6the6child's6teeth6after6giving6the6medication."
Rationale:6The6nurse6should6instruct6the6parents6to6brush6the6child's6teeth6after6administ
ering6digoxin6to6prevent6tooth6decay6caused6by6the6medication,6which6comes6as6a6sweet
ened6liquid6to6enhance6the6taste.
A6nurse6is6providing6teaching6to6the6parent6of6an6infant6who6has6diaper6dermatitis.6The6n
urse6should6instruct6the6parent6to6apply6which6of6the6following6to6the6affected6area?6-
6ans--Zinc6oxide
Rationale:6Diaper6dermatitis6is6a6common6inflammatory6skin6disorder6caused6by6contact6
with6an6irritant6such6as6urine,6feces,6soap,6or6friction,6and6takes6the6form6of6scaling,6blist
ers,6or6papules6with6erythema.6Providing6a6protective6barrier,6such6as6zinc6oxide,6against
6the6irritants6allows6the6skin6to6heal.
A6nurse6is6caring6for6a6client6who6has6been6receiving6IV6fluids6via6a6peripheral6IV6cathete
r.6When6preparing6to6discontinue6the6IV6fluids6and6catheter,6which6of6the6following6action
s6should6the6nurse6plan6to6take?6(Move6the6steps6into6the6box6on6the6right,6placing6them6
in6the6order6of6performance.6Use6all6the6steps.)6-6ans--
, First,6the6nurse6should6turn6off6the6IV6pump.6Next,6the6nurse6should6occlude6the6IV6tubin
g,6and6then6remove6the6tape6securing6the6catheter.6Last,6the6nurse6should6apply6pressur
e6over6the6catheter6insertion6site.
A6nurse6is6assessing6a6school-
age6child6who6has6an6acute6spinal6cord6injury6following6a6sports6injury616week6ago.6Identi
fy6the6area6the6nurse6should6tap6to6elicit6the6biceps6reflex.6(You6will6find6hot6spots6to6sele
ct6in6the6artwork6below.6Select6only6the6hot6spot6that6corresponds6to6your6answer.)6-6ans-
-A
A6nurse6is6caring6for6a6school-
age6child6who6is6receiving6chemotherapy6and6is6severely6immunocompromised.6Which6o
f6the6following6actions6should6the6nurse6take?6-6ans--
Screen6the6child's6visitors6for6indications6of6infection.
Rationale:6A6child6who6is6severely6immunocompromised6is6unable6to6adequately6respon
d6to6infectious6organisms,6resulting6in6the6potential6for6overwhelming6infection.6Therefore
,6the6nurse6should6screen6the6child's6visitors6for6indications6of6infection.
A6nurse6is6providing6teaching6to6the6parent6of6a6school-
age6child6who6has6a6new6prescription6for6oral6nystatin6for6the6treatment6of6oral6candidiasi
s.6Which6of6the6following6instructions6should6the6nurse6include?6-6ans--
"Shake6the6medication6prior6to6administration."
Rationale:6The6nurse6should6instruct6the6parent6to6shake6the6medication6prior6to6adminis
tration6to6disperse6the6medication6evenly6within6the6suspension.
A6nurse6is6teaching6a6group6of6parents6about6infectious6mononucleosis.6Which6of6the6foll
owing6statements6by6a6parent6indicates6an6understanding6the6teaching?6-6ans--
"Mononucleosis6is6caused6by6an6infection6with6the6Epstein-Barr6virus."
Rationale:6The6nurse6should6identify6that6mononucleosis6is6a6mildly6contagious6illness6th
at6occurs6sporadically6or6in6groups,6and6is6primarily6caused6by6the6Epstein-Barr6virus.
A6nurse6is6creating6a6plan6of6care6for6a6school-
age6child6who6has6heart6disease6and6has6developed6heart6failure.6Which6of6the6following
6interventions6should6the6nurse6include6in6the6plan?6-6ans--
Provide6small,6frequent6meals6for6the6child.
Rationale:6The6metabolic6rate6of6a6child6who6has6heart6failure6is6high6because6of6poor6ca
rdiac6function.6Therefore,6the6nurse6should6provide6small,6frequent6meals6for6the6child6be
cause6it6helps6to6conserve6energy.
A6nurse6is6providing6anticipatory6guidance6to6the6guardian6of6a6toddler.6Which6of6the6follo
wing6expected6behavior6characteristics6of6toddlers6should6the6nurse6include?6-6ans--
Expresses6likes6and6dislikes
PRACTICE 2023 A
A6nurse6in6an6emergency6department6is6caring6for6a6school-
age6child6who6is6experiencing6an6anaphylactic6reaction.6Which6of6the6following6is6the6pri
ority6action6by6the6nurse?6-6ans--Administer6epinephrine6IM6
Rationale:6When6using6the6urgent6vs.6non-
urgent6approach6to6client6care,6the6nurse6should6determine6that6the6priority6action6is6adm
inistering6epinephrine6IM6to6the6child.6During6an6anaphylactic6reaction,6histamine6release
6causes6bronchoconstriction6and6vasodilation.6This6is6an6emergency6because6ultimately6
it6causes6decreased6blood6return6to6the6heart.
A6nurse6in6a6pediatric6emergency6department6is6planning6care6for6an6adolescent.6Based6
on6the6information6in6the6adolescent's6medical6record,6which6of6the6following6actions6sho
uld6the6nurse6plan6to6take?
Select6all6that6apply.6-6ans--Apply6supplemental6oxygen
Rationale:6According6to6the6medical6record6and6chest6x-
ray6report,6the6adolescent6could6potentially6have6a6pneumothorax.6Also6according6to6the6
medical6record6and6chest6x-
ray6report,6the6adolescent's6oxygen6saturation6level6is6decreasing,6which6indicates6hypox
ia.6Therefore,6the6nurse6should6plan6to6administer6supplemental6oxygen.
Prepare6for6chest6tube6insertion
Rationale:6According6to6the6medical6record6and6chest6x-
ray6report,6the6adolescent6could6potentially6have6a6pneumothorax.6A6pneumothorax6is6th
e6presence6of6air6in6the6pleural6cavity,6which6results6in6decreased6lung6expansion.6The6a
dolescent6could6experience6dyspnea,6tachypnea,6tachycardia,6hypoxia,6and6pain.6This6r
equires6prompt6intervention6by6the6provider,6such6as6the6placement6of6a6chest6tube6into6t
he6thoracic6cavity6to6remove6air6and6fluid6from6the6pleural6space,6if6present,6allowing6the6
lung6to6re-expand.
A6nurse6in6an6emergency6department6is6caring6for6a6school-
age6child6who6has6epiglottitis.6Which6of6the6following6actions6should6the6nurse6take?6-
6ans--Monitor6the6child's6oxygen6saturation
,Rationale:6The6nurse6should6monitor6the6child's6oxygen6saturation6level6because6the6chil
d6is6experiencing6acute6respiratory6distress6and6it6is6necessary6to6determine6if6the6child6i
s6responding6to6treatment.
A6nurse6is6providing6teaching6about6play6activities6for6social6development6to6the6guardia
ns6of6a6preschooler.6Which6of6the6following6play6activities6should6the6nurse6recommend6f
or6the6child?6-6ans--Playing6dress-up
Rationale:6The6nurse6should6instruct6the6guardians6that6at6the6preschool6age,6play6shoul
d6focus6on6social,6mental,6and6physical6development.6Therefore,6playing6dress-
up6is6a6recommended6play6activity6for6this6child.
A6nurse6is6receiving6change-of-
shift6report6for6four6children.6Which6of6the6following6children6should6the6nurse6see6first?6-
6ans--A6school-
age6child6who6has6sickle6cell6anemia6and6reports6decreased6vision6in6the6left6eye
Rationale:6When6using6the6urgent6vs.6non-
urgent6approach6to6client6care,6the6nurse6should6determine6the6priority6finding6is6a6report
6of6decreased6vision6in6the6left6eye.6This6finding6indicates6that6the6child6is6experiencing6a
6vaso-
occlusive6crisis6and6should6be6reported6to6the6provider6immediately.6Therefore,6the6nurs
e6should6see6this6child6first.
A6nurse6is6providing6teaching6to6the6parents6of6a6preschooler6who6has6heart6failure6and6
a6new6prescription6for6digoxin6twice6daily.6Which6of6the6following6instructions6should6the6
nurse6include6in6the6teaching?6-6ans--
"Brush6the6child's6teeth6after6giving6the6medication."
Rationale:6The6nurse6should6instruct6the6parents6to6brush6the6child's6teeth6after6administ
ering6digoxin6to6prevent6tooth6decay6caused6by6the6medication,6which6comes6as6a6sweet
ened6liquid6to6enhance6the6taste.
A6nurse6is6providing6teaching6to6the6parent6of6an6infant6who6has6diaper6dermatitis.6The6n
urse6should6instruct6the6parent6to6apply6which6of6the6following6to6the6affected6area?6-
6ans--Zinc6oxide
Rationale:6Diaper6dermatitis6is6a6common6inflammatory6skin6disorder6caused6by6contact6
with6an6irritant6such6as6urine,6feces,6soap,6or6friction,6and6takes6the6form6of6scaling,6blist
ers,6or6papules6with6erythema.6Providing6a6protective6barrier,6such6as6zinc6oxide,6against
6the6irritants6allows6the6skin6to6heal.
A6nurse6is6caring6for6a6client6who6has6been6receiving6IV6fluids6via6a6peripheral6IV6cathete
r.6When6preparing6to6discontinue6the6IV6fluids6and6catheter,6which6of6the6following6action
s6should6the6nurse6plan6to6take?6(Move6the6steps6into6the6box6on6the6right,6placing6them6
in6the6order6of6performance.6Use6all6the6steps.)6-6ans--
, First,6the6nurse6should6turn6off6the6IV6pump.6Next,6the6nurse6should6occlude6the6IV6tubin
g,6and6then6remove6the6tape6securing6the6catheter.6Last,6the6nurse6should6apply6pressur
e6over6the6catheter6insertion6site.
A6nurse6is6assessing6a6school-
age6child6who6has6an6acute6spinal6cord6injury6following6a6sports6injury616week6ago.6Identi
fy6the6area6the6nurse6should6tap6to6elicit6the6biceps6reflex.6(You6will6find6hot6spots6to6sele
ct6in6the6artwork6below.6Select6only6the6hot6spot6that6corresponds6to6your6answer.)6-6ans-
-A
A6nurse6is6caring6for6a6school-
age6child6who6is6receiving6chemotherapy6and6is6severely6immunocompromised.6Which6o
f6the6following6actions6should6the6nurse6take?6-6ans--
Screen6the6child's6visitors6for6indications6of6infection.
Rationale:6A6child6who6is6severely6immunocompromised6is6unable6to6adequately6respon
d6to6infectious6organisms,6resulting6in6the6potential6for6overwhelming6infection.6Therefore
,6the6nurse6should6screen6the6child's6visitors6for6indications6of6infection.
A6nurse6is6providing6teaching6to6the6parent6of6a6school-
age6child6who6has6a6new6prescription6for6oral6nystatin6for6the6treatment6of6oral6candidiasi
s.6Which6of6the6following6instructions6should6the6nurse6include?6-6ans--
"Shake6the6medication6prior6to6administration."
Rationale:6The6nurse6should6instruct6the6parent6to6shake6the6medication6prior6to6adminis
tration6to6disperse6the6medication6evenly6within6the6suspension.
A6nurse6is6teaching6a6group6of6parents6about6infectious6mononucleosis.6Which6of6the6foll
owing6statements6by6a6parent6indicates6an6understanding6the6teaching?6-6ans--
"Mononucleosis6is6caused6by6an6infection6with6the6Epstein-Barr6virus."
Rationale:6The6nurse6should6identify6that6mononucleosis6is6a6mildly6contagious6illness6th
at6occurs6sporadically6or6in6groups,6and6is6primarily6caused6by6the6Epstein-Barr6virus.
A6nurse6is6creating6a6plan6of6care6for6a6school-
age6child6who6has6heart6disease6and6has6developed6heart6failure.6Which6of6the6following
6interventions6should6the6nurse6include6in6the6plan?6-6ans--
Provide6small,6frequent6meals6for6the6child.
Rationale:6The6metabolic6rate6of6a6child6who6has6heart6failure6is6high6because6of6poor6ca
rdiac6function.6Therefore,6the6nurse6should6provide6small,6frequent6meals6for6the6child6be
cause6it6helps6to6conserve6energy.
A6nurse6is6providing6anticipatory6guidance6to6the6guardian6of6a6toddler.6Which6of6the6follo
wing6expected6behavior6characteristics6of6toddlers6should6the6nurse6include?6-6ans--
Expresses6likes6and6dislikes
