NR 328 CMS EXAM PRACTICE
QUESTIONS AND ANSWERS WITH
RATIONALES A + GRADE
GUARANTEED
NR 328 CMS EXAM PRACTICE
Which Interventions Are Included In The Management Of Nosebleeds In Children? Select
All That Apply.
A. Apply Warm Compresses To The Bridge Of The Nose If Bleeding Is Persistent.
B. Apply Continuous Pressure To The Nose With Thumb And Forefinger For At Least 10
Minutes.
C. Have The Child Sit Down And Tilt The Head Backward.
D. Insert Cotton Or Wadded Tissue Into Each Nostril If Bleeding Persists.
E. Instruct The Child To Breathe Through The Mouth.
Answer: B, D, E
Rationale: During A Nosebleed, The Child Should Be Instructed To Breathe Through The
Mouth, Cotton Or Wadded Tissue Can Be Inserted Into The Nostrils To Stop Bleeding, And
Continuous Pressure Using The Thumb And Forefinger Should Be Applied For At Least 10
Minutes. The Child Should Be Instructed To Sit Up And Lean Forward, Not Tilt The Head
Backward. Ice Or Cold Cloths, Not Warm Compresses, Can Be Used On The Bridge Of The
Nose If Bleeding Persists.
The Nurse Is Developing A Teaching Plan For The Family Of A Toddler Recently
Diagnosed With Sickle Cell Disease. Of Which Does The Nurse Include As Important For
The Family To Be Aware And To Report In Order To Recognize Signs Of The Major
Cause Of Death For Children Under Age 5 With Sickle Cell Disease?
A. Presence Of Respiratory Problems
B. Signs And Symptoms Of Stroke
C. Localized Swelling Over Joints
D. Presence Of Fever
,Answer: D
Rationale: The Major Cause Of Death For Children With Sickle Cell Disease Under The Age Of
5 Is Overwhelming Infections; Thus The Family Needs To Monitor The Child Closely For
Presence Of Fever. Signs And Symptoms Of Stroke, Presence Of Respiratory Problems, And
Localized Swelling Over Joints Are Also Symptoms Of Issues Related To Sickle Cell Disease,
But Are Not Directly Related To The Leading Cause Of Death For Children Under The Age Of
5.
Brainpower
Read More
Which Symptom Would The Nurse Recognize As An Acquired Immunodeficiency
Syndrome (Aids)-Defining Condition In An American Child With Human
Immunodeficiency Virus (Hiv)?
A. Parotitis
B. Cytomegalovirus
C. Oral Candidiasis
D. Hepatosplenomegaly
Answer: B
Rationale: Cytomegalovirus Is A Defining Condition For Aids In An Hiv-Infected American
Child. Parotitis, Oral Candidiasis, And Hepatosplenomegaly Are Common Clinical
Manifestations Of Hiv Infection In Children But Not Aids-Defining Conditions.
The Nurse Is Administering A Blood Transfusion To A Child For Treatment Of
Hemophilia. Upon Assessment, The Nurse Notes That The Child Is Cyanotic, Has
Difficulty Breathing, And Has Rales Upon Inspiration Throughout The Lung Fields. What
Is The Nurse’s Best Response To These Findings?
A. Stop The Transfusion Immediately.
B. Administer Epinephrine Immediately.
C. Insert A Urinary Catheter And Monitor Hourly Outputs.
D. Reassess The Patient Again In Five Minutes.
Answer: A
Rationale: Cyanosis, Rales, And Difficulty Breathing Are All Potential Signs Of Circulatory
Overload. If Signs Of Circulatory Overload Occur, The Transfusion Should Be Stopped
Immediately. Reassessing The Patient In Five Minutes Would Not Provide An Immediate
Response To The Situation. Epinephrine Is Administered For Allergic Reactions. Insertion Of A
Urinary Catheter May Be Done To Treat An Incompatibility Reaction.
The Nurse Is Teaching The Family Of A Child Diagnosed With Iron-Deficiency Anemia
About The Proper Administration Of Iron Supplements. Which Points Should The Nurse
Include In The Education Session? Select All That Apply.
A. Stop The Medication And Call The Primary Care Provider If Tarry Stools Are Noted.
B. Administer With Milk Products To Alter The Taste If Taste Is An Issue.
, C. Administer In Two Divided Doses Between Meals.
D. Administer With Citrus Fruits Or Juices To Increase Absorption.
E. Use A Straw To Administer The Iron If It Is In Liquid Form.
Answer: C, D, E
Rationale: The Family Should Be Instructed To Administer The Iron Supplement In Two
Divided Doses Between Meals, When Free Hydrochloric Acid Is At Its Greatest Levels To Aid
In Absorption. Using A Straw For Liquid Iron Is Recommended To Avoid Staining The Teeth.
Citrus Fruits Or Juices Also Help Increase Acidity And Therefore Absorption Of The Iron. Milk
Products Bind The Iron And Interfere With Absorption And Should Not Be Used With
Administration Of Iron. Tarry Stools Are An Expected Change With Iron Supplements, And
Therefore Calling The Primary Care Provider Is Not Necessary
The Family Of A Child Hospitalized For Care During A Sickle Cell Crisis Calls The Nurse
Into The Room Because The Child Is Struggling To Breathe. Upon Assessment, The Nurse
Notes A Respiratory Rate Of 30 And That The Child Is Clutching The Abdomen And
Crying. What Does The Nurse Determine The Child May Be Experiencing?
A. Deficient Fluid Volume
B. Acute Chest Syndrome
C. Increasing Splenomegaly
D. Cerebrovascular Accident
Answer: B
Rationale: In A Child Experiencing A Sickle Cell Crisis, Dyspnea, Tachypnea, And Severe
Abdominal Pain Can Indicate Acute Chest Syndrome, Which Can Be Fatal If Not Addressed
Immediately. Deficient Fluid Volume Is Characterized By Loss Of Skin Turgor, Dry Mucous
Membranes, Sunken Eyes, Dark Urine, And Rapid Breathing Or Rapid Thready Pulse. Severe
Unrelieved Headaches, Vomiting, Seizures, Weakness, Or Inability To Move A Limb Or Hands
And Feet Can All Indicate Cerebrovascular Accident. Increasing Splenomegaly Would Be
Determined By Measuring The Spleen.
The School Nurse Is Caring For A Boy With Hemophilia Who Fell On His Arm During
Recess. What Supportive Measures Should The Nurse Use Until Factor Replacement
Therapy Can Be Instituted?
A. Applying Pressure For At Least 1 Minute
B. Beginning Passive Range-Of-Motion Exercise Unless The Pain Is Severe
C. Elevating The Area Above The Level Of The Heart
D. Applying Warm, Moist Compresses
Answer: C
Rationale: The Initial Response Should Include Elevation Of The Arm To Minimize Bleeding.
Cold Should Be Applied To The Arm. This Will Aid In Vasoconstriction, Which Will In Turn
Minimize Blood Loss. Pressure Is Effective In Small Areas But Would Not Be As Effective For
QUESTIONS AND ANSWERS WITH
RATIONALES A + GRADE
GUARANTEED
NR 328 CMS EXAM PRACTICE
Which Interventions Are Included In The Management Of Nosebleeds In Children? Select
All That Apply.
A. Apply Warm Compresses To The Bridge Of The Nose If Bleeding Is Persistent.
B. Apply Continuous Pressure To The Nose With Thumb And Forefinger For At Least 10
Minutes.
C. Have The Child Sit Down And Tilt The Head Backward.
D. Insert Cotton Or Wadded Tissue Into Each Nostril If Bleeding Persists.
E. Instruct The Child To Breathe Through The Mouth.
Answer: B, D, E
Rationale: During A Nosebleed, The Child Should Be Instructed To Breathe Through The
Mouth, Cotton Or Wadded Tissue Can Be Inserted Into The Nostrils To Stop Bleeding, And
Continuous Pressure Using The Thumb And Forefinger Should Be Applied For At Least 10
Minutes. The Child Should Be Instructed To Sit Up And Lean Forward, Not Tilt The Head
Backward. Ice Or Cold Cloths, Not Warm Compresses, Can Be Used On The Bridge Of The
Nose If Bleeding Persists.
The Nurse Is Developing A Teaching Plan For The Family Of A Toddler Recently
Diagnosed With Sickle Cell Disease. Of Which Does The Nurse Include As Important For
The Family To Be Aware And To Report In Order To Recognize Signs Of The Major
Cause Of Death For Children Under Age 5 With Sickle Cell Disease?
A. Presence Of Respiratory Problems
B. Signs And Symptoms Of Stroke
C. Localized Swelling Over Joints
D. Presence Of Fever
,Answer: D
Rationale: The Major Cause Of Death For Children With Sickle Cell Disease Under The Age Of
5 Is Overwhelming Infections; Thus The Family Needs To Monitor The Child Closely For
Presence Of Fever. Signs And Symptoms Of Stroke, Presence Of Respiratory Problems, And
Localized Swelling Over Joints Are Also Symptoms Of Issues Related To Sickle Cell Disease,
But Are Not Directly Related To The Leading Cause Of Death For Children Under The Age Of
5.
Brainpower
Read More
Which Symptom Would The Nurse Recognize As An Acquired Immunodeficiency
Syndrome (Aids)-Defining Condition In An American Child With Human
Immunodeficiency Virus (Hiv)?
A. Parotitis
B. Cytomegalovirus
C. Oral Candidiasis
D. Hepatosplenomegaly
Answer: B
Rationale: Cytomegalovirus Is A Defining Condition For Aids In An Hiv-Infected American
Child. Parotitis, Oral Candidiasis, And Hepatosplenomegaly Are Common Clinical
Manifestations Of Hiv Infection In Children But Not Aids-Defining Conditions.
The Nurse Is Administering A Blood Transfusion To A Child For Treatment Of
Hemophilia. Upon Assessment, The Nurse Notes That The Child Is Cyanotic, Has
Difficulty Breathing, And Has Rales Upon Inspiration Throughout The Lung Fields. What
Is The Nurse’s Best Response To These Findings?
A. Stop The Transfusion Immediately.
B. Administer Epinephrine Immediately.
C. Insert A Urinary Catheter And Monitor Hourly Outputs.
D. Reassess The Patient Again In Five Minutes.
Answer: A
Rationale: Cyanosis, Rales, And Difficulty Breathing Are All Potential Signs Of Circulatory
Overload. If Signs Of Circulatory Overload Occur, The Transfusion Should Be Stopped
Immediately. Reassessing The Patient In Five Minutes Would Not Provide An Immediate
Response To The Situation. Epinephrine Is Administered For Allergic Reactions. Insertion Of A
Urinary Catheter May Be Done To Treat An Incompatibility Reaction.
The Nurse Is Teaching The Family Of A Child Diagnosed With Iron-Deficiency Anemia
About The Proper Administration Of Iron Supplements. Which Points Should The Nurse
Include In The Education Session? Select All That Apply.
A. Stop The Medication And Call The Primary Care Provider If Tarry Stools Are Noted.
B. Administer With Milk Products To Alter The Taste If Taste Is An Issue.
, C. Administer In Two Divided Doses Between Meals.
D. Administer With Citrus Fruits Or Juices To Increase Absorption.
E. Use A Straw To Administer The Iron If It Is In Liquid Form.
Answer: C, D, E
Rationale: The Family Should Be Instructed To Administer The Iron Supplement In Two
Divided Doses Between Meals, When Free Hydrochloric Acid Is At Its Greatest Levels To Aid
In Absorption. Using A Straw For Liquid Iron Is Recommended To Avoid Staining The Teeth.
Citrus Fruits Or Juices Also Help Increase Acidity And Therefore Absorption Of The Iron. Milk
Products Bind The Iron And Interfere With Absorption And Should Not Be Used With
Administration Of Iron. Tarry Stools Are An Expected Change With Iron Supplements, And
Therefore Calling The Primary Care Provider Is Not Necessary
The Family Of A Child Hospitalized For Care During A Sickle Cell Crisis Calls The Nurse
Into The Room Because The Child Is Struggling To Breathe. Upon Assessment, The Nurse
Notes A Respiratory Rate Of 30 And That The Child Is Clutching The Abdomen And
Crying. What Does The Nurse Determine The Child May Be Experiencing?
A. Deficient Fluid Volume
B. Acute Chest Syndrome
C. Increasing Splenomegaly
D. Cerebrovascular Accident
Answer: B
Rationale: In A Child Experiencing A Sickle Cell Crisis, Dyspnea, Tachypnea, And Severe
Abdominal Pain Can Indicate Acute Chest Syndrome, Which Can Be Fatal If Not Addressed
Immediately. Deficient Fluid Volume Is Characterized By Loss Of Skin Turgor, Dry Mucous
Membranes, Sunken Eyes, Dark Urine, And Rapid Breathing Or Rapid Thready Pulse. Severe
Unrelieved Headaches, Vomiting, Seizures, Weakness, Or Inability To Move A Limb Or Hands
And Feet Can All Indicate Cerebrovascular Accident. Increasing Splenomegaly Would Be
Determined By Measuring The Spleen.
The School Nurse Is Caring For A Boy With Hemophilia Who Fell On His Arm During
Recess. What Supportive Measures Should The Nurse Use Until Factor Replacement
Therapy Can Be Instituted?
A. Applying Pressure For At Least 1 Minute
B. Beginning Passive Range-Of-Motion Exercise Unless The Pain Is Severe
C. Elevating The Area Above The Level Of The Heart
D. Applying Warm, Moist Compresses
Answer: C
Rationale: The Initial Response Should Include Elevation Of The Arm To Minimize Bleeding.
Cold Should Be Applied To The Arm. This Will Aid In Vasoconstriction, Which Will In Turn
Minimize Blood Loss. Pressure Is Effective In Small Areas But Would Not Be As Effective For
