RN Nursing Care of Children Proctored
Exam Latest Retake Guide
Teaching the parents of a school-aged child who has a new diagnosis of osteomyelitis of the tibia. The
nurse should identify that which of the following statements by the parents indicates an understanding
of the teaching? my child will have a cast until healing is complete.
My child will receive antibiotics for several weeks.
My child can return to playing sports once he is discharged. My
child needs to be in contact isolation.
Answer: b
The nurse should instruct the parent that the child will receive antibiotic therapy for at least 4
weeks. Surgery might be indicated if the antibiotics are not successful.
A - incorrect
Weight bearing must be avoided with osteomyelitis. Therefore, the child is placed in a
comfortable position with the limb supported. There is no indication for a cast.
C- incorrect
Weight bearing should be avoided to prevent complications and minimize pain. Therefore, it will
be several weeks to months before the child can play contact sports.
D- incorrect
Contact isolation is NOT necessary, because osteomyelitis is not a communicable illness.
A nurse is auscultating the lungs of an adolescent who has asthma. The nurse should identify the sound as
which of the following? Click the audio button to listen.
A- Biots respiration
B- Chaney Stokes respiration
C- tackypnea
D - Bradypnea
Answer- c
The nurse should identify the sound heard during auscultation as tachypnea, which is a rapid,
regular breathing pattern. This breathing pattern often occurs with anxiety, fever, metabolic
acidosis, or severe anemia.
A- Biot's respirations are periods of apnea alternating with two or three shallow breaths.
B- Cheyne-Stokes respirations are periods of apnea alternating with periods of hyperventilation.
D- Bradypnea is a slow, regular breathing pattern.
anaphylactic reaction
A nurse in an emergency department is caring for a school-age child who is experiencing an
. Which of the following is the priority action by the nurse?
A- Elevate the head of the child's bed
,B- insert a large-bore IV catheter for the child
C- determine the allergen that caused the child's reaction
D- administer IM epinephrine to the child
Answer- d
When using the urgent vs nonurgent approach to client care, the nurse determines that the
priority action is administering IM epinephrine to the child. During an anaphylactic reaction,
histamine release causes bronchoconstriction and vasodilation. This is an emergency because
ultimately it causes decreased blood return to the heart.
A- Elevating the head of the child's bed is important to facilitate breathing and circulation.
However, it is not the priority action the nurse should take.
B- Inserting a large bore IV catheter is important to facilitate administration of IV fluids and
medications. However, it is not the priority action the nurse should take.
C- Determining the allergen that caused the child's reaction is important to prevent any
additional episodes of anaphylaxis. However, it is not the priority action the nurse should take.
The nurse is preparing to administer an immunization to a four-year-old child . Which of the
following actions should the nurse plan to take?
A- Place the child in a prone position for the immunization
B- request that the child's caregiver leave the room during the immunization
C- administer the immunization using a 24 gauge needle
D- inject the immunization slowly after aspirating for 3 seconds
Answer - c
The nurse should administer an immunization for a 4-year-old child using a 24-gauge needle to
minimize the amount of pain experienced by the toddler.
A- The nurse should place the child in an upright sitting position for the immunization
because this decreases the child's fear and anxiety.
B- The nurse should allow the caregiver to stay near the child during the immunization to
provide a sense of security and reduce the child's anxiety level.
D- The nurse should inject the immunization rapidly and avoid aspiration. These actions
decrease the risk of needle displacement and lower the child's fear and anxiety level by
decreasing the amount of time it takes to administer the immunization.
A nurse is reviewing the laboratory report of an infant who is receiving treatment for severe The
dehydration. nurse should identify which of the following laboratory values indicates
effectiveness of the current treatment?
A- Potassium 2.9 mEq/L
,B- sodium 140
C- urine specific gravity 1.035
D- BUN 25 mg
Answer- b
The nurse should identify that a sodium level of 140 mEq/L is within the expected reference
range and indicates the current treatment regimen the infant is receiving for dehydration is
effective.
A- A potassium level of 2.9 mEq/L is below the expected reference range and indicates
hypokalemia.
C- A urine specific gravity of 1.035 is above the expected reference range and indicates
concentrated urine.
D- A BUN level of 25 mg/dL is above the expected reference range and indicates the
kidneys are not excreting BUN as they should be.
The nurse is providing teaching about Social Development to the parents of a preschooler.
Which of the following play activities should the nurse recommend for the child? A- Play pat-
a-cake
B- using a push pull toy
C- creating a scrapbook
D- playing dress-up
Answer - d
The nurse should instruct the parents that at the preschool age, play should focus on social,
mental, and physical development. Therefore, playing dress-up is a recommended play activity
for this child.
A- Playing pat-a-cake is a recommended play activity for an infant.
B- Using a push pull toy is a recommended play activity for a toddler.
C- Creating a scrapbook is a recommended play activity for a school-age child.
A nurse is teaching the parents of a newborn about ways to prevent sudden infant death syndrome
SIDS. Which of the following instructions should the nurse include?
A- Place the infant in a prone position to sleep.
B- Allow the infant to sleep on a large pillow.
C- User soft mattress in the infant's crib.
, D- Give the infant a pacifier at bedtime.
Answer- d
The nurse should inform the parent that protective factors against SIDS include breastfeeding
and the use of a pacifier when the infant is sleeping.
A- The nurse should instruct the parent to place the infant in a supine position to sleep.
Prone and side-lying positions are risk factors for SIDS.
B- Placing the infant on a large pillow to sleep can increase the risk of suffocation,
asphyxiation, and SIDS.
C- The nurse should instruct the parent to use a firm mattress and avoid the use of
waterbeds, beanbags, or soft mattresses when placing the infant to bed. The use of a soft
mattress in the infant's crib is a risk factor for SIDS and can lead to asphyxiation.
A nurse is assessing an infant who has pneumonia. Which of the following findings is the priority
for the nurse to report to the provider?
A- Nasal flaring
B- WBC 11,300
C- diarrhea
D- abdominal distension
Answer- a
When using the airway, breathing, circulation approach to client care, the nurse should place the
priority on nasal flaring. Nasal flaring indicates that the infant is experiencing acute respiratory
distress.
B- The nurse should report a WBC of 11,300/mm3 because it is above the expected reference
range and indicates infection. However, another finding is the priority for the nurse to report.
C- The nurse should report diarrhea because it is a manifestation of pneumonia in infants and
indicates the current treatment is not effective. However, another finding is the priority for the
nurse to report.
D- The nurse should report abdominal distension because it is a manifestation of pneumonia in
infants and indicates the current treatment is not effective. However, another finding is the
priority for the nurse to report.
A school nurse is assessing a school-age child blood pressure while he is seated in a chair.
The child starts to experience a tonic-clonic seizure. Which of the following actions should
the nurse take first?
A- Clear the immediate area around the child of hazardous objects
B- loosen the child restrictive clothing
C- assist the child to a side-lying position on the floor
D- apply an oxygen mask to the child
Exam Latest Retake Guide
Teaching the parents of a school-aged child who has a new diagnosis of osteomyelitis of the tibia. The
nurse should identify that which of the following statements by the parents indicates an understanding
of the teaching? my child will have a cast until healing is complete.
My child will receive antibiotics for several weeks.
My child can return to playing sports once he is discharged. My
child needs to be in contact isolation.
Answer: b
The nurse should instruct the parent that the child will receive antibiotic therapy for at least 4
weeks. Surgery might be indicated if the antibiotics are not successful.
A - incorrect
Weight bearing must be avoided with osteomyelitis. Therefore, the child is placed in a
comfortable position with the limb supported. There is no indication for a cast.
C- incorrect
Weight bearing should be avoided to prevent complications and minimize pain. Therefore, it will
be several weeks to months before the child can play contact sports.
D- incorrect
Contact isolation is NOT necessary, because osteomyelitis is not a communicable illness.
A nurse is auscultating the lungs of an adolescent who has asthma. The nurse should identify the sound as
which of the following? Click the audio button to listen.
A- Biots respiration
B- Chaney Stokes respiration
C- tackypnea
D - Bradypnea
Answer- c
The nurse should identify the sound heard during auscultation as tachypnea, which is a rapid,
regular breathing pattern. This breathing pattern often occurs with anxiety, fever, metabolic
acidosis, or severe anemia.
A- Biot's respirations are periods of apnea alternating with two or three shallow breaths.
B- Cheyne-Stokes respirations are periods of apnea alternating with periods of hyperventilation.
D- Bradypnea is a slow, regular breathing pattern.
anaphylactic reaction
A nurse in an emergency department is caring for a school-age child who is experiencing an
. Which of the following is the priority action by the nurse?
A- Elevate the head of the child's bed
,B- insert a large-bore IV catheter for the child
C- determine the allergen that caused the child's reaction
D- administer IM epinephrine to the child
Answer- d
When using the urgent vs nonurgent approach to client care, the nurse determines that the
priority action is administering IM epinephrine to the child. During an anaphylactic reaction,
histamine release causes bronchoconstriction and vasodilation. This is an emergency because
ultimately it causes decreased blood return to the heart.
A- Elevating the head of the child's bed is important to facilitate breathing and circulation.
However, it is not the priority action the nurse should take.
B- Inserting a large bore IV catheter is important to facilitate administration of IV fluids and
medications. However, it is not the priority action the nurse should take.
C- Determining the allergen that caused the child's reaction is important to prevent any
additional episodes of anaphylaxis. However, it is not the priority action the nurse should take.
The nurse is preparing to administer an immunization to a four-year-old child . Which of the
following actions should the nurse plan to take?
A- Place the child in a prone position for the immunization
B- request that the child's caregiver leave the room during the immunization
C- administer the immunization using a 24 gauge needle
D- inject the immunization slowly after aspirating for 3 seconds
Answer - c
The nurse should administer an immunization for a 4-year-old child using a 24-gauge needle to
minimize the amount of pain experienced by the toddler.
A- The nurse should place the child in an upright sitting position for the immunization
because this decreases the child's fear and anxiety.
B- The nurse should allow the caregiver to stay near the child during the immunization to
provide a sense of security and reduce the child's anxiety level.
D- The nurse should inject the immunization rapidly and avoid aspiration. These actions
decrease the risk of needle displacement and lower the child's fear and anxiety level by
decreasing the amount of time it takes to administer the immunization.
A nurse is reviewing the laboratory report of an infant who is receiving treatment for severe The
dehydration. nurse should identify which of the following laboratory values indicates
effectiveness of the current treatment?
A- Potassium 2.9 mEq/L
,B- sodium 140
C- urine specific gravity 1.035
D- BUN 25 mg
Answer- b
The nurse should identify that a sodium level of 140 mEq/L is within the expected reference
range and indicates the current treatment regimen the infant is receiving for dehydration is
effective.
A- A potassium level of 2.9 mEq/L is below the expected reference range and indicates
hypokalemia.
C- A urine specific gravity of 1.035 is above the expected reference range and indicates
concentrated urine.
D- A BUN level of 25 mg/dL is above the expected reference range and indicates the
kidneys are not excreting BUN as they should be.
The nurse is providing teaching about Social Development to the parents of a preschooler.
Which of the following play activities should the nurse recommend for the child? A- Play pat-
a-cake
B- using a push pull toy
C- creating a scrapbook
D- playing dress-up
Answer - d
The nurse should instruct the parents that at the preschool age, play should focus on social,
mental, and physical development. Therefore, playing dress-up is a recommended play activity
for this child.
A- Playing pat-a-cake is a recommended play activity for an infant.
B- Using a push pull toy is a recommended play activity for a toddler.
C- Creating a scrapbook is a recommended play activity for a school-age child.
A nurse is teaching the parents of a newborn about ways to prevent sudden infant death syndrome
SIDS. Which of the following instructions should the nurse include?
A- Place the infant in a prone position to sleep.
B- Allow the infant to sleep on a large pillow.
C- User soft mattress in the infant's crib.
, D- Give the infant a pacifier at bedtime.
Answer- d
The nurse should inform the parent that protective factors against SIDS include breastfeeding
and the use of a pacifier when the infant is sleeping.
A- The nurse should instruct the parent to place the infant in a supine position to sleep.
Prone and side-lying positions are risk factors for SIDS.
B- Placing the infant on a large pillow to sleep can increase the risk of suffocation,
asphyxiation, and SIDS.
C- The nurse should instruct the parent to use a firm mattress and avoid the use of
waterbeds, beanbags, or soft mattresses when placing the infant to bed. The use of a soft
mattress in the infant's crib is a risk factor for SIDS and can lead to asphyxiation.
A nurse is assessing an infant who has pneumonia. Which of the following findings is the priority
for the nurse to report to the provider?
A- Nasal flaring
B- WBC 11,300
C- diarrhea
D- abdominal distension
Answer- a
When using the airway, breathing, circulation approach to client care, the nurse should place the
priority on nasal flaring. Nasal flaring indicates that the infant is experiencing acute respiratory
distress.
B- The nurse should report a WBC of 11,300/mm3 because it is above the expected reference
range and indicates infection. However, another finding is the priority for the nurse to report.
C- The nurse should report diarrhea because it is a manifestation of pneumonia in infants and
indicates the current treatment is not effective. However, another finding is the priority for the
nurse to report.
D- The nurse should report abdominal distension because it is a manifestation of pneumonia in
infants and indicates the current treatment is not effective. However, another finding is the
priority for the nurse to report.
A school nurse is assessing a school-age child blood pressure while he is seated in a chair.
The child starts to experience a tonic-clonic seizure. Which of the following actions should
the nurse take first?
A- Clear the immediate area around the child of hazardous objects
B- loosen the child restrictive clothing
C- assist the child to a side-lying position on the floor
D- apply an oxygen mask to the child
