1) A nurse is assisting a child who has multiple closed fractures of the lower extremities due to a motorvehicle crash. The nurse should monitor the child
... [Show More] for which of the following complications during the
first 24 hr after the injury occurred?
c. Volkmann ischemic contracture
2) A nurse is teaching the parent of a toddler who has phenylketonuria about meal planning. Which of
the following information should the nurse include in the teaching?
b. Avoid foods containing milk products
3) A nurse at an inpatient facility is planning care for a child who has autism spectrum disorder. Which of
the following interventions should the nurse include in the plan of care?
c. Keep staff visits with the child brief
4) A nurse is assisting an infant who has severe dehydration due to gastroenteritis. Which of the
following findings should the nurse expect?
c. Increase respiratory rate
5) A nurse is planning care for a child who has cystic fibrosis. Which of the following interventions should
the nurse plan to include?
d. Use a vest to perform high-frequency chest compressions
6) A nurse is teaching the parent of a school age child about bicycle safety. Which of the following
instructions should the nurse include in the teaching?
b. Your child should walk the bicycle through intersections
7) A nurse is preparing a child for a lumbar puncture. In which of the following positions should the child
be placed for the procedure?
a. Lateral
8) A nurse is reviewing the complete blood count results for a child who is receiving treatment for acute
lymphoblastic leukemia. Which of the following findings should indicate to the nurse that the treatment
is having a therapeutic effect?
d. RBC count 5/mm
9) A nurse is caring for a school age child who has pertussis. Which of the following actions should the
nurse take?
a. Report the diagnosis to the public health department
b. Place the child in a protected environment for 48hr ?
c. Administer the pertussis vaccine
d. Restrict oral fluids to 500mL per day10) A nurse is assessing a week old infant. The nurse should identify which of the following
manifestations can indicate neonatal abstinence syndrome?
d. Lethargy
11 )A nurse is preparing to initiate IV antibiotic therapy for a newly admitted 12 month-old infant. Which
of the following actions should the nurse plan to take?
c. Cover the insertion site with an opaque dressing
12) A nurse is assessing a toddler who is 8 hr. postoperative following a cardiac catheterization
procedure. Which of the following findings should the nurse report to the provider?
c. Bilateral cool extremities
18) A nurse is providing teaching to the parents of a child who has varicella about management of the
disease. Which of the following instructions should the nurse include in the teaching?
b. Keep the child away from others until the skin is clever of scabs
30) A nurse is planning care for a child who is experiencing a sickle cell crisis. Which of the following
interventions should the nurse include in the plan of care?
d. Apply cold compresses to affected joints
31) A charge nurses teaching a group of nurses about identifying child abuse. Which of the following
findings should the nurse identify as a potential indicator of child abuse?
b. A toddler repeatedly refuses to let a nurse auscultate his lungs
32) A nurse is teaching the guardian of a 5 year old child who has encopresis about management of the
condition. Which of the following statements by the guardian indicates an understanding of the
teaching?
d. I will have my child try to defecate 15 minutes after each meal
33) A nurse is assisting an infant who has respiratory syncytial virus. For which of the following findings
should the nurse intervene?
a. Brisk capillary refill
b. Tachypnea
c. Rhinorrhea
d. Coughing
34) A nurse is performing a health assessment for a 6 month old infant. The nurse should begin the
assessment by performing which of the following actions while the infant is quiet and sitting on the
guardians lap?
a. Obtaining the infant's health history from the guardian35) A nurse is caring for an adolescent who has major depressive disorder. Which of the following actions
should the nurse take first
d. assist the client in completing his ADLs
36) A nurse is caring for a child in the PACU following a tonsillectomy. Which of the following findings
requires immediate intervention by the nurse?
d. Frequent swallowing
37) A nurse in the emergency department is caring for a school age child who has developed respiratory
stridor, wheezing, and urticarial after receiving an IV medication. Which of the following actions should
the nurse take first?
d. Administer epinephrine
38) A nurse is caring for an infant who has a patent ductus arteriosus. The nurse should identify that the
defect is at which of the following locations of the heart? ( You will find hot spots to select in the artwork
below. Select only the hot spot that corresponds to your answer.)
B A C D
The correct answer is =
39) A nurse is caring for a school aged child who is 1hr postoperative following a tonsillectomy. Which of
the following actions should the nurse take first? ( Select all that apply)
b. Observe the child for frequent swallowing
c. Discourage the child from coughing
d. Administer an analgesic to the child on a scheduled basis
40) a nurse is teaching the guardian of an infant who has congestive heart failure about methods to
preserve energy during bottle feeding. Which of the following statements by the guardian indicates a
clear understanding of the teaching?
a. I will feed my baby every 2 hours
41) A nurse in a family practice clinic is assessing a preschool age child who recently experienced the
death of a sibling. Which of the following reactions in an age appropriate response to death?
b. The child feels responsible for the siblings death
59) A nurse is teaching a parent of a toddler about administering digoxin. Which of the following
statements by the parent indicates a clear understanding of the teaching?
c. I should give my child water after giving the medication60) A nurse is providing a teaching to the guardian of a 2year old about typical toddler behavior. Which
of the following behaviors should the nurse include?
a. Frequency negative responses
61) A nurse is caring for a client who is postoperative following placement of a halo vest to manage a
cervical vertebral fracture. Which of the following actions should the nurse take?
c. Reposition the client using a turning sheet
62) A nurse is caring for a 1 year old infant who has GERD. Which of the following actions should the
nurse take to promote sleep for the infant?
a. Place the infant in surprise position to sleep
63) A nurse is assessing a toddler who has a history of lead poisoning. Which of the following actions
should the nurse take?
c. Perform development testing for delays
64) A nurse is collecting data from a toddler who weighs 25 kg (44ib) and has a full thickness burn to 10%
of his body. Which of the following findings should the nurse report to the provider?
c. Increased restlessness
65) A nurse is educating an adolescent following the application of an arm cast. Which of the following
statements by the client indicates an understanding of the teaching?
b. I should limit the use of fingers of my broken arm
66) A nurse is teaching a parent about home interventions for a preschooler who is experiencing night
terrors. Which of the following instructions should the nurse include in the teaching?
b. Avoid allowing your child to sleep in your bed
67) A nurse is reviewing the laboratory results of a preschooler who has gastroenteritis and notes the
client's potassium level is 3.2 mEq/L. Which of the following assessment findings should the nurse
expect?
c. Hyperactive bowel sounds
68) A nurse is assessing a child who has heart failure. Which of the following findings is a clinical
manifestation associated with this diagnosis?
a. Tachypnea
69) A nurse is planning to administer ondansetron 0.15 mg/kg IV to a child who is receiving
chemotherapy and weighs 29.4kg. Available is ondansetron 4 mg/2 solution. How many mL should the
nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a
trailing zero.)
mL13. A nurse is caring for an adolescent who has scoliosis and is refusing to wear a back brace which of
the following statement should the nurse make?
b. Let’s sit down and discuss why you do not want to wear the brace.
14. A nurse is providing teaching to a parent of a child who has HIV. which of the following statements by
the parent indicates an understanding of the teaching?
a. I will ensure that my child is tested for tuberculosis every year.
15.A nurse is caring for a 2-month-old infant who has heart failure and is receiving furosemide. Which of
the following finding is the nurse’s priority ?
b. negative doll’s eye reflex.
16.A nurse in an emergency department is caring for a child who experienced submersion injury. Which
of the following is the priority action for the nurse to take?
c. Assist with intubation.
17.A nurse is caring for a school- age child who is experiencing a sickle cell crisis. Which of the following
action s should the nurse take ?
b. Apply warm compresses to the affected area.
19. A nurse is planning care for an adolescent following repair of Meckel diverticulum. Which of the
following action should the nurse include in the plan of care?
b. Maintain an NG tube for decompression.
20. A nurse is teaching a parent of a10-month-old infant about home safety. Which of the following
instructions should the nurse include in the teaching?( select all that apply).
a. place gate at the top and bottom of the stairs.
b. Ensure the crib mattress is in the lowest position.
21. A nurse is communicating with a child who had hearing loss. Which of the following action should
the nurse take?
d. use light touch when initiating conversation.
22. A nurse is creating plan of care for an adolescent who has muscular dystrophy. Which of the
following intervention should the include in the plan ?
c .recommend the adolescent use a wheel chair to prevent stress the lower extremities.
23. A nurse is creating a plan of care for a toddler who is recovering following a routine surgical
procedure. Which of the following interventions should the include.
c. encourage the toddler to use an incentive spirometer.24. a nurse is caring for a child who has bacterial meningitis. Which of the following finding s should
indicate to the nurse that the child can be removed from droplet precaution?
a. antibiotics initiated 24hr ago
25. A nurse is preparing to perform a venipuncture to collect a blood sample from an infant. Which of
the following restraints should the nurse plan to use for this this procedure.
a. Mummy
b. Elbow ?
c. Mitten
d. Jacket
27. a nurse is planning to perform tracheostomy care for a toddler . which of the following is an
appropriated action for nurse to take?
a. use clean technique to change the tracheostomy tube.
28. A nurse is teaching an adolescent who has type1 diabetes mellitus. Which of the following finding is
the nurse priority?
d. pre-prandial blood glucose.124mg/dL.
42. A nurse is planning to admit a preschooler from the PACU following removal of a Wilms’ tumor.
Which of the following children should the nurse identify as an appropriate roommate for the
preschooler ?
a. A child who has a fractured lef t femur.
43.A nurse is planning to administer immunizations to a 2-month –old infant. Which of the following
actions should the nurse take to decrease the infant pain.
d. Administer the injections while the infant is breastfeeding.
44. A nurse is caring for a 4-year old child who is postoperative following an appendectomy. Which of the
following pain rating scales should the nurse use to assess the child’s need for pain medication ?
c. FACE
45. A nurse is reviewing the medical record of a 15-month –old child who is schedule to receive the
measles. Mumps. And rubella MMR vaccine. Which of the following finding should the nurse identify as
a contraindication for receiving this vaccine.
a. Allergy to neomycin
46A nurse is caring for a child who received partial –thickness burn s to over 50% of his body 10 days ago
and has splints over his joints to prevent contractures. Which of the following action should the nurse
take? ( select all that apply.).
b. Administer analgesi [Show Less]