An infant has tetralogy of Fallot. In reviewing the record, what laboratory result should the nurse expect to be documented?
a. Increased platelet
... [Show More] level
b. Leukopenia
c. Polycythemia
d. Anemia
• Question 2
2 out of 2 points
What is the most profound complication of prolonged middle ear disorders?
a.
Loss of hearing
b. Failure to thrive
c. Visual impairment
d. Tympanic membrane rupture
• Question 3
2 out of 2 points
A health care provider prescribes captopril (Capoten), 2.5 mg PO every 12 h for a child with heart failure. The medication label states: “Captopril 5 mg/5 ml.” The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer using one decimal place.
____________2.5____
• Question 4
2 out of 2 points
A 4-year-old girl is brought to the emergency department. She has a “froglike” croaking sound on inspiration, is agitated, and is drooling. She insists on sitting upright. The nurse should intervene in which manner?
a. Notify the physician immediately and be prepared to assist with a tracheostomy or intubation.
b. Make her lie down and rest quietly.
c. Examine her oral pharynx and report to the physician.
d. Auscultate her lungs and prepare for placement in a mist tent.
• Question 5
2 out of 2 points
What child has a congenital heart defect with decreased pulmonary blood flow?
a. An infant with patent ductus arteriosus
b. A 2-month-old infant with tetralogy of Fallot
c. A 6-month-old infant with repaired ventricular septal defect
d. A 1-year-old infant with atrial septal defect
• Question 6
2 out of 2 points
An infant’s parents ask the nurse about preventing otitis media (OM). What information should be provided?
a. Use nasal decongestants.
b. Bottle- or breastfeed in a supine position.
c. Avoid children with OM.
d. Avoid tobacco smoke.
• Question 7
0 out of 2 points
A 3-year-old child is experiencing pain after a tonsillectomy. The child has not taken in any fluids and does not want to drink anything, saying, “My throat hurts.” The following health care prescriptions are available: acetaminophen (Tylenol) PO (orally) or PR (rectally) PRN, ice chips, clear liquids. What should the nurse implement to relieve the child’s pain?
a. Popsicle
b. Ice chips
c. Tylenol PR
d. Tylenol PO
• Question 8
2 out of 2 points
A child post- tonsillectomy is being discharged from the hospital. What is the most appropriate suggestion made by the nurse for postoperative management of the child in the home setting?
a. Ice cream should be avoided.
b. Diluted citrus juice can be given.
c. A straw can be used to help drink fluids.
d. Fluids with a red or brown color should be avoided.
• Question 9
2 out of 2 points
What is a priority nursing diagnosis for the 4-year-old child newly diagnosed with leukemia?
a. Ineffective Breathing Pattern related to mediastinal disease
b. Risk for Infection related to immunosuppressed state
c. Disturbed Body Image related to alopecia
d. Impaired Skin Integrity related to radiation therapy
• Question 10
2 out of 2 points
Which is the most important laboratory test result that must be evaluated before administering digoxin to a child with congestive heart failure?
a. Serum sodium level
b. Serum chloride level
c. Serum potassium level
d. Serum bicarbonate level
• Question 11
0 out of 2 points
The physician suggests that surgery be performed for patent ductus arteriosus (PDA) to prevent which complication?
a. Right-to-left shunt of blood
b. Hypoxemia
c. Decreased workload on the left side of the heart
d. Pulmonary vascular congestion
• Question 12
2 out of 2 points
A child has been diagnosed with a Wilms tumor. What should preoperative nursing care include?
a. Careful bathing and handling
b. Maintenance of strict isolation
c. Administration of packed red blood cells
d. Monitoring of behavioral status
• Question 13
2 out of 2 points
What childhood cancer may demonstrate patterns of inheritance that suggest a familial basis?
a. Leukemia
b. Rhabdomyosarcoma
c. Retinoblastoma
d. Osteogenic sarcoma
• Question 14
2 out of 2 points
What are the most common clinical manifestations of brain tumors in children?
a. Blurred vision and ataxia
b. Headaches and vomiting
c. Hydrocephalus and clumsy gait
d. Fever and poor fine motor control
• Question 15
2 out of 2 points
The nurse reviews the laboratory report of a child with leukemia who is receiving chemotherapy. The nurse notices that the platelet count is severely reduced. Based on the laboratory report, what does the nurse include in the plan of care?
a. To use a soft brush for dental care
b. To encourage frequent fluid intake
c. To monitor the child’s temperature every four hours
d. To administer a broad-spectrum antibiotic as prescribed
• Question 16
2 out of 2 points
What frequent complication of treatment for childhood cancer results from neutropenia?
a.Alopecia
b. Infection
c. Mood changes
d. Nausea and vomiting
• Question 17
2 out of 2 points
A 6-year-old child is in the hospital for status asthmaticus. Nursing care during this acute period includes which prescribed interventions?
a.
Methylprednisolone (Solumedrol) IV every 12 hours, continuous pulse oximetry, albuterol nebulizer treatments every 4 hours and prn
b. Prednisolone (Pediapred) PO every day, IV fluids, cromolyn (Intal) inhaler bid
c. Triamcinolone (Azmacort) inhaler bid, continuous pulse oximetry, vital signs once a shift
d. Salmeterol (Serevent) PO bid, vital signs every 4 hours, spot check pulse oximetry
• Question 18
2 out of 2 points
A 6-Year-Old child has experienced a viral illness for the past week and presents with rapid onset of fever and ear pain overnight. Why do these symptoms indicate acute otitis media (AOM rather than otitis media with effusion (OME)?
a. Otitis media with effusion cannot follow a viral infection. OME may follow a viral infection, but it is not associated with rapid onset of fever or ear pain
b. Acute otitis media presents with rapid onset and signs and symptoms of infection
c. The main manifestation of otitis media with effusion is ear pain. OME can present with little to no symptoms.
d. Acute otitis media lasts longer than otitis media with effusion. OME usually lasts longer (often for weeks or months) and is more chronic than AOM.
• Question 19
2 out of 2 points
What is a common side effect of several chemotherapeutic drugs?
a. Hair loss
b. Glossomegaly
c. Increased energy
d. Increased appetite
• Question 20
2 out of 2 points
A 3-month-old infant has a hypercyanotic spell. What should be the nurse’s first action?
a. Begin cardiopulmonary resuscitation.
b. Prepare the family for imminent death.
c. Place the child in the knee–chest position.
d. Assess for neurologic defects.
• Question 21
2 out of 2 points
The nurse is caring for a child who presents with tachypnea, cyanosis, and periods of apnea.
ABG results show pH 7.32, CO2 35, HCO3 18, paO2 78.
The nurse also notes diminished breath sounds bilaterally.
Labs are obtained. Which action should the nurse take?
a. Start oxygen inhalation.
b. Document the ABG finding
c. Administer a bronchodilator
d. Notify the health care provider
• Question 22
2 out of 2 points
The health care provider prescribes ceftazidime (Fortaz) 75 mg per intravenous piggy back (IVPB) every 8 hours for a child with cystic fibrosis. The pharmacy sends the medication to the unit in a 100-ml bag with directions to run the medication over 30 minutes. What milliliters per hour will the nurse set the intravenous pump to run the medication over 30 minutes? Fill in the blank and record your answer in a whole number.
_____________
• Question 23
1 out of 2 points
A child on chemotherapy has developed rectal ulcers. What interventions should the nurse teach to the child and parents to relieve the discomfort of rectal ulcers? (Select all that apply.)
a. Record bowel movements
b. Use of an opioid for discomfort
c. Warm sitz baths
d. Occlusive ointment applied to the area
e. Use of stool softeners
• Question 24
2 out of 2 points
What is an important priority in dealing with the child suspected of having Wilms tumor?
a. Monitoring temperature for infection
b. Ensuring the abdomen is protected from palpation
c. Teaching parents how to manage the parenteral nutrition
d. Intervening to minimize bleeding
• Question 25
2 out of 2 points
What action by the school nurse is important in the prevention of rheumatic fever (RF)?
a. Recommend salicylates instead of acetaminophen for minor discomforts.
b. Conduct routine blood pressure screenings.
c. Encourage routine cholesterol screenings.
d. Refer children with sore throats for throat cultures.
• Question 26
0 out of 2 points
The parents of a child with cancer tell the nurse that a bone marrow transplant (BMT) may be necessary. What information should the nurse recognize as important when discussing this with the family?
Answers: a. If BMT fails, chemotherapy or radiotherapy will need to be continued.
b. Finding a suitable donor involves matching antigens from the human leukocyte antigen (HLA) system.
c. Parents and siblings of the child have a 25% chance of being a suitable donor.
d. BMT should be done at the time of diagnosis.
• Question 27
2 out of 2 points
After cardiac catheterization of a child, which assessment finding is a cause of concern to the nurse?
Answers: a. The pulse distal to the catheterization site is weak.
b. The affected extremity feels cool when touched.
c. The child has resumed oral intake with clear liquids.
d. The child is in bed with the affected extremity straight.
• Question 28
2 out of 2 points
What is a common clinical manifestation of Hodgkin disease?
Answers: a. Bone and joint pain
b. Nontender enlargement of lymph nodes
c. Petechiae
d. Painful, enlarged lymph nodes
• Question 29
2 out of 2 points
The nurse is administering an intravenous chemotherapeutic agent to a child with leukemia. The child suddenly begins to wheeze and have severe urticaria. What nursing action is most appropriate to initiate?
Answers: a. Recheck the rate of drug infusion.
b. Stop the drug infusion immediately.
c. Observe the child closely for next 10 minutes.
d. Explain to the child that this is an expected side effect.
• Question 30
0 out of 2 points
A child with leukemia is receiving intrathecal chemotherapy to prevent which condition?
Answers: a. Drug side effects
b. Central nervous system (CNS) disease
c. Brain tumor
d. Infection
• Question 31
2 out of 2 points
The nurse is caring for a school-age girl who has had a cardiac catheterization. The child tells the nurse that her bandage is “too wet.” The nurse finds the bandage and bed soaked with blood. What nursing action is most appropriate to institute initially?
Answers: a. Apply a new bandage with more pressure.
b. Apply direct pressure above the catheterization site.
c. Notify the physician.
d. Place the child in Trendelenburg position.
• Question 32
2 out of 2 points
What drug is usually given first in the emergency treatment of an acute, severe asthma episode in a young child?
Answers: a. Short-acting b2-agonists
b. Ephedrine
c. Aminophylline
d. Theophylline
• Question 33
2 out of 2 points
Which statement, if made by a nurse to the parents of a child with leukemia, indicates an understanding of teaching related to home care associated with the disease?
Answers: a. “Your son’s blood pressure must be taken daily while he is on chemotherapy.
b. “Limit your son’s fluid intake just in case he has central nervous system involvement.
c. “Your son must receive all of his immunizations in a timely manner.
d. “Your son’s temperature should be taken frequently.”
• Question 34
0 out of 2 points
What side effect commonly occurs with corticosteroid (prednisone) therapy?
Answers: a. Susceptibility to infection
b. Anorexia
c. Nausea and vomiting
d. Alopecia
• Question 35
2 out of 2 points
What clinical manifestations are associated with leukemia?
Answers: a. Petechiae, fever, fatigue
b. Headache, papilledema, irritability
c. Muscle wasting, weight loss, fatigue
d. Decreased intracranial pressure, psychosis, confusion
• Question 36
2 out of 2 points
An infant with bronchiolitis is hospitalized. The causative organism is respiratory syncytial virus (RSV). The nurse knows that a child infected with this virus requires what type of isolation?
Answers: a. Airborne isolation
b. Reverse isolation
c. Standard Precautions
d. Contact Precautions
• Question 37
2 out of 2 points
What clinical manifestation is a common sign of digoxin toxicity?
Answers: a. Tachycardia
b. Seizures
c. Vomiting
d. Bradypnea
• Question 38
0 out of 2 points
The nurse, preparing to give digoxin to a 9-month-old infant, checks the dosage and sees that 4 mL of the drug is to be drawn up. What is the mostappropriate action by the nurse, drawing on knowledge of this medication and safe pediatric dosages?
Answers: a. Mix the dose with juice to disguise its taste
b. Refrain from drawing up dose because there is an error in the dosage
c. Checks the heart rate and administers the dose by letting the infant suck it through a nipple
d. Checks the heart rate and administers the dose by placing it at the back and side of the mouth
• Question 39
2 out of 2 points
A 6-month-old infant presents to the clinic with failure to thrive, a history of frequent respiratory infections, and increasing exhaustion during feedings. On physical examination, a systolic murmur is detected, no central cyanosis, and chest radiography reveals cardiomegaly. An echocardiogram is done that shows left-to-right shunting. This assessment data is characteristic of what?
Answers: a. Coarctation of the aorta
b. Ventricular septal defect
c. Pulmonary stenosis
d. Tetralogy of Fallot
• Question 40
2 out of 2 points
A 1-year-old female presents with restlessness, rhinorrhea, retractions, and poor feeding.
The nurse reviews the health care provider’s prescription.
Which treatment would the nurse question?
Answers: a. Palivizumab IM
b. normal saline bolus
c. albuterol nebulizer
d. cool humidified oxygen
• Question 41
1.33333 out of 2 points (Extra Credit)
What interventions should the nurse anticipate being administered to a child with supraventricular tachycardia (SVT)?
Answers: a. Having the child perform a Valsalva maneuver
b. Bed rest
c. Administration of atropine
d. Applying ice to the face
e. Administration of adenosine (Adenocor)
• Question 42
2 out of 2 points
It is important that a child with acute streptococcal pharyngitis be treated with antibiotics to prevent which condition?
Answers: a. Diabetes insipidus (DI)
b. Otitis media
c. Acute rheumatic fever
d. Nephrotic syndrome
• Question 43
2 out of 2 points
What structural defects constitute tetralogy of Fallot?
Answers: a. Aortic stenosis, ventricular septal defect, overriding aorta, left ventricular hypertrophy
b. Pulmonary stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy
c. Aortic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy
d. Pulmonary stenosis, ventricular septal defect, aortic hypertrophy, left ventricular hypertrophy
• Question 44
2 out of 2 points
A 2-year-old child is receiving digoxin (Lanoxin). The nurse should notify the practitioner and withhold the medication if the apical pulse is less than which rate?
Answers: a. 60 beats/min
b. 140 beats/min
c. 90 beats/min
d. 130 beats/min
• Question 45
2 out of 2 points
A premature infant is about to be discharged home. The neonatologist orders palivizumab before discharge. What is the purpose of this medication?
Answers: a. To prevent secondary bacterial infection
b. To decrease toxicity of antiviral agents
c. To prevent respiratory syncytial virus (RSV) infection
d. To make isolation of the infant with RSV unnecessary
• Question 46
2 out of 2 points
A school-age child with leukemia experienced severe nausea and vomiting when receiving chemotherapy for the first time. What is the most appropriate nursing action to prevent or minimize these reactions with subsequent treatments?
Answers: a. Have the child bring favorite foods for snacks.
b. Give an antiemetic before chemotherapy begins.
c. Keep the child NPO (nothing by mouth) until nausea and vomiting subside.
d. Administer the chemotherapy between meals.
• Question 47
2 out of 2 points
During a respiratory assessment, the nurse notes a sinking in of soft tissues relative to the cartilaginous and bony thorax. What is the term for this finding?
Answers: a. Tachypnea
b. Nasal flaring
c. Grunting
d. Retractions
• Question 48
2 out of 2 points
Taking a test on the Monday after Spring Break is terrible. HINT: The answer is True
• Question 49
2 out of 2 points
The nurse should expect to care for which age of child if the admitting diagnosis is retinoblastoma?
a. Infant or toddler
b. Adolescent
c. Preschool- or school-age child
d. School-age or adolescent child
• Question 50
2 out of 2 points
An infant is diagnosed with transposition of the great vessels. Prostaglandin E1 is given intravenously. The parents ask how long the child will remain on the prostaglandin E1. What is the appropriate response by the nurse?
Answers: a. Prostaglandin E1 will be given continuously until corrective surgery is performed.
b. Prostaglandin E1 will be given intermittently until corrective surgery is performed.
c. Prostaglandin E1 will be given intermittently throughout the preoperative and postoperative periods until the child is stable.
d. Prostaglandin E1 will be given continuously throughout the preoperative and postoperative periods until the child is stable.
• Question 51
2 out of 2 points
What immunization should not be given to a child receiving chemotherapy for cancer?
Answers: a. Inactivated poliovirus vaccine
b. Measles, mumps, rubella (MMR)
c. Tetanus vaccine
d. Diphtheria, pertussis, tetanus (DPT) [Show Less]