A nurse manager on a pediatric floor is preparing an education program on working with families for a group of newly hired nurses. Which of the following
... [Show More] should the nurse include when discussing the developmental theory?
A. Describe that stress is inevitable
B. Emphasize that change with one family emmer effects the entire family
C. Provide guidance to assist families in adapting to stress
D. Defines consistencies in how families change
D. Defines consistencies in how families change
A nurse is assisting a group of parents of adolescents to develop skills that will improve communication within the family. The nurse hears one patient state "my son knows he better do what I say" which of the following parenting styles is the parent exhibiting?
A. Authoritarian
B. Permissive
C. Authoritative
D. Passive
A. Authoritarian
A nurse is performing family assessment. Which of the following should the nurse include? (select all that apply)
A. Medical history
B. Parents educational level
C. Child's physical growth
D. Support systems
E. Stressors
A. Medical history
B. Parents educational level
D. Support systems
E. Stressors
A nurse is preparing to assess a preschool-age child. Which of the following is an appropriate action by the nurse to prepare the child?
A. Allow the child to role-play using miniature equipment.
B. Use medical terminology to describe what will happen.
C. Separate the child from her parent during the examination
D. Keep medical equipment visible to the child
A. Allow the child to role-play using miniature equipment.
A nurse is assessing a holds ears. Which of the following is an expected finding?
A. Light reflex is located at the 2 o'clock position
B. Tympanic membrane is red in color
C. Bony landmarks are not visible
D. Cerumen is present bilaterally
D. Cerumen is present bilaterally
A nurse is checking the vital signs of a 3-year-old child during a well-child visit. Which of the following finding should the nurse report to the provider?
A. Temperature 372. Degrees Celsius
B. Heart rate 106/min
C. Respirations 30/min
D. Blood pressure 88/54 mm Hg
C. Respirations 30/min
A nurse is assessing a 6-month-old infant. Which of the following reflexes should the infant exhibit?
A. Moro
B. Plantar grasp
C. Stepping
D. Tonic neck
B. Plantar grasp
A nurse is performing a neurological assessment on an adolescent. Which of the following is an appropriate reaction by the adolescent when the nurse checks the trigeminal cranial nerve? (select all that apply)
A. Clenching teeth together tightly
B. Recognizing sour tastes on the back of the tongue
C. Identifying smells through one nostril
D. Detecting facial touches with eyelids closed
E. Looking down and in with the eyes
A. Clenching teeth together tightly
D. Detecting facial touches with eyelids closed
A nurse is assessing a 12-month-old infant during a well-child visit. Which of the following findings should the nurse report to the provider?
A. Closed anterior fontanel
B. Eruption of 6 teeth
C. Birth weight doubled
D. Birth length increased by 50%
C. Birth weight doubled
A nurse is preparing a developmental screening on a 10-month-pold infant. Which of the following fine motor skills should the nurse expect the infant to perform? (select all that apply)
A. Grasp a rattle by the handle
B. Try building a two-block tower
C. Use a crude pincer grasp
D. Place objects into a container
E. Walks with one hand held.
A. Grasp a rattle by the handle
C. Use a crude pincer grasp
A nurse is conducting a well-baby visit with a 4-month-old infant. Which of the following immunizations should the nurse plan to administer to the infant? (select all that apply)
A. Measles, mumps, and Rubella (MMR)
B. Polio (IPV)
C. Pneumoniacoccal Vaccine (PCV)
D. Varicella
E. Rotavirus Vaccine (RV)
B. Polio (IPV)
C. Pneumoniacoccal Vaccine (PCV)
E. Rotavirus Vaccine (RV)
A nurse is providing education about introducing new foods to the parents of a 4-month-old infant. The nurse should recommend that the parents introduce which of the following foods first?
A. Strained yellow vegetables
B. Iron-fortified cereals
C. Pureed fruits
D. Whole milk
B. Iron-fortified cereals
A nurse is providing teaching about dental care and teething to the parent of a 9-month-old infant. Which of the following statements by the parent indicates an understanding of the teaching?
A. I can give my baby a warm teething ring to relieve discomfort.
B. I should clean my baby's teeth with a cool, wet washcloth
C. I can give Advil for up to 5 days while my baby is teething
D. I should place diluted juice in the bottle my baby drinks while falling asleep
B. I should clean my baby's teeth with a cool, wet washcloth
A nurse is assessing a 2 ½-year-old toddler at a well child visit. Which of the following findings should the nurse report to the provider?
A. Height increased by 7.5 cm in the past year
B. Head circumference exceeds chest circumference
C. Anterior and posterior fontanels are closed
D. Current weight equals four times the birth weight
B. Head circumference exceeds chest circumference
A nurse is performing a developmental screening on an 18-month-old. Which of the following skills should the toddler be able to perform? (select all that apply)
A. Build a tower with 6 blocks
B. Throw a ball overhead
C. Walk up and down stairs
D. Draw circles
E. Use a spoon without rotation
B. Throw a ball overhead
E. Use a spoon without rotation
A nurse is providing teaching about age-appropriate activities to the parent of a 2-year-old. Which of the following statements by the parent indicates an understanding of the teaching?
A. I will send my child's favorite stuffed animals for when she is napping away from home
B. My child should be able to stand on one foot for a second.
C. The soccer team my child will be playing on starts practicing next week.
D. I should expect my child to be able to draw circles.
A. I will send my child's favorite stuffed animals for when she is napping away from home
A nurse is providing anticipatory guidance to the parents of a toddler. Which of the following should the nurse include? (select all that apply)
A. Develop food habits that will prevent dental carries
B. Meeting caloric needs results in an increased appetite
C. Expression of bedtime fears is common
D. Expert behaviors associated with negativism and ritualism
E. Annual screenings for phenylketonuria are important
A. Develop food habits that will prevent dental carries
C. Expression of bedtime fears is common
D. Expert behaviors associated with negativism and ritualism
A nurse is providing teaching to the parent of a preschool-age child about methods to promote sleep. Which of the following statement by the parent indicates an understanding of the teaching?
A. I will sleep in the bed with my child if she wakes up during the night
B. I will let my child stay up an additional 2 hours on weekend nights
C. I will let my child watch 30 minutes of television before bedtime each night
D. I will keep a dim lamp on in my child's room during the night
D. I will keep a dim lamp on in my child's room during the night
A nurse is conducting a well-child visit with a 5-year-old child. Which of the following immunizations should the nurse plan to administer to the child. (select all that apply)
A. Diphtheria, tetanus, pertussis (DTaP)
B. Inactivated Poliovirus (IPV)
C. Measles, Mumps, and Rubella (MMR)
D. Pneumococcal (PVC)
E. Haemophilus Influenza Type B (Hib)
A. Diphtheria, tetanus, pertussis (DTaP)
B. Inactivated Poliovirus (IPV)
C. Measles, Mumps, and Rubella (MMR)
A nurse is preparing an education program for a group of parents of preschool age children about promoting optimum nutrition. Which of the following information should the nurse include in the teaching?
A. Saturated fats should equal 20% of the daily caloric intake
B. Average caloric intake should be 1,800 calories daily
C. Daily intake of fruits and vegetables should equal 2 servings
D. Healthy diets include a total of 8 grams of protein daily
B. Average caloric intake should be 1,800 calories daily
A nurse is performing a developmental screening on a 3 year old. Which of the following skills should the nurse expect the child to perform?
A. Ride on a tricycle
B. Hop on one foot
C. Jump rope
D. Throw a ball overhead
A. Ride on a tricycle
A nurse is caring for a preschool age child who says she needs to leave the hospital because her doll is scared to be at home alone. Which of the following characteristics of preoperational thought is the child exhibiting?
A. Egocentrism
B. Centration
C. Animism
D. Magical thinking
C. Animism
A nurse is discussing prepubescence and preadolescence with a group of parents of school age children. Which of the following information should the nurse include in the discussion?
A. Initial physiologic changes appear during early childhood
B. Changes in height and weight occur slowly during this period
C. Growth differences between boys and girls becomes evident
D. Signs of sexual maturation becomes highly visible in boys.
C. Growth differences between boys and girls becomes evident
A nurse is conducting a well child visit with a child who is scheduled to receive the recommended immunizations for 11 to 12 year olds. Which of the following immunizations should the nurse administer? (select all that apply)
A. Trivalent inactivated influenza (TIV)
B. Pneumococcal (PCV)
C. Meningococcal (MCV4)
D. Tetanus and diphtheria toxoids and pertussis (Tdap)
E. Rotavirus (RV)
A. Trivalent inactivated influenza (TIV)
C. Meningococcal (MCV4)
D. Tetanus and diphtheria toxoids and pertussis (Tdap)
A nurse is providing education about age-appropriate activities for the parents of a 6-year-old child. Which of the following activities should the nurse include in teaching?
A. Jumping rope
B. Playing card games
C. Solving jigsaw puzzles
D. Joining competitive sports
A. Jumping rope
A nurse is teaching a course about safety during the school-age-years to a group of parents, which of the following information should the nurse include in the course? (select all that apply)
A. Gating stairs at top and bottom
B. Waring helmets when riding bikes or on skateboards
C. Riding safely in beds of pickup trucks
D. Implementing firearm safety
E. Wearing seat belts
B. Waring helmets when riding bikes or on skateboards
D. Implementing firearm safety
E. Wearing seat belts
A nurse is providing teaching about expected changes during puberty to a group of parents of early adolescent girls. Which of the following statements by one of the parents indicates understanding of the teaching?
A. Girls usually stop growing about 2 years after menarche
B. Girls are expected to gain about 65 pounds during puberty
C. Girls experience menstruation prior to breast development
D. Girls typically grow more than 10 inches during puberty
A. Girls usually stop growing about 2 years after menarche
A nurse is providing anticipatory guidance to the parent of a 13 year old adolescent. Which of the following screenings should the nurse recommend for the adolescent? (select all that apply)
A. Body mass index
B. Blood lead level
C. 24 hour diet recall
D. Weight
E. Scoliosis
A. Body mass index
D. Weight
E. Scoliosis
A nurse is caring for an adolescent whose mother expresses concerns about her sleeping for long hours. Which of the following conditions should the nurse inform the mother as requiring additional sleep during adolescence?
A. Sleep terrors
B. Rapid growth
C. Elevated zinc levels
D. Slowed metabolism
B. Rapid growth
A nurse is teaching a class about puberty in boys. Which of the following should the nurse include as the first manifestation of sexual maturation?
A. Pubic hair growth
B. Vocal changes
C. Testicular enlargement
D. Facial hair growth
C. Testicular enlargement
A nurse is planning to administer the influenza vaccine to a toddler. Which of the following actions should the nurse take?
A. Administer subcutaneously in the abdomen
B. Use a 20-gauge needle
C. Divide the medication into two injections
D. Place the child in the supine position
B. Use a 20-gauge needle
A nurse is preparing to administer an IM injection to a child. Which of the following muscle groups is contraindicated?
A. Deltoid
B. Ventrogluteal
C. Vastus lateralis
D. Dorsogluteal
D. Dorsogluteal
A nurse is teaching a parent of an infant about administration of oral medications. Which of the following should the nurse include in the teaching? (select all that apply)
A. Use a universal dropper for medication administration
B. Ask the pharmacy to add flavoring to the medication
C. Ask the medication to a formula bottle before feeding
D. Use the nipple of a bottle to administer the medication
E. Hold the infant in a semi reclining position
B. Ask the pharmacy to add flavoring to the medication
D. Use the nipple of a bottle to administer the medication
E. Hold the infant in a semi reclining position
A nurse is preparing to administer medication to a toddler. Which of the following actions should the nurse take? (select all that apply)
A. Identify the toddler by asking the parent
B. Tell the parent to administer the medication
C. Calculate the safe dosage
D. Ask the toddler what toy he wants to hold during administration
E. Offer juice after the medication
C. Calculate the safe dosage
D. Ask the toddler what toy he wants to hold during administration
E. Offer juice after the medication
A nurse is caring for an infant who needs otic medication. Which of the following is an appropriate action to take?
A. Hold the infant in an upright position
B. Pull the pinna downward and straight back
C. Hyperextend the infants neck
D. Ensure that the medication is cool
B. Pull the pinna downward and straight back
A nurse is reviewing the medical record of a newborn who has necrotizing endocarditis (NEC). Which of the following findings is a risk factor for NEC?
A. Macrosomia
B. Transient tachypnea of the newborn
C. Maternal gestational hypertension
D. Gestational age 36 weeks
D. Gestational age 36 weeks
A nurse is assessing a newborn who has congenital hypothyroidism. Which of the following findings should the nurse expect? (select all that apply)
A. Hypertonicity
B. Cool extremities
C. Short neck
D. Tachycardia
E. Hyperreflexia
B. Cool extremities
C. Short neck
A nurse is teaching the parent of a newborn how to treat the newborn's plagiocephaly. Which of the following statements by the parent indicates an understanding of the teaching?
A. I should put my baby to sleep on her belly during her afternoon nap
B. I should ensure my baby's head is in the same position each time she sleeps
C. I should have my baby wear the prescribed helmet 23 hours a day
D. I should allow my baby to sleep in her infant swing
C. I should have my baby wear the prescribed helmet 23 hours a day
A nurse is developing a plan of care for a newborn who has hyperbilirubinemia and is to undergo phototherapy. Which odd the following actions should the nurse include in the plan of care?
A. Reposition the newborn every 4 hours
B. Lotion the newborn's skin twice per day
C. Check the newborns temperature every 8 hours
D. Remove the newborns eye mask during feedings
D. Remove the newborns eye mask during feedings
A nurse is providing preconception teaching with a client who has phenylketonuria (PKU). Which of the following information should the nurse include in the teaching?
A. Follow a low-phenylalanine diet once pregnancy is confirmed
B. The client will undergo testing of phenylalanine levels one to two times per week throughout pregnancy
C. Increase intake of dietary proteins prior to conception
D. The client will require a cesarean section birth due to the likelihood of having a fetus with macrosomia
B. The client will undergo testing of phenylalanine levels one to two times per week throughout pregnancy
A nurse is caring for a child who is experiencing respiratory distress, which of the following findings are early manifestations of respiratory distress? (select all that apply)
A. Bradypnea
B. Peripheral cyanosis
C. Tachycardia
D. Diaphoresis
E. Restlessness
C. Tachycardia
D. Diaphoresis
E. Restlessness
A nurse in the emergency department is caring for a child whose parent reports that the child has swallowed paint thinner. The child is lethargic, gagging, and cyanotic. Which of the following actions should the nurse take?
A. Induce vomiting with syrup of ipecac
B. Insert a nasogastric tube, and administer activated charcoal
C. Prepare for intubation with a cuffed endotracheal tube
D. Administer chelation therapy using deferoxamine mesylate
C. Prepare for intubation with a cuffed endotracheal tube
A nurse in the emergency department is admitting an infant who experienced a life-threatening event. Which of the following prescriptions by the provider should the nurse anticipate? (select all that apply)
A. Electroencephalogram
B. Electrocardiogram
C. Urine culture
D. Arterial blood gasses
E. Blood culture
A. Electroencephalogram
B. Electrocardiogram
E. Blood culture
A nurse is providing teaching to a parent about acetaminophen poisoning. Which of the following information should the nurse include in the teaching?
A. Nausea beginning 24 hours after ingestion
B. Pallor can appear as early as 2 hours after ingestion
C. Jaundice will appear in 12 hours if the child is toxic
D. Children can have 4 g/day of acetaminophen
B. Pallor can appear as early as 2 hours after ingestion
A nurse in a community center is providing an in-service to help a group of parents on management of airway obstruction in toddlers. Which of the following responses by the parents indicated understanding? (select all that apply)
A. I will push on my child's abdomen
B. I will hyperextend my child's head to open his airway
C. I will listen over my child's mouth for sounds of breathing
D. I will use my finger to check my child's mouth for objects
E. I will place my child in my car and take him to the closest emergency facility.
A. I will push on my child's abdomen
C. I will listen over my child's mouth for sounds of breathing
D. I will use my finger to check my child's mouth for objects
A nurse is teaching a group of parents about characteristics of infants who have failure to thrive. Which of the following characteristics should the nurse include in the teaching?
A. Intense fear of strangers
B. Increased risk for childhood obesity
C. Inability to form close relationships with siblings
D. Developmental delays
D. Developmental delays
A nurse is providing instruction to the teacher if a child who has attention deficit disorder/hyperactivity disorder(ADHD). Which of the following classroom strategies should the nurse include in the teaching? (select all that apply)
A. Eliminate testing
B. Allow for regular breaks
C. Combine verbal instruction with visual cues
D. Establish consistent classroom rules
E. Increase stimuli in the environment
B. Allow for regular breaks
C. Combine verbal instruction with visual cues
D. Establish consistent classroom rules
A nurse is teaching a parent about posttraumatic stress disorder (PTSD). Which of the following information should the nurse include in the teaching? (select all that apply)
A. Children who have PTSD can benefit from psychotherapy
B. A manifestation of PTSD is phobias
C. Personality disorders are a complication of PTSD
D. PTSD develops following a traumatic event
E. There are 6 stages of PTSD
A. Children who have PTSD can benefit from psychotherapy
B. A manifestation of PTSD is phobias
D. PTSD develops following a traumatic event
A nurse is teaching the parent of a child about risk factors for ADHD, which of the following should the nurse include in the teaching?
A. Formula feeding as an infant
B. History of head trauma
C. History of post term birth
D. Child of a single parent
B. History of head trauma
A nurse is caring for a child who has depression. Which of the following findings should the nurse expect? (select all that apply)
A. Preferring being with peers
B. Weight loss or gain
C. Report of low self esteem
D. Sleeping more than usual
E. Hyperactivity
B. Weight loss or gain
C. Report of low self esteem
D. Sleeping more than usual
A nurse is caring for a client who has suspected meningitis and a decreased level of consciousness. Which of the following actions is appropriate?
a. Place the client on NPO status
b. Prepare the client for a liver biopsy
c. Position the client dorsal recumbent
d. Put the client in a protective environment
a. Place the client on NPO status
A nurse is reviewing cerebrospinal fluid analysis for a client who has suspected meningitis. Which of the following findings should the nurse identify as indicating viral meningitis? (select all that apply)
a. Negative gram stain
b. Normal glucose content
c. Cloudy color
d. Decreased WBC count
e. Normal protein content
a. Negative gram stain
b. Normal glucose content
e. Normal protein content
A nurse is caring for a 4-month-old infant who has meningitis. Which of the following findings is associated with this diagnosis?
a. Depressed anterior fontanel
b. Constipation
c. Presence of the rooting reflex
d. High pitched cry
d. High pitched cry
A nurse is caring for a school-age child who possibly has Reye syndrome. Which of the following is a risk factor for Reye syndrome?
a. Recent history of infectious cystitis caused by Candida
b. Recent history of bacterial otitis media
c. Recent episode of gastroenteritis
d. Recent episode of Haemophilus influenzae meningitis
c. Recent episode of gastroenteritis
A nurse is developing an in-service about viral and bacterial meningitis. The nurse should include that the introductions of which of the following immunizations decreased the incidence of bacterial meningitis in children? (select all that apply)
a. IPV
b. PCV
c. DTaP
d. Hib
e. TIV
b. PCV
d. Hib
A nurse is caring for a child who has absence seizures. Which of the following findings should the nurse expect? (select all that apply)
a. Loss of consciousness
b. Appearance of daydreaming
c. Dropping held objects
d. Falling to the floor
e. Having a piercing cry
a. Loss of consciousness
b. Appearance of daydreaming
c. Dropping held objects
A nurse is caring for a child who just experienced a generalized seizure. Which of the following is the priority action for the nurse to take?
a. Maintain the child in a side-lying position
b. Loosen the child's restrictive clothing
c. Reorient the child to the environment
d. Note the time and characteristics of the child's seizures.
a. Maintain the child in a side-lying position
A nurse is providing teaching to the parent of a child who is to have an EEG. Which of the following responses should the nurse include in the teaching?
a. "Decaffeinated beverages should be offered the morning of the procedure"
b. "Do not wash your child's hair the night before the procedure"
c. "Withhold all foods the morning of the procedure"
d. "Give your child an analgesic the night before the procedure"
a. "Decaffeinated beverages should be offered the morning of the procedure"
A nurse is teaching a group of parents about the risk factors for seizures. Which of the following factors should the nurse include in the teaching? (select all that apply)
a. Febrile episodes
b. Hypoglycemia
c. Sodium imbalance
d. Low serum lead levels
e. Presence of diphtheria
a. Febrile episodes
b. Hypoglycemia
c. Sodium imbalance
A nurse is reviewing treatment options with the parent of a child who has worsening seizures. Which of the following treatment options should the nurse include in the discussion? (select all that apply)
a. Vagal nerve stimulator
b. Additional antiepileptic medications
c. Corpus colostomy
d. Focal resection
e. Radiation therapy
a. Vagal nerve stimulator
b. Additional antiepileptic medications
c. Corpus colostomy
d. Focal resection
A nurse in the emergency department is assessing a child following a motor vehicle crash. The child is unresponsive, has spontaneous respirations of 22/min, and has a laceration on the forehead that is bleeding. Which of the following actions should the nurse take first?
a. Stabilize the child's neck
b. Clean the child's laceration with soap and water
c. Implement seizure precautions for the child
d. Initiate IV access for the child
a. Stabilize the child's neck
A nurse is caring for an adolescent who has a closed head injury. Which of the following are indications of increased intracranial pressure (ICP)? (select all that apply)
a. Report of headache
b. Alteration in pupillary response
c. Increased motor response
d. Increased sleeping
e. Increased sensory response
a. Report of headache
b. Alteration in pupillary response
d. Increased sleeping
A nurse is caring for a child who has ICP. Which of the following actions should the nurse take? (select all that apply)
a. Suction the endotracheal tube every 2 hours
b. Maintain a quiet environment
c. Use two pillows to elevate the head
d. Administer a stool softener
e. Maintain body alignment
b. Maintain a quiet environment
d. Administer a stool softener
e. Maintain body alignment
A nurse is assessing a child who has a concussion. Which of the following findings should the nurse expect? (select all that apply)
a. Amnesia
b. Systemic hypertension
c. Bradycardia
d. Respiratory depression
e. Confusion
a. Amnesia
e. Confusion
A nurse is a caring for a child who is taking mannitol for cerebral edema. Which of the following adverse effects should the nurse monitor the child for and report to the provider?
a. Bradycardia
b. Weight loss
c. Confusion
d. Constipation
c. Confusion
A nurse is planning to perform a peripheral vision test on a child. Which of the following actions should the nurse take?
a. Place the child 10 feet away from the chart
b. Show a set of cards to the child one at a time
c. Cover the child's eye while performing the test of the other eye
d. Have the child focus on an object while performing the test.
d. Have the child focus on an object while performing the test.
A nurse is teaching a group of parents about possible manifestations of Down Syndrome. Which of the following findings should the nurse include in the teaching? (select all that apply)
a. A large head with bulging fontanels
b. Larger ears that are set back
c. Protruding abdomen
d. Broad, short feet and hands
e. Hypotonia
c. Protruding abdomen
d. Broad, short feet and hands
e. Hypotonia
A nurse is assessing a child who has myopia. Which of the following findings should the nurse expect? (select all that apply)
a. Headaches
b. Photophobia
c. Difficulty reading
d. Difficulty focusing on close objects
e. Poor school performance
a. Headaches
c. Difficulty reading
e. Poor school performance
A nurse is assessing a toddler for possible hearing loss, which of the following findings are indications of hearing impairment? (select all that apply)
a. Uses monotone speech
b. Speaks loudly
c. Repeats sentences
d. Appears shy
e. Is overly attentive to the surroundings
a. Uses monotone speech
b. Speaks loudly
d. Appears shy
A nurse is teaching the parent of an infant who has downs syndrome. Which of the following statements by the parents indicates an understanding of the teaching?
a. "I should expect him to have frequent diarrhea"
b. "I should place a cool mist humidifier in his room"
c. "I should avoid the use of lotion on his skin"
d. "I should expect him to grow faster in length than other infants"
b. "I should place a cool mist humidifier in his room"
A nurse is teaching an adolescent to self-administer a corticosteroid medication using a metered-dose inhaler (MDI). Which of the following instructions should the nurse include? (select all that apply)
a. Shake the device prior to use
b. Rinse and expectorate after administration
c. Inhale slowly with medication administration
d. Exhale quickly after medication administration
e. Wait 30 seconds between puffs
a. Shake the device prior to use
b. Rinse and expectorate after administration
c. Inhale slowly with medication administration
A nurse is caring for a child who is receiving oxygen therapy and is on a continuous oxygen saturation monitor that is meeting 89%. Which of the following actions should the nurse take first?
a. Increase oxygen flow rate
b. Encourage the child to take deep breaths
c. Ensure proper placement of the sensor probe
d. Place the child in the Fowler's position.
c. Ensure proper placement of the sensor probe
A nurse in the emergency department is assessing a newly-admitted infant. Which of the following findings is an early indication of hypoxemia?
a. Nonproductive cough
b. Hypoventilation
c. Cyanosis
d. Nasal stuffiness
c. Cyanosis
A nurse is caring for a child who is receiving oxygen. Which of the following findings indicated oxygen toxicity?
a. Increased blood pressure
b. Hyperventilation
c. Decreased PaCO2
d. Unconsciousness
d. Unconsciousness
A nurse is caring for a child who is receiving bronchodilator medication by nebulized aerosol therapy. Which of the following actions should the nurse take? (select all that apply)
a. Instruct the child that the treatment will last 30 minutes
b. Obtain vital signs prior to the procedure
c. Tell the child to take slow deep breaths
d. Determine if the child should use a mask
e. Attach the device to an air source
b. Obtain vital signs prior to the procedure
c. Tell the child to take slow deep breaths
d. Determine if the child should use a mask
e. Attach the device to an air source
A nurse is caring for a child who has bronchitis. Which of the following actions should the nurse take? (select all that apply)
a. Administer oral prednisone
b. Initiate chest percussion and postural drainage
c. Administer humidified oxygen
d. Suction the nasopharynx as needed
e. Administer oral penicillin
c. Administer humidified oxygen
d. Suction the nasopharynx as needed
A nurse is teaching a group of parents about influenza. Which of the following information should the nurse include in the teaching?
a. Amantadine will prevent the illness
b. Rimantadine is administered intramuscularly
c. Zanamivir can be given to children 1 year and older
d. Oseltamivir should be given within 48 hours of the onset of symptoms
d. Oseltamivir should be given within 48 hours of the onset of symptoms
A nurse is caring for a child who is in the postoperative period following a tonsillectomy. Which of the following is a clinical finding of postoperative bleeding?
a. Hbg of 11.6 and Hct of 37%
b. Inflamed and reddened throat
c. Frequent swallowing and clearing of throat
d. Blood tinged mucus
c. Frequent swallowing and clearing of throat
A nurse is caring for a child in the postoperative period following a tonsillectomy. Which of the following actions should the nurse take?
a. Encourage the child to blow her nose gently
b. Administer analgesics on a schedule
c. Offer orange juice
d. Position the child supine
b. Administer analgesics on a schedule
A nurse is assessing a child who has epiglottitis. Which of the following findings should the nurse expect? (select all that apply)
a. Hoarseness and difficulty speaking
b. Difficulty swallowing
c. Low grade fever
d. Drooling
e. Dry barking cough
f. Stridor
a. Hoarseness and difficulty speaking
b. Difficulty swallowing
d. Drooling
f. Stridor
A nurse is assessing a child who has asthma. Which of the following are indications of deterioration in the child's respiratory status? (select all that apply)
a. O2 sat of 95%
b. Wheezing
c. Retraction of sternal muscles
d. Warm extremities
e. Nasal flaring
b. Wheezing
c. Retraction of sternal muscles
e. Nasal flaring
A nurse is teaching an adolescent about the appropriate use of asthma medications. Which of the following medications should the nurse instruct the client to use as needed before exercise?
a. Fluticasone/salmeterol
b. Montelukast
c. Prednisone
d. Albuterol
d. Albuterol
A nurse is planning care for a child who has asthma. Which of the following interventions should the nurse include in the plan of care? (select all that apply)
a. Perform chest percussion
b. Place the child in an upright position
c. Monitor O2 saturation
d. Administer bronchodilators
e. Administer Dornase alfa daily
b. Place the child in an upright position
c. Monitor O2 saturation
d. Administer bronchodilators
A nurse is teaching a child who has asthma how to use a peak flow meter. Which of the following information should the nurse include in the teaching? (select all that apply)
a. Zero the meter before each use
b. Record the average of the attempts
c. Perform 3 attempts
d. Deliver a long slow breath into the meter
e. Sit in a chair with feet on the floor
a. Zero the meter before each use
c. Perform 3 attempts
A nurse is discussing risk factors for asthma with a group of newly licensed nurses. Which of the following conditions should the nurse include in the teaching? (select all that apply)
a. Family history of asthma
b. Family history of allergies
c. Exposure to smoke
d. Low birth weight
e. Being underweight
a. Family history of asthma
b. Family history of allergies
c. Exposure to smoke
d. Low birth weight
A nurse is reviewing the diagnostic findings for a preschool aged child who is suspected of having cystic fibrosis. Which of the following findings should the nurse identify as an indication of CF?
a. Sweat chloride content 85 mEq/L
b. Increased serum levels of fat soluble vitamins
c. 72-hour stool analysis sample indicating hard, packed stools
d. Chest x ray negative for atelectasis
a. Sweat chloride content 85 mEq/L
A nurse is admitting a child who has cystic fibrosis. Which of the following medications should the nurse anticipate including in the plan of care? (select all that apply)
a. Tobramycin
b. Loperamide
c. Fat soluble vitamins
d. Albuterol
e. Dornase Alfa
a. Tobramycin
c. Fat soluble vitamins
d. Albuterol
e. Dornase Alfa
A nurse is performing an admission assessment for a child who has cystic fibrosis. Which of the following findings should the nurse expect? (select all that apply)
a. Wheezing
b. Clubbing of fingers and toes
c. Barrel shaped chest
d. Thin watery mucus
e. Rapid growth spurts
a. Wheezing
b. Clubbing of fingers and toes
c. Barrel shaped chest
A nurse is providing discharge teachings to a child who has cystic fibrosis. Which of the following instructions should the nurse include?
a. Provide a low calorie and low protein diet
b. Administer pancreatic enzymes with meals and snacks
c. Implement a fluid restriction during times of infection
d. Restrict physical activity
b. Administer pancreatic enzymes with meals and snacks
A nurse is assessing an infant who has coarctation of the aorta. Which of the following findings should the nurse expect?
a. Weak femoral pulses
b. Cool skin of the lower extremities
c. Sever cyanosis
d. Clubbing of the fingers
e. Heart failure
a. Weak femoral pulses
b. Cool skin of the lower extremities
e. Heart failure
A nurse is assessing an infant who has heart failure. Which of the following findings should the nurse expect? (select all that apply)
a. Bradycardia
b. Cool extremities
c. Peripheral edema
d. Increased urinary output
e. Nasal flaring
b. Cool extremities
c. Peripheral edema
e. Nasal flaring
A nurse is providing teaching to the mother of an infant who has a prescription for digoxin. Which of the following instructions should the nurse include?
a. Do not offer your baby fluids after giving this medication
b. Digoxin increases your baby's heart rate
c. Give the correct does of the medication at regularly scheduled times
d. If your baby vomits the does, you should repeat the does to ensure that he gets the correct amount
c. Give the correct does of the medication at regularly scheduled times
A nurse is caring for a 2-year-old child who has a heart defect and is scheduled for cardiac catheterization. Which of the following actions should the nurse take?
a. Place the patient on NPO status for 12 hours prior to the procedure
b. Check for iodine or shellfish allergies prior to the procedure
c. Elevate the affected extremity following the procedure
d. Limit fluid intake following the procedure
b. Check for iodine or shellfish allergies prior to the procedure
A nurse is caring for a client who is suspected of having rheumatic fever. Which of the following findings should the nurse expect? (select all that apply)
a. Erythema marginatum (rash)
b. Continuous joint pain of the digits
c. Tender, subcutaneous nodules
d. Decreased erythrocyte sedimentation rate
e. Elevated C-reactive protein
a. Erythema marginatum (rash)
e. Elevated C-reactive protein
A nurse is completing a pain assessment of an infant. Which of the following scales should the nurse use?
a. FLACC
b. FACES
c. Oucher
d. Non-communicating children's pain checklist
a. FLACC
A nurse is planning care for a child following a surgical procedure. Which of the following interventions should the nurse include in the plan of care?
a. Administer NSAID's for pain greater than 7 on a scale from 0-10
b. Administer intranasal analgesics PRN
c. Administer IM analgesics for pain
d. Administer IV analgesics on a schedule
d. Administer IV analgesics on a schedule
A nurse is assessing an infant. Which of the following are manifestations of pain in an infant? (select all that apply)
a. Pursed lips
b. Loud cry
c. Lowered eyebrows
d. Rigid body
e. Pushes away stimulus
b. Loud cry
c. Lowered eyebrows
d. Rigid body
A nurse is planning care for an infant who is experiencing pain. Which of the following interventions should the nurse include in the plan of care? (select all that apply)
a. Offer a pacifier
b. Use guided imagery
c. Use swaddling
d. Initiate a behavioral contract
e. Encourage kangaroo care
a. Offer a pacifier
c. Use swaddling
e. Encourage kangaroo care
A nurse is preparing for a toddler for an IV catheter insertion using atraumatic care. Which of the following actions should the nurse take? (select all that apply)
a. Explain the procedure using the child's favorite toy
b. Ask the parents to leave during the procedure
c. Perform the procedure in the child's bed
d. Allow the child to make one choice regarding the procedure
e. Apply lidocaine and prilocaine cream to three potential insertion sites.
a. Explain the procedure using the child's favorite toy
d. Allow the child to make one choice regarding the procedure
e. Apply lidocaine and prilocaine cream to three potential insertion sites.
A nurse is caring for a preschooler. Which of the following is an expected behavior of a preschool-aged child?
a. Describing manifestations of illness
b. Relating fears to magical thinking
c. Understanding cause of illness
d. awareness of body functioning
b. Relating fears to magical thinking
A nurse on a pediatric unit is caring for a toddler. Which of the following behaviors is an effect of hospitalization? (select all that apply)
a. Believes the experience is a punishment
b. Experiences separation anxiety
c. Displays intense emotions
d. Exhibits regressive behaviors
e. Manifests disturbance in body image
b. Experiences separation anxiety
c. Displays intense emotions
d. Exhibits regressive behaviors
A nurse is teaching apparent about parallel play in children. Which of the following statements should the nurse include in the teaching?
a. Children sit and observe others playing
b. Children exhibit organized play when in a group
c. The child plays alone
d. The child plays independently when in a group
d. The child plays independently when in a group
A nurse is teaching a group of parents about separation anxiety. Which of the following information should the nurse include in the teaching?
a. It is often observed in the school-age child
b. Detachment is the stage exhibited in the hospital
c. It results in prolonged issues of adaptability
d. Kicking a stranger is an example
d. Kicking a stranger is an example
A nurse is caring for a child who is dying. Which of the following are findings of impending death? (select all that apply)
a. Heightened sense of hearing
b. Tachycardia
c. Difficulty swallowing
d. Sensation of being cold
e. Cheyne-stokes respirations
c. Difficulty swallowing
e. Cheyne-stokes respirations
A nurse is teaching a parent about complicated grief. Which of the following statements should the nurse make?
a. It is considered complicated grief if you are still grieving 6 months after your loss
b. Personal activities are affected when experiencing complicated grief
c. Parents will experience complicated grief together
d. Complicated grief self-resolves in 12 months
b. Personal activities are affected when experiencing complicated grief
A nurse is teaching parent of a preschool child about factors that affect the child's perception of death. Which of the following factors should the nurse include in the teaching?
a. Preschool children have no concept of death
b. Preschool children perceive death as temporary
c. Preschool children often regress to an earlier stage of behavior
d. Preschool children experience fear related to the disease process
b. Preschool children perceive death as temporary
A nurse often cares for children eho are dying. Which of the following actions are appropriate for the nurse to take to maintain professional effectiveness? (select all that apply)
a. Remain in contact with the family after their loss
b. Develop a professional support system
c. Take time off from work
d. Suggest that a hospital representative attend the funeral
e. Demonstrate feelings of sympathy toward the family
a. Remain in contact with the family after their loss
b. Develop a professional support system
c. Take time off from work
A nurse is caring for a child who has a terminal illness and reviews palliative care with an assistive personnel (AP). Which of the following statements by the AP indicates understanding of this review?
a. I'm sure the family is hopeful that the new medication will stop the illness
b. I'll miss working with this client now that only nurses will be taking care of him
c. I will get all the clients personal objects out of his room.
d. I will listen and respond as the family talks about their child's life
d. I will listen and respond as the family talks about their child's life
A nurse is preparing to administer immunizations to a 4-month-old. Which of the following is an appropriate action for the nurse to take in providing atraumatic care?
a. Administer 81 mg of aspirin
b. Use the Z-track method when injecting
c. Ask the parents to leave the room during the injection
d. Provide sucrose solution on the pacifier
d. Provide sucrose solution on the pacifier
A nurse is planning to administer recommended immunizations to a 2-month-old infant. Which of the following vaccines should the nurse plan to give? (select all that apply)
a. RV
b. DTaP
c. Hib
d. HepA
e. PCV13
f. IPV
a. RV
b. DTaP
c. Hib
e. PCV13
f. IPV
A nurse is planning to administer recommended immunizations to a 4-year-old child. Which of the following vaccines should the nurse plan to give?
a. IPV
b. Hib
c. MMR
d. VAR
e. HepB
f. DTaP
a. IPV
c. MMR
d. VAR
f. DTaP
A nurse is preparing to administer the varicella vaccine to an adolescent, which of the following questions should the nurse ask to determine if there is a contradiction to administer the vaccine?
a. Do you have an allergy to eggs?
b. Have you ever had encephalopathy following immunizations?
c. Are you currently taking corticosteroid medication?
d. Have you ever had an anaphylactic reaction to yeast?
c. Are you currently taking corticosteroid medication?
A nurse is caring for a toddler in a clinic. Which of the following actions should the nurse take? (see below for additional info)
- 15-month-old female
- Immunization record:
HepB: 1 month, 2 months, 12 month
RV: 2 months, 4 months, 6 months
DTaP: 2 months, 4 months, 6 months
Hib: 2 months, 4 months, 12 months
IPV: 2 months, 4 months, 6 months
MMR: 12 months
Varicella: 12 months
HepA: 12 months
-Nurses Note:
Temperature: 38.7 (101.1), sore throat, family history of seizures
a. Administer DTaP vaccine
b. Administer RV vaccine
c. Hold immunizations until fever subsides
d. Administer HepA vaccine
a. Administer DTaP vaccine
A nurse is teaching a group of parents about complications of communicable diseases. Which of the following communicable diseases can lead to pneumonia? (select all that apply)
a. Rubella
b. Rubeola
c. Pertussis
d. Varicella
e. Mumps
b. Rubeola
c. Pertussis
d. Varicella
A nurse is providing teaching for an adolescent client who has mononucleosis. The client has a fever, sore throat, fatigue, swollen lymph nodes, and a sore upper abdomen. Which of the following instructions should the nurse include in the teaching? (select all that apply)
a. Take antibiotics until symptoms subside
b. Drink plenty of fluids
c. Avoid participating in strenuous activities
d. Allow for periods of rest
e. Take aspirin as needed for fever and comfort
f. Gargle with salt water every 2-3 hours
b. Drink plenty of fluids
c. Avoid participating in strenuous activities
d. Allow for periods of rest
e. Take aspirin as needed for fever and comfort
f. Gargle with salt water every 2-3 hours [Show Less]