Leading Causes of Death in Adolescents and Evidence-Based Practice, Exams of Pediatrics

Download Leading Causes of Death in Adolescents and Evidence-Based Practice and more Exams Pediatrics in PDF only on Docsity! Test Bank - Wong's Nursing Care of Infants and Children (300 Questions and Answers). 1. The clinic nurse is reviewing statistics on infant mortality for the United States versus other countries. Compared with other countries that have a population of at least 25 million, the nurse makes which determination? a. The United States is ranked last among 27 countries. b. The United States is ranked similar to 20 other developed countries. c. The United States is ranked in the middle of 20 other developed countries. d. The United States is ranked highest among 27 other industrializ - Correct Answers A- The United States is ranked last among 27 countries. 2. Which is the leading cause of death in infants younger than 1 year in the United States? a. Congenital anomalies b. Sudden infant death syndrome c. Disorders related to short gestation and low birth weight d. Maternal complications specific to the perinatal period - Correct Answers A- Congenital anomalies 3. What is the major cause of death for children older than 1 year in the United States? a. Heart disease b. Childhood cancer c. Unintentional injuries d. Congenital anomalies - Correct Answers C- Unintentional injuries 4. In addition to injuries, what are the leading causes of death in adolescents ages 15 to 19 years? a. Suicide and cancer b. Suicide and homicide c. Drowning and cancer d. Homicide and heart disease - Correct Answers B- Suicide and homicide 5. The nurse is planning a teaching session to adolescents about deaths by unintentional injuries. Which should the nurse include in the session with regard to deaths caused by injuries? a. More deaths occur in males. b. More deaths occur in females. c. The pattern of deaths does not vary according to age and sex. d. The pattern of deaths does not vary widely among different ethnic groups. - Correct Answers A- More deaths occur in males. 7. The nurse should assess which age group for suicide ideation since suicide in which age group is the third leading cause of death? a. Preschoolers b. Young school age c. Middle school age d. Late school age and adolescents - Correct Answers D- Late school age and adolescents 8. Parents of a hospitalized toddler ask the nurse, What is meant by family- centered care? The nurse should respond with which statement? a. Family-centered care reduces the effect of cultural diversity on the family. b. Family-centered care encourages family dependence on the health care system. c. Family-centered care recognizes that the family is the constant in a childs life. d. Family-centered care avoids expecting families to be part of the decision-making process. - Correct Answers C- Family-centered care recognizes that the family is the constant in a childs life. 10. Evidence-based practice (EBP), a decision-making model, is best described as which? a. Using information in textbooks to guide care b. Combining knowledge with clinical experience and intuition c. Using a professional code of ethics as a means for decision making 19. The nurse is evaluating research studies according to the GRADE criteria and has determined the quality of evidence on the subject is moderate. Which type of evidence does this determination indicate? a. Strong evidence from unbiased observational studies b. Evidence from randomized clinical trials showed inconsistent results c. Consistent evidence from well-performed randomized clinical trials d. Evidence for at least one critical outcome from randomized clinical trials had serious flaws - Correct Answers b. Evidence from randomized clinical trials showed inconsistent results 20. An adolescent patient wants to make decisions about treatment options, along with his parents. Which moral value is the nurse displaying when supporting the adolescent to make decisions? a. Justice b. Autonomy c. Beneficence d. Nonmaleficence - Correct Answers b. Autonomy 21. The nurse manager is compiling a report for a hospital committee on the quality of nursing-sensitive indicators for a nursing unit. Which does the nurse manager include in the report? a. The average age of the nurses on the unit b. The salary ranges for the nurses on the unit c. The education and certification of the nurses on the unit d. The number of nurses who have applied but were not hired for the unit - Correct Answers c. The education and certification of the nurses on the unit 1. Which responsibilities are included in the pediatric nurses promotion of the health and well-being of children? (Select all that apply.) a. Promoting disease prevention b. Providing financial assistance c. Providing support and counseling d. Establishing lifelong friendships e. Establishing a therapeutic relationship f. Participating in ethical decision making - Correct Answers a. Promoting disease prevention c. Providing support and counseling e. Establishing a therapeutic relationship f. Participating in ethical decision making 6. Which should the nurse teach to parents regarding oral health of children? (Select all that apply.) a. Fluoridated water should be used. b. Early childhood caries is a preventable disease. c. Dental caries is a rare chronic disease of childhood. d. Dental hygiene should begin with the first tooth eruption. e. Childhood caries does not happen until after 2 years of age. - Correct Answers a. Fluoridated water should be used. b. Early childhood caries is a preventable disease. d. Dental hygiene should begin with the first tooth eruption. 1. The nurse is determining if a newborn is classified in the low birth weight (LBW) category of less than 2500 g. The newborns weight is 5 lb, 4 oz. What is the newborns weight in grams? Record your answer in a whole number. - Correct Answers 2386 1. Children are taught the values of their culture through observation and feedback relative to their own behavior. In teaching a class on cultural competence, the nurse should be aware that which factor may be culturally determined? a. Ethnicity b. Racial variation c. Status d. Geographic boundaries - Correct Answers c. Status 2. The nurse is aware that if patients different cultures are implied to be inferior, the emotional attitude the nurse is displaying is what? a. Acculturation b. Ethnocentrism c. Cultural shock d. Cultural sensitivity - Correct Answers b. Ethnocentrism 5. The nurse is planning care for a patient with a different ethnic background. Which should be an appropriate goal? a. Adapt, as necessary, ethnic practices to health needs. b. Attempt, in a nonjudgmental way, to change ethnic beliefs. c. Encourage continuation of ethnic practices in the hospital setting. d. Strive to keep ethnic background from influencing health needs. - Correct Answers a. Adapt, as necessary, ethnic practices to health needs. 6. The nurse discovers welts on the back of a Vietnamese child during a home health visit. The childs mother says she has rubbed the edge of a coin on her childs oiled skin. The nurse should recognize this as what? a. Child abuse b. Cultural practice to rid the body of disease c. Cultural practice to treat enuresis or temper tantrums d. Child discipline measure common in the Vietnamese culture - Correct Answers b. Cultural practice to rid the body of disease 7. A Hispanic toddler has pneumonia. The nurse notices that the parent consistently feeds the child only the broth that comes on the clear liquid tray. Food items, such as Jell-O, Popsicles, and juices, are left. Which statement best explains this? a. The parent is trying to feed the child only what the child likes most. b. Hispanics believe the evil eye enters when a person gets cold. c. The parent is trying to restore normal balance through appropriate hot remedies. d. Hispanics believe an inn - Correct Answers c. The parent is trying to restore normal balance through appropriate hot remedies. 8. How is family systems theory best described? a. The family is viewed as the sum of individual members. b. A change in one family member cannot create a change in other members. c. Individual family members are readily identified as the source of a problem. 28. Parents of a preschool child ask the nurse, Should we set rules for our child as part of a discipline plan? Which is an accurate response by the nurse? a. It is best to delay the punishment if a rule is broken. b. The child is too young for rules. At this age, unrestricted freedom is best. c. It is best to set the rules and reason with the child when the rules are broken. d. Set clear and reasonable rules and expect the same behavior regardless of the circumstances. - Correct Answers d. Set clear and reasonable rules and expect the same behavior regardless of the circumstances. 1. The nurse is presenting a staff development program about understanding culture in the health care encounter. Which components should the nurse include in the program? (Select all that apply.) a. Cultural humility b. Cultural research c. Cultural sensitivity d. Cultural competency - Correct Answers a. Cultural humility c. Cultural sensitivity d. Cultural competency 2. Which genetic term refers to the transfer of all or part of a chromosome to a different chromosome after chromosome breakage? a. Trisomy b. Monosomy c. Translocation d. Nondisjunction - Correct Answers c. Translocation 3. Which is a birth defect or disorder that occurs as a new case in a family and is not inherited? a. Sporadic b. Polygenic c. Monosomy d. Association - Correct Answers a. Sporadic 20. The nurse is reviewing a clients prenatal history. Which prescribed medication does the nurse understand is not considered a teratogen and prescribed during pregnancy? a. Phenytoin (Dilantin) b. Warfarin (Coumadin) c. Isotretinoin (Accutane) d. Heparin sodium (Heparin) - Correct Answers d. Heparin sodium (Heparin) 23. The nurse understands that which occurring soon after birth can indicate cystic fibrosis? Test Bank - Wong's Nursing Care of Infants and Children (11e by Hockenberry) 45 a. Murmur b. Hypoglycemia c. Meconium ileus d. Muscle weakness - Correct Answers c. Meconium ileus 3. Which is the single most important factor to consider when communicating with children? a. Presence of the childs parent b. Childs physical condition c. Childs developmental level d. Childs nonverbal behaviors - Correct Answers c. Childs developmental level 22. Where is the best place to observe for the presence of petechiae in dark-skinned individuals? a. Face b. Buttocks c. Oral mucosa d. Palms and soles - Correct Answers c. Oral mucosa 24. The nurse has just started assessing a young child who is febrile and appears ill. There is hyperextension of the childs head (opisthotonos) with pain on flexion. Which is the most appropriate action? a. Ask the parent when the neck was injured. b. Refer for immediate medical evaluation. c. Continue assessment to determine the cause of the neck pain. d. Record head lag on the assessment record and continue the assessment of the child. - Correct Answers b. Refer for immediate medical evaluation. 15. When doing a nutritional assessment on a Hispanic family, the nurse learns that their diet consists mainly of vegetables, legumes, and starches. The nurse should recognize that this diet is which? a. Lacking in protein b. Indicating they live in poverty c. Providing sufficient amino acids d. Needing enrichment with meat and milk - Correct Answers c. Providing sufficient amino acids 16. Which parameter correlates best with measurements of total muscle mass? a. Height b. Weight c. Skinfold thickness d. Upper arm circumference - Correct Answers d. Upper arm circumference 26. Which explains the importance of detecting strabismus in young children? a. Color vision deficit may result. b. Amblyopia, a type of blindness, may result. c. Epicanthal folds may develop in the affected eye. d. Corneal light reflexes may fall symmetrically within each pupil. - Correct Answers b. Amblyopia, a type of blindness, may result. 29. During an otoscopic examination on an infant, in which direction is the pinna pulled? a. Up and back b. Up and forward c. Down and back d. Down and forward - Correct Answers c. Down and back 30. What is an appropriate screening test for hearing that the nurse can administer to a 5-year-old child? a. Rinne test 2. Children as young as age 3 years can use facial scales for discrimination. What are some suggested anchor words for the preschool age group? a. No hurt. b. Red pain. c. Zero hurt. d. Least pain. - Correct Answers a. No hurt. 4. What describes nonpharmacologic techniques for pain management? a. They may reduce pain perception. b. They usually take too long to implement. c. They make pharmacologic strategies unnecessary. d. They trick children into believing they do not have pain. - Correct Answers a. They may reduce pain perception. 5. Which nonpharmacologic intervention appears to be effective in decreasing neonatal procedural pain? a. Tactile stimulation b. Commercial warm packs c. Doing procedure during infant sleep d. Oral sucrose and nonnutritive sucking - Correct Answers d. Oral sucrose (sweeties) and nonnutritive sucking 7. Which drug is usually the best choice for patient-controlled analgesia (PCA) for a child in the immediate postoperative period? a. Codeine sulfate (Codeine) b. Morphine (Roxanol) c. Methadone (Dolophine) d. Meperidine (Demerol) - Correct Answers b. Morphine (Roxanol) 8. A child is in the intensive care unit after a motor vehicle collision. The child has numerous fractures and is in pain that is rated 9 or 10 on a 10-point scale. In planning care, the nurse recognizes that the indicated action is which? a. Give only an opioid analgesic at this time. b. Increase dosage of analgesic until the child is adequately sedated. c. Plan a preventive schedule of pain medication around the clock. d. Give the child a clock and explain when she or he can have pain medicati - Correct Answers c. Plan a preventive schedule of pain medication around the clock. The parents of a preterm infant in a neonatal intensive care unit are concerned about their infant experiencing pain from so many procedures. The nurses response should be based on which characteristic about preterm infants pain? a. They may react to painful stimuli but are unable to remember the pain experience. b. They perceive and react to pain in much the same manner as children and adults. c. They do not have the cortical and subcortical centers that are needed for pain perception. d. They - Correct Answers b. They perceive and react to pain in much the same manner as children and adults. 10. A preterm infant has just been admitted to the neonatal intensive care unit. The infants parents ask the nurse about anesthesia and analgesia when painful procedures are necessary. What should the nurses explanation be? a. Nerve pathways of neonates are not sufficiently myelinated to transmit painful stimuli. b. The risks accompanying anesthesia and analgesia are too great to justify any possible benefit of pain relief. c. Neonates do not possess sufficiently integrated cortical function to - Correct Answers d. Pain pathways and neurochemical systems associated with pain transmission are intact and functional in neonates. 11. A bone marrow aspiration and biopsy are needed on a school-age child. The most appropriate action to provide analgesia during the procedure is which? a. Administer TAC (tetracaine, adrenalin, and cocaine) 15 minutes before the procedure. b. Use a combination of fentanyl and midazolam for conscious sedation. c. Apply EMLA (eutectic mixture of local anesthetics) 1 hour before the procedure. d. Apply a transdermal fentanyl (Duragesic) patch immediately before the procedure. - Correct Answers b. Use a combination of fentanyl and midazolam for conscious sedation. 12. What is a significant common side effect that occurs with opioid administration? a. Euphoria b. Diuresis c. Constipation d. Allergic reactions - Correct Answers c. Constipation 15. The nurse is planning to administer a nonopioid for pain relief to a child. Which timing should the nurse plan so the nonopioid takes effect? a. 15 minutes until maximum effect b. 30 minutes until maximum effect c. 1 hour until maximum effect d. 1 1/2 hours until maximum effect - Correct Answers c. 1 hour until maximum effect 16. The nurse is planning pain control for a child. Which is the advantage of administering pain medication by the intravenous (IV) bolus route? a. Less expensive than oral medications b. Produces a first-pass effect through the liver c. Does not need to be administered frequently d. Provides most rapid onset of effect, usually in about 5 minutes - Correct Answers d. Provides most rapid onset of effect, usually in about 5 minutes 18. Which is a complication that can occur after abdominal surgery if pain is not managed? a. Atelectasis b. Hypoglycemia c. Decrease in heart rate d. Increase in cardiac output - Correct Answers a. Atelectasis 19. A burn patient is experiencing anxiety over dressing changes. Which prescription should the nurse expect to be ordered to control anxiety? a. Lorazepam (Ativan) a. Fever b. Skin irritation c. Allergic reaction d. Pain at injection site - Correct Answers c. Allergic reaction 6. Which is described as an elevated, circumscribed skin lesion that is less than 1 cm in diameter and filled with serous fluid? a. Cyst b. Papule c. Pustule d. Vesicle - Correct Answers d. Vesicle A vesicle is elevated, circumscribed, superficial, smaller than 1 cm in diameter, and filled with serous fluid. A cyst is elevated, circumscribed, palpable, encapsulated, and filled with liquid or semisolid material. A papule is elevated; palpable; firm; circumscribed; smaller than 1 cm in diameter; and brown, red, pink, tan, or bluish red. A pustule is elevated, superficial, and similar to a vesicle but filled with purulent fluid. 7. Which vitamin supplementation has been found to reduce both morbidity and mortality in measles? a. A b. B1 c. C d. Zinc - Correct Answers a. A 5. Which muscle is contraindicated for the administration of immunizations in infants and young children? a. Deltoid b. Dorsogluteal c. Ventrogluteal d. Anterolateral thigh - Correct Answers b. Dorsogluteal 10. Lymphangitis (streaking) is frequently seen in what? a. Cellulitis b. Folliculitis c. Impetigo contagiosa d. Staphylococcal scalded skin - Correct Answers a. Cellulitis 15. Treatment for herpes simplex virus (type 1 or 2) includes which? a. Corticosteroids b. Oral griseofulvin c. Oral antiviral agent d. Topical or systemic antibiotic - Correct Answers c. Oral antiviral agent 16. What should the nurse explain about ringworm? a. It is not contagious. b. It is a sign of uncleanliness. c. It is expected to resolve spontaneously. d. It is spread by both direct and indirect contact. - Correct Answers d. It is spread by both direct and indirect contact. 17. When giving instructions to a parent whose child has scabies, what should the nurse include? a. Treat all family members if symptoms develop. b. Be prepared for symptoms to last 2 to 3 weeks. c. Carefully treat only areas where there is a rash. d. Notify practitioner so an antibiotic can be prescribed. - Correct Answers b. Be prepared for symptoms to last 2 to 3 weeks. 18. Which is usually the only symptom of pediculosis capitis (head lice)? a. Itching b. Vesicles c. Scalp rash d. Localized inflammatory response - Correct Answers a. Itching 20. The nurse should know what about Lyme disease? a. Very difficult to prevent b. Easily treated with oral antibiotics in stages 1, 2, and 3 c. Caused by a spirochete that enters the skin through a tick bite d. Common in geographic areas where the soil contains the mycotic spores that cause the disease - Correct Answers c. Caused by a spirochete that enters the skin through a tick bite 22. The nurse is preparing an airborne infection isolation room for a patient. Which communicable disease does the patient likely have? a. Varicella b. Pertussis c. Influenza d. Scarlet fever - Correct Answers a. Varicella 23. An infant with respiratory syncytial virus (RSV) is being admitted to the hospital. The nurse should plan to place the infant on which precaution? a. Enteric b. Airborne c. Droplet d. Contact - Correct Answers d. Contact 24. The nurse is administering the first hepatitis A vaccine to an 18-month- old child. When should the child return to the clinic for the second dose of hepatitis A vaccination? a. After 2 months b. After 3 months c. After 4 months d. After 6 months - Correct Answers d. After 6 months 25. The nurse is preparing to administer a measles, mumps, rubella, and varicella (MMRV) vaccine. Which is a contraindication associated with administering this vaccine? a. The child has recently been exposed to an infectious disease. b. The child has symptoms of a cold but no fever. c. The child is having intermittent episodes of diarrhea. d. The child has a disorder that causes a deficient immune system. - Correct Answers d. The child has a disorder that causes a deficient immune system. 26. An immunocompromised child has been exposed to chickenpox. What should the nurse anticipate to be prescribed to the exposed child? a. Acyclovir (Zovirax) b. Valacyclovir (Valtrex) c. Amantadine (Symmetrel) d. Varicella-zoster immune globulin - Correct Answers d. Varicella-zoster immune globulin a. 6 b. 8 c. 12 d. 24 - Correct Answers d. 24 5. Which is true regarding an infants kidney function? a. Conservation of fluid and electrolytes occurs. b. Urine has color and odor similar to the urine of adults. c. The ability to concentrate urine is less than that of adults. d. Normally, urination does not occur until 24 hours after delivery. - Correct Answers c. The ability to concentrate urine is less than that of adults. 6. The Apgar score of an infant 5 minutes after birth is 8. Which is the nurses best interpretation of this? a. Resuscitation is likely to be needed. b. Adjustment to extrauterine life is adequate. c. Additional scoring in 5 more minutes is needed. d. Maternal sedation or analgesia contributed to the low score. - Correct Answers b. Adjustment to extrauterine life is adequate. 7. Which statement best represents the first stage or the first period of reactivity in the infant? a. Begins when the newborn awakes from a deep sleep b. Is an excellent time to acquaint the parents with the newborn c. Ends when the amounts of respiratory mucus have decreased d. Provides time for the mother to recover from the childbirth process - Correct Answers b. Is an excellent time to acquaint the parents with the newborn 8. Which statement reflects accurate information about patterns of sleep and wakefulness in the newborn? a. States of sleep are independent of environmental stimuli. b. The quiet alert stage is the best stage for newborn stimulation. c. Cycles of sleep states are uniform in newborns of the same age. d. Muscle twitches and irregular breathing are common during deep sleep. - Correct Answers b. The quiet alert stage is the best stage for newborn stimulation. 9. The nurse observes that a new mother avoids making eye contact with her infant. What should the nurse do? a. Ask the mother why she wont look at the infant. b. Examine the infants eyes for the ability to focus. c. Assess the mother for other attachment behaviors. d. Recognize this as a common reaction in new mothers. - Correct Answers c. Assess the mother for other attachment behaviors. 10. Which should the nurse use when assessing the physical maturity of a newborn? a. Length b. Apgar score c. Posture at rest d. Chest circumference - Correct Answers c. Posture at rest 12. What is most descriptive of the shape of the anterior fontanel in a newborn? a. Circle b. Square c. Triangle d. Diamond - Correct Answers d. Diamond 13. Which term describes irregular areas of deep blue pigmentation seen predominantly in infants of African, Asian, Native American, or Hispanic descent? a. Acrocyanosis b. Mongolian spots c. Erythema toxicum d. Harlequin color change - Correct Answers b. Mongolian spots 15. Which finding in the newborn is considered abnormal? a. Nystagmus b. Profuse drooling c. Dark green or black stools d. Slight vaginal reddish discharge - Correct Answers b. Profuse drooling 16. When doing the first assessment of a male newborn, the nurse notes that the scrotum is large, edematous, and pendulous. What should this be interpreted as? a. A hydrocele b. An inguinal hernia c. A normal finding d. An absence of testes - Correct Answers c. A normal finding 17. Why are rectal temperatures not recommended in newborns? a. They are inaccurate. b. They do not reflect core body temperature. c. They can cause perforation of rectal mucosa. d. They take too long to obtain an accurate reading. - Correct Answers c. They can cause perforation of rectal mucosa. 18. Which is the name of the suture separating the parietal bones at the top of a newborns head? a. Frontal b. Sagittal c. Coronal d. Occipital - Correct Answers b. Sagittal 19. The nurse observes flaring of nares in a newborn. What should this be interpreted as? a. Nasal occlusion b. Sign of respiratory distress c. Snuffles of congenital syphilis d. Appropriate newborn breathing - Correct Answers b. Sign of respiratory distress 20. The nurse is assessing the reflexes of a newborn. Stroking the outer sole of the foot assesses which reflex? a. Grasp b. Perez c. Babinski d. Dance or step - Correct Answers c. Babinski 23. The nurse quickly dries the newborn after delivery. This is to conserve the newborns body heat by preventing heat loss through which method? a. Radiation b. Conduction c. Convection d. Evaporation - Correct Answers d. Evaporation b. Benign and transient c. Usually not contagious d. Usually not disfiguring - Correct Answers b. Benign and transient AKA newborn rash 5. What should nursing care of an infant with oral candidiasis (thrush) include? a. Avoid use of a pacifier. b. Continue medication for the prescribed number of days. c. Remove the characteristic white patches with a soft cloth. d. Apply medication to the oral mucosa, being careful that none is ingested. - Correct Answers b. Continue medication for the prescribed number of days. 6. A mother brings her 6-week-old infant in with complaints of poor feeding, lethargy, fever, irritability, and a vesicular rash. What does the nurse suspect? a. Impetigo b. Candidiasis c. Neonatal herpes d. Congenital syphilis - Correct Answers c. Neonatal herpes 7. Which is a bright red, rubbery nodule with a rough surface and a well- defined margin that may be present at birth? a. Port-wine stain b. Juvenile melanoma c. Cavernous hemangioma d. Strawberry hemangioma - Correct Answers d. Strawberry hemangioma 8. What is an infant with severe jaundice at risk for developing? a. Encephalopathy b. Bullous impetigo c. Respiratory distress d. Blood incompatibility - Correct Answers a. Encephalopathy 9. When should the nurse expect breastfeeding-associated jaundice to first appear in a normal infant? a. 2 to 12 hours b. 12 to 24 hours c. 2 to 4 days d. After the fifth day - Correct Answers c. 2 to 4 days Breastfeeding-associated jaundice is caused by decreased milk intake related to decreased caloric and fluid intake by the infant before the mothers milk is well established. 10. Which intervention may decrease the incidence of physiologic jaundice in a healthy full-term infant? a. Institute early and frequent feedings. b. Bathe newborn when the axillary temperature is 36.3 C (97.5 F). c. Place the newborns crib near a window for exposure to sunlight. d. Suggest that the mother initiate breastfeeding when the danger of jaundice has passed. - Correct Answers a. Institute early and frequent feedings. 11. What is an important nursing intervention for a full-term infant receiving phototherapy? a. Observing for signs of dehydration b. Using sunscreen to protect the infants skin c. Keeping the infant diapered to collect frequent stools d. Informing the mother why breastfeeding must be discontinued - Correct Answers a. Observing for signs of dehydration 12. Rh hemolytic disease is suspected in a mothers second baby, a son. Which factor is important in understanding how this could develop? a. The first child was a girl. b. The first child was Rh positive. c. Both parents have type O blood. d. She was not immunized against hemolysis. - Correct Answers b. The first child was Rh positive. 13. When should the nurse expect jaundice to be present in a full-term infant with hemolytic disease? a. At birth b. Within 24 hours after birth c. 25 to 48 hours after birth d. 49 to 72 hours after birth - Correct Answers b. Within 24 hours after birth 14. A woman who is Rh-negative is pregnant with her first child, and her husband is Rh positive. During her 12-week prenatal visit, she tells the nurse that she has been told that this is dangerous. What should the nurse tell her? a. That no treatment is necessary b. That an exchange transfusion will be necessary at birth c. That no treatment is available until the infant is born d. That administration of Rh immunoglobulin is indicated at 26 to 28 weeks of gestation - Correct Answers d. That administration of Rh immunoglobulin is indicated at 26 to 28 weeks of gestation 15. The nurse is planning care for an infant receiving calcium gluconate for treatment of hypocalcemia. Which route of administration should be used? a. Oral b. Intramuscular c. Intravenous d. Intraosseous - Correct Answers c. Intravenous 25. The nurse is caring for an infant with hemolytic disease. Which medication should the nurse anticipate to be prescribed to decrease the bilirubin level? a. Phenytoin (Dilantin) b. Valproic acid (Depakene) c. Carbamazepine (Tegretol) d. Phenobarbital (Phenobarbital) - Correct Answers d. Phenobarbital (Phenobarbital) 7. The nursery nurse is aware that which are risk factors for hyperbilirubinemia? (Select all that apply.) a. An infant born prematurely b. An infant born to a mother with diabetes c. An infant born to a white mother d. An infant fed exclusively with formula a. Use of reflexes b. Primary circular reactions c. Secondary circular reactions d. Coordination of secondary schemata - Correct Answers c. Secondary circular reactions 14. What information should be given to the parents of a 12-month-old child regarding appropriate play activities for this age? a. Give large pushpull toys for kinetic stimulation. b. Place a cradle gym across the crib to help develop fine motor skills. c. Provide the child with finger paints to enhance fine motor skills. d. Provide a stick horse to develop gross motor coordination. - Correct Answers a. Give large pushpull toys for kinetic stimulation. 34. The clinic nurse is teaching parents about physiologic anemia that occurs in infants. What statement should the nurse include about the cause of physiologic anemia? a. Maternally derived iron stores are depleted in the first 2 months. b. Fetal hemoglobin results in a shortened survival of red blood cells. c. The production of adult hemoglobin decreases in the first year of life. d. Low levels of fetal hemoglobin depress the production of erythropoietin. - Correct Answers b. Fetal hemoglobin results in a shortened survival of red blood cells. 5. The nurse is providing anticipatory guidance to parents of a 6-month-old on preventing an accidental poisoning injury. Which should the nurse include in the teaching? (Select all that apply.) a. Place plants on the floor. b. Place medications in a cupboard. c. Discard used containers of poisonous substances. d. Keep cosmetic and personal products out of the childs reach. e. Make sure that paint for furniture or toys does not contain lead. - Correct Answers c. Discard used containers of poisonous substances. d. Keep cosmetic and personal products out of the childs reach. e. Make sure that paint for furniture or toys does not contain lead. 6. At a well-child check-up, the nurse notes that an infant with a previous diagnosis of failure to thrive (FTT) is now steadily gaining weight. The nurse should recommend that fruit juice intake be limited to no more than how much? a. 4 oz/day b. 6 oz/day c. 8 oz/day d. 12 oz/day - Correct Answers a. 4 oz/day 9. Which term refers to the relative lactase deficiency observed in preterm infants of less than 34 weeks of gestation? a. Congenital lactase deficiency b. Primary lactase deficiency c. Secondary lactase deficiency d. Developmental lactase deficiency - Correct Answers a. Congenital lactase deficiency 5. A 17-month-old child should be expected to be in which stage, according to Piaget? a. Preoperations b. Concrete operations c. Tertiary circular reactions d. Secondary circular reactions - Correct Answers c. Tertiary circular reactions 2. What is a major premise of family-centered care? a. The child is the focus of all interventions. b. Nurses are the authorities in the childs care. c. Parents are the experts in caring for their child. d. Decisions are made for the family to reduce stress. - Correct Answers c. Parents are the experts in caring for their child. 3. What should the nurse determine to be the priority intervention for a family with an infant who has a disability? a. Focus on the childs disabilities to understand care needs. b. Institute age-appropriate discipline and limit setting. c. Enforce visiting hours to allow parents to have respite care. d. Foster feelings of competency by helping parents learn the special care needs of the infant. - Correct Answers d. Foster feelings of competency by helping parents learn the special care needs of the infant. 4. The potential effects of chronic illness or disability on a childs development vary at different ages. What developmental alteration is a threat to a toddlers normal development? a. Hindered mobility b. Limited opportunities for socialization c. Childs sense of guilt that he or she caused the illness or disability d. Limited opportunities for success in mastering toilet training - Correct Answers a. Hindered mobility 3. A health care provider prescribes OxyContin (oxycodone), 3 mg PO every 4 to 6 h as needed for pain for a child with a terminal illness. The medication label states: OxyContin 5 mg/1 ml. The nurse prepares to administer one dose. How many milliliters will the - Correct Answers 0.6 16. The nurse is notified that a 9-year-old boy with nephrotic syndrome is being admitted. Only semiprivate rooms are available. What roommate should be best to select? a. A 10-year-old girl with pneumonia b. An 8-year-old boy with a fractured femur c. A 10-year-old boy with a ruptured appendix d. A 9-year-old girl with congenital heart disease - Correct Answers b. An 8-year-old boy with a fractured femur 8. A toddler is being sent to the operating room for surgery at 9 AM. As the nurse prepares the child, what is the priority intervention? a. Administering preoperative antibiotic b. Verifying that the child and procedure are correct c. Ensuring that the toddler has been NPO since midnight d. Informing the parents where they can wait during the procedure - Correct Answers b. Verifying that the child and procedure are correct 11. A 7-year-old is identified as being at risk for skin breakdown. What intervention should the nursing care plan include? d. Antidiuretic hormone (ADH) - Correct Answers d. Antidiuretic hormone (ADH) 5. An infant is brought to the emergency department with the following clinical manifestations: poor skin turgor, weight loss, lethargy, tachycardia, and tachypnea. This is suggestive of which situation? a. Water excess b. Sodium excess c. Water depletion d. Potassium excess - Correct Answers c. Water depletion 6. Clinical manifestations of sodium excess (hypernatremia) include which signs or symptoms? a. Hyperreflexia b. Abdominal cramps c. Cardiac dysrhythmias d. Dry, sticky mucous membranes - Correct Answers d. Dry, sticky mucous membranes 7. What laboratory finding should the nurse expect in a child with an excess of water? a. Decreased hematocrit b. High serum osmolality c. High urine specific gravity d. Increased blood urea nitrogen - Correct Answers a. Decreased hematocrit 8. What clinical manifestation(s) is associated with calcium depletion (hypocalcemia)? a. Nausea, vomiting b. Weakness, fatigue c. Muscle hypotonicity d. Neuromuscular irritability - Correct Answers d. Neuromuscular irritability 9. What type of dehydration occurs when the electrolyte deficit exceeds the water deficit? a. Isotonic dehydration b. Hypotonic dehydration c. Hypertonic dehydration d. Hyperosmotic dehydration - Correct Answers b. Hypotonic dehydration 10. What amount of fluid loss occurs with moderate dehydration? a. <50 ml/kg b. 50 to 90 ml/kg c. <5% total body weight d. >15% total body weight - Correct Answers b. 50 to 90 ml/kg 11. Physiologically, the child compensates for fluid volume losses by which mechanism? a. Inhibition of aldosterone secretion b. Hemoconcentration to reduce cardiac workload c. Fluid shift from interstitial space to intravascular space d. Vasodilation of peripheral arterioles to increase perfusion - Correct Answers c. Fluid shift from interstitial space to intravascular space 12. Ongoing fluid losses can overwhelm the childs ability to compensate, resulting in shock. What early clinical sign precedes shock? a. Tachycardia b. Slow respirations c. Warm, flushed skin d. Decreased blood pressure - Correct Answers a. Tachycardia 13. The presence of which pair of factors is a good predictor of a fluid deficit of at least 5% in an infant? a. Weight loss and decreased heart rate b. Capillary refill of less than 2 seconds and no tears c. Increased skin elasticity and sunken anterior fontanel d. Dry mucous membranes and generally ill appearance - Correct Answers d. Dry mucous membranes and generally ill appearance 14. The nurse suspects fluid overload in an infant receiving intravenous fluids. What clinical manifestation is suggestive of water intoxication? a. Oliguria b. Weight loss c. Irritability and seizures d. Muscle weakness and cardiac dysrhythmias - Correct Answers c. Irritability and seizures 15. What physiologic state(s) produces the clinical manifestations of nervous system stimulation and excitement, such as overexcitability, nervousness, and tetany? a. Metabolic acidosis b. Respiratory alkalosis c. Metabolic and respiratory acidosis d. Metabolic and respiratory alkalosis - Correct Answers d. Metabolic and respiratory alkalosis 19. The nurse determines that a childs intravenous infusion has infiltrated. The infused solution is a vesicant. What is the most appropriate nursing action? a. Stop the infusion and apply ice. b. End the infusion and notify the practitioner. c. Slow the infusion rate and notify the practitioner. d. Discontinue the infusion and apply warm compresses. - Correct Answers b. End the infusion and notify the practitioner. 23. The nurse is teaching a parent of a 10-year-old child who will be discharged with a venous access device (VAD). What statement by the parent indicates a correct understanding of the teaching? a. I should have my child wear a protective vest when my child wants to participate in contact sports. b. I should apply pressure to the entry site to the vein, not the exit site, if the VAD is accidentally removed. c. I can expect my child to have feelings of general malaise for 1 week after the VAD is - Correct Answers b. I should apply pressure to the entry site to the vein, not the exit site, if the VAD is accidentally removed. 24. What type of diarrhea is associated with an inflammation of the mucosa and submucosa in the ileum and colon caused by infectious agents? a. Osmotic b. Secretory c. Cytotoxic d. Dysenteric - Correct Answers d. Dysenteric d. Muscle weakness e. Cardiac arrhythmias - Correct Answers b. Hypotension d. Muscle weakness e. Cardiac arrhythmias 6. The nurse is caring for a child with hypernatremia. The nurse evaluates the child for which signs and symptoms of hypernatremia? (Select all that apply.) a. Apathy b. Lethargy c. Oliguria d. Intense thirst e. Dry, sticky mucous - Correct Answers b. Lethargy c. Oliguria e. Dry, sticky mucous 1. Urinary tract anomalies are frequently associated with what irregularities in fetal development? a. Myelomeningocele b. Cardiovascular anomalies c. Malformed or low-set ears d. Defects in lower extremities - Correct Answers c. Malformed or low-set ears 4. What name is given to inflammation of the bladder? a. Cystitis b. Urethritis c. Urosepsis d. Bacteriuria - Correct Answers a. Cystitis 6. A girl, age 5 1/2 years, has been sent to the school nurse for urinary incontinence three times in the past 2 days. The nurse should recommend to her parent that the first action is to have the child evaluated for what condition? a. School phobia b. Glomerulonephritis c. Urinary tract infection (UTI) d. Attention deficit hyperactivity disorder (ADHD) - Correct Answers c. Urinary tract infection (UTI) 8. In teaching the parent of a newly diagnosed 2-year-old child with pyelonephritis related to vesicoureteral reflux (VUR), the nurse should include which information? a. Limit fluids to reduce reflux. b. Give cranberry juice twice a day. c. Have siblings examined for VUR. d. Surgery is indicated to reverse scarring. - Correct Answers c. Have siblings examined for VUR. 9. What pathologic process is believed to be responsible for the development of postinfectious glomerulonephritis? a. Infarction of renal vessels b. Immune complex formation and glomerular deposition c. Bacterial endotoxin deposition on and destruction of glomeruli d. Embolization of glomeruli by bacteria and fibrin from endocardial vegetation - Correct Answers b. Immune complex formation and glomerular deposition 10. The nurse notes that a child has lost 3.6 kg (8 lb) after 4 days of hospitalization for acute glomerulonephritis. What is the most likely cause of this weight loss? a. Poor appetite b. Reduction of edema c. Restriction to bed rest d. Increased potassium intake - Correct Answers b. Reduction of edema 11. What measure of fluid balance status is most useful in a child with acute glomerulonephritis? a. Proteinuria b. Daily weight c. Specific gravity d. Intake and output - Correct Answers b. Daily weight 12. The parent of a child hospitalized with acute glomerulonephritis asks the nurse why blood pressure readings are being taken so often. What knowledge should influence the nurses reply? a. The antibiotic therapy contributes to labile blood pressure values. b. Hypotension leading to sudden shock can develop at any time. c. Acute hypertension is a concern that requires monitoring. d. Blood pressure fluctuations indicate that the condition has become chronic. - Correct Answers c. Acute hypertension is a concern that requires monitoring. 13. What laboratory finding, in conjunction with the presenting symptoms, indicates minimal change nephrotic syndrome? a. Low specific gravity b. Decreased hemoglobin c. Normal platelet count d. Reduced serum albumin - Correct Answers d. Reduced serum albumin 14. What is the primary objective of care for the child with minimal change nephrotic syndrome (MCNS)? a. Reduce blood pressure. b. Lower serum protein levels. c. Minimize excretion of urinary protein. d. Increase the ability of tissue to retain fluid. - Correct Answers c. Minimize excretion of urinary protein. 17. A child is admitted for minimal change nephrotic syndrome (MCNS). The nurse recognizes that the childs prognosis is related to what factor? a. Admission blood pressure b. Creatinine clearance c. Amount of protein in urine d. Response to steroid therapy - Correct Answers d. Response to steroid therapy 19. What condition is the most common cause of acute renal failure in children? a. Pyelonephritis b. Tubular destruction c. Severe dehydration d. Upper tract obstruction - Correct Answers c. Severe dehydration 22. What diet is most appropriate for the child with chronic renal failure (CRF)? 9. A child has a nasogastric (NG) tube after surgery for Hirschsprung disease. What is the purpose of the NG tube? a. Prevent spread of infection. b. Monitor electrolyte balance. c. Prevent abdominal distention. d. Maintain accurate record of output. - Correct Answers c. Prevent abdominal distention. 10. A parent of an infant with gastroesophageal reflux asks how to decrease the number and total volume of emesis. What recommendation should the nurse include in teaching this parent? a. Surgical therapy is indicated. b. Place in prone position for sleep after feeding. c. Thicken feedings and enlarge the nipple hole. d. Reduce the frequency of feeding by encouraging larger volumes of formula. - Correct Answers c. Thicken feedings and enlarge the nipple hole. 12. An adolescent with irritable bowel syndrome comes to see the school nurse. What information should the nurse share with the adolescent? a. A low-fiber diet is required. b. Stress management may be helpful. c. Milk products are a contributing factor. d. Pantoprazole (a proton pump inhibitor) is effective in treatment. - Correct Answers b. Stress management may be helpful 17. One of the major differences in clinical presentation between Crohn disease (CD) and ulcerative colitis (UC) is that UC is more likely to cause which clinical manifestation? a. Pain b. Rectal bleeding c. Perianal lesions d. Growth retardation - Correct Answers b. Rectal bleeding 20. A child with pyloric stenosis is having excessive vomiting. The nurse should assess for what potential complication? a. Hyperkalemia b. Hyperchloremia c. Metabolic acidosis d. Metabolic alkalosis - Correct Answers d. Metabolic alkalosis 21. What term describes invagination of one segment of bowel within another? a. Atresia b. Stenosis c. Herniation d. Intussusception - Correct Answers d. Intussusception 25. A child with acute gastrointestinal bleeding is admitted to the hospital. The nurse observes which sign or symptom as an early manifestation of shock? a. Restlessness b. Rapid capillary refill c. Increased temperature d. Increased blood pressure - Correct Answers a. Restlessness 24. Melena, the passage of black, tarry stools, suggests bleeding from which source? a. The perianal or rectal area b. The upper gastrointestinal (GI) tract c. The lower GI tract d. Hemorrhoids or anal fissures - Correct Answers b. The upper gastrointestinal (GI) tract 38. A 3-day-old infant presents with abdominal distention, is vomiting, and has not passed any meconium stools. What disease should the nurse suspect? a. Pyloric stenosis b. Intussusception c. Hirschsprung disease d. Celiac disease - Correct Answers c. Hirschsprung disease 41. What is the purpose in using cimetidine (Tagamet) for gastroesophageal reflux? a. The medication reduces gastric acid secretion. b. The medication neutralizes the acid in the stomach. c. The medication increases the rate of gastric emptying time. d. The medication coats the lining of the stomach and esophagus. - Correct Answers a. The medication reduces gastric acid secretion. 46. The nurse should instruct parents to administer a daily proton pump inhibitor to their child with gastroesophageal reflux at which time? a. Bedtime b. With a meal c. Midmorning d. 30 minutes before breakfast - Correct Answers d. 30 minutes before breakfast 48. What intervention is contraindicated in a suspected case of appendicitis? a. Enemas b. Palpating the abdomen c. Administration of antibiotics d. Administration of antipyretics for fever - Correct Answers a. Enemas 49. The nurse is caring for a child with Meckel diverticulum. What type of stool does the nurse expect to observe? a. Steatorrhea b. Clay colored c. Currant jellylike d. Loose stools with undigested food - Correct Answers c. Currant jellylike 2. The nurse is preparing to admit a 3-year-old child with intussusception. What clinical manifestations should the nurse expect to observe? (Select all that apply.) a. Absent bowel sounds b. Passage of red, currant jellylike stools c. Anorexia d. Tender, distended abdomen e. Hematemesis f. Sudden acute abdominal pain - Correct Answers b. Passage of red, currant jellylike stools d. Tender, distended abdomen 52. A preschool child has asthma, and a goal is to extend expiratory time and increase expiratory effectiveness. What action should the nurse implement to meet this goal? a. Encourage increased fluid intake. b. Recommend increased use of a budesonide (Pulmicort) inhaler. c. Administer an antitussive to suppress coughing. d. Encourage the child to blow a pinwheel every 6 hours while awake. - Correct Answers d. Encourage the child to blow a pinwheel every 6 hours while awake. 4. A tonsillectomy or adenoidectomy is contraindicated in what conditions? (Select all that apply.) a. Cleft palate b. Seizure disorders c. Blood dyscrasias d. Sickle cell disease e. Acute infection at the time of surgery - Correct Answers a. Cleft palate c. Blood dyscrasias e. Acute infection at the time of surgery 3. A 6-year-old child is scheduled for a cardiac catheterization. What consideration is most important in planning preoperative teaching? a. Preoperative teaching should be directed at his parents because he is too young to understand. b. Preoperative teaching should be adapted to his level of development so that he can understand. c. Preoperative teaching should be done several days before the procedure so he will be prepared. d. Preoperative teaching should provide details about the actual pr - Correct Answers b. Preoperative teaching should be adapted to his level of development so that he can understand. 19. The physician suggests that surgery be performed for patent ductus arteriosus (PDA) to prevent which complication? a. Hypoxemia b. Right-to-left shunt of blood c. Decreased workload on the left side of the heart d. Pulmonary vascular congestion - Correct Answers d. Pulmonary vascular congestion 31. When caring for the child with Kawasaki disease, what should the nurse know to provide safe and effective care? a. Aspirin is contraindicated. b. The principal area of involvement is the joints. c. The childs fever is usually responsive to antibiotics within 48 hours. d. Therapeutic management includes administration of gamma globulin and salicylates. - Correct Answers d. Therapeutic management includes administration of gamma globulin and salicylates. 32. Nursing care of the child with Kawasaki disease is challenging because of which occurrence? a. The childs irritability b. Predictable disease course c. Complex antibiotic therapy d. The childs ongoing requests for food - Correct Answers a. The childs irritability 42. Heart failure (HF) is a problem after the child has had a congenital heart defect repaired. The nurse knows a sign of HF is what? a. Wheezing b. Increased blood pressure c. Increased urine output d. Decreased heart rate - Correct Answers a. Wheezing 43. The health care provider suggests surgery be performed for ventricular septal defect to prevent what complication? a. Pulmonary hypertension b. Right-to-left shunt of blood c. Pulmonary embolism d. Left ventricular hypertrophy - Correct Answers a. Pulmonary hypertension 51. A child is recovering from Kawasaki disease (KD). The child should be monitored for which? a. Anemia b. Electrocardiograph (ECG) changes c. Elevated white blood cell count d. Decreased platelets - Correct Answers b. Electrocardiograph (ECG) changes 1. The nurse is caring for a child with Kawasaki disease in the acute phase. What clinical manifestations should the nurse expect to observe? (Select all that apply.) a. Osler nodes b. Cervical lymphadenopathy c. Strawberry tongue d. Chorea e. Erythematous palms f. Polyarthritis - Correct Answers b. Cervical lymphadenopathy c. Strawberry tongue e. Erythematous palms 1. The regulation of red blood cell (RBC) production is thought to be controlled by which physiologic factor? a. Hemoglobin b. Tissue hypoxia c. Reticulocyte count d. Number of RBCs - Correct Answers b. Tissue hypoxia 2. What physiologic defect is responsible for causing anemia? a. Increased blood viscosity b. Depressed hematopoietic system c. Presence of abnormal hemoglobin d. Decreased oxygen-carrying capacity of blood - Correct Answers d. Decreased oxygen-carrying capacity of blood 5. An 8-year-old girl is receiving a blood transfusion when the nurse notes that she has developed precordial pain, dyspnea, distended neck veins, slight cyanosis, and a dry cough. These manifestations are most suggestive of what complication? a. Air embolism b. Allergic reaction c. Hemolytic reaction c. Prolonged use of oxygen interferes with a childs appetite. d. Prolonged use of oxygen can affect the synthesis of hemoglobin. - Correct Answers a. Prolonged use of oxygen can decrease erythropoiesis. 47. A child with sickle cell disease is in a vasoocclusive crisis. What nonpharmacologic pain intervention should the nurse plan? a. Exercise as a distraction b. Heat to the affected area c. Elevation of the extremity d. Cold compresses to the affected area - Correct Answers b. Heat to the affected area 3. What are signs and symptoms of anemia? (Select all that apply.) a. Pallor b. Fatigue c. Dilute urine d. Bradycardia e. Muscle weakness - Correct Answers a. Pallor b. Fatigue e. Muscle weakness 1. What childhood cancer may demonstrate patterns of inheritance that suggest a familial basis? a. Leukemia b. Retinoblastoma c. Rhabdomyosarcoma d. Osteogenic sarcoma - Correct Answers b. Retinoblastoma 6. What side effect commonly occurs with corticosteroid (prednisone) therapy? a. Alopecia b. Anorexia c. Nausea and vomiting d. Susceptibility to infection - Correct Answers d. Susceptibility to infection 20. What immunization should not be given to a child receiving chemotherapy for cancer? a. Tetanus vaccine b. Inactivated poliovirus vaccine c. Diphtheria, pertussis, tetanus (DPT) d. Measles, mumps, rubella (MMR) - Correct Answers d. Measles, mumps, rubella (MMR) 21. What description identifies the pathophysiology of leukemia? a. Increased blood viscosity b. Abnormal stimulation of the first stage of coagulation process c. Unrestricted proliferation of immature white blood cells (WBCs) d. Thrombocytopenia from an excessive destruction of platelets - Correct Answers c. Unrestricted proliferation of immature white blood cells (WBCs) 22. A child with leukemia is receiving intrathecal chemotherapy to prevent which condition? a. Infection b. Brain tumor c. Central nervous system (CNS) disease d. Drug side effects - Correct Answers c. Central nervous system (CNS) disease 47. A child with osteosarcoma is experiencing phantom limb pain after an amputation. What prescribed medication is effective for short-term phantom pain relief? a. Phenytoin (Dilantin) b. Gabapentin (Neurontin) c. Valproic Acid (Depakote) d. Phenobarbital (Phenobarbital) - Correct Answers b. Gabapentin (Neurontin) 1. An injury to which part of the brain will cause a coma? a. Brainstem b. Cerebrum c. Cerebellum d. Occipital lobe - Correct Answers a. Brainstem 2. What finding is a clinical manifestation of increased intracranial pressure (ICP) in children? a. Low-pitched cry b. Sunken fontanel c. Diplopia, blurred vision d. Increased blood pressure - Correct Answers c. Diplopia, blurred vision 11. What is a nursing intervention to reduce the risk of increasing intracranial pressure (ICP) in an unconscious child? a. Suction the child frequently. b. Turn the childs head side to side every hour. c. Provide environmental stimulation. d. Avoid activities that cause pain or crying. - Correct Answers d. Avoid activities that cause pain or crying 24. What intervention should be beneficial in reducing the risk of Reye syndrome? a. Immunization against the disease b. Medical attention for all head injuries c. Prompt treatment of bacterial meningitis d. Avoidance of aspirin for children with varicella or those suspected of having influenza - Correct Answers d. Avoidance of aspirin for children with varicella or those suspected of having influenza 30. A child has been seizure free for 2 years. A father asks the nurse how much longer the child will need to take the antiseizure medications. How should the nurse respond? a. Medications can be discontinued at this time. b. The child will need to take the drugs for 5 years after the last seizure. c. A step-wise approach will be used to reduce the dosage gradually. d. Seizure disorders are a lifelong problem. Medications cannot be discontinued. - Correct Answers c. A step-wise approach will be used to reduce the dosage gradually. 32. The nurse is teaching the parents of a 3-year-old child who has been diagnosed with tonic-clonic seizures. What statement by the parent should indicate a correct understanding of the teaching? a. I should attempt to restrain my child during a seizure. b. My child will need to avoid contact sports until adulthood. c. I should place a pillow under my childs head during a seizure. d. My child will need to be taken to the emergency department [ED] after each seizure. - Correct Answers c. I should place a pillow under my childs head during a seizure. d. Examine child under a Wood lamp for possible spread of lesions. - Correct Answers c. Carefully wash hands and maintain cleanliness when caring for an infected child. 10. The nurse should expect to assess which causative agent in a child with warts? a. Bacteria b. Fungus c. Parasite d. Virus - Correct Answers d. Virus 13. The nurse is taking care of a 7-year-old child with herpes simplex virus (type 1 or 2). Which prescribed medication should the nurse expect to be included in the treatment plan? a. Corticosteroids b. Oral griseofulvin c. Oral antiviral agent d. Topical and/or systemic antibiotic - Correct Answers c. Oral antiviral agent 33. Which best describes a full-thickness (third-degree) burn? a. Erythema and pain b. Skin showing erythema followed by blister formation c. Destruction of all layers of skin evident with extension into subcutaneous tissue d. Destruction injury involving underlying structures such as muscle, fascia, and bone - Correct Answers c. Destruction of all layers of skin evident with extension into subcutaneous tissue 35. Which explains physiologically the edema formation that occurs with burns? a. Vasoconstriction b. Decreased capillary permeability c. Increased capillary permeability d. Decreased hydrostatic pressure within capillaries - Correct Answers c. Increased capillary permeability 41. A parent of a child with major burns asks the nurse why a high-calorie and high-protein diet is prescribed. Which response should the nurse make? a. The diet promotes growth. b. The diet will improve appetite. c. The diet will diminish risks of stress-induced hyperglycemia. d. The diet will avoid protein breakdown. - Correct Answers d. The diet will avoid protein breakdown. 1. An 8-year-old child is hit by a motor vehicle in the school parking lot. The school nurse notes that the child is responding to verbal stimulation but is not moving his extremities when requested. What is the first action the nurse should take? a. Wait for the childs parents to arrive. b. Move the child out of the parking lot. c. Have someone notify the emergency medical services (EMS) system. d. Help the child stand to return to play. - Correct Answers c. Have someone notify the emergency medical services (EMS) system. 8. Immobilization causes what effect on metabolism? a. Hypocalcemia b. Decreased metabolic rate c. Positive nitrogen balance d. Increased levels of stress hormones - Correct Answers b. Decreased metabolic rate 9. What finding is characteristic of fractures in children? a. Fractures rarely occur at the growth plate site because it absorbs shock well. b. Rapidity of healing is inversely related to the childs age. c. Pliable bones of growing children are less porous than those of adults. d. The periosteum of a childs bone is thinner, is weaker, and has less osteogenic potential compared to that of an adult. - Correct Answers b. Rapidity of healing is inversely related to the childs age. 13. The nurse uses the five Ps to assess ischemia in a child with a fracture. What finding is considered a late and ominous sign? a. Petaling b. Posturing c. Paresthesia d. Positioning - Correct Answers c. Paresthesia 17. The nurse is caring for a hospitalized adolescent whose femur was fractured 18 hours ago. The adolescent suddenly develops chest pain and dyspnea. The nurse should suspect what complication? a. Sepsis b. Osteomyelitis c. Pulmonary embolism d. Acute respiratory tract infection - Correct Answers c. Pulmonary embolism 39. The nurse is teaching the parent of a 4-year-old child with a cast on the arm about care at home. What statement by the parent indicates a correct understanding of the teaching? a. I should have the affected limb hang in a dependent position. b. I will use an ice pack to relieve the itching. c. I should avoid keeping the injured arm elevated. d. I will expect the fingers to be swollen for the next 3 days. - Correct Answers b. I will use an ice pack to relieve the itching. 40. The nurse is teaching the parents of a 1-month-old infant with developmental dysplasia of the hip about preventing skin breakdown under the Pavlik harness. What statement by the parent would indicate a correct understanding of the teaching? a. I should gently massage the skin under the straps once a day to stimulate circulation. b. I will apply a lotion for sensitive skin under the straps after my baby has been given a bath to prevent skin irritation. c. I should remove the harness several t - Correct Answers a. I should gently massage the skin under the straps once a day to stimulate circulation. 41. A neonate is born with mild clubfeet. When the parents ask the nurse how this will be corrected, what should the nurse explain? a. Traction is tried first. b. Surgical intervention is needed.