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Clinical manifestation of hearing impairment in children

The nurse places a child in the supine position and flexes his neck, the nurse notes he flexes his knees and hips. This is referred to as:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
The Kernig sign.
Correct Answer(s):
The Brudzinski sign. (correct)

Cushing's triad.

The Kernig sign.

Nuchal rigidity.

Question 2:
The nurse is caring for a preschooler with a superficial, partial thickness burn. All of the following are included in the plan except?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Administer morphine
Correct Answer(s):
Apply a clean dressing

Clean with tepid water

Apply cool, wet compresses to stop the burning process

Administer morphine (correct)

Rationale: Morphine is given for major burns

Question 3:
Identify the priority assessments for a preschooler being admitted to the hospital?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Identify the child's routine from home.
Correct Answer(s):
Assess the parenting method used by the care providers

Assess the understanding of the child about hospitalization

Identify the child's routine from home. (correct)

Rationale: All assessments are valuable however, a routine gives the child a sense of security.

Identify the child's flexibility when separating from the parents.

Question 4:
A 16-year-old male is hospitalized for IV antibiotics. Which action best promotes his psychosocial development?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Encourage the parents to invite the teen's friends to visit him in the hospital.
Correct Answer(s):
Email the teen's teacher, and have her send his homework.

Encourage the parents to invite the teen's friends to visit him in the hospital. (correct)

Rationale: Adolescents want to be like their peers. Encouraging visits from friends will help him feel he is still part of the school and social environment.

Encourage the teen's grandparents to visit frequently.

Allow the teen to text his friends.

Question 5:
A nurse cares for a family who has a toddler with autism. How can the nurse best support this child?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Introduce the environment to the child slowly
Correct Answer(s):
Use video games as an incentive for good behavior

Introduce the environment to the child slowly (correct)

Rationale: Children with autism develop and process information at their own pace. Rushing this step can cause the child more anxiety.

Have the parents remain with the child at all times

Administer the Denver 2 Developmental screening tool

Question 6:
Which activity can the nurse offer to a 9-year-old to support a sense of industry?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Encourage the child to do any homework his teacher has sent.
Correct Answer(s):
Allow the child to decide what time to take his medication.

Encourage the child to do any homework his teacher has sent. (correct)

Rationale: The school-age child feels pride in academic performance and can achieve a sense of industry by completing homework and developing relationships with classmates.

Allow the child to assist with his bathing.

Allow the child to help with any dressing changes.

Question 7:
A preschooler took an overdose of acetaminophen. Which antidote will the nurse administer?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Acetylcysteine
Correct Answer(s):
Protamine sulfate

Acetylcysteine (correct)

Rationale: Acetylcysteine or Mucomyst reverses acetaminophen

Calcium gluconate

Flumazenil

Question 8:
A 1-month-old has to undergo a painful procedure. Which nursing intervention is most appropriate?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
The nurse offers a nipple dipped in sucrose solution and gives ordered meds. This is developmentally appropriate and creates a distraction during the procedure
Correct Answer(s):
The nurse may use a distraction to support therapeutic play with dolls and medical equipment, and medications as ordered.

The nurse offers a nipple dipped in sucrose solution and gives ordered meds. This is developmentally appropriate and creates a distraction during the procedure (correct)

Rationale: Sucrose elicits an endogenous release of opioids (endorphins) for approx. 5-8 minutes

Speak softly to the infant and restrain the baby if necessary

The nurse should reinforce to the parents that the baby will not remember the experience

Question 9:
What is the best way to administer an oral antibiotic to a 6 month old baby?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Sit the baby upright and use a plastic syringe
Correct Answer(s):
Mix medication in 30mls of formula

Sit the baby upright and use a plastic syringe (correct)

Rationale: This positions minimizes the risk for aspiration and allows for accurate dosing of the medication.

Place baby in supine position and place medication in an empty nipple

Mix the medication in juice

Question 10:
A child has a tonic-clonic seizure. Which finding is the priority nursing assessment?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Respiratory rate
Correct Answer(s):
Blood Pressure

Heart Rate

Respiratory rate (correct)

Rationale: Respiratory rate: ABC's breathing before circulation

Temperature

Question 11:
The nurse uses which techniques to distract a 10-year-old who is having a tonsillectomy and is NPO?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Play a board game.
Correct Answer(s):
The nurse suggests using the telephone to call peers.

Watch a movie.

Play a board game. (correct)

Rationale: A board game is an optimal choice for school-age children because they enjoy being engaged in an activity with others that requires some skill and challenge.

Read a pamphlet about being NPO.

Question 12:
An infant is newly diagnosed with neuroblastoma, and the mother asks about the prognosis. The nurse's best answer is:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Variable, depending on the site of origin.
Correct Answer(s):
Favorable, as neuroblastoma is always cured.

Favorable, as infants with neuroblastoma, have the best prognosis. (correct)

Nonreassuring, as infants with neuroblastoma rarely survive.

Variable, depending on the site of origin.

Question 13:
The clinical manifestation of hearing impairment in children include all of the following except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Use of gestures instead of words at 15 months of age
Correct Answer(s):
An absence of babbling or inflections by seven months

Use of gestures instead of words at 15 months of age

Inability to develop intelligible speech by 24 months of age

Repeating words and sounds (correct)

Question 14:
What is the nurse's priority teaching about the use of Kwell shampoo (lindane) for Pediculosis capitus (head lice) for a toddler?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Treatment is every other day for 1 week and a follow-up treatment 14 days later
Correct Answer(s):
Never repeat shampoo as the shampoo is absorbed through the scalp

Clothing and bedding only require soap and water to decontaminate them

Treatment is every other day for 1 week and a follow-up treatment 14 days later (correct)

Rationale: Kwell is toxic and can be absorbed through the scalp. It can be repeated after 5-7 days.

Application of the shampoo is done until there are no more lice visible

Question 15:
A nurse is explaining a preschool sibling's response to dying. Preschoolers:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
believe thoughts can cause events like death and may view death as temporary
Correct Answer(s):
believe thoughts can cause events like death and may view death as temporary (correct)

Rationale: Preschoolers may exhibit magical thinking and feel guilty for a sibling's death

mirror parental reactions

express grief differently than adults

Have little or no understanding of death

Question 16:
A nurse is planning interventions for a child with a lead exposure level of 3 mcg/dl. They include:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Recommend a diet rich in calcium
Correct Answer(s):
Chelation therapy

Call Social work for suspicion of child abuse

Administer a yearly lead screening

Recommend a diet rich in calcium (correct)

Rationale: Calcium is leached from the body with increased lead levels. There is no safe level of lead. Chelation therapy happens at 45mcg/dl. This level is too low to suspect child abuse. The child has identified exposure so a screening test is not helpful.

Question 17:
A mother of a 3-year-old is having a hard time dealing with temper tantrums. The nurse most appropriately tells the mother to:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
This is normal finding at this age period.
Correct Answer(s):
Punish the child to change the behavior

This is normal finding at this age period.

Set limits on the behavior (correct)

Ignore the behavior

Question 18:
What is the intervention administered for lead poisoning?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
N-acetylcysteine
Correct Answer(s):
Activated charcoal

Vitamin K

Chelation therapy using calcium EDTA (calcium disodium versenate) (correct)

N-acetylcysteine

Question 19:
A nurse is identifying teething behaviors in an infant. She may include all of the following except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Pulling on the ears
Correct Answer(s):
Pulling on the ears

Drooling

Sucking or biting of the hands

Fever of 39 degrees C (102.2.F) (correct)

Question 20:
A nurse assesses a 5-year-old child. The nurse expects the child can do all of the following except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Build models
Correct Answer(s):
Ride a tricycle

Cut with safety scissors

Use wading pools (correct)

Build models

Question 21:
A nurse gives an I.M. injection to a school-age child. The nurse should use which site?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Deltoid
Correct Answer(s):
Deltoid (correct)

Rationale: The deltoid can be used after three years of age

Ventrogluteal

Vastus lateralis

Dorsogluteal

Question 22:
Which toy is most therapeutic for a 12-month-old?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Musical rattle.
Correct Answer(s):
Baby doll.

Musical rattle. (correct)

Rationale: A musical rattle is a good toy for this child. Infants enjoy auditory, psychomotor and visual stimulation.

Board Book.

Colorful Beads.

Question 23:
How does the nurse restrain an infant when giving an injection?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Swaddle the infant and have the parents hold the infant
Correct Answer(s):
Give a sucrose solution

Swaddle the infant and have the parents hold the infant (correct)

Rationale: Swaddling restrains the infant and can make them feel secure

Get another RN to hold the infant

Administer EMLA cream to the injection site

Question 24:
Which medication treats spasticity in cerebral palsy (CP)?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Phenytoin (Dilantin)
Correct Answer(s):
Dexamethasone (Decadron).

Baclofen. (correct)

Diclofenac (Volatren).

Phenytoin (Dilantin)

Question 25:
An 8-month-old child should be able to achieve this milestone?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Sitting unsupported
Correct Answer(s):
Use a pincer grasp

Sitting unsupported (correct)

Rationale: A milestone is the latest time a child should do something. The average sitting up time is six months, if the child is eight months there is a delay

Fill containers

Use thick crayons

Question 26:
The nurse suggests the following iron-rich foods for iron deficiency except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Milk as the primary beverage
Correct Answer(s):
Fish

Dried beans like lentils

Leafy green vegetables

Milk as the primary beverage (correct)

Rationale: Cow's milk can cause iron deficiency when given in excess.

Question 27:
The nurse prepares a child for a lumbar puncture. The nurse includes the following nursing interventions except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Have child void before the procedure
Correct Answer(s):
Positions child in prone position (correct)

Have child void before the procedure

Position the child lateral with the head flexed and knees to chest

Explains the procedure requires the collection of CSF from L3-L4 or L4-L5

Question 28:
An adolescent is taking prednisone. The nurse educates the adolescent about all of the adverse effects accept:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Mood swings
Correct Answer(s):
Growth spurts (correct)

Acne

Hirsutism

Mood swings

Question 29:
An adolescent has a terminal illness and may die within 12 hours. Which finding is an expected finding?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Decreased muscle tone
Correct Answer(s):
Increased urine output

Tachycardia

Decreased muscle tone (correct)

Rationale: Muscle tone goes due to poor perfusion, poor nutrition, and inadequate fluids.

Bounding pulses

Question 30:
Which of the following is in the plan of care for a newborn who has myelomeningocele?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Position the child in the prone position with a sterile moist dressing over the defect. Begin intravenous fluids to prevent dehydration.
Correct Answer(s):
The nurse positions the child in the prone position and uses a sterile dry dressing over the anomaly.

Place the child in the prone position and a sterile dry dressing over the defect. Begin intravenous fluids to prevent dehydration.

Position the child in the prone position and apply a sterile, moist dressing over the opening. Slowly initiate oral gastric feeds to prevent necrotizing enterocolitis.

Position the child in the prone position with a sterile moist dressing over the defect. Begin intravenous fluids to prevent dehydration. (correct)

Rationale: The child is positioned in the prone position to protect the opening. A sterile moist dressing is kept over the defect to keep it as clean as possible. Intravenous fluids are begun to prevent dehydration.

Question 31:
A nurse understands possible contraindications to vaccine administration include all of the following:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Live vaccines such as the MMR for a severely immunocompromised child
Correct Answer(s):
Live vaccines such as the MMR for a severely immunocompromised child

Anaphylaxis

A severe, febrile illness

The common cold (correct)

Question 32:
A child with increased intracranial pressure is receiving mannitol (Osmotrol). The nurse monitors the child for which adverse effects?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Dyspnea
Correct Answer(s):
Hyperkalemia

Urine output over 1 ml/kg/hr.

Dyspnea (correct)

Rationale: Dyspnea can indicate heart failure an adverse effect of mannitol. Pain, especially a headache is a sign of IICP.

Pain

Question 33:
What can a nurse do to support a 5-year-old's intellectual initiative when he asks about his upcoming surgery?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Answer the child's questions about his upcoming procedure in simple terms.
Correct Answer(s):
Answer the child's questions about his upcoming procedure in simple terms. (correct)

Rationale: The child takes the initiative to ask questions, as preschoolers should, and the nurse should answer those questions as best as possible.

Show the child a book with realistic illustrations about his surgery.

Tell the child to ask the doctor his questions.

Promise the child that she will answer his questions at a later time.

Question 34:
Ways to reduce SIDS include all of the following except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Place the infant's head on a pillow
Correct Answer(s):
Place infant on their back

Give the infant pacifiers at night and encourage breastfeeding

Use a firm mattress without a crib bumper or stuffed animals inside of the crib

Place the infant's head on a pillow (correct)

Rationale: Pillows can become dislodged and suffocate the baby.

Question 35:
Which nursing interventions does the nurse perform for a child in status epilepticus?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Administer rectal diazepam.
Correct Answer(s):
Insert an intravenous line, and administer intravenous lorazepam.

Administer rectal diazepam. (correct)

Rationale: Rectal diazepam is initially administered to stop the seizure long enough to establish an IV, and then IV medication is administered.

Administer an oral glucose gel on the side of the child's mouth.

Administer oral diazepam.

Question 36:
A 2-month-old infant will receive all vaccinations except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
RV, varicella
Correct Answer(s):
RV, DtaP

Hib, PCV

RV, varicella (correct)

Rationale: Varicella and MMR are administered at one year

IPV, Hep B

Question 37:
A nurse is assessing a child's trigeminal nerve. All of the following are functions of the trigeminal nerve except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Clenching the teeth
Correct Answer(s):
Controls facial expression (correct)

Gives sensation of touch on the face

Gives a perception of pain on the face

Clenching the teeth

Question 38:
The mother of a 10-month-old with iron deficiency anemia tells the nurse that her infant is currently taking iron. Which comment made by the mother indicates the nurse needs to reinforce teaching?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
I give the iron in the morning 6-oz bottle.
Correct Answer(s):
I give the iron at the same time each morning.

I give the iron in the morning 6-oz bottle. (correct)

Rationale: Medications are never be mixed in a large amount of food or formula because the parent cannot ensure that the child will take the entire feeding. Formula decreases the absorption of iron.

I give the iron 1 hour before I feed the morning bottle.

I give the iron in oral syringes toward the back of the cheek.

Question 39:
A child with a midline brain tumor has increased intracranial pressure (ICP) and voids large amounts of very dilute urine. The nurse expects the provider to order which medication as part of the plan of care?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Mannitol.
Correct Answer(s):
Mannitol.

Vasopressin. (correct)

Lasix.

Dopamine.

Question 40:
A nurse administers atomoxetine to a child. The nurse evaluates the child for which complication?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Kidney damage
Correct Answer(s):
Kidney damage

Liver damage (correct)

Decreased white cells

Cardiomyopathy

Question 41:
The nurse uses hydrotherapy to debride a burn wound. The nurse performs all of the following nursing interventions except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Uses cold water to debride the patient's burn
Correct Answer(s):
Uses a tub and warm water for debridement

Debrides the wound once or twice per day per providers order

Premedicates before the procedure and uses ROM exercises afterward.

Uses cold water to debride the patient's burn (correct)

Rationale: Cool water can make the patient susceptible to hypothermia due to the loss of skin as a protective barrier

Question 42:
Risk factors for SIDS include all of the following except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
A soft sleeping surface, being covered by a blanket or co-sleeping in the parent's bed
Correct Answer(s):
Maternal smoking or second-hand smoke from the family

A soft sleeping surface, being covered by a blanket or co-sleeping in the parent's bed

Premature birth and/or low APGAR scores

Using a baby sling (correct)

Question 43:
The nurse is caring for a postictal child following a tonic-clonic seizure. All of the following are expected findings during this time except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Vomiting or a headache
Correct Answer(s):
The child can recall some parts of the seizure (correct)

Vomiting or a headache

Impairment of coordination and fine motor skills

Difficult to arouse, sleeps for several hours

Question 44:
A nurse is administering medication to an infant. The nursing actions include all of the following except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Use an 18- gauge needle
Correct Answer(s):
Use therapeutic holding or a swaddling

Administer medication in the side of the mouth in small amounts

Use an 18- gauge needle (correct)

Rationale: Infant use a 25-27-gauge needle

Inject up to 0.5mls of medication

Question 45:
A health care team has been established to promote client care that relieves suffering and improves quality of life. What term describes this team?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Palliative care
Correct Answer(s):
Family-centered care

Palliative care (correct)

Rationale: Palliative interventions are designed to relieve suffering and to improve quality of life.

Ethics committee

Spiritual care

Question 46:
A child with ventriculoperitoneal (VP) shunt complains of a headache and blurry vision. The child is irritable and sleeping more than usual. The parents ask the nurse how they can help their child. Select the nurse's best response?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
You should go to the emergency room as these may be symptoms of a shunt malfunction.
Correct Answer(s):
Give her acetaminophen, and if symptoms do not improve, bring her to the pediatrician's office.

It is common for girls to have these symptoms, especially before beginning their menstrual cycle. Give her a few days, and see if she improves.

You are probably nervous that she is having shunt complications. This is unlikely as it has been working well for eight years.

You should go to the emergency room as these may be symptoms of a shunt malfunction. (correct)

Rationale: These are signs of a shunt malfunction and should be evaluated immediately.

Question 47:
The nurse finds several signs of neglect that include all of the following except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Low socioeconomic status
Correct Answer(s):
Unexplained weight loss, malnourished, dehydrated

Low socioeconomic status (correct)

Rationale: Socioeconomic status is not associated with neglect

Inappropriate dress for the environment

Poor hygiene

Question 48:
The nurse educates parents of a child with cerebral palsy (CP) to prevent aspiration during feeding. The nurse questions which of the following actions during the return demonstration?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
The parent feeds the child soft and blended foods.
Correct Answer(s):
The parent places a small amount of food on the tip of the tongue. (correct)

The parent places the child in semi-Fowlers or higher during feeds.

The parent feeds the child soft and blended foods.

The parent fed the child slowly.

Question 49:
A nurse discontinues an IV catheter. The removal includes all of the following except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Use sterile technique to remove the catheter
Correct Answer(s):
Holding pressure for several minutes

The use of alcohol or adhesive remover to dislodge Tegaderm

Use sterile technique to remove the catheter (correct)

Rationale: Clean technique is used to discontinue an IV

Pulling the catheter straight out of the vein

Question 50:
Which vaccine is given to infants but not older children or adults?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
DtaP
Correct Answer(s):
Rotavirus (correct)

Tdap

DtaP

Varicella

Question 51:
The nurse uses which technique to do a physical assessment of a 9-year-old child?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Explain the role of the nurse in simple, understandable terms.
Correct Answer(s):
Encourage the child's parents to remain in the room during the physical exam.

Auscultate the heart, lungs, and abdomen first.

Ensure the child that the physical exam will not hurt.

Explain the role of the nurse in simple, understandable terms. (correct)

Rationale: School-age children understand the basic functions of the body and understand how the nurse can help them if explained in basic terms.

Question 52:
The child returns from a ventriculoperitoneal (VP) shunt revision procedure. How should the nurse position the child?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Semi-Fowler in an infant seat.
Correct Answer(s):
Semi-Fowler in an infant seat.

Flat in the crib.

Trendelenburg.

In the crib with the head of the crib elevated to 90 degrees. (correct)

Question 53:
A school-age child with a head injury that affected the pituitary gland and a sodium level of 150. The child may have all of the following assessment findings except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
The loss of free water
Correct Answer(s):
The loss of free water

Bounding pulses (correct)

Polydipsia, polyuria, dehydration

A decreased Antidiuretic hormone level

Question 54:
The nurse considers all of the following when administering dornase alpha except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Dornase alpha stimulates the bone marrow to produce red blood cells
Correct Answer(s):
The nurse monitors sputum thickness and the ability of the client to expectorate.

The nurse knows that dornase alpha decreases the viscosity of secretions

The nurse monitors for improvement in Pulmonary Function Tests

Dornase alpha stimulates the bone marrow to produce red blood cells (correct)

Rationale: Epoetin alpha increases red blood cells

Question 55:
A nurse is teaching about a PKU (phenylketonuria) diet. Included in the teaching is all of the following except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
A diet low in phenylalanine minimizes cognitive damage.
Correct Answer(s):
Breastmilk contains phenylalanine, and exclusive breastfeeding is unlikely

The goal is a phenylalanine level between 2 and 8 mg/dL.

Avoid the amino acid leucine (correct)

A diet low in phenylalanine minimizes cognitive damage.

Question 56:
A nurse is monitoring for a child after a seizure. What is the best position for the postictal child?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Lateral
Correct Answer(s):
High-Fowlers

Lateral (correct)

Rationale: Lateral allows for any drainage of secretions to prevent aspiration

Trendelenburg

Semi-Fowlers

Question 57:
The nurse cares for a child with cerebral palsy (CP) whose weight is in the fifth percentile and who is hospitalized for aspiration pneumonia. The mother doesn't want a G-tube placed. Which would be the nurse's best response?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Tell me your thoughts about G-tubes.
Correct Answer(s):
A G-tube will help your son gain weight and reduce his risk for future hospitalizations due to pneumonia.

G-tubes are simple to care for and will make feeding time easier for your family.

Do you have concerns that you will not be able to care for his G-tube?

Tell me your thoughts about G-tubes. (correct)

Rationale: An open-ended question can help family members to share what they know and potentially clear any misconceptions.

Question 58:
What is the most common long-term complication of myelomeningocele?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Hydrocephalus.
Correct Answer(s):
Learning disabilities.

Urinary tract infections. (correct)

Hydrocephalus.

Pressure injuries and skin breakdown.

Question 59:
The nurse is administering oral ferrous sulfate. The nurse will implement the following action:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Administer through a straw, due to staining of the teeth, and rinse with water
Correct Answer(s):
Administer through a straw, due to staining of the teeth, and rinse with water (correct)

Rationale: Iron stains teeth. Waiting times are for IM iron dextran. Iron is best absorbed on an empty stomach even though it causes GI upset

Administer a test dose and wait one hour before giving full dose.

Administer a chelating agent such as IV Deferoxamine (Desferal)

Give drug on a full stomach

Question 60:
A nurse is administering five vaccinations at one time. The nurse will do all of the following except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Encourage parents to give aspirin after vaccinations
Correct Answer(s):
Encourage parents to give aspirin after vaccinations (correct)

Rationale: Aspirin is not given to children to prevent Reye's syndrome

Administer oral vaccines before IM vaccines

Use a sucrose solution and a pacifier for nonpharmacological pain relief

Give subcutaneous injections in the anterolateral thigh or outer aspect of the upper arm

Question 61:
The nurse educates parents of a child with cerebral palsy (CP) to prevent aspiration during feeding. The nurse questions which of the following actions during the return demonstration?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
The parent fed the child slowly.
Correct Answer(s):
The parent places a small amount of food on the tip of the tongue. (correct)

The parent places the child in semi-Fowlers or higher during feeds.

The parent feeds the child soft and blended foods.

The parent fed the child slowly.

Question 62:
The assessment findings for lead exposure include all of the following except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Hearing or growth impairment
Correct Answer(s):
Hearing or growth impairment

Speech regression

Trouble paying attention

Alopecia (correct)

Question 63:
Morphine sulfate 1mg IV q2h PRN for pain is ordered for a 5-year-old who has had abdominal surgery. Which is the most appropriate nursing action?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Ask the provider to change the medication to Demerol (meperidine).
Correct Answer(s):
Administer the morphine sulfate using a syringe pump over 1 hour.

Encourage the child to do incentive spirometer every hour during the day and when awake at night. (correct)

Ask the provider to change the medication to Demerol (meperidine).

Administer with acetaminophen

Question 64:
A child is admitted with bacterial meningitis. Which order should the nurse question?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Intravenous fluids at 1.5 times regular maintenance.
Correct Answer(s):
Maintain isolation precautions for 24 hours after receiving intravenous antibiotics.

Intravenous fluids at 1.5 times regular maintenance. (correct)

Rationale: Intravenous fluids at 1.5 times regular maintenance could cause fluid overload and lead to increased ICP.

Neurological checks every hour.

Administer acetaminophen for fevers (100.4 degrees F, 38.0 C).

Question 65:
A child has ingested gasoline. What assessment findings indicate this type of poison was ingested?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Coughing, tachypnea, vomiting
Correct Answer(s):
Coughing, tachypnea, vomiting (correct)

Rationale: Children with gasoline poisoning may present with burns to the mouth, choking, nausea, lethargy, weakness, tachypnea, cyanosis, stridor, and abdominal pain

Clumsiness, cognitive delay, speech impairment

Hives, angioedema, peripheral edema

Diuresis, chills, fever

Question 66:
The nurse suspects a rare case of protein deficiency. The nurse includes the following teaching points except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Animal products should comprise all of the protein a child gets
Correct Answer(s):
Animal products should comprise all of the protein a child gets (correct)

Rationale: Protein should also come from plant sources like beans and soy and nut products to minimize the harmful effects of eating too much meat.

Protein should make up 20% of the diet

Protein deficiencies may cause mood swings

Meat, beans and nuts are good sources of protein

Question 67:
A child with a concussion falls asleep but will respond when his name is called, or he is gently shaken. The state of consciousness is referred to as:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Delirium.
Correct Answer(s):
Coma.

Delirium.

Obtunded. (correct)

Confusion.

Question 68:
A nurse has just completed instruction on using imagery as a complementary and alternative therapy (CAT). Which client would this strategy benefit?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
A preschooler receiving a dressing change
Correct Answer(s):
A child post-appendectomy

A preschooler receiving a dressing change (correct)

Rationale: Using imagery to distract the preschooler with a minimal amount of pain is an appropriate nonpharmacologic pain intervention. The other choices require interventions for physiologic needs

An adolescent undergoing a bronchoscopy

A preschooler with an acute ear infection

Question 69:
Cloudy cerebrospinal fluid (CSF) is obtained from a lumbar puncture. This most likely indicates:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Bacterial meningitis.
Correct Answer(s):
Viral meningitis.

Bacterial meningitis. (correct)

Rationale: The cerebral spinal fluid in bacterial meningitis is usually cloudy.

No infection, as CSF is usually cloudy.

Sepsis.

Question 70:
A neonate was admitted to the hospital with vomiting and dehydration. The newborn's heart rate is 160, respiratory rate is 50, blood pressure is 85/52, and the temperature is 99 degrees F (37.2 degrees C). What is the nurse's best response when the parents ask if the vital signs are normal?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
The respiratory rate is elevated, but the other vital signs are within normal range.
Correct Answer(s):
The blood pressure too high, but the other vital signs are within normal range.

The temperature is elevated. However, the other vital signs are within normal range.

The respiratory rate is elevated, but the other vital signs are within normal range. (correct)

Rationale: The range of heart rates for a child from birth to 1 month is 90 to 160.

The heart rate is raised, but the other vital signs are within normal range.

Question 71:
The nurse weighs an infant and reports a weight of 7lb 5 oz down from the 7lb 10oz when the infant was discharged six days ago. The nurse's best explanation for the mother is:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Infant weight loss of a few ounces is expected among newborns, especially for breastfeeding mothers.
Correct Answer(s):
I will let the provider know, and she can talk with you about possible causes for your infant's weight loss.

Infant weight loss of a few ounces is expected among newborns, especially for breastfeeding mothers. (correct)

Rationale: Initially, newborns can lose up to 10% of their birth weight but should regain their birth weight by two weeks of age.

I see. You must be a first-time mother. Don't worry; we will investigate why she is underweight.

Maybe she is not getting enough milk. How often are you breastfeeding her?

Question 72:
The mothers of two toddlers meet for a playdate. The mothers expect that the children will do which of the following?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Play side by side, but not actively with one another.
Correct Answer(s):
Share toys while playing.

Play with little or no conflict.

Play side by side, but not actively with one another. (correct)

Rationale: Toddlers play style is parallel play. Toddlers often play alongside another child, but they rarely engage in activities with the other child.

They play with one or two items from a group of toys.

Question 73:
Signs of an iron deficiency include all of the following except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
irritability, and muscle weakness systolic heart murmur, enlarged heart, and/or heart failure
Correct Answer(s):
Pale conjunctiva

Shortness of breath, brittle, spoon-shaped fingernails and fatigue

irritability, and muscle weakness systolic heart murmur, enlarged heart, and/or heart failure

Hematemesis, diarrhea, gastric pain, bloody stools (correct)

Question 74:
A 2-year-old is hospitalized. The parents have to go home for a few hours. The child asks when they will be back. The nurse's best response is:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
They will be back after your nap.
Correct Answer(s):
They will be back after your nap. (correct)

Rationale: Preschoolers understand time in relation to events.

They will be back at 4 pm.

They will be back later tonight.

They will be back in 3 hours.

Question 75:
Normal vital signs of a 1-year-old infant include all of the following except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
25 to 30/min respiration rate
Correct Answer(s):
37.7C (99.9F) axillary temp

60 to 110/min pulse rate

25 to 30/min respiration rate

108/93 blood pressure (correct)

Question 76:
A nurse is conducting a scoliosis screening. Which finding would cause her to suspect scoliosis?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
An excessive cervical curvature
Correct Answer(s):
An excessive thoracic curvature

A rib hump or uneven ribs (correct)

An excessive lumbar curvature

An excessive cervical curvature

Question 77:
Which finding is abnormal when performing a physical assessment on a 10-month-old infant?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Posterior fontanel is open.
Correct Answer(s):
Posterior fontanel is open. (correct)

Rationale: The infant's posterior fontanel should close between 6 and eight weeks of age.

Anterior fontanel is open.

Beginning signs of tooth eruption.

Able to track and follow objects.

Question 78:
Which child is most at-risk for cerebral palsy (CP)?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
A 14-day-old infant with group B streptococcus meningitis.
Correct Answer(s):
A child with a congenital heart condition

A 14-day-old infant with group B streptococcus meningitis. (correct)

Rationale: Infection of the CNS increases the infant's risk of cerebral palsy.

A 12-month-old child who has experienced a febrile seizure.

An infant with a closed-head injury.

Question 79:
What is one of the most common causes of injury and death for an 8-month-old infant?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Aspiration.
Correct Answer(s):
Poisoning.

Non-accidental injury.

Aspiration. (correct)

Rationale: Aspiration is the main cause of injury and death among children of this age. Children can aspirate on small objects lying on the floor that end up in their mouths.

Dog bites.

Question 80:
A 14-year-old boy is hospitalized for a femur fracture after riding recklessly through traffic. The child's parents are concerned about his judgment. The nurse explains to the parents that his behavior is:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Typical of young teens.
Correct Answer(s):
Typical of young teens. (correct)

Rationale: Adolescent brains are not completely developed, which often leads to poor judgment and impulse control.

Related to hormonal surges during adolescence.

A one-time incident that will not likely occur again.

Related to teen rebellion.

Question 81:
The nurse gives further education about Reye syndrome when a mother states:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
I will give aspirin to my child to treat a headache.
Correct Answer(s):
I will immunize my children against varicella and influenza.

I will not give my child any products containing aspirin.

I will give aspirin to my child to treat a headache. (correct)

Rationale: The giving aspirin or products containing aspirin has been associated with Reye syndrome. A headache is often the first sign of a viral illness.

Children who have Reye syndrome are admitted to the hospital.

Question 82:
A nurse assesses a 6-month-old infant which finding would be reportable to the provider?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Strabismus
Correct Answer(s):
Teething

Sitting up unsupported

Strabismus (correct)

Rationale: Infants no longer display strabismus by 3-4 months of age

Babbling sounds

Question 83:
Which foods are appropriate for a 2-year-old with anemia?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Fruits, whole grains, and meats.
Correct Answer(s):
32oz of whole cow's milk per day.

Beans, eggs, and green vegetables. (correct)

Fruits, whole grains, and meats.

8oz of juice, three times per day.

Question 84:
A nurse completes a physical assessment on a toddler. Which assessment was completed last?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Rectal temperature
Correct Answer(s):
Breath sounds

Infant reflexes

Rectal temperature (correct)

Rationale: All invasive procedures are completed last

Capillary refill

Question 85:
A child with meningitis is admitted to the hospital, which intervention takes priority?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Administration of maintenance intravenous fluids.
Correct Answer(s):
Administration of intravenous antibiotics.

Administration of maintenance intravenous fluids. (correct)

Rationale: Cultures of spinal fluid and blood are sent to the lab, followed by the administration of intravenous fluids.

Placement of a Foley catheter.

Obtain lab results for cultures on spinal fluid and blood samples.

Question 86:
A nurse counts a 1-year-old's teeth. The infant has from __ to ___ teeth and will eventually have __deciduous teeth and __permanent teeth


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
10-12, 20, 32
Correct Answer(s):
6-8, 20, 32 (correct)

2-4, 20, 32

10-12, 20, 32

12-15, 20, 32

Question 87:
A nurse is teaching about self-administration of epinephrine. The nurse includes all of the following teaching points except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
A therapeutic response should occur after one injection but may require two injections.
Correct Answer(s):
Use a pre-filled epinephrine injector into the thigh, hold, and massage site for 10 seconds to promote absorption (IM).

A therapeutic response should occur after one injection but may require two injections.

Use a pre-filled epinephrine injector into deltoid, hold, and massage site for 10 seconds to promote absorption (IM). (correct)

Store in a cool, dark place

Question 88:
Which nursing action is most appropriate to facilitate communication about how a school-age-child is feeling?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Ask the child simple, direct questions about how she is feeling.
Correct Answer(s):
The nurse can attempt to make friends with the child to gain access to the child's feelings.

Ask the child's parents what feelings the child has expressed to them.

Allow the child to draw a picture of their feelings. (correct)

Ask the child simple, direct questions about how she is feeling.

Question 89:
The nurse knows the best way to explain a procedure to a hospitalized four-year-old child is to:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Demonstrate the procedure on a doll.
Correct Answer(s):
Provide the child with a pamphlet with pictures showing the procedure.

Have the 6-year-old next door tell the 4-year-old about the experience.

Demonstrate the procedure on a doll. (correct)

Rationale: Medical play is an effective method for helping preschoolers understand the steps of the procedure.

Show the child a video of the surgery.

Question 90:
Which abnormal assessment finding should the nurse evaluate after albuterol (Proventil) is given to a child?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
A decrease in respiratory rate from 35 to 22.
Correct Answer(s):
Excessive hip abduction.

A decrease in respiratory rate from 35 to 22.

A decrease in blood pressure.

Wheezing (correct)

Question 91:
A nurse assesses an wheezing breath sound. It sounds like:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
A high-pitched, musical or whistling like sounds heard primarily on expiration as air passes through and vibrates through narrow airways.
Correct Answer(s):
A low pitched, rattling lung sounds that often resemble snoring (correct)

A high-pitched, musical or whistling like sounds heard primarily on expiration as air passes through and vibrates through narrow airways.

A low-pitched, grating, or creaking sounds that occur when inflamed pleural surfaces rub together during breathing movements

A high-pitched breath sound resulting from the turbulent airflow in the larynx or bronchial tree

Question 92:
The nurse recognizes signs of nonaccidental injury or child abuse include all of the following except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Bruises or fracture in different stages of healing
Correct Answer(s):
Unusual bruising on back or abdomen

A blue sclera (correct)

Spiral fractures

Bruises or fracture in different stages of healing

Question 93:
To obtain an adolescent's health information, the nurse should:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Interview the adolescent using direct questions.
Correct Answer(s):
Interview the adolescent using direct questions.

Gather information during a casual conversation. (correct)

Interview the adolescent with the parent.

Interview the parents.

Question 94:
A toddler experienced a near-drowning event. The nursing actions in the plan of care include all of the following except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Administer N-acetylcysteine (Mucomyst)
Correct Answer(s):
Oxygen

Administer N-acetylcysteine (Mucomyst) (correct)

Rationale: This is an antidote for acetaminophen

Chest physiotherapy

Monitor for complications for 24 hours

Question 95:
The mother of a neonate asks when the infant will receive the first hepatitis B immunization. Which is the nurse's best response?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
The first dose of the hepatitis B vaccine is given before discharge today.
Correct Answer(s):
Babies receive the hepatitis B vaccine only if their mother is positive for hepatitis B.

The first dose of the hepatitis B vaccine is given before discharge today. (correct)

Rationale: The first injection of the hepatitis B vaccine is offered between birth and two months. In most hospitals, newborns receive the vaccine before discharge.

The first dose of the hepatitis B vaccine is offered at one year of age.

Babies get their first hepatitis B vaccine at six months of age.

Question 96:
A nurse cares for a child with increased intracranial pressure. What is the nurse's priority intervention?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Monitoring level of consciousness
Correct Answer(s):
Seizure precautions (correct)

Administering pain medication

Administering mannitol

Monitoring level of consciousness

Question 97:
A nurse administers medication into a tunneled, central venous access device. She will perform all of the following interventions except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Have the patient use the Valsalva Maneuver
Correct Answer(s):
Make sure the clear, semipermeable protective dressing is in place for infection control

Initially flush the line for patency using sterile technique. Inject the ordered medication according to the 6 Rights of Medication Administration

Flush with normal saline

Have the patient use the Valsalva Maneuver (correct)

Rationale: The Valsalva is a forceful exhalation against a closed glottis, which increases intrathoracic pressure and diminishes the return of venous blood to the heart; performed with central line insertion to create a positive phase in central venous pressure, thus reducing the risk of air being drawn into the central circulation and creating an air embolus. It is not used for medication administration. A central venous catheter is inserted into large veins in the central circulation
The tip of the central line is generally threaded into the internal or external jugular vein or into the lower third of the inferior vena cava (IVC) that leads to an area just above the RA (right atria)

Question 98:
The nurse is caring for a the parents ask the nurse why the baby's head circumference is measured in an infant with myelomeningocele. Select the nurse's best response:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
A myelomeningocele put the infant at risk for hydrocephalus, which presents as an increase in head size.
Correct Answer(s):
Babies' heads are measured to track growth to ensure it normally is occurring.

A myelomeningocele put the infant at risk for hydrocephalus, which presents as an increase in head size. (correct)

Rationale: Children with myelomeningocele can develop hydrocephalus, which can present as an increase in head circumference.

Because your baby's spinal cord did not close all the way, your infant is at risk for meningitis, which can manifest as an increase in head size.

Many infants with myelomeningocele also have microcephaly, which can show up as a decrease in head size.

Question 99:
Nurses are mandated, reporters. A nurse knows all of the following assessments indicate nonaccidental injury except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Low socioeconomic status
Correct Answer(s):
Low socioeconomic status (correct)

Rationale: Mothers in poverty may have more stressors that make them more likely to act out. However, this is not the case for the majority of mothers in poverty

Vague explanations of injuries that "don’t fit" the parental story or occur in an immobile patient

Delays for treatment

Fractures in various stages of healing

Question 100:
The nurse administers a Hepatitis B vaccine to an infant. All of the following actions occur except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Final dose no earlier than the age of 24 weeks of age and at least 16 weeks after the initial dose. It should be withheld for infants born prematurely and weighing less than 2,000 g if the mother is negative for hepatitis B.
Correct Answer(s):
The vaccine is given at birth, 1-2 months, and 6-18 months.

There is a minimum of 4 weeks between doses one and two, and a minimum of 8 weeks between doses two and three.

Administer vaccination in ventrogluteal site (correct)

Final dose no earlier than the age of 24 weeks of age and at least 16 weeks after the initial dose. It should be withheld for infants born prematurely and weighing less than 2,000 g if the mother is negative for hepatitis B.

Question 101:
The nurse knows all of the following interventions reduce pain in children during immunizations except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Saying "this will only feel like a bee sting."
Correct Answer(s):
Using the correct needle length

Holding pressure on the site for 5-10 seconds before inserting the needle

Distracting the child during the injection

Saying "this will only feel like a bee sting." (correct)

Rationale: Be honest with the child and do not assume what the injection will feel like. The nurse can explain the injection will hurt but can give a sticker as a reward

Question 102:
A mother requests that her child receives the rubeola vaccine at the 10-month well-child checkup. The nurse tells the mother that:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
The vaccine is given after the physician examines the child.
Correct Answer(s):
Vaccinated children will likely develop a mild case of the disease.

The vaccine is contraindicated be given at that visit. (correct)

The vaccine is given after the physician examines the child.

A booster vaccination will be necessary at 18 months of age.

Question 103:
A 16-year-old in Illinois is covered under her parent's insurance and requests birth control, but does not want to tell her parents. The nurse should inform the adolescent that her parents:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Will not have the right to read her medical records, but may see the insurance bill
Correct Answer(s):
Will always have the right to her medical record

Are not allowed to view the insurance records

Will have the right to read her medical record if they provide payment

Will not have the right to read her medical records, but may see the insurance bill (correct)

Rationale: The insurance bill will come addressed to her parents, so they may find out that this client utilized insurance services to pay for the visit and medication. According to the Health Information Portability and Accountability Act (HIPPA), parents have no right to review the client’s medical record even if they provide payment or insurance the patient.

Question 104:
An 18-year-old has a rash and itching in the genital area worries he has contracted a sexually transmitted disease and does not want to tell his parents. The nurse's best response is:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Who should we contact about your visit here today?
Correct Answer(s):
We will need to talk to your parents to let them know.

Your parents will not be contacted regarding this visit. (correct)

Who should we contact about your visit here today?

We cannot guarantee that the hospital will not inform your parents.

Question 105:
A nurse administers an oral dose of nystatin. What teaching should she provide?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Have the child swish and spit out the medication
Correct Answer(s):
Nystatin is an antibiotic

Nystatin is an antipruritic

Have the child swish and spit out the medication (correct)

Rationale: The oral suspension of nystatin is given by the method called "swish and swallow." The nurse has the child swish the solution throughout the mouth and then swallow or spit the drug out as directed by the provider. When nystatin troches are prescribed, teach the child to let them dissolve completely in the mouth and not to chew or swallow the whole troche. The nurse should not crush the troche unless advised to do so by the provider for a child.

Have the child swish and swallow the medication

Question 106:
The nurse completes an assessment and suspects nonaccidental injury. Assessment findings may include all of the following except?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Authoritative parents
Correct Answer(s):
Authoritative parents (correct)

Rationale: Parenting style is not associated with abuse

A history of frequent ER visits

Discrepancies in injury and age of the child

Different stories from both parents

Question 107:
A preschooler with delayed growth and development is learning to use the toilet. The nurse suggests the following strategies to help the child. These include all of the following except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Candy rewards
Correct Answer(s):
Take away screen time so the child can focus on the task until the child is successful (correct)

Keep a chart with stickers for dry days

Create a ritual like clapping or singing a song

Candy rewards

Question 108:
A nurse is teaching a parent about night terrors. The nurse includes all of the teaching points except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Don't give water right before bed
Correct Answer(s):
Don't give water right before bed (correct)

Rationale: This is for enuresis, not sleep, terrors

A consistent bedtime routine helps toddlers sleep

Use a nightlight

Reassure toddler but keep them in their beds

Question 109:
How can the nurse best support the trust relationship between the mother-baby dyad while the infant is hospitalized? The nurse should:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Encourage the parents to actively manage their child's care.
Correct Answer(s):
Invite the child's parents to stay with the child as much as possible.

Inform parents about all aspects of their child's condition. (correct)

Encourage the parents to cuddle their child as much as possible.

Encourage the parents to actively manage their child's care.

Question 110:
A 12-month-old boy weighed 7lb 4oz at birth. What would the nurse expect the infant's current weight to be?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
21lb 8oz
Correct Answer(s):
14lb 8oz

21lb 8oz

21 lb 12oz (correct)

29lbs

Question 111:
Which child should a child with newly diagnosed bacterial meningitis be cohorted with?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Semi-private room with a roommate who has bacterial meningitis but has received intravenous antibiotics for more than 24 hours.
Correct Answer(s):
Semi-private room with a roommate who also has bacterial meningitis.

Semi-private room with a roommate who has bacterial meningitis but has received intravenous antibiotics for more than 24 hours.

A private room that is kept dark with minimal stimulation. (correct)

A private room that has developmentally appropriate activities available.

Question 112:
A 13-year-old girl has an STD. Is she able to consent to the treatment?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Yes, an adolescent can consent for pregnancy or STI's. However, parents can access electronic health records on their own.
Correct Answer(s):
No, she can provide assent

Yes, if her parents also consent

Yes, an adolescent can consent for pregnancy or STI's. However, parents can access electronic health records on their own. (correct)

Rationale: Adolescents can give consent in these specific situations.

No, she needs parental consent

Question 113:
A 3-year-old with a superficial, minor burn is brought to the hospital. All of the following nursing interventions are included in the plan of care except?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Use an antimicrobial ointment
Correct Answer(s):
Use an antimicrobial ointment

Apply a clean, dry gauze dressing to immobilize and protect the burn.

Keep patient warm and consider a tetanus shot if the vaccine has not been given in 5 years

Lance blisters (correct)

Question 114:
The nurse should maintain all of the following tasks in anticipation of an organ donation from the patient except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Be the first to explain the informed consent document for organ donation
Correct Answer(s):
Provide support to the family as clinical decisions are made

Make religious or cultural preparations to support the patient and family

Maintain cardiovascular function and ventilator settings to maintain organ perfusion

Be the first to explain the informed consent document for organ donation (correct)

Rationale: Providers are the first to explain informed consent. The nurse double-checks that the consent form was signed.

Question 115:
Which action is the most developmentally appropriate way to engage a 4-year-old's cooperation in obtaining the blood pressure?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Have the child help place the blood pressure cuff.
Correct Answer(s):
Have the child help place the blood pressure cuff. (correct)

Rationale: Preschool children enjoy games, and it is an excellent way to elicit their assistance and cooperation during a procedure.

Instruct the child to sit still so the blood pressure machine will go quickly.

Ask the child if he feels the squeezing of his arm.

Promise the child that measuring the blood pressure will not hurt.

Question 116:
A nurse completes a physical assessment on a newborn. Which finding must be reported to the provider?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Chest circumference 32 cm
Correct Answer(s):
Temperature 38 degrees Celsius (correct)

Head circumference 35 cm

Chest circumference 32 cm

Apical heart rate 160 and respirations 60

Question 117:
A child with third-degree burns goes into septic shock. All of the following symptoms may present except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Confusion
Correct Answer(s):
Delayed capillary refill and decreased urine output

Confusion

Fever

Hypertension (correct)

Question 118:
Which should the nurse do to manage separation anxiety in a hospitalized toddler?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Establish a routine for the child that is similar to the child's routine at home.
Correct Answer(s):
Fulfill the parental role when parents are not able to be at the bedside.

Invite the parents to remain at the bedside.

Establish a routine for the child that is similar to the child's routine at home. (correct)

Rationale: It is important re-establish a child's home routine. This increases the child's sense of security and decreases anxiety.

Rotate the nursing team, so the child becomes comfortable with a variety of nurses.

Question 119:
A nurse provides teaching about Tinea pedis to an athletic school-age child. The nurse includes all of the following teaching points except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Use baby powder to prevent tinea pedis recurrence
Correct Answer(s):
Socks are contraindicated

Use baby powder to prevent tinea pedis recurrence (correct)

Rationale: Baby powder has no medical indication and is carcinogenic

Sport sandals or flip-flops keep feet dry and less able to proliferate the fungus

Tinea pedis is a fungal infection that causes puritis and scaling skin

Question 120:
A nurse is going to give a 6-month-old a dose of antibiotics IM. What must the nurse do when the 1.25 mL dose arrives from the pharmacy?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Divide the dose into two injections.
Correct Answer(s):
Administer the injection into the deltoid muscle

Divide the dose into two injections. (correct)

Rationale: A nurse should not deliver more than 1mL per IM injection to a 6-month-old

Administer the injection into the dorsogluteal muscle.

Give the dose as a single injection into the anterolateral leg muscle.

Question 121:
An adolescent diet is usually deficient in the following nutrients except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Iron
Correct Answer(s):
Calcium

Vitamins

Iron

Fats (correct)

Question 122:
A child is admitted to the ED and has a severe burn. After the nurse establishes that the patient is breathing with O2 saturation 98%. Which intervention is most important?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Cover the burns
Correct Answer(s):
Pain medication

IV Fluids (correct)

Cover the burns

IV antibiotics

Question 123:
A child has a terminal illness, and the father is struggling to cope. The nurse may say any of the following to the father except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
I know how you feel, I am also sad
Correct Answer(s):
Do you want to talk about your child?

I know how you feel, I am also sad (correct)

Rationale: Therapeutic communication demands the nurse not assume how any other person feels.

How have you coped with difficult events in the past?

We could provide a consistent healthcare team when possible to support you.

Question 124:
A nurse assesses a neonate. Which of the following is a normal finding?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Extrusion reflex
Correct Answer(s):
Bulging anterior fontanel

Extrusion reflex (correct)

Rationale: The extrusion reflex projects the tongue forward when touched. This reflex protects the infant's airway and disappears after 3-4 months

Respirations 40

Temperature 37.5C

Question 125:
A nurse takes a pulse ox on an infant. Which is the preferred placement of the probe?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Big toe
Correct Answer(s):
Earlobe

Fingernail

Big toe (correct)

Rationale: The probe can be placed on the fingers, toes, hand, head, foot, or wrist of the neonate. The big toe has the least chance of being pulled off.

Wrapped over the pedal pulse

Question 126:
A child has a hypospadias repair and has a stent. The nurse includes the following in the teaching except?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Keep skin clean as possible
Correct Answer(s):
Keep skin clean as possible

Let the stent drain into the diaper

Let the baby air dry before replacing the diaper

Give a tub bath to keep the area clean (correct)

Question 127:
What milestone should the child have reached by 15 months of age that would require a referral?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Putting large-piece puzzles together
Correct Answer(s):
Walking

Creeping or crawling (correct)

Putting large-piece puzzles together

Using push-pull toys

Question 128:
Which intervention is an example of family-centered care?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Including the family when the team of health care providers visits the child (rounds)
Correct Answer(s):
Calling a social worker to assist with housing needs

Including the family when the team of health care providers visits the child (rounds) (correct)

Rationale: Including the family on the plan of the day from the providers creates a healthcare team for the child.

Only allowing immediate blood relatives access to your patient

Identify physical and emotional problems of the family

Question 129:
A toddler has a head injury with pituitary involvement and a sodium level of 130. All of the following assessment findings may be found except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Decreased urine
Correct Answer(s):
Increased BP

Increased ADH secretion

Specific gravity 1.025 (correct)

Decreased urine

Question 130:
A nurse cares for a toddler with a head injury. What is the priority nursing assessment?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Respiratory rate
Correct Answer(s):
Heart Rate

Blood Pressure

Respiratory rate (correct)

Rationale: Respiratory rate: ABC's breathing before circulation

Temperature

Question 131:
A 3-year-old admitted to the hospital has been continually crying. The nurse responds to the concerned parents that this behavior indicates the child is in the:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Protest state of separation anxiety, which is typical for children during hospitalization.
Correct Answer(s):
Detachment phase of separation anxiety, which is typical for children during hospitalization.

Despair stage of separation anxiety, which is typical for children during hospitalization.

Bargaining stage of separation anxiety, which is typical for children during hospitalization.

Protest state of separation anxiety, which is typical for children during hospitalization. (correct)

Rationale: During the protest stage of separation anxiety, the child may cry more than at any other time and frequently ask to go home.

Question 132:
A child with cerebral palsy (CP) had his hamstrings surgically released and is currently on baclofen. The nurse provides teaching on baclofen and includes:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
The medication increases muscle tone
Correct Answer(s):
The medication increases muscle tone

It is a medication prevents seizures.

It is a medication to control spasms. (correct)

It is a medication that improves bladder control.

Question 133:
The nurse includes all of the following teaching points about sunburn prevention except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Avoid the sun between 10 am to 3 pm
Correct Answer(s):
Avoid the sun between 10 am to 3 pm

Wear sunscreen and reapply after sweating or going in the water

Wear protective clothing

Use sunscreen on all age groups of children regardless of age (correct)

Question 134:
A nurse is teaching school-age children about bicycle safety. The nurse includes all of the following teaching points except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
The child may wear headphones if they are only in one ear
Correct Answer(s):
Children should wear light-colored or reflective clothing while riding

The child may wear headphones if they are only in one ear (correct)

Rationale: Headphones are popular but dangerous to wear while riding a bike

Bikes are to ride single-file, in the flow of traffic to minimize accidents

The bike must be the proper size for the child. When the child is seated on the bike, they should be able to stand with the ball of each foot in contact with the ground while straddling the bike's center bar.

Question 135:
A nurse is providing anticipatory guidance for toddlers to their parents. The nurse includes all of the following developmental teaching points except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Toddlers are in the guilt vs. shame and doubt Erickson phase
Correct Answer(s):
Develop healthy eating patterns with a low sugar diet to prevent cavities

Toddlers may have night terrors or nightmares

Toddlers are in the guilt vs. shame and doubt Erickson phase (correct)

Rationale: Toddlers are in the autonomy vs. shame Erickson stage

Toddlers display negativism and ritualism

Question 136:
What information does a school nurse include in a discussion on nutrition with a fifth-grade class?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
A list of nutritious foods with how they affect the body.
Correct Answer(s):
The average number of calories that a fifth-grade child should consume a day.

A list of high-calorie processed foods that all fifth-graders should avoid.

How to read food labels.

A list of nutritious foods with how they affect the body. (correct)

Rationale: School-age children are logical and interested in how food affects their health. They understand basic medical terminology.

Question 137:
A nurse plans care for a child with an epidural bleed. The nurse includes the following nursing interventions except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Positions the patient in a supine position
Correct Answer(s):
Provides a calm environment

Provides fluids and monitors electrolytes

Positions the patient in a supine position (correct)

Rationale: Neurological patients should have an elevated head of the bed t at least semi-Fowlers

Monitors pupils and signs of ICP

Question 138:
Which child can receive the influenza vaccine via nasal spray?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
A 3-year-old with the common cold
Correct Answer(s):
An 18-month-old with hypersensitivity to amoxicillin

A 3-year-old with the common cold (correct)

Rationale: Children under two cannot receive the live, nasal vaccination. In pregnant women and people over 50 the injection is appropriate

A woman 40 weeks pregnant

A healthy 1-year-old

Question 139:
A child is to receive phenytoin (Dilantin) 100mg IV. How does the nurse administering this drug?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Mix it in dextrose 5% in water and give over 1 hour.
Correct Answer(s):
Mix it in dextrose 5% in water and give over 1 hour.

Administer no faster than 2 mg/kg/min. (correct)

Do not use an inline filter.

Administer with diuretics.

Question 140:
A nurse administers an eye medication. She does all of the following except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Administer eye medications 30 sec apart
Correct Answer(s):
Hold the dropper above the conjunctival sac about 1 to 2 cm, and drop the medication into the center of the sac.

For eye ointment, apply a thin ribbon to the edge of the lower eyelid from the inner to the outer canthus.

Administer eye medications 30 sec apart (correct)

Rationale: Administer multiple eye medications 5 minutes apart to reduce interactions.

Hold gentle pressure with your finger and clean facial tissue to the nasolacrimal duct for 30-60 seconds to minimize systemic absorption of the medication

Question 141:
An adolescent has a diagnosis of new-onset diabetes. What would most influence a teenager's food choices as he begins to make changes in his diet?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Peers and their dietary choices.
Correct Answer(s):
Parents and their dietary choices.

Cultural background.

Peers and their dietary choices. (correct)

Rationale: As an adolescent, peers are most important. Teens want to be like other teens.

Television and other forms of media influence.

Question 142:
A nurse administers IV penicillin, and the child develops hives and angioedema. What action should the nurse take?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Stop infusion and administer epinephrine
Correct Answer(s):
Stop infusion and administer epinephrine (correct)

Rationale: Stop infusion, give epinephrine and call the provider afterward

Call the provider for further orders

Finish the infusion and call the provider

Stop the infusion and administer diphenhydramine

Question 143:
A nurse checks for a history of allergies for a child who is prescribed penicillin. The mother reports the child developed a rash to penicillin two years ago. Which of the following nursing interventions is best to include in the plan of care?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Hold the dose and notify the provider
Correct Answer(s):
Hold the dose and notify the provider (correct)

Rationale: The nurse should hold the medication and notify the provider of the child's rash so an alternative antibiotic can be prescribed. Allergic reactions to penicillin include mild to severe anaphylaxis, and prior sensitization is reported to the provider

Administer the dose

Administer diphenhydramine before administering the dose

Call the provider and request an oral route and administer half and monitor for a reaction.

Question 144:
A 3-year-old child is being assessed. All of the findings are appropriate except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Pulse 60-110
Correct Answer(s):
Blood pressure of 89/56 mmHg

Pulse 60-110

37.5 degrees C (99.5 degrees F)

Respirations 25-35 (correct)

Question 145:
In caring for a 4-year-old with pain, which assessment tool is the most useful?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
FACES scale
Correct Answer(s):
Numeric scale

FACES scale (correct)

Rationale: The Faces pain rating scale is appropriate for who may have difficulty describing pain or understanding the correlation of pain to numerical descriptors or verbal commands

FLACC scale

NIPS scale

Question 146:
What is the antidote to acetaminophen?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
N-acetylcysteine (Mucomyst)
Correct Answer(s):
Activated charcoal

N-acetylcysteine (Mucomyst) (correct)

Rationale: N-acetylcysteine is the antidote to acetaminophen

Chelation therapy using deferoxamine mesylate

Vitamin K

Question 147:
The nurse knows that infants are at risk for injury from shaken baby syndrome (SBS) because:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
The anterior fontanel is open.
Correct Answer(s):
The anterior fontanel is open.

They have insufficient musculoskeletal support and a disproportionate head-to-body ratio. (correct)

They have an immature vascular system with veins and arteries that are more superficial.

The nurse understands there is immature myelination of the nervous system in a young infant.

Question 148:
The mother of 16-year-old worries that her son is sleeping too much. Which is the nurse's best response?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Teens require more sleep related to their physical growth spurts that are occurring.
Correct Answer(s):
Your son may have missed sleep and is now catching up.

Developmental theorists indicate that adolescents require more sleep as they begin to integrate new roles into their lives.

Teens require more sleep related to their physical growth spurts that are occurring. (correct)

Rationale: Teens need more sleep due to growth spurts that occur during adolescence.

Teens need more sleep due to the increase of their social obligations.

Question 149:
A 3-month-old baby has diaper dermatitis. The nurse includes all of the following teaching points in the plan of care except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Use cornstarch or baby powder on the rash
Correct Answer(s):
Avoid bubble baths and harsh detergents

Allow the area to air dry before replacing the diaper

Use a barrier cream (zinc oxide) while healing the rash

Use cornstarch or baby powder on the rash (correct)

Rationale: Cornstarch promotes yeast development on the skin. Baby powder causes lung damage

Question 150:
The nurse includes all of the following teaching points about car seats except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
The car seat remains rear facing until the child can see farther than 1 foot
Correct Answer(s):
The child needs a federally approved car seat at a 45-degree angle to minimize slumping and airway obstruction.

The car seat is placed rear-facing in the rear seat of the vehicle for children under 2 and secured using the safety belt

The car seat remains rear facing until the child can see farther than 1 foot (correct)

Rationale: Newborns should be placed in a federally approved car seat at a 45-degree angle to prevent slumping and airway obstruction. The car seat is placed rear-facing in the rear seat of the vehicle. The seat is secured with a safety belt. The shoulder harnesses are positioned in the slots at or below the level of the infant ’s shoulders. The harness should be fairly tight, and the retainer clip should be placed at the level of the infant’s armpits.

The shoulder harnesses are put in the slots at or below the level of the infant’s shoulders. The harness must fit snug and the retainer clip is put at the level of the infant’s armpits.

Question 151:
A nurse cares for a child with ADHD. The nurse includes all of the following teaching points except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Administer ADHD medications at bedtime
Correct Answer(s):
Administer ADHD medications at bedtime (correct)

Rationale: ADHD medications are stimulants and should not be taken close to bedtime

Use a calm, firm, and respectful approach with short and simple explanations

Use modeling to demonstrate respectable behavior

Get the child's attention before giving directions

Question 152:
The nurse teaches the parents about preschool children's sense of time. The nurse includes all of the following teaching points except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Preschoolers cannot sequence events
Correct Answer(s):
Preschoolers cannot sequence events (correct)

Rationale: Preschoolers can sequence events but not time on the clock

Preschoolers understand the sequence of daily events.

You can use time oriented words such as "after lunch" or "after your nap."

Preschoolers with a strong routine learn about time

Question 153:
A ketogenic diet consists of:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
High-fat and high-carbohydrate foods.
Correct Answer(s):
High-fat and low-carbohydrate foods. (correct)

High-fat and high-carbohydrate foods.

Low-fat and low-carbohydrate foods.

Low-fat and high-carbohydrate foods.

Question 154:
A nurse admits a child with spastic cerebral palsy. The nurse finds all of the following assessment findings except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Ankle clonus and contractures
Correct Answer(s):
Writhing, worm-like movements (correct)

Ankle clonus and contractures

Loss of fine and gross motor skills

A crouched gait with a scissoring motion of the legs with feet plantar flexed.

Question 155:
Identify the priority assessment for a 4-month-old baby after surgery?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Encourage skin-to-skin contact with the care providers.
Correct Answer(s):
Restrain the infant

Encourage skin-to-skin contact with the care providers. (correct)

Rationale: Tactile input supports neurological and psychosocial development in the infant and should be done first.

Decrease environmental stimuli

Encourage the care providers to assume as much of the baby's care as possible

Question 156:
Which should the nurse recommend to prevent future bicycle injuries before discharging their child after a bicycle accident?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Wear safety equipment while riding bicycles.
Correct Answer(s):
Wear safety equipment while riding bicycles. (correct)

Rationale: Safety equipment is necessary for bicycling, skateboarding, and contact sports. Many injuries occur during the school-age years when children participate in contact sports.

Read educational materials on bicycle safety.

Watch a video on bicycle safety.

Ride his bike with adult supervision.The nurse places a child in the supine position and flexes his neck, the nurse notes he flexes his knees and hips. This is referred to as:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
The Kernig sign.
Correct Answer(s):
The Brudzinski sign. (correct)

Cushing's triad.

The Kernig sign.

Nuchal rigidity.

Question 2:
The nurse is caring for a preschooler with a superficial, partial thickness burn. All of the following are included in the plan except?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Administer morphine
Correct Answer(s):
Apply a clean dressing

Clean with tepid water

Apply cool, wet compresses to stop the burning process

Administer morphine (correct)

Rationale: Morphine is given for major burns

Question 3:
Identify the priority assessments for a preschooler being admitted to the hospital?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Identify the child's routine from home.
Correct Answer(s):
Assess the parenting method used by the care providers

Assess the understanding of the child about hospitalization

Identify the child's routine from home. (correct)

Rationale: All assessments are valuable however, a routine gives the child a sense of security.

Identify the child's flexibility when separating from the parents.

Question 4:
A 16-year-old male is hospitalized for IV antibiotics. Which action best promotes his psychosocial development?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Encourage the parents to invite the teen's friends to visit him in the hospital.
Correct Answer(s):
Email the teen's teacher, and have her send his homework.

Encourage the parents to invite the teen's friends to visit him in the hospital. (correct)

Rationale: Adolescents want to be like their peers. Encouraging visits from friends will help him feel he is still part of the school and social environment.

Encourage the teen's grandparents to visit frequently.

Allow the teen to text his friends.

Question 5:
A nurse cares for a family who has a toddler with autism. How can the nurse best support this child?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Introduce the environment to the child slowly
Correct Answer(s):
Use video games as an incentive for good behavior

Introduce the environment to the child slowly (correct)

Rationale: Children with autism develop and process information at their own pace. Rushing this step can cause the child more anxiety.

Have the parents remain with the child at all times

Administer the Denver 2 Developmental screening tool

Question 6:
Which activity can the nurse offer to a 9-year-old to support a sense of industry?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Encourage the child to do any homework his teacher has sent.
Correct Answer(s):
Allow the child to decide what time to take his medication.

Encourage the child to do any homework his teacher has sent. (correct)

Rationale: The school-age child feels pride in academic performance and can achieve a sense of industry by completing homework and developing relationships with classmates.

Allow the child to assist with his bathing.

Allow the child to help with any dressing changes.

Question 7:
A preschooler took an overdose of acetaminophen. Which antidote will the nurse administer?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Acetylcysteine
Correct Answer(s):
Protamine sulfate

Acetylcysteine (correct)

Rationale: Acetylcysteine or Mucomyst reverses acetaminophen

Calcium gluconate

Flumazenil

Question 8:
A 1-month-old has to undergo a painful procedure. Which nursing intervention is most appropriate?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
The nurse offers a nipple dipped in sucrose solution and gives ordered meds. This is developmentally appropriate and creates a distraction during the procedure
Correct Answer(s):
The nurse may use a distraction to support therapeutic play with dolls and medical equipment, and medications as ordered.

The nurse offers a nipple dipped in sucrose solution and gives ordered meds. This is developmentally appropriate and creates a distraction during the procedure (correct)

Rationale: Sucrose elicits an endogenous release of opioids (endorphins) for approx. 5-8 minutes

Speak softly to the infant and restrain the baby if necessary

The nurse should reinforce to the parents that the baby will not remember the experience

Question 9:
What is the best way to administer an oral antibiotic to a 6 month old baby?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Sit the baby upright and use a plastic syringe
Correct Answer(s):
Mix medication in 30mls of formula

Sit the baby upright and use a plastic syringe (correct)

Rationale: This positions minimizes the risk for aspiration and allows for accurate dosing of the medication.

Place baby in supine position and place medication in an empty nipple

Mix the medication in juice

Question 10:
A child has a tonic-clonic seizure. Which finding is the priority nursing assessment?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Respiratory rate
Correct Answer(s):
Blood Pressure

Heart Rate

Respiratory rate (correct)

Rationale: Respiratory rate: ABC's breathing before circulation

Temperature

Question 11:
The nurse uses which techniques to distract a 10-year-old who is having a tonsillectomy and is NPO?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Play a board game.
Correct Answer(s):
The nurse suggests using the telephone to call peers.

Watch a movie.

Play a board game. (correct)

Rationale: A board game is an optimal choice for school-age children because they enjoy being engaged in an activity with others that requires some skill and challenge.

Read a pamphlet about being NPO.

Question 12:
An infant is newly diagnosed with neuroblastoma, and the mother asks about the prognosis. The nurse's best answer is:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Variable, depending on the site of origin.
Correct Answer(s):
Favorable, as neuroblastoma is always cured.

Favorable, as infants with neuroblastoma, have the best prognosis. (correct)

Nonreassuring, as infants with neuroblastoma rarely survive.

Variable, depending on the site of origin.

Question 13:
The clinical manifestation of hearing impairment in children include all of the following except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Use of gestures instead of words at 15 months of age
Correct Answer(s):
An absence of babbling or inflections by seven months

Use of gestures instead of words at 15 months of age

Inability to develop intelligible speech by 24 months of age

Repeating words and sounds (correct)

Question 14:
What is the nurse's priority teaching about the use of Kwell shampoo (lindane) for Pediculosis capitus (head lice) for a toddler?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Treatment is every other day for 1 week and a follow-up treatment 14 days later
Correct Answer(s):
Never repeat shampoo as the shampoo is absorbed through the scalp

Clothing and bedding only require soap and water to decontaminate them

Treatment is every other day for 1 week and a follow-up treatment 14 days later (correct)

Rationale: Kwell is toxic and can be absorbed through the scalp. It can be repeated after 5-7 days.

Application of the shampoo is done until there are no more lice visible

Question 15:
A nurse is explaining a preschool sibling's response to dying. Preschoolers:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
believe thoughts can cause events like death and may view death as temporary
Correct Answer(s):
believe thoughts can cause events like death and may view death as temporary (correct)

Rationale: Preschoolers may exhibit magical thinking and feel guilty for a sibling's death

mirror parental reactions

express grief differently than adults

Have little or no understanding of death

Question 16:
A nurse is planning interventions for a child with a lead exposure level of 3 mcg/dl. They include:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Recommend a diet rich in calcium
Correct Answer(s):
Chelation therapy

Call Social work for suspicion of child abuse

Administer a yearly lead screening

Recommend a diet rich in calcium (correct)

Rationale: Calcium is leached from the body with increased lead levels. There is no safe level of lead. Chelation therapy happens at 45mcg/dl. This level is too low to suspect child abuse. The child has identified exposure so a screening test is not helpful.

Question 17:
A mother of a 3-year-old is having a hard time dealing with temper tantrums. The nurse most appropriately tells the mother to:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
This is normal finding at this age period.
Correct Answer(s):
Punish the child to change the behavior

This is normal finding at this age period.

Set limits on the behavior (correct)

Ignore the behavior

Question 18:
What is the intervention administered for lead poisoning?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
N-acetylcysteine
Correct Answer(s):
Activated charcoal

Vitamin K

Chelation therapy using calcium EDTA (calcium disodium versenate) (correct)

N-acetylcysteine

Question 19:
A nurse is identifying teething behaviors in an infant. She may include all of the following except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Pulling on the ears
Correct Answer(s):
Pulling on the ears

Drooling

Sucking or biting of the hands

Fever of 39 degrees C (102.2.F) (correct)

Question 20:
A nurse assesses a 5-year-old child. The nurse expects the child can do all of the following except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Build models
Correct Answer(s):
Ride a tricycle

Cut with safety scissors

Use wading pools (correct)

Build models

Question 21:
A nurse gives an I.M. injection to a school-age child. The nurse should use which site?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Deltoid
Correct Answer(s):
Deltoid (correct)

Rationale: The deltoid can be used after three years of age

Ventrogluteal

Vastus lateralis

Dorsogluteal

Question 22:
Which toy is most therapeutic for a 12-month-old?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Musical rattle.
Correct Answer(s):
Baby doll.

Musical rattle. (correct)

Rationale: A musical rattle is a good toy for this child. Infants enjoy auditory, psychomotor and visual stimulation.

Board Book.

Colorful Beads.

Question 23:
How does the nurse restrain an infant when giving an injection?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Swaddle the infant and have the parents hold the infant
Correct Answer(s):
Give a sucrose solution

Swaddle the infant and have the parents hold the infant (correct)

Rationale: Swaddling restrains the infant and can make them feel secure

Get another RN to hold the infant

Administer EMLA cream to the injection site

Question 24:
Which medication treats spasticity in cerebral palsy (CP)?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Phenytoin (Dilantin)
Correct Answer(s):
Dexamethasone (Decadron).

Baclofen. (correct)

Diclofenac (Volatren).

Phenytoin (Dilantin)

Question 25:
An 8-month-old child should be able to achieve this milestone?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Sitting unsupported
Correct Answer(s):
Use a pincer grasp

Sitting unsupported (correct)

Rationale: A milestone is the latest time a child should do something. The average sitting up time is six months, if the child is eight months there is a delay

Fill containers

Use thick crayons

Question 26:
The nurse suggests the following iron-rich foods for iron deficiency except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Milk as the primary beverage
Correct Answer(s):
Fish

Dried beans like lentils

Leafy green vegetables

Milk as the primary beverage (correct)

Rationale: Cow's milk can cause iron deficiency when given in excess.

Question 27:
The nurse prepares a child for a lumbar puncture. The nurse includes the following nursing interventions except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Have child void before the procedure
Correct Answer(s):
Positions child in prone position (correct)

Have child void before the procedure

Position the child lateral with the head flexed and knees to chest

Explains the procedure requires the collection of CSF from L3-L4 or L4-L5

Question 28:
An adolescent is taking prednisone. The nurse educates the adolescent about all of the adverse effects accept:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Mood swings
Correct Answer(s):
Growth spurts (correct)

Acne

Hirsutism

Mood swings

Question 29:
An adolescent has a terminal illness and may die within 12 hours. Which finding is an expected finding?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Decreased muscle tone
Correct Answer(s):
Increased urine output

Tachycardia

Decreased muscle tone (correct)

Rationale: Muscle tone goes due to poor perfusion, poor nutrition, and inadequate fluids.

Bounding pulses

Question 30:
Which of the following is in the plan of care for a newborn who has myelomeningocele?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Position the child in the prone position with a sterile moist dressing over the defect. Begin intravenous fluids to prevent dehydration.
Correct Answer(s):
The nurse positions the child in the prone position and uses a sterile dry dressing over the anomaly.

Place the child in the prone position and a sterile dry dressing over the defect. Begin intravenous fluids to prevent dehydration.

Position the child in the prone position and apply a sterile, moist dressing over the opening. Slowly initiate oral gastric feeds to prevent necrotizing enterocolitis.

Position the child in the prone position with a sterile moist dressing over the defect. Begin intravenous fluids to prevent dehydration. (correct)

Rationale: The child is positioned in the prone position to protect the opening. A sterile moist dressing is kept over the defect to keep it as clean as possible. Intravenous fluids are begun to prevent dehydration.

Question 31:
A nurse understands possible contraindications to vaccine administration include all of the following:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Live vaccines such as the MMR for a severely immunocompromised child
Correct Answer(s):
Live vaccines such as the MMR for a severely immunocompromised child

Anaphylaxis

A severe, febrile illness

The common cold (correct)

Question 32:
A child with increased intracranial pressure is receiving mannitol (Osmotrol). The nurse monitors the child for which adverse effects?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Dyspnea
Correct Answer(s):
Hyperkalemia

Urine output over 1 ml/kg/hr.

Dyspnea (correct)

Rationale: Dyspnea can indicate heart failure an adverse effect of mannitol. Pain, especially a headache is a sign of IICP.

Pain

Question 33:
What can a nurse do to support a 5-year-old's intellectual initiative when he asks about his upcoming surgery?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Answer the child's questions about his upcoming procedure in simple terms.
Correct Answer(s):
Answer the child's questions about his upcoming procedure in simple terms. (correct)

Rationale: The child takes the initiative to ask questions, as preschoolers should, and the nurse should answer those questions as best as possible.

Show the child a book with realistic illustrations about his surgery.

Tell the child to ask the doctor his questions.

Promise the child that she will answer his questions at a later time.

Question 34:
Ways to reduce SIDS include all of the following except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Place the infant's head on a pillow
Correct Answer(s):
Place infant on their back

Give the infant pacifiers at night and encourage breastfeeding

Use a firm mattress without a crib bumper or stuffed animals inside of the crib

Place the infant's head on a pillow (correct)

Rationale: Pillows can become dislodged and suffocate the baby.

Question 35:
Which nursing interventions does the nurse perform for a child in status epilepticus?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Administer rectal diazepam.
Correct Answer(s):
Insert an intravenous line, and administer intravenous lorazepam.

Administer rectal diazepam. (correct)

Rationale: Rectal diazepam is initially administered to stop the seizure long enough to establish an IV, and then IV medication is administered.

Administer an oral glucose gel on the side of the child's mouth.

Administer oral diazepam.

Question 36:
A 2-month-old infant will receive all vaccinations except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
RV, varicella
Correct Answer(s):
RV, DtaP

Hib, PCV

RV, varicella (correct)

Rationale: Varicella and MMR are administered at one year

IPV, Hep B

Question 37:
A nurse is assessing a child's trigeminal nerve. All of the following are functions of the trigeminal nerve except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Clenching the teeth
Correct Answer(s):
Controls facial expression (correct)

Gives sensation of touch on the face

Gives a perception of pain on the face

Clenching the teeth

Question 38:
The mother of a 10-month-old with iron deficiency anemia tells the nurse that her infant is currently taking iron. Which comment made by the mother indicates the nurse needs to reinforce teaching?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
I give the iron in the morning 6-oz bottle.
Correct Answer(s):
I give the iron at the same time each morning.

I give the iron in the morning 6-oz bottle. (correct)

Rationale: Medications are never be mixed in a large amount of food or formula because the parent cannot ensure that the child will take the entire feeding. Formula decreases the absorption of iron.

I give the iron 1 hour before I feed the morning bottle.

I give the iron in oral syringes toward the back of the cheek.

Question 39:
A child with a midline brain tumor has increased intracranial pressure (ICP) and voids large amounts of very dilute urine. The nurse expects the provider to order which medication as part of the plan of care?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Mannitol.
Correct Answer(s):
Mannitol.

Vasopressin. (correct)

Lasix.

Dopamine.

Question 40:
A nurse administers atomoxetine to a child. The nurse evaluates the child for which complication?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Kidney damage
Correct Answer(s):
Kidney damage

Liver damage (correct)

Decreased white cells

Cardiomyopathy

Question 41:
The nurse uses hydrotherapy to debride a burn wound. The nurse performs all of the following nursing interventions except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Uses cold water to debride the patient's burn
Correct Answer(s):
Uses a tub and warm water for debridement

Debrides the wound once or twice per day per providers order

Premedicates before the procedure and uses ROM exercises afterward.

Uses cold water to debride the patient's burn (correct)

Rationale: Cool water can make the patient susceptible to hypothermia due to the loss of skin as a protective barrier

Question 42:
Risk factors for SIDS include all of the following except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
A soft sleeping surface, being covered by a blanket or co-sleeping in the parent's bed
Correct Answer(s):
Maternal smoking or second-hand smoke from the family

A soft sleeping surface, being covered by a blanket or co-sleeping in the parent's bed

Premature birth and/or low APGAR scores

Using a baby sling (correct)

Question 43:
The nurse is caring for a postictal child following a tonic-clonic seizure. All of the following are expected findings during this time except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Vomiting or a headache
Correct Answer(s):
The child can recall some parts of the seizure (correct)

Vomiting or a headache

Impairment of coordination and fine motor skills

Difficult to arouse, sleeps for several hours

Question 44:
A nurse is administering medication to an infant. The nursing actions include all of the following except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Use an 18- gauge needle
Correct Answer(s):
Use therapeutic holding or a swaddling

Administer medication in the side of the mouth in small amounts

Use an 18- gauge needle (correct)

Rationale: Infant use a 25-27-gauge needle

Inject up to 0.5mls of medication

Question 45:
A health care team has been established to promote client care that relieves suffering and improves quality of life. What term describes this team?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Palliative care
Correct Answer(s):
Family-centered care

Palliative care (correct)

Rationale: Palliative interventions are designed to relieve suffering and to improve quality of life.

Ethics committee

Spiritual care

Question 46:
A child with ventriculoperitoneal (VP) shunt complains of a headache and blurry vision. The child is irritable and sleeping more than usual. The parents ask the nurse how they can help their child. Select the nurse's best response?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
You should go to the emergency room as these may be symptoms of a shunt malfunction.
Correct Answer(s):
Give her acetaminophen, and if symptoms do not improve, bring her to the pediatrician's office.

It is common for girls to have these symptoms, especially before beginning their menstrual cycle. Give her a few days, and see if she improves.

You are probably nervous that she is having shunt complications. This is unlikely as it has been working well for eight years.

You should go to the emergency room as these may be symptoms of a shunt malfunction. (correct)

Rationale: These are signs of a shunt malfunction and should be evaluated immediately.

Question 47:
The nurse finds several signs of neglect that include all of the following except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Low socioeconomic status
Correct Answer(s):
Unexplained weight loss, malnourished, dehydrated

Low socioeconomic status (correct)

Rationale: Socioeconomic status is not associated with neglect

Inappropriate dress for the environment

Poor hygiene

Question 48:
The nurse educates parents of a child with cerebral palsy (CP) to prevent aspiration during feeding. The nurse questions which of the following actions during the return demonstration?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
The parent feeds the child soft and blended foods.
Correct Answer(s):
The parent places a small amount of food on the tip of the tongue. (correct)

The parent places the child in semi-Fowlers or higher during feeds.

The parent feeds the child soft and blended foods.

The parent fed the child slowly.

Question 49:
A nurse discontinues an IV catheter. The removal includes all of the following except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Use sterile technique to remove the catheter
Correct Answer(s):
Holding pressure for several minutes

The use of alcohol or adhesive remover to dislodge Tegaderm

Use sterile technique to remove the catheter (correct)

Rationale: Clean technique is used to discontinue an IV

Pulling the catheter straight out of the vein

Question 50:
Which vaccine is given to infants but not older children or adults?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
DtaP
Correct Answer(s):
Rotavirus (correct)

Tdap

DtaP

Varicella

Question 51:
The nurse uses which technique to do a physical assessment of a 9-year-old child?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Explain the role of the nurse in simple, understandable terms.
Correct Answer(s):
Encourage the child's parents to remain in the room during the physical exam.

Auscultate the heart, lungs, and abdomen first.

Ensure the child that the physical exam will not hurt.

Explain the role of the nurse in simple, understandable terms. (correct)

Rationale: School-age children understand the basic functions of the body and understand how the nurse can help them if explained in basic terms.

Question 52:
The child returns from a ventriculoperitoneal (VP) shunt revision procedure. How should the nurse position the child?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Semi-Fowler in an infant seat.
Correct Answer(s):
Semi-Fowler in an infant seat.

Flat in the crib.

Trendelenburg.

In the crib with the head of the crib elevated to 90 degrees. (correct)

Question 53:
A school-age child with a head injury that affected the pituitary gland and a sodium level of 150. The child may have all of the following assessment findings except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
The loss of free water
Correct Answer(s):
The loss of free water

Bounding pulses (correct)

Polydipsia, polyuria, dehydration

A decreased Antidiuretic hormone level

Question 54:
The nurse considers all of the following when administering dornase alpha except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Dornase alpha stimulates the bone marrow to produce red blood cells
Correct Answer(s):
The nurse monitors sputum thickness and the ability of the client to expectorate.

The nurse knows that dornase alpha decreases the viscosity of secretions

The nurse monitors for improvement in Pulmonary Function Tests

Dornase alpha stimulates the bone marrow to produce red blood cells (correct)

Rationale: Epoetin alpha increases red blood cells

Question 55:
A nurse is teaching about a PKU (phenylketonuria) diet. Included in the teaching is all of the following except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
A diet low in phenylalanine minimizes cognitive damage.
Correct Answer(s):
Breastmilk contains phenylalanine, and exclusive breastfeeding is unlikely

The goal is a phenylalanine level between 2 and 8 mg/dL.

Avoid the amino acid leucine (correct)

A diet low in phenylalanine minimizes cognitive damage.

Question 56:
A nurse is monitoring for a child after a seizure. What is the best position for the postictal child?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Lateral
Correct Answer(s):
High-Fowlers

Lateral (correct)

Rationale: Lateral allows for any drainage of secretions to prevent aspiration

Trendelenburg

Semi-Fowlers

Question 57:
The nurse cares for a child with cerebral palsy (CP) whose weight is in the fifth percentile and who is hospitalized for aspiration pneumonia. The mother doesn't want a G-tube placed. Which would be the nurse's best response?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Tell me your thoughts about G-tubes.
Correct Answer(s):
A G-tube will help your son gain weight and reduce his risk for future hospitalizations due to pneumonia.

G-tubes are simple to care for and will make feeding time easier for your family.

Do you have concerns that you will not be able to care for his G-tube?

Tell me your thoughts about G-tubes. (correct)

Rationale: An open-ended question can help family members to share what they know and potentially clear any misconceptions.

Question 58:
What is the most common long-term complication of myelomeningocele?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Hydrocephalus.
Correct Answer(s):
Learning disabilities.

Urinary tract infections. (correct)

Hydrocephalus.

Pressure injuries and skin breakdown.

Question 59:
The nurse is administering oral ferrous sulfate. The nurse will implement the following action:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Administer through a straw, due to staining of the teeth, and rinse with water
Correct Answer(s):
Administer through a straw, due to staining of the teeth, and rinse with water (correct)

Rationale: Iron stains teeth. Waiting times are for IM iron dextran. Iron is best absorbed on an empty stomach even though it causes GI upset

Administer a test dose and wait one hour before giving full dose.

Administer a chelating agent such as IV Deferoxamine (Desferal)

Give drug on a full stomach

Question 60:
A nurse is administering five vaccinations at one time. The nurse will do all of the following except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Encourage parents to give aspirin after vaccinations
Correct Answer(s):
Encourage parents to give aspirin after vaccinations (correct)

Rationale: Aspirin is not given to children to prevent Reye's syndrome

Administer oral vaccines before IM vaccines

Use a sucrose solution and a pacifier for nonpharmacological pain relief

Give subcutaneous injections in the anterolateral thigh or outer aspect of the upper arm

Question 61:
The nurse educates parents of a child with cerebral palsy (CP) to prevent aspiration during feeding. The nurse questions which of the following actions during the return demonstration?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
The parent fed the child slowly.
Correct Answer(s):
The parent places a small amount of food on the tip of the tongue. (correct)

The parent places the child in semi-Fowlers or higher during feeds.

The parent feeds the child soft and blended foods.

The parent fed the child slowly.

Question 62:
The assessment findings for lead exposure include all of the following except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Hearing or growth impairment
Correct Answer(s):
Hearing or growth impairment

Speech regression

Trouble paying attention

Alopecia (correct)

Question 63:
Morphine sulfate 1mg IV q2h PRN for pain is ordered for a 5-year-old who has had abdominal surgery. Which is the most appropriate nursing action?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Ask the provider to change the medication to Demerol (meperidine).
Correct Answer(s):
Administer the morphine sulfate using a syringe pump over 1 hour.

Encourage the child to do incentive spirometer every hour during the day and when awake at night. (correct)

Ask the provider to change the medication to Demerol (meperidine).

Administer with acetaminophen

Question 64:
A child is admitted with bacterial meningitis. Which order should the nurse question?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Intravenous fluids at 1.5 times regular maintenance.
Correct Answer(s):
Maintain isolation precautions for 24 hours after receiving intravenous antibiotics.

Intravenous fluids at 1.5 times regular maintenance. (correct)

Rationale: Intravenous fluids at 1.5 times regular maintenance could cause fluid overload and lead to increased ICP.

Neurological checks every hour.

Administer acetaminophen for fevers (100.4 degrees F, 38.0 C).

Question 65:
A child has ingested gasoline. What assessment findings indicate this type of poison was ingested?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Coughing, tachypnea, vomiting
Correct Answer(s):
Coughing, tachypnea, vomiting (correct)

Rationale: Children with gasoline poisoning may present with burns to the mouth, choking, nausea, lethargy, weakness, tachypnea, cyanosis, stridor, and abdominal pain

Clumsiness, cognitive delay, speech impairment

Hives, angioedema, peripheral edema

Diuresis, chills, fever

Question 66:
The nurse suspects a rare case of protein deficiency. The nurse includes the following teaching points except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Animal products should comprise all of the protein a child gets
Correct Answer(s):
Animal products should comprise all of the protein a child gets (correct)

Rationale: Protein should also come from plant sources like beans and soy and nut products to minimize the harmful effects of eating too much meat.

Protein should make up 20% of the diet

Protein deficiencies may cause mood swings

Meat, beans and nuts are good sources of protein

Question 67:
A child with a concussion falls asleep but will respond when his name is called, or he is gently shaken. The state of consciousness is referred to as:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Delirium.
Correct Answer(s):
Coma.

Delirium.

Obtunded. (correct)

Confusion.

Question 68:
A nurse has just completed instruction on using imagery as a complementary and alternative therapy (CAT). Which client would this strategy benefit?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
A preschooler receiving a dressing change
Correct Answer(s):
A child post-appendectomy

A preschooler receiving a dressing change (correct)

Rationale: Using imagery to distract the preschooler with a minimal amount of pain is an appropriate nonpharmacologic pain intervention. The other choices require interventions for physiologic needs

An adolescent undergoing a bronchoscopy

A preschooler with an acute ear infection

Question 69:
Cloudy cerebrospinal fluid (CSF) is obtained from a lumbar puncture. This most likely indicates:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Bacterial meningitis.
Correct Answer(s):
Viral meningitis.

Bacterial meningitis. (correct)

Rationale: The cerebral spinal fluid in bacterial meningitis is usually cloudy.

No infection, as CSF is usually cloudy.

Sepsis.

Question 70:
A neonate was admitted to the hospital with vomiting and dehydration. The newborn's heart rate is 160, respiratory rate is 50, blood pressure is 85/52, and the temperature is 99 degrees F (37.2 degrees C). What is the nurse's best response when the parents ask if the vital signs are normal?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
The respiratory rate is elevated, but the other vital signs are within normal range.
Correct Answer(s):
The blood pressure too high, but the other vital signs are within normal range.

The temperature is elevated. However, the other vital signs are within normal range.

The respiratory rate is elevated, but the other vital signs are within normal range. (correct)

Rationale: The range of heart rates for a child from birth to 1 month is 90 to 160.

The heart rate is raised, but the other vital signs are within normal range.

Question 71:
The nurse weighs an infant and reports a weight of 7lb 5 oz down from the 7lb 10oz when the infant was discharged six days ago. The nurse's best explanation for the mother is:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Infant weight loss of a few ounces is expected among newborns, especially for breastfeeding mothers.
Correct Answer(s):
I will let the provider know, and she can talk with you about possible causes for your infant's weight loss.

Infant weight loss of a few ounces is expected among newborns, especially for breastfeeding mothers. (correct)

Rationale: Initially, newborns can lose up to 10% of their birth weight but should regain their birth weight by two weeks of age.

I see. You must be a first-time mother. Don't worry; we will investigate why she is underweight.

Maybe she is not getting enough milk. How often are you breastfeeding her?

Question 72:
The mothers of two toddlers meet for a playdate. The mothers expect that the children will do which of the following?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Play side by side, but not actively with one another.
Correct Answer(s):
Share toys while playing.

Play with little or no conflict.

Play side by side, but not actively with one another. (correct)

Rationale: Toddlers play style is parallel play. Toddlers often play alongside another child, but they rarely engage in activities with the other child.

They play with one or two items from a group of toys.

Question 73:
Signs of an iron deficiency include all of the following except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
irritability, and muscle weakness systolic heart murmur, enlarged heart, and/or heart failure
Correct Answer(s):
Pale conjunctiva

Shortness of breath, brittle, spoon-shaped fingernails and fatigue

irritability, and muscle weakness systolic heart murmur, enlarged heart, and/or heart failure

Hematemesis, diarrhea, gastric pain, bloody stools (correct)

Question 74:
A 2-year-old is hospitalized. The parents have to go home for a few hours. The child asks when they will be back. The nurse's best response is:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
They will be back after your nap.
Correct Answer(s):
They will be back after your nap. (correct)

Rationale: Preschoolers understand time in relation to events.

They will be back at 4 pm.

They will be back later tonight.

They will be back in 3 hours.

Question 75:
Normal vital signs of a 1-year-old infant include all of the following except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
25 to 30/min respiration rate
Correct Answer(s):
37.7C (99.9F) axillary temp

60 to 110/min pulse rate

25 to 30/min respiration rate

108/93 blood pressure (correct)

Question 76:
A nurse is conducting a scoliosis screening. Which finding would cause her to suspect scoliosis?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
An excessive cervical curvature
Correct Answer(s):
An excessive thoracic curvature

A rib hump or uneven ribs (correct)

An excessive lumbar curvature

An excessive cervical curvature

Question 77:
Which finding is abnormal when performing a physical assessment on a 10-month-old infant?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Posterior fontanel is open.
Correct Answer(s):
Posterior fontanel is open. (correct)

Rationale: The infant's posterior fontanel should close between 6 and eight weeks of age.

Anterior fontanel is open.

Beginning signs of tooth eruption.

Able to track and follow objects.

Question 78:
Which child is most at-risk for cerebral palsy (CP)?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
A 14-day-old infant with group B streptococcus meningitis.
Correct Answer(s):
A child with a congenital heart condition

A 14-day-old infant with group B streptococcus meningitis. (correct)

Rationale: Infection of the CNS increases the infant's risk of cerebral palsy.

A 12-month-old child who has experienced a febrile seizure.

An infant with a closed-head injury.

Question 79:
What is one of the most common causes of injury and death for an 8-month-old infant?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Aspiration.
Correct Answer(s):
Poisoning.

Non-accidental injury.

Aspiration. (correct)

Rationale: Aspiration is the main cause of injury and death among children of this age. Children can aspirate on small objects lying on the floor that end up in their mouths.

Dog bites.

Question 80:
A 14-year-old boy is hospitalized for a femur fracture after riding recklessly through traffic. The child's parents are concerned about his judgment. The nurse explains to the parents that his behavior is:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Typical of young teens.
Correct Answer(s):
Typical of young teens. (correct)

Rationale: Adolescent brains are not completely developed, which often leads to poor judgment and impulse control.

Related to hormonal surges during adolescence.

A one-time incident that will not likely occur again.

Related to teen rebellion.

Question 81:
The nurse gives further education about Reye syndrome when a mother states:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
I will give aspirin to my child to treat a headache.
Correct Answer(s):
I will immunize my children against varicella and influenza.

I will not give my child any products containing aspirin.

I will give aspirin to my child to treat a headache. (correct)

Rationale: The giving aspirin or products containing aspirin has been associated with Reye syndrome. A headache is often the first sign of a viral illness.

Children who have Reye syndrome are admitted to the hospital.

Question 82:
A nurse assesses a 6-month-old infant which finding would be reportable to the provider?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Strabismus
Correct Answer(s):
Teething

Sitting up unsupported

Strabismus (correct)

Rationale: Infants no longer display strabismus by 3-4 months of age

Babbling sounds

Question 83:
Which foods are appropriate for a 2-year-old with anemia?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Fruits, whole grains, and meats.
Correct Answer(s):
32oz of whole cow's milk per day.

Beans, eggs, and green vegetables. (correct)

Fruits, whole grains, and meats.

8oz of juice, three times per day.

Question 84:
A nurse completes a physical assessment on a toddler. Which assessment was completed last?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Rectal temperature
Correct Answer(s):
Breath sounds

Infant reflexes

Rectal temperature (correct)

Rationale: All invasive procedures are completed last

Capillary refill

Question 85:
A child with meningitis is admitted to the hospital, which intervention takes priority?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Administration of maintenance intravenous fluids.
Correct Answer(s):
Administration of intravenous antibiotics.

Administration of maintenance intravenous fluids. (correct)

Rationale: Cultures of spinal fluid and blood are sent to the lab, followed by the administration of intravenous fluids.

Placement of a Foley catheter.

Obtain lab results for cultures on spinal fluid and blood samples.

Question 86:
A nurse counts a 1-year-old's teeth. The infant has from __ to ___ teeth and will eventually have __deciduous teeth and __permanent teeth


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
10-12, 20, 32
Correct Answer(s):
6-8, 20, 32 (correct)

2-4, 20, 32

10-12, 20, 32

12-15, 20, 32

Question 87:
A nurse is teaching about self-administration of epinephrine. The nurse includes all of the following teaching points except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
A therapeutic response should occur after one injection but may require two injections.
Correct Answer(s):
Use a pre-filled epinephrine injector into the thigh, hold, and massage site for 10 seconds to promote absorption (IM).

A therapeutic response should occur after one injection but may require two injections.

Use a pre-filled epinephrine injector into deltoid, hold, and massage site for 10 seconds to promote absorption (IM). (correct)

Store in a cool, dark place

Question 88:
Which nursing action is most appropriate to facilitate communication about how a school-age-child is feeling?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Ask the child simple, direct questions about how she is feeling.
Correct Answer(s):
The nurse can attempt to make friends with the child to gain access to the child's feelings.

Ask the child's parents what feelings the child has expressed to them.

Allow the child to draw a picture of their feelings. (correct)

Ask the child simple, direct questions about how she is feeling.

Question 89:
The nurse knows the best way to explain a procedure to a hospitalized four-year-old child is to:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Demonstrate the procedure on a doll.
Correct Answer(s):
Provide the child with a pamphlet with pictures showing the procedure.

Have the 6-year-old next door tell the 4-year-old about the experience.

Demonstrate the procedure on a doll. (correct)

Rationale: Medical play is an effective method for helping preschoolers understand the steps of the procedure.

Show the child a video of the surgery.

Question 90:
Which abnormal assessment finding should the nurse evaluate after albuterol (Proventil) is given to a child?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
A decrease in respiratory rate from 35 to 22.
Correct Answer(s):
Excessive hip abduction.

A decrease in respiratory rate from 35 to 22.

A decrease in blood pressure.

Wheezing (correct)

Question 91:
A nurse assesses an wheezing breath sound. It sounds like:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
A high-pitched, musical or whistling like sounds heard primarily on expiration as air passes through and vibrates through narrow airways.
Correct Answer(s):
A low pitched, rattling lung sounds that often resemble snoring (correct)

A high-pitched, musical or whistling like sounds heard primarily on expiration as air passes through and vibrates through narrow airways.

A low-pitched, grating, or creaking sounds that occur when inflamed pleural surfaces rub together during breathing movements

A high-pitched breath sound resulting from the turbulent airflow in the larynx or bronchial tree

Question 92:
The nurse recognizes signs of nonaccidental injury or child abuse include all of the following except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Bruises or fracture in different stages of healing
Correct Answer(s):
Unusual bruising on back or abdomen

A blue sclera (correct)

Spiral fractures

Bruises or fracture in different stages of healing

Question 93:
To obtain an adolescent's health information, the nurse should:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Interview the adolescent using direct questions.
Correct Answer(s):
Interview the adolescent using direct questions.

Gather information during a casual conversation. (correct)

Interview the adolescent with the parent.

Interview the parents.

Question 94:
A toddler experienced a near-drowning event. The nursing actions in the plan of care include all of the following except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Administer N-acetylcysteine (Mucomyst)
Correct Answer(s):
Oxygen

Administer N-acetylcysteine (Mucomyst) (correct)

Rationale: This is an antidote for acetaminophen

Chest physiotherapy

Monitor for complications for 24 hours

Question 95:
The mother of a neonate asks when the infant will receive the first hepatitis B immunization. Which is the nurse's best response?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
The first dose of the hepatitis B vaccine is given before discharge today.
Correct Answer(s):
Babies receive the hepatitis B vaccine only if their mother is positive for hepatitis B.

The first dose of the hepatitis B vaccine is given before discharge today. (correct)

Rationale: The first injection of the hepatitis B vaccine is offered between birth and two months. In most hospitals, newborns receive the vaccine before discharge.

The first dose of the hepatitis B vaccine is offered at one year of age.

Babies get their first hepatitis B vaccine at six months of age.

Question 96:
A nurse cares for a child with increased intracranial pressure. What is the nurse's priority intervention?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Monitoring level of consciousness
Correct Answer(s):
Seizure precautions (correct)

Administering pain medication

Administering mannitol

Monitoring level of consciousness

Question 97:
A nurse administers medication into a tunneled, central venous access device. She will perform all of the following interventions except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Have the patient use the Valsalva Maneuver
Correct Answer(s):
Make sure the clear, semipermeable protective dressing is in place for infection control

Initially flush the line for patency using sterile technique. Inject the ordered medication according to the 6 Rights of Medication Administration

Flush with normal saline

Have the patient use the Valsalva Maneuver (correct)

Rationale: The Valsalva is a forceful exhalation against a closed glottis, which increases intrathoracic pressure and diminishes the return of venous blood to the heart; performed with central line insertion to create a positive phase in central venous pressure, thus reducing the risk of air being drawn into the central circulation and creating an air embolus. It is not used for medication administration. A central venous catheter is inserted into large veins in the central circulation
The tip of the central line is generally threaded into the internal or external jugular vein or into the lower third of the inferior vena cava (IVC) that leads to an area just above the RA (right atria)

Question 98:
The nurse is caring for a the parents ask the nurse why the baby's head circumference is measured in an infant with myelomeningocele. Select the nurse's best response:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
A myelomeningocele put the infant at risk for hydrocephalus, which presents as an increase in head size.
Correct Answer(s):
Babies' heads are measured to track growth to ensure it normally is occurring.

A myelomeningocele put the infant at risk for hydrocephalus, which presents as an increase in head size. (correct)

Rationale: Children with myelomeningocele can develop hydrocephalus, which can present as an increase in head circumference.

Because your baby's spinal cord did not close all the way, your infant is at risk for meningitis, which can manifest as an increase in head size.

Many infants with myelomeningocele also have microcephaly, which can show up as a decrease in head size.

Question 99:
Nurses are mandated, reporters. A nurse knows all of the following assessments indicate nonaccidental injury except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Low socioeconomic status
Correct Answer(s):
Low socioeconomic status (correct)

Rationale: Mothers in poverty may have more stressors that make them more likely to act out. However, this is not the case for the majority of mothers in poverty

Vague explanations of injuries that "don’t fit" the parental story or occur in an immobile patient

Delays for treatment

Fractures in various stages of healing

Question 100:
The nurse administers a Hepatitis B vaccine to an infant. All of the following actions occur except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Final dose no earlier than the age of 24 weeks of age and at least 16 weeks after the initial dose. It should be withheld for infants born prematurely and weighing less than 2,000 g if the mother is negative for hepatitis B.
Correct Answer(s):
The vaccine is given at birth, 1-2 months, and 6-18 months.

There is a minimum of 4 weeks between doses one and two, and a minimum of 8 weeks between doses two and three.

Administer vaccination in ventrogluteal site (correct)

Final dose no earlier than the age of 24 weeks of age and at least 16 weeks after the initial dose. It should be withheld for infants born prematurely and weighing less than 2,000 g if the mother is negative for hepatitis B.

Question 101:
The nurse knows all of the following interventions reduce pain in children during immunizations except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Saying "this will only feel like a bee sting."
Correct Answer(s):
Using the correct needle length

Holding pressure on the site for 5-10 seconds before inserting the needle

Distracting the child during the injection

Saying "this will only feel like a bee sting." (correct)

Rationale: Be honest with the child and do not assume what the injection will feel like. The nurse can explain the injection will hurt but can give a sticker as a reward

Question 102:
A mother requests that her child receives the rubeola vaccine at the 10-month well-child checkup. The nurse tells the mother that:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
The vaccine is given after the physician examines the child.
Correct Answer(s):
Vaccinated children will likely develop a mild case of the disease.

The vaccine is contraindicated be given at that visit. (correct)

The vaccine is given after the physician examines the child.

A booster vaccination will be necessary at 18 months of age.

Question 103:
A 16-year-old in Illinois is covered under her parent's insurance and requests birth control, but does not want to tell her parents. The nurse should inform the adolescent that her parents:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Will not have the right to read her medical records, but may see the insurance bill
Correct Answer(s):
Will always have the right to her medical record

Are not allowed to view the insurance records

Will have the right to read her medical record if they provide payment

Will not have the right to read her medical records, but may see the insurance bill (correct)

Rationale: The insurance bill will come addressed to her parents, so they may find out that this client utilized insurance services to pay for the visit and medication. According to the Health Information Portability and Accountability Act (HIPPA), parents have no right to review the client’s medical record even if they provide payment or insurance the patient.

Question 104:
An 18-year-old has a rash and itching in the genital area worries he has contracted a sexually transmitted disease and does not want to tell his parents. The nurse's best response is:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Who should we contact about your visit here today?
Correct Answer(s):
We will need to talk to your parents to let them know.

Your parents will not be contacted regarding this visit. (correct)

Who should we contact about your visit here today?

We cannot guarantee that the hospital will not inform your parents.

Question 105:
A nurse administers an oral dose of nystatin. What teaching should she provide?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Have the child swish and spit out the medication
Correct Answer(s):
Nystatin is an antibiotic

Nystatin is an antipruritic

Have the child swish and spit out the medication (correct)

Rationale: The oral suspension of nystatin is given by the method called "swish and swallow." The nurse has the child swish the solution throughout the mouth and then swallow or spit the drug out as directed by the provider. When nystatin troches are prescribed, teach the child to let them dissolve completely in the mouth and not to chew or swallow the whole troche. The nurse should not crush the troche unless advised to do so by the provider for a child.

Have the child swish and swallow the medication

Question 106:
The nurse completes an assessment and suspects nonaccidental injury. Assessment findings may include all of the following except?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Authoritative parents
Correct Answer(s):
Authoritative parents (correct)

Rationale: Parenting style is not associated with abuse

A history of frequent ER visits

Discrepancies in injury and age of the child

Different stories from both parents

Question 107:
A preschooler with delayed growth and development is learning to use the toilet. The nurse suggests the following strategies to help the child. These include all of the following except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Candy rewards
Correct Answer(s):
Take away screen time so the child can focus on the task until the child is successful (correct)

Keep a chart with stickers for dry days

Create a ritual like clapping or singing a song

Candy rewards

Question 108:
A nurse is teaching a parent about night terrors. The nurse includes all of the teaching points except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Don't give water right before bed
Correct Answer(s):
Don't give water right before bed (correct)

Rationale: This is for enuresis, not sleep, terrors

A consistent bedtime routine helps toddlers sleep

Use a nightlight

Reassure toddler but keep them in their beds

Question 109:
How can the nurse best support the trust relationship between the mother-baby dyad while the infant is hospitalized? The nurse should:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Encourage the parents to actively manage their child's care.
Correct Answer(s):
Invite the child's parents to stay with the child as much as possible.

Inform parents about all aspects of their child's condition. (correct)

Encourage the parents to cuddle their child as much as possible.

Encourage the parents to actively manage their child's care.

Question 110:
A 12-month-old boy weighed 7lb 4oz at birth. What would the nurse expect the infant's current weight to be?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
21lb 8oz
Correct Answer(s):
14lb 8oz

21lb 8oz

21 lb 12oz (correct)

29lbs

Question 111:
Which child should a child with newly diagnosed bacterial meningitis be cohorted with?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Semi-private room with a roommate who has bacterial meningitis but has received intravenous antibiotics for more than 24 hours.
Correct Answer(s):
Semi-private room with a roommate who also has bacterial meningitis.

Semi-private room with a roommate who has bacterial meningitis but has received intravenous antibiotics for more than 24 hours.

A private room that is kept dark with minimal stimulation. (correct)

A private room that has developmentally appropriate activities available.

Question 112:
A 13-year-old girl has an STD. Is she able to consent to the treatment?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Yes, an adolescent can consent for pregnancy or STI's. However, parents can access electronic health records on their own.
Correct Answer(s):
No, she can provide assent

Yes, if her parents also consent

Yes, an adolescent can consent for pregnancy or STI's. However, parents can access electronic health records on their own. (correct)

Rationale: Adolescents can give consent in these specific situations.

No, she needs parental consent

Question 113:
A 3-year-old with a superficial, minor burn is brought to the hospital. All of the following nursing interventions are included in the plan of care except?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Use an antimicrobial ointment
Correct Answer(s):
Use an antimicrobial ointment

Apply a clean, dry gauze dressing to immobilize and protect the burn.

Keep patient warm and consider a tetanus shot if the vaccine has not been given in 5 years

Lance blisters (correct)

Question 114:
The nurse should maintain all of the following tasks in anticipation of an organ donation from the patient except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Be the first to explain the informed consent document for organ donation
Correct Answer(s):
Provide support to the family as clinical decisions are made

Make religious or cultural preparations to support the patient and family

Maintain cardiovascular function and ventilator settings to maintain organ perfusion

Be the first to explain the informed consent document for organ donation (correct)

Rationale: Providers are the first to explain informed consent. The nurse double-checks that the consent form was signed.

Question 115:
Which action is the most developmentally appropriate way to engage a 4-year-old's cooperation in obtaining the blood pressure?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Have the child help place the blood pressure cuff.
Correct Answer(s):
Have the child help place the blood pressure cuff. (correct)

Rationale: Preschool children enjoy games, and it is an excellent way to elicit their assistance and cooperation during a procedure.

Instruct the child to sit still so the blood pressure machine will go quickly.

Ask the child if he feels the squeezing of his arm.

Promise the child that measuring the blood pressure will not hurt.

Question 116:
A nurse completes a physical assessment on a newborn. Which finding must be reported to the provider?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Chest circumference 32 cm
Correct Answer(s):
Temperature 38 degrees Celsius (correct)

Head circumference 35 cm

Chest circumference 32 cm

Apical heart rate 160 and respirations 60

Question 117:
A child with third-degree burns goes into septic shock. All of the following symptoms may present except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Confusion
Correct Answer(s):
Delayed capillary refill and decreased urine output

Confusion

Fever

Hypertension (correct)

Question 118:
Which should the nurse do to manage separation anxiety in a hospitalized toddler?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Establish a routine for the child that is similar to the child's routine at home.
Correct Answer(s):
Fulfill the parental role when parents are not able to be at the bedside.

Invite the parents to remain at the bedside.

Establish a routine for the child that is similar to the child's routine at home. (correct)

Rationale: It is important re-establish a child's home routine. This increases the child's sense of security and decreases anxiety.

Rotate the nursing team, so the child becomes comfortable with a variety of nurses.

Question 119:
A nurse provides teaching about Tinea pedis to an athletic school-age child. The nurse includes all of the following teaching points except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Use baby powder to prevent tinea pedis recurrence
Correct Answer(s):
Socks are contraindicated

Use baby powder to prevent tinea pedis recurrence (correct)

Rationale: Baby powder has no medical indication and is carcinogenic

Sport sandals or flip-flops keep feet dry and less able to proliferate the fungus

Tinea pedis is a fungal infection that causes puritis and scaling skin

Question 120:
A nurse is going to give a 6-month-old a dose of antibiotics IM. What must the nurse do when the 1.25 mL dose arrives from the pharmacy?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Divide the dose into two injections.
Correct Answer(s):
Administer the injection into the deltoid muscle

Divide the dose into two injections. (correct)

Rationale: A nurse should not deliver more than 1mL per IM injection to a 6-month-old

Administer the injection into the dorsogluteal muscle.

Give the dose as a single injection into the anterolateral leg muscle.

Question 121:
An adolescent diet is usually deficient in the following nutrients except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Iron
Correct Answer(s):
Calcium

Vitamins

Iron

Fats (correct)

Question 122:
A child is admitted to the ED and has a severe burn. After the nurse establishes that the patient is breathing with O2 saturation 98%. Which intervention is most important?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Cover the burns
Correct Answer(s):
Pain medication

IV Fluids (correct)

Cover the burns

IV antibiotics

Question 123:
A child has a terminal illness, and the father is struggling to cope. The nurse may say any of the following to the father except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
I know how you feel, I am also sad
Correct Answer(s):
Do you want to talk about your child?

I know how you feel, I am also sad (correct)

Rationale: Therapeutic communication demands the nurse not assume how any other person feels.

How have you coped with difficult events in the past?

We could provide a consistent healthcare team when possible to support you.

Question 124:
A nurse assesses a neonate. Which of the following is a normal finding?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Extrusion reflex
Correct Answer(s):
Bulging anterior fontanel

Extrusion reflex (correct)

Rationale: The extrusion reflex projects the tongue forward when touched. This reflex protects the infant's airway and disappears after 3-4 months

Respirations 40

Temperature 37.5C

Question 125:
A nurse takes a pulse ox on an infant. Which is the preferred placement of the probe?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Big toe
Correct Answer(s):
Earlobe

Fingernail

Big toe (correct)

Rationale: The probe can be placed on the fingers, toes, hand, head, foot, or wrist of the neonate. The big toe has the least chance of being pulled off.

Wrapped over the pedal pulse

Question 126:
A child has a hypospadias repair and has a stent. The nurse includes the following in the teaching except?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Keep skin clean as possible
Correct Answer(s):
Keep skin clean as possible

Let the stent drain into the diaper

Let the baby air dry before replacing the diaper

Give a tub bath to keep the area clean (correct)

Question 127:
What milestone should the child have reached by 15 months of age that would require a referral?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Putting large-piece puzzles together
Correct Answer(s):
Walking

Creeping or crawling (correct)

Putting large-piece puzzles together

Using push-pull toys

Question 128:
Which intervention is an example of family-centered care?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Including the family when the team of health care providers visits the child (rounds)
Correct Answer(s):
Calling a social worker to assist with housing needs

Including the family when the team of health care providers visits the child (rounds) (correct)

Rationale: Including the family on the plan of the day from the providers creates a healthcare team for the child.

Only allowing immediate blood relatives access to your patient

Identify physical and emotional problems of the family

Question 129:
A toddler has a head injury with pituitary involvement and a sodium level of 130. All of the following assessment findings may be found except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Decreased urine
Correct Answer(s):
Increased BP

Increased ADH secretion

Specific gravity 1.025 (correct)

Decreased urine

Question 130:
A nurse cares for a toddler with a head injury. What is the priority nursing assessment?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Respiratory rate
Correct Answer(s):
Heart Rate

Blood Pressure

Respiratory rate (correct)

Rationale: Respiratory rate: ABC's breathing before circulation

Temperature

Question 131:
A 3-year-old admitted to the hospital has been continually crying. The nurse responds to the concerned parents that this behavior indicates the child is in the:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Protest state of separation anxiety, which is typical for children during hospitalization.
Correct Answer(s):
Detachment phase of separation anxiety, which is typical for children during hospitalization.

Despair stage of separation anxiety, which is typical for children during hospitalization.

Bargaining stage of separation anxiety, which is typical for children during hospitalization.

Protest state of separation anxiety, which is typical for children during hospitalization. (correct)

Rationale: During the protest stage of separation anxiety, the child may cry more than at any other time and frequently ask to go home.

Question 132:
A child with cerebral palsy (CP) had his hamstrings surgically released and is currently on baclofen. The nurse provides teaching on baclofen and includes:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
The medication increases muscle tone
Correct Answer(s):
The medication increases muscle tone

It is a medication prevents seizures.

It is a medication to control spasms. (correct)

It is a medication that improves bladder control.

Question 133:
The nurse includes all of the following teaching points about sunburn prevention except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Avoid the sun between 10 am to 3 pm
Correct Answer(s):
Avoid the sun between 10 am to 3 pm

Wear sunscreen and reapply after sweating or going in the water

Wear protective clothing

Use sunscreen on all age groups of children regardless of age (correct)

Question 134:
A nurse is teaching school-age children about bicycle safety. The nurse includes all of the following teaching points except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
The child may wear headphones if they are only in one ear
Correct Answer(s):
Children should wear light-colored or reflective clothing while riding

The child may wear headphones if they are only in one ear (correct)

Rationale: Headphones are popular but dangerous to wear while riding a bike

Bikes are to ride single-file, in the flow of traffic to minimize accidents

The bike must be the proper size for the child. When the child is seated on the bike, they should be able to stand with the ball of each foot in contact with the ground while straddling the bike's center bar.

Question 135:
A nurse is providing anticipatory guidance for toddlers to their parents. The nurse includes all of the following developmental teaching points except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Toddlers are in the guilt vs. shame and doubt Erickson phase
Correct Answer(s):
Develop healthy eating patterns with a low sugar diet to prevent cavities

Toddlers may have night terrors or nightmares

Toddlers are in the guilt vs. shame and doubt Erickson phase (correct)

Rationale: Toddlers are in the autonomy vs. shame Erickson stage

Toddlers display negativism and ritualism

Question 136:
What information does a school nurse include in a discussion on nutrition with a fifth-grade class?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
A list of nutritious foods with how they affect the body.
Correct Answer(s):
The average number of calories that a fifth-grade child should consume a day.

A list of high-calorie processed foods that all fifth-graders should avoid.

How to read food labels.

A list of nutritious foods with how they affect the body. (correct)

Rationale: School-age children are logical and interested in how food affects their health. They understand basic medical terminology.

Question 137:
A nurse plans care for a child with an epidural bleed. The nurse includes the following nursing interventions except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Positions the patient in a supine position
Correct Answer(s):
Provides a calm environment

Provides fluids and monitors electrolytes

Positions the patient in a supine position (correct)

Rationale: Neurological patients should have an elevated head of the bed t at least semi-Fowlers

Monitors pupils and signs of ICP

Question 138:
Which child can receive the influenza vaccine via nasal spray?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
A 3-year-old with the common cold
Correct Answer(s):
An 18-month-old with hypersensitivity to amoxicillin

A 3-year-old with the common cold (correct)

Rationale: Children under two cannot receive the live, nasal vaccination. In pregnant women and people over 50 the injection is appropriate

A woman 40 weeks pregnant

A healthy 1-year-old

Question 139:
A child is to receive phenytoin (Dilantin) 100mg IV. How does the nurse administering this drug?


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Mix it in dextrose 5% in water and give over 1 hour.
Correct Answer(s):
Mix it in dextrose 5% in water and give over 1 hour.

Administer no faster than 2 mg/kg/min. (correct)

Do not use an inline filter.

Administer with diuretics.

Question 140:
A nurse administers an eye medication. She does all of the following except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Administer eye medications 30 sec apart
Correct Answer(s):
Hold the dropper above the conjunctival sac about 1 to 2 cm, and drop the medication into the center of the sac.

For eye ointment, apply a thin ribbon to the edge of the lower eyelid from the inner to the outer canthus.

Administer eye medications 30 sec apart (correct)

Rationale: Administer multiple eye medications 5 minutes apart to reduce interactions.

Hold gentle pressure with your finger and clean facial tissue to the nasolacrimal duct for 30-60 seconds to minimize systemic absorption of the medication

Question 141:
An adolescent has a diagnosis of new-onset diabetes. What would most influence a teenager's food choices as he begins to make changes in his diet?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Peers and their dietary choices.
Correct Answer(s):
Parents and their dietary choices.

Cultural background.

Peers and their dietary choices. (correct)

Rationale: As an adolescent, peers are most important. Teens want to be like other teens.

Television and other forms of media influence.

Question 142:
A nurse administers IV penicillin, and the child develops hives and angioedema. What action should the nurse take?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Stop infusion and administer epinephrine
Correct Answer(s):
Stop infusion and administer epinephrine (correct)

Rationale: Stop infusion, give epinephrine and call the provider afterward

Call the provider for further orders

Finish the infusion and call the provider

Stop the infusion and administer diphenhydramine

Question 143:
A nurse checks for a history of allergies for a child who is prescribed penicillin. The mother reports the child developed a rash to penicillin two years ago. Which of the following nursing interventions is best to include in the plan of care?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Hold the dose and notify the provider
Correct Answer(s):
Hold the dose and notify the provider (correct)

Rationale: The nurse should hold the medication and notify the provider of the child's rash so an alternative antibiotic can be prescribed. Allergic reactions to penicillin include mild to severe anaphylaxis, and prior sensitization is reported to the provider

Administer the dose

Administer diphenhydramine before administering the dose

Call the provider and request an oral route and administer half and monitor for a reaction.

Question 144:
A 3-year-old child is being assessed. All of the findings are appropriate except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Pulse 60-110
Correct Answer(s):
Blood pressure of 89/56 mmHg

Pulse 60-110

37.5 degrees C (99.5 degrees F)

Respirations 25-35 (correct)

Question 145:
In caring for a 4-year-old with pain, which assessment tool is the most useful?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
FACES scale
Correct Answer(s):
Numeric scale

FACES scale (correct)

Rationale: The Faces pain rating scale is appropriate for who may have difficulty describing pain or understanding the correlation of pain to numerical descriptors or verbal commands

FLACC scale

NIPS scale

Question 146:
What is the antidote to acetaminophen?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
N-acetylcysteine (Mucomyst)
Correct Answer(s):
Activated charcoal

N-acetylcysteine (Mucomyst) (correct)

Rationale: N-acetylcysteine is the antidote to acetaminophen

Chelation therapy using deferoxamine mesylate

Vitamin K

Question 147:
The nurse knows that infants are at risk for injury from shaken baby syndrome (SBS) because:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
The anterior fontanel is open.
Correct Answer(s):
The anterior fontanel is open.

They have insufficient musculoskeletal support and a disproportionate head-to-body ratio. (correct)

They have an immature vascular system with veins and arteries that are more superficial.

The nurse understands there is immature myelination of the nervous system in a young infant.

Question 148:
The mother of 16-year-old worries that her son is sleeping too much. Which is the nurse's best response?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Teens require more sleep related to their physical growth spurts that are occurring.
Correct Answer(s):
Your son may have missed sleep and is now catching up.

Developmental theorists indicate that adolescents require more sleep as they begin to integrate new roles into their lives.

Teens require more sleep related to their physical growth spurts that are occurring. (correct)

Rationale: Teens need more sleep due to growth spurts that occur during adolescence.

Teens need more sleep due to the increase of their social obligations.

Question 149:
A 3-month-old baby has diaper dermatitis. The nurse includes all of the following teaching points in the plan of care except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Use cornstarch or baby powder on the rash
Correct Answer(s):
Avoid bubble baths and harsh detergents

Allow the area to air dry before replacing the diaper

Use a barrier cream (zinc oxide) while healing the rash

Use cornstarch or baby powder on the rash (correct)

Rationale: Cornstarch promotes yeast development on the skin. Baby powder causes lung damage

Question 150:
The nurse includes all of the following teaching points about car seats except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
The car seat remains rear facing until the child can see farther than 1 foot
Correct Answer(s):
The child needs a federally approved car seat at a 45-degree angle to minimize slumping and airway obstruction.

The car seat is placed rear-facing in the rear seat of the vehicle for children under 2 and secured using the safety belt

The car seat remains rear facing until the child can see farther than 1 foot (correct)

Rationale: Newborns should be placed in a federally approved car seat at a 45-degree angle to prevent slumping and airway obstruction. The car seat is placed rear-facing in the rear seat of the vehicle. The seat is secured with a safety belt. The shoulder harnesses are positioned in the slots at or below the level of the infant ’s shoulders. The harness should be fairly tight, and the retainer clip should be placed at the level of the infant’s armpits.

The shoulder harnesses are put in the slots at or below the level of the infant’s shoulders. The harness must fit snug and the retainer clip is put at the level of the infant’s armpits.

Question 151:
A nurse cares for a child with ADHD. The nurse includes all of the following teaching points except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Administer ADHD medications at bedtime
Correct Answer(s):
Administer ADHD medications at bedtime (correct)

Rationale: ADHD medications are stimulants and should not be taken close to bedtime

Use a calm, firm, and respectful approach with short and simple explanations

Use modeling to demonstrate respectable behavior

Get the child's attention before giving directions

Question 152:
The nurse teaches the parents about preschool children's sense of time. The nurse includes all of the following teaching points except:


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Preschoolers cannot sequence events
Correct Answer(s):
Preschoolers cannot sequence events (correct)

Rationale: Preschoolers can sequence events but not time on the clock

Preschoolers understand the sequence of daily events.

You can use time oriented words such as "after lunch" or "after your nap."

Preschoolers with a strong routine learn about time

Question 153:
A ketogenic diet consists of:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
High-fat and high-carbohydrate foods.
Correct Answer(s):
High-fat and low-carbohydrate foods. (correct)

High-fat and high-carbohydrate foods.

Low-fat and low-carbohydrate foods.

Low-fat and high-carbohydrate foods.

Question 154:
A nurse admits a child with spastic cerebral palsy. The nurse finds all of the following assessment findings except:


Type: Multiple Choice
Points Awarded: 0/1
Your Answer(s):
Ankle clonus and contractures
Correct Answer(s):
Writhing, worm-like movements (correct)

Ankle clonus and contractures

Loss of fine and gross motor skills

A crouched gait with a scissoring motion of the legs with feet plantar flexed.

Question 155:
Identify the priority assessment for a 4-month-old baby after surgery?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Encourage skin-to-skin contact with the care providers.
Correct Answer(s):
Restrain the infant

Encourage skin-to-skin contact with the care providers. (correct)

Rationale: Tactile input supports neurological and psychosocial development in the infant and should be done first.

Decrease environmental stimuli

Encourage the care providers to assume as much of the baby's care as possible

Question 156:
Which should the nurse recommend to prevent future bicycle injuries before discharging their child after a bicycle accident?


Type: Multiple Choice
Points Awarded: 1/1
Your Answer(s):
Wear safety equipment while riding bicycles.
Correct Answer(s):
Wear safety equipment while riding bicycles. (correct)

Rationale: Safety equipment is necessary for bicycling, skateboarding, and contact sports. Many injuries occur during the school-age years when children participate in contact sports.

Read educational materials on bicycle safety.

Watch a video on bicycle safety.

Ride his bike with adult supervision.

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