Deck 3: Pediatrics

Question 1

A clinical nurse specialist is caring for a one-year-old baby boy. During the assessment, the nurse notes that the patient is in respiratory distress. Which signs confirm this assessment?

A)Cyanosis and crackles
B)Crackles and wheezing
C)Tachypnea, crackles, and wheezing
D)Retractions, crackles, and cyanosis

Answer 1

Retractions, crackles, and cyanosis

Question 2

An adolescent patient who sustained an inhalation injury arrives in the emergency department. On assessment of the patient, the nurse notes that the patient is very confused and combative. The nurse determines that the patient is experiencing:

A)Pain
B)Fear
C)Hypoxia
D)Anxiety

Answer 2

Hypoxia

Question 3

A clinical nurse specialist is caring for a pediatric patient who is diagnosed with diabetic ketoacidosis. The nurse expects that this patient will experience Kussmaul respiration and there will be a high level of ketones in the blood as a result of incomplete oxidation of:

A)Carbohydrates
B)Proteins
C)Fats
D)Glucose

Answer 3

Fats

Question 4

A ten-year-old patient is admitted with a diagnosis of diabetic ketoacidosis. He is receiving intravenous fluids and insulin. The patient has complaints of tingling and numbness of the fingers and toes and shortness of breath. The nurse looks at the cardiac monitor and notes a U wave. The clinical nurse specialist should recognize that these indicate:

A)Hypercalcemia
B)Hypoglycemia
C)Hypernatremia
D)Hypokalemia

Question 5

A five-year-old boy was brought by his mother to the emergency room due to muscle weakness. The patient was diagnosed with Guillain-Barre syndrome. The nurse is aware that a potential treatment option for this patient would be:

A)Immunosuppression therapy
B)Hemodialysis
C)Plasmapheresis
D)Thrombolytic therapy

Question 6

A twelve-year-old baseball player was admitted to the hospital due to an accident that led to a subarachnoid hemorrhage. The clinical nurse specialist caring for the patient should position the patient:

A)In supine position
B)With the head of the bed elevated
C)On the unaffected side
D)Using sandbags on both sides of the head

Question 7

A mother of a ten-month-old infant asks the nurse why her baby is not receiving an anticoagulant drug considering that her baby has an intracranial bleeding. The nurse explains that in her infant's situation, anticoagulant:

A)Is necessary to prevent pulmonary thrombosis
B)Will be started soon to enhance circulation
C)Is not advisable because it can hide signs and symptoms
D)Is contraindicated because bleeding would be increased

Question 8

Roger, a seven-year-old child, was admitted to the hospital with a diagnosis of intervertebral disc herniation at the level of L5-S1. A nurse who is assigned to Roger should include which of the following nursing interventions?

A)Prepare the patient for lumbar puncture
B)Encourage the patient to ambulate freely
C)Assess the skeletal traction insertion site for redness and swelling
D)Position the patient with knees slightly flexed, with the head of the bed elevated

Question 9

A nurse is preparing a nursing care plan for a six-year-old patient who is in the acute phase of sickle cell vaso-occlusive crisis. Which of the following interventions should be included in the plan?

A)Administration of analgesia as prescribed
B)Ambulation for at least six hours a day
C)Fluid restriction of 1L per day
D)Encourage patient to increase caloric intake

Question 10

A nine-year-old child was admitted with a diagnosis of acute glomerulonephritis. She has moderate edema and mild hypertension. Which of the following nursing actions would be most appropriate at this time?

A)Maintain a high protein diet
B)Encourage physical activity to eliminate boredom
C)Observe seizure precautions
D)Obtain body weight QID

Question 11

A clinical nurse specialist is caring for a four-year-old child after a surgery for correction of tetralogy of fallot. The mother runs to the nurse's station and reports that the child started to seize. The nurse recognizes that the problem is due to:

A)Meningitis
B)Unexpected reaction to medications
C)Metabolic alkalosis
D)Cerebral vascular accident

Question 12

A mother brought her child to the emergency department following an ingestion of aspirin. The nurse should frequently monitor the child's:

A)Body temperature
B)Blood pressure
C)Serum glucose level
D)Apical pulse

Question 13

Cara, a clinical nurse specialist, is assigned to a one-year-old patient who is admitted to the unit. The child is receiving gastric feedings and Cara suspects that the patient might have a necrotizing enterocolitis. Which of the following would support this conclusion?

A)A large amount of residual formula withdrawn before lavage
B)A noticeable increase in bowel movement was noted
C)Circumoral pallor develops during the feeding process
D)Several severe bouts of projectile vomiting were noted

Question 14

Angela, a four-year-old preschooler, is admitted due to acoustic neuroma. She experiences progressive nerve deafness, tinnitus, and vertigo. The nurse is aware that these symptoms are due to the destruction of which of the following?

A)Cranial nerve 5
B)Cranial nerve 7
C)Cranial nerve 8
D)Ossicles

Question 15

A clinical nurse specialist is caring for a two-year-old child who is diagnosed with intussusception at the ileocecal valve. The nurse did an assessment and noted all of the following except:

A)Weakness and lethargy
B)Sausage-shaped stool
C)Sudden acute episodes of severe abdominal pain
D)Distended abdomen

Question 16

Which of the following is true about plasma?

A)It functions to transport hormones, ions, and nutrients throughout the body
B)It makes up nearly 22% of the blood
C)It may contain 10% or less of waste products
D)It comprises tissue macrophages derived from monocytes

Question 17

A pediatric patient has been admitted to the hospital with multiple injuries including a fractured left humerus, left femur, and ribs. Because of the patient's fractured ribs, the nurse should assess for signs of:

A)Pulmonary edema
B)Hematemesis
C)Respiratory acidosis
D)Pneumonitis

Question 18

A nine-year-old child was admitted to the hospital with a tentative diagnosis of leukemia. In order to confirm the diagnosis, a bone marrow aspiration is scheduled. Aside from giving an age-appropriate explanation of the procedure, the nurse should:

A)Administer the prescribed sedative before the procedure
B)Position the child in semi-fowler's position, supported by pillows
C)Let the child hold some equipment that is not sterile
D)Tell the child that there will be no pain, only pressure will be felt

Question 19

A nurse is caring for a three-year-old patient with a diagnosis of congestive heart failure. The nurse notes that the apical pulse is 118 beats per minute and is about to administer Lanoxin. Based on this finding, the nurse should:

A)Administer the medication as ordered
B)Recheck the apical pulse after twenty-thirty minutes
C)Hold the medication
D)Notify the physician

Question 20

Among adults, body fluids are primarily intracellular with slightly less extracellular fluid. In infants and children, all of the following but one is true about extracellular fluid:

A)At three years of age, the balance between ICF and ECF is more like that in adults
B)Infants and children have proportionately less extracellular fluid than adults
C)At birth, more than half of the child's weight is ECF
D)three years of age, the extracellular fluid is about 45% from interstitial fluid, plasma, and transcellular fluid

Question 21

A nurse is aware that the physiologic compensatory mechanism that is activated to counteract the effects of acid-base imbalance in a child with severe dehydration is:

A)Extremely high body temperature
B)Renal retention of hydrogen ions
C)Increased respirations
D)Profuse diaphoresis

Question 22

A three-month-old infant was admitted to the pediatric unit for confirmation of the diagnosis of ventricular septal defect. During the initial assessment, the nurse would expect to find:

A)A murmur at the left sternal border
B)Bounding peripheral pulse
C)Bradycardia at rest
D)An activity related to cyanosis

Question 23

A four-year-old child was admitted due to severe burns. Laboratory results show that the child is suffering from hypophosphatemia. When assessing this patient, the nurse would expect to find:

A)Hyperreflexia and tetany
B)Nausea and diarrhea
C)Muscle cramping and tachycardia
D)Hemolytic anemia and tremors

Question 24

A child with glomerulonephritis has a urinary output that decreases to 100 mL in 24 hours. The patient's creatinine clearance is 60 mL per minute and there is an irregular apical pulse. What would be the most significant laboratory finding after a diagnosis of acute renal failure is made?

A)Serum creatinine of 1.3 mg/dL
B)Serum potassium of 6.3 mEq/L
C)Serum bilirubin of 0.5 mg/dL
D)Serum sodium of 128 mEq/L

Question 25

What data would a nurse expect to assess in a sixteen-year-old patient admitted with right-sided heart failure?

A)Decreased urinary output and restlessness
B)Nausea and anorexia
C)Orthopnea and crackles
D)Tachycardia and heart sound

Question 26

A ten-year-old patient with a history of seizure disorder was admitted to the pediatric unit due to frequent seizure activity. The mother said that the child has been compliant with the medication (Phenytoin) therapy. Subsequently, a sample for the serum phenytoin level is drawn. The nurse determines that the medication has been most effective if the value is:

A)5 mcg/mL
B)12 mcg/mL
C)22 mcg/mL
D)30 mcg/mL

Question 27

Christine, a six-year-old patient, had a supratentorial craniotomy for removal of a large left tumor. After the surgery, the nurse should place the patient:

A)Supine on the left side
B)With the head in a midline position
C)With the neck flexed
D)On the left side

Question 28

A nurse is caring for a pediatric patient who had a basilar skull fracture. The nurse assessed that there is a clear fluid leaking from the ears of the child. The nurse concludes that it is cerebrospinal fluid if the fluid:

A)Is grossly bloody in appearance and has a pH level of 6.1
B)Clumps together on the dressing and has a pH level of 7
C)Separates into concentric rings and tests positive for glucose
D)Is clear and tests negative for glucose

Question 29

A nurse is caring for a pediatric patient with a fiberoptic transducer-a tipped catheter placed in the subdural space to monitor intracranial pressure. The nurse would become most concerned if the readings drifted to and stayed in the vicinity of:

A)5 mmHg
B)10 mmHg
C)15 mmHg
D)20 mmHg

Question 30

A nurse is assessing fluid balance in a fourteen-year-old patient after a craniotomy. The nurse should assess for which of the following as a sign of dehydration, which could aggravate cerebral edema?

A)BUN of 10 mg/dL
B)Serum osmolality of 305 mOsm/kg H2O
C)Shift intake of 800 mL and output of 750 mL
D)Unchanged weight

Question 31

A seven-year-old child was admitted to the hospital with a possible diagnosis of an infratentorial brain tumor. The nurse identifies the common presenting sign of this type of tumor when the child demonstrates:

A)Papilledema
B)Seizure
C)Ataxia
D)Cranial enlargement

Question 32

A clinical nurse specialist must be aware that the shift of body fluids associated with intravenous administration of albumin occurs in the process of:

A)Diffusion
B)Active transport
C)Filtration
D)Osmosis

Question 33

A clinical nurse specialist is caring for a child who is diagnosed with bacterial meningitis. During the assessment, the child extends her leg and the hamstring muscle goes into spasm. The nurse documented that the child exhibited a positive:

A)Chvostek's sign
B)Babinksi reflex
C)Kernig's sign
D)Cremasteric reflex

Question 34

A six-year-old child was admitted to the hospital with a tentative diagnosis of lead poisoning. To help in confirming the diagnosis of plumbism, the nurse should observe for:

A)Excessive salivation
B)Decreased apical pulse
C)Clumsiness
D)Epistaxis

Question 35

A unit manager discusses the issue of patients' rights and the unit nurses to enumerate a situation that represents a case of invasion of a patient's privacy. The first nurse who replied was correct when she said:

A)Telling the patient that he cannot leave the hospital premises
B)Performing bedside care without the patient's permission
C)Threatening a patient to give a medication
D)Doing a procedure without signed informed consent

Question 36

A clinical nurse specialist is caring for a preschooler with a diagnosis of acute glomerulonephritis. The child has been on bed rest for almost two days and the nurse saw the child in the playroom. The nurse is also aware that the child stayed three times in the playroom on the previous shift. To best meet the child's needs, the nurse should:

A)Place a soft restraint on the child when parents are not present
B)Let the child know the benefits of staying on bed rest
C)Place the child in the room of another preschooler patient with liver lacerations
D)Place a colored television in the patient's room

Question 37

A five-year-old child diagnosed with leukemia is hospitalized for chemotherapy. The patient is fearful of hospitalization. The nurse's most appropriate action to alleviate the patient's fears is to:

A)Encourage play with other children of the same age
B)Advise the parents to visit only during the scheduled time
C)Encourage the parents to stay with the child
D)Place the patient in a private room and allow him to bring his favorite toys

Question 38

A fifteen-year-old patient is scheduled for a skin biopsy. She is concerned and asks the nurse how painful the procedure is. The nurse's most appropriate action is to explain that there will be:

A)Some pain, but the physician will prescribe an opiod analgesic following the procedure
B)A preoperative medication that will cause the patient to sleep and not feel any pain
C)A local anesthetic and may cause a burning or stinging sensation
D)No pain associated with the procedure

Question 39

A sixteen-year-old patient with ascending paralysis was intubated and is receiving mechanical ventilation. The nurse should include what plan of care to help the patient cope with his illness?

A)Provide positive feedback and encourage active range-of-motion
B)Give full control to the patient over care decisions
C)Provide information, encourage relaxation, and give positive feedback
D)Provide intravenous sedatives and reduce distractions

Question 40

A clinical nurse specialist is caring for a fifteen-year-old female patient who is a victim of sexual assault. The patient said that she still feels as if the incident just happened recently, even though it was several months ago. The nurse should respond correctly by stating:

A)"You need to at least try to be realistic because the incident did not just happen."
B)"Do you think you can do something to alleviate your fears about being raped again?"
C)"Tell me more about the incident that causes you to feel like the incident just occurred."
D)"It will definitely take some time to get over these feelings about being raped."

Question 41

A nurse is preparing to care for a dying pediatric patient and several immediate family members are at the bedside. The nurse should not use which of the following techniques when communicating with the family?

A)Encouraging expression of feelings, concerns, and fears
B)Extending touch and holding the patient's or family member's hand if necessary
C)Explaining everything that is happening to all family members
D)Being honest and truthful and letting the patient and family know that you will not abandon them

Question 42

A clinical nurse specialist is giving a report to a nursing assistant who will accompany her in caring for a pediatric patient who has hand restraints. The nurse instructs the nursing assistant to assess the skin integrity of the hands every:

A)Thirty minutes
B)Two hours
C)Three hours
D)Four hours

Question 43

A clinical nurse specialist is preparing a plan of care for a patient who will have an insertion of an internal cervical radiation implant. Which nursing care plan should be included in caring for this patient?

A)Put a vivid sign on the door to indicate that visiting is limited to one hour
B)Assign one primary nurse to care for the patient
C)Place the patient in a private room at the endmost part of the hallway
D)Place a linen bag outside the patient's room for discarding linens after morning care

Question 44

Nurses are aware that administering intramuscular injections among young children is difficult because of the small doses and small amounts of tissue involved. What plan of care should not be instituted to minimize this difficulty?

A)Utilize ventrogluteal or vastus lateralis muscles
B)Have someone gently restrain a child if necessary
C)Administer the injection while the child is asleep to prevent aggressiveness
D)Inject medications taken from a glass ampule through a needle with a filter

Question 45

When a mother of a pediatric patient who is admitted to the intensive care unit with multiple injuries sees her child for the first time, she cries out that she didn't mean to hurt her baby. The nurse should:

A)Advise the relative to visit and comfort the mother
B)Call the child abuse hotline and report a possible case of abuse
C)Respond by saying "you must feel guilty after you hurt your baby"
D)Offer support by saying "this must be difficult for you"

Question 46

A three-month-old infant with myelomeningocele is scheduled for surgery to close the defect. A nursing intervention that best facilitates a parent-child relationship during the preoperative period is:

A)Encourage the parents to provide comfort to their child
B)Allow the parents to cuddle their child in their arms
C)Refer the parents to the spina bifida association
D)Demonstrate proper feeding technique in prone position

Question 47

A nurse gives an inaccurate dose of vancomycin to a pediatric patient. Following a thorough assessment of the patient, the nurse completes an incident report. The nurse also notified her supervisor and called the physician to report the occurrence. As a result of medication error, the nurse understands that:

A)The incident will be reported to the board of nursing
B)Incident report needs to be completed and is a method of promoting quality care and risk management
C)The incident will be documented in the personnel file
D)The medication error will result in suspension

Question 48

A nurse is caring for a child who has terminal cancer. The nurse is aware that the parents are in desperate need of support from the medical staff. The nurse should not include which care plan before the death of a child?

A)Avoid judgmental reactions to what family members say or do
B)Provide referrals to support groups if available
C)Assist them to make final arrangement like contacting a funeral home
D)Show caring by touching the child and encourage parents to do it as well

Question 49

A nurse arrives at work and is told to float in the pediatric intensive care unit for an 8-hour shift because the unit is understaffed and needs additional nurses to care for the patients. The nurse should initially:

A)Notify the hospital lawyer
B)Report to the chief nurse
C)Report to the PICU and identify tasks that can be performed safely
D)Refuse to float to the PICU

Question 50

A four-year-old hospitalized child begins to have a seizure while playing with hard plastic toys in the hallway. The nurse should initially:

A)Place the child in the bed
B)Put a padded tongue depressor in the child's mouth
C)Administer the ordered Valium
D)Remove the child's toys from the immediate area

Question 51

A pediatric patient was admitted to the hospital due to gastroenteritis. Shortly after the admission, the patient vomits. When cleaning the patient after the vomiting episode, the nurse following standard precaution should wear:

A)Gown
B)Gloves
C)Mask
D)Goggles

Question 52

A ten-month-old infant was admitted to the pediatric unit for an emergency major surgical procedure. The seventeen-year-old mother and the grandfather are present at the bedside when the nurse is about to obtain the consent for the operation. Legally, consent for the infant's medical care:

A)Is not needed since it is an emergency situation
B)Is the responsibility of the mother and she should be the one to sign the consent
C)Should be decided by the family court since the parent is a minor
D)Should be obtained from the grandfather, as he is over eighteen years of age

Question 53

A nurse suspects that a pediatric patient has been abused. The nurse's primary responsibility should be:

A)Confirming the suspected abuse
B)Having the child assessed by a practitioner
C)Treating the child's traumatic injuries
D)Protecting the child from future abuse

Question 54

A clinical nurse specialist is caring for a nine-year-old patient with meningitis. What transmission-based precautions must be implemented for this patient?

A)Private room or cohort patient
B)Private room with negative pressure
C)Mask worn by hospital staff when patient leaves the room
D)Personal respiratory protection device

Question 55

A nurse is caring for a twelve-year-old patient diagnosed with nosocomial infection due to methicillin-resistant staphylococcus aureus and contact precautions are initiated. The nurse is about to provide colostomy care to the patient and obtain items including:

A)Gloves and shoe protector
B)Gloves and gown
C)Gloves, gown, and goggles
D)Gloves, gown, goggles, and face shield

Question 56

A fourteen-year-old patient who survived a motor vehicle accident is in critical condition. At one point, the patient opens his eyes and smiles. The mother runs to the nurse and exclaims, "Look, it indicates that my son will get better soon." The best response by the nurse is:

A)"Try to get your son to hold your hands."
B)"God must have been watching over your son."
C)"We are doing everything we can to help your son."
D)"Yes, you're right; this is a very good indicator."

Question 57

A physician ordered a jacket restraint for a pediatric patient. The nurse is aware that all of the following but one should be observed when applying a jacket restraint:

A)Jacket restraint straps that do not tighten when force is applied against them
B)Restraint straps that are safely secured at the side rails
C)A safety knot in the restraint straps
D)Jacket restraint secured so that two fingers can slide easily between the restraint and the patient's skin

Question 58

A nurse is caring for a ten-year-old patient with suspected acute bacterial meningitis. Based on the infection's mode of transmission, the nurse should include which plan of care?

A)No precautions are required, so long as antibiotics have been started
B)Maintain enteric precautions
C)Maintain respiratory precaution for twenty-four hours after the initiation of antibiotics
D)Maintain neutropenic precaution

Question 59

A nurse is caring for a pediatric patient with a diagnosis of bronchitis and it was confirmed that the child has respiratory syncytial virus. Which of the following is an appropriate nursing action?

A)Leave the patient in the current room as respiratory syncytial virus is not communicable
B)Wear a gown and gloves when caring for the patient
C)Initiate strict enteric precautions
D)Place the patient in a single room

Question 60

Carmela, a clinical nurse specialist, is a newly hired nurse at the pediatric intensive care unit. She is aware that conflicts occur in any organization, including her new unit of assignment. She is also aware that all of the following but one is true about conflict:

A)Can create leaders
B)Can be destructive if the level is too high
C)Can lead to a poor performance
D)Should be prevented at all times, as it is not beneficial

Question 61

Juliet is on her fourth week of employment as a clinical nurse specialist. Most of her colleagues are very articulating, confident, and sometimes aggressive. She feels uncomfortable, believing that she is the scapegoat of everything that goes wrong in her unit. Juliet must:

A)Consult the chief nurse
B)Quit her job and seek one at another hospital
C)Identify the source of conflict and think about points of friction
D)Disregard her feelings and continue to work with confidence

Question 62

A nurse specialist is planning for the patient assignment for the day. Which of the following is the most appropriate assignment for a nursing assistant?

A)A four-year-old patient with difficulty swallowing food
B)A six-year-old patient with continuous tube feedings
C)A six-year-old patient requiring colostomy care
D)A four-year-old patient requiring tap water enema

Question 63

A nurse specialist delegates a ten-year-old patient to the nursing assistant. The nursing assistant is administering an enema to the patient. The nurse specialist should intervene if the nursing assistant:

A)Advances the catheter four inches into the anal canal
B)Lubricates four - five inches of the catheter tip
C)Positions the patient on the right side with head slightly elevated
D)Hangs the enema bag twelve - eighteen inches above the anus

Question 64

A nurse is reviewing with a nursing assistant the care assignment for a fourteen-year-old patient. Which of the following statements, if made by the nurse, regarding care of a patient with crutches, is most appropriate?

A)Ambulate the patient without bearing weight every four hours the length of the unit and back
B)The patient needs to ambulate with crutches and a two-point gait
C)Make sure the patient does not bend the elbows when using the crutches
D)Ask the patient if she understands how to use a two-point gait; if not, please explain it to the patient

Question 65

A nine-year-old boy has been transferred back to the unit after cardiac surgery. The doctor advised the nurse to monitor his hydration status. Which of the following would a nurse need to include in the plan of care to evaluate that the fluid needs are being met?

A)Notify the physician if the cardiac rate is >60 bpm
B)Insert a foley catheter
C)Prepare to assist with an arterial line to monitor BP
D)Calculate the daily maintenance fluid replacement and ensure proper delivery

Question 66

The parents of a nine-year-old female patient with rheumatic fever asks a nurse if their child can play. The nurse would suggest a diversional activity like:

A)Dancing
B)Walking through the hallway
C)A 200-piece puzzle
D)Coloring books and crayons

Question 67

A nurse is caring for a pediatric patient who is receiving intermittent tube feedings. One night, the patient insists that he cannot tolerate the feeding. The nurse should:

A)Notify the physician and suggest an antiemetic
B)Change the feeding schedule to disregard nights
C)Request for a change ion the type of solution
D)Talk to the previous night nurse and gather more data about the techniques used

Question 68

A fifteen-year-old patient refuses to proceed to a twice-a-day sessions for a physical therapy. The nurse might best approach this situation by:

A)Assuring the patient that analgesic will be given before the therapy
B)Request from the physician whether the therapy can be decreased to once daily
C)Have the patient observe the progress of a more cooperative patient with the same case
D)Planning a conference with the therapist to discuss the patient's feelings

Question 69

A sixteen-year-old patient asks the nurse whether there are any dietary restrictions that must be followed after her surgery for cholelithiasis. The nurse would recognize that the dietary teaching was successful when the patient tells a family member:

A)"I will need to avoid fatty foods."
B)"Most people can tolerate a regular diet after this type of surgery."
C)"I should avoid foods that upset me before the surgery."
D)"Most people need to eat a high-protein diet for several months after the surgery."

Question 70

A nurse stops at the scene of an accident and finds a fourteen-year-old male who has a deep laceration on his hand, a fractured arm and leg, and abdominal pain. The nurse wraps the boy's hand in soiled linen and drives him to the nearest hospital. The nurse is:

A)Negligent and can be sued for malpractice
B)Practicing under guidelines of the Nurse Practice Act
C)Protected for these actions, in most places, by the Good Samaritan Law
D)Treating a health problem that can be addressed by a physician

Question 71

A visitor from a room parallel to a pediatric patient asks the nurse what illness the patient has. The nurse answered based on the nurse's knowledge that to discuss a patient's case with someone not directly involved with that patient is an example of:

A)Libel
B)Negligence
C)Breach of confidentiality
D)Defamation of character

Question 72

A physician collaborated with the nurse to provide palliative care to a thirteen-year-old patient. A palliative approach would involve planning measures to:

A)Restore patient health
B)Promote the patient's recovery
C)Relieve the patient's discomfort
D)Support the patient's significant others

Question 73

A twelve-year-old girl has been diagnosed with rheumatic fever and is now being discharged. What statement, made by the parents, shows an understanding of long-term care?

A)"We will have yearly checkups."
B)"She will need penicillin each day."
C)"She will need antibiotic prophylaxis when she has dental work."
D)"The murmur will always go away by adolescence."

Question 74

Parents of a child who has sickle-cell anemia want to know why their child did not have the first episode until he was approximately one year old. The best reply for the nurse to
Make is:

A)Affected children can be asymptomatic in infancy because of high levels of fetal hemoglobin that inhibit sickling."
B)"Have you asked your doctor about this?"
C)"Your child probably had a crisis and you did not realize it."
D)"Are you sure your child has sickle-cell anemia and not sickle-cell trait?"

Question 75

An eleven-month-old is admitted to the hospital with bronchiolitis. He is currently in a croup tent with supplemental oxygen. Which toy is most appropriate for the nurse to recommend to
The child's parents?

A)A soft plastic stacking toy with multicolored rings
B)A set of wooden blocks
C)A pull toy
D)A stuffed animal made from a washable fabric

Question 76

Building confidence in one's worth is important for an adolescent patient who is scheduled for an amputation because it:

A)Alters a person's sexuality
B)Implies a lack of wholeness
C)Increases dependency needs
D)Affects an idealized self-image

Question 77

When planning discharge teaching for an adolescent patient who had an ileostomy, the nurse should place primary emphasis on:

A)Informing the patient about the ileostomy association
B)Telling the patient whom to contact if assistance is needed
C)Encouraging the patient to return to school or work as soon as possible
D)Teaching the patient the importance of irrigations to regulate bowel movements

Question 78

To be most effective when teaching colostomy care to an adolescent patient, the nurse should first:

A)Wait until the parents are present
B)Assess barriers to learning colostomy care
C)Start with simple written instructions concerning care
D)Wait until the patient has accepted the change in body image

Question 79

When discussing the therapeutic regimen of Vitamin B12 to an adolescent patient with pernicious anemia, the nurse should explain that:

A)Weekly Z-track injections provide needed control
B)Daily IM injections are required for control
C)IM injections once a month will maintain control
D)Oral tablets of Vitamin B12 taken daily will provide control of symptoms

Question 80

A pediatric patient receiving chemotherapy and a steroid has a WBC count of 12,000/mm3 and a RBC count of 4.5 million/mm3. The instruction that should receive priority by the nurse is:

A)Omit the daily dose of prednisone
B)Avoid large crowds and people with infections
C)Shave with an electric rather that a safety razor
D)Increase the intake of high-protein foods and red meats