1.

The parents of a child, age 6, who will begin school in the fall ask the nurse for anticipatory guidance. The nurse should explain that a child of this age: a. b. c. d. Still depends on the parents Rebels against scheduled activities Is highly sensitive to criticism Loves to tattle

palpating the toddler’s fontanels, what should the nurse expects to find? a. Closed anterior fontanel and open posterior fontanel b. Open anterior and fontanel and closed posterior fontanel c. Closed anterior and posterior fontanels d. Open anterior and posterior fontanels 7. Patrick, a healthy adolescent has meningitis and is receiving I.V. and oral fluids. The nurse should monitor this client’s fluid intake because fluid overload may cause: a. b. c. d. Cerebral edema Dehydration Heart failure Hypovolemic shock

2. While preparing to discharge an 8-monthold infant who is recovering from gastroenteritis and dehydration, the nurse teaches the parents about their infant’s dietary and fluid requirements. The nurse should include which other topic in the teaching session? a. b. c. d. Nursery schools Toilet Training Safety guidelines Preparation for surgery

3. Nurse Betina should begin screening for lead poisoning when a child reaches which age? a. b. c. d. 6 months 12 months 18 months 24 months

8. An infant is hospitalized for treatment of nonorganic failure to thrive. Which nursing action is most appropriate for this infant? a. Encouraging the infant to hold a bottle b. Keeping the infant on bed rest to conserve energy c. Rotating caregivers to provide more stimulation d. Maintaining a consistent, structured environment 9. The mother of Gian, a preschooler with spina bifida tells the nurse that her daughter sneezes and gets a rash when playing with brightly colored balloons, and that she recently had an allergic reaction after eating kiwifruit and bananas. The nurse would suspect that the child may have an allergy to: a. b. c. d. Bananas Latex Kiwifruit Color dyes

4. When caring for an 11-month-old infant with dehydration and metabolic acidosis, the nurse expects to see which of the following? a. b. c. d. A reduced white blood cell count A decreased platelet count Shallow respirations Tachypnea

5. After the nurse provides dietary restrictions to the parents of a child with celiac disease, which statement by the parents indicates effective teaching? a. “Well follow these instructions until our child’s symptoms disappear.” b. “Our child must maintain these dietary restrictions until adulthood.” c. “Our child must maintain these dietary restrictions lifelong.” d. “We’ll follow these instructions until our child has completely grown and developed.”

10. Cristina, a mother of a 4-year-old child tells the nurse that her child is a very poor eater. What’s the nurse’s best recommendation for helping the mother increase her child’s nutritional intake? a. Allow the child to feed herself b. Use specially designed dishes for children – for example, a plate with the child’s favorite cartoon character c. Only serve the child’s favorite foods

6. A parent brings a toddler, age 19 months, to the clinic for a regular check-up. When

Nurse Alice is providing cardiopulmonary resuscitation (CPR) to a child. 5% glucose 10% glucose 15% glucose 17% glucose d. An infant who has been in foster care since birth requires a blood transfusion. Keeping a night light on to allay fears c.V. Because her shift is ending. Obtaining history information from the parents d. Encouraging the child to dress without help 15. c. is recovering from surgery to remove Wilms’ tumor. Direct all teaching to the parents because the child can’t understand 14. Sheena. Compress the sternum with both hands at a depth of 1½ to 2” (4 to 5 cm) b. d. age 4. Allow the child to eat at a small table and chair by herself 11. The foster mother The social worker who placed the infant in foster home The registered nurse caring for the infant The nurse-manager 20. b. c. When planning care for a 8-year-old boy with Down syndrome. Nurse Victoria is teaching the parents of a school-age child. Assess the child’s current developmental level and plan care accordingly d. A 4-month-old with meningococcal meningitis has just been admitted to the pediatric unit. The nurse is finishing her shift on the pediatric unit. Nurse Roy is administering total parental nutrition (TPN) through a peripheral I. The main reason for administering allopurinol as part of the client’s chemotherapy regimen is to: a. Prevent metabolic breakdown of xanthine to uric acid b. David. which intervention takes top priority? a. Plan interventions according to the developmental levels of a 5-year-old because the child will have developmental delays c. Explaining normalcy of fears about body integrity d. Use the heel of one hand for sternal compressions 17. Restocking the bedside supplies needed for a dressing change on the upcoming shift c. Administering acetaminophen (Tylenol) c. Which nursing intervention has the highest priority? a. Documenting the care provided during her shift 19. b. age 15 months. d. Which teaching topic should take priority? a. line to a school-age child. Emptying the trash cans in the assigned client room 16. c. Changing the linens on the clients’ beds b. Developmental readiness of the child Consistency in approach The mother’s positive attitude Developmental level of the child’s peers 12. b. What’s the smallest amount of glucose that’s considered safe and not caustic to small veins. The most important factor for the nurse to stress to the mother is: a.d. the c. Allopurinol is included in the regimen. Perform only two-person CPR d. d. A child is undergoing remission induction therapy to treat leukemia. the nurse should: a. Instituting droplet precautions b. while also providing adequate TPN? a. Who is authorized to give written. Orienting the parents to the pediatric unit 18. Which findings best indicates that the child is free from pain? a. informed consent for the procedure? a. Prevent accidents b. tells the nurse that she wants to begin toilet training her 22-month-old child. Decreased appetite Increased heart rate Decreased urine output Increased interest in play 13. the nurse should: a. b. Deliver 12 breaths/minute c. Prevent uric acid from precipitating in the ureters . d. Plan interventions according to the developmental level of a 7-year-old child because that’s the child’s age b.

Mild work of breathing c. Nurse Kelly is teaching the parents of a young child how to handle poisoning. and eye goggles or shield b. A tuberculosis intradermal skin test to detect tuberculosis infection is given to a highrisk adolescent. Absence of intercostals or substernal retractions d. fluid intake? a. What should the nurse do to help relieve the itching? a. b. Disturbed body image related to physical appearance c. An adolescent who sustained a tibia fracture in a motor vehicle accident has a cast. Which technique is most important in recognizing possible hydrocephalus? a. Impaired urinary elimination related to fluid loss d. and mask Gown. The nurse knows she must put on personal protective equipment to protect herself while providing care. Call an ambulance immediately Call the poison control center Punish the child for being bad 26. which personal protective should the nurse wear? a. eye Gloves Gown and gloves Gown. A child has third-degree burns of the hands. c. Worsening dyspnea Gastric distension Nausea and vomiting Temperature of 102°F (38. Administer ipecac syrup 29. History of steroid-dependent asthma 23. d. “Switch to cloth diapers until the rash is gone” b. Nurse Mariane is caring for an infant with spina bifida. Which finding would alert a nurse that a hospitalized 6-year-old child is at risk for a severe asthma exacerbation? a. d. How long after the test is administered should the result be evaluated? a. If the child ingests poison. c. c. Measuring head circumference Obtaining skull X-ray Performing a lumbar puncture Magnetic resonance imaging (MRI) 30. The nurse should advise her to include which foods in her infant’s diet? a.” 25.” c. Ineffective airway clearance related to edema b. “Leave the diaper off while the infant sleeps. gloves. A 3-year-old child is receiving dextrose 5% in water and half-normal saline solution at 100 ml/hour. Oxygen saturation of 95% b. d. Apply cool water under the cast . Gracie. and chest. Risk for infection related to epidermal disruption 27. Ensure that the chemotherapy doesn’t adversely affect the bone marrow 21.” d. c. Enhance the production of uric acid to ensure adequate excretion of urine d. b. Which sign or symptom suggests excessive I. face. gloves. c. Nurse Oliver s teaching a mother who plans to discontinue breast-feeding after 5 months. Based on the mode of SARS transmission. A 10-year-old client contracted severe acute respiratory syndrome (SARS) when traveling abroad with her parents. d.V. c. What should the nurse advise? a. the mother of a 3-month-old infant calls the clinic and states that her child has a diaper rash. d. Iron-rich formula and baby food Whole milk and baby food Skim milk and baby food Iron-rich formula only 24. b.c. b. “Offer extra fluids to the infant until the rash improves. what should the parents do first? a. d. Which nursing diagnosis takes priority? a. mask. Apply cool air under the cast with a blowdryer b. b.9° C) 22. “Use baby wipes with each diaper change. Immediately Within 24 hours In 48 to 72 hours After 5 days 28. Use sterile applicators to scratch the itch c.

The best recommendation is to allow the child to feed herself because the child’s stage of development is the preschool period of initiative. Apply hydrocortisone cream under the cast using sterile applicator. then she’s likely to be allergic to latex. Some children are allergic to dyes in foods and other products but dyes aren’t a factor in a latex allergy. Answer C. 3. altered white blood cell or platelet counts are not specific signs of metabolic imbalance. by age 6. Answer D. a precarious sense of self causes overreaction to criticism and a sense of inferiority. Answer A. not just served her favorite . symptoms will reappear if the patient eats prohibited foods. 10. 8. The nurse always should reinforce safety guidelines when teaching parents how to care for their child. The infant should receive social stimulation rather than be confined to bed rest. Special dishes would enhance the primary recommendation. By age 6. which tries to eliminate the buffered acids by increasing alveolar ventilation through deep. The child should be offered new foods and choices. and 36 months. this topic is inappropriate. Answer A. 6. 30. 9. Answer C. Answer C. such as premature infants and formula-fed infants not receiving iron supplementation. most children no longer depend on the parents for daily tasks and love the routine of a schedule. Regular dental visits should begin at age 24 months. If a child is sensitive to bananas. It would be unusual for an adolescent to develop heart failure unless the overhydration is extreme. 2. The nurse should start screening a child for lead poisoning at age 18 months and perform repeat screening at age 24. The diamond-shaped anterior 1. 4. rapid respirations. For parents of a 9month-old infant. Because surgery is not used gastroenteritis. Fluid overload won’t cause dehydration. Because of the inflammation of the meninges. By giving anticipatory guidance the nurse can help prevent many accidental injuries. and chestnuts. it is too early to discuss nursery schools or toilet training. By age 18 months. A patient with celiac disease must maintain dietary restrictions lifelong to avoid recurrence of clinical manifestations of the disease. The triangular posterior fontanel normally closes between ages 2 and 3 months. kiwifruit. In a 6-year-old child. 5. Answer D. Encouraging the infant to hold a bottle would reinforce an uncaring feeding environment. the client is vulnerable to developing cerebral edema and increase intracranial pressure. The body compensates for metabolic acidosis via the respiratory system. Answer C. The other options are incorrect because signs and fontanel normally closes between ages 9 and 18 months. the child wants to make friends and be a friend. Answer C. structured environment that provides interaction with the infant to promote growth and development. The number of caregivers should be minimized to promote consistency of care.d. The nurse caring for an infant with nonorganic failure to thrive should maintain a consistent. High-risk infants. Answer B. Children with spina bifida often develop an allergy to latex and shouldn’t be exposed to it. 7. should be screened for iron-deficiency anemia at 6 months. the anterior and posterior fontanels should be closed. Tattling is more common at age 4 to 5. Hypovolemic shock would occur with an extreme loss of fluid of blood.

A child with Down syndrome is capable of learning. although it’s sake for peripheral veins. For a child. their parents or designated legal guardians are responsible for providing consent for medical procedures. Documentation should take top priority. Allopurinol doesn’t act in the manner described in the other options. child and parent will become frustrated. When children are minors and aren’t emancipated. 16. Obtaining history information and orienting the parents to the unit don’t take priority. two-person rescue may be inappropriate. 12. accident prevention should take priority when teaching parents of school-age children. Instituting droplet precautions is a priority for a newly admitted infant with meningococcal meningitis. Answer D. and should be encouraged to dress without help (with the exception of tying shoes). 18. the foster mother is authorized to give consent for the blood transfusion. adding allopurinol decreases this risk by preventing the breakdown of xanthine to uric acid. Answer A. For a small child. Accidents are the major cause of death and disability during the school-age years. 21. Documentation is the only way the nurse can legally claim that interventions were performed. Five percent glucose isn’t sufficient nutritional replacement. Consistency is important once toilet training has already started. 17. 19. The nurse should use the heel of one hand and compress 1” to 1½ “. decreased urine output may signify dehydration. the nurse should deliver 20 breaths/minute instead of 12.foods. Therefore. the nurse. A child in pain is less likely to consume food or fluids. The massive cell destruction resulting from chemotherapy may place the client at risk for developing renal calculi. and direct contact with the . Because children with Down syndrome can vary from mildly to severely mentally challenged. Answer D. Answer C. The transmission of SARS isn’t fully understood. 15. The social workers. each child should be individually assessed. Using a small table and chair would also enhance the primary recommendation. Nursing care plan should be planned according to the developmental age of a child with Down syndrome. An increased heart rate may indicate increased pain. The nurse should use the heels of both hands clasped together and compress the sternum 1½ “to 2” for an adult. Therefore. droplet. and the nurse-manager have no legal rights to give consent in this scenario. The other three options would be appreciated by the nurses on the oncoming shift but aren’t mandatory and don’t take priority over documentation. Answer A. all modes of transmission must be considered possible. One of the most valuable clues to pain is a behavior change: A child who’s pain-free likes to play. The mother’s positive attitude is important when the child is ready. Developmental levels of children are individualized and comparison to peers isn’t useful. Answer A. have fears concerning body integrity. not the chronological age. The amount of glucose that’s considered safe for peripheral veins while still providing adequate parenteral nutrition is 10%. 20. 11. 14. Answer C. If the child isn’t developmentally ready. Answer A. Preschool (not school-age) children are afraid of the dark. especially a child with mild limitations. Therefore. including airborne. Answer D. Acetaminophen may be prescribed but administering it doesn’t take priority over instituting droplet precautions. Answer A. Answer B. 13. Any amount above 10% must be administered via central venous access.

mild work of breathing. 26. 29. which may worsen the condition. the client should be cautioned not to put any object down the cast in an attempt to scratch. A lumber puncture isn’t appropriate. Waiting more than 5 days to evaluate the test is too long because any reaction may no longer be visible. Skin breakdown can occur if anything is placed under the cast. the parents should call the poison control center for specific directions. improving the condition. 30. Therefore. set. Answer A. . Answer C. a reaction should appear in 48 to 72 hours. and infection are all integral parts of burn management but aren’t the first priority. Answer C. Tuberculin skin tests of delayed hypersensitivity. Switching to cloth diapers isn’t necessary. that may make the rash worse. 28. Answer C. Itching underneath a cast can be relieved by directing blow-dyer. Answer A. Ipecac syrup is no longer recommended. impaired urinary elimination. which can occur quickly in a child as fluid shifts rapidly between the intracellular and extracellular compartments. Measuring head circumference is the most important assessment technique for recognizing possible hydrocephalus. and eye goggles or an eye shield. 22. and is a key part of routine infant screening. Immediately after the test and within 24 hours are both too soon to observe a reaction. gloves. The parents may have to call an ambulance after calling the poison control center. Dyspnea and other signs of respiratory distress signify fluid volume excess (overload). Nausea and vomiting or an elevated temperature may indicate a fluid volume deficit. Body image disturbance.Initially. Before interviewing in any way. toward the itchy area. mask. Answer A. 27. Answer D. Gastric distention may suggest excessive oral fluid intake or infection. a contributing factor to this client’s high-risk status. 24. The American Academy of Pediatrics recommends that infants at age 5 months receive iron-rich formula and that they shouldn’t receive solid food – even baby food – until age 6 months. any health care worker providing care for a client with SARS should wear a gown. Punishment for being bad isn’t appropriate because the parents are responsible for making the environment safe. in fact. If the test results are positive. Leaving the diaper off while the infant sleeps helps to promote air circulation to the area. Skull Xrays and MRI may be used to confirm the diagnosis.virus. The Academy doesn’t recommend whole milk until age 12 months. requires the nurse to treat the situation as a severe exacerbation regardless of the severity of the current episode. An oxygen saturation of 95%. and absence of intercostals or substernal retractions are all normal findings. Answer D. Extra fluids won’t make the rash better. the primary focus is on assessing and managing an effective airway. Baby wipes contain alcohol. and skim milk until after age 2 years. when a preschool client is admitted to the hospital for burns. 25. For protection from contracting SARS. 23. A history of steroiddependent asthma. on the cool setting. Answer A.

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