A child with hemophilia A fell and injured a knee while playing outside.

The knee is
swollen and painful. Which of the following measures should be taken to stop the
bleeding? Select all that apply *
1 point

The extremity should be immobilized

The extremity should be elevated
Warm moist compresses should be applied to decrease pain
Factor VIII should be administered
Passive range-of-motion exercises should be administered to the extremity

Which of the following activities should a nurse suggest for a client diagnosed with
hemophilia? Select all that apply *
1 point

Hiking
Swimming
Soccer
Fishing
Golf

Which of the following describes idiopathic thrombocytopenic purpura (ITP)? Select

all that apply *
1 point

Purpura is observed in ITP

ITP causes excessive destruction of platelets
Children with ITP have normal bone marrow
Platelets are small in ITP
ITP is a congenital hematological disorder

The nurse is caring for a child who is receiving a transfusion of PRBCs. The nurse is
aware that if the child has hemolytic reaction to the blood, the signs and symptoms
would include which of the following? Select all that apply *
1 point

Hypotension
Chills
Oliguria
Fever
Rash
A child with a ventriculoperitoneal (VP) shunt complains of headache and blurry vision
and now experienced irritability and sleeping more than usual. The parents ask the
nurse what they should do. Select the nurse’s best response *
1 point

“Give her some acetaminophen (Tylenol), and see if her symptoms improve. If they do not
improve, bring her to the health-care provider’s office.”
“It is common for girls to have these symptoms, especially prior to beginning their menstrual
cycle. Give her a few days and see if she improves.”
“You should immediately take her to the emergency department because these may be
symptoms of a shunt malfunction.”
“You are probably worried that she is having a problem with her shunt. This is very unlikely
because it has been working well for 9 years.”

Which position initially is most beneficial for an infant who has just returned from
having a ventriculoperitoneal (VP) shunt placed? *
1 point

In the crib with the head elevated to 90 degrees

Semi-Fowler’s in an infant seat
Flat in the crib
Trendelenburg

The nurse is aware that cloudy cerebrospinal fluid (CSF) most likely indicates *
1 point

Viral meningitis
No infection, because CSF is usually cloudy
Bacterial meningitis
Sepsis

A child is being admitted with the diagnosis of meningitis. Select the procedure the
nurse should do first: *
1 point

Administration of intravenous antibiotics

Administration of maintenance intravenous fluids
Send the spinal fluid and blood samples to the laboratory for cultures
Placement of a Foley catheter

The nurse is caring for a 6-month-old infant diagnosed with meningitis. When the child
is placed in the supine position and flexes his neck, the nurse notes he flexes his
knees and hips. This is referred to as *
1 point
Nuchal rigidity
Kernig sign
Cushing triad
Brudzinski sign

Select the best room assignment for a newly admitted child with bacterial meningitis  *
1 point

Private room that is dark and quiet with minimal stimulation

Semiprivate room with a roommate who also has bacterial meningitis
Semiprivate room with a roommate who has bacterial meningitis but has received intravenous
antibiotics for more than 24 hours
Private room that is bright and colorful and has developmentally appropriate activities available

Which would the nurse expect to assess on a 3-week-old infant with developmental
dysplasia of the hip (DDH)? Select all that apply *
1 point

Excessive his abduction

Pain when lying prone
Asymmetry of gluteal and thigh folds
Femoral lengthening of an affected leg
Positive Ortolani test

Which should the nurse stress to the parents of an infant in a Pavlik harness for
treatment of developmental dysplasia of the hip (DDH)? *
1 point

Put socks over the foot pieces of the harness to help stabilize the harness
Remove harness during diaper changes for ease of cleaning diaper area
Use lotions or powder on the skin to prevent rubbing of straps
Check under the straps at least two to three times daily for red areas

When planning a rehabilitative approach for a child with osteogenesis imperfecta (OI),
the nurse should prevent which of the following? Select all that apply *
1 point

Muscle weakness
Osteoporosis
Misalignment of lower extremity joints
Positional contractures and deformities
Bone infection
A 10-year-old with osteomyelitis has been intravenous antibiotics for 48 hours. The
child is allergic to amoxicillin. Vital signs are T 38.8 C, BP 100/60 mmHg, P 96, R 24.
Which is the primary reason for surgical treatment? *
1 point

Nonresponse to intravenous antibiotics

Drug allergies
Health-care provider preference
Young age

A parent of a 3-week old states that the infant was recasted this morning for clubfoot
and has been crying for the past hour. Which intervention should the nurse suggest
the parent do first? *
1 point

Use a cool blow-dryer to blow into the cast to control itching

Check the neurocirculatory status of the foot
Give pain medication
Reposition the infant in the crib

Which order would the nurse question for a child just admitted with the diagnosis of
bacterial meningitis? *
1 point

Maintain isolation precautions until 24 hours after receiving intravenous antibiotics

Intravenous fluids at 1 ½ times regular maintenance
Administer acetaminophen (Tylenol) for temperatures higher than 38 C
Neurological checks every hour

The nurse is caring for a 1-year-old who has just been diagnosed with viral
encephalitis. The parents ask if their child will be admitted to the hospital. Select the
nurse’s best response. *
1 point

“Your child will likely be sent home because encephalitis is usually caused by a virus and not
bacteria.”
“Your child will likely be admitted to the pediatric floor for intravenous antibiotics and
observation.”
“Your child will likely be admitted to the PICU for close monitoring and observation.”
“Our child will likely be sent home because she is only 1 year od. We see fewer complications and
a shorter disease process in the younger child.”

The nurse knows further education is needed about Reye syndrome when a mother
states: *
1 point

“I will make sure not to give my child any products containing aspirin.”
“I will have my children immunized against varicella and influenza.”
“Chicken with Reye syndrome are admitted to the hospital.”
“I will give aspirin to my child to treat a headache.”

A child with Reye syndrome is described in the nurse’s notes as follows: 1200 –
comatose with sluggish pupil; when stimulated, demonstrates decerebrate posturing.
1400 – unchanged except that now demonstrates decorticate posturing when
stimulated. The nurse concludes that the child’s condition is *
1 point

Improving because the child posturing reflexes are similar

Worsening and the child may likely experience cardiac and respiratory failure
Worsening and progressing to a more advanced stage of Reye syndrome
Improving and progressing to a less advanced stage of Reye syndrome

To treat a common manifestation of Reye syndrome, which medication would the

nurse expect to have readily available? *
1 point

Insulin
Morphine
Furosemide (Lasix)
Glucose