The nurse is giving preoperative instructions to a 14-year old female client who is scheduled for surgery to correct a spinal curvature. Which statement by the client best demonstrates that learning has taken place?
I will read all the literature you gave me before surgery. I have had surgery before when I broke my wrist in a bike accident, so I know what to expect. All the things people have told me will help me take care of my back. I understand that I will be in a body cast and I will show you how you taught me to turn. I understand that I will be in a body cast and I will show you how you taught me to turn.
Outcome of learning is best demonstrated when the client not only verbalizes an understanding, but also can provide a return demonstration. A 14-year old may or may not follow through with reading material and there is no way of measuring that way of learning. Have a previous surgery may help the client understand the surgical process, but wrist surgery is very different from spinal surgery and emergency surgery is different than elective surgery.
In (C), the client may be saying what the nurse wants to hear, without expressing any real understanding of what to do after surgery. During routine screening at a school clinic, an otoscope examination of a child's ear reveals a tympanic membrane that is pearly gray, slightly bulging, and not movable.
What action should the nurse take next? No action required, as this is an expected finding for a school-aged child B. Ask the child if he/she has had a cold, runny nose, or any ear pain lately.
Send a note home advising the parents to have the child evaluated by a healthcare provider as soon as possible. Call the parents and have them take the child home from school for the rest of the day.
Ask the child if he/she has had a cold, runny nose, or any ear pain lately. More information is needed to interpret these findings. The tympanic membrane is normally pearly gray, not bulging, and moves when the client blows against resistance or a small puff of air is blown into the ear canal. Since this child's findings are not completely normal, further assessment of history and related signs and symptoms is indicated for accurate interpretation of the findings.
(A), (C), and (D) are inappropriate actions based on the data obtained from the otoscope examination. The mother of a preschool-aged client asks the nurse if it is all right to administer Pepto Bismal to her son when he 'has a tummy ache.' After reminding the mother to check the label of all OTC drugs for the presence of aspirin, which instruction should the nurse include when replying to this mother's question? If the child's tongue darkness, discontinue the Pepto Bismal immediately B. Do not give if the child has chickenpox, the flu, or any other viral illness. Avoid the use of Pepto Bismal until the child is at least 16 years old. Pepto Bismal may cause a rebound hyperactivity, worsening the 'tummy-ache.'
Have a bulb syringe readily available to remove secretions A patient airway has the highest priority. Humidification will liquefy the nasal secretions thereby increasing the amount of secretions and making (C) the highest priority. (A) maintains hydration and prevents, but an open airway has the highest priority. (B) is important for evaluations of therapy. When asked 'priority' questions, remember Maslow. Physical needs usually have a higher priority than psychosocial needs.
An open airway is the highest physiological need. The nurse is assigning care for a 4-year old child with otitis media and is concerned about the child's increasing temperature over the past 24 hours. When planning care for this child, it is important for the nurse to consider that: A. Only an RN should be assigned to monitor this child's temperature. A tympanic measurement of temperature will provide the most accurate reading C. The licensed practical nurse should be instructed to obtain rectal temperatures on this child D.
The healthcare provider should be asked to prescribe the method for measurement of the child's temperatures. A tympanic measurement of temperature will provide the most accurate reading A tympanic membrane sensor is an excellent site because both the eardrum and hypothalamus (temperature-regulating center) are perfused by the same circulation. The sensor is unaffected by cerumen and the presence of suppurative or unsuppurative otitis media does not affect measurement. Rule of thumb for management-sterile procedures should be assigned to licensed personnel. Management skills will be tested on the NCLEX. An RN is not required to do this.
Rectal temperature management is less accurate because of the possibility of stool in the rectum. It is unnecessary to contacted the healthcare provider. Concern for body integrity The preschooler's major stressor is concern for his body integrity. He fears that his 'insides will leak out'. A child undergoing surgery to his genitalia is even more concerned about body integrity.
The preschooler is quite verbal so comprehension of the words he uses or hears may be inaccurate, while his imagination and fears may fantasize the reality. (B) is a concern for all children, but of most concern to the toddler. (D) is not a prime concern in this situation. At 8am, the unlicensed assistive personnel (UAP) informs the charge nurse that a female adolescent client with acute glomerulonephritis has a blood pressure of 210/110.
The 4am BP reading was 170/88. The client reports to the UAP that she is upset because her boyfriend did not visit last night. What action should the nurse take? Give the client her 9am prescription for an oral diuretic early. Administer PRN prescription of nifedipine (Procardia) sublingually.
Notify the healthcare provider and inform the nursing supervisor of the client's condition D. Attempt to calm the client and retake the BP in 30 minutes. A premature newborn girl, born 24 hours ago, is diagnosed with a patent ductus arteriosus (PDA) and placed under an oxygen hood at 35%. The parents visit the nursery and ask to hold her.
Which response should the nurse provide to the parents? Studies have shown that handling a sick newborn is not good for the baby and upsets the parents. The oxygen hood is holding the baby's oxygen level just at the point which is needed. You may stroke and talk to her. Since your baby has been doing well under oxygen for 24 hours, I can let you hold the baby without oxygen.
You can hold the baby with the oxygen blowing on the baby's face since the level is very close to room air. The oxygen hood is holding the baby's oxygen level just at the point which is needed. You may stroke and talk to her. The baby is at 35% which is much more than room air (21%) and at this time the baby should not be moved from under the hood. The nurse should offer the parents an alternative such as to stroke and reassure the infant. Holding sick babies benefits the infant and the parents, but the first consideration now has to be the infant's oxygenation. The nurse should not take the baby out from under the hood without a prescription from the healthcare provider, as this could severely compromise the infant.
A PO2 of 35% cannot be readily achieved with 'blow by' oxygen. The nurse is developing a plan of care for a 3-year old who is scheduled for a cardiac catheterization. To assist in decreasing anxiety for the child on the day of the procedure, which intervention is best for the nurse to implement? Reassure the parents that 3-year olds are cooperative and therefore are less likely to be anxious. Obtain a video film of a cardiac catheterization to show to the child prior to the procedure C. Give the child a ride on a gurney to visit the cardiac catheterization lab and meet a nurse who works there.
Obtain a cardiac catheter and demonstrate the procedure by pretending to put the catheter in a doll or stuffed animal. Give the child a ride on a gurney to visit the cardiac catheterization lab and meet a nurse who works there.
Familiarizing the child and mother with the department will help decrease anxiety of the child and mother (who may have more anxiety than the child). Three is a difficult age to undergo a procedure that requires cooperation. Restraints and possibly sedation may be required.
At three, the child is too young to understand why this must be done. (B) is not indicated and (D) is not indicated because it is likely to be interpreted as painful. A four-year old girl continues to interrupt her mother during a routine clinic visit. The mother appears irritated with the child and asks the nurse, 'Is this normal behavior for a child this age?' The nurse's response should be based on which information? Children need to retain a sense of initiative without impinging on the rights and privileges of others. Negative feelings of doubt and shame are characteristic of 4 year-old children C.
Role conflict is a common problem of children this age. She is just wondering where she fits into society. At this age children compete and like to produce and carry through with tasks. She is just competing with her mother.
Children need to retain a sense of initiative without impinging on the rights and privileges of others. Children ages 3-6 are in Erikson's 'Initiative vs. Guilt' stage, which is characterized by vigorous, intrusive behavior, enterprise, and strong imagination.
At this age, children develop a conscience and must learn to retain a sense of initiative without impinging on the rights of others. (B) describes the 'Autonomy vs.
Shame and Doubt' stage (1-3 years). (C) describes an adolescent (12-18) 'Identify vs. Role Confusion' stage. (D) describes a child 6-12 years of age in the 'Industry vs. Inferiority' stage.
Wash the hair and skin frequently with soap and hot water Washing the hair and skin with soap and hot water removes oil and debris from the skin and helps prevent and treat acne. Oily skin is especially bothersome during adolescence when hormones cause enlargement of sebaceous glands and increased glandular secretions which predispose the teenager to acne.
(A) is contraindicated. Cosmetics ('medicated' or not) should be used sparingly to avoid further blocking of sebaceous gland ducts. (D) may be indicated at a later time, if healthcare recommendations are not successful. The mother of a 2-year old boy consults the nurse about her son's increased tempter tantrums. The mother states, 'Yesterday he threw a fit in the grocery store, and I did not know what to do. I was embarrassed. What can I do if this occurs again?'
Which recommendation is best for the nurse to provide this mother? Paddle him gently as soon as the behavior is initiated B.
Immediately put him in 'time-out' C. Quietly remind him that others are watching him D. Walk away from him and ignore the behavior. A hospitalized 16-year old male refuses all visits from his classmates because he is concerned about his distorted appearance. To increase the client's social interaction, what intervention is best for the nurse to initiate?
Encourage the client to use a hand-held video game that is popular with all his friends B. Assign a 25 year old female nursing student to offer support to the client C. Arrange for an internet connection in the client's room for email communication D.
Encourage the client's mother to arrange a surprise get together in the cafeteria. 12-15 months The first measles, mumps, and rubella (MMR) vaccine should be given no sooner than 12 months of age, and ideally between 12 and 15 months of age.
Children 3-6 months should not receive the vaccine due to the presence of maternal antibodies. MMR is not routinely administered at 18-24 months, but other immunizations, such as DTaP and Hepatitis B may be given at that time.
The second dose of MMR is routinely administered at 4-6 years, provided that at least 4 weeks have elapsed since the first dose, and if both doses were administered beginning at or after 12 months. A 4-year old boy was admitted to the emergency room with a fractured right ulna and a short arm cast was applied. When preparing the parents to take the child home, which discharge instruction has the highest priority? Call the healthcare provider immediately if his nail beds appear blue.
Check his fingers hourly for the first 48 hours to see that he is able to move them without pain. Be sure your child's arm remains above his heart for the first 24 hours. Take his temperature every four hours for the next two days and call if an elevation is noted.
Call the healthcare provider immediately if his nail beds appear blue. Cyanosis indicates impaired circulation to fingers and should be reported immediately. Although the actions described in (B, C, and D) may be indicated, they are implemented rather excessively - and might tend to frighten the parents. It is not necessary to check the child's ability to move his fingers hourly for two days.
Elevating the arm above the heart helps to decrease swelling but (C) is stated in a frightening way. It is not necessary to take the child's temperature q4h unless indicated by other symptoms. Tympanic and oral temperatures are equally accurate A tympanic membrane sensor approximates core temperatures because the hypothalamus and eardrum are perfused by the same circulation.
Tympanic readings obtained using proper technique correlated moderately to strongly with oral temperatures in recent research studies. The sensor is unaffected by the cerumen or the presence of suppurative or unsuppurative otitis media. A RN is not required to take the child's temperature, but must assess readings received from assistive personnel.
Although rectal readings are highly accurate, such an invasive procedure is unnecessary and it is not necessary to contact the pediatrician. A 6-month old boy and his mother are at the healthcare provider's office for a well-baby checkup and routine immunizations. The healthcare provider recommends to the mother that the child receive an influenza vaccine. What medications should the nurse plan to administer today? The routine immunizations and schedule another appointment to administer the influenza vaccine B. All the immunizations with the influenza vaccine given at a separate site from any other injection.
The influenza vaccine and schedule another appointment to administer the immunizations D. The influenza vaccine and the polio vaccine and schedule another appointment to administer the remaining immunizations. Are you experiencing any type of nervousness? Assessing the client's physiological state upon admission is a priority, and nervousness, apprehension, hyperexcitability, and palpitations are signs of hyperthyroidism. Weight loss (even with a hearty appetite) occurs in those with hyperthyroidism, but assessing the client's neurological state has a higher priority. Hormone replacement is not administered to a client who is already producing too much thyroid.
The client may have exophthalmus (bulging eyes), but hyperthyroidism does not cause vision problems. A trial of human chorionic gonadotrophic hormone A trial of HCG (human chorionic gonadotrophic) hormone may aid in testicular descent, but does not replace surgical repair for true undescended testes.
Undescended testes (cryptorchidism) may be found in the inguinal canal due to exaggerated cremasteric reflex. (A) is not indicated. Stimulation of the cremasteric reflex causes the testes to ascend rather than to descend in the scrotum. (D) may relax the cremasteric muscle, but may not cause the testes to descend. Use a happy face/sad face pain scale A 4 year old can readily identify with simple pictures to show the nurse how he/she is feeling. (B) could be used to validate what the child is telling the nurse via the 'faces' pain scale, but it is best to elicit the child's assessment of his/her pain level. (C) may not accurately reflect the effectiveness of pain medication as they can also be affected by other variables, such as fear.
(D) requires abstract number skills beyond the level of a 4 year old. A 17 year old male student reports to the school clinic one morning for a scheduled health exam. He tells the nurse that he just finished football practice and is on his way to class. The nurse assesses his vital signs: temperature 100F, pulse 80, respirations 20, and BP 122/82. What is the best action for the nurse to take?
Tell the student to proceed directly to his regularly scheduled class. Call the parent and suggest re-taking the student's temperature at home C. Give the student a glass of cool fluids, then retake his temperature D. Send the student to class, but re-verify his temperature after lunch. Start an IV infusion of normal saline the current vital sign readings and the decreased peripheral pulse volume indicate that the child is experiencing fluid volume deficit due to the polyuria, so the priority action is to restore fluid volume. (A) is useful in obtaining a precise urine output measure, but is a lower priority than restoring fluid volume at this time.
(C) is not indicated based on the current assessment data, and (D) does not recognize the need for immediate action to combat the fluid volume deficit. A 3 week old newborn is brought to the clinic for follow after a home birth. The mother reports that her child bottle feeds for 5 minutes only and then falls asleep. The nurse auscultates a loud murmur characteristic of a ventricular septal defect (VSD) and finds the newborn is acyanotic with a respiratory rate of 64 breaths per minute. What instruction should the nurse provide the mother to ensure the infant is receiving adequate intake? (select all that apply) A. Monitor the infant's weight and number of wet diapers per day.
Increase the infant's intake per feeding by 1-2 ounces per week C. Mix the dose of prophylactic antibiotic in a full bottle of formula D. Allow the infant to rest and refeed on demand on every 2 hours E. Use a softer nipple or increase the size of the nipple opening.
Monitor the infant's weight and number of wet diapers per day. Increase the infant's intake per feeding by 1-2 ounces per week D. Allow the infant to rest and refeed on demand on every 2 hours E.
Use a softer nipple or increase the size of the nipple opening Neonates who have VSD may fatigue quickly during feeding and ingest inadequate amounts. They should be monitored for weight gain and at least 6 wet diapers per day. A one-month old infant should ingest 2-4 ounces of formula per feeding and progress to about 30 ounces per day by 4 months of age.
Due to fatigue, the infant should rest, but feed at least every 2 hours to ensure adequate intake. A softer (preemie) nipple or a larger slit in the nipple helps to reduce the sucking effort and energy expenditure thus allowing the infant to ingest more with less effort. Antibiotic prophylaxis is recommended for infants with VSDs, but should not be mixed in a bottle of formula because it is difficult to ensure that the total dose is consumed. Parental control should be consistent Discipline should be a positive and necessary component of childrearing that is started in infancy and should teach socially acceptable behavior to help children protect themselves from danger, and channel undesirable behavior into constructive activity. Misbehavior may result from inconsistent rules or messages, so parental attention should be clear, reasonable, and consistent. (B and C) are not helpful to the child.
Children need boundaries that are firm but not rigid. Explain hospital schedules to the child, such as mealtimes. Altered daily schedules and loss of rituals are upsetting to children and increase separation anxiety, and active sensitivity to the needs of children can minimize the negative effects of hospitalization.
Explaining the hospital schedules and establishing an individual schedule familiarizes the child to the hospital environment and decreases anxiety. (B) depersonalizes the child who should be addressed by name.
Family and sibling visitation should be recommended and encouraged without limitation. Although (D) should be implemented, the direct involvement of the school-aged child incorporates the child's sense of initiate and cooperation. Administer tetanus toxoid booster After the completion of the initial tetanus immunization schedule, the recommended booster for an adolescent or adult is every 10 years or less is a traumatic injury occurs that is contaminated by dirt, feces, soil, or saliva, such as puncture or crushing injuries, avulsions, wounds from missles, burns, or frostbite. The adolescent's injury is considered a contaminated wound requiring prophylactic therapy, so the tetatnus toxoid booster should be administered. Pale bluish coloration of the toes Russell's skin traction is used for fractures of the femur in young children and adolescents, whose growth plates remain open and is applied to the lower leg using moleskin and elastic wrap bandages, which can compress the peroneal nerve and arteries that supply the foot.
Assessment of adequate circulation, movement, and sensation of the toes and skin distal to the application is made to identify compromised blood flow so cyanosis should be reported immediately. Encourage the mother to have the children visit the hospitalized sibling.
Needs of a sibling will be better met with factual information and contact with the ill child, so sibling visitation should be encouraged. Parents are experts on their children and should determine when their children are old enough to visit in the hospital. Separation from family and home may intensify fear and anxiety. Children may have difficulty expressing questions so the support of parents and other caregivers are needed to help alleviate their fears.
Menstruation has not occurred Menstruation is an expected secondary sex characteristic that occurs with pubescence and typically occurs by age 18 so (A) should prompt further investigation to determine the cause of this primary amenorrhea. Children receive tetanus as part of the DPT childhood immunization series, and a booster is not typically given until age 16.
Wisdom teeth are the third molar teeth of the permanent dentition and are the last to erupt so (C) is a normal finding. (D) describes a plantar surface wart, harmless but painful because of the pressure with walking or standing. Child's height and weight C. Body surface area of child F. Nomogram determined mathematical constant. The most accurate calculations of pediatric dosages use the child's height and weight.
The child's BSA is calculated using the square root of weight in kg times height in cm divided by 3600 or the square root of weight in lb times height in inches divided by 3131, then the child's BSA is multiplied by the recommended published dose per BSA. The nomogram is used to plot the child's height and weight, and the point at which they intersect is the BSA mathematical constant used to calculate the child's dose.
Pediatric nursing revolves around providing care for children from infancy through their late teen years and their families. Let’s test your knowledge about pediatric nursing with questions like calculating, growth and development, common diseases affecting children and more. This comprehensive 50-item quiz will sharpen your critical thinking skills for the sample quiz about Pediatric Nursing.
A person’s a person, no matter how small. Seuss Topics Topics or concepts included in this exam are:. Administration of medicine to pediatric clients. Common diseases among children. Various questions about pediatric nursing Guidelines.
In Text Mode:All questions and answers are given for reading and answering at your own pace. You can also copy this exam and make a print out.
Molly, with suspected rheumatic, is admitted to the pediatric unit. When obtaining the child’s history, the nurse considers which information to be most important? A fever that started 3 days ago B.
Lack of interest in food C. A recent episode of pharyngitis D. Vomiting for 2 days 2.
Nurse Analiza is administering a medication via the intraosseous route to a child. Intraosseous drug administration is typically used when a child is: A. Under age 3 B. Over age 3 C.
Critically ill and under age 3 D. Critically ill and over age 3 3. When assessing a child’s cultural background, the nurse in charge should keep in mind that: A. Cultural background usually has little bearing on a family’s health practices B. Physical characteristics mark the child as part of a particular culture C.
Heritage dictates a group’s shared values D. Behavioral patterns are passed from one generation to the next 4. While examining a 2-year-old child, the nurse in charge sees that the anterior fontanel is open. The nurse should: A. Notify the doctor B.
Look for other signs of C. Recognize this as a normal finding D. Ask about a family history of Tay-Sachs disease 5. The nurse is aware that the most common assessment finding in a child with ulcerative colitis is: A. Intense abdominal cramps B. Anal fissures D.
Abdominal distention 6. When administering an I.M. Injection to an infant, the nurse in charge should use which site?
Dorsogluteal C. Ventrogluteal D.
Vastus lateralis 7. A child with a poor nutritional status and weight loss is at risk for a negative nitrogen balance.
To help diagnose this problem, the nurse in charge anticipates that the doctor will order which laboratory test? Total iron-binding capacity B.
Total protein D. Serum transferrin 8. When developing a plan of care for a male adolescent, the nurse considers the child’s psychosocial needs. During adolescence, psychosocial development focuses on: A.
Becoming industrious B. Establishing an identity C. Achieving intimacy D.
Developing initiative 9. When developing a plan care for a hospitalized child, nurse Mica knows that children in which age group is most likely to view illness as a punishment for misdeeds?
Preschool age C. School age D.
Adolescence 10. Nurse Sunshine suspects that a child, age 4, is being neglected physically. To best assess the child’s nutritional status, the nurse should ask the parents which question?
“Has your child always been so thin?” B. “Is your child a picky eater?” C. “What did your child eat for breakfast?” D.
“Do you think your child eats enough?” 11. A female child, age 2, is brought to the emergency department after ingesting an unknown number of tablets about 30 minutes earlier. On entering the examination room, the child is crying and clinging to the mother. Which data should the nurse obtain first? Heart rate, respiratory rate, and pressure B.
Recent exposure to communicable diseases C. Number of immunizations received D. Height and weight 12. A mother asks the nurse how to handle her 5-year-old child, who recently started wetting the pants after being completely toilet trained.
The child just started attending nursery school 2 days a week. Which principle should guide the nurse’s response? The child forgets previously learned skills B. The child experiences growth while regressing, regrouping, and then progressing C. The parents may refer less mature behaviors D.
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The child returns to a level of behavior that increases the sense of security. A female child, age 6, is brought to the health clinic for a routine checkup. To assess the child’s, the nurse should ask: A. “Do you have any problems seeing different colors?” B.
“Do you have trouble seeing at night?” C. “Do you have problems with glare?” D. “How are you doing in school?” 14. During a well-baby visit, Liza asks the nurse when she should start giving her infant solid foods. The nurse should instruct her to introduce which solid food first? Applesauce B. Egg whites C.
Rice cereal D. To decrease the likelihood of bradyarrhythmias in children during endotracheal intubation, (Anectine) is used with which of the following agents? (Adrenalin) B.
Hydrochloride (Xylocaine) 16. A 1-year-and 2-month-old child weighing 26 lb (11.8 kg) is admitted for traction to treat congenital hip dislocation. When preparing the patient’s room, the nurse anticipates using which traction system? Bryant’s traction B. Buck’s extension traction C. Overhead suspension traction D.
90-90 traction 17. Hannah, age 12, is 7 months pregnant. When teaching parenting skills to an adolescent, the nurse knows that which teaching strategy is least effective? Providing a one-on-one demonstration and requesting a return demonstration, using a live infant model B.
Initiating a teenage parent support group with first – and – second-time mothers C. Using audiovisual aids that show discussions of feelings and skills D. Providing age-appropriate reading materials 18. When performing a physical examination on an infant, the nurse in charge notes abnormally low-set ears. This finding is associated with: A.
Otogenous tetanus B. Tracheoesophageal fistula C.
Congenital heart defects D. Renal anomalies 19. Nurse Walter should expect a 3-year-old child to be able to perform which action? Ride a tricycle B. Tie the shoelaces C.
Roller-skates D. Jump rope 20. Nurse Kim is teaching a group of parents about.
When discussing why children are predisposed to this disorder, the nurse should mention the significance of which anatomical feature? Eustachian tubes B. Nasopharynx C. External ear canal 21. The nurse is evaluating a female child with acute post streptococcal for signs of improvement.
Which finding typically is the earliest sign of improvement? Increased output B. Increased appetite C. Increased energy level D. Decreased 22. Jones prescribes corticosteroids for a child with nephritic syndrome. What is the primary purpose of administering corticosteroids to this child?
To increase B. To reduce inflammation C. To decrease D. To prevent 23. Parents bring their infant to the clinic, seeking treatment for vomiting and diarrhea that has lasted for 2 days. On assessment, the nurse in charge detects dry mucous membranes and lethargy. What other findings suggests a?
A sunken fontanel B. Increased blood pressure D.
Low urine specific gravity 24. How should the nurse prepare a suspension before administration?
By diluting it with solution B. By diluting it with 5% dextrose solution C. By shaking it so that all the drug particles are dispersed uniformly D. By crushing remaining particles with a mortar and pestle 25. What should be the initial bolus of crystalloid fluid replacement for a pediatric patient in shock?
Lily, age 5, with an intelligence quotient of 65 is admitted to the hospital for evaluation. When planning care, the nurse should keep in mind that this child is: A. Within the lower range of normal intelligence B. Mildly retarded but educable C. Moderately retarded but trainable D. Completely dependent on others for care 27. Mandy, age 12, is brought to the clinic for evaluation for a suspected eating disorder.
To best assess the effects of role and relationship patterns on the child’s nutritional intake, the nurse should ask: A. “What activities do you engage in during the day?” B. “Do you have any allergies to foods?” C. “Do you like yourself physically?” D. “What kinds of food do you like to eat?” 28.
is one of the most common causes of death in infants. At what age is the diagnosis of most likely? At 1 to 2 years of age B.
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At I week to 1 year of age, peaking at 2 to 4 months C. At 6 months to 1 year of age, peaking at 10 months D. At 6 to 8 weeks of age 29.
When evaluating a severely depressed adolescent, the nurse knows that one indicator of a high risk for is: A. Excessive sleepiness C. A history of use D. A preoccupation with death 30.
A child is diagnosed with Wilms’. During assessment, the nurse in charge expects to detect: A. Nausea and vomiting D. An abdominal mass 31. Which of the following would be inappropriate when administering to a child? Monitoring the child for both general and specific adverse effects B. Observing the child for 10 minutes to note for signs of C.
Administering medication through a free-flowing intravenous line D. Assessing for signs of infusion infiltration and irritation 32. Which of the following is the best method for performing a physical examination on a toddler A.
From head to toe B. Distally to proximally C. From abdomen to toes, the to head D.
From least to most intrusive 33. Which of the following organisms is responsible for the development of? Streptococcal B. Haemophilus influenza C. Group A β-hemolytic streptococcus D. Staphylococcus aureus 34. Which of the following is most likely associated with a (CVA) resulting from?
Polycythemia B. Cardiomyopathy C. Endocarditis D.
Low blood pressure 35. How does the nurse appropriately administer Mycostatin suspension in an infant? Have the infant drink water, and then administer myostatin in a syringe B. Place Mycostatin on the nipple of the feeding bottle and have the infant suck it C. Mix Mycostatin with formula D. Swab Mycostatin on the affected areas 36. A mother tells the nurse that she is very worried because her 2-year old child does not finish his meals. What should the nurse advise the mother?
Make the child seat with the family in the dining room until he finishes his meal B. Provide quiet environment for the child before meals C. Do not give snacks to the child before meals D. Put the child on a chair and feed him 37. The nurse is assessing a who had undergone vaginal.
Which of the following findings is least likely to be observed in a normal newborn? Uneven head shape B. Respirations are irregular, abdominal, 30-60 bpm c. Heart rate is 80 bpm 38. Which of the following situations increase the risk of in children? Playing in the park with heavy traffic and with many vehicles passing by B. Playing sand in the park C. Playing plastic balls with other children D.
Playing with stuffed toys at home 39. An inborn error of metabolism that causes a premature destruction of RBC? Homocystinuria C. Celiac Disease 40.
Which of the following blood study results would the nurse expect as most likely when caring for the child with? Increased hemoglobin B. Normal hematocrit C. Decreased mean corpuscular volume (MCV) D. Normal total iron-binding capacity (TIBC) 41. The nurse answers a call bell and finds a frightened mother whose child, the patient, is having a.
Which of these actions should the nurse take? The nurse should insert a padded tongue blade in the patient’s to prevent the child from swallowing or choking on his tongue. The nurse should help the mother restrain the child to prevent him from injuring himself. The nurse should call the operator to page for seizure assistance.
The nurse should clear the area and position the client safely. At the community center, the nurse leads an adolescent health information group, which often expands into other areas of discussion.
She knows that these youths are trying to find out “who they are,” and discussion often focuses on which directions they want to take in school and life, as well as peer relationships. According to Erikson, this stage is known as: A. Adolescent rebellion. Career experimentation. Relationship testing 43. The nurse is assessing a 9-month-old boy for a well-baby check up. Which of the following observations would be of most concern?
The baby cannot say “mama” when he wants his mother. The mother has not given him finger foods. The child does not sit unsupported. The baby cries whenever the mother goes out. Cherry, the mother of an 11-month-old girl, Elizabeth, is in the clinic for her daughter’s immunizations.
She expresses concern to the nurse that Elizabeth cannot yet walk. The nurse correctly replies that, according to the Denver Developmental Screen, the median age for walking is: A. Sunshine, age 13, has had a lumbar puncture to examine the CSF to determine if bacterial infection exists.
The best position to keep her in after the procedure is: A. For two hours to prevent, should she vomit. Semi-Fowler’s so she can watch TV for five hours and be entertained.
For several hours, to prevent a headache. On her right sides to encourage return of CSF 46.
Buck’s traction with a 10 lb. Weight is securing a patient’s leg while she is waiting for to repair a hip. It is important to check circulation- sensation-movement: A. Every 4 hours.
Every 15 minutes. Kim is using bronchodilators for. The side effects of these drugs that you need to monitor this patient for include: A. Tachycardia, nausea, vomiting, heart palpitations, inability to sleep, restlessness, and seizures. Tachycardia, headache, dyspnea, temp. 101 F, and wheezing. Blurred vision, tachycardia, headache, insomnia, and oliguria.
Restlessness, insomnia, blurred vision, chest, and weakness. The adolescent patient has symptoms of: nuchal rigidity, fever, vomiting, and lethargy.
The nurse knows to prepare for the following test: A. Blood culture. Throat and ear culture. Lumbar puncture.
The nurse is drawing blood from the diabetic patient for a glycosylated hemoglobin test. She explains to the woman that the test is used to determine: A.
The highest level in the past week. Glucose levels over the past several months. Her usual fasting glucose level. The twelve-year-old boy has fractured his arm because of a fall from his bike. After the injury has been casted, the nurse knows it is most important to perform all of the following assessments on the area distal to the injury except: A. Capillary refill. Radial and ulnar pulse.
Finger movement D. Skin integrity Answers and Rationale 1. Answer: C. A recent episode of pharyngitis A recent episode of pharyngitis is the most important factor in establishing the diagnosis of. Although the child may have a history of fever or vomiting or lack interest in food, these findings are not specific to rheumatic fever.
Answer: C. Critically ill and under age 3 In an emergency, intraosseous drug administration is typically used when a child is critically ill and under age 3. Answer: D. Behavioral patterns are passed from one generation to the next A family’s behavioral patterns and values are passed from one generation to the next. Option A: Cultural background commonly plays a major role in determining a family’s health practices.
Option B: Physical characteristics do not indicate a child’s culture. Option C: Although heritage plays a role in culture, it does not dictate a group’s shared values and its effect on culture is weaker than that of behavioral patterns.
Answer: A. Notify the doctor Because the anterior fontanel normally closes between ages 12 and 18 months, the nurse should notify the doctor promptly of this finding. An open fontanel does not indicate abuse and is not associated with Tay-Sachs disease. Answer: B. Profuse diarrhea Ulcerative colitis causes profuse diarrhea, intense abdominal cramps, anal fissures, and abdominal distensions are more common in Crohn’s disease. Answer: D. Vastus lateralis The recommended injection site for an infant is the vastus lateralis or rectus femoris muscles.
Option A: The deltoid is inappropriate. Options B and C: The dorsogluteal and ventrogluteal sites can be used only in toddlers who have been walking for about 1 year.
Answer: C. Total protein A negative nitrogen balance may result from inadequate protein intake and is best detected by measuring the total protein level. Options A, B, and C: Measuring total iron-binding capacity, hemoglobin, and serum transferrin levels would help detect iron-deficiency, not a negative nitrogen balance. Answer: B. Establishing an identity According to Erikson, the primary psychosocial task during adolescence is to establish a personal identity confusion. The adolescent attempts to establish a group identity by seeking acceptance and approval from peers and strives to attain a personal identity by becoming more independent from the family.
Option A: Becoming industrious is the developmental task of the school-age child. Option C: Achieving intimacy is the task of the young adult.
Option D: Developing initiative is the task of the preschooler. Answer: B. Preschool age Preschool-age children are most likely to view illness as a punishment for misdeeds. Option A: Separation, although seen in all age group, is most common in older infants. Option A: Separation anxiety, although seen in all age group, is most common in older infants. Options C and D: of death is typical of older school-age children and adolescents. Adolescents also fear mutilation.
Answer: C. “What did your child eat for breakfast?” The nurse should obtain objective information about the child’s nutritional intake, such as by asking about what the child ate for a specific meal. The other options ask for subjective replies that would be open to interpretation.
Answer: A. Heart rate, respiratory rate, and blood pressure The most important data to obtain on a child’s arrival in the emergency department are vital sign measurements. The nurse should gather the other data later. Answer: D. The child returns to a level of behavior that increases the sense of security. The of starting nursery school may trigger a return to a level of successful behavior from earlier stages of development.
Option A: A child’s skills remain intact, although increased stress may prevent the child from using these skills. Option B: Growth occurs when the child does not regress. Option C: Parents rarely desire less mature behaviors. Answer: D. “How are you doing in school?” A child’s poor progress in school may indicate a visual disturbance. The other options are more appropriate questions to ask when assessing vision in a geriatric patient. Answer: C. Rice cereal Rice cereal is the first solid food an infant should receive because it is easy to digest and is associated with few allergies. Next, the infant can receive pureed fruits, such as bananas, applesauce, and pears, followed by pureed vegetables, egg yolks, cheese, yogurt, and finally, meat.
Option B: Egg whites should not be given until age 9 months because they may trigger a food. Answer: C. Atropine sulfate Succinylcholine is an ultra-short-acting depolarizing agent used for rapid-sequence intubation. Bradycardia can occur, especially in children. Atropine is the drug of choice in treating succinylcholine-induced bradycardia. Options A and B: Epinephrine bolus and isoproterenol are not used in rapid-sequence intubation because of their profound cardiac effects. Option D: Lidocaine is used in adults only.
Answer: A. Bryant’s traction Bryant’s traction is used to treat femoral fractures of congenital hip dislocation in children under age 2 who weigh less than 30 lb (13.6 kg). Option B: Buck’s extension traction is skin traction used for short-term immobilization or to correct bone deformities or contractures. Option C: Overhead suspension traction is used to treat fractures of the; and.
Option D: 90-90 traction is used to treat femoral in children over age 2. Answer: D. Providing age-appropriate reading materials Because adolescents absorb less information through reading, providing age-appropriate reading materials is the least effective way to teach parenting skills to an adolescent. Options A, B, and C: The other options engage more than one of the senses and therefore serve as effective teaching strategies. Answer: D. Renal anomalies Normally the top of the ear aligns with an imaginary line drawn across the inner and outer canthus of the. Ears set below this line are associated with renal anomalies or mental retardation.
Options A, B, and C: Low-set ears do not accompany otogenous tetanus, tracheoesophageal fistula, or congenital heart defects. Answer: A. Ride a tricycle At age 3, gross motor development and refinement in eye-hand coordination enable a child to ride a tricycle. Options B, C, and D: The fine motor skills required to tie shoelaces and the gross motor skills require for roller-skating and jumping rope develop around age 5. Answer: A. Eustachian tubes In a child, Eustachian tubes are short and lie in a horizontal plane, promoting entry of nasopharyngeal secretions into the tubes and thus setting the stage for. Options B, C, and D: The nasopharynx, tympanic membrane, external ear canal have no unusual features that would predispose a child to otitis media.
Answer: A. Increased urine output Increased urine output, a sign of improving function, typically is the first sign that a child with acute post streptococcal glomerulonephritis (APSGN) is improving. Options B, C, and D: Increased appetite, an increased energy level, and decreased diarrhea are not specific to APSGN. Answer: C. To decrease proteinuria The primary purpose of administering corticosteroids to a child with nephritic syndrome is to decrease proteinuria. Option A: Corticosteroids have no effect on blood pressure. Option B: Although they help reduce inflammation, this is not the reason for their use in patients with nephritic syndrome.
Option D: Corticosteroids may predispose a patient to infection. Answer: A. A sunken fontanel In an infant, signs of fluid volume deficit include sunken, increased pulse rate, and decreased blood pressure. They occur when the body can no longer maintain sufficient intravascular fluid volume. When this happens, the kidneys conserve water to minimize fluid loss, which results in concentrated urine with a high specific gravity. By shaking it so that all the drug particles are dispersed uniformly The nurse should shake a suspension before administration to dispersed drug particles uniformly. Options A, B, and D: Diluting the suspension and crushing particles are not recommended for this drug form.
Answer: A. 20 ml/kg Fluid volume replacement must be calculated to the child’s weight to avoid over-hydration. Initial fluid bolus is administered at 20 ml/kg, followed by another 20 ml/kg bolus if there is no improvement in fluid status.
Answer: B. Mildly retarded but educable According to the American Association on Mental Deficiency, a person with an intelligence quotient (IQ) between 50 and 70 is classified as mildly mentally retarded but educable. Option C: One with an IQ between 35 and 50 is classified as moderately retarded but trainable.
Option D: One with an IQ below 36 is severely and profoundly impaired, requiring custodial care. Answer: C. “Do you like yourself physically?” Role and relationship patterns focus on and the patient’s relationship with others, which commonly interrelated with food intake.
Options A and C: Questions about activities and food preferences elicit information about health promotion and health protection behaviors. Option B: Questions about food allergies elicit information about health and illness patterns. Answer: B. At I week to 1 year of age, peaking at 2 to 4 months SIDS can occur any time between 1 week and 1 year of age. The incidence peaks at 2 to 4 months of age. Answer: D. A preoccupation with death An adolescent who demonstrates a preoccupation with death (such as by talking about death frequently) should be considered at high risk for suicide.
Options A, B, and C: Although depression, excessive sleepiness, and a history of cocaine use may occur in suicidal adolescents; they also occur in adolescents who are not suicidal. Answer: D. An abdominal mass The most common sign of Wilms’ tumor is a painless, palpable abdominal mass, sometimes accompanied by an increase in abdominal girth.
Option A: Gross hematuria is uncommon, although microscopic hematuria may be present. Option B: Dysuria is not associated with Wilms’ tumor. Option C: Nausea and vomiting are rare in children with Wilms’ tumor. Answer: B. Observing the child for 10 minutes to note for signs of When administering chemotherapy, the nurse should observe for an anaphylactic reaction for 20 minutes and stop the medication if one is suspected. Chemotherapy is associated with both general and specific adverse effects, therefore close monitoring for them is important. Answer: D. From least to most intrusive When examining a toddler or any small child, the best way to perform the exam is from least to most intrusive. Option A: Starting at the head or abdomen is intrusive and should be avoided.
Option B: Proceeding from distal to proximal is inappropriate at any age. Answer: C. Group A β-hemolytic streptococcus Rheumatic fever results from a delayed reaction to inadequately treated group A β-hemolytic streptococcal infection.
Answer: A. Polycythemia The child with congenital heart disease develops polycythemia resulting from an inadequate mechanism to compensate for decreased oxygen saturation 35. Answer: D. Swab Mycostatin on the affected areas Mycostatin suspension is given as swab. Never mix medications with food and formula. Answer C. do not give snacks to the child before meals If the child is hungry he/she more likely would finish his meals.
Therefore, the mother should be advised not to give snacks to the child. The child is a “busy toddler.” He/she will not able to keep still for a long time. Answer D. heart rate is 80 bpm Normal heart rate of the newborn is 120 to 160 bpm. Options A, B, and C are normal assessment findings (uneven head shape is molding). Answer: A. playing in the park with heavy traffic and with many vehicles passing by Lead poisoning may be caused by inhalation of dust and smoke from leaded gas. It may also be caused by lead-based paint, soil, water (especially from plumbings of old houses).
Ob Peds Hesi Exam
G6PD Glucose-6-phosphate dehydrogenase deficiency (G6PD) is an X-linked recessive hereditary disease characterised by abnormally low levels of glucose-6-phosphate dehydrogenase (abbreviated G6PD or G6PDH), a metabolic enzyme involved in the pentose phosphate pathway, especially important in red blood cell metabolism. Answer: C. Decreased mean corpuscular volume (MCV) For the child with, the blood study results most likely would reveal decreased mean corpuscular volume (MCV) which demonstrates microcytic, decreased hemoglobin, decreased hematocrit and elevated total iron binding capacity. Answer: D. The nurse should clear the area and position the client safely. The primary role of the nurse when a patient has a seizure is to protect the patient from harming him or herself.
Answer: A. identity vs. Role confusion. During this period, which lasts up to the age of 18-21 years, the individual develops a sense of “self.” Peers have a major big influence over behavior, and the major decision is to determine a vocational goal. Answer: C. The child does not sit unsupported. Over 90% percent of babies can sit unsupported by nine months. Most babies cannot say “mama” in the sense that it refers to their mother at this time.
Answer: A. 12 months. By 12 months, 50 percent of children can walk well.
Answer: C. supine for several hours, to prevent a headache. Lying flat keeps the patient from having a “spinal headache.” Increasing the fluid intake will assist in replenishing the lost fluid during this time. Answer: C. every 4 hours.
Hesi Study Book
The patient can lose vascular status without the nurse being aware if left for more than 4 hours, yet checks should not be so frequent that the patient becomes anxious. Vital signs are generally checked q4h, at which time the CSM checks can easily be performed.
Answer: A. tachycardia, nausea, vomiting, heart palpitations, inability to sleep, restlessness, and seizures. Bronchodilators can produce the side effects listed in answer choice (A) for a short time after the patient begins using them.
Answer: D. lumbar puncture. Is an infection of the meninges, the outer membrane of the. Since it is surrounded by, a lumbar puncture will help to identify the organism involved. Answer: C. glucose levels over the past several months. The glycosylated hemoglobin test measures glucose levels for the previous 3 to 4 months. Answer: D. skin integrity Capillary refill, pulses, and skin temperature and color are indicative of intact circulation and absence of compartment syndrome.
Skin integrity is less important. See Also You may also like these quizzes:. – Tons of practice questions for various topics in the NCLEX-RN!
Related Study Notes. Pediatric Nursing NCLEX Practice Quizzes Questions related to the nursing care of our pediatric clients. Maternal and Child Health Nursing Questions in this set are about the care of the pregnant mother and her child. Recommended Books and Resources Selected NCLEX-RN review books:. MUST HAVE – A must-have book if you're taking the NCLEX-RN. You need to have this.
– An invaluable guide that will help you master what matters most in passing nursing school and the NCLEX. – This book has helped nurses pass the NCLEX exam for over 60 years. Practice with over 600 alternative item question formats. – A different approach to NCLEX-RN review.
– An NCLEX review book that focuses on prioritization, delegation, and patient assignment.