Quiz
Exam 2
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Questions in this quiz (163)
1Respiratory problems are the number one reason children are hospitalized
- ATrue
- BFalse
2A nurse is caring for a preschooler who has excoriated skin r/t diarrhea. Which of the following actions should the nurse take?
- ACleanse the area w/ an alkaline soap during each diaper brief change
- BAvoid using extra absorbent diaper briefs until the skin is healed
- CApply a thin layer of zinc oxide to the affected area during each diaper brief change
- DExpose the affected area to a heat lamp Q8h for 10 minutes
3A nurse is preparing to obtain a stool specimen for C diff for a preschooler who is wearing diaper briefs d/t recent occurences of diarrhea. Which of the following actions should the nurse take?
- AInsert the swab 1 inch into the rectum for 30 seconds
- BPlace a specimen from 2 different stools into the container to be tested.
- CPut the stool sample in a sterile container before sending it to the lab
- DPlace a urinary collection bag on the child before collecting the stool specimen
4A nurse is assessing a 4 year old w/ severe dehydration. Which of the following manifestations would the nurse expect?
- A10% weight loss
- BRR 18
- CCap refill 3 seconds
- Durine output 24mL/hr
5A nurse providing discharge teaching about oral rehydration to the parent of a preschooler w/ dehydration would include which of the following in the teaching?
- AOffer a cup or oral rehydration fluid every time he has diarrhea
- BGive your child apple juice to keep him hydrated in b/w meals
- CKeep your child on a BRAT diet until his diarrhea subsides
- DGive your child chicken broth TID
6A nurse is preparing to administer IV K to a preschooler who has dehydration. Which of the following actions should the nurse take?
- AEnsure the child has voided prior to administration
- BGive the med IV bolus over 5 minutes
- CGive calcium gluconate prior to the med
- Dw/hold food high in K for 24 hours following the med
7Which of the following describes a child who is abused by the parent(s)?
- AUnintentionally contributes to the abusing situation
- BBelongs to a low socioeconomic population
- CIs healthier than the non-abused siblings
- DAbuses siblings in the same way as child is abused by the parent(s)
8A common characteristic of those who sexually abuse children is which of the following?
- APressure victim into secrecy
- BAre usually unemployed and unmarried
- CAre unknown to victims and victim’s families
- DHave many victims that are each abused only once
9A 3-month-old infant dies shortly after arrival to the Emergency Department. The infant has subdural and retinal hemorrhages but no external signs of trauma. The nurse should expect:
- Aunintentional injury
- Bshaken-baby syndrome
- CSIDS
- Dcongenital neurologic problem
10Probably the most important criterion on which to base the decision to report suspected child abuse is which of the following?
- AInappropriate parental concern for the degree of injury
- BAbsence of parents for questioning about child’s injuries
- CInappropriate response of child
- DIncompatibility between the history and injury observed
11Which of the following statements is correct about young children who report sexual abuse by one of their parents?
- AThey may exhibit various behavioral manifestations
- BIn most cases, the child has fabricated the story
- CTheir stories are not believed unless other evidence is apparent
- DThey should be able to retell the story the same way to another person
12A 3-year-old child is brought to the Emergency Department for treatment of injuries the father stated were obtained when the child fell off of his tricycle. Upon assessment,numerous bruised areas, old and fresh, are noted on the child’s back, buttocks, and shoulders. Radiologic examination reveals fractured ribs and a healed fractured humerus. Based on these findings, the nurse’s next course of action would be to:
- Areport the child as a victim of child abuse immediately
- Bask the father to provide further details of the incident, obtain a medical history of the child, and then interview the child separately
- Cask the father if he has been physically abusive to the child
- Dask the father if he believes the child’s mother has been physically abusive to the child
13The nurse overhears a group of student nurses in the break room discussing the role of the health care professional in suspected child abuse. The nurse concludes that the student who most accurately understands the role is one who makes which of the following statements?”
- A“Nurses should only report child abuse if they are certain.”
- B“Nurses should tell the child’s doctor if child abuse is suspected.”
- C“Only the physician can report child abuse.”
- D“Nurses are required to report any case of suspected child abuse to child protective services.”
14A nurse is evaluating a family in which child abuse has occurred. Which of the following best indicates that the parents are making progress toward resolution of the violence?
- AParents plan weekly outings to the park
- BParents are attending parenting classes
- CParents report high expectations for their children
- DParents relate an understanding of normal growth and development
15A nurse is assessing the family of a child brought in for severe injuries. Which of the following behaviors by the parents indicates probable abuse?
- ADelay in seeking treatment for the child’s injuries
- BDetailed description of the events prior to the injuries
- CAnxious, concerned attitude
- DEncouraging the child to explain the injuries
16What is Munchausen Syndrome by Proxy?
- AA condition in which a person suffers from Munchausen Syndrome as a symptom of another illness such as depression or anxiety disorder.
- BA caregiver who fabricates or induces illness on a child in order to gain control over him or her or because they crave the attention it brings.
- CA condition in which a patient thinks he or she suffers from an illness because someone close to them suffers from an illness.
- DNone of these
17The parent of a child with neuroblastoma verbalizes regret at not coming in earlier for the child’s complaints. An appropriate response is:
- A“This tumor may be diagnosed early because of obvious symptoms.”
- B“This is a silent tumor, which is difficult to diagnose early.”
- C“This is a very common brain tumor in children.”
- D“I know you feel guilty about not being more observant, but you shouldn’t blame yourself.”
18A 4-year-old is diagnosed with acute lymphocytic leukemia (ALL). Following teaching about the testing and therapy, the nurse evaluates the family’s understanding of the problem. The statement by the family that indicates appropriate knowledge would be: “Tests will:
- ADetermine the extent of the tumor process and support the need for palliation.
- BHelp determine if treatment is needed.
- CDetermine if surgery is needed.
- DDetermine the extent of the malignant process and stage of the leukemia.
19The school health nurse has seen a child several times with the same complaints. The school health nurse would suspect a brain tumor after noting the presence of which of the following symptoms that is compatible with this health problem?
- AAtaxia and irritability
- BPapilledema and positive red reflex
- CEarly morning headache and vomiting
- DFever and seizures
20A 17-year-old is being admitted for an amputation related to a bone tumor. The nurse is developing a nursing care plan and determines the most appropriate age-related diagnosis is:
- ARisk for disuse syndrome
- BDisturbed body image
- CSelf-care deficit
- DActivity intolerance
21A child has been treated with chemotherapy for cancer. The nurse anticipates that neutropenia is an expected consequence and teaches the parents to:
- AAvoid contact sports
- BAvoid crowded spaces
- CAvoid spicy foods
- DAvoid all immunizations
22A child diagnosed with Ewing’s sarcoma is being treated with chemotherapy. The results of a complete blood count (CBC) indicate severe thrombocytopenia. Nursing interventions related to this finding would include: (Select all that apply.)
- AEncouraging foods high in iron
- BLimiting physical contact with the child
- CRemoving fresh flowers from the child’s room
- DClearing the floor of the child’s room to prevent falls and bruises
- EMinimizing needle sticks and intrusive procedures
23The parents of a child with neutropenia secondary to chemotherapy have been taught protective isolation behaviors. Nursing observations that indicate a need for further education is when the parents:
- ABring the child toys from home
- BEncourage friends to visit by phone rather than in person
- CPull the child in a wagon around the nursing unit for entertainment
- DWash their hands before entering the child’s room but not upon exiting the room
24A child will be undergoing chemotherapy. The nurse discusses the issue of hair loss with the child and family before chemotherapy begins. Later the family asks the nurse why this information was given to the child at this time. The nurse’s response will include the information that:
- AHair loss is a symptom of toxic blood levels of chemotherapy, so the child should be watching for this phenomenon.
- BThe presence or absence of hair is related to body image. Strategies for handling hair loss should precede the event.
- CIt is the nurse’s legal responsibility to discuss this issue with the child.
- DHair loss can be prevented with appropriate nursing interventions.
25A child is receiving chemotherapy to induce remission in acute leukemia. When considering common side effects of chemotherapy, the nurse would write which of the following as appropriate nursing diagnoses early in the course of therapy? (Select all that apply.)
- ADisturbed sleep pattern
- BImpaired oral mucous membranes
- CRisk for infection
- DRisk for impaired tissue perfusion: peripheral
- EImbalanced nutrition: less than body requirements related to nausea and vomiting
26An adolescent receiving cyclophosphamide (Cytoxan) for acute lymphocytic leukemia (ALL) asks the nurse to come quickly to evaluate “blood in my urine.” The most important action by the nurse would be to:
- AExplain this is normal for these drugs
- BMeasure intake and output
- CForce fluids to improve the hematuria
- DRecognize that this is untoward and report the event
27A pediatric client who is known to have cancer is being admitted for mild neutropenia and a severe oral monilial infection. The nurse should assign the child to which room?
- AA semi-private room with a medical patient
- BA semi-private room with a surgical patient
- CA private room without further precautions
- DA private room with protective isolation
28The nurse is assigned to the postoperative care of a child with a below-the-knee amputation for osteogenic sarcoma. The nurse plans to include which of the following in nursing care of the child?
- AMaintain bedrest until able to use permanent prosthesis
- BKeep stump elevated continuously until prosthesis applied
- CApply a dressing to the stump that allows continuous visualization of the distal stump
- DEncourage early visits from friends
29The nursing diagnosis for a child undergoing chemotherapy for leukemia is “Imbalanced nutrition: less than body requirements related to nausea and anorexia.” The nurse would formulate which of the following as an appropriate goal for this client?
- AAdminister antiemetics PRN
- BThe child’s caloric intake will be within normal range
- CThe child does not complain of nausea
- DIntake and output are approximately equal
30A child is to receive chemotherapy with a vesicant drug by the IV route. The nurse can ensure safe administration of this drug by doing which of the following?
- AAdministering the drug using a positive pressure infusion pump
- BChecking for blood return before, during, and after administration of the drug
- CMaintaining the infusion site below the level of the heart
- DDelivering the infusion as rapidly as possible
31A child with leukemia has developed pancytopenia. The nurse would institute which measures designed to reduce stomatitis in this child during the course of chemotherapy? (Select all that apply.)
- AUsing alcohol-based mouthwash to reduce oral organisms
- BAdministering pain medication as ordered
- CIncreasing intake of citrus juices, such as orange juice, that contain vitamin C
- DRinsing the mouth several times a day with plain water
- EBrushing the teeth twice a day with a firm-bristled toothbrush
32uring rounds, the interdisciplinary team is discussing a child with leukemia who has just been diagnosed as terminal. The nurses describe the mother’s behavior as angry, claiming the nurses are not providing care for her child. The team leader then focuses on which of the following, which is most likely the cause of the mother’s anger?
- APoor care on the part of the nurses
- BLack of attention for the mother’s needs
- COverwhelming guilt for having caused the leukemia
- DA stage of bereavement over the anticipated loss of the child
33A nurse is caring for a school-age child who has suspected osteosarcoma. Which of the following laboratory values is likely to be elevated if this diagnosis is correct?
- ABlood glucose
- BHct
- CAlkaline phosphatase
- DSerum potassium
34A nurse is caring for a 14-year-old adolescent boy who has been diagnosed with osteosarcoma of the left proximal tibia. The adolescent is 4 days preoperative for an above-the-knee amputation and is admitted to the hospital for preoperative chemotherapy. The adolescent knows about the surgery. Which of the following is the nurse’s responsibility in the next 4 days regarding this adolescent’s emotional health?
- AEnsure that the adolescent has a referral for a psychiatrist visit.
- BPrepare a teaching plan to educate the adolescent in detail about what he should know regarding his diagnosis and treatment.
- CSpend time with the adolescent to answer any questions he may have.
- DPerform a mental status examination to assess the adolescent’s through patterns.
35The nurse is administering an IV chemotherapeutic agent to a child with leukemia. The child suddenly begins to wheeze and have severe urticaria. Which is the most appropriate nursing action?
- AStop drug infusion immediately.
- BRecheck rate of drug infusion.
- CObserve child closely for next 10 minutes.
- DExplain to child that this is an expected side effect.
36A school-age child with leukemia experienced severe nausea and vomiting when receiving chemotherapy for the first time. Which is the most appropriate nursing action to prevent or minimize these reactions with subsequent treatments?
- AEncourage drinking large amounts of favorite fluids.
- BEncourage child to take nothing by mouth (remain NPO) until nausea and vomiting subside.
- CAdminister an antiemetic before chemotherapy begins.
- DAdminister an antiemetic as soon as child has nausea
37A nurse is caring for an 8 year old who has acute glomerulonephritis. Which of the following findings can the nurse expect?
- Ahypotension
- Bstomatitis
- Cbloody diarrhea
- Dperiorbital edema
38A nurse is teaching a school age child and his parents how to self-administer insulin. Which of the following actions should the nurse take first?
- AAllow a parent to administer an injection to the nurse
- BHave the child teach the injection technique to the parents
- CHave a parent administer the insulin injection to the child
- DDemonstrate the injection technique to an orange
39A nurse is assessing a 2 month old who has a ventricular septal defect. Which of the following findings should the nurse report to the provider?
- Aweight gain of 4 lb
- BHR 125
- Csoft, flat fontanell
- Dsystemic murmur
40A nurse is preparing to obtain an ASO titer from a child who has acute glomerulonephritis. The child's parent asks the nurse to explain the purpose of the test. Which of the following responses should the nurse make?
- AThe test determines the level of abx in your child's blood
- BThe test tells us if the child has ever had the measles
- CThe test verifies the amount of albumin in your child's blood
- DThe test shows us if your child has had a recent strep infection
41A nurse is reviewing the lab results of a child who has experienced diarrhea for the past 24 hours. Which of the following values for urine specific gravity should the nurse expect?
- A1.010
- B1.035
- C1.020
- D1.005
42A nurse in the ER is assessing a school-age child who is experiencing an acute asthma exacerbation. Which of the following findings is the priority for the nurse to report to the provider?
- Aexcessively long expiration
- Bincreased diaphoresis
- Cincreased production of frothy sputum
- Dsudden decreased in wheezing
43A nurse is teaching about s/s of tracheomalacia to the parent of an infant who had tracheoesophagel fistula repair as a newborn. Which of the following findings should the nurse include in the teaching?
- Aabsent bowel sounds
- Bneck contortions
- Cbarking cough
- Dprojectile vomiting
44A nurse is providing teaching to the parents of an infant who has a acute otitis media about how to administer abx eardrops. Which of the following instructions should the nurse include?
- AChill the med prior to administration
- BMassage the anterior area of the infant's ear following administration
- CHyperextend the infant's neck during administration
- DPull the auricle up and back during med administration
45A nurse is caring for a 12 month old following surgical repair of a cleft palate. The nurse should plan to feed the infant using which of the following?
- Aspool
- Bstraw
- Csoft nipple
- Dcup
46A nurse is caring for a child who has possible intussusception. The parents ask the nurse how the Dx is made. How should the nurse respond?
- AAn abdominal US will confirm the pocket in the intestine
- BGenotyping will be done to ID this condition
- CA biopsy will be done on a small amount of tissue from the colon
- DAn upper GI series should ID the area involved
47A nurse is teaching the parent of a pre-schooler about treatment of pinworms. Which of the following statements by the parents indicates an understanding of the teaching?
- AI will give my child a dose of albendazole today and again in 2 weeks
- BI will collect specimens immediately after my child has a BM
- CI will give my child a tub bath BID
- DI will place my child's bed linens in a sealed plastic bag for 7 days
48A nurse is providing teaching about immunizations to the parents of a severely immunocompromised child who has HIV. Which of the following statements should the nurse include in the teaching?
- AYour child's immunizations today will be half-doses
- BThe pneumococcal and influenza vaccine are recommended for your child
- CImmunizations will be delayed until your child's HIV test is negative
- DYour child will need to start the immunization schedule over once the lab values are w/in reference range.
49A nurse is providing teaching to the parents of a school age child who has DM1 about management of hypoglycemia. Which of the following responses by the parents indicate an understanding of the teaching?
- AI will make sure my child drinks 8oz of milk ASAP
- BI will give my child 2 units of regular insulin
- CI will insist that my child lies down to rest for 30 mins
- DI will check my child's urine for glucose BID
50A nurse is assessing a 6 month old who was recently admitted w/ acute vomiting and diarrhea. Which of the following findings indicates the infant has moderate dehydration?
- Abulging anterior fontannel
- Bbradycardia
- Ctachypnea
- Dpolyuria
51A nurse is assessing a child who has a ventricular septal defect. Which of the following findings should the nurse expect?
- Adiastolic murmur
- Bmurmur at the left sternal border
- Ccyanosis that increases with crying
- Dwidened pulse pressure
52A nurse is providing teaching to the parents of a 2 year old about nutrition. Which of the following statements by the parents indicates an understanding of the teaching?
- AMy child should consume 1,000 calories per day
- BMy child should have 4oz of protein per day
- CI should give my child 32oz of milk per day
- DI should feed my child 4oz of veggies per day
53A nurse is creating a plan of care for a child who has leukopenia secondary to chemo. Which of the following interventions should the nurse include in the plan?
- AMaintain the child on bed rest
- BMonitor child for increased temp
- CAdminister O2 to the child
- DMonitor child for bleeding
54A nurse is providing teaching to an adolescent who has a fiberglass arm cast. Which of the following instructions should the nurse include in the teaching?
- APlace a plastic bag over the cast when showering
- BInsert a dull knitting needle into the cast to rub itchy skin
- CExercise fingers Q8h for the first 24 hours
- DDraw on the cast using magic markers
55This type of cancer develops in the marrow spaces, typically in the shafts of long bones
- AEwing sarcoma
- Brhabdomyosarcoma
- Cretinoblastoma
- Dosteosarcoma
56Amputation or limb salvage is the appropriate treatment option for this type of cancer
- Aosteosarcoma
- BWilms Tumor
- CGraft vs Host Disease
- DALL leukemia
57This is a priority nursing diagnosis for a pediatric pt diagnosed with cancer and undergoing chemo
- Arisk for infection
- Bdisturbed body image
- Cremission
- Dlumbar puncture
58A pt status post-op above the knee amputation as a result of bone cancer would have this priority nursing diagnosis in his/her plan of care
- Adisturbed body image
- Bremission
- Clumbar puncture
- Dradiation therapy
59The obvious sign of this type of cancer is a whitish glow or cat's eye reflex
- Aretinoblastoma
- Bosteosarcoma
- CWilms tumor
- DGraft vs Host disease
60Unrestricted proliferation of immature WBCs defins this type of cancer
- AALL leukemia
- BHodgkin's lymphoma
- Cneuroblastoma
- DEwing sarcoma
61The clinical manifestations of this cancer is a painless, swollen mass in the abdomen usually confined to one side. It would be inappropriate to palpate this mass.
- AWilms tumor
- BGraft vs Host disease
- CALL leukemia
- DHodgkin's lymphoma
62This cancer is called the silent tumor originating as a firm, non-tender, irregular abdominal mass across the midline. Metastatic lesions are of common occurrence.
- Aneuroblastoma
- BEwing sarcoma
- Crhabdomyosarcoma
- Dretinoblastoma
63A procedure in which cerebral spinal fluid is collected in a sterile fashion by a physician to assess for CNS involvement of certain types of cancer
- Alumbar puncture
- Bchemo
- Cradiation therapy
- Drisk of infeciton
64In this cancer diagnosis, pts present w/ painless, enlarged lymph nodes typically in the cervical area and less frequently in the axillary and inguinal lymph nodes
- AHodgkin's lymphoma
- Bneuroblastoma
- CEwing sarcoma
- Drhabdomyosarcoma
65A major concern for a pt and family who have undergone a bone marrow transplant
- AGraft vs Host disease
- BALL leukemia
- CHodgkin's lymphoma
- Dneuroblastoma
66A term given to a cancer pt who has absence of clinical indicators and symptoms following cancer treatment
- Aremission
- Brisk of infection
- Cdisturbed body image
- Dlumbar puncture
67A side effect of this cancer treatment can be skin reactions, infertility, or bone growth abnormalities
- Aradiation
- Brisk of infection
- Cchemo
- Dlumbar puncture
68A muscle, tendon, bursa, fascia, fibrous, connective, lymphatic, or vascular tissue cell is invaded by this type of malignant neoplasm
- Arhabdomyosarcoma
- Bretinoblastoma
- Costeosarcoma
- DWilms tumor
69This treatment option offers the pediatric cancer pt a chance at remission and survival, yet poses a risk of infection, bleeding, nausea, vomiting, altered nutrition, and stomatitis
- Achemo
- Bradiation
- Cremission
- Dlumbar puncture
70Which of the following best describes how preschoolers react to the death of a loved one?
- APreschooler is too young to have a concept of death.
- BPreschooler may feel guilty and responsible for the death.
- CGrief is acute but does not last long at this age.
- DGrief is usually expressed in the same way in which the adults in the preschooler’s life are expressing grief.
71A preschooler is found digging up a pet bird that was recently buried after it died. The best explanation for this behavior is which of the following?
- AHe has a morbid preoccupation with death.
- BHe is looking to see if a ghost took it away.
- CThe loss is not yet resolved, and professional counseling is needed.
- DReassurance is needed that the pet has not gone somewhere else.
72At what age do most children have an adult concept of death as being inevitable?
- A4-5 years
- B6-8 years
- C9-11 years
- D12-16 years
73Which of the following is most descriptive of a school-age child’s reaction to death?
- AIs very interested in funerals and burials
- BHas little understanding of words such as 'forever'
- CImagines the deceased person to be still alive
- DHas an idealistic view of world and criticizes funerals as barbaric
74At what developmental period do children have the most difficulty coping with death particularly if it is their own?
- AToddlerhood
- BPreschool
- CSchool-age
- DAdolescence
75A school-age child is diagnosed with a life-threatening illness. The parents want to protect their child from knowing the seriousness of the illness. The nurse should explain that:
- Athis will help the child cope effectively by denial.
- Bthis attitude is helpful to give parents time to cope.
- Cterminally ill children know when they are seriously ill.
- Dterminally ill children usually choose not to discuss the seriousness of their illness.
76A cure is no longer possible for a young child with cancer. The nursing staff recognizes that the goal of treatment must shift from cure to palliation. Which of the following is an important consideration at this time?
- AThe family is included in the decision to shift the goals of treatment.
- BThe decision must be made by the health professionals involved in the child’s care.
- CThe family needs to understand that palliative care takes place in the home.
- DThe decision should not be communicated to the family because it will encourage a sense of hopelessness
77The nurse is caring for a child who has just died. The parents ask to be left alone so that they can rock their child one more time. The nurse should do which of the following?
- AGrant their request.
- BAssess why they feel this is necessary.
- CDiscourage this because it will only prolong their grief.
- DKindly explain that they need to say good-bye to their child now and leave.
78The nurse is talking with the parents of a child who died 6 months ago. They sometimes still “hear” the child’s voice and have trouble sleeping. They describe feeling “empty” and depressed. The nurse should recognize which of the following?
- AThese are normal grief responses.
- BThe pain of the loss is usually less by this time.
- CThese grief responses are more typical of the early stages of grief.
- DThis grieving is essential until the pain is gone and the child is gradually forgotten.
79At the time of a child’s death, the nurse tells his mother, “We will miss him so much.” The best interpretation of this is that the nurse is doing which of the following?
- APretending to be experiencing grief
- BExpressing personal feelings of loss.
- CDenying the mother’s sense of loss.
- DTalking when listening would be better.
80Which of the following is an appropriate nursing intervention when providing comfort and support for a child when death is imminent?
- ALimit care to essentials.
- BAvoid playing music near child.
- CExplain to child need for constant measurement of vital signs.
- DWhisper to child instead of using normal voice.
81The nurse is providing support to a family who is experiencing anticipatory grief related to their child’s imminent death. Which of the following is an appropriate nursing intervention?
- ABe available to family.
- BAttempt to “lighten the mood.”
- CSuggest activities to cheer up the family.
- DDiscourage crying until actual time of death.
82The nurse and a new nurse are caring for a child who will require palliative care. Which of the following statements made by the new nurse would indicate a correct understanding of palliative care?
- A“Palliative care serves to hasten death and make the process easier for the family.”
- B“Palliative care provides pain and symptom management for the child.”
- C“The goal of palliative care is to place the child in a hospice setting at the end of life.”
- D“The goal of palliative care is to act as the liaison between the family, child, and other health care professionals.”
83The nurse notes that the parents of a critically ill child spend a large amount of time talking with the parents of another child who is also seriously ill. They talk with these parents more than with the nurses. The nurse should recognize that this behavior indicates:
- AThat parent-to-parent support is valuable.
- BThat parent-to-parent dependence is unhealthy.
- CThe situation has developed because the nurses are unresponsive to the parents.
- DThe situation is unusual and has the potential to increase friction between the parents and nursing staff.
84Which of the following best describes the 4-year-old’s concept of death?
- ADeath is temporary.
- BDeath is permanent.
- CDeath is personified in various forms.
- DDeath is inevitable at some age.
85A 5-year-old girl’s sibling dies from sudden infant death syndrome. The parents are concerned because the girl showed more outward grief when her cat died than for her sibling’s death. The nurse should explain that:
- AThis behavior suggest maladaptive coping, and a referral is needed for counseling.
- BThe child is not old enough to have a concept of death.
- CThe child is not old enough to have formed a significant attachment to her sibling.
- DThe death may be so painful and threatening that the child must deny it for now to protect her psyche.
86The nurse is caring for a child dying from cancer. Physical signs that the child is approaching death include which of the following?
- ARapid pulse
- BChange in respiratory pattern
- CSensation of cold although body feels hot
- DLoss of hearing followed by loss of other senses
87Several nurses tell their nursing supervisor that they want to be able to attend the funeral of a child for whom they had cared. They say they felt especially close to both the child and the family. The supervisor should recognize that attending the funeral is:
- AAppropriate because families expect this expression of concern.
- BAppropriate because it can assist in the resolution of personal grief.
- CInappropriate because it is considered unprofessional behavior on the part of the nurses.
- DInappropriate because it increases burnout of the nursing staff
88Which of the following represents the major stressor of hospitalization for children from middle infancy throughout the preschool years?
- ASeparation anxiety
- BLoss of control
- CFear of bodily injury
- DFear of pain
89During the first 4 days of hospitalization, Eric, age 18 months, cried inconsolably when his parents left him, and he refused the staff’s attention. Now the nurse observes that Eric appears to be “settled in” and unconcerned about seeing his parents. The nurse should interpret this as which of the following?
- AHe has successfully adjusted to the hospital environment.
- BHe has transferred his trust to the nursing staff.
- CHe may be experiencing detachment, which is the third stage of separation anxiety.
- DBecause he is “at home” in the hospital now, seeing his mother frequently will only start the cycle again.
90When a preschool child is hospitalized without adequate preparation, the nurse should recognize that the child may likely see hospitalization as which of the following?
- APunishment
- BThreat to child’s self-image
- CAn opportunity for regression
- DLoss of companionship with friends
91Because of their striving for independence and productivity, which age-group of children is particularly vulnerable to events that may lessen their feeling of control and power?
- AInfants
- BToddlers
- CPreschoolers
- DSchool-age children
92A 10-year-old girl needs to have another intravenous (IV) line started. She keeps telling the nurse, “Wait a minute,” and, “I’m not ready.” The nurse should recognize that:
- Athis is normal behavior for a school-age child.
- Bthis behavior is usually not seen past the preschool years.
- Cthe child thinks the nurse is punishing her.
- Dthe child has successfully manipulated the nurse in the past.
93The most common initial reaction of parents to illness or injury and hospitalization in their child is which of the following?
- Aanger
- Bfear
- Cdepression
- Ddisbelief
94Amy, age 6 years, needs to be hospitalized again because of a chronic illness. The clinic nurse overhears her school-age siblings tell her, “We are sick of Mom always sitting with you in the hospital and playing with you.It isn’t fair that you get everything and we have to stay with the neighbors.” Which of the following is the nurse’s best assessment of this situation?
- AThe siblings are immature and probably spoiled.
- BJealousy and resentment are common reactions to the illness or hospitalization of a sibling.
- CFamily has ineffective coping mechanisms to deal with chronic illness.
- DThe siblings need to better understand their sister’s illness and needs.
95An appropriate nursing intervention to minimize separation anxiety in a hospitalized toddler would be which of the following?
- AProvide for privacy.
- BEncourage parents to room in.
- CExplain procedures and routines.
- DEncourage contact with children the same age.
96Four-year-old Brian appears to be upset by hospitalization. Which of the following is an appropriate intervention?
- ALet him know it is all right to cry.
- BGive him time to gain control of himself.
- CShow him how other children are cooperating.
- DTell him what a big boy he is to be so quiet.
97Latasha, age 8 years, is being admitted to the hospital from the emergency department with an injury from falling off her bicycle. Which of the following will help her most in her adjustment to the hospital?
- AExplain hospital schedules to her, such as mealtimes.
- BUse terms such as “honey” and “dear” to show a caring attitude.
- CExplain when parents can visit and why siblings cannot come to see her.
- DOrient her parents, because she is young, to her room and hospital facility.
98Samantha, age 5 years, tells the nurse that she “needs a Band-Aid” where she had an injection. Which of the following is the best nursing action?
- AApply a Band-Aid.
- BAsk her why she wants a Band-Aid.
- CExplain why a Band-Aid is not needed.
- DShow her that the bleeding has already stopped.
99Kimberly, age 3 years, is being admitted for about 1 week of hospitalization. Her parents tell the nurse that they are going to buy her “a lot of new toys, because she will be in the hospital.” The nurse’s reply should be based on an understanding of which of the following?
- ANew toys make hospitalization easier.
- BNew toys are usually better than older ones for children of this age.
- CAt this age, children often need the comfort and reassurance of familiar toys from home.
- DBuying new toys for a hospitalized child is a maladaptive way to cope with parental guilt.
100Matthew, age 18 months, has just been admitted with croup. His parent is tearful and tells the nurse, “This is all my fault. I should have taken him to the doctor sooner so he wouldn’t have to be here.” Which of the following is appropriate in the care plan for this parent who is experiencing guilt?
- AClarify misconception about the illness.
- BExplain to parent that the illness is not serious.
- CEncourage parent to maintain a sense of control.
- DAssess further why parent has excessive guilt feelings.
101The nurse is doing a prehospitalization orientation for Diana, age 7, who is scheduled for cardiac surgery. As part of the preparation, the nurse explains that she will not be able to talk because of an endotracheal tube but that she will be able to talk when it is removed. This explanation is:
- Aunnecessary.
- Bthe surgeon’s responsibility.
- Ctoo stressful for a young child.
- Dan appropriate part of the child’s preparation.
102The nurse is caring for an adolescent who had an external fixator placed after suffering a fracture of the wrist during a bicycle accident. Which of the following statements by the adolescent would be expected about separation anxiety?
- A“I wish my parents could spend the night with me while I am in the hospital.”
- B“I think I would like for my siblings to visit me but not my friends.”
- C“I hope my friends don’t forget about visiting me.”
- D“I will be embarrassed if my friends come to the hospital to visit.”
103When performing the initial assessment, the nurse found that when the infant’s head was flexed his knees and hips also flexed. The nurse should document this finding as
- AKernig’s sign
- BNuchal rigidity
- CBrudzinski’s sign
- DCushing’s reflex
104A 3-year old child with meningitis is documented as having photophobia. Which of the following interventions is most effective in minimizing this symptom?
- AAvoid using the TV
- BKeep the volume down on the radio
- CBandage both eyes temporarily
- DElevate the head of the bed
105Lab calls the nurse with results of the CSF sample that was obtained during the lumbar puncture of the child. The nurse would suspect bacterial meningitis with which of the following CSF results?
- AElevated glucose, elevated protein
- BDecreased glucose, decreased protein
- CElevated glucose, decreased protein
- DDecreased glucose, elevated protein
106A child is admitted with possible Reye syndrome. Which of the following factors in the child’s health history might be supportive of this diagnosis?
- ARecent history of urinary tract infection
- BRecent history of bacterial otitis media
- CRecent episode of gastroenteritis
- DRecent episode of Haemophilus influenzae meningitis
107Which of the following positions is the mos teffective in preventing a further increase in pressure for a child with increased intracranial pressure?
- ALeft side-lying, head flexed, knees drawn up
- BTrendelenburg position
- CFowler’s position
- DSupine with 30° head elevation
108A school-age child with spina bifida has a shunt in place for hydrocephalus. Which of the following signs and symptoms is not a manifestation of increased intracranial pressure?
- Ah/a
- BLethargy
- CBulging anterior fontanel
- DChange in school performance
109All of the following are preparations the nurse should do to prepare the room for an admission of a child with seizures except?
- APlace the bed in low position
- BAdminister Tylenol for comfort
- CPad the side rails
- DPlace suction in the room
110The adolescent is discharged with a prescription for phenytoin (Dilantin). Which of the following statements by the father indicates that discharge teaching has been effective?
- A“I need to administer her medicine in the morning and evening.”
- B“I will keep the annual appointment for follow-up on her medication.”
- C“I will be sure to encourage good oral care and regular dental visits.”
- D“I can allow her to stop taking the medication after 6 weeks, as long as there are no seizures.”
111Generalized movements of all extremities which would be which type of seizure?
- ATonic-clonic
- BAbsence seizure
- CFebrile seizure
- DComplex partial seizure
112A child has sustained a fall from a window. Her father finds her completely unconscious and not speaking or moving. What should her Glasgow Coma Scale score be?
- A3
- B5
- C10
- D15
113Which of the following sets of vital signs is indicative of Cushing’s reflex in a 6-year-old child?
- ATemperature 37.2°C, pulse 100/min, respiratory rate 22/min, and blood pressure 100/70
- BTemperature 37.9°C, pulse 140/min, respiratory rate 26/min, and blood pressure 60/30
- CTemperature 35.6°C, pulse 50/min, respiratory rate 18/min, and blood pressure 80/50
- DTemperature 37.8°C, pulse 64/min, respiratory rate 20/min, and blood pressure 140/40
114A child who has a concussion is being discharged home with her parents. Which of the following statements by the parent indicates a need for further teaching?
- A“I will keep him awake all night to make sure there is no change.”
- B“I should call the hospital if I cannot arouse him.”
- C“His pupils should remain equal and get smaller when I shine a light into them.”
- D“I should call the doctor if he starts to vomit.”
115A 6-month old infant is admitted to the PICU with a basilar skull fracture. Which of the following assessment findings would the nurse no texpect?
- ATwo black eyes
- BNuchal rigidity
- CBruising of neck posterior to infant’s ear
- DNosebleed
116The nurse is doing a neurologic assessment on a child whose level of consciousness has been variable since sustaining a cervical neck injury 12 hours ago. Which of the following is the priority assessment for this child?
- AReactivity of pupils
- BDoll’s head maneuver
- COculovestibular response
- DFunduscopic examination to identify papilledema
117Which of the following is characteristic of most neonatal seizures?
- AGeneralized
- BTonic-Clonic
- CWell organized
- DSubtle and barely discernible
118The nurse is admitting a young child to the hospital because bacterial meningitis is suspected. Which of the following is the major priority of nursing care?
- AInitiate isolation precautions as soon as diagnosis is confirmed
- BInitiate isolation precautions as soon as the causative agent is identified
- CAdminister antibiotic therapy as soon as it is ordered
- DAdminister sedatives and analgesics on a preventive schedule to manage pain
119The nurse is discussing long-term care with the parents of a child who has a ventriculoperitoneal shunt to correct hydrocephalus. Which of the following should the nurse include?
- AParental protection is essential until child reaches adulthood
- BMental retardation is to be expected with hydrocephalus
- CShunt malfunction or infection requires immediate treatment
- DMost usual childhood activities must be restricted
120Which of the following is a clinical manifestation of increased ICP in infants?
- AShrill, high-pitched cry
- BPhotophobia
- CPulsating anterior fontanel
- DVomiting and diarrhea
121The nurse is caring for a child with multiple injuries who is comatose. The nurse should recognize that pain:
- ACannot occur if child is comatose
- BMay occur if child regains consciousness
- CRequires astute nursing assessment and management
- DIs best assessed by family members who are familiar with child
122The nurse is caring for a toddler who has had surgery for a brain tumor. During an assessment the nurse notes that the child is becoming irritable and pupils are unequal and sluggish. The most appropriate nursing action is to:
- ANotify the practitioner immediately
- BAssess for level of consciousness (LOC)
- CObserve closely for signs of increased ICP
- DAdminister pain medication and assess for response
123A child with a history of a seizure was admitted 2 hours ago. The history indicates fever, chills, and vomiting for the past 24 hours. In report, the nurse is told that the child has a positive Brudzinski’s sign.The nurse infers this most likely caused by:
- AIncreased ICP
- BMeningeal irritation
- CEncephalitis
- DIntraventricular hemorrhage
124A nurse is assessing a new admission. The 6-month-old infant displays irritability, bulging fontanels, and setting-sun eyes. The nurse would suspect.
- AIncreased ICP
- BHTN
- CSkull fracture
- DMyelomeningocele
125An 8-year-old client with a ventriculoperitoneal shunt was admitted for shunt malfunction. He presents with symptoms of increased intracranial pressure. The mechanisms of the development of his symptoms is most probably related to:
- AIncreased flow of cerebrospinal fluid
- BIncreased reabsorption of cerebrospinal fluid
- CObstructed flow of cerebrospinal fluid
- DDecreased production of cerebrospinal fluid
126A child with myelomeningocele is started on a bowel management plan. The child’s mother questions why this is being done. The nurse’s response will be based on the understanding that lack of:
- AInnervation to the colon predisposes the child to diarrhea
- BInnervation to the anal sphincter predisposes the child to being incontinent
- CMobility increases the gastric-colic reflex
- DMobility decreases the need for regular bowel movements
127A child has just been diagnosed with bacterial meningitis. The parent asks the nurse how long the child will be in isolation. The nurse’s reply will be based on a protocol that isolation continues until:
- AThe organism is located
- BThe antibiotics are initiated
- CThe antibiotics have been administered for 24 hours
- DTen days of antibiotic therapy have been completed
128The nurse observes a client with the neck and back arched and extremities severely extended. The mother asks why the child is doing that. The nurse explains that this posturing is called:
- ADecerebrate
- BDecorticate
- CJacksonian seizure
- DOpisthotonos
129A child is being treated for increased intracranial pressure (ICP). Appropriate actions to decrease ICP would include: (Select all that apply).
- AKeeping head of bed at a 30-degree angle
- BProviding supplemental oxygen
- CTurning head to one side
- DAdministering IV osmotic diuretics as ordered
- EPromote fluid intake
130A 10-year-old boy receives a blow to his head with a hard baseball and is admitted to the hospital for observation. If the child were to develop an epidural hematoma, he would most like display symptoms:
- AIn the emergency room or soon after arriving on the unit
- BOn the unit over the next few days
- CAfter discharge home
- DOver the next two months
131A 15-year-old client is seen in the emergency department following a head injury from football. During the first few hours after admission, he sleeps unless awakened, but he can be aroused easily and is oriented.In charting assessment findings, the nurse would describe this level of consciousness as:
- ASemicomatose
- BLethargic
- CObtunded
- DStupurous
132A young child has just been diagnosed with spastic cerebral palsy. The nurse is teaching the parents how to meet the dietary needs of their child. The nurse would explain that children with cerebral palsy frequently have special dietary needs or feeding challenges because:
- AThe paralysis of their muscles decreases their caloric need
- BThe spasticity of their muscles increases their caloric needs
- Cthe hypotonic muscles make eating difficult
- DThe child’s inactivity increases the risk of obesity
133A 3-month-old infant has been admitted with a diagnosis of encephalitis. The first nursing priority would be to assess:
- APupillary reaction
- BLOC
- CAbility to maintain airway
- DBlood glucose level
134The nurse places a young child scheduled for a lumbar puncture in a side-lying position with the head flexed and knees drawn up to the chest. The mother asks why the child has to be positioned this way. The nurse explains the rationale for the positioning is that:
- APain is decreased through this comfort measure
- BInjury to the spinal cord is prevented
- CAccess to the spinal fluid is facilitated
- DRestraint is needed to prevent unnecessary movements
135An 18-month-old child is observed having a seizure. The nurse notes that the child’s jaws are clamped. The priority nursing responsibility at this time would be:
- AStart oxygen via mask
- BInsert padded tongue blade
- CRestrain child to prevent injury to soft tissue
- DProtect the child from harm from the environment
136A 3-year-old child is admitted to the hospital unit with a diagnosis of viral meningitis. The nurse should take which of the following actions in the care of this child?(Select all that apply)
- AAllow the child to assume a position of comfort
- BKeep the lights bright to monitor skin color
- CAdminister acetaminophen for pain
- DMonitor the child for seizures
- EAdminister antibiotics
137The nurse is providing client education for a family whose child has cerebral palsy and is receiving baclofen epidural therapy to control spasticity. Which of the following is most important for the nurse to include in the discussion?
- AThe drug acts to inhibit the neurotransmitter GABA
- BThe child should be able to run with normal gait after insertion of the pump
- CParents must bring the child back to the clinic on a regular basis to have more medicine added to the pump
- DParents can be taught to regular the dosage on a sliding scale
138A 10-year-old client presents with weakness in legs and history of the flu. The medical diagnosis is Guillain-Barre syndrome. It would be imperative for the nurse to inform the physician after observing which of the following?
- AWeak muscle tone in feet
- BWeak muscle tone in legs
- CIncreasing hoarseness
- DTingling in hands
139The nurse is providing discharge instructions for a child who has suffered a head injury within the last four hours. The nurse determines there is a need for additional teaching when the mother states:
- A“I will call my doctor immediately if my child starts vomiting.”
- B“I won’t give my child anything stronger than Tylenol for headache.”
- C“My child should sleep for at least 8 hours without arousing after we get home.”
- D“I recognize that continued amnesia about the injury is not uncommon.”
140A 2-year-old is admitted to the neurosurgical unit following a head injury. The nurse is using the Glasgow Coma Scale to measure neurological functioning. Which of the following assessment findings indicate the lowest level of functioning for this child?
- Aconfusion
- BIrritable and cries
- CEyes open only to pain
- DNo response to painful stimuli
141Upon performing a physical assessment of a 7-month-old child, the nurse notes the following findings. The nurse concludes that which finding is abnormal and could suggest cerebral palsy (CP)?
- ANo head lag when pulled to a sitting position
- BNo Moro or startle reflex
- CPositive tonic neck reflex
- DAbsence of tongue extrusion
142A 4-year-old child is being evaluated for hydrocephalus. The nurse notes which of the following as an early sign of hydrocephalus in this child?
- ABulging fontanels
- BRapid enlargement of the head
- CShrill, high-pitched cry
- DEarly morning headache
143A nurse is caring for an 8 year old with sickle cell anemia. Which of the following actions should the nurse take?
- AApply cool compresses to the painful area
- BInitiate contact isolation precautions
- CGive the child flavored popsicles
- DAdminister phytonadione
144A nurse is caring for a 4 month old who has acute otitis media and a fever of 101. Which of the following meds should the nurse administer?
- Adiphenhydramine
- Bfurosemide
- Camoxicillin
- Dibuprofen
145A nurse is preparing a school-age child for a tonsillectomy. Which of the following actions should the nurse take?
- ASchedule the child for a pre-op visit to the facility
- BInform the child he will be put to sleep during the procedure
- CRead the child a story about a cartoon character having the same surgery
- DTell the child the appt is to have his throat checked
146A nurse is teaching a group of parents of toddlers about growth and development. A parent asks, "Why does my child's abdomen stick out?" Which of the following statements should the nurse make?
- AYou should give your child a stool softener daily
- BToddlers gain weight at a rapid pace
- CYou should have your child assessed for a spinal deformity
- DToddlers don 't have well-developed abdominal muscles
147A nurse is caring for a child who is having an exacerbation of CF. Which of the following lab findings should the nurse report to the provider immediately?
- ABlood glucose 140
- BO2 sat 85%
- CRBC 3.2
- DNa 156
148A nurse is planning care for a pre-school aged child who has autism and is being admitted to the facility. Which of the following actions should the nurse plan to take?
- AEncourage the parent's to bring in the child's stuffed animal
- BGive the child choices when planning daily activities.
- CAdminister phenytoin TID
- DProvide a shared room with another child his age
149A nurse is caring for a 4 year old who has pneumonia. The child's mother left 2 hours ago and he is currently experiencing the separation anxiety stage of despair. Which of the following findings should the nurse expect?
- Acrying and screaming
- Binactive and thumb-sucking
- Cshows interest in toys around him
- Dattempts to escape and find parent
150A nurse is caring for a child who has a vesicular rash. The parents of the child ask the nurse what illness can cause a rash for 6 days. The nurse should suspect the child has which of the following conditions?
- Ameasles
- BFifth disease
- Ctetanus
- Dvaricella
151A nurse is caring for a child who has Tetralogy of Fallot. Which of the following lab values should the nurse expect to find?
- Aplatelet count 20,000
- BWBC 4.000
- CTSH 7.0
- DRBC 6.8
152A nurse is caring for a pre-schooler who has mucosal ulcerations after getting chemo. Which of the following actions should the nurse take?
- APlace viscous lidocaine on the oral lesions
- BInstruct the child to use a soft sponge toothbrush when brushing her teeth
- CEncourage the child to mouth rinse w/ hydrogen peroxide Q2-4h
- DGive the child lemon glycerin swabs to use after each meal
153A nurse is teaching the parents of a child w/ rheumatic fever. Which of the following statements by the parent indicates an understanding of the teaching?
- AMy child may take ASA for his joint pain
- BMy child will need a blood transfusion prior to discharge
- CI will need to wear a gown when in my child's room
- DI will apply lotion to my child's peeling hands
154A nurse on the Peds unit is caring for a group of pts. Which of the following findings should be the priority?
- AA child w/ asthma who has a pulse ox of 94%
- BA child w/ nephrotic syndrome and 1+ protein on the urine dipstick
- CA child w/ sickle cell anemia and a urine specific gravity of 1.030
- DA child w/ DM 1 w/ a glucose reading of 110
155A nurse is caring for a group of infants w/ congenital heart defects. For which of the following defects should the nurse expect to observe cyanosis?
- Atransposition of great arteries
- Bventricular-septal defect
- Ccoarctation of the aorta
- Dpatent-ductus arteriosis
156A nurse is teaching a school-age child who is to undergo a bone marrow aspiration. Which of the following statements should the nurse make?
- AI will give you an abx before the procedure
- BI will place you on your side during the procedure
- CYou might have a h/a following the procedure
- DI will place a pressure dressing over the area following the procedure
157A school nurse is assessing an adolescent who returned to school following a case of mono. The child has a note from his provider excusing him from gym class. Which of the following findings should the nurse ID as the reason for this excusal?
- Apotential for sustaining abdominal trauma
- Bdeficient dietary intake
- Cexposing peers to the illness
- Dstraining sore joints
158A nurse is caring to a child who has acute glomerulonephritis. Which of the following actions should the nurse take?
- Amaintain child on strict bed rest
- BCheck BP q4h
- Cadminister albumin q8h
- Dprovide a low-carb diet
159A nurse is caring for a child who has suspected nephrotic syndrome. Which of the following lab values should the nurse expect?
- Aplatelet count 120,000
- BNa 160
- CHgb 9
- Dcholesterol 700
160A nurse is caring for a 2 day old infant who has myelomeningocele. Which of the following actions should the nurse take?
- Amonitor infant's head circumference
- Bposition the infant supine
- Cplace the infant under a radiant warmer
- Dtape a piece of plastic over the protruding membranes
161The nurse is reviewing the medical record of a two month old who has rotavirus. The nurse notes an Hgb of 12 and an Hct of 51%. Which of the following statements by the nurse indicates an understanding of the lab values?
- AThe infant might be dehydrated
- BThe infant might be anemic
- CThe infant might have received too much fluid
- DThe infant might have leukemia
162A nurse is teaching the parents of a 10 year old who has iron def anemia. Which of the following statements by a parent indicates an understanding of the teaching?
- AI will give my child an iron tablet qhs
- BI will give the iron tablet w/ OJ
- CI will encourage my child to take an antacid w/ the iron tablet
- DI will crush the iron tablet before giving it to my child
163A school nurse is assessing a child who has been stung by a bee. The child's hand is swelling and the nurse notes that the child has an allergy to insect stings. Which of the following findings should the nurse expect if the child develops anaphylaxis? (select all that apply)
- Abradycardia
- Bnausea
- CHTN
- Dstridor
- Eurticaria
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- Peds Quiz on Exam 2, created by Nicole Buda on 19/09/2017.
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- Nicole Buda
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- English
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