Pediatric Nursing Practice Test and Answers, Exams of Nursing

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CPN Practice Test (50 Questions) and

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Which of the following laboratory tests is used to confirm the diagnosis of acute glomerulonephritis? A. antistreptolysin O titer B. blood urea nitrogen C. serum potassium level D. urine culture - A. antistreptolysin O titer When complete independence for a specific activity is unrealistic for a child with cerebral palsy, success is based on A. accomplishing any part of a task. B. compensating for physical liabilities. C. meeting developmental milestones. D. refining fine motor coordination. - A. accomplishing any part of a task. Which of the following is MOST effective when assisting an obese 10 year old to increase physical activity? A. encourage modified weight-training to increase muscle mass B. discuss options for different physical activities related to interests C. determine the amount of time currently spent in sedentary activities D. establish home rules limiting screen time to 3 hours per day - B. discuss options for different physical activities related to interests Parents have expressed heightened concern that their adolescent son may be contemplating suicide. Which of the following questions is the MOST important to ask? A. Has he recently experienced a loss? B. Does he have access to firearms? C. Has he withdrawn from friends? D. Is there is a family history of suicide? - B. Does he have access to firearms? Which elements of a child's physical assessment can yield the MOST information about possible nutritional deficiencies? A. eyes, ears, and nose B. mouth, skin, and hair C. chest, abdomen, and muscle development D. heart, lungs, and peripheral circulation - B. mouth, skin, and hair A sexually active female adolescent with cystic fibrosis (CF) mentions that her new boyfriend also has CF. Which of her statements BEST confirms that teaching related to pregnancy has been effective? (2 correct answers) A. "Pregnancy isn't happening since guys with CF can't have erections."

B. "A pregnancy could cause problems with my breathing." C. "If we had children together, all our children would have CF." D. "Using the pill to prevent pregnancy is not an option with CF." - B. "A pregnancy could cause problems with my breathing." C. "If we had children together, all our children would have CF." Which statement BEST conveys a caregiver's understanding of discharge instructions for a child treated nonoperatively for intussusception? A. "I will seek medical help if my child's stool looks ribbon-like." B. "We will check for blood in every bowel movement for 2 weeks." C. "My child needs to avoid foods with gluten." D. "This will most likely not happen again." - D. "This will most likely not happen again." Which of the following BEST assures the cooperation of a preschooler when preparing for a peripheral IV placement? A. approach the child with confidence B. ask the parents to hold the child C. describe each step of the procedure D. explain how another child stayed very still - A. approach the child with confidence A chronically ill child being treated with antibiotics has developed foul smelling, watery diarrhea. Which is the MOST likely cause? A. Clostridium difficile B. Rotavirus C. Salmonella typhi D. Yersinia enterocolitis - A. Clostridium difficile A preschooler is admitted with an altered level of consciousness, light sensitivity, and vomiting. Assessment findings include a purpuric rash to both lower extremities. The INITIAL response should be to A. administer ordered antibiotics and antiemetics. B. implement isolation precautions. C. obtain immunization and admission data. D. prepare for a lumbar puncture. - B. implement isolation precautions. A normal sinus arrhythmia can be distinguished from an abnormal arrhythmia by asking the child to A. take deep breaths. B. breathe normally. C. hold his/her breath. D. breathe slowly. - C. hold his/her breath. What is the MOST significant risk associated with the use of headsets or ear buds? A. accidental injury B. hearing loss

C. sleep deprivation D. social isolation - B. hearing loss Mandated reporting to child protective services for potential abuse is MOST warranted for which of the following children? A. 2 year old with a glove-patterned burn on hand B. 3 year old with scattered bruising bilaterally on lower extremities C. 8 year old with cerebral palsy needing several stitches on forehead D. 13 year old with healing horizontal scars on the forearm - A. 2 year old with a glove-patterned burn on hand Which of the following findings in a child is MOST urgent to discuss with the healthcare provider? A. temperature of 100°F (37.8° C) after 1 dose of IV cefuroxime (Ceftin) B. heart rate of 144 and 5 episodes of diarrhea in 2 hours C. mild retractions on 1 liter of O2 per nasal cannula with SaO2 of 93% D. pain level of 5 out of 10 after pain medication given 15 minutes ago - B. heart rate of 144 and 5 episodes of diarrhea in 2 hours When a newborn's availability to initiate breastfeeding is delayed, the mother should be A. told that the delay will likely cause latching problems. B. advised that colostrum production will be diminished. C. instructed on using a pump routinely to express milk. D. given information about formulas for the infant's use. - C. instructed on using a pump routinely to express milk. When providing opportunities for diversional play for a hospitalized 18 month old, which of the following toys is MOST appropriate? A. blocks for stacking B. shape sorter C. crayons and paper for scribbling D. small slide - A. blocks for stacking A child receiving a blood transfusion develops fluid overload. In addition to stopping the infusion, which intervention should be anticipated FIRST? A. positioning child upright with feet dependent B. beginning oxygen administration per face mask C. administering furosemide over 30 minutes D. restarting transfusion at slower rate - A. positioning child upright with feet dependent When an adolescent reports being involved in sexting, which of the following questions is the MOST appropriate to initiate education? A. "Are you aware that your photos can get posted on the internet?" B. "Do you realize that sexting photos can be considered child pornography?"

C. "What have you told your parents about this?" D. "What are your thoughts and feelings about sexting?" - D. "What are your thoughts and feelings about sexting?" Based on the details provided for the four following school-age children during shift report, the PRIORITY is the child with A. leukemia scheduled for chemotherapy but complaining of a sore throat. B. asthma with moderate retractions and an SaO2 of 90% on room air. C. postoperative pain reported as 7 out of 10 after an appendectomy. D. diabetes requesting insulin before eating breakfast. - B. asthma with moderate retractions and an SaO2 of 90% on room air. Children have a GREATER vulnerability for environmental exposure to contaminants because of developing bodies, metabolism, and A. their smaller size that keeps them closer to the ground. B. the lack of regulations on products marketed to children. C. their cognitive and developmental abilities. D. the retention of toxins in fat stores. - A. their smaller size that keeps them closer to the ground. Which of the following hospitalized children is at GREATEST risk of falling? A. a toddler with an atrial septal defect who is impatient to get out of the hospital bed B. a preschooler with cystic fibrosis who is riding a tricycle in the unit C. a school-age child receiving long-term antibiotics for osteomyelitis D. an adolescent administered midazolam for a procedure that was just canceled - D. an adolescent administered midazolam for a procedure that was just canceled When a parent caring for a dying child at home states, "Sometimes I wonder if I am doing what is right for my child," it is MOST likely A. a sign that the parent is in the bargaining stage of grief. B. an invitation to open discussions and explore feelings. C. a reason to review options including treatment. D. an indication of the need for respite support. - B. an invitation to open discussions and explore feelings. Opportunities for a preschooler to work through feelings or fears about an inpatient procedure is BEST facilitated by A. drawing or painting pictures. B. putting together large-piece puzzles. C. enacting with safe hospital equipment. D. having one-to-one play time with the nurse. - C. enacting with safe hospital equipment. The recommended dairy intake in a 1 year old's nutritional plan includes: A. iron fortified formula B. 1% cow's milk

C. 2% cow's milk D. whole cow's milk - D. whole cow's milk Behavioral and emotional responses MOST typical of young school-age children whose parents are divorcing include A. eating and sleeping disturbances. B. conflicts about parental loyalties. C. withdrawing from friends. D. blaming self. - D. blaming self. When delivering patient and caregiver education that is culturally sensitive, it is important to A. use relatives or friends familiar with the situation to interpret. B. determine the value of non-traditional health practices. C. consider their reading and speaking preferences. D. evaluate perceptions about the authority of female nurses. - C. consider their reading and speaking preferences. For children experiencing chronic pain, a criteria used to evaluate role functioning is their A. school attendance. B. level of depression. C. amount of sleep disruption. D. pain intensity. - A. school attendance Parents of a child on life-support after a traumatic brain injury need to be approached about transitioning to end-of-life care. Which of the following is MOST appropriate when introducing this transition? A. ensure a clergy member of their faith is present B. reassure that the change in care does not mean abandonment C. discuss the need to confirm a Do-Not-Resuscitate (DNR) status D. share the value of organ or tissue donation - B. reassure that the change in care does not mean abandonment Which of the following is the MOST appropriate guidance for a caregiver asking about discipline for a preschooler? A. "Mimic the child's behavior; if he raises his voice, then you raise yours." B. "Offer explanations such as, 'I'm sorry you can't color, we need to run errands.'" C. "Provide incentives to get him to do what you need him to do." D. "Use 'you' statements such as, 'You are mean when you hit your brother.'" - B. "Offer explanations such as, 'I'm sorry you can't color, we need to run errands.'" A disparaging remark is made by another nurse about the frequently absent caregivers of a child with a chronic illness. Which is the MOST appropriate response? A. "Have the caregiver's support system and resources been assessed?" B. "It is hard to care for a child whose caregivers are difficult or absent."

C. "Have you called child protective services to discuss your concerns?" D. "Let's notify social services so we can establish visiting rules for the family." - A. "Have the caregiver's support system and resources been assessed?" Which of the following should be the INITIAL response when there is concern that a family may have given uninformed consent? A. relay concerns to the unit manager B. confirm the caregivers' understanding C. explain the risks related to the procedure D. suggest the caregivers list questions for the healthcare provider - B. confirm the caregivers' understanding A 3 year old has a poor appetite, documented weight loss, and diminished energy. Which lab result would indicate a need for lead exposure screening? A. decreased platelet B. increased magnesium C. decreased hemoglobin D. increased neutrophil - C. decreased hemoglobin Which of the following symptoms would be MOST critical to report when a 16 year old is being evaluated after a recent respiratory infection? A. recurrent headaches B. chest wall pain C. lower extremity weakness D. productive cough - C. lower extremity weakness Which statement about the use of social media by an adolescent MOST indicates a need for further clarification? A. "I can tell people what I think." B. "I get to talk to other kids like me." C. "I know what I post has lasting power." D. "It's easy to be up late when I'm on the computer." - A. "I can tell people what I think." Despite compliance with the prescribed treatment plan, a child with type 1 diabetes has a hemoglobin A1C consistently above 8%. The BEST treatment option is: A. continuous subcutaneous insulin infusion device B. continuous blood glucose monitoring device C. long-acting insulin (Lantus) plus a rapid-acting insulin (Humalog) used prn D. rapid-acting insulin (Humalog) and intermediate-acting insulin (NPH) - A. continuous subcutaneous insulin infusion device In which situation is it appropriate to provide teaching about the principle of double effect for a family of a terminally ill child? A. child is receiving multiple antibiotics B. parents disagree about appropriate supportive measures

C. child wishes to stop treatment and parents disagree D. parents are concerned that pain medications will cause child's death - D. parents are concerned that pain medications will cause child's death The caregiver of a child with chronic illness, who is frequently hospitalized, expresses frustration with the healthcare team. The MOST appropriate response is to A. encourage the caregiver to continue trusting the team. B. offer instruction on bedside care the caregiver can provide. C. rotate staff assignments as possible to reduce staff burnout. D. organize a team meeting with the caregiver to discuss concerns. - D. organize a team meeting with the caregiver to discuss concerns. Which symptom is associated with a potential complication of transfusing blood under pressure? A. rales B. bradycardia C. sharp chest pain D. Expiratory wheezing - C. sharp chest pain Which of the following behaviors is MOST consistent with effective coping by a family caring for a child with chronic illness or disability? A. focuses on care needs one day at a time B. limits child's interactions to immediate family C. focuses efforts on addressing child's limitations D. avoids exposing child to medical-related details - A. focuses on care needs one day at a time The MOST important criterion in deciding whether to report suspected child abuse is: A. history and injury assessment are incompatible B. amount of detail provided to explain the injury C. parent has a history of domestic violence D. history of poor weight gain - A. history and injury assessment are incompatible An adolescent football player is evaluated for an episode of chest pain during practice. His parents describe vigorous weight lifting that has "really bulked him up," and they are concerned about recent fights at school. Which of the following substances is MOST suspect for abuse? A. amphetamines B. anabolic-androgenic steroids C. ephedra D. methylphenidate - B. anabolic-androgenic steroids Which of the following is an expected lab value in a child with a hypotonic fluid overload?

A. increased urine specific gravity B. decreased liver function tests C. increased hematocrit D. decreased electrolytes - D. decreased electrolytes In the teaching provided to caregivers after a child's bicycle fall, it is MOST important to A. emphasize the need for the child to ride with a buddy. B. explain the need for helmet replacement. C. provide information about local bike safety classes. D. discuss normal reluctance of the child to ride again. - B. explain the need for helmet replacement. When a child's treatment includes home care nursing, the family's need for control is BEST supported by A. sharing the nursing care and treatment plans. B. maintaining a daily routine for the child's care. C. suggesting reliable community resources. D. establishing boundaries and expectations together - D. establishing boundaries and expectations together A neighbor asks for advice about her school-age child's daily headaches over the last month. There has been no history of head trauma or fever. The MOST appropriate response is to recommend that the parent A. consider having the child's vision checked. B. give the child acetaminophen or ibuprofen. C. keep a diary to document when headaches occur. D. have the child evaluated by a healthcare provider. - D. have the child evaluated by a healthcare provider. When an adolescent with cystic fibrosis presents with abdominal distention and rectal prolapse, INITIAL discussion about compliance with taking pancreatic enzymes should include A. identifying ways to discretely take enzymes at school. B. taking enzymes within an hour of any food intake. C. increasing enzymes when eating food from the cafeteria. D. asking about challenges with taking enzymes. - D. asking about challenges with taking enzymes. When a child enters palliative care, the PRIMARY focus of treatment is A. ensuring multidisciplinary team involvement. B. alleviating suffering while respecting choices. C. terminating any curative-based treatments. D. ensuring viability of family's wish for organ donation. - B. alleviating suffering while respecting choices.

Which of the following topics is MOST appropriate to include in the anticipatory guidance offered to the caregiver of a 1 year old? A. introduce coloring with crayons to improve hand dexterity B. name body parts and ask child to point to on self C. place gates around stairways as mobility increases D. verify that hot water temperature is below 130° F (54.4° C) - C. place gates around stairways as mobility increases Which of the following beverages is MOST appropriate to promote nutrition for a preschooler AFTER rehydration therapy for acute diarrhea? A. apple juice B. broth C. milk D. soda - C. Milk Which of the following responses by a caregiver BEST recognizes appropriate awareness of safety concerns for a toddler? A. "I limit the number of stuffed animals in the crib." B. "I understand the need to protect my toddler from strangers." C. "I work at ensuring my toddler is closely supervised at all times." D. "I will introduce a new puppy when my child can care for it." - C. "I work at ensuring my toddler is closely supervised at all times."