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NCLEX PEDS Exam Questions with Answers 2022/2023 Update Graded A+, Exams of Nursing

A set of questions and answers related to pediatric health issues, including acute otitis media, croup, asthma, and cystic fibrosis. It provides rationales for each answer and highlights important nursing considerations for the care of children with these conditions. useful for nursing students and healthcare professionals who are preparing for the NCLEX-PN or NCLEX-RN exams, as well as for those who want to review their knowledge of pediatric nursing.

Typology: Exams

2022/2023

Available from 05/03/2023

Expertsolution
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Download NCLEX PEDS Exam Questions with Answers 2022/2023 Update Graded A+ and more Exams Nursing in PDF only on Docsity!

ANSWERS 2022/2023 UPDATE GRADED A+

Which of the following statements is characteristic of AOM? a. The etiology is unknown. b. Permanent hearing loss often results. c. It can be treated by intramuscular (IM) antibiotics. d. It is treated with a broad range of antibiotics. - d. It is treated with a broad range of antibiotics Rationale: Historically AOM has been treated with a range of antibiotics. However, new research shows that antibiotics do not improve outcomes in children with uncomplicated AOM. An 18-month-old child is seen in the clinic with AOM. Trimethoprim- sulfamethoxazole (Bactrim) is prescribed. Which of the following statements made by the parent indicates a correct understanding of the instructions? a. "I should administer all of the prescribed medication." b. "I should continue medication until the symptoms subside." c. "I will immediately stop giving medication if I notice a change in hearing." d. "I will stop giving medication if fever is still present in 24 hours." - a. "I should administer all of the prescribed medication." Rationale: Antibiotics should be given for their full course to prevent recurrence of infection with resistant bacteria An infant's parents ask the nurse about preventing OM. Which of the following should be recommended? a. Avoid tobacco smoke. b. Use nasal decongestant. c. Avoid children with OM. d. Bottle-feed or breastfeed in supine position. - a. Avoid tobacco smoke. Rationale: Eliminating tobacco smoke from the child's environment is essential for preventing OM and other common childhood illnesses. The nurse is assessing a child with croup. Examining the child's throat by using a tongue depressor might precipitate which of the following? a. Inspiratory stridor b. Complete obstruction c. Sore throat d. Respiratory tract infection - b. Complete obstruction Rationale: If a child has acute epiglottitis, examination of the throat may cause complete obstruction and should be performed only when immediate intubation can take place

ANSWERS 2022/2023 UPDATE GRADED A+

Which of the following types of croup is always considered a medical emergency? a. Laryngitis b. Epiglottitis c. Spasmodic croup d. Laryngotracheobronchitis (LTB) - b. Epiglottitis Rationale: Epiglottitis is always a medical emergency needing antibiotics and airway support for treatment.

ANSWERS 2022/2023 UPDATE GRADED A+

The nurse encourages the mother of a toddler with acute LTB to stay at the bedside as much as possible. The nurse's rationale for this action is primarily which of the following? a. Mothers of hospitalized toddlers often experience guilt. b. The mother's presence will reduce anxiety and ease child's respiratory efforts. c. Separation from mother is a major developmental threat at this age. d. The mother can provide constant observations of the child's respiratory efforts. - b. The mother's presence will reduce anxiety and ease child's respiratory efforts. Rationale: The family's presence will decrease the child's distress. A school-age child had an upper respiratory tract infection for several days and then began having a persistent dry, hacking cough that was worse at night. The cough has become productive in the past 24 hours. This is most suggestive of which of the following? a. Bronchitis b. Bronchiolitis c. Viral-induced asthma d. Acute spasmodic laryngitis - a. Bronchitis Rationale: Bronchitis is characterized by these symptoms and occurs in children older than 6 years. Skin testing for tuberculosis (TB) (the Mantoux test) is recommended: a. every year for all children older than 2 years. b. every year for all children older than 10 years. c. every 2 years for all children starting at age 1 year. d. periodically for children who reside in high-prevalence regions. - d. periodically for children who reside in high-prevalence regions Rationale: Children who reside in high-prevalence regions for TB should be tested every 2 to 3 years. Which of the following is the most important consideration in managing TB in children? a. Skin testing b. Chemotherapy c. Adequate nutrition d. Adequate hydration - b. Chemotherapy Rationale: Drug therapy for TB includes isoniazid, rifampin, and pyrazinamide daily for 2 months and two or three times a week for the remaining 4 months. The mother of a toddler yells to the nurse, "Help! He is choking to death on his food." The nurse determines that lifesaving measures are necessary based on which of the following?

ANSWERS 2022/2023 UPDATE GRADED A+

a. Gagging b. Coughing c. Pulse over 100 beats/min d. Inability to speak - d. Inability to speak

ANSWERS 2022/2023 UPDATE GRADED A+

Rationale: The inability to speak is indicative of a foreign-body airway obstruction of the larynx. Abdominal thrusts are needed for treatment of the choking child. The nurse is caring for a child with acute respiratory distress syndrome (ARDS) associated with sepsis. Nursing actions should include which of the following? a. Force fluids. b. Monitor pulse oximetry. c. Institute seizure precautions. d. Encourage high-protein diet. - b. Monitor pulse oximet Rationale: Monitoring cardiopulmonary status is an important evaluation tool in the care of the child with ARDS. The nurse is caring for a child with carbon monoxide poisoning associated with smoke inhalation. Which of the following is essential in this child's care? a. Monitor pulse oximetry. b. Monitor arterial blood gases. c. Administer oxygen if respiratory distress develops. d. Administer oxygen if child's lips become bright, cherry red. - b. Monitor arterial blood gases. Rationale: Arterial blood gases are the best way to monitor carbon monoxide poisoning. Asthma in infants is usually triggered by: a. medications. b. a viral infection. c. exposure to cold air. d. allergy to dust or dust mites. - b. a viral infection. Rationale: Viral illnesses cause inflammation that causes increased airway reactivity in asthma. Which of the following statements is the most descriptive of bronchial asthma? a. There is heightened airway reactivity. b. There is decreased resistance in the airway. c. The single cause of asthma is an allergic hypersensitivity. d. It is inherited. - a. There is heightened airway reactivity. Rationale: In bronchial asthma, spasm of the smooth muscle of the bronchi and bronchioles causes constriction, producing impaired respiratory function. A child has a chronic, nonproductive cough and diffuse wheezing during the expiratory phase of respiration. This suggests which of the following? a. Asthma b. Pneumoni a c.

ANSWERS 2022/2023 UPDATE GRADED A+

Bronchiolitis d. Foreign body in trachea - a. Asthma Rationale: Asthma may have these chronic symptoms.

ANSWERS 2022/2023 UPDATE GRADED A+

It is now recommended that children with asthma who are taking long- term inhaled steroids should be assessed frequently because which of the following may develop? a. Cough b. Osteoporosis c. Slowed growth d. Cushing syndrome - c. Slowed growth Rationale: The growth of children on long-term inhaled steroids should be assessed frequently to assess for systemic effects of these drugs. β-Adrenergic agonists and methylxanthines are often prescribed for a child with an asthma attack. What is their action? a. Liquefy secretions b. Dilate the bronchioles c. Reduce inflammation of the lungs d. Reduce infection - b. Dilate the bronchioles Rationale: These medications work to dilate the bronchioles in acute exacerbations. A parent whose two school-age children have asthma asks the nurse in what sports, if any, they can participate. The nurse should recommend which of the following? a. Soccer b. Running c. Swimming d. Basketball - c. Swimming Rationale: Swimming is well tolerated in children with asthma because they are breathing air fully saturated with moisture and because of the type of breathing required in swimming. Which of the following drugs is usually given first in the emergency treatment of an acute, severe asthma episode in a young child? a. Ephedrine b. Theophylline c. Aminophylline d. Short-acting β2-agonists - d. Short-acting β2-agonists Rationale: Short-acting β2 agonists are the first treatment in an acute asthma exacerbation. Which statement expresses accurately the genetic implications of cystic fibrosis (CF)? a. If it is present in a child, both parents are carriers of this defective gene. b. It is inherited as an autosomal dominant trait. c. It is a genetic defect found primarily in non-Caucasian population groups.

ANSWERS 2022/2023 UPDATE GRADED A+

d. There is a 50% chance that siblings of an affected child also will be affected. - a. If it is present in a child, both parents are carriers of this defective gene. Rationale: CF is an autosomal recessive gene inherited from both parents. What is the earliest recognizable clinical manifestation(s) of CF? a. Meconium ileus

ANSWERS 2022/2023 UPDATE GRADED A+

b. History of poor intestinal absorption c. Foul-smelling, frothy, greasy stools d. Recurrent pneumonia and lung infections - a. Meconium ileus Rationale: The earliest clinical manifestation of CF is a meconium ileus, which is found in about 10% of children with CF. Clinical manifestations include abdominal distention, vomiting, failure to pass stools, and rapid development of dehydration. Which of the following tests aid in the diagnosis of CF? a. Sweat chloride test, stool for fat, chest radiograph films b. Stool for fat, gastric contents for hydrochloride, chest radiograph films c. Sweat chloride test, bronchoscopy, duodenal fluid analysis d. Sweat chloride test, stool for trypsin, biopsy of intestinal mucosa - a. Sweat chloride test, stool for fat, chest radiograph films Rationale: A sweat test result of greater than 60 mEq/L is diagnostic of CF, a high level of fecal fat is a gastrointestinal (GI) manifestation of CF, and a chest radiograph showing patchy atelectasis and obstructive emphysema indicates CF. CF is suspected in a toddler. Which of the following tests is essential in establishing this diagnosis? a. Bronchoscopy b. Serum calcium c. Urine creatinine d. Sweat chloride test - d. Sweat chloride test Rationale: A sweat chloride test result greater than 60 mEq/L is diagnostic of CF. A child with CF receives aerosolized bronchodilator medication. This medication should be administered: a. before chest physiotherapy (CPT). b. after CPT. c. before receiving 100% oxygen. d. after receiving 100% oxygen. - a. before chest physiotherapy (CPT). Rationale: Bronchodilators should be given before CPT to open bronchi and make expectoration easier. A child with CF is receiving recombinant human deoxyribonuclease (rhDNase). This drug: a. may cause mucus to thicken. b. may cause voice alterations. c. is given subcutaneously.

ANSWERS 2022/2023 UPDATE GRADED A+

d. is not indicated for children younger than 12 years. - b. may cause voice alterations. Rationale: One of the only adverse effects of DNase is voice alterations and laryngitis. Pancreatic enzymes are administered to the child with CF. Nursing considerations should include which of the following? a. Do not administer pancreatic enzymes if child is receiving antibiotics. b. Decrease dose of pancreatic enzymes if child is having frequent, bulky stools.

ANSWERS 2022/2023 UPDATE GRADED A+

c. Administer pancreatic enzymes between meals if at all possible. d. Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal. - d. Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal. Rationale: Enzymes may be administered in a small amount of cereal or fruit at the beginning of a meal or swallowed whole. In providing nourishment for a child with CF, which of the following factors should the nurse keep in mind? a. Diet should be high in carbohydrates and protein. b. Diet should be high in easily digested carbohydrates and fats. c. Most fruits and vegetables are not well tolerated. d. Fats and proteins must be greatly curtailed. - a. Diet should be high in carbohydrates and protein. Rationale: Children with CF require a well-balanced, high-protein, high- calorie diet because of impaired intestinal absorption. Cardiopulmonary resuscitation (CPR) is begun on a toddler. Which of the following pulses is usually palpated because it is the most central and accessible? a. Radial b. Carotid c. Femoral d. Brachial - b. Carotid Rationale: In a toddler, the carotid pulse is palpated. Which of the following drugs is considered the most useful in treating cardiac arrest? a. Bretylium b. Lidocaine hydrochloride c. Epinephrine hydrochloride d. Naloxone (Narcan) - c. Epinephrine hydrochloride Rationale: Epinephrine works on alpha and beta receptors in the heart and is the most useful drug in cardiac arrest. Effective CPR on a 5-year-old child should include which of the following? a. One breath to every five chest compressions b. Two breaths to every 15 chest compressions c. Reassessment of child after 50 cycles of compression and ventilation d. Reassessment of child every 10 minutes that CPR continues - a. One breath to every five chest compressions Rationale: One breath to five chest compressions is the standard for infants.

ANSWERS 2022/2023 UPDATE GRADED A+

The Heimlich maneuver is recommended for airway obstruction in children older than: a. 1 year. b. 4 years. c. 8 years. d. 12 years. - a. 1 year.

ANSWERS 2022/2023 UPDATE GRADED A+

Rationale: The Heimlich maneuver is recommended for airway obstruction in children older than 1 year. Younger than 1 year, back blows and chest thrusts are administered. An important nursing consideration when caring for a 10-month-old infant with respiratory syncytial virus (RSV)/bronchiolitis would be which of the following? a. Place in a mist tent. b. Administer antibiotics. c. Administer cough syrup. d. Encourage to drink 8 ounces of formula every 4 hours. - d. Encourage to drink 8 ounces of formula every 4 hours. Rationale:Hydration is very important in children with RSV bronchiolitis to loosen secretions and prevent shock. An infant has developed staphylococcal pneumonia. Nursing care of the child with pneumonia includes which of the following? (Select all that apply.) a. Cluster care to conserve energy b. Round-the-clock administration of antitussive agents c. Strict intake and output to avoid congestive heart failure d. Administration of antibiotics - a. Cluster care to conserve energy d. Administration of antibiotics Rationale: Antibiotics are indicated for a bacterial pneumonia. Often the child will have decreased pulmonary reserve, and the clustering of care is essential. The nurse is caring for a 10-month-old infant with respiratory syncytial virus (RSV) bronchiolitis. Which of the following interventions should be included in the child's care? (Select all that apply.) a. Place in a mist tent. b. Administer antibiotics. c. Administer cough syrup. d. Encourage to drink 8 ounces of formula every 4 hours. e. Cluster care to encourage adequate rest. f. Place on noninvasive oxygen monitoring. - d. Encourage to drink 8 ounces of formula every 4 hours. e. Cluster care to encourage adequate rest. f. Place on noninvasive oxygen monitoring. Rationale: Hydration is important in children with RSV bronchiolitis to loosen secretions and prevent shock. Clustering of care promotes periods of rest. The use of noninvasive oxygen monitoring is recommended The nurse is caring for a 5-year-old child who is scheduled for a

ANSWERS 2022/2023 UPDATE GRADED A+

tonsillectomy in 2 hours. Which of the following actions should the nurse include in the child's postoperative care plan? (Select all that apply.) a. Notify the surgeon if the child swallows frequently. b. Apply a heat collar to the child for pain relief. c. Place the child on the abdomen until fully wake. d. Allow the child to have diluted juice after the procedure.

ANSWERS 2022/2023 UPDATE GRADED A+

e. Encourage the child to cough frequently. - a. Notify the surgeon if the child swallows frequently. c. Place the child on the abdomen until fully wake. d. Allow the child to have diluted juice after the procedure. Rationale: Frequent swallowing is a sign of bleeding in children after a tonsillectomy. The child should be placed on the abdomen or the side to facilitate drainage. The child can drink diluted juice, cool water, or popsicles after the procedure. The nurse enters a room and finds a 6-year-old child who is unconscious. After calling for help and before being able to use an automatic external defibrillator, what steps should the nurse take? Place in correct order. a. Place on a hard surface. b. Administer 30 chest compressions with two breaths. c. Feel carotid pulse while maintaining head tilt with the other hand. d. Use the head tilt-chin lift maneuver and check for breathing. e. Place heel of one hand on lower half of sternum with other hand on top. f. Give two rescue breaths. - a. Place on a hard surface. d. Use the head tilt-chin lift maneuver and check for breathing. f. Give two rescue breaths. c. Feel carotid pulse while maintaining head tilt with the other hand. e. Place heel of one hand on lower half of sternum with other hand on top. b. Administer 30 chest compressions with two breaths. Which of the following terms is used to describe a child's level of consciousness when the child is arousable with stimulation? a. Stupor b. Confusion c. Obtundation d. Disorientation - c. Obtundation Rationale: Obtundation describes a level of consciousness in which the child is arousable with stimulation. Which of the following terms is used when a patient remains in a deep sleep, responsive only to vigorous and repeated stimulation? a. Coma b. Stupor c. Obtundation d. Persistent vegetative state - b. Stupor Rationale: Stupor exists when the child remains in a deep sleep, responsive only to vigorous and repeated stimulation.

ANSWERS 2022/2023 UPDATE GRADED A+

The Glasgow Coma Scale consists of an assessment of: a. pupil reactivity and motor response. b. eye opening and verbal and motor responses. c. level of consciousness and verbal response. d. ICP and level of consciousness. - b. eye opening and verbal and motor responses.

ANSWERS 2022/2023 UPDATE GRADED A+

Rationale: The Glasgow Coma Scale assesses eye opening and verbal and motor responses. The nurse is closely monitoring a child who is unconscious after a fall and notices that the child suddenly has a fixed and dilated pupil. The nurse should interpret this as which of the following? a. Eye trauma b. Neurosurgical emergency c. Severe brainstem damage d. Indication of brain death - b. Neurosurgical emergency Rationale: The sudden appearance of a fixed and dilated pupil(s) is a neurosurgical emergency. The nurse should immediately report this finding. The nurse is caring for a child with severe head trauma after a car accident. Which of the following is an ominous sign that often precedes death? a. Papilledema b. Delirium c. Doll's head maneuver d. Periodic and irregular breathing - d. Periodic and irregular breathing Rationale: Periodic or irregular breathing is an ominous sign of brainstem (especially medullary) dysfunction that often precedes complete apnea. Which of the following tests is never performed on an awake child? a. Oculovestibular response b. Doll's head maneuver c. Funduscopic examination for papilledema d. Assessment of pyramidal tract lesions - a. Oculovestibular response Rationale: The oculovestibular response (caloric test) involves the instillation of ice water into the ear of a comatose child. The caloric test is painful and is never performed on an awake child or one who has a ruptured tympanic membrane. The nurse is preparing a school-age child for computed tomography (CT scan) to assess cerebral function. The nurse should include which of the following statements in preparing the child? a. "Pain medication will be given." b. "The scan will not hurt." c. "You will be able to move once the equipment is in place." d. "Unfortunately no one can remain in the room with you during the test."

  • b. "The scan will not hurt." Rationale: For CT scans, the child must be immobilized. It is important to emphasize to the child that at no time is the procedure painful. Which of the following neurologic diagnostic tests gives a visualized

ANSWERS 2022/2023 UPDATE GRADED A+

horizontal and vertical cross section of the brain at any axis? a. Nuclear brain scan b. Echoencephalography

ANSWERS 2022/2023 UPDATE GRADED A+

c. CT scan d. Magnetic resonance imaging (MRI) - c. CT scan Rationale: A CT scan provides a visualization of the horizontal and vertical cross sections of the brain at any axis. Which of the following is the priority nursing intervention when a child is unconscious after a fall? a. Establish adequate airway. b. Perform neurologic assessment. c. Monitor intracranial pressure. d. Determine whether a neck injury is present. - a. Establish adequate airway. Rationale: Respiratory effectiveness is the primary concern in the care of the unconscious child. Establishment of an adequate airway is always the first priority. Which of the following drugs would be used to treat a child who has increased ICP resulting from cerebral edema? a. Mannitol b. Epinephrine hydrochloride c. Atropine sulfate d. Sodium bicarbonate - a. Mannitol Rationale: For increased ICP, mannitol, an osmotic diuretic, administered intravenously, is the drug used most frequently for rapid reduction. An appropriate nursing intervention when caring for an unconscious child would be which of the following? a. Change the child's position infrequently to minimize the chance of increased ICP. b. Avoid using narcotics or sedatives to provide comfort and pain relief. c. Monitor fluid intake and output carefully to avoid fluid overload and cerebral edema. d. Give tepid sponge baths to reduce fever, since antipyretics are contraindicated. - c. Monitor fluid intake and output carefully to avoid fluid overload and cerebral edema. Rationale: Often comatose patients cannot cope with the quantity of fluids that they normally tolerate. Overhydration must be avoided to prevent fatal cerebral edema. Which of the following is descriptive of a concussion? a. Petechial hemorrhages cause amnesia. b. Visible bruising and tearing of cerebral tissue occur. c. It is a transient and reversible neuronal dysfunction. d. A slight lesion develops remote from the site of trauma. - c. It is a transient and reversible neuronal dysfunction.

ANSWERS 2022/2023 UPDATE GRADED A+

Rationale: A concussion is a transient, reversible neuronal dysfunction with instantaneous loss of awareness and responsiveness resulting from trauma to the head. Which of the following types of fractures describes traumatic separation of cranial sutures? a. Basilar b. Compound

ANSWERS 2022/2023 UPDATE GRADED A+

c. Diastatic d. Depressed - c. Diastatic Rationale: Diastatic skull fractures are traumatic separations of the cranial sutures. Which of the following statements best describes a subdural hematoma? a. Bleeding occurs between the dura and the skull. b. Bleeding occurs between the dura and the cerebrum. c. Bleeding is generally arterial, and brain compression occurs rapidly. d. The hematoma commonly occurs in the parietotemporal region. - b. Bleeding occurs between the dura and the cerebrum Rationale: A subdural hematoma is bleeding that occurs between the dura and the cerebrum as a result of a rupture of cortical veins that bridge the subdural space. The nurse should recommend medical attention if a child with a slight head injury experiences which of the following? a. Sleepiness b. Vomiting, even once c. Headache, even if slight d. Confusion or abnormal behavior - d. Confusion or abnormal behavior Rationale: Medical attention should be sought if the child exhibits confusion or abnormal behavior, loses consciousness, has amnesia, has fluid leaking from the nose or ears, complains of blurred vision, or has an unsteady gait. A 10-year-old boy on a bicycle has been hit by a car in front of the school. The school nurse immediately assesses airway, breathing, and circulation. The next nursing action should be which of the following? a. Place on side. b. Take blood pressure. c. Stabilize neck and spine. d. Check scalp and back for bleeding. - c. Stabilize neck and spine. Rationale: After determining that the child is breathing and has adequate circulation, the next action is to stabilize the neck and spine to prevent any additional trauma. An adolescent boy is brought to the emergency department after a motorcycle accident. His respirations are deep, periodic, and gasping. There are extreme fluctuations in blood pressure. Pupils are dilated and fixed. The nurse should suspect what type of head injury? a. Brainstem b. Skull fracture c. Subdural hemorrhage d. Epidural hemorrhage - a. Brainstem Rationale: Signs of brainstem injury include deep, rapid, periodic or intermittent, and gasping respirations. Wide fluctuations or noticeable

ANSWERS 2022/2023 UPDATE GRADED A+

slowing of the pulse, widening pulse pressure, or extreme fluctuations in blood pressure are consistent with a brainstem injury.

ANSWERS 2022/2023 UPDATE GRADED A+

A child is unconscious after a motor vehicle accident. The watery discharge from the nose tests positive for glucose. The nurse should recognize that this suggests: a. diabetic coma. b. brainstem injury. c. upper respiratory tract infection. d. leaking of cerebrospinal fluid (CSF). - d. leaking of cerebrospinal fluid (CSF). Rationale: Watery discharge from the nose that is positive for glucose suggests leaking of CSF from a skull fracture. A toddler fell out of a second-story window. She had brief loss of consciousness and vomited four times. Since admission, she has been alert and oriented. Her mother asks why a CT scan is required when she "seems fine." The nurse should explain that she: a. may have a brain injury. b. needs this because of her age. c. may start having seizures. d. probably has a skull fracture. - a. may have a brain injury. Rationale: The child's history of the fall, brief loss of consciousness, and vomiting four times necessitates evaluation of a potential brain injury. The severity of a head injury may not be apparent on clinical examination but will be detectable on a CT scan. The nurse is assessing a child who was just admitted to the hospital for observation after a head injury. Which of the following is the most essential part of the nursing assessment to detect early signs of a worsening condition? a. Posturing b. Vital signs c. Focal neurologic signs d. Level of consciousness - d. Level of consciousness Rationale: The most important nursing observation is assessment of the child's level of consciousness. Alterations in consciousness appear earlier in the progression of an injury than do alterations of vital signs or focal neurologic signs. A school-age child has sustained a head injury and multiple fractures after being thrown from a horse. The child's level of consciousness is variable. The parents tell the nurse that they think their child is in pain because of periodic crying and restlessness. The most appropriate nursing action is which of the following? a. Discuss with parents the child's previous experiences with pain. b. Discuss with practitioner what analgesia can be safely

ANSWERS 2022/2023 UPDATE GRADED A+

administered. c. Explain that analgesia is contraindicated with a head injury. d. Explain that analgesia is unnecessary when child is not fully awake and alert. - b. Discuss with practitioner what analgesia can be safely administered. Rationale: A key nursing role is to provide sedation and analgesia for the child. Consultation with the appropriate practitioner is necessary to avoid conflict between the necessity to monitor the child's neurologic status and the promotion of comfort and relief of anxiety.

ANSWERS 2022/2023 UPDATE GRADED A+

A 5-year-old girl sustained a concussion when she fell out of a tree. In preparation for discharge, the nurse is discussing home care with her mother. Which of the following statements made by the mother indicates a correct understanding of the teaching? a. "I should expect my child to have a few episodes of vomiting." b. "If I notice sleep disturbances, I should contact the physician immediately." c. "I should expect my child to have some behavioral changes after the accident." d. "If I notice diplopia, I will have my child rest for 1 hour." - c. "I should expect my child to have some behavioral changes after the accident." Rationale: The parents are advised of probable posttraumatic symptoms that may be expected. These include behavioral changes and sleep disturbances. A 3-year-old child is hospitalized after a near-drowning accident. The child's mother complains to the nurse, "This seems unnecessary when he is perfectly fine." The nurse's best reply would be which of the following? a. "He still needs a little extra oxygen." b. "I'm sure he is fine, but the doctor wants to make sure." c. "The reason for this is that complications could still occur." d. "It is important to observe for possible central nervous system problems." - c. "The reason for this is that complications could still occur." Rationale: All children who have a near-drowning experience should be admitted to the hospital for observation. Although many children do not appear to have suffered adverse effects from the event, complications such as respiratory compromise and cerebral edema may occur 24 hours after the incident. The most common clinical manifestation(s) of brain tumors in children is which of the following? a. Irritability b. Seizures c. Headaches and vomiting d. Fever and poor fine motor control - c. Headaches and vomiting Rationale: Headaches, especially on awakening, and vomiting that is not related to feeding are the most common clinical manifestation(s) of brain tumors in children. Five-year-old José is being prepared for surgery to remove a brain tumor. Nursing actions should be based on which of the following? a. Removal of tumor will stop the various symptoms. b. Usually the postoperative dressing covers the entire scalp. c. He is not old enough to be concerned about his head being shaved. d. He is not old enough to understand the significance of the brain. - b. Usually the postoperative dressing covers the entire scalp