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NSG-3600 EXAM 4 (GALEN) NEWEST 2025 ACTUAL
EXAM TEST BANK| PEDIATRIC NURSING EXAM 4
REVIEW WITH COMPLETE 4 50 REAL EXAM
QUESTIONS AND CORRECT VRIFIED ANSWERS/
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The nurse preceptor is discussing causes of contact dermatitis with a student nurse. Which of the following causes listed by the student nurse requires further teaching by the nurse preceptor? a. Scented diaper wipes. b. Poison ivy. c. Laundry detergent. d. Pollen – Correct Answer - d. Pollen The nurse is preparing to teach a parent about how to care for a child who has impetigo contagiosa. Which of the following should the nurse include in the teaching plan? a. Apply bactericidal ointment to lesions. b. Give the child an antimicrobial bath twice a day. c. The lesions will need to be covered at all times. d. Administer salicylates for any pain – Correct Answer - a. Apply bactericidal ointment to lesions. Impetigo Contagiosa is a BACTERIAL infection usually around the nose and mouth, but can appear anywhere.
Bacterial infection = antibiotics (abx) = bactericidal. Med education: Remove honey crust before applying cream to lesion (get the honey crust off the lesion before applying abx). The nurse is providing an educational class to staff regarding burns. Which of the following should the nurse use for an adolescent client with burns? a. FACES. b. Braden scale. c. Rule of nines. d. Glasgow coma scale (GCS). – Correct Answer - c. Rule of nines. Rule of Nines (London Bridge Burn/ Lund and Browder Chart) is used to determine the percentage of the body or body part(s) that is covered with burns The nurse is caring for an 8-year-old child who has cat scratch disease. Which of the following findings should the nurse expect to assess with this child? a. Papule at site of bite and malaise. b. Weeping vesicles and fever. c. Wheal with necrotic center and papules. d. Generalized urticaria and pruritis. – Correct Answer - a. Papule at site of bite and malaise. Cat Scratch Disease s/s include:
b. Sharing hairbrushes. c. Ringworm. d. Fungal infection. – Correct Answer - d. Fungal infection. Cutaneous Candidiasis is a fungal infection (candida albicans). Triggered by antibiotics, Occurs in infants (diaper rashes, thrush) and children who use corticosteroid inhalers. The nurse is caring for a child that had an escharotomy to the right anterior thigh. Which of the following assessment findings indicates a therapeutic response to the procedure? a. Decreased pain in the right leg. b. Decreased red blood cell (RBC) count. c. Absence of infection. d. Capillary refill of < 3 seconds on the right big toe. – Correct Answer - d. Capillary refill of < 3 seconds on the right big toe. If the capillary refill time is impaired or the injury is circumferential (perimeter of the wound), an escharotomy ( a surgical incision through the necrotic skin) is performed within the 1st 24-48 hours. The nurse is performing a skin assessment on a child and notes pallor. Which of the following additional actions should the nurse take? a. Determine if the child has had a fever. b. Raise the head of the bed (HOB). c. Check the child's hemoglobin (Hgb) level.
d. Ask the parent about recent bowel movements. – Correct Answer - c. Check the child's hemoglobin (Hgb) level. Pallor can be caused by associated anemia which correlates with low hemoglobin. Example: Iron Defficiency Anemia is caused by decreased iron supply, impairs it's absorption, increases the body's need for iron, or AFFECTS THE SYNTHESIS OF HEMOGLOBIN. The nurse is caring for a 5-year-old child who has sickle cell disease. An assessment of the child includes the following: respirations 10 and unarousable. The child is currently on intravenous (IV) fluids and continuous IV morphine sulfate. Based on the assessment information, which of the following actions should the nurse take first? a. Administer naloxone to reverse the effect of the morphine. b. Obtain a set of vital signs (VS). c. Perform a sternal rub on the client. d. Increase the IV fluids to decrease vaso-occlusion. – Correct Answer - a. Administer naloxone to reverse the effect of the morphine. when giving morphine sulfate (Astramorph), be sure to have the opioid antagonist nalaxone (Narcan) available IF RESPIRATORY DEPRESSION OCCURS. Narcan completely blocks the effects of opioids including central nervous system effects and respiratory depression. The nurse preceptor is observing a newly hired nurse care for a child who has Down syndrome. Which of the following manifestations
The nurse is teaching the parent of a toddler about animal bite prevention. Which of the following statements by the parent indicates a correct understanding of the teaching? a. "I should teach my child to run away if an animal attacks them." b. "I will keep our child away from our pet when it is eating." c. "I will teach our child to gently wake our pet if it is sleeping." d. "I trust my child around our pet if I'm not present." – Correct Answer - b. "I will keep our child away from our pet when it is eating." Animals/pets may feel threatened or possessive over their food which can increase the risk of aggression towars the individual interfering with their mealtime. The nurse working in the emergency department (ED) is caring for a 10- year-old child who has minor burns to the lower legs. Which of the following interventions should the nurse perform on the client? a. Cover the moist wound with non-adherent gauze to absorb drainage. b. Check if the child has had a rubeola booster in the last year. c. Administer aspirin prior to providing care. d. Apply ice wrapped in gauze to the burn sites to cool the burn. a. Cover the moist wound with non-adherent gauze to absorb drainage.
Cover to prevent infection, moist non-adherent gauze because you don't want anything sticking to the burn that you would have to painfully peel off. The nurse is caring for assigned pediatric clients. Which of the following children should the nurse see first? a. 10-year-old who has acute lymphocytic leukemia (ALL) and has a morning hemoglobin (Hgb) level of 7.5 g/dL. b. 12-year-old who weighs 40 kg, has a superficial burn, and has an hourly urine output of 30 mL/hr. c. 5-year-old who has a blood glucose level of 120 mg/dL and reports feeling hungry and thirsty. d. 8-year-old who had three diarrheal episodes following a chemotherapy treatment 12 hours ago a. 10-year-old who has acute lymphocytic leukemia (ALL) and has a morning hemoglobin (Hgb) level of 7.5 g/dL. Pediatric Hemoglobin Levels: 1 - 6 years old: 9.5 - 14 6 - 18 years old: 10 - 15.
inflammation with papules, pustules, or nodules. Avoid popping or scrubbing because it can cause scarring. Clean GENTLY with water soluble cleansers. The nurse working in a clinic is caring for a child who has been diagnosed with tinea corporis. Which of the following actions by the nurse is a priority? a. Reinforcing that the affected area of hair growth may not grow back. b. Making a follow-up appointment to monitor response to treatment. c. Explaining that if the family has any pets that they will need to be seen by the veterinarian. d. Ensure fomites are not shared with other members of the family. d. Ensure fomites are not shared with other members of the family. Pages 766 Formities are anything you can share that will spread a disease from one person to another. Example: towels, combs, hats, helmets, etc.
The nurse is teaching a parent about caring for their child who has eczema. Which of the following statements by the parent indicates a need for further teaching? a. "Bathwater should be hot in temperature." b. "I should dress my child in light soft clothing." c. "Medications can be used to help relieve any itching." d. "Emollient lotions should be applied to the skin." a. "Bathwater should be hot in temperature." Eczema (Atopic Dermatitis) Education: Warm bath without harsh soaps. Dress in light, soft, non-irritating clothing (avoid rough fabics/wear cotton, use unscented detergent). Apply emollient lotions (to hold in moisture). The nurse working in the emergency department (ED) is caring for a child who was involved in a house fire. The child has singed eyebrows and sounds hoarse. After applying oxygen to the child, which of the following actions is a priority? a. Cleanse the burned areas of the skin.
Topical antibiotics. Clean non-adherent dressing (to not stick to the scab) Tetanus booster (if haven't had one in 5 years). Report bite to health department (last thing we do). The nurse is discussing with a mother about the need to keep her infant warm. The mother asks why this is so important. Which of the following is a correct response by the nurse? a. "Infants' total body surface is very small compared to adults and causes them to lose heat rapidly." b. "The infant's immune system is immature and is unable to regulate their body temperature." c. "The skin of an infant is thin, and they have little fat making it hard for them to hold in heat." d. "The sweat glands of an infant are not fully functional and are unable to assist in temperature control." c. "The skin of an infant is thin, and they have little fat making it hard for them to hold in heat." Page 752 Refers to thermoregulation
The nurse is talking with a female adolescent about their acne and how they care for it at home. Which of the following questions is best for the nurse to ask? a. "What cleansing products do you currently use at home?" b. "Did you start getting acne when you were young?" c. "What concerns or feelings do you have about having acne?" d. "Have you ever been made fun of for having acne?" a. "What cleansing products do you currently use at home?" Pulled directly from the box on page 758 titled "What to Say". "When did your acne begin?" "What types of cleansing products, makeup, or moisturizers and hair care products are you currently using?" "What medications are you taking, including over-the-counter and natural products?" "Have you noticed certain foods, activities, or environmental factors that may affect your acne?" "Do you notice a change in your acnce related to your menses?" "What other dermatological problems have you had recently or in the past?"
a. "Children typically experience pain at the primary tumor site." b. "A common clinical manifestation is limping if a weight-bearing limb is affected." c. "In the early stage, the symptoms of this disease are usually attributed to normal growing pains." d. "The sternum is the most common site of this sarcoma." d. "The sternum is the most common site of this sarcoma." All the other answers are considered correct teachings. Page 882 The nurse is caring for a 4-year-old child who is 36 hours postoperative following removal of a Wilm's tumor. Which of the following requires immediate follow-up by the nurse? a. White blood cell (WBC) count of 10.0 mm³. b. Bowel sounds present in all 4 quadrants. c. Temperature of 100.4° F that occurs 1 time in a 24-hour period. d. Incision site is red with edema at the edges. d. Incision site is red with edema at the edges. REEDA
Redness, Echymosis, Edema, Drainage, Amount/Approximated REEDA are s/s of infection The nurse is assessing a child who has severe iron deficiency anemia. Which of the following assessment findings should the nurse expect to observe? a. Visual disturbances. b. Conjunctival pallor. c. Painful joints. d. An enlarged abdomen b. Conjunctival pallor. Iron Deficiency Anemia s/s include: Pale skin/Conjunctival pallor. Fatigue. Pale mucous membranes. Pica --> eat anything (dirt). Delayed motor development. Tachycardia. SOB.
Decreased appetite/thirst/oral intake. Slurred speech/loss of awareness/consciousness. Confusion/delirium/disorientation. Loss of sensation/pain/thermoregulation/pale in color. Loss of bowel/bladder function. Altered respirations, Cheyne-Stokes respirations,noisy respirations (fluid). Restlessness, agitation. Seizures The nurse is admitting a child who has vaso-occlusive sickle cell crisis. Which of the following interventions should the nurse anticipate being prescribed for the child? a. Correction of alkalosis and reduction of energy expenditure. b. Hydration and pain management. c. Electrolyte replacement and administration of heparin. d. Globulins and factor VIII replacement. b. Hydration and pain management. HOP to it! Page 829 under "Medical Care".
Hydration Oxygen Pain management Ischemia is causing mild to severe pain. Stasis of blood with clumping of cell in microcirculation>distal ischemia.infarction Signs: fever, pain, tissue engorgement. The nurse is caring for a child suspected of having acute lymphocytic leukemia (ALL). The parent reports the following concerns: reluctance to walk, tired all the time, and pale. Which of the following additional questions should the nurse ask? a. "Does the child have difficulty staying asleep at night?" b. "Has there been an increase in the child's urine?" c. "Have you noticed any small red dots on your child?" d. "Have you noticed an increase in thirst?" c. "Have you noticed any small red dots on your child?" Page 875 ALL s/s include:
