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NUR 254 EXAM 4 FULL PROGRAM & SYSTEM
RECAP MASTER DOMAIN / LATEST 2026
◍ The nurse is providing a teaching session to the health care staff regarding osteosarcoma. Which of the following statements by an attendee indicates a need for additional teaching? Answer: "In the early stage, the symptoms of this disease are usually attributed to normal growing pains.
◍ The nurse is caring for a child who is suspected of having a Wilm's tumor. Which of the following actions by the nurse indicates the need for additional training? Answer: Palpating the child's abdomen
◍ The nurse is caring for a 5-year-old child who has sickle cell disease (SCD). 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? Answer: Administer naloxone to reverse the effect of the morphine.
◍ The nurse is admitting a child who has a vaso-occlusive sickle cell crisis. Which of the following interventions should the nurse anticipate to be prescribed for the child? Answer: Hydration and pain management
◍ The nurse working in the emergency department (ED) is caring for a child who has hemophilia and developed a swollen knee after falling off a bicycle. The nurse is teaching the child's parents about care when similar incidents occur at home in the future. Which of the following actions should the nurse teach the parents? Answer: Apply an ice pack and compression dressings to the knee.
◍ The newly hired nurse is talking with the nurse preceptor about the prevention of irondeficiency anemia in infants. Which of the following statements by the newly hired nurse is correct regarding prevention of this condition? Answer: "Iron-fortified commercial formula should be given for the first 6 months of life
◍ The nurse is assessing a child who has severe iron deficiency anemia. Which of the following assessment finds should the nurse expect to observe? Answer: Pallor
◍ The nurse is caring for 4-year-old child who is 36 hours postoperative following a removal of a Wilm'stumor. Which of the following requires immediate follow up by the nurse? Answer: Incision site is pink at the edges.
◍ The nurse is providing discharge instructions to the parents of a child who had surgical resection of a neuroblastoma 4 days ago. Which of the following statements by the parents indicates teaching has been effective? Answer: We will provide pain relief using pain medication and rest."
◍ The nurse preceptor is observing a newly hired nurse care for a child who has Down syndrome. Which of the following manifestations, if documented by the newly hired nurse, requires follow up by the nurse preceptor? Answer: Protruding tongue
◍ The nurse is caring for a child who had a ventricular shunt placement 24 hours ago. The child is sitting up in bed crying and has vomited a small amount on the bed linens. Which of the following actions should the nurse take first? Answer: Complete a neurological assessment.
◍ The nurse working in the emergency department (ED) is caring for a 2-month-old child who presents with intraocular bleeding, bradycardia, and bulging fontanels, but no trauma to the head, face, or neck. Health history and physical examination is incongruent, and abuse is suspected. Which of the following actions should the nurse perform? Answer: Notify child protective services (CPS)
◍ The nurse is caring for a child who is hospitalized for 24-hour observation following a head injury. Which of the following actions by the nurse is the priority? Answer: Checking pupil reaction every 4 hours
◍ The nurse is assessing a child in a coma and notes that the child has decorticate posturing. Which of the following findings should the nurse expect the child to demonstrate? Answer: Rigid flexion with elbows, wrists and fingers flexed, and legs extended and rotated inward
◍ The nurse is admitting a toddler who is being hospitalized following a near-drowning accident/submersion injury. The child's motherstates to the nurse, "Thisis unnecessary. My child seems perfectly fine." What is an appropriate response for the nurse to provide to the mother? Answer: "Complications can still occur with your child."
◍ The nurse is caring for an infant who is having an active seizure. Which of the following actions should the nurse perform when caring for the infant during a seizure? Answer: Remove any items out of the crib that can harm the infant
◍ The nurse is caring for an infant with a myelomeningocele sac. Which of the following interventions demonstrates appropriate care for the infant? Answer: Use latex-free medical products
◍ The school nurse is instructing a school-age child who has diabetes mellitus (type 1). The child participates in soccer practice 3 afternoons a week. Which of the following statements by the child indicates a correct understanding of how to prevent hypoglycemia during practice? Answer: "I will eat a small box of raisins or a cup of juice before soccer practice."
◍ The nurse is preparing discharge instructionsfor a child who has precocious puberty. Which of the following should the nurse include in the teaching? Answer: Explain the importance for the child to have peers of the same age
◍ The school nurse is teaching parents about pediculosis capitis. Which of the following should the nurse include in the teaching plan? Answer:. Children should be instructed to refrain from sharing headbands with others.
◍ A nurse is admitting an infant diagnosed with phenylketonuria (PKU). Which of the following should the nurse consider when planning care for this infant? Answer: roviding teaching about a low- phenylalanine diet.
◍ The nurse is caring for a 5-year-old child who has been bitten on the leg by a dog. After cleansing the area with soap and water, which of the following actions should the nurse take next? Answer: Report the bite to the local health department.
◍ The nurse is teaching the parent of a toddler about insect bites. Which of the following statements by the parents indicates an understanding of the teaching? "If my child ever gets stung by a bee, I will Answer: Remove the stinger immediately
◍. The nurse is caring for the following assigned clients. Which client should the nurse follow up with first? Answer: The client who is in skeletal traction and has warmth, redness, and pain in the affected leg.
◍ A nurse is caring for a child who has a new cast and is at risk for compartment syndrome. Which of the following manifestations should the nurse monitor with this child? Answer: Paresthesia
◍ The nurse is caring for an infant who is undergoing serial casting for the correction of clubfoot and has had the initial cast applies. Which of the following actions should the nurse teach the parents? Answer: Perform neurovascular checks every 2 hours
◍ The nurse is caring for a child who is diagnosed with severe scoliosis. Which of the following prescriptions should the nurse expect to be ordered? Answer: A referral to an orthopedic surgeon for surgery
◍ The nurse manager is providing an in-service to nursing staff about juvenile idiopathic arthritis (JIA). Which of the following statements by a staff member indicates a need for additional teaching Answer: "JIA tends to disappear after age 15."
◍ The nurse is giving discharge instructions to the parents of an infant in a Pavlik harness. Which of the following statements by a parent indicates the need for further instructions? Answer: "I will loosen the straps when bathing my infant so all areas of the skin can be cleansed
◍ The nurse is teaching parents of a 2-year-old child who has a hip Spica cast about care management when discharged home. Which of the following statements by the parents indicates a need for further teaching? Answer: "Our child can stand in the cast while we support them."
