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An otherwise healthy 18-month-old child with a history of febrile seizures is in the well-child clinic. Which statement by the father would indicate to the nurse that additional teaching should be done? A. "I have ibuprofen available in case it's needed." B. "My child will likely outgrow these seizures by age 5." C. "I always keep phenobarbital with me in case of a fever." D. "The most likely time for a seizure is when the fever is rising." - Answer C A 6-month-old infant is admitted with a diagnosis of bacterial meningitis. The nurse would place the infant in which room? A. A room with a 12-month-old infant with a urinary tract infection B. A room with an 8-month-old infant with failure to thrive C. A private room near the nurses' station D. A two-bed room in the middle of the hall - Answer C The parents of a child with a history of seizures who has been taking phenytoin (Dilantin) ask the nurse why it's difficult to maintain therapeutic plasma levels of this medication. Which statement by the nurse would be most accurate? A. "A drop in the plasma drug level will lead to a toxic state."
B. "The capacity to metabolize the drug becomes overwhelmed over time." C. "Small increments in dosage lead to sharp increases in plasma drug levels." D. "Large increments in dosage lead to a more rapid stabilizing therapeutic effect." - Answer C A panicked mother calls the health care provider's office and reports that her 5- year-old has a high fever and just had a seizure. The mother asks the nurse what she should do. Which is the nurse's best response? A. Report to the emergency room for medical evaluation B. Immerse the child in a bathtub of tepid water C. Administer oral acetaminophen per package directions D. Remove any heavy clothing and cover with a thin sheet - Answer A The nurse is assessing a 7-year-old with a hearing aid. His mother says he is losing his hearing again. Which finding would the nurse identify as contributing to this current complaint? A. Overproduction of cerumen B. Soreness of the outer ear C. History of a normal term birth D. The eardrum responds to a puff of air - Answer A
B. Support the parents in starting a ketogenic diet C. Pad the side rails on the bed D. Teach her to do deep breathing techniques - Answer A A nurse is caring for a 3-year-old girl with microcephaly. Which of the following actions is appropriate for the nurse to take? A. Playfully ask the child to touch her nose B. Teach the parents about ventriculoperitoneal (VP) shunts C. Prepare the child for the experience of cranial surgery D. Administer antipyretics as ordered - Answer A The nurse caring for a neonate experiencing seizures asks the charge nurse: "How can I tell if a baby is having a seizure or is just crying for attention?" Which response would be most appropriate? Select all that apply. A. "You will not be able to stop a seizure with gentle restraint." B. "The baby experiencing a seizure will be tachycardic." C. "Stimulating the baby by singing to him will not stop a seizure." D. "There will be no changes in the baby's vital signs with a seizure" E. "The baby will become more active with sensory stimulation with a seizure." - Answer A, B, C
An 18-month-old child is admitted with signs of increased intracranial pressure. What should the nurse observe when assessing this patient? A. Numbness of fingers and decreased temperature B. Increased pulse rate and decreased blood pressure C. Increased temperature and decreased respiratory rate D. Decreased level of consciousness and increased respiratory rate - Answer C An 8-year-old child is being treated for tonic-clonic seizures. What should the nurse emphasize when teaching the parents about this disorder? A. The child should maintain an active lifestyle. B. Immediately provide medication if a seizure begins. C. Have the child carry a padded tongue blade with her at all times. D. Ensure quiet time late in the day, when seizure activity is most likely to occur. - Answer A The nurse instructs a hearing-impaired school-age child on to how self-inject a prescribed medication. Which observation indicates to the nurse that additional teaching is required? A. The child pinches the skin together before inserting the needle. B. The child injects the appropriate amount of air into the vial before withdrawing medication.
The nurse is educating parents of a male infant with Chiari type II malformation about the condition. Which of the following would be most important for the nurse to include? A. Taking time to feed the infant B. Laying the infant down after a feeding C. Being able to see major difference after surgery D. Not needing to change diapers as often - Answer A A nurse is obtaining the history from a parent of a child who experiences absence seizures. Which of the following would the nurse expect the mother to describe? A. Brief, sudden onset with muscles that become tense B. Loss of motor activity accompanied by a blank stare C. Sudden, brief jerking motions of a muscle group D. Loss of muscle tone and loss of consciousness - Answer B ABSENCE= BLANK STARE The school nurse is educating the parents of a child with infectious conjunctivitis. Which of the following statements by the nurse would be most helpful for the parents related to prevention? A. "Use all the medication as directed."
B. "Don't use anything that touches her face." C. "This could have started with a head cold." D. "Place the ointment inside the lower eyelid." - Answer B A 7-month-old is scheduled for surgical correction of strabismus. The child's mother says to the nurse, "I'm glad my child will never have to wear that patch again." Which of these responses would be most appropriate for the nurse to make? A. "Your child will never need to wear the patch again." B. "Your child will need to wear the patch for a few days to keep him/her from rubbing or putting pressure on the eye." C. "Your child will need to wear the patch for several months to keep the eye in alignment." D. "Your child will have to be in restraints for a week to keep him/her from rubbing the eye." - Answer B A 4-month-old infant is seen at the ambulatory care clinic and diagnosed with nasolacrimal duct obstruction. The mother asks what can be done. What information should be included in the information provided to the parent? A. Once the child is 6 to 9 months old a specialist will be able to drain the duct. B. Most of these conditions will spontaneously resolve. C. Antiviral therapy can be prescribed to manage this condition.
practitioner. This mother has been extremely resistant to medication and insists that the medication is not working. How should the nurse respond? A. "Tell me what makes you think the medication is not working" B. "Do you want to try a different medication?" C. "Are you sure you are administering it properly" D. "Do you want to increase the dosage?" - Answer A A nurse is assessing a 5-year-old boy and suspects that the child may have an autism spectrum disorder. Which assessments would help support the nurse's suspicions? Select all that apply. A. Inability to make eye contact B. Hypersensitivity to touch C. Lack of facial expression D. Distinct interest in others around him E. Easily distracted from playing - Answer B, C An extremely thin preadolescent is being assessed by the nurse. Which client statement should the nurse identify as being consistent with that of a person with anorexia nervosa? A. "I'd like to grow up to be a model."
B. "I'd like to gain weight but just can't." C. "I feel chubby no matter what I wear." D. "I'm afraid that someone is poisoning my food." - Answer C A child with attention deficit hyperactivity disorder (ADHD) is prescribed methylphenidate hydrochloride. What should the nurse instruct the parents regarding an adverse effect of this medication? A. Anorexia B. Sleepiness C. Garbled speech D. Rapid increase in height - Answer A For which child's behavior should the nurse identify as being characteristic of separation anxiety disorder? A. An 8-month-old who cries when left with strangers B. A 7-year-old who withdraws from contact with all strangers C. An 8-year-old who will not stay overnight at a friend's house D. A 10-year-old who reports headaches if there is to be a test in school - Answer C
A. Child reports abdominal pain. B. Child has a change in school performance. C. Child demonstrates anxiety or trouble sleeping. D. Child does not want to be left alone with a certain adult. E. Child spends a great deal of time with peer-group friends. - Answer A, B, C, D The nurse is reviewing the medical record of a child with a mental health disorder and finds that the child is receiving cognitive behavioral therapy. How does the nurse interprets this information? A. Process that requires the individual to view a situation from a different perspective B. Interventions that address family dynamics and family coping C. Individual exploration of the person's conflicts and stressors D. Use of play to explore problems, issues, and conflicts - Answer A A nurse is assessing a child for possible obsessive-compulsive disorder. Which question would be most helpful for obtaining information from the child? A. "Are you having any recurring dreams about the trauma you experienced?" B. "Has anything happened at home recently that has upset you?" C. "Is there anything that you do over and over again and can't resist doing?"
D. "Do you have times when you wake up during the night without any reason?" - Answer C A nurse is teaching the parents of a child diagnosed with attention deficit/hyperactivity disorder about the condition. The nurse determines that the teaching was successful when the parents make which statements? Select all that apply. A. "We need to set clear limits for our child's behavior." B. "A reward system would be useful to give our child positive feedback." C. "We need to limit the number of choices our child has." D. "We need to give our child all directions at once in case the child gets distracted." E. "If the child acts out, we can explain that this is being bad." - Answer A, B, C The nurse is conducting an assessment of a 5-year-old client. During the assessment, the nurse notes that the child does not maintain eye contract or speak. The nurse suspects an autism spectrum disorder. Which additional finding would help support the nurse's suspicion? A. The child constantly opens and closes the hands. B. The child is highly active and inattentive. C. The child has a slight decrease in head circumference. D. The child has a long face and prominent jaw. - Answer A
B. Orthostatic hypotension C. Weak pulse D. Hypertension E. Hypothermia - Answer B, C, E The nurse is assessing a 30-month-old child during a routine well-child visit. Which statement by the parent would alert the nurse to further assess for a learning disorder? A. "My child seems to prefer playing with certain toys and will not play with other toys very much." B. "My child likes a certain type of food and does not want to try new foods very often." C. "My child gets restless when we go to a restaurant to eat and we have to wait for our food." D. "My child does not say more than one or two words and grunts to indicate needs." - Answer D The nurse is caring for a child who has been hospitalized for maltreatment. When reviewing the child's records which findings may have placed the child at an increased risk for abuse? Select all that apply. A. The child's mother has a history of substance use disorder. B. Both parents work outside of the home.
C. The child was born prematurely. D. The child has cerebral palsy. E. The child's father is the primary care taker. - Answer A, C, D The nurse is completing the physical assessment of a 12-year-old child who has a series of bruises in various stages of healing. When asked about the bruises the child appears frightened and offers inconsistent accounts about how the child got the bruises. The nurse suspects abuse. Which initial action of the nurse is most appropriate? A. Take photographs of the bruises. B. Ask the child to provide a written statement of how he or she got the bruises. C. Document the bruises and any statements made by the child relating to them. D. Interview the child's parents about the origin of the bruises. E. Interview the child's parents about the origin of the bruises. - Answer C A high-school football player has been diagnosed as having osteosarcoma of the femur. The parents are angry because they told the adolescent not to play football. Which health teaching points would the nurse include in the teaching plan for the adolescent and parents? A. Osteosarcoma often follows trauma, such as a football injury. B. You can expect some discoloration of the leg following chemotherapy. C. Football injuries do not contribute to the development of a tumor.
B. Observing petechiae, purpura, or unusual bruising C. Noting adventitious breath sounds during auscultation D. Palpation of abdomen reveals enlarged liver and spleen - Answer A A 10-year-old who is receiving chemotherapy has received ondansetron before this therapy session. About an hour later, the child tells the nurse that his mouth feels really dry. The child has urinated several times and his skin turgor is normal. Which response by the nurse would be most appropriate? A. "The drug you got to help with the nausea can cause dry mouth." B. "Let me increase your intravenous fluids." C. "You might be having a severe allergic reaction. Are you itchy?" D. "This indicates an infection. We need to start antibiotics." - Answer A A child is to receive an oral corticosteroid as part of the treatment regimen for leukemia. After teaching the child and family about this drug, the nurse determines the need for additional teaching when they state: A. "We should administer the drug on an empty stomach." B. "We should check our son's urine for glucose." C. "He might develop a rounded face from this drug." D. "We will need to gradually decrease the dosage." - Answer A
A child receiving chemotherapy is experiencing significant reduction in red blood cells secondary to myelosuppression. Which agent would the nurse most likely expect to be ordered? A. Epoetin alfa B. Filgrastim C. Sargramostim D. Gamma interferon - Answer A A 9-year-old child with leukemia is scheduled to undergo an allogenic hematopoietic stem cell transplant. When teaching the child and parents, what information would the nurse include? A. "We'll need to have a match to a donor." B. "The risk for rejection is much less with this type of transplant." C. "You won't need to receive the high doses of chemotherapy before the transplant." D. "You'll need to have an incision in your hip area to instill the cells." - Answer A A preschooler who received chemotherapy in the pediatric oncology outpatient department 1 week ago now has a temperature of 101.5°F (38.6°C). Which is the most appropriate response by the nurse? A. Tell the parent to administer acetaminophen every 4 hours until the fever dissipates. B. Ask whether any family members or other close associates are ill.
