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1. The nurse is giving preoperative instructions to a 14-year old female
client who is scheduled for surgery to correct a spinal curvature. Which
statement by the client best demonstrates that learning has taken place?: D.
I understand that I will be in a body cast and I will show you how you taught me to
turn.
2. To take the vital signs of a 4-month old child, which order will give the most
accurate results?: A. Respiratory rate, heart rate, then rectal temperature
3. During routine screening at a school clinic, an otoscope examination of a
child's ear reveals a tympanic membrane that is pearly gray, slightly bulging,
and not movable. What action should the nurse take next?: B. Ask the child if
he/she has had a cold, runny nose, or any ear pain lately.
4. Which restraint should be used for a toddler after a cleft palate repair?: C.
elbow restraints
5. What preoperative nursing intervention should be included in the plan of
care for an infant with pyloric stenosis?: D. observe for projectile vomiting.
6. A six-month-old returns from surgery with elbow restraints in place. What
nursing care should be included when caring for any restrained child?: B.
remove restraints one at a time and provide range of motion exercises
7. A 2-year old child with Down syndrome is brought to the clinic for his
regular physical examination. The nurse knows which problem is frequently
associated with Down syndrome?: A. congenital heart disease
8. When assessing a child with asthma, the nurse should expect intercostal
retractions during: A. inspiration
9. When planning the care for a child who has had a cleft lip repair, the nurse
knows that crying should be minimized because it: D. stresses the suture line
10. A full-term infant is admitted to the newborn nursery. After careful assessment, the nurse suspects that the infant may have an esophageal atresia. Which symptoms is this newborn likely to have exhibited?: A. choking,
coughing, and cyanosis
11. Which behavior would the nurse expect a two-year-old child to exhibit?: C. display possessiveness of toys
12. the mother of a preschool-aged client asks the nurse if it is all right
to administer Pepto Bismal to her son when he 'has a tummy ache." After
reminding the mother to check the label of all OTC drugs for the presence
of aspirin, which instruction should the nurse include when replying to this
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mother's question?: B. do not give if the child has chickenpox, the flu, or any
other viral illness.
13. The nurse observes a 4-year old boy in a daycare setting. Which behavior
should the nurse consider normal for this client?: C. demonstrates aggressiveness by boasting when telling a story
14. A burned child is brought to the emergency room. In estimating the
percentage of the body burned, the nurse uses a modified "Rule of Nines."
Which part of a child's body is calculated as a larger percentage of total body
surface than an adult?: A. head and neck
15. The nurse receives a lab report stating a child with asthma has a theophylline level of 15 mcg/dl. What action will the nurse take?: A. pass the
information on in the report
16. A 12-month old boy is admitted with a respiratory infection and possible
pneumonia. He is placed in a mist tent with oxygen. Which nursing intervention has the greatest priority for this infant?: C. have a bulb syringe readily
available to remove secretions
17. All of the following interventions can be used to evaluate the effectiveness of nursing and medical interventions used to treat diarrhea. Which intervention is least useful in the nurse's evaluation of a 20-month-old child.: B.
assessing fontanels
18. A 5-month-old is admitted to the hospital with vomiting and diarrhea. The
pediatrician prescribed dextrose 5% and 0.25% normal saline with 2 mEq
KCI/100 mL to be infused at 25mL/hr. Prior to initiating the infusion, the nurse
should obtain which assessment finding?: B. serum BUN and creatinine levels
19. The nurse is assigning care for a 4-year old child with otitis media and is
concerned about the child's increasing temperature over the past 24 hours.
When planning care for this child, it is important for the nurse to consider
that:: B. a tympanic measurement of temperature will provide the most accurate
reading
20. The nurse is assessing an 8-month old child who has a medical diagnosis
of Tetrology of Fallot. Which symptom is this client most likely to exhibit?: D.
clubbed fingers
21. As part of the physical assessment of children, the nurse observes and
palpates the fontanels. Which child's fontanel finding should be reported to
the healthcare provider?: A. A 5-month old with failure to thrive that has a closed
anterior fontanel
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22. A preschool-age child who is hospitalized for hypospadias repair is most
strongly influenced by which behavior?: C. concern for body integrity
23. An infant is born with a ventricular septal defect (VSD) and surgery is
planned to correct the defect. The nurse recognizes that surgical correction
is designed to achieve which outcome?: C. prevent the return of oxygenated
blood to the lungs.
24. A three-month old boy weighing 10 lbs, 15 oz has an axillary temperature
of 98.9 degrees F. The nurse determines the daily caloric need for this child
is approximately:: C. 600 cal/day
10 lbs, 15 oz = 10.9 lbs. Convert lbs to kg by dividing pounds by 2.2 (10.9/2.2)
= 4.954 kg rounded to 5 kg. an infant requires 108 cal/kg/day (108 x 5 = 540
cal/day). However this infant requires 10% more calories because he has one
degree temperature elevation. 10% of 540 is 54 and 54 + 540 = 594. This infant will
require approximately 600 calories/day. Remember that a temperature elevation
necessitates consumption of more calories.
25. The nurse is preparing a health teaching program for parents of toddlers
and preschoolers and plans to include information about prevention of
accidental poisonings. It is most important for the nurse to include which
instructions?: B. store all toxic agents and medicines in locked cabinets.
26. A 6-month old infant with congestive heart failure (CHF) is receiving
digoxin elixer. Which observation by the nurse warrants immediate intervention?: A. apical heart rate of 60.
27. At 8am, the unlicensed assistive personnel (UAP) informs the charge
nurse that a female adolescent client with acute glomerulonephritis has a
blood pressure of 210/110. The 4am BP reading was 170/88. The client reports
to the UAP that she is upset because her boyfriend did not visit last night.
What action should the nurse take?: B. administer PRN prescription of nifedipine
(Procardia) sublingually.
28. A premature newborn girl, born 24 hours ago, is diagnosed with a patent
ductus arteriosus (PDA) and placed under an oxygen hood at 35%. The
parents visit the nursery and ask to hold her. Which response should the
nurse provide to the parents?: B. the oxygen hood is holding the baby's oxygen
level just at the point which is needed. You may stroke and talk to her.
29. The nurse is developing a plan of care for a 3-year old who is scheduled
for a cardiac catheterization. To assist in decreasing anxiety for the child
on the day of the procedure, which intervention is best for the nurse to
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implement?: C. give the child a ride on a gurney to visit the cardiac catheterization
lab and meet a nurse who works there.
30. When taking the health history of a child, the nurse knows that which
finding is an early indication of hypothyroidism in children?: D. cessation of
growth in a child that had been normal.
31. The nurse is teaching a 12-year old male adolescent and his family about
taking injections of growth hormone for idiopathic hypopituitarism. Which
adverse symptoms, commonly associated with growth hormone therapy
should the nurse plan to describe to the child and his family?: A. polyuria and
polydipsia
32. The nurse is caring for a 12-year old with Syndrome of Inappropriate
Antidiuretic Hormone (SIADH). This child should be carefully assessed for
which complication?: B. changes in LOC
33. A four-year old girl continues to interrupt her mother during a routine
clinic visit. the mother appears irritated with the child and asks the nurse,
"Is this normal behavior for a child this age?" The nurse's response should
be based on which information?: A. children need to retain a sense of initiative
without impinging on the rights and privileges of others.
34. a 14-year old female client tells the nurse that she is concerned about the
acne she has recently developed. Which recommendation should the nurse
provide?: C. Wash the hair and skin frequently with soap and hot water
35. The mother of a 2-year old boy consults the nurse about her son's
increased tempter tantrums. The mother states, "Yesterday he threw a fit in
the grocery store, and I did not know what to do. I was embarrassed. What
can I do if this occurs again?" Which recommendation is best for the nurse
to provide this mother?: D. walk away from him and ignore the behavior
36. During discharge teaching of a child with juvenile rheumatoid arthritis,
the nurse should stress to the parents the importance of obtaining which
diagnostic testing?: B. eye exam
37. A hospitalized 16-year old male refuses all visits from his classmates
because he is concerned about his distorted appearance. To increase the
client's social interaction, what intervention is best for the nurse to initiate?: C. arrange for an internet connection in the client's room for email communication
38. The nurse is assessing a 2-year old. What behavior indicates that the
child's language development is within normal limits?: C. is capable of making
a three word sentence
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39. When evaluating the effectiveness of interventions to improve the nutritional status of an infant with gastro-esophageal reflux, which intervention
is most important for the nurse to implement?: A. record weight daily
40. Which menu selection by a child with celiac disease indicates to the nurse
that the child understands necessary dietary considerations?: A. oven-baked
potato chips and cola.
41. The parents of a 3-week old infant report that the child eats well but
vomits after each feeding. what information is most important for the nurse
to obtain?: A. description of vomiting episodes in the past 24 hours
42. A 3-month old infant develops oral thrush. Which pharmacologic agent
should the nurse plan to administer for treatment of this disorder?: A. Nystantin (Mycostatin)
43. Which class of antiinfective drugs is contraindicated for use in children
under 8 years of age?: B. tetracyclines
44. A female teenager is taking oral tetracycline HCL (Achromycin V) for acne
vulgaris. What is the most important instruction for the nurse to include in
this client's teaching plan?: A. Use sunscreen when lying by the pool.
45. The mother of a 6-month old asks the nurse when her baby will get the
first measles, mumps, and rubella (MMR) vaccine. Based on the recommended childhood immunization schedule published by the Centers for Disease
Control, which response is accurate?: B. 12-15 months
46. Preoperative nursing care for a child with Wilm's tumor should include
which intervention?: D. Put a sign on the bed reading, "DO NOT PALPATE
ABDOMEN."
47. A 4-year old boy was admitted to the emergency room with a fractured
right ulna and a short arm cast was applied. When preparing the parents to
take the child home, which discharge instruction has the highest priority?: A.
call the healthcare provider immediately if his nail beds appear blue.
48. An 18-month old is admitted to the hospital with possible Hirschsprung's
disease. When obtaining a nursing history, the nurse asks about bowel
habits. What describes the disease?: D. ribbon-like and brown
49. The nurse must prevent a 2-year old with severe eczema on the face, neck
and scalp from scratching the affected areas. Which nursing intervention is
most effective in preventing further excoriation due to the pruritis?: C. place
elbow restraints on the child's arms
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50. The nurse assigning care for a 5-year old with otitis media is concerned
about the child's increasing temperature over the past 24 hours. Which
statement is accurate and should be considered when planning care for the
remainder of the shift?: B. tympanic and oral temperatures are equally accurate
51. A 3-year old boy is brought to the emergency room because he swallowed
an entire bottle of children's vitamin pills. Which intervention should the
nurse implement first?: B. determine the child's pulse and respirations
52. A 2-year old with gastro-esophageal reflux has developed a fear of eating.
What instruction should the nurse include in the parents' teaching plan?: D.
consistently follow a set mealtime routine.
53. A 6-month old boy and his mother are at the healthcare provider's office
for a well-baby checkup and routine immunizations. the healthcare provider
recommends to the mother that the child receive an influenza vaccine. What
medications should the nurse plan to administer today?: B. All the immunizations with the influenza vaccine given at a separate site from any other injection.
54. The nurse is assessing a 13-year old girl with suspected hyperthyroidism.
Which question is most important for the nurse to ask her during the admission interview?: B. Are you experiencing any type of nervousness?
55. The nurse is planning care for school aged children at a community care
center. Which activity is best for the children?: B. playing follow-the-leader
56. Surgery is being delayed for an infant with undescended testes. In collaboration with the healthcare provider and the family, which prescription
should the nurse anticipate?: C. a trial of human chorionic gonadotrophic hormone
57. A 3 year old client with sickle cell anemia is admitted to the Emergency
Department with abdominal pain. The nurse palpates an enlarged liver, an
x-ray reveals an enlarged spleen, and a CBC reveals anemia. these findings
indicate which type of crisis?: B. sequestration
58. To assess the effectiveness of an analgesic administered to a 4 year old,
what intervention is best for the nurse to implement?: A. use a happy face/sad
face pain scale
59. In developing a teaching plan for a 5 year old child with diabetes, which
component of diabetic management should the nurse plan for the child to
manage first?: C. process of glucose testing
60. A 17 year old male student reports to the school clinic one morning for
a scheduled health exam. He tells the nurse that he just finished football
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practice and is on his way to class. The nurse assesses his vital signs:
temperature 100F, pulse 80, respirations 20, and BP 122/82. What is the best
action for the nurse to take?: A. tell the student to proceed directly to his regularly
scheduled class.
61. The vital signs of a 4 year old child with polyuria are BP 80/40, pulse 118,
and respirations 24. the child's pedal pulses are present with a volume of +1
and no edema is observed. What action should the nurse implement first?: B.
start an IV infusion of normal saline
62. A 3 week old newborn is brought to the clinic for follow after a home
birth. the mother reports that her child bottle feeds for 5 minutes only and
then falls asleep. the nurse auscultates a loud murmur characteristic of a
ventricular septal defect (VSD) and finds the newborn is acyanotic with a
respiratory rate of 64 breaths per minute. What instruction should the nurse
provide the mother to ensure the infant is receiving adequate intake? (select
all that apply): A. monitor the infant's weight and number of wet diapers per day.
B. increase the infant's intake per feeding by 1-2 ounces per week
D. allow the infant to rest and refeed on demand on every 2 hours
E. use a softer nipple or increase the size of the nipple opening
63. When discussing discipline with the mother of a 4 year old child, the
nurse should include which guideline?: A. parental control should be consistent
64. Which action by the nurse is most helpful in communicating with a
preschool-aged child?: B. use a doll to play and communicate
65. The nurse is having difficulty communicating with a hospitalized 6 year
old child. Which approach by the nurse is the most helpful in establishing
communication?: A. engage the child through drawing pictures
66. A child falls on the playground and is brought to the school nurse with
a small laceration on the forearm. Which action should the nurse implement
first?: C. wash the wound gently with mild soap and water
67. A 6 year old is admitted to the pediatric unit after falling off a bicycle.
Which intervention should the nurse implement to assist the child's adjustment to hospitalization?: A. explain hospital schedules to the child, such as
mealtimes.
68. A 16 year old is brought to the emergency department with a crushed
leg after falling off a horse. the adolescent's last tetanus toxoid booster was
received eight year ago. What action should the nurse take?: C. administer
tetanus toxoid booster
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69. A child with cystic fibrosis is having stools that float and are foul
smelling. Which descriptive term should the nurse use to document the
finding?: D. steatorrhea
70. The clinic nurse is taking the history for a new 6 month old client. The
mother reports that she took a great deal of aspirin while pregnant. Which
assessment should the nurse obtain?: A. type of reaction to loud noises
71. The nurse is giving a liquid iron preparation to a 3 year old child. Which
technique should the nurse implement to engage the child's cooperation?: A.
use a colorful straw
72. The nurse is teaching a mother to give 4 mL of liquid antibiotic to a 10
month old infant. Which statement by the parent indicates a need for further
teaching?: B. using a teaspoon will help me measure this correctly.
73. Which growth and development characteristic should the nurse consider
when monitoring the effects of a topical medication for an infant?: B. a thin
stratum corneum that increases topical absorption
74. A 2 year old child recently diagnosed with hemophilia A is discharged
home. What information should the nurse include in a teaching plan about
home care?: D. apply pressure and ice for bleeding while elevating and resting
the extremity.
75. A nurse provides the parents with information on health maintenance
for their child with sickle cell disease. Which information reflected by the
parents indicates understanding of the child's care?: B. plenty of fluids should
be consumed daily
76. The nurse reviews the latest laboratory results for a child who received
chemotherapy last week and identifies a reduced neutrophil count. Which
nursing diagnosis has the highest priority for this child?: A. risk for infection
77. During administration of a blood transfusion, a child complains of chills,
headache and nausea. Which action should the nurse implement?: C. stop
the infusion immediately and notify the healthcare provider
78. The nurse is teaching the parents of a 5 year old with cystic fibrosis
about respiratory treatments. Which statement indicates to the nurse that
the parents understand?: C. Administer aerosol therapy followed by postural
drainage before meals
79. The nurse is assessing the neurovascular status of a child in Russell's
traction. Which finding should the nurse report to the healthcare provider?: A. pale bluish coloration of the toes
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80. A child is rescued from a burning house and brought to the emergency
room with partial-thickness burns on the face and chest. Which action should
the nurse implement first?: D. assess the child's respiratory status
81. The mother of a 4 year old child asks the nurse what she can do to help
her other children cope with their sibling's repeated hospitalizations. Which
is the best response that the nurse should offer?: D. encourage the mother to
have the children visit the hospitalized sibling.
82. Which finding in a 19 year old female client should trigger further assessment by the nurse?: A. menstruation has not occurred
83. A 15 year old girl tells the school nurse that all of her friends have started
their periods and she feels abnormal because she has not. Which response
is best for the nurse to provide?: C. explain that menarche varies and occurs
between the ages of 12 and 18 years.
84. Which measurements should be used to accurately calculate a pediatric
medication dosage? (Select all that apply)
A. child's height and weight
B. adult dosage of medication
C. body surface area of child
D. average adult's body surface area
E. average pediatric dosage of medication
F. nomogram determined mathematical constant.: A. child's height and weight
C. body surface area of child
F. nomogram determined mathematical constant.
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