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4.

A nurse is assisting with the care of a child who is postoperative and received a

transfusion during a surgical procedure. Which of the following findings indicates the

child is havig a hemolytic reaction?

a) Chills and flank pain (Chills and flank pain are findings that indicate an

incompatibility of the transfused blood product with the client's blood. The nurse

should identify this finding as an indication that the child is having a hemolytic

reaction.)

b) Pruritus and flushing

c) Rales and cyanosis

d) Bradycardia and diarrhea

5. A guardian calls the clinic nurse after his child has developed symptoms of varicella

and asks when his child will no longer be contagious. Which of the following responses

should the nurse make?

a) “When your child no longer has a fever.”

b) “Three days after the rash started.”

c) “Six days after lesions appear if they are crusted.” (The nurse should inform the

guardian that a child will stop being contagious around 6 days after the lesions

appeared, as long as they are crusted over.)

d) “When your child’s lesions disappear.”

6. A nurse is collecting date from a child during a well-child visit. The nurse should

recognize that which of the following findings places the child at a higher risk for

abuse?

a) The child is 6 years old.

b) The child is male.

c) The child was born at 30 weeks of gestation. (The nurse should identify that

children who are born prematurely are at greater risk for abuse because of the

potential for impaired bonding during early infancy.)

d) The child was born via cesarean birth.

7. A nurse is reinforcing teaching with the guardian of a child who has a new diagnosis of

rheumatic fever. Which of the following statements by the guardian indicates an

understanding of the teaching?

a) “I should not give my child aspirin for pain or fever.”

b) “My child will take antibiotic for 6 months.”

c) “My child might have a period of irregular movement of the extremities.” (The

nurse should instruct the guardian that the child might experience chorea weeks or

months after the initial diagnosis. Chorea is a temporary lack of coordination and

the presence of sudden, irregular movements or periods of clumsiness.)

d) “I should expect there to be blood in my child’s urine.”

8. A nurse is collecting data from an infant during a well-child visit. Which of the

following sites should the nurse use when obtaining the infant’s heart rate?

a) Apical (The nurse should use the apical pulse to obtain the infant's heart rate and

count it for a full minute, because it gives a reliable rate and rhythm and provides

accurate baseline assessment data. In an infant, the apical heart rate is auscultated at

the fourth intercostal space lateral to the midclavicular line.)

b) Radial

c) Carotid

d) Femoral

9. A nurse is preparing a toddler for suturing of a minor facial laceration. The nurse

should place the toddler in which of the following restraints?

a) Mummy restraint (The nurse should use a mummy wrap when a short-term restraint

is needed for treatment of the toddler that involves the head and neck. The nurse

should always use the least amount of restraint necessary.)

b) Jacket restraint

c) Elbow restraint

d) Wrist restraint

10. A nurse is reinforcing dietary teaching with the parent of a 2-year-old toddler. Which

of the following should the nurse include in the teaching?

a) "It is recommended that the toddler consumes no more than 12 ounces of fruit juice

each day."

b) "An appropriate serving size is 1 tablespoon of food per year of age." (The nurse

should include that an appropriate serving size for a 2-year-old toddler is 1 tbsp of

food per year of age.)

c) "Introduce healthy finger foods like carrots and celery sticks."

d) "Encourage 5 cups of low-fat milk each day."

11. During a well-child visit, the parent of a toddler expresses concern to the nurse that

the toddler takes several hours to fall asleep at night. Which of the following

recommendations should the nurse make?

a) Vary the time the toddler goes to bed each night

b) Allow the toddler to watch television before bedtime

c) Provide the toddler with a favorite toy at bedtime. (The nurse should recommend to

the parent that providing the toddler with a favorite toy at bedtime will help the

toddler to feel more secure and facilitate sleep.)

d) Increase the toddler's activity prior to bedtime

12. A nurse is assisting with the care for a 7-month-old infant who has a cleft palate.

Which of the following actions should the nurse take to decrease the infant’s risk for

aspiration?

a) Feed the infant in supine position.

b) Encourage the mother to breastfeed the infant exclusively.

c) Burp the infant frequently during feedings. (Infants with a cleft palate have

difficulty creating a seal around a bottle. Burping the infant frequently, following

every ounce of fluid consumed, dissipates swallowed air and helps to prevent

aspiration.)

d) Perform nasotracheal suctioning if coughing occurs

13. A nurse is reviewing the laboratory values of a school-age child who has iron

deficiency anemia. Which of the following findings should the nurse expect?

a) Hgb 9.0 g/dL (The nurse should expect a child who has iron deficiency anemia to

have an Hgb level below the expected reference range of 9.5 to 15.5 g/dL. An Hgb

of 9.0 g/dL is below the expected reference range.)

b) Hct 37%

c) Iron 100 mcg/dL

d) Total iron binding capacity 325 mcg/dL

14. A nurse is reinforcing teaching about vital signs with the guardian of a 1-year-old

toddler. Which of the following statements by the guardian indicates an understanding

of the teaching?

a) "My child's pulse could increase to 150 beats a minute with activity.” (A pulse rate

of 150/min is within the expected reference range for a toddler during physical

activity.)

b) "My child's temperature should be 96.8 degrees Fahrenheit."

c) "My child should take 40 breaths a minute."

d) "My child's pulse could get as low as 60 beats a minute while asleep."

15. A nurse is caring for an adolescent who has acne and anew prescription for

isotretinoin. For which of the following adverse effects should the nurse monitor?

a) Hypersalivation

b) Depression (Clients taking isotretinoin can experience mental status changes, such

as suicidal thoughts, aggression, emotional lability, and depression. The nurse

should monitor the adolescent's mental status while taking isotretinoin.)

c) Bradycardia

d) Hyperreflexia

16. A nurse is reinforcing teaching about interventions for mild hypoglycemia with the

parent of a child who has diabetes mellitus. Which of the following statements by the

parent indicates that the teaching has been effective?

a) "I should administer a glucagon injection to my child."

b) "I should give my child 5 grams of a simple carbohydrate."

c) "I should give my child 4 ounces of orange juice followed by cheese and crackers."

(The parent should treat mild hypoglycemia with 10 to 15 g of a simple

carbohydrate, such as 4 oz. of orange juice, and follow it with a starch-protein

snack.)

d) "I should give my child a snack that is 10 percent of his daily caloric intake."

17. A nurse is collecting data from a 10-month-old infant. Which of the following findings

should the nurse report to the provider?

a) Pulls self to standing position

b) Moves by creeping on hands and knees

c) Takes intentional steps when standing

d) Sits with support by leaning on hands (The nurse should identify that sitting with

support can indicate a developmental delay, because an infant should be able to sit

unsupported by 8 months of age. Therefore, the nurse should report this finding to

the provider.)

18. A nurse is preparing to administer phenobarbital to a toddler who has a seizure

disorder and weights 10 kg (22 lb). The prescription reads phenobarbital sodium 2.5

mg/kg PO BID. Available is phenobarbital 20 mg/5 mL. How many mL should the

nurse administer with each dose? (Round to the nearest hundredth. Use a leading zero

if it applies. Do not use a trailing zero

Ratio and Proportion

6.26 mL

Step 1: What is the unit of measurement the nurse should calculate? mL

Step 2: What is the dose the nurse should administer? Dose to administer = Desired 2.5

mg/kg = 2.5 x 10 = 25 mg

Step 3: What is the dose available? Dose available = Have 20 mg

Step 4: Should the nurse convert the units of measurement? No

Step 5: What is the quantity of the dose available? 5 mL

Step 6: Set up an equation and solve for X.

Have/Quantity = Desired/X

20 mg/5 mL = 25 mg/X mL

X = 6.25

19. A nurse is caring for a child who has type 1 diabetes mellitus and has been receiving

insulin via subcutaneous infusion pump. Which of the following laboratory tests would

verify the average blood glucose level over the past 2 months?

a) Postprandial blood glucose

b) Fasting blood glucose

c) Glycosylated hemoglobin (Glycosylated hemoglobin provides an accurate average

of the client's blood glucose level over the past 120 days. This test can be used to

determine the effectiveness of, or compliance with, a treatment plan. It can also be

used to diagnose diabetes mellitus.)

d) Mean corpuscular hemoglobin

20. A nurse is reinforcing teaching with the guardian of a child who has a new

prescription for levalbuterol solution for use in a nebulizer. Which of the following

statements by the guardian indicates an understanding of the teaching?

a) "I should store the unused medication in the freezer."

b) "I should make sure I use the vial within 3 weeks of opening it from the foil

package."

c) "My child might be drowsy while taking this medication."

d) "My child might experience palpitations after taking this medication." (Palpitations

are an adverse effect of levalbuterol. If this occurs, the guardian should discontinue

the medication and notify the provider

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