Practice Questions

The most developed sense of the new born is ___.

Touch
Taste
Sight
Hearing

The terms growth and development are often used interchangeably. To which of the following does development refer?

A boy grows taller all through early childhood
He learns to throw a ball overhand
He triples his weight during the first year
His brain increases in size until school age

Which of the following factors would contribute least to the ultimate height that a child reaches?

His mother including nutritious food at meals
The genetic material the child inherited
Whether he enjoys active sport or not
The occupations of his father and mother

The primary critical observation for Apgar scoring is the:

Heart rate
Respiratory rate
Color
Reflex irritability

Establishment of warmth after birth is made possible through the following means EXCEPT:

Drying the skin immediately with towel
Putting the baby on a pre-warmed crib with floor lamp
Giving warm sterile water to warm up his stomach
Letting the mother embrace the baby

At one minute after birth, a newborn’s body is pink with blue extremities, the heart rate is 99, there is withdrawal when the soles are flicked, the respiration are easy with no evidence of distress, and the arms and legs are flexed vigorously moving. The nurse assess the Apgar score to be:

The following is true of neonatal screening except:

Done 24 hours after birth or before one week old
Cord blood is sent to the laboratory
Mandated to be done on all neonates
Provides information on some inborn error in metabolism that could be dangerous to the neonate

Several days after a baby girl’s birth she begins to vomit and lose weight. Galactosemia is diagnosed. The nurse explains to the parents that galactosemia is an inherited autosomal recessive disorder which is the result of:

An intolerance of wheat and rye
An inborn error of carbohydrate metabolism
The inability to metabolize an essential amino acid
The absence of parasympathetic ganglion cells in the colon

The nurse is aware that another diagnostic test is needed to further confirm phenylketonuria. The nurse is correct in choosing which of the following tests that utilizes urine specimen?

Schillings test
Phenistix
Guthrie test
Urinalysis

The parent of a child with congenital hypothyroidism is concerned about the condition of her child. The nurse knows that the most important consideration in caring for this child is all but which of the following?

Safety
Give levothyroxine
Isolation
Allow to play

During physical assessment of a newborn, which of the following comparative measurements would necessitate additional investigation?

Head circumference 34 cm; chest circumference 31 cm
Head circumference 31 cm; chest circumference 33 cm
Head circumference 34.5 cm; chest circumference 32 cm
Head circumference 32 cm; chest circumference 30 cm

A 6 month old infant is admitted with a diagnosis of failure to thrive. The birth weight was 7 pounds. Based on growth and development chart, the nurse should expect an infant at 6 months to weigh approximately:

10 pounds
14 pounds
18 pounds
21 pounds

Which of the following behaviors indicates normal biological development?

A 6 week old begins to roll over
A 6 months old sits without support
A 7 month old transfer a toy from hand to hand
A 7 month old stands unassisted

Appetite lags occur in toddlers for all the following reasons except:

A form of rebellion against parents
Physiology anorexia
Preference from one type of food
High activity level

During the oedipal stage of growth and development, the child:

Loves and hates both parents
Loves the parent of the same sex and the parent of the opposite sex
Loves the parent of the opposite sex and hates the parent of the same sex
Loves the parent of the same sex and hates the parent of the opposite sex

The usual position of the hand in the newborn is:

Open with fingers spread apart
Open with fingers flexed apart
Close with thumb inside the fingers
Close with thumb outside the fingers

Negativism and ritualistic behaviors are normal characteristics of:

Preschoolers
Toddlers
Infants
Adolescents

A 5-year-old boy believes that there are “bogeymen and monsters” in his bedroom at night. What advice can the nurse give to Eric’s parent to help Eric cope with his fears?

Let Eric sleep with his parent
Tell Eric that bogeymen and monster do not exist
Keep a night-light on in Eric’s room
Tell Eric that no one else sees any monsters, so he must not see them either

On admission, the child’s weight is taken for the following purpose EXCEPT:

As basis for child’s nutritional status
To determine child’s approximate age
As basis for the dose of drug doctor will give
To determine if child’s growth is within the normal.

Zendy was assessing melber, a 30 month-old child. She is correct if she states that the expected type of play Melbert should be exhibiting at his age would be:

Parallel play
Solitary play
Competitive play
Associative play

When assessing the social and emotional needs of a school-age child, you should focus on:

Psychosexual development and establishment of relationship
Development of self-esteem and feeling of social responsibility
Body image and feelings about future adult responsibility
Resolving role model conflict with parent of the same sex

The following are typical characteristics in the social behavior of a schooler. The most important is:

Opposite sex friends are preferred for variety
Not so significant as long as feeling of achievement is met
Same gender company gives more satisfaction
Teachers become most preferred company

Nutritional problems during adolescence are caused by all of the following except:

Increased concern about their developing body image
Greater variability in caloric needs about due to variability in activity patterns and growth requirements
Peer group influence
A lower basal metabolism

Which of the following statements best describes the nutritional profile of the adolescent?

Slow but steady growth, poor eating habits
Stunted growth, voracious appetite
Rapid growth, likes to eat alone
Rapid growth, desires companionship at meals

An 11-year-old adolescent asks you what the term puberty means. You tell her:

It is the age at which one becomes capable of sexual reproduction
It denotes completion of the development of secondary sex characteristics
It is the time span between 12 and 18 years
It is when boys and girls go out on dates

A nurse is performing an admission assessment on a 6-month-old infant with a diagnosis of hydrocephalus. The nurse assesses for the major sign associated with hydrocephalus when the nurse

Palpates anterior fontanel.
Takes the blood pressure.
Takes the apical pulse.
Test the urine for protein

The following are normal characteristics of NB except:

Jaundice after delivery
pink body, blue extremities
With full flexion of extremities
Vigorous cry

A maternity nurse employed in a newborn nursery receives a telephone call from the delivery room and is told the newborn with spina bifida (meningomyelocele type) will be transported to the nursery. The maternity nurse prepares for the arrival of the newborn and places which of the following priority items at the newborn’s bedside?

A bottle of sterile normal saline.
A specific gravity urinometer.
A rectal thermometer.
A blood pressure cuff.

The nurse assesses a 5 year old child after a shunt procedure to correct increased ICP. The observation that is most concern would be:

Marked irritability
Complaints of pain
A temperature of 99.4 degree F
A pulse of 100 beats per minute

A newborn is diagnosed with coarctation of the aorta. The baby is discharged with a prescription for digoxin (Lanoxin) 0.01 mg po q12h. The bottle of digoxin is labeled 0.01 mg in ½ teaspoon. The nurse should teach the mother to administer the medication by using:

A nipple
A plastic baby spoon
The calibrated dropper in the bottle
The small size baby bottle with 1 0z of water

Which nursing diagnosis would best apply to an infant with Tetralogy of Fallot?

Impaired gas exchange related to a left-to-right shunt
Impaired skin integrity related to constant cyanosis
Ineffective airway clearance related to constricted aorta
Altered tissue perfusion related to pulmonary artery stenosis

Tetralogy of Fallot is the most frequently occurring type of cyanotic heart disease. The four anomalies associated with this defect are:

Atrial septal defect, pulmonary stenosis, left ventricular hypertrophy, overriding of aorta
Ventricular septal defect, aortic stenosis, mitral stenosis, right-sided aorta
Mitral stenosis, right ventricular hypertrophy, pulmonary stenosis, atrial-septal defect
Ventricular septal defect and right ventricular hypertrophy, pulmonary stenosis, overriding of aorta

A child with sickle cell anemia is admitted to the hospital with a vaso occlusive pain episode. The nurse is aware that this is a result of:

Diminished red blood cell production by the bone marrow
Pooling of blood in the spleen with resultant splenomegaly
Blockage of small blood vessels with clumped red blood cells
Severe depression in circulating thrombocytes

When giving nursing care to a child with leukemia, the nurse notes blood on the pillow case and several bloody tissues. The nurse should check the child’s laboratory report for the:

Platelet count
Uric acid level
Prothrombin time
Red blood cell count

The mother of a 13 year old has sickle cell anemia tells the nurse that the family is going camping this summer. She asks what activities would be appropriate for the child. The nurse should suggest:

Softball games with the family
Collecting logs for the campfire
Motorboat rides around the lake
Walking along the mountain trails

When obtaining history from the mother of an infant with celiac disease, the nurse would expect the mother to say that he baby:

Is irritable at all times
Has bulky, foul, frothy stools
Drinks large amount of fluids
Voids strong, concentrated urine

A 10-month-old infant was admitted to the hospital for severe abdominal pain. The doctor found out that the distal ileal segment of the child’s bowel has invaginated into the cecum. The nurse will suspect what disease condition?

Intussusception
Pyloric stenosis
Hirschprung’s disease
Vaginismus

Why does a toddler typically experience temper tantrums?

It is the only way the toddler can gain attention from his or her mother
More than likely, toddler is spoiled and needs a spanking
The toddler cannot express his or her frustration verbally
The toddler is expressing his or her need for identity

For which of the following findings should the nurse notify the physician?

Absent Pupillary reflex
Expiratory grunt
Respiratory rate of 40 breath/minutes
Full breast areola

Which of the following assessment findings would alert the nurse that a newborn needs special attention?

Birth weight of 3,500 grams
APGAR score of 3
Positive Babinski reflex
RBC of 6 million/mm³

The following are true in Apgar Scoring except:

Done by the birth attendant at 1 minute then 5 minutes after baby’s birth
Must have a perfect score of 10 at one minute to guarantee baby’s survival
Determines prioritization of the baby’s care after birth
Shows capability of the baby to adapt to extra-uterine life

While assessing the neonate, the nurse explains to the mother that post-term neonates typically have

Soft, oily skin
A long, thin body
Very few sole creases
Abundant lanugo

Soon after delivery, the neonate receives an injection of Vitamin K. The nurse explains to the mother that Vitamin K is given to the neonate because

Neonates have no gastrointestinal bacteria
Neonates are susceptible to clotting disorders
Hemolysis of the fetal red blood cells destroys vitamin K
The neonate’s liver does not produce vitamin K

In caring for a newborn the nurse should consider the following normal EXCEPT:

Meconium which colored greenish black is passed 20 hours after birth
Yellow discoloration of skin and sclera 6 hours after birth
Secretions coming from slightly engorged breast
Urine is colorless, odorless

A nurse is assigned to the NICU. During endorsement rounds the nurse performs her assessment of the newborn.

A newborn’s bilirubin level is 12mg/dl. The Doctor ordered Phototherapy. Which of the following interventions is NOT appropriate?

Covering eyes and scrotum with an opaque mask
Exposing the infant’s skin to light, turning q2h
Assess capillary Blood glucose q6h
Measure Intake and output

Which of the following interventions is done in order to hasten the excretion of Direct Bilirubin in a Newborn?

Gentle exercise to stop muscle breakdown
Keep Infant in a warm & dark environment
Administration of oxygen supplement
Early feeding

A nurse performs physical assessment to a two-month-old infant. Which of the following findings would require further investigation?

Closed anterior fontanelle
Symmetrical magnet reflex
Multiple mongolian spots
Positive moro reflex

An infant’s parent says “The soft spot near the front of my baby’s head is still big. When will it close?” The nurse’s best response would be at

2 to 4 months
5 to 8 months
9 to 11 months
12 to 18 months

When providing instructions regarding play to a mother of a 4-month old infant, the nurse should include which of the following?

A rattle is an appropriate toy for baby this age
A teething ring is an appropriate toy for baby his age.
The baby should be provided with a playpen where he can roll over
The mother can play peek-a-boo with the baby to stimulate cognitive development

When developing plan of care for a child, the nurse identifies which Eriksonian stage as corresponding to Freud’s oral stage of psychosexual development?

Initiative vs. Guilt
Autonomy vs. Shame & Doubt
Industry vs. Inferiority
Trust vs. Mistrust

A mother of a 5-month-old baby asks the nurse which tooth typically erupts first?

Lower central incisor
Upper central incisor
Lower lateral incisor
Upper lateral incisor

When teaching the mother on accident prevention on a 6-month-old infant, the nurse should emphasize that at this age the infant can usually

Sit up
Roll over
Crawl lengthy distances
Stand while holding on a furniture

An infant’s developmental task in the psychosocial theory is “trust vs mistrust”. Which of the following interventions will help the infant develop trust?

Attend to the infant’s needs
Motivate to explore and produce
Allow child to make simple choices
Encourage creativity and imagination

When obtaining vital signs on a sleeping 3-month old infant, which of the following assessments would the nurse obtains first

Respiratory rate
Apical pulse
Axillary temperature
Blood pressure

A 2 ½-year-old child is brought with her 2-month-old sibling to the clinic by his father, who explains that the older child says “no” whenever asked to do something. The nurse would explain that the negativism demonstrated by toddlers is frequently an expression of

A need to expend excess energy
A pursuit of autonomy
Separation anxiety
Sibling rivalry

A father brings his 18 month old son to the clinic. He asks the nurse why his son is so difficult to please, has temper tantrums, and annoys him by throwing food from the table. The nurse should explain that

Toddlers need to be disciplined at this stage to prevent the development of antisocial behaviors
The child is learning to assert independence, and his behavior is considered normal for his age
This is the usual way that the toddler expresses his needs during the initiative stage of development
It is best to leave the child alone in his crib after calmly telling him why his behavior is unacceptable

Ear drops, instilled twice a day, are prescribed for a 2 year old child. When observing the parent instilling the drops, the nurse decides the teaching concerning how to position the ear lobe when instilling drops is effective when the parent pulls the toddler’s ear lobe

Up and forward
Up and backward
Down and forward
Down and backwards

Mrs. Wallace expresses concern because Robby has begun thumb sucking which he had previously outgrown. The nurse would note this behavior as:

Conservation
Regression
Castration
Bruxism

Which of the following type of play would a preschooler typically be involved in?

Solitary
Parallel
Associative
Competitive

The Oedipus or Electra Complex is likely to occur In which period of development according to Freud?

Oral
Anal
Phallic
Genital

While playing Joshua accidentally obtained an inch of scraped skin on the left knee. He cries intensely after seeig the injury, you described it as a manifestation to fear of:

Dark
Mutilation
Separation
Abandonment

A mother shares to the nurse about her preschooler child who is bedwetting. Which of the following would be appropriate to advise?

“Give less fluid at night.”
“Allow Robby to wear diapers every night.”
“Bribe your child as a way of reinforcement.”
“Threaten him as a way of disciplining.”

According to Erikson’s theory of development, chronic illness can interfere with which stage of development in an 11-year-old?

Intimacy versus isolation
Trust versus mistrust
Industry versus inferiority
Identity versus role confusion

A mother of a 7-year-old boy ported that he son resist to attend his classes. As a school nurse which of the following is the appropriate action?

Determine the cause of resistance to school
Allow the client to take a vacation
Discipline and punish the child
Isolate the child

On average, the adolescent growth spurt begins:

Earlier for boys than for girls
Earlier for girls than for boys
At approximately the same time for both sexes
Between the seventh and eighth years

According to developmental authorities, the tasks of adolescents include the following except:

Development of strong family ties
Acquiring a set of values and ethics
Acceptance of a new body image
Achieving a masculine or feminine social role

A 14-year-old child must have the capacity for self-awareness to:

Develop role identity
Eliminate fear of the dark
Maintain self-control
Focus on more than one dimension of an object

A post-mature baby will be anticipated for the following problems EXCEPT:

Infection due to meconium aspiration
Metabolic acidosis due to cold stress
Hyperbilirubinemia due to polycythemia
Hyperglycemia due to overstaying inside the uterus

Immediate nursing care for a neonate born with a cleft lip is directed primarily toward:

Modifying feeding methods
Keeping the baby from crying
Minimizing handling by parents
Preventing the occurrence of infection

A priority nursing measure for an infant during the immediate post-operative period following a surgical repair of a cleft lip is to:

Minimize the infant’s crying
Restraint the infant at all times
Oxygenate the infant frequently
Handle the infant as little as possible

The characteristic cough of laryngotracheobronchitis will be:

Dry and hacking
Barking and “seal-like”
Moist and productive
Spasmodic with wheezing

An infant with tetralogy of Fallot became cyanotic and dyspneic after a crying episode. To relieve the cyanosis and dyspnea, the nurse should place the infant in the:

Knee-chest position
Orthopneic position
Side lying position
Semi Fowler’s position

The mother of a 5-month-old infant with heart failure questions the necessity of weighing the infant every morning. The nurse’s response should be based on the fact that this daily information is important in determining:

Renal failure
Fluid retention
Nutritional status
Medication dosage

The clubbing seen on the fingers of patients with Tetralogy of Fallot indicates:

Clot formation on the distal extremities
The body responding to peripheral hypoxia
The child is dehydrated
The child is calcium deficient

A 1-year-old with postductal coarctation of the aorta is admitted to the acute care unit for treatment. When performing an assessment, you find that the lower extremities are cool. Which finding should you anticipate as the assessment continues?

Bounding femoral pulse
Low blood pressure in the arms
Low blood pressure in the legs
Bilateral pedal edema

When a child with hemophilia complains of joint pains, what should be the immediate management upon noting that the part is swelling?

Apply warm compress to relieve the pain
Give aspirin then apply ice to the area
Immobilize the part then bring to the hospital
Consider this as normal for hemophilic patient

Teaching for parents whose baby is undergoing frequent casting to correct a foot deformity should include information on cast care, such as:

Covering damp cast with adhesive petals
Applying lotion to the skin at cast edges to keep it soft
Checking the skin at the edges of the cast daily for redness
Immersing the cast briefly during the tab bath and wiping it lightly

When assessing a newborn for developmental dysplasia of the hip, the nurse would expect to asses which of the following?

Symmetrical gluteal folds
Trendelenburg sign
Ortolani sign
Characteristic limp

A 6-week-old infant is brought to the clinic by her parents. They state that their baby has been vomiting with increasing frequency and force after feeding. Pyloric stenosis is diagnosed. The nurse is aware that the manifestations of pyloric stenosis are:

Avid hunger and effortless vomitus
Non-bile stained vomitus and visible peristaltic wavesc
Vomiting several hours after a feeding and tarry stools
Bile-stained vomitus and generalized abdominal distention

An 8-month-old infant was admitted to the ER from the OPD. The manifestations presented points to a possible Hirschsprungs disease. These would include the following EXCEPT:

olive-shaped mass
stool with blood and mucus
severe abdominal distention
history of constipation

The nurse assessing newborn babies and infants during their hospital stay after birth will notice which of the following symptoms as a primary manifestation of Hirschsprung’s disease?

A fine rash over the trunk
Failure to pass meconium during the first 24 to 40 hours after birth
The skin turns yellow and then brown over the first 48 hours of life
High-grade fever

For a child with hypospadias, which description of this condition is most accurate?

Ventral curvature of the penis.
Meatal opening located on the dorsal surface of the penis.
Narrowing or stenosis of the prepuce opening of the foreskin.
Urethral opening located behind the glans penis or along the ventral surface of the penile shaft.

If shunting procedure is done, it is for what purpose?

Provide outlet for excess CSF
Restore cerebral function
Remove and correct the obstruction
Control meningeal irritation

The mother asks what cerebral palsy is. The nurse base her response on the understanding that CP is

An infectious disease of the central nervous system
The inflammation of the brain due to bacterial infection
A congenital condition that results from folic acid deficiency
A chronic disability characterized by impaired muscle movement and posture

A 7-year-old has been scheduled for a tonsillectomy. Which of the following would be most important to assess prior to surgery?

Specific gravity of urine.
Pulse and respiratory rate.
Bleeding and clotting time.
Blood pressure both lying down and sitting up

Which statement about cystic fibrosis is true?

It is a disorder involving excess mucus production in the lungs and digestive tract
It causes obstruction of the airways from bronchospasm
It is caused by allergic reaction to food, dust, or other substances such as smoke or pollens
It is characterized by polyps in the respiratory tract that impede breathing

Mark, diagnosed of cystic fibrosis is underdeveloped and small for his age primarily because he:

Ingested little food for several months because of poor appetite
Was unable to absorbed nutrients because of lack of pancreatic enzymes
Secreted less than normal amounts of pituitary growth hormones
Developed muscular and bony atrophy from lack of motor activity

An infant was diagnosed with phenylketonuria (PKU) at age 6 weeks. At follow-up home visits, you assess for:

Hemolytic disease
Delayed development
Erythroblastosis fetalis
Hyaline membrane disease

A mother tells you her 6 year old has been biting his fingernails since he began first grade. After analyzing the cause of this as increased stress, the advice you would give his mother regarding this problem would be to:

Encourage the child to drink more milk for stronger nails
Distract the child by teaching him a new skill, such as wrestling
Allow some time everyday for the for the child to talk about new experiences
Allow the child to choose a reward for not biting his nails

Upon admission to the nursery, this infant would necessitate the following EXCEPT:

immediate suctioning and O2 administration as ordered
warmth by putting them inside the isolette
assessment for early jaundice
immediate feeding to increase weight

Vomiting is common on these babies. To prevent this, the nurse should:

feed the infant first before doing all procedures so that they are satisfied
do all nursing procedures before feeding the baby
position infant on the left side after feeding
turn the infant side to side to promote gastric emptying

In measuring the neonate, the nurse would refer if:

she notices the head bigger than the chest
she notices the chest and abdomen to be of same size
she notices the length to be 47 cm on a 6 lbs baby
she notices the chest bigger than the abdomen

Daily umbilical cord care to prevent the potential for infection should include which of the following?

Bathe daily with warm water and pat dry
Apply oil to the cord
Apply lotion to the area just next to the cord
Keep the cord and area directly surrounding clean and dry

At 72 hours after birth, the umbilical stump finding is considered normal?

Slight swelling at the base of the stump
Slight amount of drainage from the stump
Redness at the base of the stump
Beginning to dry and atrophy

Popcorn and nuts should not be given to a toddler primarily because they

Will spoil the child’s appetite
Are easily aspirates
Have very little food value
Can cause tooth decay

Mrs. Lucas, mother of 10 month-old Malou, feeds her baby only formula and baby cereals. In preparing to teach her methods for introducing solid foods, the nurse would include which of the following statements:

“Baby cereals should be discontinued at 1 year of age when the infant is eating other sources of food.”
“Eggs are the best source of protein to introduce initially.”
“Introduce one food at a time, trying this food at least 1 week before adding new food.”
“Once cereals are added to your child’s diet, her vitamins can be stopped.

Which of the following behaviors indicates normal biological development?

A 6 week old begins to roll over
A 6 months old sits without support
A 7 month old transfer a toy from hand to hand
A 7 month old stands unassisted

When ordering a regular diet for a young toddler the nurse should choose foods such as:

Spaghetti and bread
Corn dog and French fries
Hamburger with bun and grapes
Hot dog with bun and potato chips

Which of the following is the most accurate description of cognitive development in Wendy, aged 5?

Thinks abstractly
Has magical thinking
Comprehends conservation of matter
Sees more than one dimension of an object

Which of the following statements best describes a child’s cognitive ability during Piaget’s concrete operations stage?

Behavior changes from reflexive to purposeful
The child is unable to put himself or herself in the place of another
Thought processes become more systematic and logical
Abstract thinking and logical conclusions are made more frequently

In assessing Dorie, the nurse would expect to observe:

Acrocyanosis
An elevated hematocrit
Absence of femoral pulses
Dyspnea and brow sweats during feeding

Thorough evaluation of Dorie revealed a large patent ductus arteriosus (PDA). A correct understanding of PDA will make the nurse anticipate which of the following symptoms?

Becoming cyanotic during feeding and exertion
Often assuming a squatting position
Being acyanotic but having difficulty breathing after physical activity
Having breathing difficulty and becoming cyanotic with slight activity

Which of the following signs is the hallmark of a patent ductus arteriosus in newborn assessment?

Machinery-like murmurs
Dyspnea that is relieved by crying
Acrocyanosis that is relieved by crying
Circumoral cyanosis after feeding

When developing a plan of care for Dorie, who has congestive heart failure, pediatric doses of furosemide (Lasix) is given. The nurse should include in their plan frequent monitoring of which of the following?

Weight increase
Decrease in serum potassium
Decrease in urine output
Increase in respiratory rate

While on furosemide, which of the following nursing actions ensures the client’s safety? Measure body weight weekly Document input and output strictly Measure serum potassium for hyperkalemia Assess the client for hypovolemia

The physical assessment of Susie yielded signs and symptoms typical of cystic fibrosis. Which of the following is not a true sign of this disease?

Undernutrition
Decreased perspiration
Clubbing of fingers
Recurrent respiratory infection

Susie, a school-aged child, also has asthma. Which of the following exercises is most appropriate?

Running
Basketball
Swimming
Baseball

A recommended treatment for cystic fibrosis to promote the clearing of thick secretions from the lower airway is:

Postural drainage
Narcotics
Antitussives
Antibiotics

Susie is order to continue taking Pancrelipase (Viokase). Which of the following verbalizations indicates a need for further teaching?

“I should start avoiding fatty foods.”
“I should take the enzyme with or before meals.”
“Doubling the dose is okay if I eat jelly, fruit sherbets, and bread.”
“I should take it after the ordered antacid.”

When doing discharge teaching, the nurse instructs Susie who is taking Theophylline (Theodur) that she should avoid drinking which of these beverages?

Tea and coffee
Orange and grape juice
Milk and milk shakes
Cranberry juice

Which of the following would be the priority nursing diagnosis for a preschool child with ALL?

Risk for injury related to thrombocytopenia
Oral mucous membranes, altered related to chemotherapy
Interrupted family processes related to a life-threatening illness of a family member
Fatigue related to the disease process

The mother of a child with leukemia asks the nurse why sores developed in the mouth of her child. What is the most appropriate response of the nurse?

“There is no need to worry; all kids receiving chemotherapy tend to have them.”
“Mouth sores result because the cells in the mouth are sensitive to chemotherapy.”
“The child’s oral hygiene needs to be improved.”
“He is allergic to the drug. I will notify the doctor and ask for an alternative drug.”

As part of a chemotherapy protocol, an adolescent is to receive cyclophosphamide (Cytoxan). To prevent the side effects of Cytoxan, she should be instructed to:

Drink at least 2,500 mL of fluids each day
Restrict iron in her diet
Test her urine for acetone and glucose
Brush her hair several times a day

While on chemotherapy, David also takes ordered allopurinol (Zyloprim). The nurse should recognize that the purpose of Zyloprim for the child with ALL is to:

Stimulate the kidneys to release erythropoietin, which stimulates erythrocyte production.
Inhibit uric acid production.
Promote the deposition of calcium in the long bones.
Interfere with the production of leukemic cells.

The nurse would prepare the parents of the child with suspected leukemia for which of the following tests that would confirm this diagnosis?

Lumbar puncture
Bone marrow aspiration
Complete blood count
Blood culture

The best immediate response of the nurse would be to:

Hold the child’s arms down
Cradle the child’s head in her lap
Move the child back to his bed
Place something in the child’s mouth

The following statements concerning Epilepsy are true, with the exception:

The causes of most cases of epilepsy remain unknown.
There is still a stigma connected with the term epilepsy.
The nursing diagnosis high-risk for injury is the priority in care of children with epilepsy.
All cases of epilepsy can be controlled through medication.

4-year-old Kathy is admitted for management of a brain tumor. While assessing Kathy, the nurse understands that the most important prognostic indicator for a child with neurologic impairment is which of the following?

Level of consciousness
Superficial reflexes
Pupil reactivity
Vital signs

Kathy has signs of increased intracranial pressure for which an osmotic diuretic is ordered. The nurse prepares to administer which of these drugs?

Furosemide (Lasix)
Chlorothiazide (Duril)
Mannitol
Spironolactone (Aldactone)

For a client on diuretic therapy, which of the following is the most important primary assessment?

Serum potassium, q4°
Intake and output, q1°
Weight, q3d
CVP, q1°

The proper positioning for a child who is in Bryant’s traction is:

Both hips and knees maintained at 90-degree flexion angle, with the back flat on the bed.
Both hips flexed at a 90-degree angle, with the knees extended and the buttock elevated off the bed.
Affected hip maintained flexed and affected leg extended, with the buttock elevated off the bed.
Both hips and legs extended, with the back flat on the bed.

A child who sustained a closed fracture of the femur is admitted for treatment. When assessing for vascular injury, the nurse should be alert for signs of ischemia, which include:

Increase in serum levels of creatinine, alkaline, phosphatase, and aspartate transaminase
Bleeding, bruising, and hemorrhage
Generalized swelling, pain, and decrease of or loss of function
Pain, pallor, pulselessness, paresthesias, and paralysis

17-year-old Lorenzo sustained major injuries of the body, including a compound fracture of the shaft on the left femur in a motorcycle accident. Emergency treatment includes the application of a splint. How should the splint be applied?

Apply it after aligning the involved limb
Extend the splint from the fracture site downward
Extend the splint from the fracture site upward
Apply the split to the limb

For care of children with compound fractures, which should be carried out initially by the nurse?

Assess his respiratory status
Cover the open wounds
Prevent infections
Clean the fracture site

To achieve the desired outcome of functional healing of fractures, which nursing goal should receive the highest priority?

Provide relief from pain
Prevent infection with prophylactic antibiotics
Provide optimum nutrition rich in protein, vitamin D, and calcium
Maintain immobilization and alignment

A mother is watching her school-age child learn self-care techniques after being recently diagnosed with Type 1 Diabetes Mellitus. Which of the following is a correct statement?

“Bandura’s theory states children new behaviors best when imitating others.”
“Erikson’s stages describes school-age children as learning by attaining goals.”
“Piaget believes that learning will take place more quickly when abstract thinking develops.”
“Freud’s description of personality development affects learning ability.”

During a developmental assessment, a parent complains that she has a “difficult” toddler. What advice would the nurse offer to the parent?

“Toddlers are flexible. Accepting new rules will occur quickly.”
“Do not expect the child to adapt quickly to new situations.”
“Encourage associative play and this will get better.”
“Spanking your child will make the difficult behavior improve.”

A mother who uses the time-out method of discipline for her 5-year-old child is asking the nurse what type of parenting this exemplifies. What is the response that would be most appropriate?

Indifferent
Authoritative
Authoritarian
Permissive

Which is the most important nursing intervention to facilitate communication with a hospitalized preschool-age child?

Provide detailed explanations of procedures to the child.
Encourage the child to engage in play with dolls, puppets, or safe medical equipment.
Ask the child to write a story about the hospitalization.
Keep visitors to a minimum.

A nurse is assessing a 2-year-old boy with the following vital signs: axillary temperature of 97.8°F, respiration rate of 28, and a blood pressure of 125/80.

Reevaluate the child’s temperature in 1 hour.
Report the blood pressure to the physician.
Assess for additional signs of respiratory distress in the child.
Determine why the child has tachycardia.

Which statement indicates nutrition counseling has been effective for the mother of a 6-month-old infant?

“I will start my infant on rice cereal since it is iron fortified and has little chance of causing allergy.”
“I will start my infant on egg whites since they are high in iron and protein and have little chance of causing allergy.”
“I will start feeding fruits and vegetables and progress to whole grain cereals as tolerated.”
“I know that I can start feeding my baby strained meats for the iron and protein and progress to more irritating fruits and vegetables.”

Which observation during a healthcare visit alerts the nurse to the need for further developmental assessment in an infant?

A four-month-old has just started to roll from front to back.
A nine-month-old now stands while holding onto furniture.
A nine-month-old is able to sit with support from pillows on each side.
A 12-month-old says two words: “dog” and “bottle”.

The nurse knows that teaching about car seat safety to the parents of a 4-year-old child has been effective when which statement is made?

“Now that our child is 4 years old, weighs 40 pounds, and is 42 inches tall, we can move to a forward-facing booster seat.”
“Now that our child is 4 years old, she can sit in the regular car seat and use the seat belt and shoulder belt like adults.”
“Now that our child is 4 years old, she can sit in her booster seat in the front seat.”
“Our 4-year-old must stay in her forward-facing car seat until she is 6 years old.”

Which is the best advice the nurse can give to parents asking for help in handling their toddler’s temper tantrums?

“I think you should start using time-outs when he throws a temper tantrum.”
“Reward him for good behavior and the temper tantrums will decrease.”
“There is nothing to be done. They are a symptom of emotional instability.”
“Temper tantrums will increase in number through the preschool years.”

The high school principal asks the school nurse to provide injury prevention information to the students. What does the nurse identify as priority for the majority of students?

Driving and substance abuse
CPR and emergency care
Sports injuries
Driving patterns

The nurse is preparing a disaster education plan for school-age children to discuss fire prevention and fire evacuation planning. What information is priority in the plan?

It is essential for the child to stay with the family at the time of the fire.
The child and family need to have a definite evacuation plan in place.
The child should stay indoors in the event of a fire.
It is important for the child to remember to drink more water than usual after a fire.

A school nurse is packing a portable emergency bag for a potential disaster. Which indicates the need for further education in disaster preparedness?

A list of staff and students and their location
A blueprint of the school and its grounds
Handheld portable radios with batteries
A portable automatic external defibrillator

Which is the correct developmental stage at which a child begins to have a more realistic understanding of death?

Preschooler
Adolescent
School-age
Preteen

A nurse obtains a history from a breastfeeding mother with a small 3-month-old infant who has been vomiting. Which would give the nurse an indication that this infant has severe dehydration?

The infant is having a seizure.
The pulse rate is slightly elevated.
Skin turgor is normal.
Mucous membranes are dry.

The nurse notes changes in a toddler with heart failure since the shift yesterday. Which finding is the most significant for extracellular fluid volume overload?

Jugular venous distention
Weight gain of 0.8 kg
Weak pulse
Presence of lung crackles

The parents of a child who had a tonsillectomy 3 days ago call about concerns with symptoms they are seeing. Which symptom would alert the nurse that the child may be having a postoperative problem?

The child has white crusts on the back of the throat.
The child is having increased swallowing.
The child will only eat popsicles.
The child complains of throat pain.

A child is brought to the emergency department with an abrupt onset of decreased appetite, stridor, high fever, and agitation. Which information is needed to determine the nurse’s priority intervention?

Determine if the child has been drooling.
Ask if the child will lie down.
Ask if the child has been around anyone sick.
Auscultate the child’s breath sounds

A child is being treated with dexamethasone in conjunction with other chemotherapy for treatment of leukemia. On a follow-up visit, the pediatric oncology clinic nurse expects which finding as a side effect?

Weight gain
Decreased blood pressure
Anorexia
Improved mood

A child with leukemia has a white blood cell count of 10,000, a red blood cell count of 5, and a platelet count of 20,000. The child is also fairly active, visiting the playroom twice a day. When planning for the child’s care, which risk should the nurse consider most significant?

Infection
Anemia
Hemorrhage
Pain

A 3-year-old female with nephrotic syndrome is being admitted to the general pediatric floor. Who is the most appropriate roommate for this child?

A 2-year-old female recovering from varicella
A 4-year-old female with a fractured femur
A 6-year-old male postoperative appendectomy
A 3-year-old female with cystic fibrosis

When a child with type 1 diabetes is sick, which is the most appropriate recommendation?

The usual dose of insulin may need to be decreased or omitted.
Test blood glucose if the urine ketones are positive.
Urine ketones are tested when the glucose level is greater than 200 mg/dL.
Maintain fluid intake, avoiding fluids that contain carbohydrates.

Identify the priority nursing diagnosis for an adolescent with hyperthyroidism:

Disturbed Body Image related to changes in appearance caused by disease process of metabolic disorder
Imbalanced Nutrition: More than Body Requirements related to decreased metabolic needs
Risk for Decreased Fluid Volume related to excess salt excretion
Constipation related to thyroid medication side effects.

The parents of a child recently diagnosed with viral meningitis is concerned about the permanent effects from the disease. Her neighbor’s child had viral encephalitis with learning and mobility dysfunction as sequelae. How should the nurse respond to her concerns?

“Let’s wait and see if this disease becomes viral encephalitis.”
“Have they been playing together?”
“Most children with viral meningitis have future learning problems. You’ll need to make plans for a special school.”
“Children who have viral meningitis usually have a complete recovery without permanent effects.”

An infant is brought to the emergency department with assessment findings of failure to thrive, vomiting, and a decreased level of consciousness. Which should the nurse suspect?

Influenza
Reaction to the dTaP immunization
Shaken baby syndrome
A malabsorption syndrome

A 6-year-old child is having burn care following premedication for pain. The child is not cooperative for dressing changes and begins screaming and kicking. What is the best action by the nurse?

Inform the child that cooperation is necessary for proper healing and will shorten the hospital stay.
Allow the parents to change the dressings with coaching from the nurse.
Allow the child to participate in the dressing change process as much as possible.
Inform the child that restraints will be used if there is no cooperation.

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