PEDS Exam 2 Practice Questions

The nurse is providing care to several pediatric clients in the hospital setting. Which client diagnosis is capable of producing chronic limitations for the child?

A. Pneumonia from the bacillus Haemophilus influenzae

B. Respiratory syncytial virus

C. Streptococcus pneumoniae, a gram-positive diplococcus

D. Congenital heart defect

D. Congenital heart defect

The nurse is providing care to several hospitalized pediatric clients. Which child has the greatest risk for a developmental disability?

A. An 18-month-old admitted with a diagnosis of near drowning.

B. A school-age child newly diagnosed with type 1 diabetes mellitus.

C. A toddler with sepsis.

D. A 2-year-old child with a fractured femur.

A. An 18-month-old admitted with a diagnosis of near drowning.

The nurse is planning care for a school-aged child who requires oxygen, enteral tube feedings, and IV medications during the school day. To which category of chronic illness does this child belong?

A. Dependent on special diet

B. Dependent on medical technology

C. Increased use of healthcare services

D. Functional limitations

B. Dependent on medical technology

The nurse is partnering with the family of a hospitalized premature neonate who suffered an

intraventricular hemorrhage (IVH). After 3 months in the neonatal intensive care unit

(NICU), the infant is being discharged. Which activities will the nurse suggest to the family

to help stimulate the infant's development? Select all that apply.

1. Using a day care for stimulation

2. Discouraging sibling interaction

3. Holding and rocking the infant

4. Interacting face to face

5. Talking softly and singing to the infant

3, 4, 5

The nurse is providing care to a pediatric client who is newly diagnosed with a chronic

condition. The parents ask, "When will our child be able to assume more responsibility for

managing the disease?" Which age group will the nurse include in the response to the

parents?

1. Preschooler

2. School-age

3. Adolescent

4. Toddler

2. School-age

Which does the nurse include in the plan of care for an adolescent with a chronic condition?

1. Being more concerned for parents

2. Exhibiting less concern about appearance

3. Having an altered body image

4. Portraying a higher self-esteem

3. Having an altered body image

The nurse is working with the parents of a child with a chronic condition. Which statement

made by the child's parents indicates the need for intervention related to overwhelming

caregiver burden?

1. "My mother moved in and helps us with the care of our family."

2. "I chose to quit my job to be home with my child, and my husband helps in the evening

when he can."

3. "I have to care for my child day and night, which leaves little time for me."

4. "Our health insurer sent us a rejection letter for my child's brand-name medication, and

we must fill out forms to get the generic."

3. "I have to care for my child day and night, which leaves little time for me."

The nurse is planning care for the family of a child with a chronic illness. Which activities

will the nurse recommend to decrease the risk for compassion fatigue? Select all that apply.

1. Fostering social relationships

2. Exercising

3. Developing a hobby

4. Moving away

5. Sleeping more than 9 hours per 24-hour period

1, 2, 3

The nurse observes that over time, the parents of a child with a chronic condition have

experienced a pattern of periodic grieving alternating with denial. Which will the nurse

include in the child's updated plan of care?

1. Pathologic Grieving

2. Compassion Fatigue

3. Chronic Sorrow

4. Dysfunctional Parenting

3. Chronic Sorrow

The nurse is conducting a nursing assessment of the parent and child with severe cerebral

palsy during a routine clinic visit. Which nursing action is appropriate based on the current

data?

1. Measuring the urine output

2. Measuring the child's head circumference

3. Observing the parent-child relationship

4. Observing how the child interacts during play

3. Observing the parent-child relationship

The nurse is conducting an educational program for parents of children with chronic

conditions. Which parental statement indicates the need for further instruction?

1. "I know my child will get better and not have to take any more medication."

2. "I know my child will need assistance with activities of daily living."

3. "I know my child may need specialized education."

4. "I know my child will have to stay on a special diet."

1. "I know my child will get better and not have to take any more medication."

An adolescent diagnosed with type 1 diabetes mellitus (DM) is prescribed dietary

restrictions and daily insulin injections. Which behavior does the nurse anticipate from the

adolescent upon return to school?

1. Administering medication in front of peers

2. Teaching peers about the diagnosis

3. Acknowledging the condition to classmates

4. Exhibiting poor adherence to the prescribed treatment plan

4. Exhibiting poor adherence to the prescribed treatment plan

The nurse is caring for a 17-year-old client with a chronic condition who will be

transitioning into adulthood. When planning care for this client, which should the nurse

consider? Select all that apply.

1. Ability to work

2. Ability to live independently

3. Psychosocial needs

4. Parental needs

5. Sibling needs

1, 2, 3

The nurse is providing care to a toddler-age client newly diagnosed with a chronic

condition. Which nursing action will prepare the family for providing care to the toddler

once discharged from the hospital setting?

1. Suggesting that the parents use a mobile to provide sensory stimulation

2. Helping the parents recognize their child's capabilities

3. Allowing the child to choose the color of the gown during hospitalization

4. Suggesting the child be enrolled in a special camp to learn about the diagnosis

2. Helping the parents recognize their child's capabilities

After the infant is diagnosed with a chronic health condition, the family is assigned a nurse

case manager. Which will the nurse include in the explanation to the infant's parents

regarding this role?

1. Limiting the number of visits to the healthcare facility

2. Preventing duplication of services

3. Improving the quality of life for the child and parents

4. Recognizing the equipment needs of the child and providing assistance with equipment

acquisition

5. Visiting the child in the home to assist with physical care

2, 3, 4

The nurse works in a clinic for medically fragile children who require home care. The nurse

has noticed that a high percentage of the families parents divorce. In an attempt to reduce

the divorce rate among the parents, the nurse creates an educational session for parents of

medically fragile children. Which should be the focus of this session?

1. Communication

2. Financial stability

3. Ways to meet the child's physical needs

4. The state laws that have relevance to the medically fragile child.

1. Communication

The school nurse is reviewing the records of all incoming kindergarten students. Which

students will require an individualized education plan (IEP)?

1. The child with diabetes controlled with insulin

2. The child with a casted arm due to a fracture

3. The child with a hearing deficit

4. The child with autism spectrum disorder

5. The child with an IQ of 60

3, 4, 5

Which nursing action is appropriate when preparing the family of a school-age child with a chronic illness to provide care in the home setting?

1. Teaching the family about appropriate sensory stimuli, such as a mobile

2. Educating the family to allow the child choices, such as which food to eat first

3. Preparing the family for the transition of care into adulthood

4. Encouraging interaction between the child and others with the same diagnosis

4. Encouraging interaction between the child and others with the same diagnosis

The mother of an adolescent with multiple medical and developmental issues says to the

nurse: "There are times that I think about just walking out of the house and not coming

back." Which would be an appropriate nursing diagnosis for this mother?

1. Caregiver Role Strain related to providing 24-hour care for a child with medical and

developmental issues

2. Risk for Injury (maternal) related to overwhelming demands of the medically fragile

child

3. Knowledge Deficit (maternal) related to nursing care of the child

4. Health-seeking Behaviors (maternal) related to interest in learning to care for her child

1. Caregiver Role Strain related to providing 24-hour care for a child with medical and

developmental issues

A 3-year-old child, recently hospitalized for the exacerbation of a chronic illness, presents

for a follow-up appointment at the pediatric clinic. The child's mother states, "He was potty

trained before the hospital stay but now he is having daily accidents." Which response by

the nurse is most appropriate?

1. "This is probably a reaction to the antibiotics and will disappear when the antibiotics are

finished."

2. "Urinary incontinence is a common symptom of progression of cystic fibrosis. Be sure

to notify the healthcare provider of this change."

3. "The child may have a urinary tract infection and needs to be evaluated."

4. "Children often regress after hospitalization. Be patient and remind him to go to the

bathroom frequently."

4. "Children often regress after hospitalization. Be patient and remind him to go to the

bathroom frequently."

The nurse learns that a newborn is diagnosed with phenylketonuria (PKU). Which is the

most appropriate way to inform the newborn's parents about this diagnosis?

1. Calling the parents to provide the diagnosis over the phone

2. Mailing a certified letter explaining the diagnosis and requesting the parents make a

pediatric office appointment

3. Planning a group meeting for all parents whose children received the diagnosis in the

last two months

4. Scheduling an appointment for the parents to see the healthcare provider in person to

discuss the diagnosis

4. Scheduling an appointment for the parents to see the healthcare provider in person to

discuss the diagnosis

The parents of a 4-month-old child learn that there will be long-term consequences due to

the head injury sustained in a motor vehicle accident, including intellectual disability and

cerebral palsy. The parents express anger at the diagnosis and project that anger on the

nursing staff. Which responses by the nursing staff are appropriate? Select all that apply.

1. Referring the family to the hospital administrator

2. Recognizing that the parents' anger is a normal response to the news

3. Continuing to provide physical and emotional care to the child and family

4. Offering hospital resources to the parents in addition to continued nursing support

5. Explaining to the family that you are sorry about their child's injury but suggest they

transfer the child to another hospital for their own comfort

2, 3, 4

The nurse is assigned as the care coordinator for a child with special healthcare needs. Which

actions by the nurse enhance the family's ability to participate in their child's care coordination?

Select all that apply.

1. Coordinating the healthcare team

2. Arranging the needed healthcare services

3. Modifying the home for care

4. Helping with decision making for meeting goals of care

5. Educating the family about the diagnosis

4, 5

The nurse care coordinator is supporting a family who wishes to become their child's care

coordinator. Which statements will the nurse include in the teaching session to prepare the

family for this task? Select all that apply.

1. "You won't need to set aside much time to properly coordinate your child's care."

2. "Care coordination requires ongoing assessment of your child's needs."

3. "Since you are the parent you will not be required to use cost-efficient strategies when

coordination your child's care."

4. "Care coordination requires you to be educated regarding your child's diagnosis."

5. "There is a care coordination workshop provided by hospital educators that will help

you to learn this role."

2, 4, 5

The nurse of the family who is assuming the role of care coordinator is providing education

regarding the use of a healthcare log. Which will the nurse encourage the family to include on

this log? Select all that apply.

1. Role of each provider

2. Date of each appointment

3. Prescribed interventions

4. Future treatments

5. Out-of-pocket cost

1, 2, 3, 4

The nurse provides care to pediatric clients with chronic disease process. Which diagnoses

does the nurse categorize as dependent on medications or special diets? Select all that apply.

1. Diabetes mellitus

2. Epilepsy

3. Celiac disease

4. Down syndrome

5. Traumatic brain injury

1, 2, 3

The nurse provides care to pediatric clients with chronic disease process. Which diagnoses

does the nurse categorize as needing increased use of healthcare services? Select all that apply.

1. Cancer

2. Sickle cell disease

3. Renal failure

4. Cystic fibrosis

5. Autism spectrum disorder

1, 2, 4

The nurse is providing care to a pediatric client who is experiencing separation anxiety.

Which data would support the documentation of the "despair" phase?

1. Lies quietly in bed.

2. Does not cry if his parents return and leave again.

3. Appears to be happy and content with staff.

4. Screams and cries when his parents leave.

1. Lies quietly in bed.

Which is a common fear, in addition to separation anxiety, for the hospitalized pediatric

client between the ages of 6 and 18 months?

1. Disfigurement

2. Death

3. Stranger anxiety

4. Bodily injury

3. Stranger anxiety

The parents of a child who is critically injured wish to stay in the room while the child is

receiving emergency care. Which nursing action is most appropriate in this situation?

1. Asking the healthcare provider if the parents can stay with the child

2. Allowing the parents to stay with the child

3. Escorting the parents to the waiting room and assuring them that they can see their child

soon

4. Telling the parents that they do not need to stay with the child

2. Allowing the parents to stay with the child

The pediatric group is providing care to a group of hospitalized clients. Which client is at

the greatest risk for developing separation anxiety if the parents are unable to stay with the

child at all times?

1. 6 month old

2. 18 month old

3. 4 year old

4. 6 year old

2. 18 month old

A preschool-age boy presents to the outpatient clinic for a sore throat. In the child's mind,

which is the most likely causative agent of the sore throat?

1. Being exposed to a classmate with strep throat

2. Yelling at sibling for being annoying

3. Not eating the right foods

4. Not taking daily vitamins

2. Yelling at sibling for being annoying

A school-age client is in the playroom when the respiratory therapist arrives to give a

scheduled breathing treatment. Which is the most appropriate nursing action?

1. Escorting the child to his room and asking the child-life specialist to bring toys to the

bedside

2. Rescheduling the treatment for a later time

3. Assisting the child back to his room for the treatment but reassuring him that he may

return when the procedure is completed

4. Showing the respiratory therapist to the playroom so the treatment can be performed

3. Assisting the child back to his room for the treatment but reassuring him that he may

return when the procedure is completed

A preschool-age child is admitted to the pediatric unit for surgery. The parents request to

stay with their child. Which is the best response by the nurse?

1. Tell the parents they can stay in the hospital but not on the unit.

2. Read the rules and regulations of rooming in with the child.

3. Let the parents know they are allowed to stay with the child.

4. Explain to the parents why they cannot stay with the child.

3. Let the parents know they are allowed to stay with the child.

A child is being prepared for surgery. The parents request to be present during anesthesia

induction. Which response by the nurse is most appropriate?

1. Telling the parents the names of all the medications that will be administered

2. Explaining what the parents will see and hear during induction

3. Telling the parents they will be upset to see the child under anesthesia

4. Ignoring the request and focusing on the child

2. Explaining what the parents will see and hear during induction

The mother of a child admitted to the intensive care unit (ICU) appears very angry and tells

the nurse no one is providing information about the child. Which response by the nurse is

most appropriate?

1. Asking the mother to leave if the behavior continues

2. Apologizing for the mother's perception and assure the mother that the staff will keep

her informed.

3. Offering to ask the healthcare provider to come and talk with her

4. Telling the mother her behavior will upset the child

2. Apologizing for the mother's perception and assure the mother that the staff will keep

her informed.

The nurse is caring for a child in the pediatric intensive care unit (PICU). The parents have

expressed anger over the nursing care their child is receiving. Which nursing action is most

appropriate?

1. Explaining to the parents that their anger is affecting their child, and they will not be

allowed to visit the child until they calm down

2. Asking the healthcare provider to talk with the family

3. Acknowledging the parents' concerns and collaborating with them regarding the care of

their child

4. Calling the hospital chaplain to sit with the family

3. Acknowledging the parents' concerns and collaborating with them regarding the care of

their child

The nursing action is most appropriate when performing a procedure on a toddler-age child?

1. Allowing the child to cry or scream

2. Performing the procedure in the child's hospital bed

3. Asking the child if it is okay to start the procedure

4. Asking the mother to restrain the child during the procedure

1. Allowing the child to cry or scream

A child has a planned hospitalization in a few weeks, and the client and family appear very

stressed. Which nursing action will minimize the stress for the client and family?

1. Telling the client and family that everything will be fine

2. Explaining to the client and family how the child will benefit from the surgery

3. Telling the client and family that the surgeon is very good

4. Giving a tour of the hospital unit or surgical area to the client and family

4. Giving a tour of the hospital unit or surgical area to the client and family

Which is the rationale for why parents should be allowed to be present with their children

during a medical procedure?

1. Parents want to support their child before, during, and immediately after the procedure.

2. Parents want to ensure that nothing goes wrong with the child.

3. Parents are interested because they are also in the medical field.

4. Parents want to ensure that the correct medication is being used.

1. Parents want to support their child before, during, and immediately after the procedure.

14) The parents have requested to be present during their child's procedure. How should the

nurse plan for this request?

1. Explain in detail, using medical terms, what will occur.

2. Explain to the family that it is not permitted for family members to be present.

3. Prepare family members for what they should anticipate and what is expected of them.

4. Prepare the family to speak with the healthcare provider.

3. Prepare family members for what they should anticipate and what is expected of them.

The mother of a child admitted after a motor vehicle accident expresses concern about

caring for the child's wounds at home. The mother has demonstrated appropriate technique

with medication administration and wound care. Which is the priority nursing diagnosis?

1. Parental Anxiety related to care of the child at home

2. Altered Family Processes related to hospitalization

3. Risk for Infection for related to presence of healing wounds

4. Knowledge Deficit related to home care

1. Parental Anxiety related to care of the child at home

A child is being discharged from the hospital requiring complex, long-term care with

medication administration through a central line and maintenance of oxygen administration

by nasal cannula. A home health nurse will be visiting each day. What should the nurse

teach the family members prior to hospital discharge?

1. How to insert an IV line

2. Nothing, the family is familiar with the care

3. Instruction on oxygen administration

4. How to remove a central line

3. Instruction on oxygen administration

Prior to discharging the child from the hospital, what routine discharge instructions should

the nurse discuss with the family?

1. Monitoring signs and symptoms specific to condition

2. Instruction on performing a medical examination on the child

3. No instructions are needed; the family is familiar with the child.

4. A list of all diagnostic tests obtained during the hospitalization and their results

1. Monitoring signs and symptoms specific to condition

Which age groups can best tolerate separation from parents during hospitalization? Select

all that apply.

1. Infants birth to 5 months

2. Infants 5 months to 1 year

3. Toddlers and preschoolers

4. School-age children

5. Adolescents

1, 4, 5

A hospitalized preschool-age child will be left alone for short periods of time for the mother

to return home to care for the child's siblings. The mother asks the nurse what is the best

way to leave. Which response by the nurse is appropriate? Select all that apply.

1. "Leave after your child falls asleep so he won't know you are going."

2. "Tell your child you are leaving and identify when you will return after dinner."

3. "Leave an article of clothing behind to comfort your child."

4. "Tell the nurse on duty when you are leaving so that the nurse can stay with your child

while you are gone."

5. "Plan to leave when your child is having procedures performed as the child will be busy

and less aware of the parents' absence."

2, 3

A 6-year-old child is hospitalized for a surgical procedure. The parents ask if the child's

four siblings can visit. Which response by the nurse is the most appropriate?

1. "Let's plan their visit for a time when the child has received pain medication."

2. "Only those siblings over 16 will be allowed to visit."

3. "I don't think the other children should visit because it might scare them to see their

sibling so sick."

4. "Very young children shouldn't visit as they may carry germs."

1. "Let's plan their visit for a time when the child has received pain medication."

The 4-year-old child is undergoing cardiac surgery. Which nursing action will reduce the

child's stress in the preoperative period? Select all that apply.

1. Explain the procedure to the child in simple terms of what the child will see, hear, and

feel while awake.

2. Explain to the child that the surgery will fix her "broken" heart.

3. Allow the parents to accompany the child to the surgical holding room and wait with the

child.

4. Allow the child to hold onto their special "teddy bear" while awake.

5. Wait until the child is in the holding room to insert the Foley catheter.

1, 3, 4

An adolescent tells the nurse that the new diagnosis of diabetes has him "stressed out."

Which stress-reduction activities will the nurse recommend to this adolescent? Select all

that apply.

1. Daily exercise, such as walking

2. Learning more about his illness

3. Practicing deep breathing and other relaxation techniques

4. Not thinking about his diagnosis

5. Allowing the parents control of his disease

1, 2, 3

The healthcare provider has prescribed the toddler an oral medication. The toddler has

fought medication administration in the past. Which strategies may be helpful when

administering the medication to this toddler? Select all that apply.

1. Request the medication in liquid form and draw the medication in an oral syringe.

2. Put the medication in a favorite drink in the child's sippy cup.

3. Allow the mother to administer the medication to the child.

4. Notify the healthcare provider to change the route to intravenous.

5. Hold the child down and squirt the medication in the corner of his mouth.

1, 3

Which changes can a nurse manager implement to reduce the stress experienced by

hospitalized pediatric clients?

1. Having only female nurses on the unit

2. Assigning nurses one-on-one with clients

3. Allowing the nurses to wear colored scrubs in place of white uniforms

4. Having the nurses avoid entering the client's room unless a procedure is to be performed

3. Allowing the nurses to wear colored scrubs in place of white uniforms

Which nursing actions are important when providing care to a pediatric client who is on

contact precautions due to a communicable disease? Select all that apply.

1. Encouraging frequent family visits

2. Scheduling physical therapy (PT) for the child

3. Providing age-appropriate stimulation and activities

4. Allowing the parents to have physical contact with the child

5. Educating the family about personal protective equipment (PPE)

1, 3, 4, 5

The nurse is providing care to an infant who is hospitalized for bronchiolitis. Which infant

stressors should the nurse plan for when providing care for this infant? Select all that apply.

1. Separation anxiety

2. Stanger anxiety

3. Disrupted sleep-wake cycle

4. Loss of self-control

5. Fear of the dark

1, 2, 3

The nurse is providing care to a hospitalized adolescent client. Which should the nurse

include in the adolescent's plan of care related to stressors? Select all that apply.

1. Loss of privacy

2. Fear of the dark

3. Loss of identity

4. Fear of altered body image

5. Separation anxiety

1, 3, 4

Which are barriers to successful discharge planning that the nurse may need to plan for when

providing care to a pediatric client who is approaching discharge? Select all that apply.

1. Financial concerns

2. Parental unavailability for teaching

3. Lack of equipment

4. Poor teamwork

5. Insurance payment for services

1, 2, 3, 4

Which nursing actions are appropriate for teaching the family of a pediatric client requiring

skilled care prior to discharge?

1. Teaching how to use home equipment

2. Educating on symptoms that indicate distress

3. Encouraging participation in a cardiopulmonary resuscitation course

4. Recommending that one parent take a leave of absence from work

5. Discouraging participation in case coordination activities

1, 2, 3

While making rounds, the nurse observes all of the following client behaviors. Which

child should the nurse further evaluate for postoperative pain?

1. The 6-month-old in deep sleep.

2. The 2-year-old who is cooperative when the nurse takes vital signs.

3. The 4-year-old who is actively watching cartoons.

4. The 14-month-old who is thrashing his arms and legs.

4. The 14-month-old who is thrashing his arms and legs.

The nurse is taking care of a postoperative school-age child. The child's mother requests

that the child not receive narcotics because she is afraid the child will become addicted. The

nurse should explain that children who do not receive adequate pain control will be at risk

for which complication?

1. Respiratory

2. Urinary

3. Cardiac

4. Bowel

1. Respiratory

The nurse is caring for a postoperative toddler-age child. Which pain assessment tool should

the nurse use to assess this child's pain?

1. Poker Chip Tool

2. Oucher Scale

3. Faces Pain Rating Scale

4. FLACC Behavioral Pain Assessment Scale

4. FLACC Behavioral Pain Assessment Scale

A 5-year-old child is hospitalized with a fractured femur. Which tool should the nurse use to

assess this child's pain?

1. CRIES Scale

2. Faces Pain Rating Scale

3. SUN Scale

4. PIPP Scale

2. Faces Pain Rating Scale

During the nurse's initial assessment of a school-age child, the child reports a pain level of

6 out of 10. The child is lying quietly in bed watching television. Which nursing action is

appropriate?

1. Reassess the child in 15 minutes to see if the pain rating has changed.

2. Administer the prescribed analgesic.

3. Do nothing, since the child appears to be resting.

4. Ask the child's parents if they think the child is hurting.

2. Administer the prescribed analgesic.

A hospitalized 3-year-old child needs to have an IV restarted. The child begins to cry when

carried into the treatment room by the mother. Which is an appropriate nursing diagnosis to

address this situation?

1. Knowledge Deficit of the procedure

2. Fear related to the unfamiliar environment

3. Anxiety related to anticipated painful procedure

4. Ineffective Individual Coping related to an invasive procedure

3. Anxiety related to anticipated painful procedure

A nurse is providing care for a pediatric client in the intensive care unit (ICU) who has been

on opioids for an extended period of time. Which assessment finding indicates to the nurse

that the child is experiencing withdrawal symptoms related to the opioid weaning process?

1. Hyperactive deep tendon reflexes, vomiting, and abdominal cramps.

2. Bradycardia and pallor.

3. Decreased blood pressure and drowsiness.

4. Voracious appetite and hypotonicity.

1. Hyperactive deep tendon reflexes, vomiting, and abdominal cramps.

An analgesic is prescribed for a postsurgical pediatric client to be administered every 3 to 4

hours. Which can occur if the nurse is delayed in administering the prescribed analgesic?

1. Decrease in the chance of withdrawal symptoms

2. Decrease in the chance of addiction

3. Increase in the chance of breakthrough pain

4. Increase in the child's pain tolerance

3. Increase in the chance of breakthrough pain

The nurse is preparing to perform a heel stick on a neonate. Which complementary therapy

should the nurse implement to decrease pain during this quick but painful procedure?

1. Holding the newborn

2. Providing a sucrose pacifier to the newborn

3. Massaging the newborn

4. Swaddling the newborn

2. Providing a sucrose pacifier to the newborn

A 6-year-old postoperative client's IV infiltrates and has to be restarted immediately for

medication. There is no time for placing local anesthetic cream on the skin. Which

complementary therapy would be helpful when placing this IV?

1. Restraints

2. Moderate sedation

3. Anesthesia

4. Distraction

4. Distraction

The pediatric nurse would expect that patient-controlled analgesia (PCA) would be most

appropriate for which client?

1. 12-year-old client who is postoperative for spinal fusion for scoliosis

2. 10-year-old client who has a fractured femur and concussion from a bike accident

3. 5-year-old client who is postoperative for tonsillectomy

4. Developmentally delayed 16-year-old client who is postoperative for bone surgery.

1. 12-year-old client who is postoperative for spinal fusion for scoliosis

Which statement by the parent of a preschool-age child would indicate the need for further

teaching regarding pain management?

1. "I will call the office tomorrow if the pain medicine is not relieving the pain."

2. "I can expect my child to have some pain for the next few days."

3. "Because my child just had surgery today, I can expect the pain level to be higher

tomorrow."

4. "I will plan to give my child pain medicine around the clock for the next day or so."

3. "Because my child just had surgery today, I can expect the pain level to be higher

tomorrow."

The nurse is caring for a child who has been sedated for a painful procedure. Which is the

priority nursing action?

1. Placing the child on a cardiac monitor

2. Allowing parents to stay with the child

3. Monitoring pulse oximetry

4. Assessing the child's respiratory effort

4. Assessing the child's respiratory effort

The nurse is planning care for a preschool-age child who is intellectually disabled and is

scheduled for surgery the next day. Which should the nurse consider when choosing a pain

assessment tool? Select all that apply.

1. The child's language skills

2. The child's ability to understand the concept of more and less

3. The child's ability to sit for a 10-minute evaluation

4. The child's ability to perceive pain

5. The child's ability to understand pain

1, 2

The nurse administers IV morphine to a 4-year-old postoperative client. Which assessment

finding requires further evaluation by the nurse?

1. Pulse decreased from 136 to 104

2. Blood pressure dropped from 110/72 to 90/55

3. Respiratory rate went from 42 to 16

4. Child pulls away from nurse who wants to assess surgical site

3. Respiratory rate went from 42 to 16

The healthcare provider prescribes hydromorphine (Dilaudid) intravenously for the

postoperative 4-year-old child. The therapeutic range for Dilaudid has been determined to

be 0.01 to 0.015 mg/kg/dose every 3 to 4 hours. What is the maximum therapeutic dose of

Dilaudid if the child weighs 30 pounds? Round your answer to the nearest hundredth.

0.2mg

During shift report, the night nurse reports that a terminally ill child has developed tolerance

to the prescribed morphine. Which concept should the nurse use when planning care for this

child?

1. The child is physically dependent on morphine.

2. The child is addicted to morphine.

3. The child is showing physical signs of withdrawal.

4. The child will need more medication to achieve the same effect.

4. The child will need more medication to achieve the same effect.

The 17-month-old toddler, diagnosed with terminal cancer, is experiencing constant pain.

Which prescription does the nurse anticipate from the healthcare provider for this toddler?

1. Patient-controlled analgesia (PCA) with the parents controlling the button that

administers the dosage

2. Intravenously administered opioids on a scheduled basis

3. Intravenously administered opioids on a prn basis

4. Orally administered opioids on a prn basis

2. Intravenously administered opioids on a scheduled basis

Which distraction techniques should the nurse to use for a school-age child during a painful

procedure? Select all that apply.

1. Blowing bubbles

2. Music therapy

3. Guided imagery

4. Hypnosis

5. Sucrose solution

1, 2, 3

Which nonpharmacologic interventions are appropriate for the nurse to use when treating

pediatric clients in pain? Select all that apply.

1. Regional nerve block

2. Cutaneous stimulation

3. Application of heat

4. Electroanalgesia

5. Use of EMLA cream

2, 3, 4

The nurse is providing care to a pediatric client who is receiving sedation for a painful

procedure. Which are the priority nursing actions? Select all that apply.

1. Monitoring respirations

2. Assessing for manifestations of deep sedation

3. Ensuring a crash cart is available

4. Administering the prescribed opioid

5. Administering the prescribed benzodiazepine

1, 2, 3

Which are the priority nursing assessments when providing care to a pediatric client who is

receiving sedation? Select all that apply.

1. Respiratory effort

2. Chest wall movement

3. Skin color

4. Level of consciousness

5. Pain

1, 2, 3, 4

Which are discharge criteria the nurse includes in the plan of care for a client who has

received sedation? Select all that apply.

1. Stable vital signs

2. Patent airway

3. Ability to sit up without assistance

4. Adequate fluid intake

5. Ability to urinate

1, 2, 3

Which pediatric diagnoses require the nurse to include interventions to treat chronic pediatric

client pain in the plan of care? Select all that apply.

1. Juvenile idiopathic arthritis

2. Sickle cell disease

3. Attention deficit hyperactivity disorder (ADHD)

4. Cancer

5. Human immunodeficiency virus (HIV)

1, 2, 4

Which complementary pain management interventions should the nurse include in the plan

of care for a pediatric client who is experiencing chronic pain? Select all that apply.

1. Hypnosis

2. Guided imagery

3. Patient-controlled analgesia (PCA)

4. Fentanyl patch

5. EMLA cream

1, 2

Which pediatric client will the community health nurse assess first?

1. A 6-year-old who is wheezing and short of breath.

2. A 2-year-old who has been pulling at his ear.

3. A 2-month-old with a 2-day history of diarrhea.

4. A 10-year-old with a sore throat and low-grade fever.

1. A 6-year-old who is wheezing and short of breath.

A community assessment conducted by the nurse reveals that the number of serious injuries

in children has doubled in the past year. Which is the most appropriate nursing diagnosis

when planning care to address the increased number of injuries?

1. Altered Family Processes related to hospitalization of an injured child

2. Risk for Injury related to inadequate use of bicycle helmets

3. Noncompliance related to inappropriate use of child safety seats

4. Knowledge Deficit related to injury prevention in children

4. Knowledge Deficit related to injury prevention in children

Which must the nurse realize prior to accepting any assignment as a home health nurse?

1. All decisions will be made by the healthcare provider.

2. Independent decisions regarding emergency care of the child will be made by the nurse.

3. The family will adapt their lifestyle to the needs of the nurse.

4. The family is in charge.

4. The family is in charge.

The home health nurse is providing care to a 2-week-old newborn, and notes that the baby

has a necklace with a charm around the neck. The parents state that they believe the charm

will keep the baby healthy. Which nursing action is most appropriate?

1. Report the parent to Social Services for endangering the child.

2. Respect the parents' wishes and leave the necklace in place.

3. Remove the necklace and inform the parents that it is dangerous.

4. Ask the parents to remove the necklace.

2. Respect the parents' wishes and leave the necklace in place.

A 2-month-old infant with bronchopulmonary dysplasia (BPD) is being prepared for

discharge from the neonatal intensive care unit. The infant will continue to receive oxygen

via nasal cannula at home. Prior to discharge, the home health nurse assesses the home.

Which finding poses the greatest risk to this infant?

1. Paint peeling on the walls

2. A wood stove used for heating

3. A sibling who has an ear infection

4. Small toys strewn on the floor

2. A wood stove used for heating

An adolescent client has a long leg cast secondary to a fractured femur. Which nursing

action is most appropriate in order to effectively facilitate the adolescent's return to school?

1. Develop an individualized health plan (IHP) that focuses on long-term needs of the

adolescent.

2. Meet with all of the other students prior to the student's return to school to emphasize

the special needs of the injured teen.

3. Meet with teachers and administrators at the school to make sure entrances and

classrooms are wheelchair accessible.

4. Meet with parents of the injured student to encourage homebound schooling until a

short leg cast is applied.

3. Meet with teachers and administrators at the school to make sure entrances and

classrooms are wheelchair accessible.

Which is the priority topic the nurse will include when teaching newly hired teachers at a

child care center within the community?

1. How to take a temperature

2. The schedule for immunizations

3. How to interpret healthcare records

4. Principles of infection control

4. Principles of infection control

In which situation will the school nurse collaborate with the family and other members of

the healthcare team in order to develop an individualized health plan (IHP)?

1. For a child who recently developed a penicillin allergy

2. For a child who has been treated for head lice

3. For a child who has missed 2 weeks of school due to mononucleosis

4. For a child who is newly diagnosed with insulin-dependent diabetes mellitus.

4. For a child who is newly diagnosed with insulin-dependent diabetes mellitus.

The telephone triage nurse receives a call from a parent who describes a crowing sound

when the 18-month-old breathes and the child is hard to wake up. Which is the appropriate

nursing action?

1. Making an appointment for the child to see the healthcare provider

2. Obtaining the history of the illness from the parent

3. Advising the parent to hang up and call 911

4. Reassuring the parent and providing instructions on home care for the child

3. Advising the parent to hang up and call 911

Which actions are expected for a nurse who works in the school environment? Select all

that apply.

1. Developing a plan for emergency care of injured children

2. Teaching a class on wellness to teachers and staff

3. Prescribing antibiotics for streptococcal pharyngitis

4. Diagnosing an ear infection

5. Screening for head lice

1, 2, 5

A child who has had a tracheostomy for several years is scheduled to begin kindergarten in

the fall. The teacher is concerned about this child being in the class, and consults the school

nurse. Which nursing action is appropriate?

1. Making arrangements for the child to go to a special school

2. Recommending that the child be home schooled

3. Asking the parents of the child to provide a caregiver during school hour

4. Teaching the teacher how to care for the child in the classroom

4. Teaching the teacher how to care for the child in the classroom

A child who is dependent on a ventilator is being discharged from the hospital. Which will

the nurse recommend for the emergency plan of care for this family during the discharge

instruction process?

1. Designating an emergency shelter site

2. Notifying the power company that the child is on life support

3. Acquiring a backup generator

4. Having an alternate heating source if power is lost

3. Acquiring a backup generator

Which aspect of an emergency medical services system (EMS) indicates the providers are

prepared to provide emergency care to children?

1. Listing hospitals in the area that treat children

2. Having pediatric-sized equipment and supplies

3. Placing small stretchers in emergency vehicles

4. Educating staff related to assessment and treatment of children of all ages

4. Educating staff related to assessment and treatment of children of all ages

The nurse is planning care for a pediatric client who has a fractured femur and requires a

spica cast after being involved in a motor vehicle accident. The client's adolescent brother was driving the car, which was a total loss. The client's father lost his job 3 weeks ago and the mother has just accepted a temporary waitress job. Which is an appropriate nursing

diagnosis for this child, and family, based on the current data?

1. Interrupted Family Processes related to a child with significant disability requiring

alteration in family functioning.

2. Risk for Caregiver Role Strain related to a child with a newly acquired disability and the

associated financial burden.

3. Impaired Social Interaction (parent and child) related to the lack of family or respite

support.

4. Compromised Family Coping related to multiple simultaneous stressors.

4. Compromised Family Coping related to multiple simultaneous stressors.

The nurse is developing an ecomap for a pediatric client and family. Which explanation

should the nurse provide prior to beginning this task?

1. "It provides information about your family structure including family life events, health,

and illness."

2. "It illustrates your family relationships and interactions with community activities

including school, parental jobs, and children's activities."

3. "It is a short questionnaire of five questions that measures your family's growth,

affection, and resolve."

4. "It is an assessment that consists of three categories of information about your family's

strengths and problems."

2. "It illustrates your family relationships and interactions with community activities

including school, parental jobs, and children's activities."

Which are resources that enable families to develop and adapt to stressors? Select all that

apply.

1. Education

2. Communication

3. Prior experiences

4. Problem solving

5. Adequate finances

1, 3, 5

Which nursing actions will allow a family to further develop resilience when faced with an

illness of a child? Select all that apply.

1. Teaching skills to provide care

2. Suggesting adaptations related to discipline

3. Providing positive reinforcement

4. Recommending the use of defensive coping strategies

5. Focusing on the weaknesses

1, 2, 3

The nurse is preparing to collect data for a family assessment. Which nursing actions are

appropriate? Select all that apply.

1. Conducting interviews

2. Observing interactions

3. Reviewing reports from the healthcare provider

4. Monitoring daily living patterns

5. Asking a family friend his or her opinion of the family

1, 2, 3, 4

The nurse is constructing a genogram as part of the family assessment process. Which will

the nurse include in the genogram? Select all that apply.

1. Social class

2. Occupation

3. Place of residence

4. Social networks

5. Ethnicity

1, 2, 3, 5