2023 PEDS ATI Proctored Exam

The nurse is preparing to administer an immunization to a four-year-old child.

Which of the following actions should the nurse plan to take?

A- Place the child in a prone position for the immunization

B- request that the child's caregiver leave the room during the immunization

C- administer the immunization using a 24-gauge needle

D- inject the immunization slowly after aspirating for 3 seconds

C- administer the immunization using a 24-gauge needle; The nurse should administer an immunization for a 4-year-old child using a 24-

gauge needle to minimize the amount of pain experienced by the toddler.

A nurse is reviewing the laboratory report of an infant who is receiving

treatment for severe dehydration. The nurse should identify which of the

following laboratory values indicates effectiveness of the current treatment?

A- Potassium 2.9 mEq/L

B- sodium 140

C- urine specific gravity 1.035

D- BUN 25 mg

B- sodium 140; The nurse should identify that a sodium level of 140 mEq/L is within the

expected reference range and indicates the current treatment regimen the infant

is receiving for dehydration is effective.

The nurse is providing teaching about Social Development to the parents of a

preschooler. Which of the following play activities should the nurse

recommend for the child?

A- Play pat-a-cake

B- using a push pull toy

C- creating a scrapbook

D- playing dress-up

D- playing dress-up; The nurse should instruct the parents that at the preschool age, play should focus

on social, mental, and physical development. Therefore, playing dress-up is a

recommended play activity for this child.

A nurse is teaching the parents of a newborn about ways to prevent sudden

infant death syndrome SIDS. Which of the following instructions should the

nurse include?

A- Place the infant in a prone position to sleep.

B- Allow the infant to sleep on a large pillow.

C- User soft mattress in the infant's crib.

D- Give the infant a pacifier at bedtime.

D- Give the infant a pacifier at bedtime; The nurse should inform the parent that protective factors against SIDS include

breastfeeding and the use of a pacifier when the infant is sleeping.

A- The nurse should instruct the parent to place the infant in a supine

A nurse is assessing an infant who has pneumonia. Which of the following

findings is the priority for the nurse to report to the provider?

A- Nasal flaring

B- WBC 11,300

C- diarrhea

D- abdominal distension

A- Nasal flaring; When using the airway, breathing, circulation approach to client care, the nurse

should place the priority on nasal flaring. Nasal flaring indicates that the

infant is experiencing acute respiratory distress.

A school nurse is assessing a school-age child blood pressure while he is seated

in a chair. The child starts to experience a tonic-clonic seizure. Which of the

following actions should the nurse take first?

A- Clear the immediate area around the child of hazardous objects

B- loosen the child restrictive clothing

C- assist the child to a side-lying position on the floor

D- apply an oxygen mask to the child

C- assist the child to a side-lying position on the floor; The greatest risk to this child is aspiration, occlusion of the airway, and bodily

injury from falling out of the chair. The nurse should ease the child down to

floor in a side-lying position immediately. This position enables the child's

secretions to drain from the mouth, preventing aspiration, and maintaining a

patent airway.

A nurse is receiving change-of-shift Report on for children. Which of the

following children should the nurse assesses first?

A- A toddler who has a concussion and an episode of forceful vomiting

B- an adolescent who has infective endocarditis and reports having a headache

C- an adolescent who was placed into Halo traction 1 hour ago and rates his pain

at a 6 on a 0-10 scale

D- school-age child who has acute glomerulonephritis and brown colored urine

A- A toddler who has a concussion and an episode of forceful vomiting; When using the urgent vs. no urgent approach to client care, the nurse should assess

this child first. An episode of forceful vomiting is an indication of increased

intracranial pressure in a toddler who has a concussion.

A nurse in the emergency department is caring for an adolescent who has

severe abdominal pain due to appendicitis. Which of the following

locations should the nurse identify as mcburney's point?

A is correct. The nurse should identify the lower right quadrant of the abdomen

between the umbilicus and the anterior iliac crest as the location of Burney's

point.

A nurse is providing teaching to the family of a school-age child who has

juvenile idiopathic arthritis. Which of the following instructions should

the nurse include in the teaching?

A- Limit the movement of the child large joints.

B- Encourage the child to perform independent self-care.

C- Provide the child with a soft mattress for sleeping.

D- Schedule a 2-hour daily nap for the child in the afternoon.

B- Encourage the child to perform independent self-care; The nurse should teach the family the importance of encouraging the child to

perform independent self-care. This will minimize the child's pain while maximizing

mobility.

A nurse is assessing a client who has a new diagnosis of celiac disease. Which

of the following clinical manifestations should the nurse expect?

A- Steatorrhea

B- projectile vomiting

C- sunken abdomen

D- weight gain

A- Steatorrhea; The nurse should realize that clients who have celiac disease are unable to digest

gluten. This will cause damage to the cells in the bowel, leading to

malabsorption, steatorrhea, and diarrhea.

A nurse is providing teaching to an adolescent about how to manage tinea

pedis. Which of the following statements by the Adolescent indicates an

understanding of the teaching?

A- I should buy some plastic shoes to wear at the swimming pool

B- I should wear sandals as much as possible

C- I should place the permethrin cream between my toes twice-daily

D- I should I seal my non washable shoes in plastic bags for a couple of weeks

D- I should I seal my non washable shoes in plastic bags for a couple of weeks; Sealing non-washable items in plastic bags for 14 days is a recommended

practice for clients who have pediculosis. This practice is not recommended for

tinea pedis.

A Nurse is teaching the parents of a school-aged child who has a new diagnosis of osteomyelitis of the tibia. The nurse should identify that which of the following statements by the parents indicates an understanding of the teaching?

A- my child will have a cast until healing is complete.

B- My child will receive antibiotics for several weeks.

C- My child can return to playing sports once he is

discharged.

D- My child needs to be in contact

isolation.

B- My child will receive antibiotics for several weeks; The nurse should instruct the parent that the child will receive antibiotic therapy for

at least 4weeks. Surgery might be indicated if the antibiotics are not successful.

A nurse is auscultating the lungs of an adolescent who has asthma. The nurse

should identify the sound as which of the following? Click the audio button

to listen.

A- Biots respiration

B- Chaney Stokes respiration

C- tachypnea

D - Bradypnea

C- tachypnea; The nurse should identify the sound heard during auscultation as tachypnea, which

is a rapid, regular breathing pattern. This breathing pattern often occurs with

anxiety, fever, metabolic acidosis, or severe anemia.

A nurse in an emergency department is caring for a school-age child who is experiencing an anaphylactic reaction. Which of the following is the

priority action by the nurse?

A- Elevate the head of the child's bed

B- insert a large-bore IV catheter for the child

C- determine the allergen that caused the child's reaction

D- administer IM epinephrine to the

child

D- administer IM epinephrine to the

child; When using the urgent vs no urgent approach to client care, the nurse determines that

the priority action is administering IM epinephrine to the child. During an

anaphylactic reaction, histamine release causes bronchoconstriction and

vasodilation. This is an emergency becauseultimately it causes decreased blood

return to the heart.

A nurse at an urgent care clinic is assessing an adolescent client who has an

upper respiratory tract infection. Which of the following findings should the

nurse recognize as a manifestation of pertussis?

A- Inflamed throat with exudate

B- purulent eye drainage

C- dry, hacking cough

D- koplik spots on buccal mucosa

C- dry, hacking cough; The nurse should recognize that a dry, hacking cough is a manifestation of

pertussis. This disease usually begins with indications of an upper respiratory

tract infection, which includes a dry, hacking cough that is sometimes more

severe at night.

A nurse is providing teaching about car seat use to the mother of a six-monthold

infant. Which of the following statements by the mother indicates an

understanding of the teaching?

A- I should secure the car seat using lower

anchors and tethers instead of the seat belt

B- I should position the car seat harness one inch above my baby's shoulders

C- I will make sure that the car seat is placed at a 90-degree angle

D- I will pad my baby's car seat with a blanket for traveling long distances

A- I should secure the car seat using lower

anchors and tethers instead of the seat belt; Lower anchors and tethers, or the LATCH child safety seat system, should be

used to secure an infant's car seat in the vehicle. This system provides anchors

between the front cushion and the back-rest for the car seat. Therefore, if this

system is available, the seatbelt does not have to be used.

A nurse is assessing the pain level of a three-year-old toddler. Which of the

following pain assessment scales should the nurse use?

A- FACES Pain rating scale

B- numeric pain rating scale

C- CRIES pain assessment scale

D- non communicating children's pain checklist

A- FACES Pain rating scale; The nurse should use the FACES pain rating scale for pediatric clients who are 3

years old and older. This scale allows the toddler to point to the face that depicts the

current level of pain. The nurse can then determine the need for pain management.

A nurse is caring for a preschooler who is scheduled for hydrotherapy

treatment for wound debridement following a burn injury. Which of

the following actions should the nurse take prior to the procedure?

A- Apply topical antimicrobial ointment to the child wound

B- place a mesh gauze dressing over the child wound

C- administer an analgesic to the child

D- initiate prophylactic antibiotic therapy for the child

C- administer an analgesic to the child; Hydrotherapy for debridement of a wound is an extremely painful procedure

which requires analgesia and/or sedation. When pain is controlled, it leads to reduced physiological demands on the body caused by stress and decreases the

likelihood of children developing depression and post-traumatic stress disorder.

A nurse is caring for a 10-year-old child following a head injury. Which

of the following findings should the nurse identify as an indication that

the child is developing diabetes insipidus?

A- Urine specific gravity of 1.045

B- sodium 155

C- blood glucose 45

D- urine output 35 ml per hour

B- sodium 155; A child who has a head injury can develop diabetes insipidus as a result of

pituitary hypo function leading to a deficiency of antidiuretic hormone.

Under excretion of antidiuretic hormone leads to polyuria and polydipsia and

possibly dehydration. With the excessive loss of free water, sodium levels rise

above the expected reference range.

A nurse is creating a plan of care for a toddler who has minimal change

nephrotic syndrome mcns and 3 + pitting edema. Which of the following

interventions should the nurse include in the plan?

A- Encourage an increased fluid intake for the toddler

B- place the child in an Airborne infection isolation room

C- increase the toddler's dietary sodium intake

D- administer corticosteroids to the toddler

D- administer corticosteroids to the toddler; The nurse should recognize that corticosteroids are the treatment of choice for

providers caring for children who have MCNS. Therefore, the nurse should

include administration of prescribed corticosteroids in the plan of care for this toddler.

A nurse is providing discharge teaching to the parent of a school-age child who

has moderate persistent asthma. Which of the following instructions should

the nurse include?

A- You should give your child his salmeterol inhaler every 4 hours when he is

having an acute episode of wheezing.

B- You should monitor your child's weight weekly while he is receiving inhaled

corticosteroid therapy

C- pulmonary function test will be performed every 12 to 24 months to

evaluate how yourchild is responding to therapy

D- when using the peak expiratory flow meter, record your child average of three

readings

C- pulmonary function test will be performed every 12 to 24 months to

evaluate how your child is responding to therapy; The nurse should inform the parent that her child will need pulmonary function

tests every 12to 24 months to evaluate the presence of lung disease and how the

child is responding to the current treatment regimen. As children grow,

sometimes their symptoms can improve or decline and treatment needs to change

accordingly.

A nurse is assessing a three-year-old toddler at a well-child visit. Which of the

following manifestations should the nurse report to the provider?

A- Blood pressure 90/ 50

B- respiratory rate 45/min

C- weight 14.5 kg or 32 lb

D- heart rate 110/min

B- respiratory rate 45/min; A respiratory rate of 45/min is above the expected reference range for a 3-year-old

toddler and can indicate respiratory dysfunction and acute respiratory distress.

Therefore, the nurse should report this finding to the provider immediately.

A nurse is preparing an adolescent for a lumbar puncture. Which of the

following actions should the nurse take?

A- Place a cardiac monitor on the Adolescent prior to the procedure

B- apply topical analgesic cream to the site one hour prior to the procedure

C- keep the Adolescent in a semi Fowler's position for 4 hours following the

procedure

D- restrict fluids for 2 hours following the procedure

B- apply topical analgesic cream to the site one hour prior to the procedure; The nurse should apply a topical analgesic to the lumbar site 60 min prior to the

procedure to decrease the adolescent's pain while the lumbar needle is inserted.

A nurse is providing teaching to the parents of a toddler about the

administration of a prescribed eye drops and eye ointment. Which of the

following instructions should the nurse include?

A- Apply the eye ointment within 30 minutes of your toddler Awakening in the

morning

B- apply the eye ointment from the outer canthus to the inner campus

C- use one hand to pull the upper eyelid upward when instilling the eye drops

D- administer the eye drops 3 minutes before the ointment

D- administer the eye drops 3 minutes before the ointment; The nurse should instruct the parents to administer the eye drops first and then wait

3 min before administering the eye ointment. This action provides adequate time and

spacing for each separate medication to work.

The nurse is providing discharge teaching to the parent of an 18-month old

toddler who has dehydration as a result of acute diarrhea. Which of the

following statements by the parent indicates an understanding of the teaching?

A- I will offer my child small amounts of fruit juice frequently

B- I will avoid giving my child solid foods until his diarrhea has stopped

C- I will monitor my child's number of wet diapers

D- I will give my child polyethylene glycol daily for 7 days

C- I will monitor my child's number of wet diapers; The nurse should teach the parent to closely monitor the child's number of

wet diapers. Monitoring the number of wet diapers per day is the best way

for the parent to monitor adequate output and hydration status.

A nurse is preparing to collect a sample from a toddler for a sickle turbidity

test. Which of the following actions should the nurse plan to take?

A- Obtain a sputum specimen

B- perform an allen test

C- perform a finger stick

D- obtain a stool specimen

C- perform a finger stick; The nurse should perform a finger stick on a toddler as a component of the sickleturbidity

test. If the test is positive, hemoglobin electrophoresis is required to

distinguish between children who have the genetic trait and children who have the

disease.

A nurse is caring for a school-age child who has peripheral edema. Which of

the following assessments should the nurse perform to confirm peripheral

edema?

A- Palpate the dorsum of the child's feet

B- play the child daily using the same scale

C- assess the child's skin turgor

D- observe the child for periorbital swelling

A- Palpate the dorsum of the child's feet; The nurse should palpate the dorsum of the feet by pressing her fingertip against a

bony prominence for 5 seconds to assess for peripheral edema.

A nurse in the emergency department is caring for a toddler who has partial

thickness burns on his right arm. Which of the following actions should the

nurse take?

A- Insert a nasogastric tube

B- initiate prophylactic antibiotics therapy

C- cleanse the affected area with mild soap and water

D- apply a topical corticosteroid to the affected area

C- cleanse the affected area with mild soap and water; The nurse should wash the affected area with mild soap and water to remove any

loose tissue that could cause infection.

A nurse is performing hearing screenings for children at a community health

fair. Which of the following children should the nurse refer to a provider for

a more extensive hearing evaluation?

A- A toddler who is 18 months old and has unintelligible speech

B- an infant who is 3 months old and has an exaggerated startle response

C- a preschooler who is 4 years old and prefers playing with others rather than alone

D- an infant who is 8 months old and is not yet making babbling sounds

D- an infant who is 8 months old and is not yet making babbling sounds; The nurse should refer an infant who is not making babbling sounds by the age of 7

months to a provider for more extensive evaluation of hearing.

A nurse is providing dietary teaching to the parent of a school-age child who

has cystic fibrosis. Which of the following statements should the nurse

make?

A- You should offer your child high protein meals and snacks

throughout the day

B- your child should decrease dietary fats to less than 10% of her caloric intake

C- your child will need to take a 1-gram sodium chloride tablet daily throughout her

lifetime

D- you should calculate your child carbohydrate needs based on her daily activities

A- You should offer your child high protein meals and snacks

throughout the day; The parent should provide a diet that is well-balanced and high in protein and

calories. Children who have cystic fibrosis require a higher percentage of the

recommended dietary allowances of all nutrients in order to meet their

energy requirements. Children who have good nutritional intake have

improved lung function and decreased risk of infection.

The nurse is providing dietary teaching to the parent of a school-age child

who has celiac disease. The nurse should recommend that the parent offer

which of the following foods tote child?

A- Wheat bread

B- vanilla malt

C- barley soup

D- rice pudding

D- rice pudding; The nurse should instruct the parent that the child will remain on a lifelong glutenfree

diet. The child cannot consume oats, rye, barley or wheat, and sometimes

lactose deficiency can be secondary to this disease. The nurse should recognize that

rice pudding is a gluten-free food.

A nurse is providing teaching to the parents of a preschooler who has heart

failure and who is to begin taking Digoxin twice-daily. Which of the

following instructions should the nurse include in the teaching?

A- Use a kitchen teaspoon to measure the medication

B- brush the child teeth after giving the medication

C- double the next dose If the child misses a dose

D- repeat the dose If the child vomits

B- brush the child teeth after giving the medication; The nurse should instruct the parents to brush the child's teeth after administering

digoxin to prevent tooth decay caused by the medication, which comes as a

sweetened liquid to enhance the taste.

A nurse is providing teaching to the parent of a school-age child who has oral candidiasis and is to begin taking oral Nystatin. Which of the following

instructions should the nurse include?

A- Check the medication prior to

Administration

B- provide the medication through a straw

C- rinse the child mouth with water immediately after giving the medication

D- next the medication with applesauce If the child dislikes the taste

A- Check the medication prior to

Administration; The nurse should instruct the parent to shake the medication prior to administration

in order to disperse the medication evenly within the suspension.

The nurse is providing anticipatory guidance to the mother of a toddler.

Which of the following expected Behavior characteristics of toddlers should

the nurse include in the teaching?

A- Controls impulsive feelings

B- understand right from wrong

C- usually separated from parents for a long periods of time

D- expresses likes and dislikes

D- expresses likes and dislikes; The nurse should teach the mother that her toddler will begin to express her likes

and dislikes. This is the time in life when a toddler is developing autonomy and

self-concept. She will try to assert herself and frequently refuse to comply. The

parent should allow the child to have some control but also set limits in order

for her to learn from her behavior and learn to control her actions.

The nurse is reviewing the laboratory report of a school-age child who is

experiencing fatigue. Which of the following findings should the nurse

recognize as an indication of anemia?

A- Hematocrit 28%

B- hemoglobin 13.5 g

C- WBC 8000

D- platelet 250,000

A- Hematocrit 28%; The nurse should recognize that this hematocrit level is below the expected

reference range fora school-age child. The child can exhibit fatigue,

lightheadedness, tachycardia, dyspnea, and pallor due to the decreased oxygencarrying

capacity.

A nurse is creating a plan of care for an infant who has an epidural hematoma with a skull fracture. Which of the following actions should the nurse include in the plan?

A- Position the infant side lying with her head at a 0 - 5 degree angle

B- monitor the infant for tachycardia to prevent brain stem herniation

C- suction the infant snares every two hours while awake to maintain patency

D- implements seizure precautions for the infants

D- implements seizure precautions for the infants; The nurse should implement seizure precautions for an infant who has an epidural

hematomas' a safety measure.

A nurse in an emergency department is performing a physical assessment

on a 2-week old male infant. Which of the following manifestations is the

priority for the nurse to report to the provider?

A- Excoriated scrotal area

B- multiple capillary hemangiomas

C- depressed posterior fontanel

D- substernal retractions

D- substernal retractions; When using the airway, breathing, circulation approach to client care, the nurse

should determine that the priority finding to report to the provider is substernal

retractions. This finding indicates the infant is experiencing acute respiratory

distress and increased respiratory effort, which could quickly progress to

respiratory failure.

A nurse is providing discharge teaching to the parents of a three-month-old

infant following acheiloplasty. which of the following instructions should the nurse include?

A- Clean your baby's sutures daily with a mixture of chlorhexidine and water

B- expect your baby to swallow more than usual over the next few days

C- inspect your baby's tongue for white patches using a tongue depressor every 8 hours

D- apply a thin layer of antibiotic ointment on your babies' suture line daily for the next three days

D- apply a thin layer of antibiotic ointment on your babies' suture line daily for the next three days; The nurse should instruct the parents to apply a thin layer of antibiotic ointment on the infant's suture line daily for 3 days and then continue to apply petroleum jelly

to the area for several weeks to promote healing.

A nurse is caring for a hospitalized preschooler. The child's mother is going

home for a few hours while another relative stay with the child. Which of the

following statements should the nurse make to explain to the child when her

mother will return?

A- Your mommy will be back at 7 p.m.

B- your mommy will be back after she takes care of your brother

C- your mommy will be back in the morning

D- your mommy will be back after you eat

D- your mommy will be back after you eat; Preschoolers make sense of time best when they can associate it with an expected

daily routine, such as meals and bedtime. Therefore, the child comprehends time

best when it is explained to them in relation to an event they are familiar with,

such as eating.

A nurse is planning developmental activities for a newly admitted 10-year-old

child who has neutropenia. Which of the following actions should the nurse

plan to take?

A- Provide the child with a book about Adventure

B- arrange frequent visits from family members and peers

C- give the child a large piece puzzle

D- use puppet to entertain the child

A- Provide the child with a book about Adventure; The nurse should provide a school-age child with a book about adventure as a

developmental activity because children are expanding their knowledge and

imagination during this age.

A nurse in the emergency department is caring for a school-age child who has

epiglottitis.Which of the following actions should the nurse take?

A- Obtain a throat culture from the child

B- monitor the child's oxygen saturation

C- put a warm mist humidifier in the child's room

D- Place the child in a Supine position

B- monitor the child's oxygen saturation; The nurse should monitor the child's oxygen saturation level because the child is

experiencing acute respiratory distress and it is necessary to determine if the

child is responding to treatment.

A nurse in an Emergency Department is assessing a three-month-old infant

who has rotavirusand is experiencing acute vomiting and diarrhea. Which of

the following manifestations should the nurse identify as an indication that

the infant has moderate to severe dehydration?

A- Heart rate 124/ minute

B- increase tear production

C- sunken anterior fontanel

D- capillary refill 2 seconds

C- sunken anterior fontanel; The nurse should recognize that a sunken anterior fontanel is an indication of

moderate to severe dehydration due to the acute loss of fluid.

A nurse is creating a plan of care for a newly admitted adolescent who has

bacterial meningitis. How long should the nurse plan to maintain the

Adolescent in droplet precautions?

A- Until the Adolescent is afebrile

B- for 7 days following an admission to the facility

C- until the Adolescent has a negative blood culture

D- for 24 hours following initiation of antimicrobial therapy

D- for 24 hours following initiation of antimicrobial therapy; The nurse should plan to maintain the adolescent on droplet precautions for at least

24 hr following initiation of antimicrobial therapy. This practice will ensure that the

adolescent is nolonger contagious, which protects family members and the

personnel caring for the client.

Prophylactic antibiotics might be prescribed to individuals who were in close

contact with the adolescent.

A school nurse is assessing an adolescent who presents with multiple Burns in

various stages of healing. Which of the following behaviors should the nurse

identify as suggestive of possible physical abuse?

A- Expresses a reluctance to leave home

B- provides a detailed description of how the burns occurred

C- denies discomfort during assessment of injuries

D- describes strong relationships with peers

C- denies discomfort during assessment of injuries; The nurse should suspect child maltreatment in the form of physical abuse if the

adolescent has a blunted response to painful stimuli or injury.

A nurse is assessing an adolescent who received a sodium polystyrene

sulfonate enema. Which of the following findings indicates effectiveness

of the medication?

A- The Adolescents reports in absence of nausea and vomiting

B- the client experiences onset of loose stools within 15 minutes of administration

C- The Adolescents serum potassium level is 4.1

D- the Adolescent has a blood pressure of 86/ 52

C- The Adolescents serum potassium level is 4.1; The nurse should monitor the adolescent's serum potassium level following the

administration of sodium polystyrene sulfonate. This medication is used to

treat hyperkalemia by exchanging sodium ions for potassium ions in the

intestine.

A nurse is planning care for a toddler who has a serum lead level of 4 mcg/dL.

which of the following actions should the nurse plan to take?

A- Instruct the parents to decrease the calcium in their toddler's diet

B- prepare the toddler for chelation therapy

C- refer at the family to Child Protective Services

D- schedule the toddler for a yearly screening

D- schedule the toddler for a yearly screening; The nurse should schedule the toddler for a lead level rescreening in 1 year and

educate the family on ways to prevent exposure.

A nurse is assessing a school-age child immediately post-operative following a

perforatedappendix repair. Which of the following findings should the nurse

expect?

A- Purulent nasogastric drainage

B- absence of peristalsis

C- passage of dark red stool with mucus

D- WBC of 6000

B- absence of peristalsis; The nurse should expect absence of peristalsis in the immediate postoperative

period, until thebowel resumes functioning.

A nurse is teaching the parents of a toddler who has cognitive

impairment about toilet training. which of the following instructions

should the nurse include in the teaching? A- Scold the child when he has

a toileting accident

B- award the child with a sticker when he sits on the potty chair

C- play the child favorite song while teaching him to use the potty chair

D- teach multiple steps of the skill at the same time

B- award the child with a sticker when he sits on the potty chair; The child with a cognitive impairment learns through shaping behaviors. The parents should reward the child for sitting on the potty chair as a reinforcement of

the desired behavior of continence. As the child repeats this action, the parents can

gradually decrease this reward and then give rewards for the next step in the task,

such as voiding while sitting on the potty chair.

A nurse in a provider's office is caring for a school-age child who has

varicella. The parent askthe nurse when her child will no longer be

contagious. Which of the following responses should the nurse make?

A- When your child no longer has an increased temperature

B- three days after you first noticed the rash appear on your child

C- when your child lesions are crusted, 6 days after they appear

D- 2 - 3 weeks, when your child's lesions completely disappear

C- when your child lesions are crusted, 6 days after they appear; The nurse should inform the parent that the child is contagious 1 day prior to lesion eruption and until the vesicles have crusted over, which usually takes about

6 days.

A nurse is caring for a school-age child who has primary nephrotic syndrome

and is taking prednisone. Following one week of treatment, which of the

following clinical manifestationsindicate to the nurse that the medication is

effective?

A- Decrease edema

B- increased abdominal girth

C- decreased appetite

D- increased protein in the urine

A- Decrease edema; A child who has nephrotic syndrome can experience edema due to the increased glomerular permeability, which increases protein loss. Prednisone decreases

glomerular permeability, which causes fluid to shift from the extracellular spaces, decreasing edema.

A nurse is caring for a toddler who has spastic (pyramidal) cerebral palsy.

Which of thefollowing clinical manifestations should the nurse expect? Select

all that apply.

A- Negative Babinski reflex

B- Ankle clonus

C- exaggerated stretch reflexes

D- uncontrollable movements of the face

E- contractures

B- Ankle clonus

C- exaggerated stretch reflexes

E- contractures; Ankle clonus is correct. A child who has spastic cerebral palsy will exhibit ankle

clonus which isa rhythmic reflex tremor when the foot is dorsiflexed.

Exaggerated stretch reflexes is correct. A child who has spastic cerebral palsy will

exhibit spasticity or exaggerated stretch reflexes. Contractures is correct. A child who has spastic cerebral palsy will exhibit

contractures due tothe tightening of the muscles.

A nurse is assessing the vital signs of a 10 year old child following a burn

injury. Which of thefollowing clinical manifestations indicate early septic

shock?

A- Blood pressure 130/ 90

B- heart rate 60/ Minute

C- temperature 39.1 degrees Celsius or 102.4 degrees Fahrenheit

D- urinary output 100 mL/hr

C- temperature 39.1 degrees Celsius or 102.4 degrees Fahrenheit; The nurse should expect a child who has early septic shock to have a fever and

chills.

A nurse is creating a plan of care for a preschooler who has Wilms tumor and

is scheduled forsurgery. Which of the following interventions should the nurse

include?

A- Avoid palpating the abdomen when bathing the child before surgery

B- refrain from auscultating the child bowel sounds during the post-operative

assessment

C- encourage the child to play with other children on the unit prior to surgery

D- explain it to the child that his pain will be managed after the surgery

A- Avoid palpating the abdomen when bathing the child before surgery; The nurse should avoid palpating the abdomen when bathing the child before

surgery because movement of the tumor can cause cancer cells to disseminate to other sites, adjacent and distant to the tumor site.

A charge nurse in an emergency department is preparing an in-service for a

group of newly licensed nurses on the clinical manifestations of child

maltreatment. Which of the followingclinical manifestations should the charge

nurse include as suggestive of potential physical abuse?

A- Recurrent urinary tract infections

B- symmetric Burns of the lower extremities

C- growth failure

D- lack of subcutaneous fat

B- symmetric Burns of the lower extremities; The nurse should include in the teaching that symmetric burns of the lower

extremities are a suggestive clinical manifestation of physical abuse. The patterns

are usually characteristic of the method or object used, such as cigar or cigarette

burns, or burns in the shape of an iron.

The nurse is caring for a 15 year old client following a head injury. Which of

the following findings should the nurse identify as an indication that the child is

developing syndrome ofinappropriate antidiuretic hormone secretion SIADH?

A- sodium 148

B- urine specific gravity of 1.020

C- mental confusion

D- weak peripheral pulses

C- mental confusion; A child who has a head injury can develop SIADH as a result of altered pituitary

function, leadingto an oversecretion of antidiuretic hormone. Oversecretion of

antidiuretic hormone leads to a decrease in urine output, hyponatremia, and

hypoosmolality due to overhydration.

A nurse in a provider's office is preparing to administer immunizations to a

toddler during awell-child visit. Which of the following actions should the

nurse plan to take?

Prescriptions:

-tuberculin skin test (TST)

-measles mumps rubella

vaccine

-inactivated influenza vaccine

-diphtheria, tetanus, and pertussis (DTaP vaccine)

Vital signs

-respiratory rate 24/minute

-heart rate 115/minute

-temperature 37.4 degrees Celsius or 99.3 degrees Fahrenheit

History and physical

-Age 12 months 9 days

-height 71.1cm/28-in

allergies

neomycin - anaphylactic reaction

caregiver reports:

-rhinitis with clear nasal drainage for 2days

-occasional non productive cough for 2 days

-history of asthma

A- Withhold the measles mumps and rubella MMR vaccine

B- withhold the DTaP vaccine

C- withhold the influenza vaccine

D- withhold the tuberculin skin test TST

A- Withhold the measles mumps and rubella MMR vaccine; The nurse should recognize that an allergy to neomycin with an anaphylactic

reaction is a contraindication to receiving the MMR vaccine. Clients who have a

severe allergy to eggs orgelatin should not receive this vaccine.

A nurse is caring for a preschooler who has been receiving IV fluids via a peripheral IV catheter. When preparing a to discontinue the IV fluids and

catheter, which of the followingactions should the nurse plan to take? Place

the steps in order of performance.

A- remove the tape securing the catheter

B- turn off the IV pump

C- occlude the IV tubing

D- apply pressure over the catheter insertion site

1) B- turn off the IV pump

2) C- occlude the IV tubing

3) A- remove the tape securing the catheter

4) D- apply pressure over the catheter insertion site

A nurse is reviewing the dietary choices of an adolescent who has iron

deficiency anemia. the nurse should identify that which of the following menu

items has the highest amount of iron?A- 1/2 cup whole milk

B- 1 cup orange juice

C- 1/2 cup raisins

D- one cup raw carrots

C- 1/2 cup raisins; The nurse should encourage the adolescent to eat raisins because they contain the highest amount of non-heme iron.

A nurse is creating an educational plan to teach parents about protecting their

children fromsun burns. Which of the following instructions should the nurse

plan to include?

A- Choose a waterproof sunscreen with an SPF of at least 15

B- apply sunscreen liberally to infants over three months of age

C- dress children in a loose weave polyester fabric prior to sun exposure

D- reapply sunscreen every 4 hours

A- Choose a waterproof sunscreen with an SPF of at least 15; The nurse should instruct parents to apply a waterproof sunscreen with an SPF of at

least 15 forchildren. The parents should apply the sunscreen prior to sun exposure

to reduce the risk of sunburn.