a nurse is planning care for a child who has severe diarrhea. which of the
following actions is the nurse priority?
Assess fluid balance
A nurse is caring for a toddler who's parent states that the child has a mass in his
abdominal area and his urine is a pink color. Which of the following actions is the
nurse's priority?
Instruct the parent to avoid pressing on the abdominal area
A nurse is caring for a child who has acute glomerulonephritis. Which of the
following actions is the nurse's priority?
Check the Childs weight daily
A nurse is caring for a child who has a suspected diagnosis of bacterial meningitis.
Which of the following is the nurse's priority?
Administer antibiotics when available
A nurse is collecting data from an adolescent. Which of the following represents
the greatest risk for suicide?
Active psychiatric disorder (Mark, mental problems, patients mind is unstable)
A nurse is collecting data from an infant who has otitis media (middle ear
infection). The nurse should expect which of the following findings?
Tugging on the affected ear lobe
,A nurse is reinforcing reaching with a parent of a 1 month old infant who is to
undergo the initial surgery to treat Hirschsprung's disease (a ganglionic
megacolon, part of the colon isn't connected to the nerves or not functioning, so
there will be an increase size of the colon and stool gets stuck in there). Which of
the following statements should indicate to the nurse that the parent
understanding the goal of surgery?
"I'm glad that the ostomy is only temporary " (1st there going to cut the
nonfunctioning of the colon, and then apply temporary colostomy, after a couple
of months they will suture it together)
A nurse is caring for an infant who is 1 day postoperative following surgical repair
of a cleft lip. Which of the following actions should the nurse take?
Apply an antibiotic ointment to the suture site
A nurse is reinforcing discharge instructions with a parent of a child who has cystic
fibrosis. Which of the following statements by the parent indicates an
understanding of the teaching?
"I will make sure my child washes her hands before eating"
A nurse working at a clinic speaks on the telephone with a parent of a 2-monthold
infant. The parent tells the nurse that the infant has projectile vomiting followed
by hunger after meals. Which of the following response by the nurse is
appropriate?
"Bring your infant into the clinic today to be seen"
, A nurse is caring for a 4 year old child who is 2 days postoperative following the
insertion of a ventriculoperitoneal shunt. Which of the following findings should
the nurse identify as the priority . (causes icp hydrocephalus)
lethargy (high pitched cry, respiratory changes, bradycardia, wide pulse pressure,
irritability
a nurse is caring for a child following an open reduction and internal fixation of a
fractured femur and application of a cast. The cast has a window cut in it for
viewing of the incision. Which of the following actions should the nurse take first?
Perform neurovascular checks of the affected extremity (check for infection,
color, capillary refill, redness)
A nurse is an urgent care clinic is assisting with the care of a toddler who ingested
30 tablets of aspirin. Which of the following substances should the nurse
administer to the toddler?
Activated charcoal (can work with toxin, poison. Given through ng tube absorbs
toxins)
A nurse is caring for a 3 year old client who has persistent otitis media. To help
identify contributing factors, the nurse should ask the parents which of the
following questions?
Does anyone smoke in the same house as your daughter? (smoking can cause
irritation, cause mucus in respiratory and causes otitis media?) (otitis media is
purulent color)