Exam (elaborations) MED SURG F LEVEL 4-Pediatric Prepu Alt Latest

MED SURG F LEVEL 4-Pediatric Prepu Alt Latest When performing a physical examination on a neonate, the nurse notes low-set ears. What action should the nurse perform next? You Selected:  Assess the neonate to determine if other apparent abnormalities are present. Correct response:  Assess the neonate to determine if other apparent abnormalities are present. Explanation: Remediation: Question 2 See full question A nurse is teaching the mother of a 5-month-old infant diagnosed with bronchiolitis. Which statement by the mother indicates that teaching has been effective? You Selected:  "My baby has been sick. A machine will help him breathe." Correct response:  "I know that this disease is serious and can lead to asthma." Explanation: Remediation: Question 3 See full question A 15-month-old child is being discharged after treatment for severe otitis media and bacterial meningitis. Which statement by the parents indicates effective discharge teaching? You Selected:  "We're just so glad this is all behind us." Correct response:  "We'll go to the physician if our child pulls on the ears or won't lie down." Explanation: Remediation: Question 4 See full question A 2-year-old child is brought to the emergency department with suspected croup. Which assessment finding reflects increasing respiratory distress? You Selected: MED SURG F LEVEL 4-Pediatric Prepu Alt Latest  Flushed skin Correct response:  Intercostal retractions Explanation: Remediation: Question 5 See full question A 3-year-old child with Down syndrome is admitted to the pediatric unit with asthma. The child doesn't enunciate words well and holds onto furniture when he walks. The nurse should ask the mother: You Selected:  if the child always drools. Correct response:  how the child's condition today differs from his normal condition. Explanation: Remediation: Question 6 See full question A registered nurse (RN) has been "care-paired" with a licensed practical nurse (LPN) during the evening shift. Whose care should the RN assign to the LPN? You Selected:  A 12-month-old infant who has a white blood cell (WBC) count of 34/μl and a fever Correct response:  The 2-year-old child who has started eating soft, solid foods following a tonsillectomy Explanation: Question 7 See full question Before performing an otoscopic examination on a child, where should the nurse palpate for tenderness? You Selected:  Tragus, cochlea, and lobule Correct response:  Tragus, mastoid process, and helix Explanation: Remediation: Question 8 See full question A child is diagnosed with Wilms' tumor. During assessment, the nurse expects to detect: You Selected:  dysuria. Correct response:  an abdominal mass. Explanation: Remediation: Question 9 See full question A preschooler has vomiting, diarrhea, and a potassium level of 3 mEq/L (3 mmol/L). The physician orders an I.V. infusion of 500 ml of dextrose 5% in water and half-normal saline solution with 20 mEq (20 mmol/L) of potassium chloride. The nurse knows that a child with vomiting and diarrhea needs fluids and potassium chloride to: You Selected:  avoid hyperglycemia. Correct response:  meet physiologic needs. Explanation: Remediation: Question 10 See full question When telling a 4-year-old child about an upcoming procedure, the nurse's most important consideration is to: You Selected:  speak loudly and clearly. Correct response:  use simple terms. Explanation: Remediation: Question 11 See full question Encouraging fantasy play and participation by children in their own care is a useful developmental approach for which pediatric age-group? You Selected:  School age (5 to 10 years) Correct response:  Preschool age (3 to 5 years) Explanation: Remediation: Question 12 See full question The nurse is caring for a 3-year-old client being treated for severe status asthmaticus. After comparing clinical manifestations with laboratory results (reported below), a nurse determines evidence that this client has progressed to which condition? You Selected:  Respiratory acidosis Correct response:  Respiratory acidosis Explanation: Remediation: Question 13 See full question A 6-year-old child has tested positive for West Nile virus infection. The nurse suspects the child has the severe form of the disease when she recognizes which signs and symptoms? You Selected:  Fever, muscle weakness, and change in mental status Correct response:  Fever, muscle weakness, and change in mental status Explanation: Remediation: Question 14 See full question A 15-year-old girl visits the neighborhood clinic seeking information on "how to keep from getting pregnant." What should the nurse say in response to her request? You Selected:  "Can you tell me if you've told your parents you're having sex?" Correct response:  "Can you tell me about the precautions you're taking now?" Explanation: Question 15 See full question The parents of an adolescent girl have recently learned that their daughter has a terminal illness. At first, as they try to cope, they display avoidance behaviors. Then they demonstrate behaviors that indicate possible acceptance of the diagnosis. Which behavior indicates acceptance? You Selected:  Avoidance of staff, family members, or the girl herself Correct response:  Expression of feelings, such as sorrow and anger, about the girl's condition Explanation: Remediation: Question 16 See full question The nurse on the adolescent unit delegates a task to the nursing assistant. After delegating the task, the nurse should: You Selected:  document in the chart that the task has been completed. Correct response:  allow adequate time for the nursing assistant to complete the task, then follow-up with her. Explanation: Question 17 See full question An adolescent presents to a community clinic for treatment of vulvar lesions associated with Type 2 herpes simplex. The nurse should: You Selected:  inform the adolescent that she can't guarantee her confidentiality. Correct response:  show the adolescent to a private examination room. Explanation: Remediation: Question 18 See full question A 3-year-old child with a history of being abused has blood drawn. The child lies very still and makes no sound during the procedure. Which comment by the nurse would be most appropriate? You Selected:  "That really did not hurt, did it?" Correct response:  "It is okay to cry when something hurts." Explanation: Question 19 See full question A 17-year-old client who has been taking an antidepressant for 6 weeks has returned to the clinic for a medication check. When the nurse talks with the client and her parent, the mother reports that she has to remind the client to take her antidepressant every day. The client says, “Yeah, I am pretty bad about remembering to take my meds, but I never miss a dose because Mom always bugs me about taking it.” Which response would be effective for the nurse to make to the client? You Selected:  "I am surprised your mother allows you to be so irresponsible." Correct response:  "It seems there are some difficulties with being responsible for your medications that we need to address". Explanation: Question 20 See full question Which child should the nurse identify as being most at risk for an episode of major depression? You Selected:  a 10-year-old male who has never liked school and has few friends Correct response:  a 14-year-old female who recently moved to a new school after her parents' divorce Explanation: Remediation: Question 21 See full question The mother of a toddler asks the nurse what she should do with her toddler when he has a temper tantrum. Which suggestion would be most appropriate? You Selected:  Leave the toddler alone during the tantrum as long as he is safe. Correct response:  Leave the toddler alone during the tantrum as long as he is safe. Explanation: Question 22 See full question A school-age child with cystic fibrosis asks the nurse what sports she can become involved in as she becomes older. Which activity would be appropriate for the nurse to suggest? You Selected:  baseball Correct response:  swimming Explanation: Remediation: Question 23 See full question After a plaster cast has been applied to the arm of a child with a fractured right humerus, the nurse completes discharge teaching. The nurse should evaluate the teaching as successful when the mother agrees to seek medical advice if the child experiences which symptom? You Selected:  vomiting after the cast is applied Correct response:  inability to extend the fingers on the right hand Explanation: Remediation: Question 24 See full question A 3-year-old child is to receive 500 ml of dextrose 5% in normal saline (D5NSS) solution over 8 hours. At what rate (in milliliters/hour) would the nurse set the infusion pump? Record your answer using one decimal place. Your Response:  5 Correct response:  62.5 Explanation: Question 25 See full question While examining a 12-month-old child, the nurse notes that the child can stand independently but cannot walk without support. The nurse should: You Selected:  tell the mother that the child may have a developmental delay. Correct response:  do nothing because this is a normal finding in a child this age. Explanation: Question 26 See full question A young child with sickle cell anemia prefers a side-lying position with the knees sharply flexed. The nurse should assess further for: You Selected:  nausea. Correct response:  abdominal pain. Explanation: Remediation: Question 27 See full question Which nursing action is most appropriate to include in the plan of care for a dying child to meet the child's emotional needs during the last days of life? You Selected:  Answer the child's questions about illness and death honestly. Correct response:  Answer the child's questions about illness and death honestly. Explanation: Question 28 See full question Which method should the nurse use to feed an infant after surgical repair of a cleft lip? You Selected:  IV fluids Correct response:  bottle with a cross-cut nipple Explanation: Remediation: Question 29 See full question The parent of a preschool-age child has been told the child has sleep terrors. Which statement should the nurse include when teaching the parents about sleep terrors? You Selected:  “Sleep terrors require psychological counseling.” Correct response:  “It is appropriate to intervene only if it is necessary to protect the child.” Explanation: Question 30 See full question Which topic would be most important to include when teaching the parents how to promote overall toddler development? You Selected:  Language is the most important achievement. Correct response:  Safety is a priority concern for this age-group. Explanation: Question 31 See full question After receiving a report, the nurse is making out assignments. Which client would be appropriate to assign to unlicensed assistive personnel? You Selected:  a 6-year-old with a femur fracture and a fever Correct response:  an 8-month-old with pneumonia who will be discharged today Explanation: Question 32 See full question A 17-year-old adolescent with a history of muscular dystrophy is admitted with aspiration pneumonia. The nurse asks the parents if the client has an advance directive. Which response by the parents leads the nurse to believe that the parents don't understand the severity of the client's medical condition? You Selected:  "He is only 17. He doesn't need an advance directive." Correct response:  "He is only 17. He doesn't need an advance directive." Explanation: Remediation: Question 33 See full question A 3-month-old infant just had a cleft lip and palate repair. To prevent trauma to the operative site, the nurse should: You Selected:  place the infant's arms in soft elbow restraints. Correct response:  place the infant's arms in soft elbow restraints. Explanation: Remediation: Question 34 See full question The nurse is caring for a 9-month-old with Reye syndrome. Which nursing interventions should be included when assisting with the plan of care? You Selected:  Monitor the child’s intake and output Correct response:  Monitor the child’s intake and output Explanation: Remediation: Question 35 See full question A 6-month-old on the pediatric floor has a respiratory rate of 68, mild intercostal retractions, and an oxygen saturation of 89%. The infant has not been feeding well for the last 24 hours and is restless. Using the SBAR (Situation-Background-Assessment-Recommendation) technique for communication, the nurse calls the health care provider (HCP) with the recommendation for: You Selected:  prescribing a chest CT scan. Correct response:  starting oxygen. Explanation: Remediation: Question 36 See full question A 4-year-old boy presents to the emergency department. His father tearfully reports that he was in the driveway and had his son on his shoulders when the child began to fall. The father grabbed him by the leg, swinging him toward the grass to avoid landing on the pavement. As the father swung his son, the child hit his head on the driveway and twisted his right leg. After a complete examination, it is determined that the child has a skull fracture and a spiral fracture of the femur. What action should the nurse take? You Selected:  Record the father's story in the medical record. Correct response:  Record the father's story in the medical record. Explanation: Remediation: Question 37 See full question The most reliable early indicator of infection in a client who is neutropenic is: You Selected:  fever. Correct response:  fever. Explanation: Remediation: Question 38 See full question When developing the plan of care for a 12-year-old child who is to receive chemotherapy that is associated with nausea and vomiting, the nurse should plan to administer an antiemetic at which time? You Selected:  thirty minutes after the chemotherapy has started, then as needed Correct response:  thirty minutes before the chemotherapy starts, then routinely Explanation: Remediation: Question 39 See full question The parents of a 2-year-old bring their child to the emergency department because the child ingested approximately 15 acetaminophen tablets 30 minutes ago. Place the following nursing actions in the order the nurse should perform them, from most important to least important. You Selected:  Establish an airway.  Administer activated charcoal.  Administer N-acetylcysteine.  Assess vital signs. Correct response:  Establish an airway.  Assess vital signs.  Administer activated charcoal.  Administer N-acetylcysteine. Explanation: Remediation: Question 40 See full question When teaching the parents of an infant how to perform back slaps to dislodge a foreign body, what should the nurse tell the parents to use to deliver the blows? You Selected:  entire hand Correct response:  heel of the hand Explanation: Remediation: Question 41 See full question The school nurse is discussing healthy eating strategies with a group of 8-year-old students. One student repeatedly makes comments of a sexual nature. The student seems to be preoccupied with sexual comments and is knowledgeable regarding a variety of sexual activities. Which of the following is the most crucial intervention for the nurse to take to manage the student’s behavior? You Selected:  Investigate the possibility that the student may have been sexually abused. Correct response:  Investigate the possibility that the student may have been sexually abused. Explanation: Remediation: Question 42 See full question A nurse is providing health teaching focusing on urinary tract infections to a group of adolescent girls. One of the girls tells the nurse that she has heard of a condition called honeymoon cystitis and wants to know what it is. Which statement by the nurse is the most appropriate response? You Selected:  “This is a fictitious condition used to prevent sexual experiences in young women.” Correct response:  “This condition results from irritation and inflammation from sexual activity.” Explanation: Remediation: Question 43 See full question A school nurse is called to assess a 12-year-old child with type 1 diabetes mellitus who is experiencing lightheadedness, tachycardia, pallor, headache, and confusion during gym class. What is the priority action by the nurse? You Selected:  Provide a snack of hard candy or raisins. Correct response:  Provide a snack of hard candy or raisins. Explanation: Remediation: Question 44 See full question A nurse on the pediatric unit is caring for a group of preschool children. Which situation takes highest priority? You Selected:  A child with asthma who is wheezing with an oxygen saturation level of 96% Correct response:  A child who develops a fever during a blood transfusion Explanation: Question 45 See full question A premature infant has been placed on a home apnea monitor. The nurse is giving discharge instructions to the parents. The nurse begins teaching by stating: You Selected:  "You can only give your baby sponge baths until monitoring is discontinued because it's dangerous to take the monitor off at any time." Correct response:  "Using the monitor will help your physician determine the frequency of apneic events and how long monitoring is required." Explanation: Remediation: Question 46 See full question The nurse is discontinuing an intravenous catheter on a 10-year-old child with hemophilia. What would be the most important intervention for this client? You Selected:  Apply firm pressure on the site for 5 minutes after removal Correct response:  Apply firm pressure on the site for 5 minutes after removal Explanation: Remediation: Question 47 See full question The nurse is assessing a 5-year-old client and wants to gain the client's cooperation. Which of the following actions is appropriate for the nurse? You Selected:  Tell the child not to be afraid because it will not hurt Correct response:  Save the more intimidating or intrusive parts of the assessment, such as eyes, ears, and genitalia, until the end of the assessment Explanation: Remediation: Question 48 See full question Which of the following is a priority nursing action for a child with croup? You Selected:  Giving antipyretics to alleviate fever Correct response:  Continually assessing respiratory status Explanation: Remediation: Question 49 See full question A nurse assessing an 8-year-old child obtains a heart rate of 80 beats/minute. Which of the following is the appropriate action by the nurse? You Selected:  Assessing for signs and symptoms of heart failure Correct response:  Continuing with the assessment; this is a normal finding Explanation: Remediation: Question 50 See full question The nurse is assessing children at risk for phenylketonuria (PKU). Which child is at greatest risk? You Selected:  child with dark complexion who is overweight and has labile personalities Correct response:  blond, blue-eyed, fair-skinned child with eczema Explanation: Question 1 See full question A mother brings her 8-month-old son to the pediatrician's office. When the nurse approaches to measure the child's vital signs, he clings to the mother tightly and starts to cry. The mother says, "He used to smile at everyone. I don't know why he's acting this way." The nurse begins teaching the mother about growth and development by stating: You Selected:  "Children at his age begin to fear pain." Correct response:  "Your baby's behavior indicates stranger anxiety, which is common at his age." Explanation: Remediation: Question 2 See full question A nurse is preparing to administer an I.V. containing dextrose 10% in ¼ normal saline solution to a 6- month-old infant. The nurse should select which tubing to safely administer the solution? You Selected:  Standard I.V. tubing used for adults Correct response:  I.V. tubing with a volume-control chamber Explanation: Question 3 See full question When teaching parents of a toddler with congenital heart disease, the nurse should explain all medical treatments and emphasize which instruction? You Selected:  "Try to maintain your child's usual lifestyle to promote normal development." Correct response:  "Try to maintain your child's usual lifestyle to promote normal development." Explanation: Question 4 See full question A nurse is caring for a toddler who was diagnosed with an inoperable brain tumor. The parents are having difficulty deciding on a course of action for their child. Why is it important to have the nurse involved in an ethical discussion about a planned course of treatment? You Selected:  It isn't important to involve the nurse in this type of discussion. Correct response:  The nurse can act as a liaison between the child, the child's parents, and the health care team. Explanation: Question 5 See full question For a child with hemophilia, what is the most important nursing goal? You Selected:  Promoting tissue oxygenation Correct response:  Preventing bleeding episodes Explanation: Remediation: Question 6 See full question A nurse is teaching the parents of a young child how to handle suspected poisoning. If the child ingests poison, the parents should first: You Selected:  administer ipecac syrup. Correct response:  call the poison control center. Explanation: Remediation: Question 7 See full question A mother of a child with sickle cell anemia confides in the nurse that she feels guilty about letting the child run and play with the neighborhood children and that if she had been a better mother, the child wouldn't have suffered a sickle cell crisis. Which response would be most appropriate? You Selected:  "But you know that children with sickle cell anemia often have crises." Correct response:  "Tell me more about how you feel." Explanation: Remediation: Question 8 See full question A nurse feels that a 5-year-old boy in her care is showing signs and symptoms of diabetes mellitus. The nurse should: You Selected:  ask the laboratory to perform a random glucose test. Correct response:  gather supporting evidence and contact the physician with her concerns. Explanation: Remediation: Question 9 See full question A school-age child has a fever, joint inflammation, and a nonpruritic rash. Knowing that these are signs of rheumatic fever, the nurse should ask the parents: You Selected:  "Has your child recently been exposed to other children with rheumatic fever?" Correct response:  "Has your child had strep throat recently?" Explanation: Remediation: Question 10 See full question A young child who has been sexually abused has difficulty putting feelings into words. Which approach should the nurse employ with the child? You Selected:  reporting the abuse to a prosecutor Correct response:  engaging in play therapy Explanation: Remediation: Question 11 See full question A 15-year-old girl is sent to the school nurse with reports of dizziness and nausea. While assessing the girl, who denies any health problems, the nurse smells alcohol on her breath. Which response by the nurse is most appropriate? You Selected:  "Tell me everything that you have had to eat and drink yesterday and today." Correct response:  "Tell me everything that you have had to eat and drink yesterday and today." Explanation: Remediation: Question 12 See full question The nurse should instruct the parent of a child who is taking valproic acid that the child will need to have what routine blood analyses? You Selected:  cholesterol and platelet levels Correct response:  platelet and fibrinogen levels Explanation: Remediation: Question 13 See full question An IV infusion is to be administered through a scalp vein on an infant's head. What should the nurse tell the parents to prepare them for the procedure? You Selected:  Holding the infant will be contraindicated while the infusion is being administered. Correct response:  It may be necessary to remove a small amount of hair from the infant's scalp. Explanation: Remediation: Question