12/30/21, 7:44 PM Session 4 Exam 4 - Focus on Child Health Exam: NCLEX Remediation Course Nov 2021
Session 4 Exam 4 - Focus on Child Health Exam
Due Dec 31 at 11:59pm Points 97 Questions 97
Available Dec 26 at 12am - Jan 4, 2022 at 11:59pm 10 days
Time Limit 150 Minutes
Attempt History
Attempt Time Score
LATEST Attempt 1 111 minutes 94 out of 97
Score for this quiz: 94 out of 97
Submitted Dec 30 at 3:18am
This attempt took 111 minutes.
Question 1 pts
An HIV-positive woman delivers an infant. The pediatrician prescribes
testing for the newborn, and the nurse prepares for which action?
Perform a heelstick to obtain a specimen for a Western blot assay
Obtain blood from the umbilical cord to send to the laboratory
Correct!
Ask the laboratory to perform virologic testing
Perform a fingerstick to obtain a specimen for an enzyme-linked
immunosorbent assay (ELISA)
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,12/30/21, 7:44 PM Session 4 Exam 4 - Focus on Child Health Exam: NCLEX Remediation Course Nov 2021
Rationale: Traditional HIV antibody measurement by ELISA or
Western-blot assay is not accurate in infants younger than 18
months because of the persistence of maternal antibodies.
Because of the potential for maternal contamination during
delivery, umbilical cord blood should not be used for testing. HIV-
exposed infants should undergo virologic testing within 48 hours of
birth and follow-up testing, depending on the initial results.
Test-Taking Strategy: Focus on the subject, a newborn infant
exposed to HIV. Recalling that the ELISA and Western blot assay
are not accurate in an infant younger than 18 months will assist
you in eliminating these options. Next eliminate the option
involving cord blood, knowing that such blood could be
contaminated. Review the tests to detect HIV in a newborn infant.
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Implementation
Content Area: Child Health—Infectious Diseases
Giddens Concepts:Immunity, Infection
HESI Concepts: Immunity, Infection
References: McKinney, E., James, S., Murray, S., Nelson, K. &
Ashwill, J. (2013). Maternal-child nursing (4th ed., p. 1046). St.
Louis: Elsevier.
Pagana, K., & Pagana, T. (2013). Mosby’s diagnostic and
laboratory tests reference (11th ed., p. 531). St. Louis: Mosby.
Question 2 pts
A nurse providing home care instructions to a mother of a HIV-positive
child discusses measures to prevent transmission of the virus. Which
statement by the mother indicates a need for further instruction?
“I’ll wash my hands with soap and water if I touch any blood from my child.”
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,12/30/21, 7:44 PM Session 4 Exam 4 - Focus on Child Health Exam: NCLEX Remediation Course Nov 2021
“I’ll rinse bloodstained clothing with hydrogen peroxide and then wash it as
usual.”
“I won’t let my children share toothbrushes.”
Correct!
“I’ll wash up blood spills with soap and hot water and allow them to air dry.”
Rationale: The correct method of cleaning up blood spills is to
wash the area with soap and water, rinse with bleach, and let the
area air dry. The remaining statements by the mother reflect
correct measures to prevent transmission of the virus.
Test-Taking Strategy: Note the strategic words “need for further
instruction,” which indicate a negative event query and the need to
select the incorrect statement. Recalling that blood spills must be
cleaned with a 1:10 bleach/water solution will direct you to the
correct option. Review these home care measures for HIV.
Level of Cognitive Ability: Evaluating
Client Needs: Safe and Effective Care Environment
Integrated Process: Teaching and Learning
Content Area: Child Health—Infectious Diseases
Giddens Concepts:Client Education, Infection
HESI Concepts: Infection, Teaching and Learning/Patient
Education
Reference: McKinney, E., James, S., Murray, S., Nelson, K. &
Ashwill, J. (2013). Maternal-child nursing (4th ed., p. 1053). St.
Louis: Elsevier.
Question 3 pts
A child has been in the hospital for several days for treatment of severe
vomiting related his HIV-positive status. Which assessment finding is the
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, 12/30/21, 7:44 PM Session 4 Exam 4 - Focus on Child Health Exam: NCLEX Remediation Course Nov 2021
best indication that the child’s condition is improving?
Temperature Changed from 100.2° F to 99.2° F (37.3°C)
Capillary refill slowing from 2 seconds to 3 seconds
No lesions in the mouth and throat
Correct!
Weight increase of 1 lb (0.45 kg) over 3 days
Rationale: Vomiting results in fluid volume deficit. The most
accurate method of evaluating fluid volume increase (the desired
outcome) is weight. A temperature decrease is not reflective of
fluid volume increase. Increasing capillary refill time is indicative of
a fluid volume decrease, not an increase. The absence of mouth
ulcers would allow the child to drink without pain but does not
reflect a fluid volume increase.
Test-Taking Strategy: Note the data in the question and the
strategic word, best, and remember that the child is experiencing
severe vomiting. Use the process of elimination and focus on the
subject, an assessment finding indicating fluid volume increase.
The correct option is the only one that related to fluid volume.
Review the findings that indicate a positive outcome in a child with
HIV with severe vomiting.
Level of Cognitive Ability: Evaluating
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Evaluation
Content Area: Child Health—Infectious Diseases
Giddens Concepts: Fluid and Electrolytes, Evidence
HESI Concepts: Evidence-Based Practice/Evidence, Fluids and
Electrolytes
Reference: Hockenberry, M, & Wilson, D. (2015). Wong’s nursing
care of infants and children (10th ed. pp. 1067-1068). St Louis:
Mosby.
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Session 4 Exam 4 - Focus on Child Health Exam
Due Dec 31 at 11:59pm Points 97 Questions 97
Available Dec 26 at 12am - Jan 4, 2022 at 11:59pm 10 days
Time Limit 150 Minutes
Attempt History
Attempt Time Score
LATEST Attempt 1 111 minutes 94 out of 97
Score for this quiz: 94 out of 97
Submitted Dec 30 at 3:18am
This attempt took 111 minutes.
Question 1 pts
An HIV-positive woman delivers an infant. The pediatrician prescribes
testing for the newborn, and the nurse prepares for which action?
Perform a heelstick to obtain a specimen for a Western blot assay
Obtain blood from the umbilical cord to send to the laboratory
Correct!
Ask the laboratory to perform virologic testing
Perform a fingerstick to obtain a specimen for an enzyme-linked
immunosorbent assay (ELISA)
https://jerseycollege.instructure.com/courses/2491/quizzes/27607 1/130
,12/30/21, 7:44 PM Session 4 Exam 4 - Focus on Child Health Exam: NCLEX Remediation Course Nov 2021
Rationale: Traditional HIV antibody measurement by ELISA or
Western-blot assay is not accurate in infants younger than 18
months because of the persistence of maternal antibodies.
Because of the potential for maternal contamination during
delivery, umbilical cord blood should not be used for testing. HIV-
exposed infants should undergo virologic testing within 48 hours of
birth and follow-up testing, depending on the initial results.
Test-Taking Strategy: Focus on the subject, a newborn infant
exposed to HIV. Recalling that the ELISA and Western blot assay
are not accurate in an infant younger than 18 months will assist
you in eliminating these options. Next eliminate the option
involving cord blood, knowing that such blood could be
contaminated. Review the tests to detect HIV in a newborn infant.
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Implementation
Content Area: Child Health—Infectious Diseases
Giddens Concepts:Immunity, Infection
HESI Concepts: Immunity, Infection
References: McKinney, E., James, S., Murray, S., Nelson, K. &
Ashwill, J. (2013). Maternal-child nursing (4th ed., p. 1046). St.
Louis: Elsevier.
Pagana, K., & Pagana, T. (2013). Mosby’s diagnostic and
laboratory tests reference (11th ed., p. 531). St. Louis: Mosby.
Question 2 pts
A nurse providing home care instructions to a mother of a HIV-positive
child discusses measures to prevent transmission of the virus. Which
statement by the mother indicates a need for further instruction?
“I’ll wash my hands with soap and water if I touch any blood from my child.”
https://jerseycollege.instructure.com/courses/2491/quizzes/27607 2/130
,12/30/21, 7:44 PM Session 4 Exam 4 - Focus on Child Health Exam: NCLEX Remediation Course Nov 2021
“I’ll rinse bloodstained clothing with hydrogen peroxide and then wash it as
usual.”
“I won’t let my children share toothbrushes.”
Correct!
“I’ll wash up blood spills with soap and hot water and allow them to air dry.”
Rationale: The correct method of cleaning up blood spills is to
wash the area with soap and water, rinse with bleach, and let the
area air dry. The remaining statements by the mother reflect
correct measures to prevent transmission of the virus.
Test-Taking Strategy: Note the strategic words “need for further
instruction,” which indicate a negative event query and the need to
select the incorrect statement. Recalling that blood spills must be
cleaned with a 1:10 bleach/water solution will direct you to the
correct option. Review these home care measures for HIV.
Level of Cognitive Ability: Evaluating
Client Needs: Safe and Effective Care Environment
Integrated Process: Teaching and Learning
Content Area: Child Health—Infectious Diseases
Giddens Concepts:Client Education, Infection
HESI Concepts: Infection, Teaching and Learning/Patient
Education
Reference: McKinney, E., James, S., Murray, S., Nelson, K. &
Ashwill, J. (2013). Maternal-child nursing (4th ed., p. 1053). St.
Louis: Elsevier.
Question 3 pts
A child has been in the hospital for several days for treatment of severe
vomiting related his HIV-positive status. Which assessment finding is the
https://jerseycollege.instructure.com/courses/2491/quizzes/27607 3/130
, 12/30/21, 7:44 PM Session 4 Exam 4 - Focus on Child Health Exam: NCLEX Remediation Course Nov 2021
best indication that the child’s condition is improving?
Temperature Changed from 100.2° F to 99.2° F (37.3°C)
Capillary refill slowing from 2 seconds to 3 seconds
No lesions in the mouth and throat
Correct!
Weight increase of 1 lb (0.45 kg) over 3 days
Rationale: Vomiting results in fluid volume deficit. The most
accurate method of evaluating fluid volume increase (the desired
outcome) is weight. A temperature decrease is not reflective of
fluid volume increase. Increasing capillary refill time is indicative of
a fluid volume decrease, not an increase. The absence of mouth
ulcers would allow the child to drink without pain but does not
reflect a fluid volume increase.
Test-Taking Strategy: Note the data in the question and the
strategic word, best, and remember that the child is experiencing
severe vomiting. Use the process of elimination and focus on the
subject, an assessment finding indicating fluid volume increase.
The correct option is the only one that related to fluid volume.
Review the findings that indicate a positive outcome in a child with
HIV with severe vomiting.
Level of Cognitive Ability: Evaluating
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Evaluation
Content Area: Child Health—Infectious Diseases
Giddens Concepts: Fluid and Electrolytes, Evidence
HESI Concepts: Evidence-Based Practice/Evidence, Fluids and
Electrolytes
Reference: Hockenberry, M, & Wilson, D. (2015). Wong’s nursing
care of infants and children (10th ed. pp. 1067-1068). St Louis:
Mosby.
https://jerseycollege.instructure.com/courses/2491/quizzes/27607 4/130
