NURS 618 Disease Management I exam question and answers
with rationale latest update 2022
Pediatric Evolve Test
1. A child’s mother tells the nurse that during a seizure the child has a blank expression and exhibits eyelid fluttering lasting
just 5 to 10 seconds. The nurse determines that the child is experiencing:
A. Atonic seizures
B. Absence seizures Correct
C. Myoclonic seizures
D. Tonic-clonic seizures
Rationale: Absence seizures, formerly called petit mal seizures, are characterized by brief episodes of altered
consciousness. There is no muscle activity except for eyelid fluttering, twitching, or head bobbing, and the child has a blank
expression. Absence seizures last only 5 to 10 seconds but may occur one after another, several times a day. Atonic
seizures are marked by an abrupt loss of postural tone, impairment of consciousness, confusion, lethargy, and sleep.
Myoclonic seizures are brief, random contractions of a muscle group that may occur on both sides of the body and may
occur singly or in clusters. Tonic-clonic seizures, formerly called grand mal seizures, consist of a tonic phase (a sustained,
generalized stiffening of muscles lasting a few seconds) and a clonic phase (symmetric and rhythmic, consisting of
alternating contraction and relaxation of major muscle groups).
Test-Taking Strategy: Use the process of elimination and focus on the data in the question. Recalling the characteristics of
the various types of seizures will direct you to the correct option. Also note the relationship of the words ―blank expression‖
in the question and the correct option. Review the various types of seizures if you had difficulty with this question.
2. The nurse is caring for a 3-year-old with leukemia. The child is not eating and is losing weight as a result of nausea and
mucositis stemming from the chemotherapy. Which interventions are appropriate? Select all that apply.
A. Providing small, frequent high-protein foods Correct
B. Administering oral viscous lidocaine before meals
C. Having the parents bring in the child’s favorite foods
D. Providing cool liquids and soft foods at room temperature Correct
E. Applying a solution of Benadryl (diphenhydramine) and Maalox as prescribed to the mouth Correct
Rationale: High-protein, high-calorie foods should be given to the child. Protein promotes tissue healing, and calories are
needed for growth. Small, frequent meals are easier for a child to handle. Viscous lidocaine is not recommended for young
children, because it may depress the gag reflex and increase the risk of aspiration. Local anesthetics without alcohol, such
as a solution of diphenhydramine (Benadryl) and Maalox, may be recommended. Favorite foods should not be given to a
child who is nauseated, because the child will associate these foods with being sick. Cool liquids are soothing and reduce
the risk of burning fragile mucosa. Soft foods are gentler on inflamed mucosa.
Test-Taking Strategy: Note that the child is experiencing nausea and mucositis. Read each option carefully and think about
the effect of the intervention on the client’s problems. This will help you answer correctly. Review the interventions for a
child with nausea and mucositis if you had difficulty with this question.
NURS 618 Disease Management I exam question and answers
with rationale latest update 2022
,NURS 618 Disease Management I exam question and answers
with rationale latest update 2022
3. The nurse assesses a child with suspected meningitis for the presence of the Kernig sign. Which finding is the Kernig sign?
A. Calf pain on dorsiflexion of the foot
B. Pain with extension of the leg and knee Correct
C. Flexion of the hips and knees when the head is flexed
D. Calf pain when the calf muscle is squeezed against the tibia
dorsiflexion of the foot or when the calf muscle is squeezed against the tibia are not manifestations of meningitis.
Test-Taking Strategy: Use the process of elimination. Eliminate first the options that are comparable or alike and relate to
calf pain. From the remaining options it is necessary to know the characteristics of the Kernig sign. Remember that the
Kernig sign is present if pain occurs with extension of the leg and knee. Review the characteristics of both the Kernig and
Brudzinski signs if you had difficulty with this question.
4. A nurse provides information to new parents about measures to reduce the risk of sudden infant death syndrome (SIDS).
The nurse tells the parents to:
A. Obtain a soft crib mattress and soft bedding
B. Place the infant in a supine position for sleep Correct
C. Place the infant in a face-down position for sleep
D. Be sure that the infant sleeps in a crib in the parent’s room until the age of 12 months
Rationale: As a means of reducing the risk of SIDS, the infant should be positioned on his or her back rather than in the
prone (face-down) position to sleep. The use of soft bedding is also a risk factor. Infants may suffocate by rebreathing
carbon dioxide–laden expired air when sleeping face down on soft bedding. SIDS occurs most frequently between the
second and fourth months of life, with most of cases occurring before the age of 2 to 3 months.
Test-Taking Strategy: Use the process of elimination. Think about the risk factors associated with SIDS and visualize each
of the options. This will direct you to the correct option. Review the risk factors associated with SIDS if you had difficulty with
this question.
5. A lumbar puncture is performed on a child with suspected bacterial meningitis, and the cerebrospinal fluid (CSF) obtained
for analysis. The nurse determines that the diagnosis is confirmed if which findings are noted?
A. Cloudy CSF Correct
B. High glucose level
C. Decreased CSF pressure
D. Low protein concentration
NURS 618 Disease Management I exam question and answers
with rationale latest update 2022
,NURS 618 Disease Management I exam question and answers
with rationale latest update 2022
Rationale: The diagnosis of meningitis is made by testing CSF obtained by lumbar puncture. Findings usually include cloudy
CSF (in the case of bacterial meningitis), a low glucose level, increased CSF pressure, and a high protein concentration.
Test-Taking Strategy: Use the process of elimination and focus on the suspected diagnosis, bacterial meningitis. Recalling
that CSF is normally clear will direct you to the correct option. Review findings in bacterial meningitis if you had difficulty with
this question.
6. A nurse provides home care instructions to the mother of a child with pediculosis capitis (head lice). Which statement by the
mother indicates a need for further instruction?
A. ―I need to wash her clothes and bedding in hot water and dry them on a hot setting.‖
B. ―I need to use an antilice spray on her and on anything that she’s been in contact with.‖ Correct
C. ―I need to boil or soak her combs and brushes in antilice shampoo or hot water for at least 10 minutes.‖
D. ―I can get the lice and nits off her eyelashes by applying petrolatum to the eyelashes twice a day for 8 days.‖
petrolatum to the eyelashes twice a day for 8 days.
Test-Taking Strategy: Use the process of elimination and note the strategic words ―need for further instruction,‖ which
indicate a negative event query and the need to select the incorrect statement. Recall that antilice sprays should never be
sprayed on the child. This will direct you to the correct option. Review home care instructions for the child with lice if you
had difficulty with this question.
7. A physician prescribes oral amoxicillin (Amoxil) 60 mg 3 times daily for a child who weighs 12.5 lb. The safe pediatric
dosage is 20 to 40 mg/kg/day in 3 equal doses. The medication label reads, "Amoxicillin 125 mg/5 mL." How many milliliters
will the nurse administer per dose?
Correct Responses: "2.4"
8. The mother of a child admitted to the hospital with Kawasaki disease asks the nurse about the disease. The nurse responds
that it is:
A. A common communicable disease
B. Caused by exposure to an individual with rheumatic fever
C. A disease that affects the smooth muscle cells of the vascular walls Correct
D. A disease that most often occurs in the summer after swimming in a lake
NURS 618 Disease Management I exam question and answers
with rationale latest update 2022
, NURS 618 Disease Management I exam question and answers
with rationale latest update 2022
Rationale: Kawasaki disease, also called mucocutaneous lymph node syndrome, is an acute febrile exanthematous illness
of children with a generalized vasculitis of unknown origin. A generalized immune response affects the smooth muscle cells
of the vascular walls. It is not a communicable disease and is not caused by exposure to an individual with rheumatic fever.
Kawasaki disease is diagnosed most often in late winter and early spring. It is not associated with swimming.
Test-Taking Strategy: Knowledge regarding the characteristics of Kawasaki disease is required to answer this question.
Eliminate the options that are comparable or alike in that they indicate that Kawasaki disease is communicable. To select
from the remaining options it is necessary to know that the disease affects the smooth muscle cells of the vascular walls. If
you are unfamiliar with this disorder, review this content.
9. A nurse provides instructions on the administration of oral iron to the mother of a child with iron-deficiency anemia. The
nurse determines that the mother understands the instructions if the mother states that she will administer the iron with:
A. Milk
B. Cereal
C. Formula
D. Orange juice Correct
Rationale: Oral iron is administered with a vitamin C–rich food to aid its absorption. Milk, cereal, and formula are avoided
with the administration of iron because these foods may impede absorption.
Test-Taking Strategy: Use the process of elimination. Recalling that vitamin C aids in the absorption of iron will direct you to
the correct option. Review the procedure for administering iron if you had difficulty with this question.
10. A nurse is preparing a child admitted from the emergency department with a diagnosis of acute appendicitis for an
appendectomy, to be performed in an hour. The child tells the nurse that the acute abdominal pain has suddenly subsided.
The priority nursing intervention is to:
A. Contact the physician Correct
B. Document the findings
C. Tell the parents that the pain was probably a result of gastroenteritis
NURS 618 Disease Management I exam question and answers
with rationale latest update 2022
with rationale latest update 2022
Pediatric Evolve Test
1. A child’s mother tells the nurse that during a seizure the child has a blank expression and exhibits eyelid fluttering lasting
just 5 to 10 seconds. The nurse determines that the child is experiencing:
A. Atonic seizures
B. Absence seizures Correct
C. Myoclonic seizures
D. Tonic-clonic seizures
Rationale: Absence seizures, formerly called petit mal seizures, are characterized by brief episodes of altered
consciousness. There is no muscle activity except for eyelid fluttering, twitching, or head bobbing, and the child has a blank
expression. Absence seizures last only 5 to 10 seconds but may occur one after another, several times a day. Atonic
seizures are marked by an abrupt loss of postural tone, impairment of consciousness, confusion, lethargy, and sleep.
Myoclonic seizures are brief, random contractions of a muscle group that may occur on both sides of the body and may
occur singly or in clusters. Tonic-clonic seizures, formerly called grand mal seizures, consist of a tonic phase (a sustained,
generalized stiffening of muscles lasting a few seconds) and a clonic phase (symmetric and rhythmic, consisting of
alternating contraction and relaxation of major muscle groups).
Test-Taking Strategy: Use the process of elimination and focus on the data in the question. Recalling the characteristics of
the various types of seizures will direct you to the correct option. Also note the relationship of the words ―blank expression‖
in the question and the correct option. Review the various types of seizures if you had difficulty with this question.
2. The nurse is caring for a 3-year-old with leukemia. The child is not eating and is losing weight as a result of nausea and
mucositis stemming from the chemotherapy. Which interventions are appropriate? Select all that apply.
A. Providing small, frequent high-protein foods Correct
B. Administering oral viscous lidocaine before meals
C. Having the parents bring in the child’s favorite foods
D. Providing cool liquids and soft foods at room temperature Correct
E. Applying a solution of Benadryl (diphenhydramine) and Maalox as prescribed to the mouth Correct
Rationale: High-protein, high-calorie foods should be given to the child. Protein promotes tissue healing, and calories are
needed for growth. Small, frequent meals are easier for a child to handle. Viscous lidocaine is not recommended for young
children, because it may depress the gag reflex and increase the risk of aspiration. Local anesthetics without alcohol, such
as a solution of diphenhydramine (Benadryl) and Maalox, may be recommended. Favorite foods should not be given to a
child who is nauseated, because the child will associate these foods with being sick. Cool liquids are soothing and reduce
the risk of burning fragile mucosa. Soft foods are gentler on inflamed mucosa.
Test-Taking Strategy: Note that the child is experiencing nausea and mucositis. Read each option carefully and think about
the effect of the intervention on the client’s problems. This will help you answer correctly. Review the interventions for a
child with nausea and mucositis if you had difficulty with this question.
NURS 618 Disease Management I exam question and answers
with rationale latest update 2022
,NURS 618 Disease Management I exam question and answers
with rationale latest update 2022
3. The nurse assesses a child with suspected meningitis for the presence of the Kernig sign. Which finding is the Kernig sign?
A. Calf pain on dorsiflexion of the foot
B. Pain with extension of the leg and knee Correct
C. Flexion of the hips and knees when the head is flexed
D. Calf pain when the calf muscle is squeezed against the tibia
dorsiflexion of the foot or when the calf muscle is squeezed against the tibia are not manifestations of meningitis.
Test-Taking Strategy: Use the process of elimination. Eliminate first the options that are comparable or alike and relate to
calf pain. From the remaining options it is necessary to know the characteristics of the Kernig sign. Remember that the
Kernig sign is present if pain occurs with extension of the leg and knee. Review the characteristics of both the Kernig and
Brudzinski signs if you had difficulty with this question.
4. A nurse provides information to new parents about measures to reduce the risk of sudden infant death syndrome (SIDS).
The nurse tells the parents to:
A. Obtain a soft crib mattress and soft bedding
B. Place the infant in a supine position for sleep Correct
C. Place the infant in a face-down position for sleep
D. Be sure that the infant sleeps in a crib in the parent’s room until the age of 12 months
Rationale: As a means of reducing the risk of SIDS, the infant should be positioned on his or her back rather than in the
prone (face-down) position to sleep. The use of soft bedding is also a risk factor. Infants may suffocate by rebreathing
carbon dioxide–laden expired air when sleeping face down on soft bedding. SIDS occurs most frequently between the
second and fourth months of life, with most of cases occurring before the age of 2 to 3 months.
Test-Taking Strategy: Use the process of elimination. Think about the risk factors associated with SIDS and visualize each
of the options. This will direct you to the correct option. Review the risk factors associated with SIDS if you had difficulty with
this question.
5. A lumbar puncture is performed on a child with suspected bacterial meningitis, and the cerebrospinal fluid (CSF) obtained
for analysis. The nurse determines that the diagnosis is confirmed if which findings are noted?
A. Cloudy CSF Correct
B. High glucose level
C. Decreased CSF pressure
D. Low protein concentration
NURS 618 Disease Management I exam question and answers
with rationale latest update 2022
,NURS 618 Disease Management I exam question and answers
with rationale latest update 2022
Rationale: The diagnosis of meningitis is made by testing CSF obtained by lumbar puncture. Findings usually include cloudy
CSF (in the case of bacterial meningitis), a low glucose level, increased CSF pressure, and a high protein concentration.
Test-Taking Strategy: Use the process of elimination and focus on the suspected diagnosis, bacterial meningitis. Recalling
that CSF is normally clear will direct you to the correct option. Review findings in bacterial meningitis if you had difficulty with
this question.
6. A nurse provides home care instructions to the mother of a child with pediculosis capitis (head lice). Which statement by the
mother indicates a need for further instruction?
A. ―I need to wash her clothes and bedding in hot water and dry them on a hot setting.‖
B. ―I need to use an antilice spray on her and on anything that she’s been in contact with.‖ Correct
C. ―I need to boil or soak her combs and brushes in antilice shampoo or hot water for at least 10 minutes.‖
D. ―I can get the lice and nits off her eyelashes by applying petrolatum to the eyelashes twice a day for 8 days.‖
petrolatum to the eyelashes twice a day for 8 days.
Test-Taking Strategy: Use the process of elimination and note the strategic words ―need for further instruction,‖ which
indicate a negative event query and the need to select the incorrect statement. Recall that antilice sprays should never be
sprayed on the child. This will direct you to the correct option. Review home care instructions for the child with lice if you
had difficulty with this question.
7. A physician prescribes oral amoxicillin (Amoxil) 60 mg 3 times daily for a child who weighs 12.5 lb. The safe pediatric
dosage is 20 to 40 mg/kg/day in 3 equal doses. The medication label reads, "Amoxicillin 125 mg/5 mL." How many milliliters
will the nurse administer per dose?
Correct Responses: "2.4"
8. The mother of a child admitted to the hospital with Kawasaki disease asks the nurse about the disease. The nurse responds
that it is:
A. A common communicable disease
B. Caused by exposure to an individual with rheumatic fever
C. A disease that affects the smooth muscle cells of the vascular walls Correct
D. A disease that most often occurs in the summer after swimming in a lake
NURS 618 Disease Management I exam question and answers
with rationale latest update 2022
, NURS 618 Disease Management I exam question and answers
with rationale latest update 2022
Rationale: Kawasaki disease, also called mucocutaneous lymph node syndrome, is an acute febrile exanthematous illness
of children with a generalized vasculitis of unknown origin. A generalized immune response affects the smooth muscle cells
of the vascular walls. It is not a communicable disease and is not caused by exposure to an individual with rheumatic fever.
Kawasaki disease is diagnosed most often in late winter and early spring. It is not associated with swimming.
Test-Taking Strategy: Knowledge regarding the characteristics of Kawasaki disease is required to answer this question.
Eliminate the options that are comparable or alike in that they indicate that Kawasaki disease is communicable. To select
from the remaining options it is necessary to know that the disease affects the smooth muscle cells of the vascular walls. If
you are unfamiliar with this disorder, review this content.
9. A nurse provides instructions on the administration of oral iron to the mother of a child with iron-deficiency anemia. The
nurse determines that the mother understands the instructions if the mother states that she will administer the iron with:
A. Milk
B. Cereal
C. Formula
D. Orange juice Correct
Rationale: Oral iron is administered with a vitamin C–rich food to aid its absorption. Milk, cereal, and formula are avoided
with the administration of iron because these foods may impede absorption.
Test-Taking Strategy: Use the process of elimination. Recalling that vitamin C aids in the absorption of iron will direct you to
the correct option. Review the procedure for administering iron if you had difficulty with this question.
10. A nurse is preparing a child admitted from the emergency department with a diagnosis of acute appendicitis for an
appendectomy, to be performed in an hour. The child tells the nurse that the acute abdominal pain has suddenly subsided.
The priority nursing intervention is to:
A. Contact the physician Correct
B. Document the findings
C. Tell the parents that the pain was probably a result of gastroenteritis
NURS 618 Disease Management I exam question and answers
with rationale latest update 2022
