PEDS PRACTICE A NGN PROCTORED NEWEST
2024 EXAM WITH STUDY GUIDE TEST BANK 60
QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES (VERIFIED ANSWERS)
|ALREADY PASSED
1. A nurse in an urgent care clinic is assessing an adolescent who has an
upper respiratory tract infection. Which of the following findings should the
nurse identify as a manifestation of pertussis?
a. inflamed throat with exudate
b. purulent eye drainage
c. dry, hacking cough
d. Koplik spots on buccal mucosal: dry, hacking cough
Rationale: The nurse should identify 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.
-inflamed throat = acute strep pharyngitis
-purulent eye drainage = bacterial conjunctivitis
-koplik spots = rubella or measles
2. A nurse is caring for a school-age child who is receiving a blood
transfusion. Which of the following manifestations should alert the nurse to a
possible hemolytic transfusion reaction?
a. laryngeal edema
b. flank pain
c. distended neck veins
,d. muscular weakness: Flank pain
Rationale: The nurse should recognize that flank pain is caused by the breakdown
of RBCs and is an indication of a hemolytic reaction to the blood transfusion.
-laryngeal edema = allergic reaction
-distended neck veins = circulatory overload
-muscular weakness = electrolyte disturbance
3. A nurse is caring for a school-age child who is receiving cefazolin via
intermittent IV bolus. The child suddenly develops diffuse flushing of the skin
and angioedema. After discontinuing the medication infusion, which of the
following medications should the nurse administer first?
a. prednisone
b. epinephrine
c. diphenhydramine
d. albuterol: Epinephrine
Rationale: This child is most likely experiencing an anaphylactic reaction to the
cefazolin. According to evidence-based practice, the nurse should first administer
epinephrine to treat the anaphylaxis. Epinephrine is a beta adrenergic agonist that
stimulates the heart, causes vasoconstriction of blood vessels in the skin and
mucous membranes, and triggers bronchodilation in the lungs.
-prednisone = treats inflammation
- diphenhydramine & albuterol = not first medication
4. A nurse is teaching the guardian of a 6-month-old infant about car seat use.
Which of the following statements by the guardian 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 1 inch above my babies
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 when traveling long
distances"-: "I should secure the car seat using lower anchors and tethers
instead of the seat belt."
, Rationale: 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 seat belt does not have to be used.
-rear facing seats harness should be placed just below the infant's shoulders, 45
degree angle to prevent slumping, padding increases risk for injury
5. 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 the family to CPS
d. schedule the toddler for a yearly rescreening: Schedule the toddler for a
yearly rescreening.
Rationale: The nurse should schedule the toddler for a lead level rescreening in 1
year and educate the family on ways to prevent exposure.
-provide diet rich in calcium, vitamin C, and iron to decrease lead absorption,
chelation is used for lead level of over 45, this is not an indicator of child
endangerment
6. A nurse is caring for a toddler who has spastic (pyramidal) cerebral palsy.
Which of the following findings should the nurse expect? (Select all that
apply.)
a. negative Babinski reflex
b. ankle clonus
c. exaggerated stretch reflexes
d. uncontrolled movements of the face
e. contractures: Ankle clonus
Exaggerated stretch reflexes
Contractures
-negative Babinski reflex is associated with spastic cerebral palsy
-uncontrolled movements of the face is associated with nonspastic (dyskinetic)
cerebral palsy
2024 EXAM WITH STUDY GUIDE TEST BANK 60
QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES (VERIFIED ANSWERS)
|ALREADY PASSED
1. A nurse in an urgent care clinic is assessing an adolescent who has an
upper respiratory tract infection. Which of the following findings should the
nurse identify as a manifestation of pertussis?
a. inflamed throat with exudate
b. purulent eye drainage
c. dry, hacking cough
d. Koplik spots on buccal mucosal: dry, hacking cough
Rationale: The nurse should identify 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.
-inflamed throat = acute strep pharyngitis
-purulent eye drainage = bacterial conjunctivitis
-koplik spots = rubella or measles
2. A nurse is caring for a school-age child who is receiving a blood
transfusion. Which of the following manifestations should alert the nurse to a
possible hemolytic transfusion reaction?
a. laryngeal edema
b. flank pain
c. distended neck veins
,d. muscular weakness: Flank pain
Rationale: The nurse should recognize that flank pain is caused by the breakdown
of RBCs and is an indication of a hemolytic reaction to the blood transfusion.
-laryngeal edema = allergic reaction
-distended neck veins = circulatory overload
-muscular weakness = electrolyte disturbance
3. A nurse is caring for a school-age child who is receiving cefazolin via
intermittent IV bolus. The child suddenly develops diffuse flushing of the skin
and angioedema. After discontinuing the medication infusion, which of the
following medications should the nurse administer first?
a. prednisone
b. epinephrine
c. diphenhydramine
d. albuterol: Epinephrine
Rationale: This child is most likely experiencing an anaphylactic reaction to the
cefazolin. According to evidence-based practice, the nurse should first administer
epinephrine to treat the anaphylaxis. Epinephrine is a beta adrenergic agonist that
stimulates the heart, causes vasoconstriction of blood vessels in the skin and
mucous membranes, and triggers bronchodilation in the lungs.
-prednisone = treats inflammation
- diphenhydramine & albuterol = not first medication
4. A nurse is teaching the guardian of a 6-month-old infant about car seat use.
Which of the following statements by the guardian 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 1 inch above my babies
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 when traveling long
distances"-: "I should secure the car seat using lower anchors and tethers
instead of the seat belt."
, Rationale: 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 seat belt does not have to be used.
-rear facing seats harness should be placed just below the infant's shoulders, 45
degree angle to prevent slumping, padding increases risk for injury
5. 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 the family to CPS
d. schedule the toddler for a yearly rescreening: Schedule the toddler for a
yearly rescreening.
Rationale: The nurse should schedule the toddler for a lead level rescreening in 1
year and educate the family on ways to prevent exposure.
-provide diet rich in calcium, vitamin C, and iron to decrease lead absorption,
chelation is used for lead level of over 45, this is not an indicator of child
endangerment
6. A nurse is caring for a toddler who has spastic (pyramidal) cerebral palsy.
Which of the following findings should the nurse expect? (Select all that
apply.)
a. negative Babinski reflex
b. ankle clonus
c. exaggerated stretch reflexes
d. uncontrolled movements of the face
e. contractures: Ankle clonus
Exaggerated stretch reflexes
Contractures
-negative Babinski reflex is associated with spastic cerebral palsy
-uncontrolled movements of the face is associated with nonspastic (dyskinetic)
cerebral palsy
