NACE Care of the Child Real Exam
Questions and Correct Detailed
Answers with Rationales || 100%
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After each formula feeding, a 4 month old infant
who has CHF should be positioned to meet which
of these goals?
· To promote venous return from the lower
extremities
· To promote the use of the accessory muscles of
respiration
· To minimize pressure of the abdominal contents
on the diaphragm
· To prevent rapid movement of the formula
through the GI Tract - ANSWER The goal should
be to minimize pressure of the abdominal contents
on the diaphragm. This will help decrease any
additional energy that will be needed to breathe,
decreasing the workload on the heart.
When performing a physical assessment of an
unusually small newborn infant, by which of these
characteristics can a nurse determine that the infant
is small for gestational age (SGA), rather than
premature?
,· Increased lanugo
· Vigorous cry
· Weak sucking reflex
· Diminished ear recoil - ANSWER Vigorous cry
would indicate the child is SGA and not premature.
Premature infants have a weak cry due to
immaturity of the lungs. The others are all
characteristics of a premature infant.
A 7 y/o girl who has a known seizure disorder is
admitted to the hospital for the adjustment of a
medication dosage. A nurse witnesses the onset of
a generalized seizure. Which of these actions
should the nurse take first?
· Place the padded tongue blade between the child's
teeth
· Position the child on her side
· Restrain the child's limbs gently
· Obtain the child's blood pressure and pulse rate -
ANSWER The first action nurse should take is to
position the child on her side. This will prevent
aspirating the secretions the child may have during
the seizure activity.
Which of these measures is most important to
include in the care of a 3-month-old that is
dehydrated?
· Placing a urine collection device on the baby
· Assessing the baby for the presence of the rooting
reflex
, · Checking the baby's Babinski reflex
· Palpating the baby's abdomen to determine areas
of tenderness - ANSWER Placing a urine
collection device on the baby is the most important
measure to include in the care of a 3-month old
who is dehydrated. This will allow accuracy in
determining output.
An 18 month old child has been placed on Bryant
traction. The traction has been properly applied if a
nurse observes that
· Both legs are at a 35 degree angle
· 10-pound weights are in place
· The ropes are slack
· Both buttock are off the bed - ANSWER Bryant's
traction is used for children with fractured femurs
and both legs are suspended at 90 degree angles to
the trunk of the body and the weight of the body
pulls the bone fragments of the fractures leg into
alignment. If both buttocks are off the bed, then the
traction is properly applied.
Which of these measures should a nurse plan for a
3 ½ y/o child whose scrotum is very edematous?
· Applying a lanolin-based lotion to his scrotum
· Instructing him to avoid touching his scrotum
when voiding
· Supporting his scrotum on a soft pad
· Placing cold compresses on his scrotum -
ANSWER The nurse should plan on supporting his
Questions and Correct Detailed
Answers with Rationales || 100%
Guaranteed Pass!! <Recent
Version>
After each formula feeding, a 4 month old infant
who has CHF should be positioned to meet which
of these goals?
· To promote venous return from the lower
extremities
· To promote the use of the accessory muscles of
respiration
· To minimize pressure of the abdominal contents
on the diaphragm
· To prevent rapid movement of the formula
through the GI Tract - ANSWER The goal should
be to minimize pressure of the abdominal contents
on the diaphragm. This will help decrease any
additional energy that will be needed to breathe,
decreasing the workload on the heart.
When performing a physical assessment of an
unusually small newborn infant, by which of these
characteristics can a nurse determine that the infant
is small for gestational age (SGA), rather than
premature?
,· Increased lanugo
· Vigorous cry
· Weak sucking reflex
· Diminished ear recoil - ANSWER Vigorous cry
would indicate the child is SGA and not premature.
Premature infants have a weak cry due to
immaturity of the lungs. The others are all
characteristics of a premature infant.
A 7 y/o girl who has a known seizure disorder is
admitted to the hospital for the adjustment of a
medication dosage. A nurse witnesses the onset of
a generalized seizure. Which of these actions
should the nurse take first?
· Place the padded tongue blade between the child's
teeth
· Position the child on her side
· Restrain the child's limbs gently
· Obtain the child's blood pressure and pulse rate -
ANSWER The first action nurse should take is to
position the child on her side. This will prevent
aspirating the secretions the child may have during
the seizure activity.
Which of these measures is most important to
include in the care of a 3-month-old that is
dehydrated?
· Placing a urine collection device on the baby
· Assessing the baby for the presence of the rooting
reflex
, · Checking the baby's Babinski reflex
· Palpating the baby's abdomen to determine areas
of tenderness - ANSWER Placing a urine
collection device on the baby is the most important
measure to include in the care of a 3-month old
who is dehydrated. This will allow accuracy in
determining output.
An 18 month old child has been placed on Bryant
traction. The traction has been properly applied if a
nurse observes that
· Both legs are at a 35 degree angle
· 10-pound weights are in place
· The ropes are slack
· Both buttock are off the bed - ANSWER Bryant's
traction is used for children with fractured femurs
and both legs are suspended at 90 degree angles to
the trunk of the body and the weight of the body
pulls the bone fragments of the fractures leg into
alignment. If both buttocks are off the bed, then the
traction is properly applied.
Which of these measures should a nurse plan for a
3 ½ y/o child whose scrotum is very edematous?
· Applying a lanolin-based lotion to his scrotum
· Instructing him to avoid touching his scrotum
when voiding
· Supporting his scrotum on a soft pad
· Placing cold compresses on his scrotum -
ANSWER The nurse should plan on supporting his
