NUR 2633 / NUR2633 MCH final Exam (Questions) Detailed Answers (100% Correct) with Rationales Rated A+!!! Rasmussen College

NUR 2633 / NUR2633 MCH final Exam (Questions) Detailed Answers (100% Correct) with Rationales Rated A+!!! Rasmussen College NUR 2633 MCH final Exam Rasmussen College The student nurse is preparing education for the parents of a 6yo that will begin Fe supps following a dx of Fe deficient anemia. What should be included in the ed. Select allthat apply. o Fe should be given with a glass of OJ o Given with Food o Black tarry stools o Cause constipation o Cause increase in appetite 2. Pedi nurse assesses 7mo infant brought to the clinic with S/S of irritability N?V and taut anterior fontanel. Based on the standard growth chart, the nurse notes that the child has an increased head circumference which may indicate which of the following med conditions? o Brain tumor o Gastrointestinal infection o Acute lymphocytic leukemia o Chronic lyphocytic leukemia 3. To offset chemo related effects of nausea and vomiting. The pediatric nurse administers which medications? o Ondasetron o Bethamethasone o Doxorubicin o Mesna 4. The periatric nurse is familiar with kubler ross stages of grief. Parents who are feeling confused and refuse to discuss the disease with any nurse or doctor are in which stage of grief? o Denial o Grief o Bargaining o Acceptance 5. During a pedi nursing orientation session to a new unit. The child like specialist is introduced as an important member of the healthcare team. What is an important role of the child like specialist. o To pro 1. The student nurse is preparing education for the parents of a 6yo that will begin Fe supps following a dx of Fe deficient anemia. What should be included in the ed. Select allthat apply. o Fe should be given with a glass of OJ o Given with Food o Black tarry stools o Cause constipation o Cause increase in appetite 2. Pedi nurse assesses 7mo infant brought to the clinic with S/S of irritability N?V and taut anterior fontanel. Based on the standard growth chart, the nurse notes that the child has an increased head circumference which may indicate which of the following med conditions? o Brain tumor o Gastrointestinal infection o Acute lymphocytic leukemia o Chronic lyphocytic leukemia 3. To offset chemo related effects of nausea and vomiting. The pediatric nurse administers which medications? o Ondasetron o Bethamethasone o Doxorubicin o Mesna 4. The periatric nurse is familiar with kubler ross stages of grief. Parents who are feeling confused and refuse to discuss the disease with any nurse or doctor are in which stage of grief? o Denial o Grief o Bargaining o Acceptance 5. During a pedi nursing orientation session to a new unit. The child like specialist is introduced as an important member of the healthcare team. What is an important role of the child like specialist. o To provide opportunities for therapeutic play and information 2 NUR 2633 MCH FINAL EXAM RASMUSSEN COLLEGE!@$@)*)@!_)@*@) o To accompany children on their way to surgery o To assist with family counseling regarding discipline and limits o To describe normal growth and development to parents and families 6. The pedi nurse is caring for a child who has been in a motor vehicle collision. The dr explains to the family that there serious physical disabilities. The father is upset and states I don’t know how I will be able to cope. I have two other children. What can I do? What is the nurses response? o You obviously were not listening to the dr. he can explain it to you again o Don’t worry. You will be able to manage o Don’t worry. You will get through the crisis o Many parents find the initial news to be overwhelming. What questions can I answer for you? 7. Asking the pregnant woman about her use of recreational drug is essential component of the prenatal hx. The use of rec drugs cause harm to the fetus resulting in which OB outcomes? Select all. o Miscarriage/ spontaneous abortions o Low birth weight o Macrosomia o Postterm labor birth o Cord prolapse 8. Management of primary dysmenorrhea often requires a multifaceted approach. The nurse who provides care for a client with this condition should be away that the optimal pharm therapy for pain is? o NSAID o Oral contraceptives o ASA o Acetaminophen 9. Screening at 23wks reveals that a pregnant woman has gest DM. in planning her care the nurse and the woman mutually agree that an expected outcome is to prevent injury to the fetus as a result of GDM. What is the fetus at greatest risk for? o Preterm birth o Low birth weight o Congenital anomalies of the CNS o Macrosomia 10. The nurse caring for a pregnant client knows that her health teach regarding fetal circulation has been effective when the client reports that she has been sleeping in what position? o On her back with a pillow under her knees o In a sidelying position o On her abs o With HOB elevated 11. Which of the following are S/S that a pregnant woman should report immediately to her health care provider? Select all. 3 NUR 2633 MCH FINAL EXAM RASMUSSEN COLLEGE!@$@)*)@!_)@*@) o Decreased libido o Urinary frequency in early preg o Ruptured membranes o Vaginal bleed o HA that do not respond to usual therapy 12. 34wks, experiencing preterm labor. Interventions nurse will provide for client. Select All. o Iv fluid bolus o Obtain urine specimen o Place on fetal monitor o Keep pt in supine for the FHR monitoring o Follow physstanding order to ambulation as desired for comfort 13. Perinatal nurse prepare the laboring woman for an epidural. What intervention can the nurse provide to prevent maternal hypotension? o Assists the woman to lie down in supine position o Admin a rapid IV infuse 500mL of NS o Assesses BP and Pulse q5min 3x before epidural o Encouragesfrequent cleansing breaths after the patient has been placed in the correct position for the anesthesia admin 14. According to agency policy the perinatal nurse provides which intrapartal nursing care for the patient with preeclampsia? o Take the patients blood pressure q6h o Encourage the patient to rest on her back o Notify phys of urine output greater than 30 mLs o Admin mag sulfate according to agency policy 15. Perinatal nurse providing care to a laboring woman recognizes a nonreassuring FHR tracing. An appropriate initial actions is to which of the following? o Assist the laboring woman to a lef t lateral position o Increase the IV solution o Request that the phys/ certified nurse midwife apply fetalscalp ectrode o Document the FHR and variability 16. Nurse performs assessment of the newborns skin and documents the presence of a yellow coloration of the skin surface sclera and oral mucous membranes. What condition is most likely the cause of these findings? o Hypoglycemia o Physiological anemia of infancy o Low GFR o Jaundice 17. 4yo has croup is admitted to the hospital and wes the bed overnight. When the parent comes to visit the next day the nurse explains the situation and the parents says my child neer wets the bed at home. I am so embarrassed. Which of the following is an appropriate response by the nurse? o It is normal for hospitalized children to regress. The toileting skills will return when your child is feeling better 4 NUR 2633 MCH FINAL EXAM RASMUSSEN COLLEGE!@$@)*)@!_)@*@) o I know this can be embarrassing. I have kids myself, so I understand and it doesn’t bother me o Your child did not seem upset so I wouldn’t worry about it if I were you o I will discuss your childs loss of bladder control with the provider as this may be an indication of some neurological issue 18. A nurse is assessing a newborn to a mother who is addicted to drugs. Which assessment findings would the nurse expect to note during the assessment of this newborn o Lethargy o Sleepiness o Incessant crying o Cuddles when being held 19. A nurse performs an admission assessment on a child and suspects physical aburse. Based on this suspicion, the primary legal nursing responsibility to which of the following? o Refer the family to the appropriate support groups o Assist the family in ID resources and support groups o Report the case in which the abuse is suspected to the local authorities and your supervisor or charge o Coordinate info with the primary phys so he may report findings 20. A nurse is caring or a child after tonsillectomy. The nurse monitorsthe child knowing that which of the following indicates that the child is beeling o Frequentswallowing o Decreased pulse rate o Complaints of discomfort o An elevation in BP 21. A nurse provides home care instructions to the parents of a child with congestive heart failure regarding the procedure for administration of digoxin. Which statement made indicated need for for further instructions? o I will not mix the med with food o If more than 1 missed dose is missed, call the phys o I will take pulse before admin meds o If child vomits after med, I will repeat the dose 22. Informed consent requires which of the following actions o A signature of someone of legal age which is 18 in most states o That the nurse isresponsible person to explain the procedure o Is not require for every procedure if the patient verbal agrees o Two witnesses since thisis a minor child 23. The nurse is caring for a laboring client and notesthe fetal monitor pattern of accelerations. Which of the following is appropriate? o Notify the phys of the findings o Change the mothers position increase fluids and provide oxygen o Take VS and explain to the mothershe must stay in bed to conserve O2 o Document the normal finding and reassure the monitor and family 5 NUR 2633 MCH FINAL EXAM RASMUSSEN COLLEGE!@$@)*)@!_)@*@) 24. A nurse has ID that her pregnant client has a labor dystocia and is not progressing normally through the labor process. The nurse is preparing to augment her labor and will prepare the client for which of following nonpharm procedure? o Amniotomy o Epidural o IV admin of Pitocin o Foley cath insert 25. Uterine atony occurs after your patient has vaginal delivery of her 9lbs baby. The initial nursing intervention to prevent hemorrhage is which of the following interventions? o Call phys o Start Pitocin iv therapy o Position the patient prone o message fundus 26. Health teaching that the nurse would provide for parents of an immunosupp child focuses on which important measure? o Nutrition o Pain control o hand washing o restricted visit hrs 27. the nurse observed some children in the playroom. Which play situation exhibitsthe characteristics of parallel play. o A&B sharing clay to each make things o A playing with a truck next to B playing with a truck o A playing a board game with BC&E o A playing music while sitting on her mothers lap 28. Appropriate nursing Dx for a child with anemia o Activity intolerance R/T gen weakness o Decreased CO R/T abnorm hemoglobin o Risk for injury R/T to depressed sensorium o Risk for injury R/T to dehydration and abnorm hemoglobin 29. Discipline is important to the growth and development of children. Discipline can teach a child how to manage behavior. Some discipline will destroy a childs self esteem. Which discipline is appropriate. Select All/ o Distraction o Corporal punishment o Removal of privileges o Time out o Consequences of actions o Yelling to get the childs attention 30. 4yo comesinto ED. Hasfrog-like croaking sounding upon inspiration is agitation and is drooling. She insists on sitting upright. Priority action? o Maintain an open airway o Start IV line 6 NUR 2633 MCH FINAL EXAM RASMUSSEN COLLEGE!@$@)*)@!_)@*@) o Obtain throat culture o Transport to chest xray 31. 12y/o dx with type 1 diabetes. Pedi nurse explainsto the nurse explainsto the patients parents that the symptoms of this disease include which of the following? o Decreased urination o Decreased thirst o Unintended weight loss o Low levels of glucose in the blood 32. is described as enhancing the quality of life by keeping the patients comfortable in the face of terminal condition such as cancer. o Curative o Palliative o Organized o Spiritual 33. Why are cool mist vaporizers vs steam heat humidifiers recommended in home treatment of respiratory tract infections o Safer o Less expensive o Respirator secretions are dried with use o More comfortable environment is produced 34. 8yo dx with sickle cell anemia. Hospitalized and nurse recognized which of the following as the initial nursing intervention o hydration and pain management o blood administration and lab valuesfor Hgb and Hct o antibiotic therapy and blood cultures o physical and occupational therapy 35. advantage of peritoneal dialysis o treatments are done in the hospital o protein loss is less extensive o dietary limitations are not necessary o parents and older children can perform treatments at home 36. toddler’s parents ask forsuggestions on dealing with temper tantrums. What is the most appropriate recommendation the nurse can share with the parents? o Ignore the behavior provided that is not injurious o Punish the child o Leave the child alone until tantrum is over o Explain the child that this is wrong 37. That is most critical nursing action in caring or the newborn immediately after birth o Keeping the newborns airway clear o Fostering parent newborn attachment o Drying the newborn and wrapping the infant in a blanket administering eye drops and vita k 38. Newborns that maybe more at risk for developing cold stress are those infants without 7 NUR 2633 MCH FINAL EXAM RASMUSSEN COLLEGE!@$@)*)@!_)@*@) sufficient brown fat thermogenesis. The neonatal nurse will recognize which baby is at the greatest risk? o Macrosomic baby that is breastfeeding every 3 hours o IUGR whose mother underwent an emergency c-section for preeclampsia o LGA at 37.5 wks whose mother gained 45 lbs o AGA single mom that is giving him up for adoption 39. Young child brought to ED with severe dehydration secondary to acute diarrhea and vomiting Therapeutic management of this child will begin with which nursing intervention? o IV Fluid o Oral rehydration solution o Clear liquids 1-2 oz at a time o Admin of antidiarrheal medication 40. 3mo infant dies shortly after arriving to the ED. Infant has a subdural and retinal hemorrhages but no external signs of trauma. The nurse should expect which injury? o Unintentional injury o Shaken baby syndrome o Sudden infant death syndrome o Congenital neurologic problem 41. 1min after birth the nurse assesses the infant and notes a HR of 80bpm some flexion of extremities a weak cry slight grimacing and pink body but blue extremities. The nurse would calculate an APGAR score as which number. o 2 o 5 o 8 o 10 42. clinic is lending a federally approved car seat to an infantsfamily. The nurse should explain where the safest place is to put the car seat in the vehicle o front facing back o rear facing back o front facing in front with airbag on passengerside o rear facing in front with airbag on the passengerside 43. student nurse notesthat population of a STI health clinic consistslargely of teenagers. The nurse explains that adolescents are at greater risk for contracting STIs because of which factor? o Immune system of an adolescents is immature o Untreated UTI will develop into an STI o Adolescents are risk takers and believe they are invincible o Adolescents often lack parentalsupervision 44. Pedi nurse routinely administers blood productsto the patients on the unit. Safe administration includes the following procedure o 2 blood banks employees must check and sign the accuracy of the blood products 8 NUR 2633 MCH FINAL EXAM RASMUSSEN COLLEGE!@$@)*)@!_)@*@) o call for the blood products 1hr prior to administration o allow 4hrsfor maxium time for blood infusion o add prescribed medsto blood products prior to administration 45. school aged girl who has had a cardiac cath. the child tells the nurse that her bandage is too wet. The nurse find the bandage and bed soaked with blood. What is the most appropriate initial nursing action? o Notify the phys o Apply new bandage with more pressure o Place in Trendelenburg position o Apply direct pressure about the cath site 46. What is the priority nursing intervention when a child is unconscious after a fall o Establish adequate airway o Perform neurologic assessment o Monitor ICP o Determine whether a neck injury is present 47. After the acute stage and during the healing process the primary complication from burn injury is o Asphyxia o Shock o Renal shut down o Infection 48. A mother brings her 15mo old child to the clinic. During nursing assessment the mother makes the following comments. Which comment warrants further investigation. o My son cries when I leave him at his grandparents house o Always take his blankets with him o Is not crawling yet o Likes to eat mashed potatoes 49. 10yo is discharged home from the ED after a fracture his left lower extremity. Cast was applied and nurse give discharge instruction to the patient and his parents. The nurse notes the parents require additional education when the mother states which of the following o I will use a hair dryer to help dry the cast faster o Son needs to help his leg elevated to prevent swelling o Son can bathe if we can protect the cast from getting wet o Son is not to put anything in the cast if his lefts starts itching 50. Perinatal nurse preparesthe laboring woman for an epidural anesthesia insertions. What nursing action should be taken to prevent maternal hypotension o Admin a rapid IV infusion of 500mls of NS o Assess the blood pressure every 5 min 3x before epidural insertion o Encourage frequent cleansing breaths after the patient has been placed in the corrected position for anesthesia administration o Assist the woman to lie down in a supine position 51. Methergine is prescribed for a woman to treat postpartum hemorrhage. What isthat 9 NUR 2633 MCH FINAL EXAM RASMUSSEN COLLEGE!@$@)*)@!_)@*@) priority nursing assessment before administering this drug to the postpartum client. o DTR o Uterine tone o BP o Amount lochia 52. Receiving MgSulfate for the management of preeclampsia. A nurse determinesthat the client is experiencing toxicity from the med if which of the following is noted on assessment o Serum mg lvl 4mEq/L o Proteinuria of +3 o RR of 10bpm o Presence of DTR 53. A nurse in the newborn nursery is monitoring newborn infant for respiratory distress syndrome. Which assessment signs if noted in the newborn would alert the nurse to the possibility of this syndrome o Tachypnea and retractions o Acrocyanosis and grunting o Hypotension and bradycardia o Presence of a barrel chest with clubbing 54. Nurse determines that a new mother understands the teaching about prevention of newborn abduction if she makes which statement o I will place the crib near the door o If Someone in scrubs asks to see my baby. I can feel safe agreeing to let them take my baby to the nursery o If I am planning a shower I should return the baby to the nursery if my husband is not here o The CAN can carry the baby to the newborn nursery for lab testing 55. Developing a plan of care for a child who is at risk for seizures. What are the nursing interventions that the nurse should perform if the child has a seizure. Select All. o Provide a safe environment o Place the child in the prone position o Ensure the child has an adequate airway o Stay with the child o Restrain the child 56. A new mother expresses concerns regarding SIDS. She asks the nurse how to position the new infant for sleep. What is the nurses best response to this new mother o Side or prone o Stomach with face turned o Back rather than on tummy o Raise the head of the crib 57. Hospitalized 2yo with croup isreceiving corticosteroid therapy and the mother asks why the provider did not prescribe antibiotics? What is the best response to the mother? o Child still has the maternal antibodies from birth and does not need antibiotics 10 NUR 2633 MCH FINAL EXAM RASMUSSEN COLLEGE!@$@)*)@!_)@*@) o Child may be allergic to the antibiotics o Antibiotics are not indicated unless a bacterial infections isthe cause of illness o Child is too young for antibiotics 58. Nurse is monitoring an infant with CHF. Which of the following symptoms alertsthe nurse to suspect fluid accumulation and the need to call the provider? o Decreased BP o Jaundice o Weight gain of 1lb in 1day o Bradypnea 59. When is it generally recommended that a child return to school with an acute strep pharyngitis. o After taking antibioticsfor 5days o If not complications develop o Fater taking antibioticsfor 24hrs o When the sore throat is gone 60. Which type is croup is considered a medical emergency o Laryngitis o Spasmodic cough o Laryngotracheobronchitis o Epiglottitis 61. An appropriate nursing intervention when caring for a child with pneumonia is which of the following o Encourage rest o Administer antiemetics o Place the child in Trendelenburg o Encourage child to lie on the unaffected side 62. Infant brought to the ED with poor skin turgor weight loss lethargy an tachycardia. What does the nurse suspect is the problem? o Overhydration o Excess K+ o Excess Na o Dehydration 63. Therapeutic management of a child with acute diarrhea and mild dehydration usually beings with what nursing action? o Absorbents such as kaolin and pectin o Antidiarrheal medications such as paregoric o Clear liquids o Oralrehydration solution 64. 5yo scheduled for cardiac cath. what does the nurse know about the preop teaching for this client. o Provide detailed info about the procedure so he will be prepared o Complete this education several days before the procedure so he hastime to relax 11 NUR 2633 MCH FINAL EXAM RASMUSSEN COLLEGE!@$@)*)@!_)@*@) o Adapt the education to his age and level of development so he can understand o Direct the education to his parents because he istoo young to understand 65. Parents of a 3yo child with congenital heart disease are afraid to let their child play with other children because of possible over exertion. Which statements by the nurse istrue? o Parent can meet all of the childs need o Child needs to under that peer activities are too strenuous o Child needs opportunities to play with others o Constant parental supervision is needed to avoid exertion 66. Several complications can occur when a child received a blood transfusion. What is an immediate sign of an air embolus o Chills and shaking o Irregular heart reate o N/V o Sudden difficulty breathing 67. The nurse is caring for an adolescent who has just started dialysis. 15yo seems angry hostile and depressed. Nurse should recognize this is related to which of the following issues? o Adolescents have a few coping skills o Adolescents often resent the control and enforced dependence imposed by dialysis o Neurologic manifestations that occur with dialysis o Physiologic manifestations of renal disease 68. The nurse is assessing a child who was just admitted to the hospital for observation after a head injury. What is the most essential part of the nursing assessment to detect early signs of worsening conditions o VS o Focal neurological signs o Posturing o LOC 69. Which of the following does not predispose the child to UTI o Urinary reflux o The presence of urinary stasis o Lower urine pH o Short urethra in young females 70. The most immediate threat to life in children with thermal injuries? o Local infection o Anemia o Shock o Systemic sepsis 71. A child has a chronic nonproductive cough and diffuse wheezing during the expiratory phase of respiration. What should this suggest to the nurse o bronchiolitis o pneumonia 12 NUR 2633 MCH FINAL EXAM RASMUSSEN COLLEGE!@$@)*)@!_)@*@) o tonsillitis o asthma 72. all but which of the following techniques are acceptable for medications administration to an infant? o Allowing the infant to sit in the parent’s lap during administration o Adding the medicationsto the infantsformula o Inserting the needleless syringe into the side of the infants mouth o Allow the infant to such the medications from an empty nipple 73. Choose the nursing interventions for a child after a cardiac cath. select all. o Maintain a patient peripheral IV Cath o Remove the pressure dressing 2hrs after procedure o Assessthe affected extremity for color and temperature o Monitor VS q4h o Check pulses above the procedure site for equality and symmetry 74. Which action is likely to encourage parentsto talk about their feeling related to their childs illness o Use openended questions o Avoid periods of silence o Use direct questions o Be sympathetic 75. In preparing to insert an IV into a 5yo then nurse should consider which of the following. Select all. o Use procedure room o Have a family member or assistant in the room o Use a transitional object for explaining o Call the provider for sedation if uncooperative 76. While planning postop care for the toddler. The nurse recognizesthat the child islikely to have which concern based on age? o Anticipated pain o Body image changes o Loss of peers o Separation from parents 77. Infant weighted 6lms at birth. expected weight at 1 yr? o 12 o 18 o 24 o 27 78. the nurse knows that all women should perform self breast exams to ID changes. If a woman telephones your clinic and reports a lump in her breast what is the nurse’s best response to her? o How old are you? Mammograms are not necessary for anyone under the age of 35 o Lumps are common in women that smoke. Do you smoke? 13 NUR 2633 MCH FINAL EXAM o When was you LMP. It does not help to do self breast exams during your menstrual cycle o Please make an apt to come to the clinic. The provider will see you and discuss options after an exam. 79. Pregnant client presents to L&D with no prenatal care and it is quickly determined to ultrasound that she is 39wks gest. What lab specimens mu