NR 328 CMS Exam Practice Questi sd sd sd sd sd
ons
1. Which interventions are included in the management of nosebl
sd sd sd sd sd sd sd sd
eeds in chil- dren? Select all that apply.
sd sd sd sd sd sd sd
a. Apply warm compresses to the bridge of the nose if bleeding i
sd sd sd sd sd sd sd sd sd sd sd
persistent.
d
b. Apply continuous pressure to the nose with thumb and forefinge
sd sd sd sd sd sd sd sd sd
r for at least 10 minutes.
sd sd sd sd sd
c. Have the child sit down and tilt the head backward.
sd sd sd sd sd sd sd sd sd
d. Insert cotton or wadded tissue into each nostril if bleeding pers
sd sd sd sd sd sd sd sd sd sd
sts.
e. Instruct the child to breathe through the mouth.: Answer: B, D, E
sd sd sd sd sd sd sd sd sd sd sd
Rationale: During a nosebleed, the child should be instructed to breathe through the mouth, cotton
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
or wadded tissue can be inserted into the nostrils to stop bleeding, and continuous pressure using th
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
e thumb and forefinger should be applied for at least 10 minutes. The child should be instructed to
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
sit up and lean forward, not tilt the head backward. Ice or cold cloths, not warm compresses, can b
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
e used on the bridge of the nose if bleeding persists.
sd sd sd sd sd sd sd sd sd sd
2. The nurse is developing a teaching plan for the family of a todd
sd sd sd sd sd sd sd sd sd sd sd sd
ler recently diagnosed with sickle cell disease. Of which does the
sd sd sd sd sd sd sd sd sd sd sd
nurse include as impor-
sd sd sd
sdtant for the family to be aware and to report in order to recogniz
sd sd sd sd sd sd sd sd sd sd sd sd sd
e signs of the major cause of death for children under age 5 with
sd sd sd sd sd sd sd sd sd sd sd sd sd sd
sickle cell disease? sd sd
a. Presence of respiratory problems sd sd sd
b. Signs and symptoms of stroke sd sd sd sd
c. Localized swelling over joints sd sd sd
d. Presence of fever: Answer: D sd sd sd sd
Rationale: The major cause of death for children with sickle cell disease under the age of 5 is overwh
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
elming infections; thus the family needs to monitor the child closely for presence of fever. Signs and
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
symptoms of stroke, presence of respiratory problems, and localized swelling over joints are also sy
sd sd sd sd sd sd sd sd sd sd sd sd sd sd
mptoms of issues related to sickle cell disease, but are not directly related to the leading cause of d
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
eath for children under the age of 5.
sd sd sd sd sd sd sd
3. Which symptom would the nurse recognize as an acquired immuno
sd sd sd sd sd sd sd sd sd
deficiency syndrome (AIDS)- sd sd
1sd/
sd31
, NR 328 CMS Exam Practice Questi
sd sd sd sd sd
ons
defining condition in an American child with human immun-
sd sd sd sd sd sd sd sd
sdodeficiency virus (HIV)?sd sd
a. Parotitis
b. Cytomegalovirus
c. Oral candidiasis
sd
d. Hepatosplenomegaly: Answer: B sd sd
Rationale: Cytomegalovirus is a defining condition for AIDS in an HIV-
sd sd sd sd sd sd sd sd sd sd
infected American child. Parotitis, oral candidiasis,
sd sd sd sd sd
2sd/
sd31
, NR 328 CMS Exam Practice Questi sd sd sd sd sd
ons
and hepatosplenomegaly are common clinical manifestations of HIV infection in children but not AIDS
sd sd sd sd sd sd sd sd sd sd sd sd sd
-defining conditions. sd
4. The nurse is administering a blood transfusion to a child for t
sd sd sd sd sd sd sd sd sd sd sd
reatment of hemophilia. Upon assessment, the nurse notes that t
sd sd sd sd sd sd sd sd sd
he child is cyanotic, has difficulty breathing, and has rales upon
sd sd sd sd sd sd sd sd sd sd sd
inspiration throughout the lung fields. What is the nurse's best r
sd sd sd sd sd sd sd sd sd sd
esponse to these findings? sd sd sd
a. Stop the transfusion immediately.
s d s d s d
b. Administer epinephrine immediately. s d s d
c. Insert a urinary catheter and monitor hourly outputs.
sd sd sd sd sd sd sd
d. Reassess the patient again in five minutes.: Answer: A sd sd sd sd sd sd sd sd
Rationale: Cyanosis, rales, and diflculty breathing are all potential signs of circulatory overload. If sig
sd sd sd sd sd sd sd sd sd sd sd sd sd sd
ns of circulatory overload occur, the transfusion should be stopped immediately. Reassessing the pat
sd sd sd sd sd sd sd sd sd sd sd sd sd
ient in five minutes would not provide an immediate response to the situation. Epinephrine is administ
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
ered for allergic reactions. Insertion of a urinary catheter may be done to treat an incompatibility rea
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
ction.
5. The nurse is teaching the family of a child diagnosed with ir
sd sd sd sd sd sd sd sd sd sd sd
on-
deficiency anemia about the proper administration of iron sup
sd sd sd sd sd sd sd sd
plements. Which points should the nurse include in the educati
sd sd sd sd sd sd sd sd sd
on session? Select all that apply.
sd sd sd sd sd
a. Stop the medication and call the primary care provider if tar
sd sd sd sd sd sd sd sd sd sd
ry stools are noted.
sd sd sd
b. Administer with milk products to alter the taste if taste is an is sd sd sd sd sd sd sd sd sd sd sd sd
ue.
c. Administer in two divided doses between meals. s d s d s d s d s d s d
d. Administer with citrus fruits or juices to increase absorption. s d s d s d s d s d s d s d s d
e. Use a straw to administer the iron if it is in liquid form.: Answer: C,
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
,E sd
Rationale: The family should be instructed to administer the iron supplement in two divided doses b
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
etween meals, when free hydrochloric acid is at its greatest levels to aid in absorption. Using a stra
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
w for liquid iron is recommended to avoid staining the teeth. Citrus fruits or juices also help increas
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
3sd/
sd31
, NR 328 CMS Exam Practice Questi sd sd sd sd sd
ons
e acidity and therefore absorption of the iron. Milk products bind the iron and interfere with absorpti
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
on and should not be used with administration of iron. Tarry stools are an expected change with iro
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
n supplements, and therefore calling the primary care provider is not necessary
sd sd sd sd sd sd sd sd sd sd sd
6. The family of a child hospitalized for care during a sickle cell c
sd sd sd sd sd sd sd sd sd sd sd sd
risis calls the nurse into the room because the child is struggling
sd sd sd sd sd sd sd sd sd sd sd s
dto breathe. Upon assess-
sd sd sd
ment, the nurse notes a respiratory rate of 30 and that the child
sd sd sd sd sd sd sd sd sd sd sd sd sd
is clutching the abdomen and crying. What does the nurse deter
sd sd sd sd sd sd sd sd sd sd sd
mine the child may be sd sd sd sd
4sd/
sd31
ons
1. Which interventions are included in the management of nosebl
sd sd sd sd sd sd sd sd
eeds in chil- dren? Select all that apply.
sd sd sd sd sd sd sd
a. Apply warm compresses to the bridge of the nose if bleeding i
sd sd sd sd sd sd sd sd sd sd sd
persistent.
d
b. Apply continuous pressure to the nose with thumb and forefinge
sd sd sd sd sd sd sd sd sd
r for at least 10 minutes.
sd sd sd sd sd
c. Have the child sit down and tilt the head backward.
sd sd sd sd sd sd sd sd sd
d. Insert cotton or wadded tissue into each nostril if bleeding pers
sd sd sd sd sd sd sd sd sd sd
sts.
e. Instruct the child to breathe through the mouth.: Answer: B, D, E
sd sd sd sd sd sd sd sd sd sd sd
Rationale: During a nosebleed, the child should be instructed to breathe through the mouth, cotton
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
or wadded tissue can be inserted into the nostrils to stop bleeding, and continuous pressure using th
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
e thumb and forefinger should be applied for at least 10 minutes. The child should be instructed to
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
sit up and lean forward, not tilt the head backward. Ice or cold cloths, not warm compresses, can b
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
e used on the bridge of the nose if bleeding persists.
sd sd sd sd sd sd sd sd sd sd
2. The nurse is developing a teaching plan for the family of a todd
sd sd sd sd sd sd sd sd sd sd sd sd
ler recently diagnosed with sickle cell disease. Of which does the
sd sd sd sd sd sd sd sd sd sd sd
nurse include as impor-
sd sd sd
sdtant for the family to be aware and to report in order to recogniz
sd sd sd sd sd sd sd sd sd sd sd sd sd
e signs of the major cause of death for children under age 5 with
sd sd sd sd sd sd sd sd sd sd sd sd sd sd
sickle cell disease? sd sd
a. Presence of respiratory problems sd sd sd
b. Signs and symptoms of stroke sd sd sd sd
c. Localized swelling over joints sd sd sd
d. Presence of fever: Answer: D sd sd sd sd
Rationale: The major cause of death for children with sickle cell disease under the age of 5 is overwh
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
elming infections; thus the family needs to monitor the child closely for presence of fever. Signs and
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
symptoms of stroke, presence of respiratory problems, and localized swelling over joints are also sy
sd sd sd sd sd sd sd sd sd sd sd sd sd sd
mptoms of issues related to sickle cell disease, but are not directly related to the leading cause of d
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
eath for children under the age of 5.
sd sd sd sd sd sd sd
3. Which symptom would the nurse recognize as an acquired immuno
sd sd sd sd sd sd sd sd sd
deficiency syndrome (AIDS)- sd sd
1sd/
sd31
, NR 328 CMS Exam Practice Questi
sd sd sd sd sd
ons
defining condition in an American child with human immun-
sd sd sd sd sd sd sd sd
sdodeficiency virus (HIV)?sd sd
a. Parotitis
b. Cytomegalovirus
c. Oral candidiasis
sd
d. Hepatosplenomegaly: Answer: B sd sd
Rationale: Cytomegalovirus is a defining condition for AIDS in an HIV-
sd sd sd sd sd sd sd sd sd sd
infected American child. Parotitis, oral candidiasis,
sd sd sd sd sd
2sd/
sd31
, NR 328 CMS Exam Practice Questi sd sd sd sd sd
ons
and hepatosplenomegaly are common clinical manifestations of HIV infection in children but not AIDS
sd sd sd sd sd sd sd sd sd sd sd sd sd
-defining conditions. sd
4. The nurse is administering a blood transfusion to a child for t
sd sd sd sd sd sd sd sd sd sd sd
reatment of hemophilia. Upon assessment, the nurse notes that t
sd sd sd sd sd sd sd sd sd
he child is cyanotic, has difficulty breathing, and has rales upon
sd sd sd sd sd sd sd sd sd sd sd
inspiration throughout the lung fields. What is the nurse's best r
sd sd sd sd sd sd sd sd sd sd
esponse to these findings? sd sd sd
a. Stop the transfusion immediately.
s d s d s d
b. Administer epinephrine immediately. s d s d
c. Insert a urinary catheter and monitor hourly outputs.
sd sd sd sd sd sd sd
d. Reassess the patient again in five minutes.: Answer: A sd sd sd sd sd sd sd sd
Rationale: Cyanosis, rales, and diflculty breathing are all potential signs of circulatory overload. If sig
sd sd sd sd sd sd sd sd sd sd sd sd sd sd
ns of circulatory overload occur, the transfusion should be stopped immediately. Reassessing the pat
sd sd sd sd sd sd sd sd sd sd sd sd sd
ient in five minutes would not provide an immediate response to the situation. Epinephrine is administ
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
ered for allergic reactions. Insertion of a urinary catheter may be done to treat an incompatibility rea
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
ction.
5. The nurse is teaching the family of a child diagnosed with ir
sd sd sd sd sd sd sd sd sd sd sd
on-
deficiency anemia about the proper administration of iron sup
sd sd sd sd sd sd sd sd
plements. Which points should the nurse include in the educati
sd sd sd sd sd sd sd sd sd
on session? Select all that apply.
sd sd sd sd sd
a. Stop the medication and call the primary care provider if tar
sd sd sd sd sd sd sd sd sd sd
ry stools are noted.
sd sd sd
b. Administer with milk products to alter the taste if taste is an is sd sd sd sd sd sd sd sd sd sd sd sd
ue.
c. Administer in two divided doses between meals. s d s d s d s d s d s d
d. Administer with citrus fruits or juices to increase absorption. s d s d s d s d s d s d s d s d
e. Use a straw to administer the iron if it is in liquid form.: Answer: C,
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
,E sd
Rationale: The family should be instructed to administer the iron supplement in two divided doses b
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
etween meals, when free hydrochloric acid is at its greatest levels to aid in absorption. Using a stra
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
w for liquid iron is recommended to avoid staining the teeth. Citrus fruits or juices also help increas
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
3sd/
sd31
, NR 328 CMS Exam Practice Questi sd sd sd sd sd
ons
e acidity and therefore absorption of the iron. Milk products bind the iron and interfere with absorpti
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
on and should not be used with administration of iron. Tarry stools are an expected change with iro
sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd sd
n supplements, and therefore calling the primary care provider is not necessary
sd sd sd sd sd sd sd sd sd sd sd
6. The family of a child hospitalized for care during a sickle cell c
sd sd sd sd sd sd sd sd sd sd sd sd
risis calls the nurse into the room because the child is struggling
sd sd sd sd sd sd sd sd sd sd sd s
dto breathe. Upon assess-
sd sd sd
ment, the nurse notes a respiratory rate of 30 and that the child
sd sd sd sd sd sd sd sd sd sd sd sd sd
is clutching the abdomen and crying. What does the nurse deter
sd sd sd sd sd sd sd sd sd sd sd
mine the child may be sd sd sd sd
4sd/
sd31
