NSG 3600 Exam 1 Pediatric Nursing Galen College of Nursing

NSG 3600 Exam 1 Pediatric Nursing Galen College of Nursing 39. A nurse is providing a child safety class to a parent group. Which instruc- tions are appropriate for the age group? (Select all that apply.) a. adolescent: ride in the back seat of the car b. infant: never attach a pacifier to the infants clothing c. preschool: teach stop, drop and roll for fire d. school-age: keep toilet seats down and tubs empty e. toddler: never leave unattended in a walker: B, C 40. The nursing faculty explains to a group of students about the body's immune response. What action by the immune response is most important for its functioning? a. creating and maintaining immunoglobulins b. inducing a febrile response to an invading organism c. producing a mechanical barrier against infection d. recognizing non-self material and reacting to it: D 41. A child with a congenital immunodeficiency is scheduled for a routine vaccination. What instruction is most important for the nurse to provide the parent before they leave the clinic? a. "if your child has a little temperature, give acetaminophen (Tylenol)" b. keep your child away from other children for the next few days" c. "let's schedule your return visit to have blood drawn for a titer" d. "put ice not he injection site 4 times a day for 15 minutes": C 42. A parent rushes her child to the emergency pediatric clinic after she picks up her baby from day care and sees a bright red spot on his cheek that looks as if he was slapped by a caregiver. Which information does the nurse anticipate providing to the mother? a. keep your child away from any pregnant women while he is sick b. the rash will probably spread to the trunk, arms, and legs c. warm baths with oatmeal will decrease the pain from the rash d. you can treat your child's fever with salicylates (baby aspirin): A 43. The clinic nurse is evaluating a teen who reports extreme fatigue and a sore throat. On physical exam, the nurse notes swollen, tender occipital lymph nodes and an enlarged area on abdominal palpation. Which diagnostic testing does the nurse anticipate being ordered as the priority? a. complete blood count b. monospot test c. rheumatoid factors d. titer for Epstein-Barr virus: B 44. A nurse is providing community education on preventing mosqui- to-borne diseases in children. Which instruction is most appropriate for the nurse to provide? a. avoid spraying repellent directly onto child's skin b. DEET-containing repellent can be sprayed on the clothes c. dress your body warmly even on hot days when going outside d. keep babies less than 1 year of age inside at all times: B 45. The family practice nurse is teaching a student about different types of vaccines. Which information about vaccines is correct? a. attenuated vaccines are used only in adults b. inactivated vaccines prevent disease reactivation c. live virus vaccines need occasional boosters d. toxoid vaccines contain highly potent viruses: C 46. A nursing faculty member is explaining the pediatric immune system to students. Which statement is correct? a. children are born with intact immune systems b. children's immune systems develop over 1 year c. immunity isn't functional until about 6 months d. mothers immunity is babies primary line of defense: A 47. A nurse is providing anticipatory guidance to new parents. Which in- struction by the nurse will assist the parents in painting physical barriers to prevent infection int heir newborn? a. breastfeeding provides some antibodies b. ensure your baby is getting enough nutrition c. keep your baby away from people who are sick d. was your body with gentle soap and dry well: D 48. A 10-month-old-child is int he pediatric clinic for his 8th ear infection. Which assessment is most important for the nurse to perform on this child? a. ask the parent about possible allergy testing b. assess the Childs mouth for oral thrush c. graph height and weight on the growth chart d. inquire about the health of the entire family: C 49. A parent calls a pediatric information line to ask about treating sinus congestion in a child. Which suggestions is not appropriate for the nurse to make the parent? a. warm-facial compress b. cool-mist steamer c. Sine-Off sinus medication d. gentle nasal suctioning: C 50. An immunocompromised child has been admitted to the hospital with Fifths disease. Which action by the nurse is most appropriate? a. place the child in contact precautions b. place the child in droplet precautions c. place the child in protective isolation d. place the child on standard precautions: B 51. A child is hospitalized with a. serious bacterial infection. Which assess- ment finding indicates that he goals for a priority nursing diagnosis have been met? a. intact skin integrity b. normal temperature c. stable weight d. urine output of 1mL/kg/hour: D 52. The pediatric nurse explains to a nursing student about the most impor- tant role that nurse has in preventing disease What does this role include? a. ensuring that immunizations are up to date in all children b. facilitating research on new forms of immunizations c. giving reminders about immunizations to parents in clinic d. scheduling and conducting immunization clinics: A 53. A parent is refusing to have a child vaccinated, preferring to have the child contract the illness and develop natural immunity. Which response by the nurse is the best? a. i'm sure you know what is best for your baby b. I'll have to report you to social work c. that practice is dangerous and illegal d. these diseases have many serious consequences: D 54. A nurse has given an infant a vaccination. Which information is important to document for this vaccination? a. date of next regularly scheduled immunization b. drug, dose, site of administration, infants reaction c. parental education provided before administration d. vaccine information sheet given before administration: D 55. A child has been hospitalized with rubella. Which action by the charge nurse is most appropriate? a. do not allow pregnant nursing staff in the room b. inform the parents that fresh produce is not allowed c. place the child on contact isolation precautions d. use standard precautions when caring for this child: A 56. The pediatric charge nurse receives this report on an incoming admis- sion: a 3-year-old boy with ear and jaw pain, bilateral parotid gland swelling, and mild dehydration. Which action by the charge nurse is most appropriate? a. do not assign any pregnant nursing staff b. inform parents that sterility is common c. place the child on droplet precautions d. place the child on airborne precautions: C 57. The family practice nurse counsels parents to avoid giving their child salicylates for fever or mild pain. Which over-the-counter medications does the nurse warn about that contain this product? (Select all that apply.) a. Alka-Seltzer b. Bufferin c. Dristan d. Kaopectate E. Robitussin: A, B, C, D 58. A nurse is educating a community group of parents about prevention of West Nile virus. Which information does the nurse include in the teaching session? (Select all that apply.) a. all children should be sprayed with DEEt before going outside b. eliminate standing water around your house, such as in birth-baths c. holistic mosquito repellent, such as lavender, is very effective d. long sleeves and long pants help prevent mosquito bites e. the peak season for the virus is late summer to early autumn: B, D, E 59. A child has been hospitalized with rubeola. Which actions by the nursing staff are most important? (Select all that apply.) a. administer ordered antibiotics on time b. assess the child for Kopliks spots c. ensure the room is dark for photophobia d. monitor the child for febrile seizures e. report the disease to health authorities: B, C, E 60. The pediatric nurse is caring for a 5 y/o child in traction related to a broken femur. Which action by the nurse takes priority? a. assess neuromuscular status every 4 hours b. provide diversional activities for the child c. educate parents on the principles of traction d. provide high-protein, high-fiber menu items: A 61. The nurse consults the child life specialist to help plan care for a child who is immobilized and is increasingly anxious. Which is the priority inter- vention for this child? a. allowing the school to provide a tutor b. providing diversional activities c. consulting a social worker d. administering pain medication: B 62. The nurse is preparing a 7 y/o child to have a cast removed from his leg. Which statement would be most appropriate to prepare the child for the procedure? a. "As soon as the cast comes off, you can get up and move around" b. "the sound of the cast saw is very loud and may be a little scary" c. "you must sit very still so we don't accidentally hurt your leg" d. "don't worry, you will be asleep during the cast removal": B 63. A nurse reads the diagnosis of neurogenic clubfoot on an infants chart. Which other diagnosis does the nurse expect to find when reviewing the medical record? a. osteogenesis imperfecta b. spina bifida c. muscular dystrophy d. no associated diagnosis: B 64. The pediatric nurse is aware that which is the precipitating cause of Legg-Calve-Pearths disease? a. genetic abnormality b. interruption in blood flow c. birth trauma d. dietary deficiency: B 65. The pediatric nurse understands that which classification of fracture has the most potential to affect growth? a. type III b. type V c. closed d. open: B 66. Which explanation by the pediatric nurse is most appropriate for a child with ankylosis? a. ROM restriction in the vertebrae b. adhesions causing joint immobility c. curvature of the cervical spine d. bowed legs caused by low calcium: B 67. A nurse visiting a day care notices a boy trying to get up off the floor by kneeling, rising to his feet while keeping his hands on the flood, and then walking his hands up his legs until he is standing. Which assessment finding does this nurse document? a. positional instability b. Grower's maneuver c. Kernig's sign d. Grey Turner's sign: B 68. The nurse is providing care to a child diagnosed with lordosis. Which comment erm might the parents have heard to describe this condition? a. hunchback b. swayback c. spinal curvatura d. flat feel: B 69. A nurse admitting a child to the intensive care unit is told the child has risus sardonicus. Which disease process does the nurse suspect the child has? a. scoliosis b. osteogenesis imperfecta c. Duchenne's muscular dystrophy d. tetanus: D 70. A pediatrician asks a patient with a knee injury to squat. Which disorder is this patient suspected of having? a. juvenile arthritis b. muscular dystrophy c. Osgood-Schlatter disease d. Osteomyelitis: C 71. A nurse is conducting a sports fitness class for volunteer coaches. Which information provided by the nurse is the most appropriate? a. fractures heal more quickly in children bc their bones are still growing b. children are prone to fractures bc their bones are weaker than adults bones c. ligaments are bands of fibrous tissue that hols muscles to the bones d. once a child reaches adult height, bone development eventually stops: A 72. A woman who wishes to become pregnant again consults with the nurse about preventing her child from being born with clubfoot. She has two other children, both treated for this disorder. Which information does the nurse provide about preventing clubfoot? a. avoid second-hand cigarette smokes while pregnant b. fetal positioning in utero cannot be controlled c. getting enough folic acid early in the pregnancy is advisable d. the disorder is genetic so no prevention is preventable: D 73. A child who has been limping for several weeks is brought to the clinic and undergoes radiological studies. The results show osteonecrosis. Which information does the nurse plan to teach the parents about their child's condition? a. non-weight-bearing status and mobility limitations b. overcorrection with the Z-plasty technique d. wearing and caring for a Browne splint: A 74. A child has been hospitalized with an acute-grade IV slipped femoral capital epiphysis (SFCE) and is on bedrest awaiting surgical correction. A new nurse places the following interventions on the childs care plan. Which intervention leads the experienced nurse to intervene? a. consult child-life therapist for diversionary activities b. perform range-of-motion exercises to both lower extremities c. reinforce teaching on crutch-walking postoperatively d. teach child and family about non-weight-bearing status: B 75. A nurse is caring for an 8-year-old child hospitalized 2 days after open reduction and internal fixation (ORIF) of a femur fracture sustained in a motor vehicle crash. The child is now in a long-leg cast. Which assessment finding prompts the nurse to notify the health- care provider? a. a foul odor coming from the cast b. child eating only 20% of meals c. old dried drainage marked not he cast d. request for pain medicine every 4 hours: A 76. A new nurse is placing an elastic wrap on a patient with an ankle sprain. Which action by this nurse causes an experienced nurse to intervene? a. exerts moderate pull on the wrap b. instructs the pt on wrapping the injury c. starts wrapping distal to the injury d. wraps in a proximal-to-distal fashion: D 77. A 5-year-old child is hospitalized with osteomyelitis and will be going home in the next few days on intravenous (IV) antibiotics. Which action by the nurse is the most appropriate? a. ensure that a valid permit for a PICC line is on the chart b. locate a pharmacy that will supply the IV medications c. research the pt's insurance for home infusion coverage d. teach the child about PICC line using a doll: A 78. An 8-month-old child with congenital myotonic dystrophy has been hos- pitalized with a severe respiratory infection. Which action by the nurse is the most appropriate? a. determine if the family wants aggressive ventilatory support b. discuss the option of lung transplantation w/ the family c. hold a family meeting to discuss palliative care measures and code status d. inform the family the child will be ventilator dependent as she gets older: C 79. A home health-care nurse is visiting a child with Duchennes muscular dystrophy (MD). The child has a new cough, poor appetite, fatigue, and a reddened area on his coccyx from sitting in his wheelchair all day. What intervention by the nurse takes priority? a. assess child for his favorite high-protein foods b. develop a protocol for changing positions more often c. encourage family to allow the child plenty of rest d. notify the health-care provider and request antibiotics: D 80. The parents of a 3-year old cannot understand how their child has devel- oped osteoporosis, stating We didnt think children could get this disease. Which assessment by the nurse is most important? a. attainment of developmental milestones b. dietary intake of calcium c. height and weight d. labor and birth history: D 81. A student nurse is caring for a patient in skin traction. What action by the student causes the registered nurse to intervene? a. assesses neurovascualr status every 24 hours b. ensures correct weights are hanging freely c. positions child perpendicular to the traction d. removes traction to assess the skin every 4 hours: C 82. A parent asks about the process of bone growth. When explaining bone development to the parent, which substances does the nurse include in the teaching session as being necessary? (Select all that apply.) a. calcitonin b. calcium c. estrogen d. thyroid hormones e. vitamin D: A, B, E 83. The nurse is caring for a child diagnosed with clubfoot. Which assess- ment findings does the nurse anticipate in the affected extremity? (Select all that apply.) a. adducted forefoot b. dorsifelxion c. everted heel d. plantar flexion e. rigidity: A, D, E 84. A nurse is teaching part of a babysitting class to teenagers. Which infor- mation about fractures does the nurse include in the lesson? (Select all that apply.) a. approximately 10%-15% of childhood injuries are fractures b. bicycle crashes account for many fractures c. girls rarely have stress fractures from sports d. new bone growth is complete in 6 weeks E. some fractures can interrupt normal growth: A, B, E 85. A pediatrician orders Russell traction for a 12-year-old patient with Legg-Calv-Perthes disease. Which interventions are appropriate for the nurse to include in the care plan for this patient? (Select all that apply.) a. bony areas are massaged frequently b. child is lying in a supine position c. hip is flexed and abducted d. skin is inspected every 12 hours e. the child uses a trapeze to move: B, C, E 86. Following hip surgery, a patient is placed in a spica cast. What nursing interventions are appropriate for this patient? (Select all that apply.) a. cutting a window in the cast b. icing the area of the incision c. increasing fiber in the diet d. increasing fluid intake e. maintaining the same position: A, C, D 87. The pediatric nurse is caring for a patient with juvenile arthritis. The health-care provider tells the nurse the patient will be started on dis- ease-modifying antirheumatic drugs (DMARDs). Which drugs does the nurse anticipate administering? (Select all that apply.) a. acetaminophen (Tylenol) b. indomethacin (Indocin) c. infliximab (Remicade) d. leflunomide (Arava) e. methotrexate (Rheumatrex): C, E 88. The pediatric nurse explains to the parents of a child with kyphosis that it is caused by a congenital or acquired condition. Which conditions are considered congenital causes of kyphosis? (Select all that apply.) a. ankylosing spondylitis b. chronic poor posture c. osteogenesis imperfecta d. osteomyelitis e. rheumatoid arthritis: A, C 89. The pediatric nurse discusses home care with the parents of a patient who is returning home following a spinal fusion. Which teaching points will the nurse include in the discharge teaching for this patient? (Select all that apply.) a. allow the child to return to school about 4-6 weeks following surgery b. encourage ambulation when permitted, usually 2-3 weeks postoperatively c. explain activity restrictions such as no twisting, bending, or lifting d. maintain a regular diet with added calcium, fiver, and vitamin C e. participation in contact sports such as football needs to be delayed for 1 year: A, C, D 90. A young teen has been diagnosed with Osgood-Schlatter disease. Which information does the nurse teach the patient and family regarding this diag- nosis? (Select all that apply.) a. activity level is determined by pain b. apply ice to the knee after activity c. modified bedrest for 1 week is needed d. surgical correction is usually required e. use ibuprofen (Motrin) for pain: A, B, E 91. A child's family history includes muscular dystrophy (MD). What diagnos- tic testing does the nurse prepare the child and family for? (Select all that apply.) a. blood urea nitrogen b. creating kinase c. electromyelogram d. muscle biopsy e. ultrasound: B, C, D 92. During hand-off report, the off-going nurse reports that a newborn is tachycardic. What heart rate does the nurse expect to find on assessment? a. 80 to 100 beats/min b. 100 to 120 beats/min c. greater than 140 beats/min d. greater than 160 beats/min: D 93. A nurse assessing a newborn for birth injuries knows that the bone most often factored during delivery is which of the following? a. clavicle b. femur c. wrist d. ankle: A 94. The perinatal nurse teaches new parents that the best sleeping position for infants is which of the following? a. prone b. side-lying c. side-lying with a blanket roll behind the infants back d. supine: D 95. A nurse is preparing to discharge an infant who has developmental dysplasia of the hip (DDH). What discharge instruction would be most im- portant? a. how to correctly perform Ortolanis maneuver b. how to properly use the Pavlik harness c. when to return for corrective surgery d. where to take the baby to be for for corrective shoes: B