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Pediatric Proctor (2016) (70/70 Questions and Answers GRADED A) ALL YOU NEED TO PASS YOUR EXAM

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Pediatric Proctor (2016) (70/70 Questions) 1. A nurse is preparing to assess a 4-year old child’s visual acuity. Which of the following actions should the nurse plan first?  Use a tumbling E c... hart for the assessment  Position the child 4.6 meters (15 feet) from the chart  Assess both eyes together first, then each eye separately  Test the child without glasses before testing with glasses 2. A nurse is providing discharge teaching to a parent of a child who has juvenile idiopathic arthritis and a new prescription of prednisone/etarnecept. Which of the following statement should the nurse include in the teaching?  “Discontinue this medication if gastrointestinal upset occurs.”  “Expect that this medication will stimulate a growth spurt.”  “Limit your child’s intake of potassium-rich foods.”  “Monitor your child for indications of infection.” 3. A nurse on a pediatric unit is caring for four children. The nurse should use droplet precautions for which of the following children?  An adolescent who has hepatitis A  A toddler who has seasonal influenza  A preschool-age child who has pediculosis capitis  A school-age child who has viral conjunctivitis 4. A nurse is providing teaching to an adolescent who has vulvovaginitis. Which of the following statements should the nurse include in the teaching?  “Apply a warm, moist compress three times per day.”  “Apply scented baby powder to absorb residual moisture.”  “Wear a feminine deodorant pad for vaginal drainage.”  “Wear nylon underwear at night.” 5. A nurse is creating a plan of care for a school-age child who has nephrotic syndrome. Which of the following interventions should the nurse include? (Select all that apply)  Provide a low-sodium diet  Encourage increased fluid intake  Assess for protein in the urine  Initiate contact precautions  Obtain a daily weight 6. A nurse in a pediatric unit is caring for a school-age child following a cardiac catheterization. Which of the following interventions would the nurse take? Maintain NPO status for 24 hrs. following the procedure  Administer meperidine for pain every 4 hrs.  Perform a sterile dressing change 8 hrs. after the procedure  Keep the affected extremity straight for 6 hrs. 7. A nurse is teaching a parent of a toddler about administering digoxin. Which of the following statements by the parent indicates understanding of the teaching?  “I should mix the medication with 4 ounces of my child’s favorite juice.”  “I should give my child water after giving the medication.”  “I should give my child another dose if he vomits right after taking the medication.”  “I should give the medication with foods that are high in fiber.” 8. A nurse is caring for a 9-year-old child who has major burns to her face and upper torso. Which of the following actions should the nurse take first?  Administer a tetanus vaccine  Give pain medication  Begin enteral feedings  Initiate a crystalloid IV bolus 9. A nurse is planning care for a toddler who has developed oral ulcers in response to chemotherapy. Which of the following should the nurse include in the plan of care?  Schedule routine oral care every 8 hrs.  Administer oral viscous lidocaine  Moisten the mucous with lemon glycerin swabs  Cleanse the gums with saline soaked gauze 10. A nurse in a community health clinic is assessing the needs of a single parent who has three young children and works full time. Which of the following resources should the nurse recommend?  12-step support group  Respite child care  Child home health care  Counseling for depression 11. A nurse is caring for a child who has a prescription for fluticasone and has developed white patches and sores in his mouth. Which of the following is an appropriate action for the nurse to take?  Encourage the use of a spacer  Withhold the medication until the lesions heal Obtain a prescription for oral prednisone  Collect a culture from the lesions 12. A nurse is providing teaching to the parents of a child who has impetigo. Which of the following instructions should the nurse include in the teaching?  Seal soft toys in a plastic bag for 14 days  Apply bactericidal ointment to lesions  Administer acyclovir PO two times per day  Soak hairbrushes in boiling water for 10 min. 13. A nurse in an emergency department is caring for a child who has epiglottis. Which of the following actions should the nurse take?  Provide nebulizer aerosol therapy  Administer IV antibiotics  Inspect the tonsils using a tongue depressor  Collect a throat culture 14. A nurse is planning care for a child who is placed in skin traction. Which of the following is the priority action for the nurse to take?  Increase fluid intake  Maintain proper body alignment  Use an alternate pressure mattress  Monitor pedal pulses 15. A nurse is preparing to administer ondansetron 0.15 mg/kg IV to a child who is receiving chemotherapy and weighs 29.4 kg. Available is ondansetron 4 mg/2 mL solution. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero)  Answer: 2.2 mL 16. A nurse is performing a physical assessment of a school-age child who has acute glomerulonephritis. Which of the following findings should the nurse expect?  Hypotension  Increased urinary output  Flushed skin  Facial edema 17. A nurse in an emergency department is assessing an adolescent who reports inhalation of gasoline. Which of the following findings should the nurse expect?  Hypothermia  Pinpoint pupils  Hyperactive reflexes  Ataxia18. A nurse in the emergency department is assessing a toddler who has hyperpyrexia, severe dyspnea, and is drooling. Which of the following actions should the nurse take first?  Prepare the toddler for nasotracheal intubation  Insert an IV catheter for the toddler  Obtain a blood culture from the toddler  Administer an antibiotic to the toddler 19. A nurse is caring for an infant who has a patent ductus arteriosus. The nurse should identify that the defect is at which of the following locations of the heart? (You will find hot spots to select in the artwork below. Select only the hot spot that corresponds to your assessment)  Answer: 20. A nurse is caring for an infant who has hydrocephalus and ventriculoperitoneal shunt malfunction. Which of the following assessment findings indicates that the infant is experiencing increased intracranial pressure?  Increased appetite  Irritability  Flat fontanel  Tachycardia 21. A nurse is assessing an infant who has iron deficiency anemia. Which of the following findings should the nurse expect?  Increased hemoglobin level  Hyperactive muscle tone  Bradycardia  Pale conjunctiva 22. A nurse is caring for a child who received partial thickness burns to over 50% of his body 10 days ago and has splints over his joints to prevent contractions. Which of the following actions should the nurse take? (Select all that apply)  Provide a high-calorie diet  Administer analgesics IM  Remove splints during sleep  Change dressings using aseptic technique  Monitor intake and output23. A school nurse is assessing a 7-year-old student. The nurse should identify which of the following findings as a potential indicator of physical abuse?  Bruising around the wrists  Abrasions on the knees  Weight in 45th percentile  Front deciduous teeth missing 24. A nurse is assessing an 18-month-old child during a well-child visit. Which of the following findings should the nurse report to the provider?  The child crawls to navigate the room  The child has frequent temper tantrums  The child consistently throws items to the floor  The child scribbles on the wall with a crayon 25. A nurse is caring for an infant who has rotavirus. Which of the following findings indicates that the infant is inadequately dehydrated?  Weight loss 7%  Capillary refill 1 second  Bradycardia  Respiratory rate 26/min 26. A nurse is providing teaching about injury prevention to the parents of a toddler. Which of the following safety measures should the nurse include in the teaching?  Adjust the water heater temperature to 54° C (129.2° F)  Check clothing for loose buttons  Provide balloons for play  Place screens on all windows 27. A nurse is caring for a school-age child who is in 90°/90° skeletal traction. Which of the following actions should the nurse take?  Release the traction to allow the child to bathe  Place the child on an alternating pressure mattress  Adjust the weights to allow the child to turn  Ensure that the pulley mechanism is attached to the skin 28. A nurse is caring for a child who has increased intracranial pressure and is unconscious due to a closed head injury. Which of the following actions should the nurse take?  Maintain the child’s neck in a flexed position  Turn the child side to side every 2 hrs. Initiate seizure precautions  Perform chest percussion as needed 29. A nurse is providing teaching to the parents of a school-age child newly diagnosed with a seizure disorder. The nurse should teach the parents to take which of the following actions during a seizure?  Clear the area of hard objects  Minimize movement of the limbs  Insert a tongue blade between the teeth  Place the child in a prone position 30. A nurse is providing teaching to a parent of an infant who has diaper rash. Which of the following statements by the parent indicates an understanding of the teaching?  “I will use antibacterial soap to wash the rash with each diaper change.”  “I will keep the area warm and moist.”  “I will use super-absorbent disposable diapers.”  “I will sprinkle talcum powder over the affected area twice daily.” 31. A nurse in a provider’s office is assessing the vital signs of a 1-year-old toddler. Which of the following findings should the nurse report to the provider?  Blood pressure 88/42 mm Hg  Heart rate 110/min.  Respiratory rate 54/min.  Temperature 37.7° C (99.9° F) 32. A nurse is teaching about growth and development to a parent of a 12-year-old child. The nurse should instruct the parent to expect the child to exhibit which of the following characteristics during early adolescence?  Emotional separation from parents  Mood swings  Increased self-esteem  Decelerating growth rate 33. A nurse is caring for a child who is 2 hrs. postoperative. Which of the following actions should the nurse take first? (Click the “exhibit” button for additional information about the client. There are three tabs that contain separate categories of data)  Recheck the child’s temperature  Determine the child’s sedation level  Assess the child’s pain level Compare the child’s pedal pulses 34. A nurse is assessing an adolescent who has Cushing’s syndrome. Which of the following findings should the nurse expect?  Potassium 4.2 mEq/L  Blood glucose 320 mg/dL  Advanced bone age  Cachectic appearance 35. A nurse is caring for a preschool-age child who is 2 hrs. postoperative following a tonsillectomy and adenoidectomy. Which of the following manifestations should the nurse report to the provider?  Tachycardia  Blood-tinged mucus  Dark brown emesis  Halitosis 36. A nurse is assessing a 6-month old infant who has respiratory syncytial virus. The nurse should immediately report which of the findings to the provider?  Coughing  Tachypnea  Pharyngitis  Rhinorrhea 37. A nurse is admitting an infant who has GERD. Which of the following is the priority assessment finding?  Weight loss  Excessive crying  Wheezing  Regurgitation 38. A nurse is planning care for a child who is experiencing sickle cell crisis. Which of the following interventions should the nurse include in the plan of care?  Administer meperidine as needed for pain  Initiate bed rest  Limit fluid intake  Apply cold compresses to affected joints39. A nurse is providing teaching to a parent of a child who has cystic fibrosis and a new prescription for dornase alfa. Which of the following instructions should the nurse include in the teaching?  “Store the medication in the refrigerator.”  “Use a spacer with this medication.”  “Administer every 4 hours as needed for cough.”  “Mix the medication with albuterol solution prior to administration.” 40. A nurse is caring for a preschool-age child who has a terminal illness. Which of the following findings should the nurse expect?  Believes the condition is a punishment  Expresses interests in the funeral arrangements  Accepts death is inevitable  Feels excessive anxiety about physical changes 41. A nurse is reviewing the laboratory values of a school-age child who has nephrotic syndrome. Which of the following laboratory results should the nurse expect?  Serum sodium 144 mg/dL  Serum protein 4.2 g/dL  Hgb 12 g/dL  BUN 15 mg/dL 42. A nurse is planning care for a school-age child who has autism spectrum disorder. Which of the following actions should the nurse include in the plan?  Give the child three options when making choices  Stay with the child for long periods of time  Explain procedures in detail to the child  Introduce the child to new situations slowly 43. A nurse is preparing to administer morphine 0.2 mg/kg IV to a child who is postoperative and in pain. The child weighs 34 kg. Available is morphine 1 mg/mL solution. How many mL should the nurse administer? (round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero)  Answer: 6.8 mL 44. A nurse is providing teaching to a parent of an 11-month-old infant who has acute diarrhea and dehydration. Which of the following fluids should the nurse instruct the parent to provide to the infant?  Chicken broth  Oral electrolyte solution  Glucose water  Half-strength apple juice45. A nurse is providing teaching to a parent of a child who has HIV. Which of the following statements by the parent indicates an understanding of the teaching?  “The risk of transmission decreases since my child is on zidovudine for 2 weeks.”  “My child will need to repeat his childhood immunizations since he is in remission.”  “My child will need to double his medications for the next 6 months.”  “I will ensure that my child is tested for tuberculosis every year.” 46. A nurse is caring for a school-age child who has diabetes mellitus. Which of the following findings should the nurse recognize as being consistent with hyperglycemia?  Pallor  Thirst  Sweating  Tremors 47. A nurse in an urgent care clinic is prioritizing care for four children. Which of the following children should the nurse assess first?  A preschool-age child who has a muffled voice and no spontaneous cough  An adolescent who has Crohn’s disease and a recent weight loss of 5 kg (11 lbs.)  A toddler who has nephrotic syndrome and facial edema  A school-age child who has diabetes mellitus and a blood glucose of 200 mg/dL 48. A nurse is prioritizing care for four clients. Which of the following clients should the nurse assess first?  An adolescent who has sickle cell anemia and slurred speech  A toddler who has a new diagnosis of osteomyelitis and is to receive an IV bolus of nafcillin  An adolescent who is in skin traction and reports a pain level of 7 on a scale from 0 to 10  A toddler who has a partial-thickness burn on his right hand and requires a dressing change 49. A nurse is preparing to administer immunizations to a 3-month-old infant. Which of the following is an appropriate method to take to deliver atraumatic care?  Use a 20-gauge needle for the injections  Apply eutectic mixture of local anesthetics (EMLA) cream immediately before the injections  Inject the immunizations into the deltoid muscle  Provide a pacifier coated with an oral sucrose solution prior to the injections50. A nurse is reviewing the laboratory results of a child who was recently admitted for suspected rheumatic fever. The nurse should expect that which of the following laboratory tests can contribute to confirming this diagnosis? (Select all that apply)  Antistreptolysin O (ASO) titer  Blood urea nitrogen (BUN)  Partial thromboplastin (PTT)  Erythrocyte sedimentation rate (ESR)  C-reactive protein (CRP) 51. A nurse is reviewing the laboratory report of a school-age child who has bacterial pneumonia. Which of the following laboratory values should the nurse expect?  WBC 18,000/mm3  Ph. 7.40  Hgb 14 g/dL  Creatinine 0.5 mg/dL 52. A nurse is providing teaching about medication administration to the parents of a toddler who has a new prescription for liquid ferrous sulfate. Which of the following instructions should the nurse include in the teaching?  “Report tarry, green stools to the provider.”  “Administer the drops with milk.”  “Dilute the drops with water prior to administration.”  “Provide an antacid prior to administration.” 53. A nurse in an emergency department is caring for a child following an overdose of acetylsalicylic acid. Which of the following medications should the nurse plan to administer?  Flumazenil  Phytonadione  Midazolam  Naloxone 54. A nurse is planning care for a newly admitted child who has rotavirus. Which of the following precautions should be implemented?  Airborne  Contact  Protective  Droplet 55. A nurse is developing a plan of care for a child who is dying. Which of the following measures should the nurse implement to the child and his family?  Maintain consistent nursing staff assignments Ask the parents to leave the room for procedures  Select one family member to receive information  Limit the number of visitors in the client’s room 56. A nurse is planning to perform tracheostomy care for a toddler. Which of the following is an appropriate action for the nurse to take?  Have the client flex his head when securing the ties  Place the child in Trendelenburg position when performing care  Clean around the stoma with full-strength hydrogen peroxide  Use clean technique to change the tracheostomy tube 57. A nurse in the emergency department is caring for a child who has a temperature of 39.1° C (102.4° F) and a suspected diagnosis of bacterial meningitis. Which of the following actions should the nurse take first?  Prepare the child for a lumbar puncture  Administer an antipyretic to the child  Dim the lights in the child’s room  Implement droplet precautions for the child 58. A nurse is caring for a toddler who has a short leg cast. Which of the following findings should the nurse report to the provider?  Positive pedal pulse in the distal extremity  Pallor of the distal extremity  Mobility of the distal extremity  Warm temperature of the distal extremity 59. A nurse is caring for a newly admitted toddler who has acute diarrhea. Which of the following actions should the nurse take first?  Initiate contact precautions  Administer an antibiotic  Obtain a stool specimen for culture  Give 0.9% sodium chloride IV bolus 60. A nurse is planning to teach an adolescent who is lactose intolerant about dietary guidelines. Which of the following instructions should the nurse include in the teaching?  “You may tolerate plain milk better than chocolate milk.”  “You can drink milk on an empty stomach.”  “You can replace milk with nondairy sources of calcium.”  “You should consume flavored yogurt instead of plain yogurt.”61. A nurse is providing discharge teaching to the parents of a school-age child following placement of a ventriculoperitoneal shunt. The nurse should determine that the teaching was effective when the parents identify which of the following as an indicator the shunt has been displaced?  Hyperactive bowel sounds  Elevated temperature  Increased sleeping  Decreased urine output 62. A nurse is providing teaching to a parent of a 2-month-old infant about immunization schedules. Which of the following statements by the parent indicates an understanding of the teaching?  “My child needs to get the MMR immunization when she’s 12 months old.”  “My child needs to get the varicella immunization when she’s 6 months old.”  “My child will receive the influenza immunization today.”  “My child will receive the hepatitis A immunization today.” 63. A nurse is performing a cranial nerve assessment on a school-age child. Which of the following findings indicates proper functioning of the child’s trigeminal nerve?  The child maintains balance when standing with eyes closed  The child has symmetrical jaw strength when biting down  The child exhibits a gag reflex when stimulated with a tongue blade  The child correctly identifies specific scents 64. A nurse is planning care for a child immediately following the insertion of a chest tube for continuous suction with a closed drainage system. Which of the following interventions should the nurse include in the plan of care?  Ensure continuous bubbling is present in the suction control chamber  Report the presence of tiddling of fluid in the water seal chamber  Change the chest tube insertion site dressing every 12 hrs.  Record the amount of chest tube drainage every 2 hrs. 65. A nurse is educating an adolescent following the application of an arm cast. Which of the following statements by the client indicates an understanding of the teaching?  “I will sprinkle baby powder into the cast if my arm itches.”  “I should limit the use of the fingers of my broken arm.”  “I will elevate my forearm on pillows at night.”  “I should expect my fingers to be swollen for several days.”66. A nurse in a community center is providing an in-service for parents about nutritional guidelines. Which of the following guidelines should the nurse include in the teaching?  Encourage a 15-year-old to increase calcium intake  Provide 36 oz. of milk per day to a toddler  Offer 8 to 10 oz. of juice per day to a preschooler  Introduce popcorn as a healthy snack at 12 months of age 67. A nurse is caring for a school-age child who is experiencing pain. Which of the following assessment teachings would be the most accurate information regarding the child’s pain?  Ask the child to use a FACES rating scale  Monitor the child’s involuntary movements  Observe the child’s facial expressions  Assess the child’s pulse and respirations 68. A nurse in an emergency department is assessing a school-age child who has asthma. Which of the following should the nurse identify as the priority?  Decreased breath sounds  Hyperresonance on percussion  Nonproductive cough  Pulse rate 118/min 69. A nurse is caring for a child who is postoperative following surgical correction of tetralogy of Fallot. Which of the following is a manifestation of heart failure?  Exercise intolerance  Bradycardia  Weight loss  Decreased respirations 70. A nurse is caring for a 4-year-old child who has meningitis and is receiving gentamycin. Which of the following laboratory results should the nurse report to the provider?  Creatinine 1.4 mg/dL  BUN 12 mg/dL  BUN 6 mg/dL  Creatinine 0.2 mg/dL Peds 3 70 Written questions1. A nurse is preparing to perform peritoneal dialysis for a child who has an elevated serum creatinine level. After explaining the procedure, which of the following actions should the nurse plan to take? Obtain the child's weight 2. A nurse is providing discharge teaching to the parents of a toddler who has iron deficiency anemia and a new prescription for ferrous sulfate elixir. Which of the following instructions should the nurse include? Administer this medication to your child with a dropper. 3. A nurse is administering albuterol by metered dose inhaler for a preschool-age child who is experiencing an asthma exacerbation. Which of the following findings should the nurse report to the provider? Intercostal retractions 4. A nurse is caring for a 4-year-old child who has meningitis and is receiving gentamicin. Which of the following laboratory values should the nurse report to the provider? Creatinine 1.4 mg/dL 5. A nurse is preparing to administer cephalexin 25 mg/kg PO to a child who has otitis media and weighs 22 kg (48.5lb). Available is cephalexin solution 250 mg/5mL. How many mL should the nurse administer? (Round to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) 11 mL 6. A nurse is providing dietary teaching to a parent of a 10-month-old infant who has phenylketonuria. Which of the following responses by the parent indicates an understanding of the teaching? I will steam carrots and cut them into small pieces for her. 7. A nurse is providing discharge teaching to the parents of a school-age child who has cystic fibrosis. Which of the following responses by the parents indicates an understanding of the teaching?"I will give my child pancreatic enzymes with snacks and meals." 8. A nurse is caring for a preschooler who has a brain tumor. Which of the following findings is the priority for the nurse to report to the provider? Diplopia 9. A nurse is providing education about dietary modifications to the parents of a school-age child who has glomerulonephritis. Which of the following information should the nurse include in the teaching? Decrease the child's sodium intake. 10. A nurse is assessing an adolescent who has type 1 diabetes mellitus. Which of the following findings is the nurse's priority? HbA1c 11.5% 11. A nurse is providing teaching to the parents of a school-age child newly diagnosed with a seizure disorder. The nurse should teach the parents to take which of the following actions during a seizure? Clear the area of hard objects 12. A nurse in an emergency department is caring for a child following an overdose of acetylsalicylic acid. Which of the following mediations should the nurse plan to administer? Phytonadione 13. A nurse is providing teaching to the parents of a preschool-age child who has celiac disease. Which of the following instructions should the nurse include? Your child will be on a gluten-free diet for the rest of her life. 14. A nurse is teaching a parent of a 10-month-old infant about home safety. Which of the following instructions should the nurse include in the teaching? (Select all that apply)Place gates at the top and bottom of the stairs and Ensure the crib mattress is in the lowest position 15. A nurse is prioritizing care for four clients. Which of the following clients should the nurse assess first? An adolescent who has a sickle cell anemia and slurred speech . 16. A nurse is providing teaching to the parent of a school-age child who has diabetes mellitus about managing diabetes during illness. Which of the following statement by the parent indicates an understanding of the teaching? I will increase the amount of fluids I offer my children 17. A nurse is reviewing the medical record of a 24-month-old child who has acute lymphocytic leukemia. Which of the following actions should the nurse take? (Click the exhibit button for additional information about the client. There are three tabs that contain separate categories of data.) Initiate bleeding precaution 18. A nurse is caring for an infant who has tetralogy of fallot and is having a hypercyanotic episode after crying. Which of the following intervention should the nurse implement? Place the infant in the knee-chest position. 19. A nurse is assessing a toddler who has a history of lead poisoning. Which of the following actions should the nurse take? Perform development testing for delays. 20. A nurse is assessing a 6-month-old infant who has respiratory syncytial virus. The nurse should immediately report which of the following findings to the provider? Pharyngitis21. A nurse in an emergency department is caring for a child who weighs 18 kg (39.7 lb) and indigested six 500 mg acetaminophen tablets 4 hr ago. Which of the following actions should the nurse take? Prepare to give oral N-acetylcysteine 22. A nurse is providing discharge instructions to the parents of a toddler who has heart failure and a new prescription for digoxin. Which of the following statements indicate an understanding of the instructions? We will wait to give the medication at the next scheduled time if dose is missed. 23. A nurse in a provider's office is providing teaching to the parents of preschooler who has Down syndrome. Which of the following statements by one of the parent indicates an understanding of the instructions? We'll be sure to demonstrate a new skill before expecting our son to perform it. 24. A nurse is caring for a child who has impetigo contagiosa that developed in the hospital. Which of the following actions should the nurse take? Initiate contact isolation precautions. 25. A nurse is planning to teach an adolescent who is lactose intolerant about dietary guidelines. Which of the following instructions should the nurse include in the teaching? You can replace milk with nondairy sources of calcium. 26. During a well-baby visit, the parent of a 2-week-old newborn tells the nurse, "My baby always keeps her head tilted to the right side." The nurse should further assess which of the following areas? Sternocleidomastoid muscle 27. A nurse is caring for an adolescent who is 1 hr postoperative following an appendectomy. Which of the following findings should the nurse report to the provider? muscle rigidity28. A nurse is preparing to perform a venipuncture to collect a blood sample from an infant. Which of the following restraints should the nurse plan to use for this procedure? Mummy 29. A nurse is preparing to assess a 4-year-old child's visual acuity. Which of the following actions should the nurse plan to take? Use a tumbling E chart for the assessment 30. A nurse is planning care of r a toddler who has developed oral ulcers in response to chemotherapy. Which of the following actions should the nurse include in the plan of care? Cleanse the gums with saline soaked gauze 31. A nurse is caring for an infant who has severe dehydration. Which of the following clinical findings should the nurse expect? Rapid respirations 32. A nurse is assessing an adolescent who has Crushing's syndrome. Which of the following should the nurse expect? blood glucose 320 33. A nurse in an emergency department is assessing an adolescent who reports inhalation of gasoline. Which of following findings should the nurse expect? Ataxia 34. A nurse is teaching a group of female adolescents about healthy eating. Which of the following instructions should the nurse include in the teaching? "Increase the amount of your dietary iron intake" 35. A nurse is caring for a school-age child who has heart failure. Which of the following findings should the nurse expect? (Select all that apply)Tachycardia, Dyspnea, and cyanosis 36. A nurse is caring for a single mother of a 6-month-old infant. During a well-baby visit, the mother expresses feeling "inexperienced" in caring for the baby. The nurse should recommend which of the following community resources? Parent Enhancement Center 37. A nurse is assessing a 1-month-old infant at a well-child visit. Identify the location the nurse should stroke to elicit the rooting reflex. (You will find hot spots to select in the artwork below. Select only the hot spot that corresponds to your answer.) Stroke the cheek 38. A nurse is providing teaching to the parents of a toddler who is exhibiting negativism during mealtimes. Which of the following statements by the nurse is appropriate? Tell her that she may have a sandwich or soup for lunch 39. A nurse is providing teaching to the parents of a child who has impetigo. Which of the following instructions should the nurse include in the teaching? Apply bactericidal ointment to lesions. 40. A nurse is reviewing the laboratory report of a school-age child who has rheumatic fever. Which of the following laboratory findings should the nurse expect? Increased antistreptolysin o titer (ASO) 41. A nurse is caring for a preschool-age child who is postoperative following a tonsillectomy and is clearing her throat frequently. Which of the following actions should the nurse take first? Observe the child throat with a flashlight 42. A nurse is providing anticipatory guidance to a parent of a 1-month-old infant. The nurse should include that it is recommended to start the series of which of the following immunization first?Inactive poliovirus 43. A nurse in a provider's office is assessing the vital signs of a 2-year old child at a wellchild visit. Which of the following findings should the nurse report to the provider? BP 118/74 mm Hg 44. A nurse in an emergency department is assessing a toddler who has a head injury. Which of the following findings should the nurse report to the provider? Vomiting 45. A nurse is providing teaching to a parent of an infant who has a 1 cm (0.4 in) umbilical hernia. Which of the following instructions should the nurse include in the teaching? The bulge can temporarily enlarge when your baby cries. 46. A nurse is caring for a school-age-child who is experiencing a sickle cell crisis. Which of the following action should the nurse take? Apply warm compresses to the affected areas. 47. A nurse is reviewing the laboratory report of a toddler who has hemolytic uremic syndrome. Which of the following findings should the nurse expect? BUN 28 mg/dL 48. A nurse is preparing to administer immunizations to a 3-month-old infant. Which of the following is an appropriate action for the nurse to take to deliver atraumatic care? Provide a pacifier coated with oral sucrose solution prior to the injections. 49. A nurse on a pediatric intensive care unit is caring for a toddler who weighs 12 kg (26.5lb) and is postoperative following open-heart surgery. Which of the following findings should the nurse report to the provider? Urine output of 15 ml in the last 2 hr - 1 mL/kg/hour50. A nurse in a provider's office is caring for a preschool-age child who might have acute epiglottitis. Which of the following actions should the nurse take? Provide humidified oxygen via nasal cannula. 51. A nurse is providing postoperative care for a child following an arterial cardiac catheterization. Which of the following actions should the nurse take? Keep the affected extremity straight for at least 6 hrs. 52. A nurse is admitting an infant who has GERD. Which of the following is the priority assessment finding? Wheezing 53. A nurse is providing teaching to the parents of a school-age child who has ADHD and a new prescription for methylphenidate. The nurse should explain that this medication will have which of the following therapeutic effects? Increasing focus 54. A nurse is admitting a child who has pertussis. Which of the following transmissionbased precaution should the nurse initiate? Droplet 55. A nurse is providing teaching to an adolescent who has vulvovaginitis. Which of the following statement should the nurse include in the teaching? Apply a warm, moist compress three times per day. 56. A charge nurse is planning care for an infant who has failure to thrive. Which of the following actions should the nurse include in the plan of care? Use half-strength formula when feeding the infant. 57. A nurse is assessing a 3-month-old infant who has diarrhea. Which of the following findings should the nurse expect?Increased hematocrit 58. A nurse is teaching an adolescent how to manage his cystic fibrosis. Which of the following statements y the adolescent indicates an understanding of the teaching. "I will increase my intake of vitamin D." 59. A nurse is planning care for an adolescent following repair of Meckel diverticulum. Which of the following actions should the nurse include in the plan of care? Maintain an NG tube for decompression 60. A school nurse is assessing a 7-year-old student. The nurse should identify which of the following findings as a potential indicator of physical abuse? Bruising around the wrists 61. A nurse is providing discharge teaching to the parents of an infant who is at risk for sudden infant death syndrome (SIDS). Which of the following statements by the parents indicates an understanding of the teaching? "I will dress my baby in lightweight clothing to sleep." 62. A nurse is caring for a toddler who is in the terminal stage of neuroblastoma. The parents ask, "How can we help our child now?" Which of the following responses by the nurse is appropriate? Stay close to your child. 63. A nurse is assessing an adolescent who has infectious mononucleosis. Which of the following findings should the nurse expect? Cervical adenopathy 64. A nurse is preparing to administer imipenem/cilastatin 25 mg/kg to a child who weights 77 lb. How many mg should the nurse plan to administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) 875 mg(77/2.2= 35 kg >25mg X 35=875 mg)65. A nurse is planning care for a child immediately following the insertion of a chest tube for continuous suction with a closed drainage system. Which of the following interventions should the nurse include in the plan of care? Change the chest tube insertion site dressing every 12hr. 66. A nurse is caring for a child who has acute glomerulonephritis. Which of the following finding should the nurse expect? Periorbital edema 67. A nurse is providing discharge teaching to a parent of a toddler who has a ventriculoperitoneal shunt. Which of the following statement by the parent indicates an understanding of the teaching? I should call my doctor if my child begins vomiting. 68. A nurse is administering an opioid to an adolescent who is in sickle cell crisis. Which statement is true regarding opioid pain management? Oral opioids should not be combined with other types of pain relievers. 69. A nurse is planning an in-service for parents of school-age children about the treatment of pediculosis capitis. Which of the following instructions should the nurse plan to include in the teaching? Apply medication to the child scalp twice daily until the symptoms subside - 1 % permethrin shampoo. 70. A nurse is caring for a school-age child who is 1hr postoperative following a tonsillectomy. Which of the following actions should the nurse take? (Select all that apply.) Administer an analgesic to the child on a scheduled basis, Observe the child for frequent swallowing, Discourage the child form coughingForm C ped 3 1. A nurse is caring for a child during a tonic-clonic seizure. Which of the following actions should the nurse take? ( select all that apply) A. Clear the area of hard objects. B. Firmly hold the child’s arms to one side. C. Place a pillow under the child’s head. D. Insert a tongue blade into the child’s mouth. E. Loosen tight clothing around the child’s neck 2. A nurse is preparing to perform a venipuncture to collect a blood sample from an infant. Which of the following restraints should the nurse plan to use for this procedure? A. Elbow B. Mitten C. Jacket D. Mummy 3. A nurse is teaching a parent of a preschool-age child about management of sleep terrors. Which of the following instructions should the nurse include? A. Take the child to the parent’s bed to resume sleep. B. Allow the child to fall asleep with the television on. C. Remain uninvolved until the child awakens D. Schedule professional counseling for the child 4. A nurse is assessing a toddler who is 8 hr postoperative following a cardiac catheterization procedure. Which of the following findings should the nurse report to the provider? A. Weak pedal pulse distal to the site. B. Bilateral cool extremities C. Serum glucose 90 mg/DL D. Blood pressure 102/58 mm Hg 5. A nurse is assessing a preschool-age child who is in the immediate postoperative period following a tonsillectomy. Which of the following assessment findings in the priority? A. The child swallows frequently B. The child refuses clear liquidsC. The child’s throat pain increases D. The child cries often 6. A nurse is planning care for an 8 month-old infant who has bronchitis. Which of the following actions the nurse include in the plan of care? A. Use a bulb syringe to suction the nares. B. Place the infant in a room with negative-pressure airflow. C. Administer a meningococcal vaccine upon admission D. Initiate IV antibiotic therapy. 7. **A nurse is preparing a parent's’ education class about nutrition for toddlers. The nurse should identify which of the following findings as an indication of protein deficiency? A. Dry, thinning hair B. Muscle twitching C. Dental caries D. Poor skin turgor 8. A nurse is caring for a 10 month-old child who was brought to the ED by his parents following a head injury. Which of the following actions should the nurse take first? A. Examine the scalp for lacerations. B. Inspect for fluid leaking from the ears. C. Assess respiratory status D. Check pupil reactions 9. A nurse is collecting data from a toddler who weighs 20 kg (44lb) and has a full-thickness burn to 10% of his body.Which of the following findings should the nurse report to the provider? A. Bowel sounds 20/min B. Increased restlessness C. Resp. rate 25/min D. Urinary output 35 mL/hr 10. A nurse is an ED is caring for a preschool-age child who has acute acetylsalicylic acid poisoning. Which of the following should the nurse expect. A. Jaundice B. HyperpyrexiaC. Polyuria D. Neck vein distention 11. A nurse is assessing a preschool-age child who has celiac disease. Which of the following finds should the nurse expect? A. Obesity B. Polyphagia C. Steatorrhea D. Chronic constipation 12. A school nurse is assessing a 7 y/o student. The nurse should identify which of the following findings as a potential indicator of physical abuse? A. Bruising around the wrists B. Front deciduous teeth missing C. Abrasions on the knees D. Weight in 45th percentile 13.** A nurse is planning care for a child who has osteomyelitis. Which of the following interventions should the nurse include in the plan of care? A. Provide a high-calorie, low-protein diet B. Encourage frequent physical activity to increase bone mass. C. Initiate contact precautions for the child D. Maintain a patent intravenous catheter. 14. A nurse is reviewing the laboratory results of a preschool-age who has hematuria. Which of the following results should the nurse report to the provider? A. Platelet count 170,000/mm3 B. Hgb 12 g/dL C. Hematocrit 36% D. BUN 21 mg/dL 15. A nurse is preparing to administer immunizations to a 3-month-old infant. Which of the following is an appropriate action for the nurse to take to deliver atraumatic care? A. Apply eutectic mixture of local anesthetics (EMLA) cream immediately before the injections.B. Provide a pacifier coated with an oral sucrose solution prior to the injections. C. Inject the immunizations into the deltoid muscle. D. Use a 20-gauge needle for the injections. 16. A nurse is conducting a well-child visit with the parents of a 2 week-old newborn. The nurse should inform the parents that their NB should receive the measles, mumps, and rubella (MMR) immunization at what age? A. 12 months B. 9 months C. 4 months D. 6 months 17. A nurse is admitting a school-age child who has osteomyelitis, Which of the following actions should the nurse take first? A. Administer antibiotics B. Teach the child nonpharmacological pain management techniques. C. Request a referral for physical therapy D. Obtain a blood culture 18. A nurse is preparing to administer an enteral feeding to an adolescent who has an NG tube. Which of the following actions should the nurse take first? A. Check the pH of the gastric secretions. B. Flush the tube with water C. Set the administration rate on the feeding pump D. Attach the feeding bag tubing to the end of the NG tube 19. A nurse is caring for a 3 y/o who is recovering from surgery. Which of the following methods should the nurse use to assess the child’s pain level? A. Visual analog scale B. Oucher scale C. Poker chip tool D. Word-graphic rating scale 20. A nurse is caring for a 4 y/o child who has meningitis and is receiving gentamicin. Which of the following lab values should the nurse report to the provider?A. BUN 6 mg/dL B. Creatinine 1.4 mg/dL C. Creatinine 0.3 mg/dL D. BUN 12 mg/dL 21. A nurse is providing education to a parent of toddler who is experiencing sickle cell crisis. Which of the following statements by the parent indicates an understanding of the teaching? A. I should avoid massaging affected area B. I should expect my child to have an altered mental status C. I will apply cold compresses to painful areas D. I will increase my child’s fluid intake 22.** A nurse is caring for a child who has epiglottitis due to an infection with Haemophilus influenzae type B. Which of the following actions should the nurse take? Select all that apply: A. Initiate IV access B. Obtain a throat culture C. Inspect the epiglottis D. Begin droplet precautions E. Monitor oxygen saturation 23. A nurse is teaching home care to the parents of a preschool-age child who has heart failure. Which of the following information should the nurse include in the teaching? A. Withhold digoxin if the child’s pulse is greater than 100/min B. Provide for periods of rest C. Increases the child’s oxygen flow rate until the child no longer has cyanosis D. Weigh the child once each month 24. A nurse is planning postoperative care for an adolescent following scoliosis repair with spinal instrumentation. Which of the following actions should the nurse include in the plan of care? A. Offer sips of water 4 hr following surgery B. Maintain the head of the bed at a 30 degree angle C. Assist the adolescent to ambulate 12 hr following surgery D. Ensure two nurses logroll the adolescent every 2 hour25. A nurse is providing teaching to a parent of an 11 month old infant who has acute diarrhea and dehydration. Which of the following fluid should the nurse instruct the parent to provide to the infant? A. Glucose water B. Chicken broth C. Half-strength apple juice D. Oral electrolyte solution 26. A charge nurse is teaching a group of nurse about identifying child abuse. Which of the following findings should the nurse identify as a potential indicator of child abuse? A. A mother is hesitant to comfort her 6 month-old infant B. An 8 month old infant cries when his parent leaves the room C. A toddler has bruises on his knees D. A toddler repeatedly refuses to let a nurse auscultate his lungs 27. A nurse is reviewing the medical record of a 6 month old infant who has heart failure prior to administering medications. The nurse should recongize that which of the following medications is contraindicated? (click on the “exhibit” button) A. Furosemide B. Digoxin C. Sprionolcatone D. Enalapril 28. A nurse is assessing a 24 month old toddler. Which of the following findings should the nurse report to the provider? A. Holds his breath when having a temper tantrum B. Sleeps 11-12 hr per day C. Has a vocabulary of 30 words D. Eats a large amt of food one day than very little the next 29. A nurse is helping a school-age child who has celiac disease select menu items for the next day’s meals & snacks. Which of the following foods should the nurse encourage the client to choose? A. A cheese omelet with OJ B. Graham crackers with peanut butterC. Beef, barley and vegetable soup D. Sliced chicken breast on whole wheat bread 30. A nurse is providing discharge teaching to the parents of a preschool age child who has heart failure and a new prescription for digoxin oral solution. Which of the following instructions should the nurse include? A. Rinse your child’s mouth with water after giving the medication B. Mix the medication with 6 oz of your child’s favorite juice C. If your child vomits, do not give the medication for 48 hours D. If a dose is missed, double the next dose 31. A nurse is providing teaching to the parents of a child who had varicella about management of the disease. Which of the following instructions should the nurse include in the teaching? A. Avoid giving the child a bath while vesicles are present B. Keep the child away from others until the skin is clear of scabs C. Apply calamine lotion to vesicles on the child’s skin D. Dress the child in warm clothing to promote healing of vesicles 32. A nurse is teaching an adolescent who has a methicillin-resistant staphylococcus aureus (MRSA) infection. Which of the following statements by the adolescent indicates an understanding of the teaching? A. I can continue to participate in wrestling matches B. I will use a new razor each time I shave C. I will soak in a warm bath every evening D. I will wash the infected area first when I shower 33. A nurse in an ED is caring for a child who experienced a submersion injury. Which of the following is the priority action for the nurse to take? A. Assist with intubation B. Obtain an ABG sample C. Administer an IV bolus D. Apply warming blankets. 34. A nurse is administering an opioid to an adolescent who is in sickle cell crisis. Which statement is true regarding opioid pain management? A. Oral opioid doses should be larger than parenteral doses.B. Oral opioids should not be combined with other types of pain relievers C. Opioid doses should be used for mild pain D. Opioid doses should be treated until sedation occurs. 35. A nurse is providing teaching to the parents of a school-age child who has ADHD. Which of the following should the nurse include? A. Place the child’s daily activities on an organizational chart. B. Instruct the child to study challenging subjects in the afternoon C. Administer the child’s medication at bedtime D. Have the child do homework with siblings 36. A nurse in the emergency department is caring for an adolescent who is requesting testing for STIs. Which of the following actions is appropriate for the nurse to take? Request for verbal consent from the social worker Obtain written consent from the client Postpone testing until the client’s parents are present Contact the client’s parents to obtain phone consent. 37. A nurse is providing in discharge teaching to the parents of school age child following placement of ventriculoperitoneal shunt. The nurse should determine that the teaching was effective when the parents identify which of the following as an indicator the shunt has been displaced? Hyperactive bowel sounds Decreased urine output Elevated temperature Increased sleeping 38. A nurse is planning care for a child immediately following the insertion of a chest tube for continuous suction with a closed drainage system. Which of the following interventions should the nurse include in the plan of care? Ensure continuous bubbling present in the suction control chamber Record the amount of chest tube drainage every 2 hours Change the chest tube insertion site dressing every 12 hours Report the presence of tidaling of fluid in the water seal chamber39. A nurse is providing teaching to a parent of an infant who has diaper rash. Which of the following statements by the parent indicates an understanding of the teaching? I will keep the area warm and moist I will sprinkle talcum powder over the affected area twice daily I will use antibacterial soap to wash the rash with each diaper change I will use super-absorbent disposable diapers 40. A nurse is assessing a child who is 2 hour post-operative following cardiac catherization and finds the dressing is saturated with blood. Which of the following actions should the nurse take first? Monitor pulse distal to the insertion site Administer acetaminophen Apply pressure just above the insertion site Check the child’s blood glucose level 41. A nurse is providing dietary teaching to a parent of a 10-month-old infant who has phenylketonuria. Which of the following responses by the parent indicates an understanding of the teaching? I will steam carrots and cut them into small pieces for her My daughter can’t drink orange juice I will switch her to whole milk now that she’s old enough I should ensure that my daughter eats 1 ounce of meat every day 42. A nurse is providing teaching about medication administration to the parents of a toddler who has a new prescription for liquid ferrous sulfate. Which of the following instructions should the nurse include in the teaching? Report tarry, green stools to the provider Provide an antacid prior to administration Dilute the drops with water prior to administration Administer the drops with milk 43. A nurse is reviewing laboratory results of a school age child. Which of the following findings should the nurse report to the provider? Erythrocytes 4.5 million/mm^3 Platelets 110,000/mm^3Hemoglobin 12 g/dL Leukocytes 10,000 cells/mm^3 44. A nurse in PACU is caring for a school age child immediately following tonsillectomy. Which of the following actions should the nurse take? Place the child in a side-lying position Instruct the child to drink fluids through a straw Encourage the child to deep breathe and cough Offer the child ice cream when alert 45. A nurse is caring for an infant who has heart failure and is receiving digoxin. Which of the following findings indicates a positive response to the medication? Urine output 2 mL/kg/hr Capillary refill 4 seconds Heart rate 187 min Respiratory rate 32/min 46. A nurse is caring for a child that has sickle cell anemia. Which of the following is the priority for the nurse to report to the provider? Facial twitching Constipation Enuresis Kyphosis 47. A nurse is caring for a child who is 2 days postoperative following an appendectomy due to rupture of the appendix. The child’s NG tube is set to low intermittent suction. Which of the following findings indicate that the child’s gastrointestinal function has returned? The abdomen is soft and nondistended on palpation The NG tube has 20 mL of output every hour The nurse auscultates bowel sounds The child reports thirst and hunger 48. A nurse is planning to teach an adolescent who is lactose intolerant about dietary guidelines. Which of the following instructions should the nurse include in the teaching? You should consume flavored yogurt instead of plain yogurtYou can drink milk on a empty stomach You can replace milk with nondairy sources of calcium You may tolerate plain milk better than chocolate milk 49. A nurse in a family practice clinic is assessing a preschool-age child who recently experienced the death of a sibling. Which of the following reactions is an age-appropriate response to death? The child can give a logical explanation for the sibling’s death The child feels responsible for the sibling’s death The child is curious about what happened to the sibling’s body The child views the sibling’s death as permanent 50. A nurse is caring for a toddler who is postoperative following cleft palate repair. Which of the following actions should the nurse take? Keep the toddler NPO for 24 hours postoperative Use a bulb syringe to suction oral secretions Change oral packing every 6 hours Administer opioids for mouth pain 51. A nurse is reviewing the results of the newborn screening for a newborn who is 1 week old. Results include total T4 0.8 mcg/dL, phenylalanine 0.7 mg/dL, and negative galactosemia. Which of the following interventions should the nurse include in the plan of care? Monitor the newborn’s urine for ketones Instruct the newborn’s parent about how to administer levothyroxine Initiate a diet low in phenylalanine Obtain blood glucose levels every 4 hour 52. A nurse is caring for a 4-year-old child who has moderate dehydration. Which of the following findings should the nurse expect? Weight gain Heart rate 70/min Orthostatic hypotension Respiratory rate 18/min 53. A nurse is caring for a school age child who is in 90 degree/90 degree skeletal traction. Which of the following actions should the nurse take?Ensure that the pulley mechanism is attached to the skin Release the traction to allow the child to bathe Adjust the weights to allow the child to turn Place the child on an alternating pressure mattress 54. A nurse is assessing an infant who has acute otitis media. Which of the following findings should the nurse expect? (Select all that apply) Crying Fever Restlessness Enlarged sub clavicular lymph node Increased appetite 55. A nurse is assessing a 6-month old infant who has respiratory syncytial virus. The nurse should immediately report which of the following findings to the provider. Pharyngitis Rhinorrhea Tachypnea Coughing 56. A nurse is providing teaching to the parents of a child who is receiving radiation therapy. Which of the following instructions should the nurse include in the teaching? (Select all that apply) Avoid giving your child lengthy baths Encourage mild activity daily Offer a diet rich in fresh fruits and vegetables Apply an oil based lotion over the irradiated area twice per day Dress your child in loose-fitting clothes 57. A nurse in an emergency department is assessing and adolescent who reports inhalation of gasoline. Which of the following findings should the nurse expect? Hyperactive reflexes Ataxia Pinpoint pupilsHypothermia 58. A nurse is caring for a newly admitted toddler who has acute diarrhea. Which of the following actions should the nurse take first? Initiate contact precautions Obtain a stool specimen for culture Administer an antibiotic Give 0.9% sodium chloride IV bolus 59. A nurse is assessing a child who has measles. Which of the following areas should the nurse inspect for Koplik spots? Cheeks 60. A nurse is caring for a child who is to receive the first dose of IV gentamicin. Which of the following actions should the nurse take? Initiate airborne precautions Monitor for constipation Maintain strict I&O Encourage the bed rest 61. A nurse is providing teaching to the parents of an infant who is to undergo pilocarpine iontophoresis testing for cystic fibrosis. Which of the following statements should the nurse include teaching? “We will measure the amount of protein in your baby’s urine over a 24 hour period.” “Your baby will need to fast for 8 hours prior to the test.” “A nurse will insert an IV prior to the test.” “The test will measure the amount of chloride in your baby’s sweat.” 62. A nurse in prioritizing care for four clients. Which of the following clients should the nurse assess first? An adolescent who has sickle cell anemia and slurred speech An adolescent who is in skin traction and reports a pain level of 7 on a scale from 0 to 10 A toddler who has a new diagnosis of osteomyelitis and is to receive an IV bolus of nafcillinA toddler who has a partial-thickness burn on his right hand and requires a dressing change 63. A nurse is providing teaching to a parent of a child who has cystic fibrosis and a new prescription for dornase alfa. Which of the following instructions should the nurse include the teaching? “Store the medication in the refrigerator.” “Use a spacer with this medication.” “Administer every 4 hours as needed for cough.” “Mix the medication with albuterol solution prior to administration.” 64. A nurse is caring for a child who has bacterial meningitis. Which of the following criteria indicates the nurse should remove the child from droplet precautions? Absent nuchal rigidity Negative cerebrospinal fluid culture Temperature below 37.4 degree Celsius (99.4 F) Antibiotics initiated 24 hr ago 65. A nurse is assessing a school age child who has type 1 DM. The nurse notes that the child is diaphoretic. Which of the following actions should the nurse take? Obtain a blood glucose level Administer 1 unit of regular insulin Give 500 mL 0.9% sodium chloride IV bolus Check urinary ketones 66. A nurse is caring for a child who is terminally ill. The parents tell the nurse that their child is going to be fine because they heard about another child who survived the same illness. Which of the following responses should the nurse make? “The provider told you that your child’s illness is terminal.” “Let’s talk about some happy memories with your child.” “Tell me what you know about your child’s illness.” “It is important that you believe your child will survive.”67. A nurse is assessing a toddler who has cystic fibrosis. Which of the following findings should the nurse expect? Rhinorrhea Steatorrhea Weight gain Visible peristalsis 68. A nurse is providing teaching to the parents of a child who has impetigo. Which of the following instructions should the nurse include in the teaching? Soak hairbrushes in boiling water for 10 minutes Apply bactericidal ointment to lesions Administer acyclovir PO two times per day Seal soft toys in a plastic bag for 14 days 69. A nurse is preparing to administer naproxen 150 mg PO to a child who is experiencing pain. Available is naproxen 125 mg/ 5 ml solution. How many mL should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) 6 ml 70. A nurse is preparing to administer immunizations to a 5-year-old child who is up to date with the current immunization schedule. Which of the following immunizations should the nurse plan to administer? Hepatitis B Varicella Haemophilus influenzae type B RotavirusPed notes 1. Inform consent (12-20yo) ch7  Adolescent can refuse treatment; we still need to get consent from mom but nurses obtain the minors assent when minor is able to give it 2. Priority action for acute diarrhea Ch. 22 pg 135  Start with oral rehydration 3. Infection control: teaching about methicillin-resistant staphylococcus aureus FUNDBOOK Ch. 11  Contact precautions 4. Restraining methods for an infant ch8 pg40  Use therapeutic hugging  Secure the child firm to decrease movement of the needle while injection 5. Recommended immunization scheduled for Preschooler-age child ch35 pg 227,228  4 yo: IPV, MMR, VAR, DTap  1yo: IVA, MMR, hep A  2mo: IPV,RV, PCV13, DTaP 6. Indications for protein deficiency NUTRITIONBOOK ch7  Growth failure, vomiting, irritability 7. Health promoting for a toddler (1-3yo): reportable findings ch4 pg 23  Head circumference exceeds chest circumference 8. Immunization scheduled for an infant ch35 pg232  2mo: IPV, RV, PCV13, DTab9. Evaluation parent understanding of diaper rash ch31 pg 205  Allow buttocks to air dry  Apply zinc oxide ointment to effected area 10. Dietary teaching about phenylketonuria PKU ch42 pg 271,285  Range: 0.5-1  Lack of enzyme phenylalanine  NB is placed on a formula low in phenylalanine  The ct will undergo testing of phenylalanine levels one to two time per week throughout pregnancy 11. Evaluating response to digoxin Ch. 20 pg 117,121  Withheld:  Infants <90 beats/min  Children <70 beats/min  Teen <60 beats/min  Ther. Level: 0.8-2  s/sx of toxicity: bradycardia, dysrhythmias, N/V, anorexia 12. Administering liquid ferrous sulfate Ch. 21 pg 124,129  Drink out of a straw  1 hr b4 and after milk and antacids  Give w/ vit C (orange juice)  Use Z-track into deep muscles  Stool may turn tarry green if dose is adequate  Brush teeth after 13. Opioid administration ch9 pg 44,46  Opioids are acceptable for moderate to sever e pain  Meds use: morphine sulfate, oxycodone and fentanyl 14. Blood neoplasms: labs values to report Ch. 40 pg 257  Anemia  Thrombocytopenia Neutropenia  Leukemic blast (immature WBC) 15. Newborn screening results ch42 pg 271 16. Renal dis: labs value to report Ch. 26 pg 157,163  10-yo w/ glomerulonephritis: serum creatinine 1.3 mg/dL  10-yo w/ nephrotic syndrome: serum protein 5.0 g/dL 17. Providing teaching about increased intracranial pressure ch29 pg 185, 73  Shunt malfunction and hydrocephalus and when to notify provider  Infants: high-pitch cry, lethargic, vomiting, bulging fontanels, widening cranial suture lines, increased head circ.  Children: headache, lethargic, N/V, double vision, decreased school performance, decreased LOC, seizure  Adolescent: headache, alteration in pupillary response, increased sleeping  Maintain quiet environment and use two pillows to elevate the head, and maintain body alignment 18. Planning care for an adolescent who has scoliosis ch28 pg 177, 179  Curvature of the spine and spinal rotation that causes rib asymmetry  Asymmetry in scapula rib, flanks, shoulders, and hips 19. Planning care for an infant who has bronchiolitis Ch. 17 pg 94, 97  Administer humidified oxygen and suction the nasopharynx PRN 20. Postoperative care for tonsillectomy Ch. 17 pg 97  Maintain NPO  Place in position to facilitate drainage; elevate HOB  Assess for bleeding; frequent swallowing, clearing throat, restlessness, bright emesis, tachycardia, pallor  Administer analgesics on a scheduled 21. Postoperative care foe cleft palate repair ch23 pg 140, 145  Place infant in a upright position  Avoid sucking nipple/bottle/pacifier Elbow restrains to prevent injury  Face mask for oxygen  Packing will stay for about 2-3 days 22. Caring for a child during a tonic-clonic seizure ch13 pg 67  Protect from injury  Maintain a side lying position; patent airway 23. Identifying medication contraindications PHARMBOOK Ch. 19 24. Nursing action for a child who has epiglottitis ch17 pg 97  s/sx:  hoarsesness and difficulty speaking  difficulty swallowing  drooling  stridor 25. Head injury: priority assessment ch14 pg 73  Stabilize the child’s neck  Ensure the spine is stabilized intil spinal cord injury is ruled out 26. Priority action for submersion injury ch43 pg 288  Near-drowning  Administer oxygen; can need mechanical ventilation ATI PROCTORED PEDS 1. A nurse is completing an admission assessment on an adolescent child who is a vegetarian. He eats milk products but does not like beans. Which of the following items should the nurse suggest the client order for lunch to provide nutrients most likely to be lacking in his diet? a. Peanut butter and jelly sandwich 2. A nurse is caring for a 1-month old infant who weighs 3540 g and is prescribed a dose of cephazolin 50mg/kg IV bolus TID. How many mg should the nurse administer per dose? 3. A nurse is preforming a pre-college assessment on an adolescent. Which of the followingimmunizations should the nurse anticipate administering? a. Meningococcal polysaccharide vaccine 4. A nurse is assessing a client who has left-sided heart failure. Which of the following findings should the nurse expect? a. Dependent edema 5. A nurse is caring for a client who has active TB and is to be started on IV rifampin therapy. The nurse should instruct the client that this medication can cause which of the following adverse effects? a. Body secretions turning a red-orange color 6. A nurse is caring for a 6-week-old infant who as a pyloric stenosis. Which of the following manifestations should the nurse expect? a. Projectile vomiting 7. A nurse receives a call from a parent of a child who has von Willebrand disease and has having a nosebleed. Which of the following instructions should the nurse give to the parents? a. “have you child sit with their head tilted forward and hold pressure on her nose for 10 minutes.” 8. A nurse is assessing a child who is in sickle cell crisis. Which of the following findings should the nurse expect? a. Pain 9. A nurse is providing preoperative teaching by demonstrating diaphragmatic breathing to a client who is scheduled for surgery in the morning. Which of the following actions should the nurse include in the demonstration? a. Place both hands on the sides of her rib cage. 10. A nurse is assessing a 3-year-old child who has aortic stenosis. Which of the following findings should the nurse expect? (select all that apply).a. Most common: Murmur b. weak pulses, HTN, dizziness, chest pain 11. A nurse is planning care for a client who has idiopathic thrombocytopenic purpur (ITP). Which of the following manifestations is the most appropriate for the nurse to monitor? a. Fever? 12. A nurse is providing teaching to a parent of a child who has Hirschsprung disease is scheduled for initial surgery. Which of the following statements indicates an understanding of the teaching? a. “I’m glad that my child’s ostomy is only temporary.” 13. A school nurse identifies that a child has pediculosis capitis and educates the child’s parents about the condition. Which of the following statements by the parents indicated an understanding of the teaching? a. “all recently used clothes, bedding, and towels must be washed in hot water.” 14. A nurse is providing dietary teaching to the parents of a newborn who is being breastfed. The nurse should instruct that the transition to whole milk can occur at which of the following ages? a. 12 months 15. A nurse is assessing a 6-month old patient at a well-child visit. Which of the following findings should the nurse expect? a. Closed posterior fontanel (8 weeks). 16. A nurse is caring for a 2-year old child who has seizures and is receiving phenytoin in suspension form. Which of the following actions should the nurse take before administering each dose? a. ?? 17. A nurse is planning care for a female client who has a T4 spinal cord injury and is at risk for acquiring urinary tract infections. Which of the following actions should the nurse include in the client’s plan of care? a. Encourage fluid intake at and between meals.18. A nurse is planning care for a child who has suspected epiglottis. Which of the following actions should the nurse take? a. place the child in an upright position 19. A nurse is instructing a group of clients regarding calcium rich food. Which of the following should the nurse include in the teaching as the best source of calcium? a. 1 cup milk 20. A nurse is caring for an 8-month-old infant who screams when the parent leaves the room. The parent begins to cry and says “ I don’t understand why my child is so upset. I’ve never seen my child act this way around others before.” Which of the following statements should the nurse make? a. “This is a normal, expected reaction for a child of this age.” 21. A nurse is caring for a 4-year-old child who is resistant to taking medication. Which of the following strategies should the nurse use to elicit the child’s cooperation? a. Offer the child a choice of taking it with juice or water. 22. A nurse is caring for a client who requires droplet precautions. Which of the following personal protective equipment should the nurse wear when setting up the meal tray? a. Mask 23. A nurse is teaching a client who has asthma about how to use an albuterol inhaler. Which of the following actions by the client indicates an understanding of the teaching? a. The client holds his breath 10 seconds after inhaling the medication. 24. A nurse is caring for a 2-month-old infant who is post-operative following surgical repair of a cleft lip. Which of the following actions should the nurse take? a. Administer ibuprofen as needed for pain. 25. A nurse is caring for a child who has Kawasaki disease. Which of the following systems should the nurse monitor in response to this diagnosis?a. Cardiovascular 26. A nurse is providing teaching to a client who has oral candidiasis and a new script for nystatin suspension. Which of the following statements by the client indicates an understanding of the teaching? a. “I will store the medicine at room temp” 27. A nurse is assessing a client who has diabetes mellitus and reports foot pain. The nurse should evaluate the client for which of the following alterations as indications that the client has an infection? (Select all that apply). a. ?? 28. A nurse is removing PPE after giving direct care to a client who requires isolation. Which of the following must be removed first? a. Gloves 29. A nurse is assessing a client who is receiving a unit of RBC. Which of the following findings is a manifestation of acute hemolytic reaction? a. Client reports low back pain. 30. A nurse is teaching a group of clients about emergency care for a snake bite. Which of the following information should the nurse include in the teaching? a. Raise the affected extremity above the level of the heart. 31. A nurse is assessing a client who has right ventricular failure. Which of the following findings should the nurse expect? a. Hepatomegaly 32. A nurse is planning care for a 6-year-old child who has bacterial meningitis. Which of the following nursing interventions is unnecessary in the client’s plan of care? a. Measuring head circumference every shift.33. A nurse is caring for a pre-school child who has epiglottitis with a barking cough. Which of the following actions should the nurse take? a. Monitor O2 sat. 34. A nurse is caring for a child who 2 hr postoperative following a tonsillectomy. Which of the following fluid items should the nurse offer the child at this time? a. Crushed ice 35. A nurse is assessing a client who has a fracture of the femur. The nurse obtains vital signs on admission and again in 2 hours. Which of the following assessment should indicate to the nurse that the client could be developing a serious complication? a. Increased resp rate from 18 to 44/min. 36. A nurse is providing discharge teaching to a client who has SLE. Which of the following instructions should the nurse include? a. Wash hair with mild protein shampoo. 37. A nurse is caring for an infant who has congenital heart defect. Which of the following defects is associated with increased pulmonary blood flow? a. Patent ductus arteriosus. 38. A community health nurse in a pediatric clinic is reviewing a history of a 12-year-old client. Which of the following immunizations should the nurse expect to administer? a. Meningococcal conjugate b. HPV, Tdap. 39. A nurse is presenting an in-service about the use of postural drainage for infants who have cystic fibrosis. Which of the following positions should the nurse identify as being contraindicated for the infant? a. Trendelenburg? 40. A nurse is caring for a client who has a prescription for digoxin 0.25mg PO daily. The amount available is 0.125mg tab. The client’s current vital signs are: BP 144/96, hear rate 54/min,respirations 18/min, and temperature 98.6 F. Which of the following actions should the nurse take? a. Withhold for decreased pulse rate. 41. A nurse is speaking with the mother of a 6-year-old child. Which of the following statements by the mother should concern the nurse? a. “My teacher says my child has to squint to see the board.” 42. A nurse is conducting a primary survey of a client who has sustained life-threatening injuries do to a motor-vehicle crash. Identify the sequence of actions the nurse should take. 1. Open airway using a jaw-thrust maneuver 2. Determine effectiveness of ventilator efforts 3. Establish IV access 4. Glasgow Coma Scale assessment 5. Remove clothing for a thorough assessment. 43. A nurse is reinforcing teaching about food choices with the mother of an 8-month-old infant. Which of the following statements by the mother indicates a need for further teaching? a. “I will give my child strained carrots and mashed egg yolks.” 44. A nurse in an emergency room is caring for a client who sustained partial-thickness burns to both lower legs, chest, face, and both forearms. Which of the following is the priority action the nurse should take? a. Inspect the mouth for signs of inhalation injuries 45. A charge nurse is making a room assignment for a client who has scabies. In which of the following rooms should the nurse place the client? a. Private room 46. A nurse is reviewing the lab findings for a client who has ITP. Which of the following findings should the nurse expect to be decreased? a. Platelets47. A nurse is assessing a client who has SLE. Which of the following findings should the nurse expect? a. Facial rash 48. A client is admitted to the emergency room with a respiratory rate of 7/min. ABG reveal the following values. Which of the following is an appropriate analysis of the ABGs? pH 7.22 paCO2 68 Base excess -2 PaO2 78 Sat 80% Bicarb 26 a. Respiratory acidosis 49. A nurse is caring for a group of clients in an infectious disease unit. The nurse should wear OSHA-approved N95 respirator mask when caring for a client with which of the following infectious diseases? a. TB 50. A nurse is teaching a client about taking diphenhydramine. The nurse should explain to the client that which of the following is an adverse effect of this medication? a. Sedation 51. A nurse is admitting a child who has leukemia. Which of the following clients should the nurse place in the same room with this child? a. Child who has nephrotic syndrome 52. A nurse is instructing the parents of a client who has a new prescription for methylphenidate. Which of the following instructions should the nurse include? a. Avoid activities that require alertness such as driving. 53. A nurse is caring for a client who is experiencing anaphylactic shock in response to the administration of PCN. Which of the following meds should the nurse administer first?a. Epinephrine 54. A nurse is providing teaching to a parent of a toddler about appropriate snacks. Which of the following foods should the nurse include? a. Sliced bananas 55. A nurse is creating a teaching plan for a client who has thrombocytopenia. Which of the following instructions should the nurse include? (select all that apply). a. Lubricate lips with water soluble solution, blow nose gently, brush teeth with a soft toothbrush. 56. A nurse is admitting a toddler who has respiratory syncytial virus (RSV). Which of the following actions should the nurse take? a. Keep thermometer in toddler’s room. 57. A nurse is caring for an adolescent who has hemophilia A and is scheduled for wisdom teeth extractions. Prior to the procedure, the nurse should anticipate that the client will receive which of the following products? a. Fresh frozen plasma / cryoprecipiatate 58. A nurse is assessing a school-aged child whose blood glucose level is 280. Which of the following findings should the nurse expect? a. Pallor? 59. A nurse is assessing for cyanosis in a client who has dark skin. Which of the following sites should the nurse examine to identify cyanosis in this client? a. Conjuctivae 60. A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of nausea and weakness. Which of the following action should the nurse take first? a. Check vitals. 61. A nurse is teaching a client who has a new prescription for prednisone to treat rheumatoid arthritis. The nurse should inform the client that which of the following is a therapeutic effect ofthis medication? a. Decreases inflammation 62. A nurse is caring for a client who just had a cardiac catherization. Which of the following nursing interventions should the nurse include in the clients plan of care? a. Have client remain in bed for up to 6 hours, check peripheral pulses in affected extremity, keep leg and hip extended. 63. A nurse in an urgent care center is caring for a client who is having an acute asthma exacerbation. Which of the following actions is the nurse’s highest priority? a. Administering a nebulized beta-adrenergic 64. A nurse is assessing a 9-month-old infant. Which of the following findings require further interventions? a. Positive moro reflex 65. A nurse is caring for a client who has HIV. Which of the following lab values is the nurse’s priority? a. CD4-T-cell count 180 66. A nurse is providing dietary teaching to a client who has a burn injury and adheres to a vegan diet. The nurse should recommend which of the following foods as the best source of protein to promote wound healing? a. 1 c lentils 67. A nurse is caring for a client who has hemophilia A and hemarthrosis of the left knee. Which of the following actions should the nurse take? a. Obtain a stool specimen 68. A nurse is assessing a client who has infective endocarditis. Which of the following findings should be the priority for the nurse to report to the provider? a. Dyspnea. 69. A nurse is caring for a client who is well-hydrated and who demonstrates no evidence of anemia. Which of the following lab values gives the nurse an assessment of the adequacy of theclient’s protein uptake and synthesis? a. Albumin 70. A child is admitted with suspected diagnosis of Wilms’ tumor. The nurse should place a sign with which of the following warnings over the child’s bed? a. “Don’t palpate the abdomen” 71. A nurse in the ER is caring for a client who has extensive partial and full-thickness burns of the head, neck, and chest. While planning the client’s care, the nurse should identify which of the following risks as the priority for assessment and intervention? a. Airway obstruction 72. A client tells the nurse that he is concerned because his provider told him he has a heart murmur. The nurse should explain to the client that a murmur a. Indicated turbulent blood flow through a valve. 73. A nurse is administering nasal decongestant drops for a client. Which of the following actions should the nurse take? a. Tell the client to blow her nose gently before the instillation. 74. A nurse is caring for an 8-year-old who has acute rheumatic fever. Which of the following assessments is the nurse’s priority immediately after admission? a. Auscultating the rate and characteristics of the child’s heart sounds. PEDS PROCTOR 2016 1. Acetaminophen overdose:  Acetylcysteine 2. Adolescent with ADHD prescribed methylphenidate and asks what it's for:  Decrease anxiety 3. Appendectomy post-op care what to report:  Muscle rigidity 4. Aspirin overdose:  Activated charcoal 5. Asthma what to reprot:  Intercostal retractions 6. Cardiac cath post op care:  Straight extremity 6-8 hrs7. Celiac disease:  Gluten free diet 8. Chemotherapy, mouth ulcer:  Clean with saline soak gauze 9. Chest tubes draining:  A disposable three chamber drainage system is most often used.‐ -First chamber: drainage collection -Second chamber: water seal (tidaling) - (bubbling = air leak) -Third chamber: suction control (can be wet or dry) (continuous bubbling) 10. Cystic fibrosis:  Pancreatic enzymes with meals or snacks 11. Cystic fibrosis s/s:  Steatorrhea 12. Down syndrome: Congenital heart malformation hypotonicity dysfunction of immune system thyroid dysfunction leukemia vision and hearing loss. Dry mucus membranes due to mouth breathing, increased risk for respiratory infection, cool mist humidification. 13. Epiglottitis: Comfortable position 14. Epiglottitis nursing interventions: Avoid throat culture or tongue blade, IV corticosteroids, droplet precautions for first 24 hours after IV antibiotics initiated. 15. Failure to thrive nursing plan of care: Consistent nursing care 16. GERD priority to report:  Wheezing 17. Glomerulonephritis lab value to be present: Antistreptolysin (ASO titer) 18. Head injury what to report:  Vomiting 19. Head lice: Comb nits off 20. Hemolytic uremic syndrome nurse should expect which labs: Acute renal failure, hemolytic anemia, thrombocytopenia. 21. Decrease H&H H&H levels: HCT Login to interact Logged in users can save documents, make comments, download and much more Sign in  I will demonstrate what she needs to do before i expect her to do it on my own 43. Patient teaching for parents of child with seizures:  Remove heavy objects nearby and clear area 44. Pediculosis captits understanding:  I will use a fine comb to get nits out 45. Peritoneal dialysis:  Weigh patient 46. Peritoneal dialysis nursing interventions  no answer 47. Pertussis:  Droplet precaution 48. Picture question about rooting reflex:  Check the picture of cheek (hot spot) 49. PKU foods to avoid and allow:  Avoid high protein, allow fruits and veggies 50. Prevent SIDS:  Light clothing 51. Put teaching PKU:  Cook soft carrots and cut into small pieces 52. Restraints venipuncture in a child:  Put them in a mummy position. 53. Seizure intervention:  Move hard objects 54. SIDS prevention:  Dress infant in light clothing 55. Signs of severe dehydration:  Sunken anterior fontanel  No tearing with sunken eyeballs  Oliguria/anuria 56. S/s icp:  Vomiting 57. Teenager healthy eating female:  Increase iron uptake58. Tonsillectomy:  Inspect throat with flash light 59. Tonsillectomy:  Use flashlight to visualize the throat 60. Umbilical hernias:  If doesn't resolve by age 2, surgery 61. Ventriculoperitoneal shunt report to provider:  Vomiting (increased ICP) 62. Vulvoginitis:  Warm compress soak 3X per day 63. What expect to see in child with cushings disease:  Hyperglycemia 64. What should nurse do to minimize the traumatic experience of getting immunizations:  Provide pacifier with sugar 65. When administering gentamycin which lab value to report?: Creatinine 3.0 [Show More]

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