Following a traumatic birth, an infant is admitted to the neonatal intensive care unit.
When the grandparents arrive at the hospital, they question the nurse caring for the baby
about its condition and plan of care. The nurse who provides this information without
permission from the parents would be committing:
1. Negligence
2. A breach of privacy
3. Malpractice
4. A breach of ethics
A mother brings her two-year-old child to the pediatric office for a sick visit. The child
is seen regularly at the office and was last seen at her well-child visit two months ago.
Based on this information, which is the most appropriate action by the nurse?
1. Asking the mother to leave the room after obtaining the history
2. Obtaining a comprehensive history, including sociodemographic data
3. Focusing exclusively on the reported illness
4. Reviewing health promotion and maintenance activities
An adolescent reports that after hearing about all the hazards of cigarette smoking, he
has changed to chewing tobacco. The nurse will want to inform that adolescent of the
risk factors associated with smokeless tobacco, including:
Standard Text: Select all that apply.
1. Lung cancer.
2. Nicotine addiction.
3. Mouth cancers.
4. Emphysema .
5. Mouth ulcers.
When assigned to the patient on complete bed rest for spinal fusion secondary to
scoliosis, the nurse will want to intervene to prevent common complications of
immobility. Nursing interventions will include:
Standard Text: Select all that apply.
1. Encouraging use of the spirometer every two hours while the child is awake.
2. Log-rolling the patient every two hours while awake.
3. Increasing intake of milk to maintain bone calcium.
4. Increasing fruit and grains in the diet.
5. Limiting fluid intake to reduce the need to void.
The nurse is evaluating an infant for dehydration. Which assessment provides the most
accurate information on dehydration?
1. Urine output
2. Urine specific gravity
3. The infant’s vital signs
4. Weight loss
While assessing a 10-month-old African American infant, the nurse notices that the
sclerae have a yellowish tint. Which organ system would the nurse suspect as having an
ongoing disease process?
1. Genitourinary
2. Cardiac
3. Gastrointestinal
4. Respiratory
The nurse is evaluating the immunization status of a child. The nurse recognizes that
the child can acquire active immunity against a disease by:
Standard Text: Select all that apply.
1. Receiving a dose of immunoglobulins.
2. Immunization with a killed virus vaccine.
3. Immunization with a toxoid.
4. Antibiotic therapy.
5. Acquiring the disease.
Put the following nursing assessments of a toddler in the best order for the nurse to
proceed (from first assessment to last assessment).
Standard Text: Click and drag the options below to move them up or down.
Choice 1. Auscultation of chest
Choice 2. Examination of eyes, ears, and throat
Choice 3. Palpation of abdomen
Choice 4. General appearance
The nurse is discussing autosomal recessive inheritance with a patient. The nurse will
include which statements in the discussion?
Standard Text: Select all that apply.
1. “The disorder may appear to skip generations.”
2. “Boys and girls are affected in equal numbers.”
3. “The disorder passes from mother to son but not from father to daughter.”
4. “Daughters that are affected will be more severely involved than sons.”
5. “Both parents must be carriers for the disorder.”
A six-year-old child is hospitalized for a surgical procedure. The parents ask if the
child’s four siblings can visit. The best response by the nurse would be:
1. “Let’s plan their visit for a time when the child has received pain medication.”
2. “Only those siblings over 16 will be allowed to visit.”
3. “I don”t think the other children should visit because it might scare them to see their
sibling so sick.”
4. “Very young children shouldn”t visit as they may carry germs.”
The nurse is caring for a nine-month-old who just returned from the PACU after a shunt
placement for hydrocephalus. Which of the physician’s orders would the nurse
question?
1. Vital signs and neuro checks hourly
2. Small, frequent formula feedings
3. Elevate head of bed
4. Daily head circumference
A nine-month-old who is not sitting independently has been diagnosed with ataxic
cerebral palsy (CP). Which clinical manifestations would the nurse expect to see in the
baby?
1. Hypotonia and muscle instability
2. Hypertonia and persistence primitive reflexes
3. Tremors and exaggerated posturing
4. Hemiplegia and hypertonia
The nurse recommends to the mother of a 10-month-old child that cow’s milk not be
introduced into the diet until after 12 months of age. The mother asks why she can”t
switch to cow’s milk earlier. The nurse explains that cow’s milk can lead to iron
deficiency anemia because:
Standard Text: Select all that apply.
1. Cow’s milk is a poor source of iron.
2. The child may be exposed to an antibiotic in processed milk.
3. Cow’s milk has a high fat content.
4. In young children, cow’s milk can lead to bleeding from the gastrointestinal tract.
5. Cow’s milk contains no vitamin C, which is necessary for iron absorption.
A nurse is assessing language development in all the infants presenting at the
physician’s office for well-child visits. The nurse would want to evaluate the child
further who is not able to verbalize the words “dada” and “mama” by the age of:
1. 18 months.
2. 8 months.
3. 5 months.
4. 12 months.
A four-year-old with intractable seizures has been on a ketogenic diet for the last six
months, with a decrease in seizure activity. This child is now admitted to the pediatric
unit with left-sided pain. The nurse knows that possible complications of the ketogenic
diet include:
1. Appendicitis.
2. Bowel obstruction.
3. Urinary tract infection.
4. Kidney stones.
Nurses working with adolescents should encourage the adolescents to assume more of
the responsibility for their healthy behaviors. To promote this personal responsibility,
the nurse will want to provide adolescents with information about which health
promotion activities?
1. Self-breast exams for girls and self-testicular exams for the boys
2. Immunizations that need to be updated
3. Communicable diseases that are prevalent in the community
4. The importance of eating together as a family several times a week
In addition to separation anxiety, infants between six and 18 months of age also might
display:
1. Fear of disfigurement.
2. Fear of death.
3. Stranger anxiety.
4. Fear of bodily injury.