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There has been an outbreak of communicable diseases in the community. To reduce
parental anxiety, the nurse presents information about disease at the school's Parent
Teacher Association meeting. The nurse explains that children cannot acquire
vector-borne diseases from other children. The nurse explains that vector-borne diseases
include:
Standard Text: Select all that apply.
1. Measles (Rubeola).
2. Pertussis (whooping cough).
3. Rocky Mountain Spotted Fever.
4. West Nile Virus.
5. Lyme disease.
The nurse is planning care for a three-month-old infant with eczema. Which
intervention would take top priority in this infant's care?
1. Applying antibiotics to lesions
2. Keeping the baby content
3. Maintaining adequate nutrition
4. Preventing infection of lesions
While assessing risk factors in adolescents, the nurse recognizes that dental issues may
be related to:
Standard Text: Select all that apply.
1. Fluoridated water.
2. Failure to use a mouth guard when playing physical sports.
3. Adolescent obesity.
4. Diagnosis of bulimia.
A child is admitted to the hospital and diagnosed with aplastic anemia. The parents ask
the nurse what aplastic anemia is. Which would be the best description of aplastic
anemia?
1. Causes a proliferation of white blood cells
2. Is characterized by abnormally shaped red blood cells
3. Is characterized by failure of the bone marrow to produce adequate numbers of cells
4. Is a disorder that occurs following a viral illness
The nurse notes that the specific gravity of urine is lower in infants than in older
children. The nurse recognizes that the rationale for this difference is related to:
1. The infant having a greater body surface area.
2. The infant having a higher basal metabolic rate.
3. The infant having a greater percentage of body weight that is water.
4. The infant's kidneys being less able to concentrate urine.
A nine-year-old has been diagnosed with a learning disorder that is characterized by
problems with manual dexterity and coordination. The nurse teaches parents that this
disorder is called:
1. Dysgraphia.
2. Dyscalculia.
3. Dyspraxia.
4. Dyslexia.
An infant has been born with an esophageal atresia and tracheoesophageal fistula. What
is a priority preoperative nursing diagnosis?
1. Ineffective tissue perfusion: gastrointestinal, related to decreased circulation
2. Ineffective infant feeding pattern related to uncoordinated suck and swallow
3. Acute pain related to esophageal defect
4. Aspiration, risk for related to regurgitation
Following an outbreak of chicken pox in the school, the school nurse is concerned that
children are at risk for Reye syndrome. The nurse sends home letters reminding the
parents not to administer aspirin and describes the initial symptoms of Reye syndrome
which are:
1. Nausea, vomiting, and confusion.
2. Headache, vomiting, and seizures.
3. Sore throat, moist respirations, and cough.
4. Fever, rash, and photophobia.
A child is being prepared for surgery. The parent requests to be present during
anesthesia induction. How should the nurse respond?
1. The nurse should tell the parent the names of all the medications the child will
receive.
2. The nurse should explain what the parent will see and hear when present during
induction.
3. The nurse should tell the parent he will be upset to see his child under anesthesia.
4. The nurse should ignore the request and focus on the child.
The nurse in the well-child clinic is concerned with injury prevention and includes
topics appropriate to the age and behaviors of the child. Which injury prevention topics
would be appropriate to prevent hearing loss?
1. The five-year-old child should wear ear plugs when swimming to prevent otitis
media.
2. The 12-year-old child should restrict noise levels when listening to music through
earphones.
3. The bike helmet for a seven-year-old should be carefully fitted to prevent damage to
the ear canal.
4. The nine-year-old child should avoid sports activities that involve cheering crowds to
prevent hearing loss.
During a sports physical, a client is found to have myopia, long digits, tall stature, an
arm span greater than his height, scoliosis, and a hollow chest. The nurse should
suspect:
1. Phenylketonuria.
2. Turner's syndrome.
3. Huntington's chorea.
4. Marfan's syndrome.
A child has been admitted to the hospital unit in congestive heart failure (CHF).
Symptoms related to this admission diagnosis would include:
1. Tachycardia.
2. Weight loss.
3. Increased blood pressure.
4. Bradycardia.
A Southern, nominally Pentecostal, African American pediatric client is being assessed
during admission. He has braided, black, kinky hair, and he celebrates Kwanzaa. The
nurse should document his ethnicity and race on the nursing admission form as:
1. Ethnicity African American, race Black
2. Ethnicity Black, race African American
3. Ethnicity Pentecostal, race African American
4. Ethnicity Southern, race Black
The nurse is taking care of a child who is terminally ill. The nurse notices the child is
having periods of shallow breathing followed by short periods of apnea. The nurse
recognizes that this is:
1. Normal respiratory function of a young child.
2. Cheyne-Stokes respiration, which is a sign of imminent death. The child should be
assessed for other signs of imminent death.
3. Dyspnea secondary to muscle relaxation.
4. A sign of air hunger.
A teenager has arrived in the emergency department (ED) with confusion. The
physician suspects diabetic ketoacidosis (DKA). A stat serum glucose is done, and the
result is 76l5 mg/dL. The nurse expects that this teen has which symptoms?
1. Tachycardia, dehydration, and abdominal pain
2. Sweating, photophobia, and tremors
3. Dry mucous membranes, blurred vision, and weakness
4. Dry skin, shallow rapid breathing, and dehydration
While breastfeeding is recommended by the American Academy of Pediatrics, there are
maternal and infant conditions that should be evaluated as being possible
contraindications to breastfeeding. Some of these contraindications include:
Standard Text: Select all that apply.
1. The mother has heart disease.
2. The mother is infected with HIV.
3. The infant has been diagnosed with galactosemia.
4. The mother has small breasts.
5. The mother takes medications for a chronic health condition.
A parent reports that her five-year-old child, who has had all recommended
immunizations, had a mild fever one week ago and now has bright red cheeks and a
lacy red maculopapular rash on the trunk and arms. The nurse recognizes that this child
might have:
1. Rubeola (measles).
2. German measles (rubella).
3. Chickenpox (varicella).
4. Fifth disease (erythema infectiosum).
The charge nurse is reviewing the care plans written by the unit's staff nurses. The
charge nurse recognizes that the NANDA nursing diagnosis most likely to be construed
as culturally biased and possibly offensive is:
1. Interrupted family processes related to shift in family roles secondary to demands of
illness.
2. Fear related to separation from support system during hospitalization.
3. Noncompliance related to impaired verbal communication secondary to recent
immigration from a non-English-speaking area.
4. Spiritual distress related to discrepancy between beliefs and prescribed treatment.
A child has a planned hospitalization in a few weeks, and the patient and family appear
very stressed. What is the best way to minimize the stress for the patient and family?
1. Tell the patient and family that everything will be fine.
2. Explain to the patient and family how the child will benefit from the surgery.
3. Tell the patient and family that the surgeon is very good.
4. Give a tour of the hospital unit or surgical area.
Shortly after birth, all newborns are tested for phenylketonuria. The test results are not
available before mother and baby are discharged from the hospital. When the diagnosis
of PKU is made, the most appropriate means of informing the parents would be:
1. Immediately in a phone call requesting a follow-up office visit
2. In a certified letter explaining the diagnosis and requesting the parents make a
pediatric office appointment.
3. In a group meeting of all parents whose children tested positive for phenylketonuria
during the last two months.
4. In person with the physician and both parents present.
A child has recently been diagnosed with leukemia. The child's sibling is expressing
feelings of anger and guilt. This reaction by the sibling is:
1. Abnormal; the sibling should be referred to a psychologist.
2. Unexpected; the cancer is easily treated.
3. Unusual; the illness doesn't affect the sibling.
4. Normal; the sibling is affected, too, and anger and guilt are expected feelings.
The pediatric clinic is scheduled to be remodeled. The charge nurse has been asked to
design the new well-child waiting area. In planning the area, the nurse will want to
include:
Standard Text: Select all that apply.
1. Subdued colors to help calm the children.
2. A separate area where parents can sit and not be disturbed by the children's noise.
3. Avoiding carpet and draperies which cannot be readily cleaned.
4. Coloring books, crayons, and story books that are stored on a low shelf for easy child
access.
5. All wall decorations securely fastened to the walls.
A 16-year-old boy has a stiff neck, a headache, a fever of 103 Fahrenheit, and purpuric
lesions on his legs. He is admitted to the hospital for treatment of suspected
meningococcemia. Although the adolescent's physical needs take priority at the present
time, the nurse can expect which of the following to be the most significant
psychological stressor for this adolescent?
1. Fear of getting behind in schoolwork
2. Fear of painful procedures and bodily mutilation
3. Separation from friends and permanent changes in appearance
4. Separation from parents and home
A two-year-old child is admitted to the hospital for chronic diarrhea. After investigation,
the child is diagnosed with celiac disease. The nurse teaches the family to avoid all
glutens and to carefully read all labels. In evaluating the parents' understanding, the
nurse allows the family to complete the child's menus. The nurse recognizes the family
understands glutens when they choose which foods?
Standard Text: Select all that apply.
1. Milk
2. Mashed potatoes with gravy
3. Apple sauce
4. Corn in cream sauce
5. Rice cakes
Which statement indicates that parents have understood the nurse's teaching with regard
to colostomy stoma care for their toddler?
1. "We will change the colostomy bag with each wet diaper."
2. "We will expect a moderate amount of bleeding after cleansing the area around the
stoma."
3. "We will watch for skin irritation around the stoma."
4. "We will use adhesive enhancers when we change the bag."
Following an automobile accident, a teenager is left paraplegic. The child is being
prepared for discharge. The nurse is reviewing instructions to avoid decubitus ulcers on
the buttocks and instructs the teenager to:
1. Contract the buttock muscles five times every two hours.
2. Increase fat in the diet to provide a protective coating over the boney prominences.
3. Do wheelchair push-ups every 15 to 30 minutes.
4. Avoid use of sheepskin as it prevents air from reaching the area.
A nine-month-old infant is hospitalized with vomiting and diarrhea. The mother
questions why her child needed hospitalization since her school-age nephew had the
same symptoms and was treated at home. The nurse would explain that an infant is
more at risk for dehydration than a school-age child because:
1. Infants have a lower proportion of their body weight as water.
2. The percentage of extra-cellular fluid is higher in the infant than the school-age child.
3. School-age children have a larger body surface area.
4. The school-age child's kidneys are more mature and better able to conserve water.
5. The metabolic rate of the school-age child is higher.
A child has been diagnosed with a basilar skull fracture. The nurse should monitor this
child for:
1. Periorbital ecchymosis.
2. Subdural hematoma.
3. Protruding bone.
4. Epidural hematoma.
A nurse is planning to provide education for a family who has a child with sickle-cell
anemia. For the prevention of a sickle-cell crisis, the nurse teaches the family the
importance of avoiding which condition?
1. Respiratory infection and dehydration
2. Midrange altitudes
3. Weight loss without dehydration
4. Overhydration
A child is admitted for scald burns to his buttocks and thighs. According to the mother,
she was preparing the child's bath and before she could test the water, the child fell in
and was scalded. The nurse would suspect child abuse because:
1. The burns are uneven, with some burns deeper than others.
2. The child's hands and feet are free of burns.
3. In addition to the main burn site, there are splash burns surrounding the area.
4. The mother was home alone with the child.
A nurse is planning care for a child with hyponatremia. The nurse, delegating care of
this child to a licensed vocational nurse (LVN), cautions the LVN to watch for which
clinical manifestation?
1. Seizures
2. Respiratory distress
3. Hyperthermia
4. Bradycardia
The 10-year-old boy is admitted to the pediatric neurologic unit with a suspected
craniopharyngioma. The nurse will assess the child with which symptoms related to this
brain tumor?
Standard Text: Select all that apply.
1. Evening nausea
2. Excessive urination leading to dehydration
3. Nystagmus
4. Headaches
5. Orbital ecchymosis
When the newborn female is born with ambiguous genitalia, the follow-up investigation
discovers adrenogenital syndrome (also called congenital adrenal hyperplasia). The
parents question why the baby's genitalia looks more male than female. The nurse
would explain that:
1. The disorder caused the infant to be a hermaphrodite with both male and female sex
organs.
2. The changes in the genitalia are due to increased androgens secondary to deficient
cortisol.
3. The excessive cortisol caused the enlargement of the female tissue, creating a male
appearance.
4. The child has only one sex chromosome resulting in an XO configuration.
An infant has just returned from surgery for correction of bilateral congenital clubfeet.
The infant has bilateral long-leg casts. The toes on both feet are edematous, but there is
color, sensitivity, and movement to them. What should the nurse do first?
1. Apply a warm, moist pack to the feet.
2. Elevate the infant's legs on pillows.
3. Encourage movement of the toes.
4. Call the physician to report the edema.
Parents of a preschool-age child report that they find it necessary to spank the child at
least once a day. Which response should the nurse make to the parents?
1. "Spanking is one form of discipline; however, you want to be certain that you do not
leave any marks on the child."
2. "Let's talk about other forms of discipline that have a more positive effect on the
child."
3. "I think you are not parenting your child properly, so let's talk about ways to improve
your parenting skills."
4. "Can you try only spanking the child every other day for one week and see how that
affects the child's behavior?"
During rounds, the interdisciplinary team is discussing the care of a child with a newly
diagnosed Wilms' tumor. The nurse describes the mother as being angry and upset that
they are not caring properly for her child. What behavior probably is the cause of the
mother's anger?
1. The mother is beginning the stages of grief over loss of her previously well child.
2. The mother is feeling guilty for not recognizing that the child was ill.
3. The nurses are negligent in providing safe care for the child.
4. The mother does not have adequate support from Social Services.
A child has thrombocytopenia secondary to chemotherapy treatments. Based on this
finding, what should the nurse do?
1. Avoid administering intramuscular injections (IM).
2. Monitor intake and output.
3. Use palpation as a component of assessment.
4. Avoid performing oral hygiene.
A two-month-old infant is admitted to the hospital with a diagnosis of "failure to thrive"
(FTT). The nurse recognizes that the infant will be evaluated for:
Standard Text: Select all that apply.
1. Over-dilution of formula concentrate.
2. Parental neglect.
3. Rumination.
4. Malabsorption syndromes.
5. Pica
The nurse has recommended respite care for the family of a two-year-old child who is
medically fragile. The mother asks what respite can do for them. The nurse's response
will be based on the knowledge that:
1. Respite care will admit the child for an evaluation of the child's medical condition.
2. Respite care gives the family a break from the daily demands of caring for a child
who is medically fragile.
3. Respite care can provide support for the child during local disasters.
4. Respite care will admit the child and family to their facility and provide the whole
family a vacation experience.
A ten-year-old boy with classic hemophilia is admitted to the hospital for hemorrhage
into the knee joint. Treatment is instituted on admission. What would be an appropriate
nursing diagnosis for this child?
1. Risk for impaired physical mobility related to joint stiffness and contractures
2. Risk for impaired tissue perfusion (cerebral) related to blood loss.
3. Activity intolerance related to bleeding
4. Disturbed body image related to swollen knee
The mother of an 18"month-old expresses concern that her toddler is having temper
tantrums when things don"t go her way. What advice should the nurse offer the mother?
Standard Text: Select all that apply.
1. "This is common in the toddler and represents a loss of self-control."
2. "Remove the child from the area where the tantrum occurs."
3. "Provide a distraction for the child without giving in to the child's desire."
4. "Remain calm while handling the child and do not raise your voice to the child."
5. "If the tantrum continues for more than a few minutes, the mother should tap the
child lightly on the behind to remind the child the consequences of misbehavior."
The school nurse recognizes that an adolescent comes from a family with limited
financial resources. The nurse is developing a nursing care plan to assist the adolescent
with his needs. An appropriate nursing diagnosis would be:
1. Altered financial support related to inadequate parental support.
2. Imbalanced nutrition: Less than body requirements related to familial financial
difficulties.
3. Knowledge deficit related to sources of financial support.
4. Risk for injury related to imbalanced nutrition.
The surgeon is discussing plans for orchiopexy with the parents of an infant born with
cryptorchidism. The parents are overwhelmed and do not hear much of the discussion.
The nurse will clarify the surgeon's explanation by discussing that the risk of
undescended testes include:
Standard Text: Select all that apply.
1. Sperm production will be affected after puberty.
2. Abdominal testes are subject to injury.
3. Abdominal testes have a higher risk of developing cancer.
4. Hormonal production will be affected.
5. The testes are at greater risk of torsion.
The nurse overhears the new parents discussing the care of the newborn. The father is
heard to say, "We want to be careful not to spoil the baby by holding him too much."
The nurse will want to provide anticipatory guidance and might respond by saying:
1. "You are so right. A spoiled baby is hard to manage. Only pick the baby up when he
needs to be fed."
2. "It is important that the baby learns to soothe himself, so wait at least 15 minutes
before you respond to his cries."
3. "When the baby cries, offer him the bottle. If that doesn"t work, put him in his bed to
cry it out."
4. "Don"t worry about spoiling the baby by holding him. You will find both the baby
and you will be better satisfied if you respond to the baby's cries quickly and soothe
him with your presence, voice, and touch.
While working at a weekend "free clinic," the nurse is assessing a three-year-old when
the mother of the child confides that it has been very difficult providing for her family
of four children on her limited budget. She is not sure that she has enough money to
buy both food for the rest of the month and the antibiotic that is needed for the child's
ear infection. Which intervention by the nurse would be most beneficial for the child
and this family?
1. Talking with the mother about keeping the child's ear clean by using a Q-tip
2. Putting the mother in contact with a local agency that provides food on a regular
basis to needy families and helps them access other resources in the community
3. Providing the mother with samples of food and food stamps for the child
4. Giving the mother free samples of an antibiotic.
A preschooler is hospitalized following an injury. The mother has been staying with the
child but now must leave to care for the other children. The mother asks the nurse what
is the best way to leave. The nurse's response will include:
Standard Text: Select all that apply.
1. Leave the child after he falls asleep so he won"t know you are going.
2. Tell the child you are leaving and identify when you will return by the child's
schedule (e.g., after you eat supper).
3. Have the mother leave an article of clothing behind.
4. Tell the nurse when she is leaving so the nurse can stay with the child while the
parents are absent.
5. Plan to leave when the child is having procedures performed as the child will be busy
and less aware of the parents' absence.
As children grow and develop, their style of play changes. Place the following
descriptions of play styles in order from infancy to school-age.
Standard Text: Click and drag the options below to move them up or down.
Choice 1. Plays beside but not with other children
Choice 2. Plays games with other children and is able to follow the rules of the game
Choice 3. Plays alone with play directed by others
Choice 4. Plays with others in loose groups
A nurse is applying a 5% permethrin lotion to a toddler with scabies. Which instruction
describes the best way to apply this lotion?
1. Apply the lotion over the entire body from the chin down, as well as on the scalp and
forehead.
2. Apply the lotion only on the areas with evidence of scabies activity.
3. Apply the lotion only to the hands.
4. Apply the lotion to the scalp only.
While changing the diaper on a newborn in the presence of the mother, the nurse notes a
belly binder wrapped around the umbilical cord. When questioned, the mother states
this is the way the umbilical area is cared for in her culture. The nurse should:
1. Accept this practice as a cultural variation and allow the mother to care for the
umbilicus.
2. Explain to the mother the risks associated with belly binders and encourage her to
remove it.
3. Remove the belly binder and discard it.
4. Replace the belly binder with a coin as a safer cultural practice.
