A nasogastric tube to suction is ordered for a child newly diagnosed with a
diaphragmatic hernia. The nurse notes that the surgeon has not ordered fluid
replacement for the NG drainage. What might occur if large amounts of gastric drainage
are noted without replacement?
1. The infant may lose weight due to loss of nutrition.
2. The infant will develop metabolic alkalosis.
3. The infant will become dehydrated.
4. The infant will develop hyperbilirubinemia.
The hospital has just provided its nurses with information about biologic threats and
terrorism. After completing the course, a group of nurses are discussing their
responsibility in relation to terrorism. The nurse who correctly understood the
presentation is the one who identifies their action to be:
1. Initiating isolation precautions for a hospitalized client with methicillin-resistant
staphylococcus aureus (MRSA).
2. Notifying the Centers for Disease Control and Prevention (CDC) if a large number of
persons with the same life-threatening infection present to the emergency department.
3. Separating clients according to age and illness to prevent the spread of disease.
4. Disposing of blood-contaminated needles in the lead-lined container.
The school nurse notices a sixth-grade girl with bald patches in her hair. The hair itself
is clean and shiny. Prior to referring the girl to her healthcare provider for alopecia, the
nurse would want to watch the child for signs of:
1. Lice.
2. Dietary imbalances.
3. Schizophrenia.
4. Trichotillomania.
The nurse who works in the newborn nursery must be alert for infants with congenital
gastrointestinal defects. Defects that might be diagnosed in the newborn nursery would
include:
Standard Text: Select all that apply.
1. Pyloric stenosis.
2. Biliary atresia.
3. Hirschsprung’s disease.
4. Umbilical hernia.
5. Diaphragmatic hernia.
A five-year-old child is on chemotherapy for rhabdomyosarcoma. Despite antiemetics,
the child complains of nausea. The mother wants the child to eat and is pushing the
child to eat the food. The nurse would talk with the mother and suggest that she not
push the food on the nauseated child because:
1. The child does not need to eat as he is on intravenous fluids.
2. Forcing the child to eat may lead to a food aversion for the child.
3. Vomiting can lead to damage to the stomach.
4. Pushing the child to eat leads to a psychological conflict that may turn the child away
from the parent.
The woman has a normal pregnancy except for polyhydramnios. The delivery goes well
and the baby is born and receives APGAR scores of seven and nine. Upon admission to
the newborn nursery, the nurse is unsuccessful in inserting a nasogastric tube. The
infant is suspected of having an esophageal atresia/tracheoesophageal fistula. While
waiting for the pediatrician to see the infant, the nurse should:
1. Position the infant in semi-Fowler position.
2. Allow the infant to be taken to the mother’s room for bonding.
3. Offer the infant formula feeding instead of breastfeeding.
4. Wrap the infant in blankets and place in a crib by the viewing window.
A child has been admitted to the hospital for treatment of otitis media. When explaining
to the mother that the child will be treated for an ear infection, the mother states: “Oh, it
is important that my child receives hot foods to help my child.” Recognizing that this is
a cultural preference and that ear infections are “cold conditions,” the nurse will include
which of the following in the child’s diet?
1. Cheese and eggs
2. Chicken and fish
3. Fresh fruits and vegetables
4. Goat meat and raisins
A child is being discharged from the hospital following treatment of asthma. Discharge
medications include cromolyn sodium (a mast cell stabilizer). Nursing instructions to
the parents about this medication would include explaining:
Standard Text: Select all that apply.
1. The medication works to prevent exacerbations.
2. The medication should be administered at the first symptom of an asthmatic attack.
3. The medication should be taken on a daily basis.
4. Avoid taking the medication if the child has symptoms of a cold.
5. The medication desensitizes the child against specific allergens.
The antiemetic drug ondansetron (Zofran) is being administered to a child receiving
chemotherapy. It should be administered:
1. Only if the child experiences nausea.
2. Before chemotherapy administration, as a prophylactic measure.
3. After the chemotherapy has been administered.
4. Never; this antiemetic is not effective for controlling nausea and vomiting associated
with chemotherapy.
A six-year-old recently diagnosed with asthma also has a peanut allergy. The nurse
instructs the family not only to avoid peanuts, but also to check food label ingredients
carefully for peanut products and to make sure dishes and utensils are adequately
washed prior to food preparation. The mother asks why this is specific for her child.
The nurse should reply that in comparison with other children, this child has a higher
risk for:
1. Urticaria.
2. Anaphylaxis.
3. Diarrhea.
4. Headache.
An infant has acute otitis media. Which of the following would be the most important
for the nurse to teach the parents?
1. Keep the baby in a flat position during sleep.
2. Administer a decongestant.
3. Place the baby to sleep with a pacifier.
4. Administer acetaminophen (Tylenol) to relieve discomfort.
The nurse is teaching the parents of a four-month-old infant about good feeding habits.
The nurse emphasizes the importance of holding the baby during feedings and not
letting the infant go to sleep with the bottle, as this is most likely to increase the
incidence of both dental caries and:
1. Aspiration.
2. Otitis media.
3. Malocclusion problems.
4. Sleeping disorders.
There has been an outbreak of tinea pedis among the high school football team. The
school nurse meets with the team and discusses preventative activities to reduce spread
of the organism. The nurse will instruct the team members to:
Standard Text: Select all that apply.
1. Wear 100% white cotton socks, changed twice a day.
2. Use talc on feet daily.
3. Use an over-the-counter corticosteroid cream to treat the area.
4. Wear foot covers such as flip flops in the locker room and shower.
5. Apply heat to the area twice a day.
A six-year-old child is in the pediatric intensive care unit (PICU) with a fractured femur
and head trauma. The child was not wearing a helmet while riding his new bicycle on
the highway, and he collided with a car. The parents appear lost and unable to take in
the medical discussion. Which nursing diagnosis is most appropriate for the parents of
this child?
1. Parental role conflict related to child’s wellness vs. illness
2. Guilt related to buying a bicycle for the child
3. Family coping: compromised, related to the critical injury of the child
4. Knowledge deficit home care of fractured femur
A toddler has been started on digoxin (Lanoxin) for cardiac failure. The nurse will teach
the parents to monitor the child for signs of digoxin (Lanoxin) toxicity including:
1. Bradycardia.
2. Tinnitus.
3. Ataxia.
4. Lowered blood pressure.
The nurse is attempting to take the blood pressure of a four-year-old child. The child is
afraid of the sphygmomanometer. Which action by the nurse will help allay the child’s
feelings of anxiety?
1. Explain to the child: “I am just going to take your blood pressure.”
2. Have the mother hold the child still while the nurse takes the blood pressure.
3. Allow the child to handle the equipment and then demonstrate how the equipment
works.
4. Tell the child: “This won”t hurt. I”ve had it done a bunch of times.”
The policy of the pediatric clinic is that head circumferences are performed at each
visit, if appropriate. The nurse should plan to check head circumferences on which of
the children being seen today?
Standard Text: Select all that apply.
1. One-month-old child who is coming for his first well-child visit
2. Two-month-old child with failure to thrive
3. Nine-month-old child with otitis media
4. 18-month-old well-child visit for a child with Down’s syndrome
The school nurse is screening all second graders for tonsillitis and pharyngitis. Which
finding is a normal finding in this age group?
1. Tonsils are large and seem to fill the throat.
2. Child is complaining of sore throat and drooling
3. White patches are observed on the tonsils.
4. Throat appears red, and child has a low-grade fever
The home health nurse visits a home with an eight-month-old baby. Which observation
is a safety issue that should be discussed with the mother?
1. The infant crib mattress has been lowered to its lowest level.
2. The mother cuts hot dogs into pieces for the baby to “gum.”
3. The cords to the window blinds have been shortened and do not hang below the
window.
4. The mother has placed infant barriers around the gas heat stove.
A three-year-old child has a brain tumor and is now dying. The child has an Allow
Natural Death order (AND order). Which of the following care and interventions are
allowed for a child with an AND order?
Standard Text: Select all that apply.
1. Oxygen
2. Suctioning
3. Use of a ventilator if respiratory failure occurs
4. Pain control
5. Cardiac compressions
The nurse is working with first-time parents. Which of these activities will the nurse
suggest to encourage the development of good muscle tone?
1. Placing the infant in an infant seat rather than lying down in a crib
2. Surrounding the infant with toys and other stimulating items to encourage motor
movement
3. Swaddling the infant
4. Putting the infant to bed each night at 8 p.m., even if the infant protests with crying
The nurse knows that the mother of a six-year-old needs more teaching about her son’s
diagnosis of ADHD when she states:
1. “I will develop a reward system for desired behaviors.”
2. “I will take my child to the physician every three months for a weight and height
check.”
3. “I will let him do his homework while he is watching his favorite television show.”
4. “I will stick to the same routine each day after school.”
The nurse is working with a child whose religious beliefs differ from those of the
general population. The best nursing intervention to use to meet the specific spiritual
needs of this child and family is to:
1. Ask, “What do you think caused the child’s illness?”
2. Show respect while allowing time and privacy for religious rituals.
3. Identify health care practices forbidden by religious or spiritual beliefs.
4. Ask, “How do the child and family’s religious and spiritual beliefs impact their
practices for health and illness?”
A seven-year-old child has been seen in the pediatric clinic three times in the last two
months for complaints of abdominal pain. On each occasion, the physical exam and all
ordered lab work have been normal. The most important information to assess at this
time would be:
1. The child’s normal eating habits.
2. Recent viral illnesses or other infectious symptoms.
3. Review of the child’s immunization history.
4. Changes in school or home life.
The nurse is preparing the hospital room for admission of a child with multiple allergies
including cow’s milk, peanuts, and latex. The nurse’s priority responsibility in preparing
for this child would include:
1. Evaluating the hospital room for equipment containing latex.
2. Ordering an EpiPen for the child.
3. Notifying dietary of the milk and peanut allergy.
4. Placing a sign on the door which identifies all allergies.
The family rushes a four-month-old infant to the hospital after finding the infant not
breathing. The child is diagnosed as a victim of sudden infant death syndrome.
Supportive care for this family would include:
1. Sheltering parents from the grief by not giving them any personal items of the infant,
such as footprints.
2. Allowing parents to hold, touch, and rock the dead infant.
3. Advising parents that an autopsy is not necessary.
4. Interviewing parents to determine the cause of the SIDS incident.
The community health nurse is making an initial visit to a family. The most effective
and efficient way for the nurse to assess the parenting style in use is to:
1. Ask the parents, “What rule is hardest for your child to obey?”
2. Ask the children what happens when they break the rules.
3. Ask the parents, “How often do you hug or kiss your children?”
4. Observe the parent interacting with the child for five minutes.
A mother brings her 22-month-old child to the well-child clinic for an evaluation. The
mother states that this child does not seem to be developing like her sister’s child of the
same age. The nurse will perform which screening test that may provide information
about the child’s development?
1. MRI of the head
2. An EEG
3. A Denver II
4. Chromosomal study
The nurse is teaching the parents of a child with idiopathic rheumatoid arthritis about
chronic pain. Which statement by the parent indicates teaching has been successful?
1. “When children have chronic pain, they may not have the same behavior as those in
acute pain.”
2. “It is associated with a single event.”
3. “Chronic pain can be managed successfully with NSAIDs.”
4. “It is sudden and of short duration.”
The parents of a child who is critically injured wish to stay in the room while the child
is receiving emergency care. The nurse should:
1. Ask the physician if the parents can stay with the child.
2. Allow the parents to stay with the child.
3. Escort the parents to the waiting room and assure them that they can see their child
soon.
4. Tell the parents that they do not need to stay with the child.
A neonatal nurse who encourages parents to hold their baby and provides opportunities
for kangaroo care most likely is demonstrating concern for which aspect of the infant’s
psychosocial development?
1. Attachment
2. Assimilation
3. Resilience
4. Centration
While assessing the blood pressure of an eight-year-old child, the nurse notes the
following: Systolic sound is heard at 98, but the sound continues until it reaches 0.
There is a distinct sound softening at 48. How should the nurse record this finding?
1. 98/48
2. 98/48/0
3. 98/0
4. 48/0
The clinic administrator has suggested that the nurse teach all children newly diagnosed
with diabetes in a single class to save nursing time. The children recently diagnosed
range in age from 6 to 15. The argument the nurse will use in to advocate for more than
one group session would be based on:
1. Freud’s theory of psychosexual development, which states that the six-year-old
child’s sexual energy is at rest while the adolescent has developed mature sexuality.
2. Erikson’s psychosocial theory, which discusses how children learn to relate to others.
3. Piaget’s cognitive development theory, which says the six-year-old learns by concrete
examples while the 15-year-old can think abstractly.
4. Kohlberg’s theory, which says the young child is conventional in his thinking and will
want to learn to please others while the older child can internalize values and will learn
for his own principles.