All of the following adolescents are in the emergency room for treatment. Which
adolescent would be an emancipated minor?
1. The 15-year-old adolescent who disagrees with the parents in regard to the medical
plan of care
2. The 14-year-old adolescent who understands the risks and benefits of treatment
3. The 17-year-old adolescent who is self-supporting and maintains her own apartment
4. The 16-year-old adolescent who ran away from home and is living with a friend
The nurse is planning postoperative care for an infant after a cleft lip repair. Which
intervention should the nurse include in this infant’s plan of care?
1. Suctioning with a tonsil tip (Yankauer) device
2. Using a pacifier to reduce straining the suture line with crying
3. Supine positioning
4. Frequent breast or bottle feeding
The nurse is giving discharge instructions to the parents of a child whose adrenal glands
have been removed due to a tumor. The nurse knows that the mother needs more
instructions when the mother states:
1. “I will call the doctor if my child has restlessness and confusion.”
2. “If my child has any gastric irritation, I will give him antacids.”
3. “If my child has vomiting and diarrhea, I will hold his hydrocortisone.”
4. “I will give my child his hydrocortisone in the morning.”
The clinic nurse has completed teaching the teenager about skin care and acne
prevention. Which statement by the teenager indicates the need for additional teaching?
1. “I shouldn”t squeeze my blackheads or pimples.”
2. “I need to watch my diet and cut out all chocolates.”
3. “I should avoid applying drying materials, such as astringents, to my face”
4. “I should wash my hands frequently and avoid touching my face.”
A mother brings her four-month-old infant in for a routine checkup and vaccinations.
The mother reports that the four-month-old was exposed to a brother who has the flu. In
this case, the nurse will:
1. Withhold the DTaP vaccination but give the others as scheduled.
2. Give the infant the flu vaccination but withhold the others.
3. Give the vaccinations as scheduled.
4. Withhold the vaccinations.
A nurse is providing information to a group of new mothers. The nurse would explain
that newborns and young infants are more susceptible to infection because they have:
1. Low levels of antibodies.
2. High levels of maternal antibodies to diseases to which the mother has been exposed.
3. Passive transplacental immunity from maternal immunoglobulin G.
4. Been exposed to microorganisms during the birth process.
An 11-year-old child tells the nurse that she is having trouble falling asleep at night.
What recommendations will the nurse make?
Standard Text: Select all that apply.
1.
“Drink a cup of warm tea at nighttime to induce sleep.”
2. “Try to follow a nighttime routine.”
3. “Avoid sleeping late in the morning or taking a nap.”
4. “Exercise 30 minutes before bedtime to tire the body out.”
5. “Darken the room at bedtime.”
A nurse is talking to the mother of an exclusively breastfed, African American infant
who is three months old and was born in late fall. The nurse would want to make sure
that this child is receiving:
1. Iron
2. Vitamin D
3. Calcium
4. Fluoride
A nurse is examining different nursing roles. Which best illustrates an advanced
practice nursing role?
1. A clinical nurse specialist with whom other nurses consult for her expertise in caring
for high-risk children
2. A clinical nurse specialist working as a staff nurse on a medical-surgical pediatric
unit
3. A registered nurse who is the circulating nurse in surgery
4. A registered nurse who is the manager of a large pediatric unit
The nurse is leading a recovery group made up of parents who have lost a child. As the
opening topic for the night’s discussion, the nurse has again reviewed information about
the grief process to the parents and talked about how different people grieve. During the
discussion phase, several fathers speak. The nurse recognizes that the father who needs
more time to understand the grief process is the father who says:
1. “I understand that everyone grieves differently.”
2. “Looking back, I realize why I became so angry when the doctors didn’t cure my
daughter.”
3. “It’s been six months since my son died, so why isn”t my wife ready to move on with
our lives?”
4. “I”m glad you described some common grief reactions. I thought I was going crazy
for a while.”
The parent of a child newly diagnosed with cancer verbalizes regret to the nurse for not
seeking earlier medical attention for the child’s symptoms. Which response would be
most therapeutic?
1. “You may feel guilty, but you should not blame yourself.”
2. “Most cancers can be treated easily.”
3. “Many types of cancer are difficult to diagnose and might not show early symptoms.”
4. “Early diagnosis is not significant in the diagnosis and management of cancer.”
The nurse is teaching a group of mothers of infants about the benefits of immunization.
The nurse will explain that the life-threatening disease epiglottitis can be prevented by
immunization against:
1. Hepatitis B.
2. Polio.
3. Measles, mumps, and rubella (MMR).
4. Haemophilus influenzae type B (HIB).
A mother says to a nurse, “I am so concerned about my 14-year-old daughter because
she has been caught stealing small articles of clothing and jewelry from stores on
several occasions.” The nurse begins a discussion on strategies for improving ethical
behavior. This plan of care is part of:
1. Moral conditioning.
2. Health maintenance.
3. Behavioral discipline.
4. Health promotion.
Which should the nurse use when reconstituting vaccines?
1. The diluents provided
2. Normal saline
3. Any solution available
4. Sterile water
While trying to inform a five-year-old girl about what will occur during an upcoming
CT scan, the nurse notices that the child is engaged in a collective monologue, talking
about a new puppy. The nurse’s best response would be:
1. “You must be so excited to have a new puppy! They are so much fun. Now let me tell
you again about going downstairs in a wheelchair to a special room.”
2. “Please stop talking about your puppy. I need to tell you about your CT scan.”
3. “I’ll come back when you are ready to talk with me more about your CT scan.”
4. Ignore the child’s responses and continue discussing the procedure.
A six-year-old postoperative patient IV has infiltrated and has to be restarted
immediately for medication. There is no time for placing local anesthetic cream on the
skin. What other complementary therapies would be most helpful when placing this IV?
1. Restraints
2. Moderate sedation
3. Anesthesia
4. Distraction
The nurse is explaining the primary purpose of performing health maintenance
activities at each pediatric visit. The best explanation touches on:
1. Planning appropriate disciplinary measures for control of behavior.
2. Reviewing developmental milestones with the parents.
3. Prevention of disease and injury.
4. Teaching growth and development to the parents.
A new pediatric hospital will open soon. While planning nursing care, the hospital
administration is considering two models of providing health care: family-focused care
and family-centered care. The best example of a nursing action in the family-centered
care approach would be when the nurse:
1. Assumes the role of an expert professional to direct the health care.
2. Encourages the parents to stay with and comfort the child during an invasive
procedure.
3. Assumes the role of a healthcare authority and intervenes for the child and family as
a unit.
4. Tells the family what must be done for the family’s health.
A premature infant is being tube fed. The physician ordered the feeding to total 120
kcal/kg/day. The infant weighs 1.86 kg. The formula contains 20 kcal per ounce. How
many ounces of formula should the infant receive per day? Round your answer to the
hundredth.
Standard Text:
A three-year-old child is lying in a fetal position. The child has pale skin, glassy eyes,
and a flat affect. The child is irritable and refuses food and fluids. The child’s vital signs
are temperature 40.1°C (104.2°F), pulse 120/minute, respirations 28/minute. The best,
most comprehensive description of this child’s condition is:
1. Tired.
2. Feverish.
3. Flushed.
4. Toxic.