Unit 2 Flashcards
1
Q
The nurse is conducting a health history for a 9-year-old childswith stomach pains. What is a recommended guideline when approaching the child for information?
A) Wear a white examination coat when conducting the interview.
abirb.com/test
B) Allow the child to control the pace and order of the health history. C) Use quick deliberate gestures to get your point across.
D) Do not make physical contact with the child during the interview
A
B
2
Q
For which children would the nurse conduct an immediateo comprehensive health history?
A) A child who is brought to the emergency room with labored breathing
abirb.com/test B) A child who is a new client in a pediatric office
C) A child who is a routine client and presents with signs of a sinus infection
D) A child whose condition is improving
A
B
3
Q
The nurse is performing a health history on a 6-year-old boy who is having trouble adjusting to school. Which question would be most likelyr to elicit valuable
information?
A) “Do you like your new school?”
B) “Are you happy with your teacher?” C) “Do you enjoy reading a book?”
D) “What are your new classmates like?”
A
D
4
Q
The nurse performing a health history on a child asks the parents if their child has
experienced increased appetite or thirst. What body system is the nurse assessing
with this question?
A) Endocrine
B) Genitourinary
C) Hematologic
D) Neurologic
A
A
5
Q
The nurse is questioning the parents of a 2-year-old child to obtain a functional
history. Which topics might the nurse include? Select all that apply.
A) The child’s toileting habits
B) Use of car seats and other safety measures C) Problems with growth and development
D) Prenatal and perinatal histories E) The child’s race and ethnicity
F) Use of supplements and vitamins
A
A B F
6
Q
The nurse is conducting a physical examination of a child following a
comprehensive health history. What should be the focus of the/physical examination?
A) The child
B) The parents
C) Chief complaint
D) Developmental age
A
C
7
Q
The nurse is teaching the student nurse how to perform a physical assessment
based on the child’s developmental stage. Which statement accurately describes a
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recommended guideline for setting the tone of the examination for a school-age
child?
A) Keep up a running dialogue with the caregiver, explaining each step as you do it.
B) Include the child in all parts of the examination; speak to the caregiver before and after the examination.
C)Speak to the childusing mature language and appeal to his or her desire for self-care. abirb.com/test
D)Address the child by name; speak to the caregiver and do the most invasive
parts last.
A
B
8
Q
Which would be least effective in gaining the cooperation of/ a toddler during a physical examination?
A) Tell the child that another child the same age wasn’t afraid.
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B) Allow the child to touch and hold the equipment when possible.
C) Permit the child to sit on the parent’s lap during the examination. D) Offer immediate praise for holding still or doing r whate was asked
A
A
9
Q
The nurse is performing a physical examination on a sleepingt newborn. Which body
system should the nurse examine last? A) Heart
B) Abdomen C) Lungs
D) Throat
A
D
10
Q
The nurse is teaching the student nurse the sequencerfor performing the assessment techniques during a physical examination. What is the appropriate
order?
A) Inspection, palpation, percussion, auscultation
B) Inspection, percussion, palpation, auscultation
C) Palpation, percussion, inspection, auscultation
D) Inspection, auscultation, palpation, percussion
A
A
11
Q
The nurse is examining the posture of a male toddler and notes lordosis. What would be the appropriate reaction of the nurse to this finding?
A) Explain that the child will need a back brace. B) Refer the toddler to a physical therapist.
C) Do nothing; this is a normal condition for toddlers.
D) Notify the primary care healthcare provider about the condition.
A
C
12
Q
The nurse is assessing the temperature of a diaphoretic.toddler who is crying and being uncooperative. What would be the best method to assess temperature in this
child?
A) Oral thermometer B) Axillary method
C) Temporal scanning D) Rectal route
A
B
13
Q
The nurse is preparing to take a tympanic temperature reading of a 4-year-old. In
order to get an accurate reading, what does the nurse need to do? A) Pull the earlobe back and down.
B) Direct the infrared sensor at the tympanic membrane. C) Pull the earlobe down and forward. D) Remove any visible cerumen from inside the ear canal.
A
B
14
Q
A mother brings her 3-year-old daughter to the emergency department because the child has been vomiting and having diarrhea for the past 36t hours. When
assessing this child’s temperature, which method would be least appropriate?
A) Oral
B) Tympanic C) Rectal
D) Axillary
A
C
15
Q
The nurse is assessing heart rate for children on thea pediatric ward. What is a
normal finding based on developmental age? A) An infant’s rate is 90 bpm.
B) A toddler’s rate is 150 bpm.
C) A preschooler’s rate is 130 bpm.
D) A school-age child’s rate is 50 bpm
A
A
16
Q
The nurse is assessing the heart rate of a healthy school-age child. The nurse expects that the child’s heart rate will be in what ranges?
A) 80 to 150 bpm B) 70 to 120 bpm C) 65 to 110 bpm D) 60 to 100 bpm
A
D
17
Q
The nurse is preparing to assess the pulse of an 18-month-old child. Which pulse
would be most difficult for the nurse to palpate?
A) Radial B) Brachial C) Pedal D) Femoral
A
A
18
Q
While auscultating the heart of a 5-year-old child, the nurse notes a murmur that is soft and quiet and heard each time the heart is auscultated. The nurse documents
this finding as what grade?
A) Grade 1 B) Grade 2 C) Grade 3 D) Grade 4
A
B
19
Q
The parents of a 2-day-old girl are concerned because her feet and hands are slightly blue. How should the nurse respond?
A) “Your daughter has acrocyanosis; this is causing her blue hands and feet.”
B) “Let’s watch her carefully to make sure she does nott have a circulatory problem.”
C) “This is normal; her circulatory system will take a few days to adjust.”
D) “This is a vasomotor response caused by cooling or warming.”
A
C
20
Q
A nurse is assessing the fontanels of a crying newborn and notes that theposterior fontanel pulsates and briefly bulges. What do these findings indicate?
A) Increased intracranial pressure B) Overhydration
C) Dehydration
D) These are normal findings
A
D
21
Q
The nurse is assessing the neck of an 8-year-old child with Down syndrome. Which finding would the nurse expect during the examination?est
A) Webbing
B) Excessive neck skin C) Lax neck skin
D) Shortened neck
A
C
22
Q
The nurse is conducting a routine health assessment of a 3-month-old boy and
notices a flat occiput.The nurse provides teaching and emphasizes the importance of
tummy time. Which response by the mother indicates a need for further teaching? A) “I should have him sleep on his tummy.”
B) “I need to watch him during his tummy time.”
C) “I need to change his head position while he isbin an t upright chair.” D) “His head has flattened due to the pressure of his head position.”
A
A
23
Q
The nurse is measuring the blood pressure of a 12-year-old boy with an oscillometric device. The boy’s reading is greater than ther90thepercentile for gender
and height. What is the appropriate nursing action?
A) Repeat the reading with the oscillometric device..com/test B) Repeat the blood pressure reading using auscultation.
C) Measure the blood pressure in all four extremities.m/test D) Measure the blood pressure with a Doppler.
A
B
24
Q
.The nurse is inspecting the fingernails of an 18-month-old girl. What finding
indicates chronic hypoxemia?
A) Nails that curve inward B) Clubbing of the nails
C) Nails that curve outward D) Dry, brittle nails
A
B
25
The nurse is using pulse oximetry to measure oxygen saturation in a 3-year-old
girl. The nurse understands that falsely high readings may be associated with which situation or condition?
A) A nonsecure connection B) Cold extremities
C) Hypovolemia D) Anemia
D
26
Assessment reveals that a child weighs 73 lb and is 4 ft 1 in tall. The nurse
calculates this child’s body mass index as: A) 19.1
B) 20.7 C) 21.4 D) 24.5
C
27
The nurse is teaching the student nurse about abnormal findings when assessing the breasts of children. What may be associated with renalcdisorders?
A) Swollen nipples upon inspection of a newborn’s breasts
B) Tender nodule palpated under the nipple of a 10-year-old
C) Observation of enlarged breast tissue in a male adolescent
D) Observation of a supernumerary nipple along the mammary ridge
D
28
The nurse is inspecting the genitals of a prepubescent girl. Which is a normal sign
of the onset of puberty?
A) Appearance of pubic hair around 11 to 13 yearsr old /test
B) Swelling or redness of the labia minora C) Presence of labial adhesions
D) Lesions on the external genitalia
A
29
A teenage client tells the nurse that she is being abused by her boyfriend, but she
doesn’t want her parents to know because they won’t let i her see him any longer. What is the best response by the nurse?
A) “It’s my responsibility to tell your parents if you are in danger.”
B) “I understand your fear, but I am obligated to be sure your parents know
you are in danger. Would you like for us to talk to them together?”
C) “I won’t tell them this time, but Imust inform you .that legally I must inform your parents if abuse is occurring. Next time it happens, I will have to tell
them.”
D) “You need to tell them because the abuse isn’t going to get any better. It
will only escalate no matter what your boyfriend says.”
B
30
The nurse is collecting information from the parents of a 3-year-old child about her sleeping patterns. Which question by the nurse will best elicit information from the parents?
A) “How are things going at home?”
B) “Is your child sleeping well at night?”
C) “How many hours does your child sleep at night?”
D) “What time does your child go to bed at night?”
C
31
The nurse educator working in the emergency room monitors the admission of children. For which admission diagnosis, should the nursebeducator encourage the emergency room staff to be the most prepared?
A) Mental health problems
B) Injuries
C) Respiratory disorders
D) Gastrointestinal disorders
B
32
The nurse is caring for a 7-year-old girl hospitalized in isolation. The nurse notices that she has begun sucking her thumb and changing her speech patterns to those of
a toddler. What condition is the girl manifesting?
A) Regression
B) Suppression
C) Repression
D) Denial
A
33
The nurse is caring for an 8-year-old boy hospitalized forr a bonemarrow transplant. His parents are in and out of his room throughout the day. Which behaviors of the child would alert the nurse that he is in the second stagei of separation anxiety?
A) He ignores his parents when they return to his room.
B) He cries uncontrollably whenever they leave.
C) He forms superficial relationships with his caregivers.
D) He sits quietly and is uninterested in playing and eating.
D
34
The nurse is caring for a 4-year-old girl who has beenahospitalized for over a week with severe burns. Which would be a priority intervention to help satisfy this preschool child’s basic needs?
A) Encourage friends to visit as often as possible.
B) Suggest that a family member be present withbher 24s hours a day.
C) Explain necessary procedures in simple language that she will understand.
D) Allow her to make choices about her meals and activities as much as
permitted.
C
35
The nurse is caring for a hospitalized 13-year-old girl, who is questioning everything the medical staff is doing and is resistant to treatment. How should the nurse respond?
A) “Let's work together to plan your day along with your treatments.”
B) “The sooner you cooperate, the sooner you arei going to leave.”
C) “If you are more cooperative, perhaps we can arrange a visit from friends.”
D) “Please don't make me call your parents about this.”
A
36
The nurse is caring for a 10-year-old boy who is in traction. The boy has a nursing diagnosis of deficient diversional activity related to confinement in bed that is evidenced by verbalization of boredom and lack of participation in play, reading, and schoolwork. What would be the best intervention?
A) Offer the child reading materials.
B) Enlist the aid of a child life specialist.
C) Encourage the child to complete his homework.rb.com/test
D) Ask for the parents' assistance.
B
37
The nurse is caring for a 13-year-old girl hospitalized for complications from type 1
diabetes. The girl has a nursing diagnosis of powerlessness related to lack of control
of multiple demands associated with hospitalization, procedures, treatments, and
changes in usual routine. How can the nurse help promote control?
A) Ask the child to identify her areas of concern.
B) Encourage participation of parents in care activities.
C) Offer the girl as many choices as possible.
D) Enlist the family's assistance in creating a timei schedule.
C
38
The nurse is caring for an 8-year-old girl who requires numerousvenipunctures and
injections daily. The nurse understands that the child is exhibiting signs of sensory
overload and enlists the assistance of the child life specialist. What should the
therapeutic play involve to best deal with the child’s stressors?
A) Puppets and dolls
B) Drawing paper and crayons
C) Wooden hammer and pegs
D) Sewing puppets with needles
D
39
After teaching a group of students about therapeutic play, the instructor
determines that additional teaching is needed when the students identify what as a
characteristic of therapeutic play?
A) Focus on coping
B) Use of a highly structured format
C) Dramatization of emotions
D) Expression of feelings
B
40
The mother of a hospitalized child reports that her daughter, who is having some
difficulty eating, just had a 4-ounce cup of ice chips. The nurse documents this on the
child's intake flow sheet as how much?
A) 2 ounces
B) 4 ounces
C) 6 ounces
D) 8 ounces
A
41
.The nurse is preparing a nursing care plan for a childbhospitalized for cardiac surgery. Which are examples of interventions that nurses perform in the “building a trusting relationship” stage? Select all that apply.
A) Gathering information about the child using the child’s own toys
B) Preparing the child for a procedure by playing gamesest
C) Explaining in simple terms what will happen during surgery
D) Allowing the child to devise an exercise plan following surgery
E) Praising the child for how well he is doing following instructions
F) Giving the child a favorite toy to cuddle following a painful procedure
B C
42
The nurse is preparing a hospitalized 7-year-old girl for a lumbar puncture. Which
actions would help reduce her stress related to the procedure? Select all that apply.
A) Pretend to perform the procedure on her doll.
B) Explain the procedure to her in medical terms.
C) Do not allow her to see or touch the equipment.
D) Teach her the steps of the procedure.
E) Tell her not to pay attention to any sounds she might hear.
F) Introduce her to the health care personnel.
A D F
43
The nurse is completing an admission of a 10-year-old boy. Which actions will help the nurse establish a trusting and caring relationship with the child and his family? Select all that apply.
A) The nurse should not minimize the child’s fears by smiling.
B) The nurse should initiate introductions.
C) The nurse should not use formal titles at the introduction.
D) The nurse should maintain eye contact at the appropriate level.
E) The nurse should start communication with the child first and then move on
to the family.
F) The nurse should use age-appropriate communication with the child.
B D F
44
The nurse is caring for an 11-year-old girl preparingato undergo a magnetic resonance imaging (MRI) scan. Which statement would best help prepare the girl for the diagnostic test and decrease anxiety?
A) “You won’t hear a sound if you wear your headphones.”
B) “The machine makes a very loud rattle; however,c headphones will help.”
C) “There are a variety of loud sounds you will hear.”
D) “The MRI scanner sounds like a machine gun.”
B
45
The nurse is caring for a 10-year-old girl who is in an isolation room. Which intervention would be a priority intervention for this child?om/test
A) Reduce noise as much as possible.
B) Provide age-appropriate toys and games.
C) Discourage visits from family members.
D) Put on mask prior to entering the room.
B
46
An adolescent is scheduled for outpatient arthroscopic surgery on his knee next week. As part of preparing him for the procedure, which action would be most appropriate?
A) Discussing the events with the adolescent and his mother upon arrival the
morning of the procedure
B) Providing detailed explanations of the procedurerat least a week in advance
of the procedure
C) Encouraging the parent to stay with the adolescent as much as possible
before the procedure
D) Answering the adolescent’s questions with simple answers, encouraging
him to ask the surgeon
B
47
The nurse is providing developmentally appropriate care for a toddler hospitalized for observation following a fall down the steps. Which measurest might the nurse consider when caring for this child? Select all that apply.
A) Use the en face position when holding the toddler. m/test
B) Use a bed for toddlers who have an adult present.
C) Avoid leaving small objects that can be swallowed in the bed.
D) Explain activities in concrete, simple terms.
E) Allow the child to select meals and activities.
F) Encourage parents to stay to prevent separation anxiety.
C F
48
.The nurse isordered to apply restraints to a toddler who keepspulling at the tubes in his arm. Which criteria must occur to ensure proper use of these restraints? Select all that apply.
A) The nurse must check the restraints every 15 minutest while they are in
place.
B) Secure the restraints with ties to the side rails, not the bed or crib frame.
C) Assess the temperature of the affected extremities, pulses, and capillary refill every 15 minutes after placement.
D) Use a clove-hitch type of knot to secure the restraints with ties.
E) Remove the restraint every 2 hours to allow for range of motion and
repositioning.
F) Encourage parent participation, providing continuous explanations about
the reasons and time frame for restraints.
D E F
49
The nurse is caring for a 7-year-old boy who needs his left leg immobilized. What is the priority nursing intervention?
A) Enlist the assistance of a child life specialist.
B) Explain to the boy that he must keep his leg very still.
C) Apply a clove-hitch restraint to the boy's left leg..com/test
D) Explain that a restraint will be applied if he cannot hold still
B
50
The nurse is transporting a 6-month-old with a suspected blood disorder to the
nursery. What is themostappropriatemethod of transporting the child by the nurse?
A) A wagon with rails
B) Cradle hold
C) A crib with rails
D) Over-the-shoulder
D
51
.The nurse is caring for an immunosuppressed 3-year-old girl and is providing teaching to the mother about proper oral hygiene. Which r response from the mother indicates a need for further teaching?
A) “I really need to carefully check for skin breakdown.”est
B) “I must really scrub her teeth and gums well.”
C) “I must use a soft toothbrush.”
D) “I can use a soft gauze sponge to care for her gums.”
B
52
When preparing to apply a restraint to a child, what would be most important for the nurse to do?
A) Expect to keep the restraint on for at least 8 hours.
B) Explain that safety, not punishment, is the reason for the restraint.
C) Plan to use a square knot to secure the restraint to the side rails.
D) Use a limb restraint rather than a jacket restraint for most issues.
B
53
The nurse is providing discharge planning for a 12-year-old boy with multiple medical conditions. What would be the best teaching method for this child and his family?
A) Demonstrate the care and ask for a return demonstration.
B) Provide and review educational booklets and materials.
C) Provide a written schedule for the child’s care.
D) Provide a trial period of home care.
D
54
The nurse is working as a community health care nurse. What would be the nurse's focus when providing care of the child?
A) Providing care to the individual and family in acute care settings
B) Providing care to the indigent in family care settings
C) Providing care in geographically and culturally diverse settings
D) Providing care for particular age groups or particular diagnoses
C
55
The nurse working in community nursing uses epidemiologys as a tool. What
information can be obtained using this process?
A) Health needs of a population
B) Cultural needs of a population
C) Income levels of a population
D) Mortality rates of a population
A
56
When speaking to a group of parents at a local elementary school, the nurse
describes school nursing as a specialized practice of nursing based on the fact that a
healthy child has a better chance to succeed in school. What best describes the
strategy school nurses use to achieve student success?
A) They coordinate all school health programs.
B) They link community health services.
C) They work to minimize health-related barriers to learning.
D) They promote student health and safety.
C
57
The nurse referring a child to home care services discusses the advantages and
disadvantages with the child's family. What are disadvantages of this method of health care? Select all that apply.
A) The nurse is performing care of the child in the family's home.
B) The home care nurse is not always equipped to perform technical care.
C) The out-of-pocket cost of home care is more expensive.
D) The technical procedures may be overwhelming for the family.
E) The financial burden may cause more stress for rthe family.
F)The child does not receive continuity of care provided in the hospital setting.
A C D E
58
The nurse working with children in a hospital setting notes that they are being
discharged earlier and earlier. Which is a primary reason i for this trend?
A) Nursing shortages
B) Increased funding for home care
C) National healthcare initiatives
D) Cost containment
D
59
The nurse caring for a child on a pediatricintensive care unit notices that when the parents go to work the child is very angry and cries easily. What does the nurse suspect is occurring with this client?
A) Protest phase of separation anxiety
B) Regressive behavior
C) Detachment from the parents
D) Despair
A
60
The nurse is teaching a group of parents with premature.infants about the various medical and developmental problems that may occur. The nurse determines that
additional teaching is needed when the group identifies what as a problem?
A) Sudden infant death syndrome
B) Hydrocephalus
C) Peptic ulcer
D) Bronchopulmonary dysplasia
C
61
The nurse is caring for a toddler with special needs. Which developmental tasks
related to toddlerhood might be delayed in the child with special needs?
A) Developing body image
B) Developing peer relationships
C) Developing language and motor skills
D) Learning through sensorimotor exploration
C
62
The nurse is providing home care for a 1-year-old girl who is technologically
dependent. Which intervention will best support the family process?
A) Finding an integrated health program for the family /test
B) Teaching modifications of the medical regimen for vacation
C) Assessing family expectations for the special needs child
D) Creating schedules for therapies and interventions
D
63
The nurse is caring for families with vulnerable child syndrome. Which situation would be most likely to predispose the family to this condition?t
A) Having a postterm infant
B) Having an infant who is reluctant to feed properly
C) Having a child diagnosed with impetigo at age 10
D) Having a child with juvenile diabetes
B
64
A 7-year-old boy has reentered the hospital for the second time in a month. Which
intervention is particularly important at this time?
A) Assessing his parents’ coping abilities
B) Seeking his parents’ input about their child’s needs
C) Educating his family about the procedure
D) Notifying the care team about his hospitalization.com
A
65
The nurse is caring for a special needs infant. Which intervention will be most
important in helping the child reach his or her maximum developmental potential?
A) Directing her parents to an early intervention program
B) Monitoring her progress in elementary school
C) Serving on an individualized education program committee
D) Preparing a plan for her to transition to college
A
66
The nurse is caring for a 4-year-old girl with special care needs in the hospital. Which intervention would have the most positive effect on cthis child?
A) Taking her on an adventure down the hall
B) Helping her do a simple craft project
C) Introducing her to children in the playroom
D) Limiting the staff providing care for her
A
67
The nurse iscaring for infants with failure to thrive (FTT).Which infants would be at
risk for this condition? Select all that apply.
A) A newborn baby with tetralogy of Fallot
B) An infant with a cleft palate
C) An infant born to a diabetic mother
D) An infant born to an impoverished mother
E) An infant with bronchopulmonary dysplasia
F) An infant born to a teenage mother
A B D E
68
The nurse is weighing an underweight infant diagnosedi with tfailure to thrive (FTT) and notes that the baby does not make eye contact and is less active than the other
infants. What would be a probable cause for the FTT related to the infant’s body language?
A) Congenital heart defect
B) Cleft palate
C) Gastroesophageal reflux disease
D) Maternal abuse
D
69
Which would be least appropriate to include in the discharge plan for a medically fragile child?
A) Assisting with referrals for financial support
B) Arranging for necessary care equipment and supplies
C) Assessing the family's home environment
D) Encouraging passive caregiving
D
70
The nurse is looking into the Individuals with Disabilities Education Improvement Act of 2004 to help provide resources for a client with multiple chronic diseases. What are mandates of this legislation? Select all that apply.
A) The law mandates government-funded care coordination and special
education for children up to 8 years of age.
B)Thisearly intervention program is a state-funded program run at the federal
level.
C) This federal law allows each state to define “developmental disability”
differently.
D) An evaluation of the child’s physical, language,i emotional, and social
capabilities is performed to determine eligibility.
E) The primary care nurse manages the developmental/ services and special
education that the child requires.
F) The goal is to maintain a natural environment, so most services occur in the
home or day care center.
C D F
71
The nurse is reviewing the Adolescent Health Transition cProject's recommended schedule for transition planning. According to the schedule, at what age should the
nurse explore healthcare financing for young adults?
A) 12 years old
B) 14 years old
C) 17 years old
D) 19 years old
C
72
The nurse is caring for a 14-year-old girl with special health needs. What is the priority intervention for this child?
A) Encouraging the parents to promote the child's self-care
B) Assessing the child for signs of depression
C) Discussing how her care will change as she growsom
D) Monitoring for compliance with treatment
D
73
The nurse is helping a 20-year-old woman transition to adult care. Which would be
the most important role of the nurse following a successful transition?
A) Teacher
B) Consultant
C) Care provider
D) Advocate
B
74
The nurse caring for young children in a hospice setting is aware of the following
statistics related to the occurrence of death in children. Which statement accurately
reflects one of these statistics?
A) Each year, about 50,000 children die in the United States; of those, about
15,000 are infants.
B)It is unusual for a child's chronic illness to progress totthe point of becoming
a terminal illness.
C) Despite strides made, diabetes remains the leading cause of death from
disease in all children older than the age of 1 year.
D) Congenital defects and traumatic injuries are the. more common causes of
diseases leading to death.
D
75
The nurse is providing home care for the family of an 8-year-old boy who is dying
of leukemia. Which action will be most supportive to the parents of the child?
A) Encouraging organ and tissue donation
B) Being patient with parental indecision
C) Getting prior authorization for treatments
D) Explaining how anorexia is a natural process
B
76
The nurse is providing palliative care for a 9-year-old boy in hospice. Which is
unique to hospice care for children?
A) Encouraging visits from friends and family
B) Educating parents about terminal dehydration
C) Prolonging treatment that might possibly help
D) Treating constipation to relieve abdominal pain.com
C
77
When providing care to a dying child and his family, which would be most
important?
A) Focusing on the family as the unit of care
B) Teaching the family appropriate care measures
C) Offering the child support and encouragement
D) Assisting the parents in decision making
A
78
Theparents ofan 11-year-old boy who is dying from cancer are concerned that he
is not eating. Which intervention would serve both the parents' and child's needs?
A) Urging the child to eat one good meal per day b.com
B) Serving small meals of things the child likes
C) Straightening up around the child before meals.com
D) Administering antiemetics as ordered for nausea
B
79
The nurse is caring for a child involved in an automobile accident whose family has been informedthat the child is brain dead.What teachingmight the nurse provide the family regarding organ donation?
A) The nurse should ask about organ donation when the family is informed of
their child's condition.
B) The nurse should explain that written consent is necessary for the organ
donation.
C) The nurse should make sure the parents know that procurement of organs
may mar their child's appearance.
D) The nurse should make sure the parents know that they will be responsible
for expenses related to organ procurement.
B
80
The nurse is caring for a preschool child who is receiving palliative care for
end-stage cancer. What would be the focus of age-appropriate interventions for this child?
A) Providing unconditional love and trust
B) Providing a familiar and consistent routine
C) Teaching the child that death is not punishment
D) Providing specific, honest details of death
C
81
The nurse is caring for a 5-year-old boy who is terminally ill.t Which intervention
would best meet the needs of this dying child?
A) Offer the child decision-making opportunities.
B) Provide the child with specific details.
C) Assure the child that he did nothing wrong.
D) Act as a confidant for the child's concerns.
C
82
.What would the nurse include in the plan of care for a r dyingschild with pain?
A) Administering analgesics as needed
B) Using measures the nurse finds comforting
C) Playing the television or radio so the child can hear it
D) Changing the child's position frequently but gently
D
83
When describing organ donation to the family of a dying child, what would the
nurse include in the discussion?
A) Telling them that further harm may occur to the child through the process
B) Tell them that their cultural and religious beliefs will be considered
C) Including this topic in the discussion of impending death
D) Informing the family that organ donation will delay the funeral
B
84
.A child is admitted to the hospital with a spinal cord injury resulting in paralysis
below the level of the waist. When should the nurse begin planning with the parents
for rehabilitation placement for this child after acute hospitalization?
A) After hospitalization when the parents are ready
B) As soon after the patient is admitted as possible
C) When the child starts showing improvement in their condition
D) Once the child and the parent feel it is time to seek extended care
B
85
The parents of a child with a developmental disability tell the nurse that they feel
guilty because they sometimes find themselves feeling sad.and wondering how their child would be without the disability. Which response by the nurse best shows
empathy and encourages the parents to vent their feelings?
A) “I'm sure it must be difficult to have a child developmentally delayed.”
B) “There are lots of parents that are experiencing the difficulty and feelings of hopelessness and grief you're having. Maybe if you talk to someone it might
help you both.”
C) “I can only imagine how hard it is for you. You should know that it is
common for parents to have these feelings when having a child with special needs.”
D) “It's important to focus on the positives that can come from the experience of being the parents of a child that has these issues.”m
C
86
The parents of a child with physical and developmental special needs state, “We
wish our child could get some kind of educational experience.” How should the nurse respond?
A) “This must be difficult for you. Let's talk with the social worker to see what programs are available for your child.”
B)“I am sure it must be difficult toknow that your child will never be able to go to school like other children.”
C) “Since all children can attend school regardless of their special need, I
suggest you talk with your local school about enrolling your child.”
D) “It would be very difficult for your child to attend school with all of their
disabilities. It's unfortunate, but it is reality.”
A
87
The nurse is meeting with the parents of a 7-year-old boy with Down syndrome. The child's mother reports an interest in hippotherapy. The child's father reports that this seems to be a waste of money. The parents then ask the nurse for additional
information. What information may be included in the nurse's/ response? Select all that apply.
A) Hippotherapy has limited research demonstrating citst actual effectiveness.
B) This type of therapy is most helpful for teens.
C) A variety of conditions including Down syndrome. havet used hippotherapy
with success.
D) Self-esteem may be improved with hippotherapy.om
E) The benefits of hippotherapy are both physical and psychological
C D E
88
The mother of a 7-year-old boy with autism tearfully reports feeling as if she is not
qualified to care for her child. Which initial action by the nurse is most appropriate?
A) Tell the child's mother that this is a common feeling when caring for a
special needs child.
B) Encourage the child's mother to keep a journal to best identify areas
needing improvement in the home routine.
C) Recognize the mother's positive accomplishments in caring for her child.
D) Recommend the child's mother seek counseling.
C
89
The nurse is reviewing the therapist's documentation in cthe medical record of an assigned client who has cerebral palsy. The therapist has noted the parents may be
experiencing vulnerable child syndrome. Which observation oft the family unit best supports this potential diagnosis?
A) The parents regularly attend a support group for parents of special needs
children.
B) The child has been diagnosed with pneumonia twice/ int the past year.
C) The parents report they feel their child requires more therapy than the care
team has indicated will be needed.
D) The child is schooled at home with a private tutor.
C
90
The nurse is teaching the student nurse the physiology involved in pain transmission. Which statements accurately describe a physiologic event in the nervous system related to pain transmission? Select all that apply.
A) Thermal stimulation may involve the release ofimediators, such as histamine, prostaglandins, leukotrienes, or bradykinin.
B) When nociceptors are activated by noxious stimuli, the stimuli are
converted to electrical impulses that are relayed to the spinal cord and brain.
C) Myelinated A-delta fibers are large fibers that conduct the impulse at very
rapid rates; unmyelinated small C fibers transmit the impulse slowly.
D) Once in the dorsal horn of the spinal cord, theanerve/fibers divide and then
cross to the opposite side and rise upward to the thalamus.
E) The point at which the person first feels the highest intensity of the painful
stimulus is termed the pain threshold.
F) Peripheral sensitization allows the nerve fibers to react to a stimulus that is
of lower intensity than would be needed to cause pain.
B C D F
91
The nurse is managing children who have chronic diseases in a neighborhood clinic.
What are some examples of chronic conditions? Select all that apply.
A) Diabetes mellitus
B) Myocardial infarction
C) Rheumatoid arthritis
D) Compound fracture
E) Acute asthma
F) Bronchopneumonia
a c e
92
The nurse is caring for a child who is recovering from an appendectomy.What is the
appropriate term for the pain this child is experiencing?
A) Nociceptive pain
B) Neuropathic pain
C) Chronic pain
D) Superficial somatic pain
A
93
The nurse is conducting an assessment of a high school tracks athlete. The client tells the nurse he is experiencing pain along his outer thigh. He describes it as tight, achy, and tender, particularly after he runs. The nurse understands that he is most likely experiencing what kind of pain?
A) Cutaneous
B) Neuropathic
C) Visceral
D) Deep somatic
D
94
The nurse is caring for a child who is experiencing pain related to chemotherapy
treatment. What is a behavioral factor that might affect the child's pain experience?
A) Knowledge of the therapy
B) Fear about the outcome of therapy
C) Participation in normal routine activities
D) Ability to identify pain triggers
C
95
The nurse caring for infants in the neonatal intensive care unit (NICU) relies on the
use of behavioral and physiologic indicators for determiningopain. Which examples are behavioral indicators? Select all that apply.
A) The infant grimaces.
B) The infant's heart rate is elevated.
C) The infant flails his arms and legs.
D) The infant's respiratory rate is elevated.
E) The infant is crying uncontrollably.
F) The infant's oxygen saturation is low
A C E
96
A nurse is providing teaching to the mother of an adolescent girl about how to
manage menstrual pain nonpharmacologically. Which statement by the mother indicates a need for further teaching?
A) “I need to help her learn techniques to distract her; card games, for example.”
B) “I need to be able to identify the subtle ways she shows pain.”
C) “I need to follow these instructions exactly for them to work properly.”
D) “I need to encourage her to practice and utilizei these techniques.”
C
97
The nurse is counseling the parents of a 9-year-old boyrwhotis receiving morphine for postoperative pain. Which statement from the nurse accurately reflects the pain experience in children?
A) “You can expect that your child will tell you when he is experiencing pain.”
B) “Your child will learn to adapt to the pain he is experiencing.”
C) “Your child will experience more adverse effects to narcotics than adults.”
D) “It is very rare that children become addicted to narcotics.”
D
98
The nurse is using the acronym QUESTT to assess the pain of a child. Which is an
accurate descriptor of this process?
A) Question the child's parents.
B) Understand the child's pain level.
C) Establish a caring relationship with the child.
D) Take the cause of pain into account when intervening
D
99
When the nurse is assessing a child's pain, which action by the nurse is most
important?
A) Obtaining a pain rating from the child with each assessment
B) Using the same tool to assess the child's pain each time
C) Documenting the child's pain assessment
D) Asking the parents about the child's pain tolerancem
B
100
Which tool would be the least appropriate scale for the nurse to use when
assessing a 4-year-old child's pain?
A) FACES pain rating scale
B) Oucher pain rating scale
C) Poker chip tool
D) Numeric pain intensity scale
D
101
The nurse uses the FLACC behavioral scale to assess a 6-year-old’s level of postoperative pain and obtains a score of 9. The nurse interprets this to indicate that the child is experiencing:
A) little to no pain.
B) mild pain.
C) moderate pain.
D) severe pain
D
102
The nurse is assessing the pain of a postoperative newborn. The nurse measures the infant's facial expression, body movement, sleep, verbal or vocal ability, consolability, and response to movements and touch. Which behavioral assessment
tool is being used by the nurse?
A) Riley Infant Pain Scale
B) Pain Observation Scale for Young Children
C) CRIES Scale for Neonatal Postoperative Pain Assessment
D) FLACC Behavioral Scale for Postoperative Pain in Young Children
A
103
The nurse tells a joke to a 12-year-old to distract himrfromea painful procedure.
What pain management technique is the nurse using?
A) Relaxation
B) Distraction
C) Imagery
D) Thought stopping
B
104
The nurse is providing instructions to a mother on how rtoouset thought stopping to help her child deal with anxiety and fear associated with frequent painful injections. Which statement indicates the mother understands the technique?
A) “We will imagine that we are on the beach in Florida.”
B) “We can talk about our favorite funny movie and .laugh.”
C) “She can let her body parts go limp, working from head to toe.”
D) “We'll repeat ‘quick stick, feel better, go home soon’ several times.”
D
105
The student nurse is learning about the effects of heat and cold when used in a
pain management plan. What accurately describes one of these effects?
A) Cold results in vasodilation.
B) Cold alters capillary permeability.
C) Heat results in vasoconstriction.
D) Heat decreases blood flow to the area
B
106
The nurse is teaching an 8-year-old child and his familychow t to manage cancer pain using nonpharmacologic methods. Which parent statement signifies successful child teaching?
A) “I will avoid using descriptive words like pinching, pulling, or heat.”
B) “I will not use positive reinforcement until theatechnique is perfected.”
C) “I will begin using the technique before he experiences pain.”
D) “I will be honest and tell him that the procedure will hurt a lot.”
C
107
For which child would nonopioid analgesics be recommended?
A) A child with juvenile arthritis
B) A child with end-stage cancer
C) A child with a broken arm
D) A child with severe postoperative pain
A
108
Prior to administering morphine to a 10-year-old child, the nurse reviews the adverse effects of the drug. Which system is primarily affected by the drug, causing most of the adverse effects?
A) Central nervous system
B) Peripheral nervous system
C) Digestive system
D) Musculoskeletal system
A
109
The nurse is administering pain medication to a child with continuous pain from internal injuries. Which method would be ordered to dispense/ the medication?
A) Administer the medication PRN (as needed).
B) Administer the mediation when pain has peaked.
C) Administer the medication around the clock at timedt intervals.
D) Administer the medication when the child reports pain.
C
110
The nurse has applied EMLA cream as ordered. How does the nurse assess that
the cream has achieved its purpose?
A) Assess the skin for redness.
B) Note any blanching of skin.
C) Lightly tap the area where the cream is.
D) Gently poke the child with a needle
C
111
The nurse is preparing to administer a topical anesthetic for / a 10-year-old girl with a chin laceration. The nurse would expect to apply which medication as ordered in preparation for sutures?
A) TAC (tetracaine, epinephrine, cocaine)
B) Iontophoretic lidocaine
C) EMLA
D) Vapocoolant spray
A
112
The nurse is caring for a child who reports chronic pain. What is the priority nursing assessment?
A) How the pain impacts the child's and family's stress level
B) The pain's history, onset, intensity, duration, and location
C) The child's and parents' feeling of anxiety and depression
D) The child's cognitive level and emotional response
B
113
The nurse is monitoring a child who has received epidural analgesia with
morphine. The nurse is careful to monitor for which adverse effect of the medication?
A) Epidural hematoma
B) Arachnoiditis
C) Spinal headache
D) Respiratory depression
D
114
The nurse is providing teaching to the parents of a newborn prior to a heelstick. The nurse is describing the procedure and recommending various methods for the parents to help comfort their baby. Which statement by the parents indicates a need for further teaching?
A) “It's better if we are not in the room for this.”
B) “We can use kangaroo care before and after.”
C) “We hope you are using a very tiny needle.”
D) “We can offer him nonnutritive sucking to calm him.”
A
115
The nurse is conducting a pain assessment of a 10-year-old boy who has been
taking acetaminophen for chronic knee pain. The assessment indicates that the
recommended dose is no longer providing adequate relief. What is the appropriate
nursing action?
A) Increase the dosage of the acetaminophen.
B) Tell the child he is experiencing the ceiling effect.
C) Use guided imagery to help his pain.
D) Obtain an order for a different medication.
D
116
The nurse is preparing a child for a lumbar puncture. How far ahead of the
procedure should the nurse apply the EMLA cream?
A) 30 minutes
B) 1 hour
C) 3 hours
D) 4 hours
C
117
The nurse is explaining the effects of heat application foropain relief. Which effect
would the nurse be likely to include?
A) Decreased blood flow to the area
B) Increased pressure on nociceptive fibers
C) Possible release of endogenous opioids
D) Altered capillary permeability
B
118
Pentazocine is prescribed for a child with moderate pain. Thet nurse identifies this
drug as an example of which type?
A) Nonsteroidal anti-inflammatory drug (NSAID)
B) Prostaglandin inhibitor
C) Opioid
D) Mixed opioid agonist–antagonist
D
119
The nurse is researching behavioral-cognitive pain relief strategies to use on a
5-year-old child with unrelieved pain. Which methods might the nurse choose?Select
all that apply.
A) Relaxation
B) Distraction
C) Thought stopping
D) Massage
E) Sucking
A B C
120
