Drill 6

1. Andrea with suspected rheumatic fever is admitted to the pediatric unit. When obtaining the childs history, the nurse considers which information to be most important? a. A fever that started 3 days ago b. Lac of interest in food c. A recent episode of pharyngitis d. !omiting for " days ". #urse Li$a is administering a medication via the intraosseous route to a child. %ntraosseous drug administration is typically used when a child is& a. 'nder age 3 b. (ver age 3 c. )ritically ill and under age 3 d. )ritically ill and over age 3 3. a. b. c. d. When assessing a childs cultural bac ground, the nurse in charge should eep in mind that& )ultural bac ground usually has little bearing on a familys health practices *hysical characteristics mar the child as part of a particular culture +eritage dictates a groups shared values ,ehavioral patterns are passed from one generation to the ne-t

.. While e-amining a "/year/old child, the nurse in charge sees that the anterior fontanel is open. 0he nurse should& a. #otify the doctor b. Loo for other signs of abuse c. 1ecogni$e this as a normal finding d. As about a family history of 0ay/2achs disease 3. a. b. c. d. 4. a. b. c. d. 0he nurse is aware that the most common assessment finding in a child with ulcerative colitis is& %ntense abdominal cramps *rofuse diarrhea Anal fissures Abdominal distention When administering an %.5. in6ection to an infant, the nurse in charge should use which site? 7eltoid 7orsogluteal !entrogluteal !astus lateralis

8. A child with a poor nutritional status and weight loss is at ris for a negative nitrogen balance. 0o help diagnose this problem, the nurse in charge anticipates that the doctor will order which laboratory test? a. 0otal iron/binding capacity b. +emoglobin c. 0otal protein d. 2erum transferring 9. When developing a plan of care for a male adolescent, the nurse considers the childs psychosocial needs. 7uring adolescence, psychosocial development focuses on& a. ,ecoming industrious b. :stablishing an identity c. Achieving intimacy d. 7eveloping initiative ;. When developing a plan care for a hospitali$ed child, nurse 5ica nows that children in which age group are most li ely to view illness as a punishment for misdeeds? a. %nfancy b. *reschool age c. 2choll age d. Adolescence 1<. #urse 0aylor suspects that a child, age ., is being neglected physically. 0o best assess the childs nutritional status, the nurse should as the parents which =uestion? a. >+as your child always been so thin?? b. >%s your child a pic y eater?? c. >What did your child eat for brea fast?? d. >7o you thin your child eats enough??

11. A female child, age ", is brought to the emergency department after ingesting an un nown number of aspirin tablets about 3< minutes earlier. (n entering the e-amination room, the child is crying and clinging to the mother. Which data should the nurse obtain first? a. +eart rate, respiratory rate, and blood pressure b. 1ecent e-posure to communicable diseases c. #umber of immuni$ations received d. +eight and weight 1". A mother as s the nurse how to handle her 3/year/old child, who recently started wetting the pants after being completely toilet trained. 0he child 6ust started attending nursery school " days a wee . Which principle should guide the nurses response? a. 0he child forgets previously learned s ills b. 0he child e-periences growth while regressing, regrouping, and then progressing c. 0he parents may refer less mature behaviors d. 0he child returns to a level of behavior that increases the sense of security. 13. A female child, age 4, is brought to the health clinic for a routine chec up. 0o assess the childs vision, the nurse should as & a. >7o you have any problems seeing different colors?? b. >7o you have trouble seeing at night?? c. >7o you have problems with glare?? d. >+ow are you doing in school?? 1.. 7uring a well/baby visit, @enny as s the nurse when she should start giving her infant solid foods. 0he nurse should instruct her to introduce which solid food first? a. Applesauce b. :gg whites c. 1ice cereal d. Aogurt 13. 0o decrease the li elihood of bradyarrhythmias in children during endotracheal intubation, succinylcholine BAnectineC is used with which of the following agents? a. :pinephrine BAdrenalinC b. %soproterenol B%suprelC c. Atropine sulfate d. Lidocaine hydrochloride BDylocaineC 14. A 1 year and "/month/old child weighing "4 lb B11.9 gC is admitted for traction to treat congenital hip dislocation. When preparing the patients room, the nurse anticipates using which traction system? a. ,ryants traction b. ,uc s e-tension traction c. (verhead suspension traction d. ;</;< traction 18. 5andy, age 1", is 8 months pregnant. When teaching parenting s ills to an adolescent, the nurse nows that which teaching strategy is least effective? a. *roviding a one/on/one demonstration and re=uesting a return demonstration, using a live infant model b. %nitiating a teenage parent support group with first E and E second/time mothers c. 'sing audiovisual aids that show discussions of feelings and s ills d. *roviding age/appropriate reading materials 19. When performing a physical e-amination on an infant, the nurse in charge notes abnormally low/set ears. 0his findings is associated with& a. (togenous tetanus b. 0racheoesophageal fistula c. )ongenital heart defects d. 1enal anomalies 1;. a. b. c. d. #urse 1aven should e-pect a 3/year/old child to be able to perform which action? 1ide a tricycle 0ie the shoelaces 1oller/s ates @ump rope

"<. #urse ,etina is teaching a group of parents about otitis media. When discussing why children are predisposed to this disorder, the nurse should mention the significance of which anatomical feature? a. :ustachian tubes b. #asopharync. 0ympanic membrane d. :-ternal ear canal

"1. 0he nurse is evaluating a female child with acute poststreptoccocal glomerulonephritis for signs of improvement. Which finding typically is the earliest sign of improvement? a. %ncreased urine output b. %ncreased appetite c. %ncreased energy level d. 7ecreased diarrhea "". 7r. 2mith prescribes corticosteroids for a child with nephritic syndrome. What is the primary purpose of administering corticosteroids to this child? a. 0o increase blood pressure b. 0o reduce inflammation c. 0o decrease proteinuria d. 0o prevent infection "3. *arents bring their infant to the clinic, see ing treatment for vomiting and diarrhea that has lasted for " days. (n assessment, the nurse in charge detects dry mucous membranes and lethargy. What other findings suggests a fluid volume deficit? a. A sun en fontanel b. 7ecreased pulse rate c. %ncreased blood pressure d. Low urine specific gravity ".. a. b. c. d. "3. a. b. c. d. +ow should the nurse 5ay prepare a suspension before administration? ,y diluting it with normal saline solution ,y diluting it with 3F de-trose solution ,y sha ing it so that all the drug particles are dispersed uniformly ,y crushing remaining particles with a mortar and pestle What should be the initial bolus of crystalloid fluid replacement for a pediatric patient in shoc ? "< mlG g 1< mlG g 3< mlG g 13 mlG g

"4. ,ec y, age 3, with intelligence =uotient of 43 is admitted to the hospital for evaluation. When planning care, the nurse should eep in mind that this child is& a. Within the lower range of normal intelligence b. 5ildly retarded but educable c. 5oderately retarded but trainable d. )ompletely dependent on others for care "8. 5aureen, age 1", is brought to the clinic for evaluation for a suspected eating disorder. 0o best assess the effects of role and relationship patterns on the childs nutritional inta e, the nurse should as & a. >What activities do you engage in during the day?? b. >7o you have any allergies to foods?? c. >7o you li e yourself physically?? d. >What inds of food do you li e to eat?? "9. 2udden infant death syndrome B2%72C is one of the most common causes of death in infants. At what age is the diagnosis of 2%72 most li ely? a. At 1 to " years of age b. At % wee to 1 year of age, pea ing at " to . months c. At 4 months to 1 year of age, pea ing at 1< months d. At 4 to 9 wee s of age ";. When evaluating a severely depressed adolescent, the nurse nows that one indicator of a high ris for suicide is& a. 7epression b. :-cessive sleepiness c. A history of cocaine use d. A preoccupation with death 3<. a. b. c. d. A child is diagnosed with Wilms tumor. 7uring assessment, the nurse in charge e-pects to detect& Hross hematuria 7ysuria #ausea and vomiting An abdominal mass

31. 0he parents of a child, age 3, who will begin school in the fall as the nurse for anticipatory guidance. 0he nurse should e-plain that a child of this age& a. 2till depends on the parents b. 1ebels against scheduled activities c. %s highly sensitive to criticism d. Loves to tattle 3". While preparing to discharge an 9/month/old infant who is recovering from gastroenteritis and dehydration, the nurse teaches the parents about their infants dietary and fluid re=uirements. 0he nurse should include which other topic in the teaching session? a. #ursery schools b. 0oilet 0raining c. 2afety guidelines d. *reparation for surgery 33. a. b. c. d. #urse ,etina should begin screening for lead poisoning when a child reaches which age? 4 months 1" months 19 months ". months

3.. When caring for an 11/month/old infant with dehydration and metabolic acidosis, the nurse e-pects to see which of the following? a. A reduced white blood cell count b. A decreased platelet count c. 2hallow respirations d. 0achypnea 33. After the nurse provides dietary restrictions to the parents of a child with celiac disease, which statement by the parents indicates effective teaching? a. >Well follow these instructions until our childs symptoms disappear.? b. >(ur child must maintain these dietary restrictions until adulthood.? c. >(ur child must maintain these dietary restrictions lifelong.? d. >Well follow these instructions until our child has completely grown and developed.? 34. A parent brings a toddler, age 1; months, to the clinic for a regular chec /up. When palpating the toddlers fontanels, what should the nurse e-pects to find? a. )losed anterior fontanel and open posterior fontanel b. (pen anterior and fontanel and closed posterior fontanel c. )losed anterior and posterior fontanels d. (pen anterior and posterior fontanels 38. *atric , a healthy adolescent has meningitis and is receiving %.!. and oral fluids. 0he nurse should monitor this clients fluid inta e because fluid overload may cause& a. )erebral edema b. 7ehydration c. +eart failure d. +ypovolemic shoc 39. An infant is hospitali$ed for treatment of nonorganic failure to thrive. Whichnursing action is most appropriate for this infant? a. :ncouraging the infant to hold a bottle b. Ieeping the infant on bed rest to conserve energy c. 1otating caregivers to provide more stimulation d. 5aintaining a consistent, structured environment 3;. 0he mother of Hian, a preschooler with spina bifida tells the nurse that her daughter snee$es and gets a rash when playing with brightly colored balloons, and that she recently had an allergic reaction after eating iwifruit and bananas. 0he nurse would suspect that the child may have an allergy to& a. ,ananas b. Latec. Iiwifruit d. )olor dyes

.<. )ristina, a mother of a ./year/old child tells the nurse that her child is a very poor eater. Whats the nurses best recommendation for helping the mother increase her childs nutritional inta e? a. Allow the child to feed herself b. 'se specially designed dishes for children E for e-ample, a plate with the childs favorite cartoon character c. (nly serve the childs favorite foods d. Allow the child to eat at a small table and chair by herself .1. #urse 1oy is administering total parental nutrition B0*#C through a peripheral %.!. line to a school/ age child. Whats the smallest amount of glucose thats considered safe and not caustic to small veins, while also providing ade=uate 0*#? a. 3F glucose b. 1<F glucose c. 13F glucose d. 18F glucose .". 7avid, age 13 months, is recovering from surgery to remove Wilms tumor. Which findings best indicates that the child is free from pain? a. 7ecreased appetite b. %ncreased heart rate c. 7ecreased urine output d. %ncreased interest in play .3. When planning care for a 9/year/old boy with 7own syndrome, the nurse should& a. *lan interventions according to the developmental level of a 8/year/old child because thats the childs age b. *lan interventions according to the developmental levels of a 3/year/old because the child will have developmental delays c. Assess the childs current developmental level and plan care accordingly d. 7irect all teaching to the parents because the child cant understand ... #urse !ictoria is teaching the parents of a school/age child. Which teaching topic should ta e priority? a. *revent accidents b. Ieeping a night light on to allay fears c. :-plaining normalcy of fears about body integrity d. :ncouraging the child to dress without help .3. 0he nurse is finishing her shift on the pediatric unit. ,ecause her shift is ending, which intervention ta es top priority? a. )hanging the linens on the clients beds b. 1estoc ing the bedside supplies needed for a dressing change on the upcoming shift c. 7ocumenting the care provided during her shift d. :mptying the trash cans in the assigned client room .4. a. b. c. d. #urse Alice is providing cardiopulmonary resuscitation B)*1C to a child, age .. the nurse should& )ompress the sternum with both hands at a depth of 1J to "? B. to 3 cmC 7eliver 1" breathsGminute *erform only two/person )*1 'se the heel of one hand for sternal compressions

.8. A ./month/old with meningococcal meningitis has 6ust been admitted to the pediatric unit. Which nursing intervention has the highest priority? a. %nstituting droplet precautions b. Administering acetaminophen B0ylenolC c. (btaining history information from the parents d. (rienting the parents to the pediatric unit .9. 2heena, tells the nurse that she wants to begin toilet training her ""/month/old child. 0he most important factor for the nurse to stress to the mother is& a. 7evelopmental readiness of the child b. )onsistency in approach c. 0he mothers positive attitude d. 7evelopmental level of the childs peers .;. An infant who has been in foster care since birth re=uires a blood transfusion. Who is authori$ed to give written, informed consent for the procedure? a. 0he foster mother b. 0he social wor er who placed the infant in the foster home c. 0he registered nurse caring for the infant d. 0he nurse/manager

3<. A child is undergoing remission induction therapy to treat leu emia. Allopurinol is included in the regimen. 0he main reason for administering allopurinol as part of the clients chemotherapy regimen is to& a. *revent metabolic brea down of -anthine to uric acid b. *revent uric acid from precipitating in the ureters c. :nhance the production of uric acid to ensure ade=uate e-cretion of urine d. :nsure that the chemotherapy doesnt adversely affect the bone marrow 31. A psychotic client reports to the evening nurse that the day nurse put something suspicious in his water with his medication. 0he nurse replies, KAouLre worried about your medication?K 0he nurseLs communication is& A. an e-ample of presenting reality. ,. reinforcing the clientLs delusions. ). focusing on emotional content. 7. a nontherapeutic techni=ue called mind reading. 3". A client receiving haloperidol B+aldolC complains of a stiff 6aw and difficulty swallowing. 0he nurseLs first action is to& A. reassure the client and administer as needed lora$epam BAtivanC %.5. ,. administer as needed dose of ben$tropine B)ogentinC %.5. as ordered. ). administer as needed dose of ben$tropine B)ogentinC by mouth as ordered. 7. administer as needed dose of haloperidol B+aldolC by mouth. 33. Aesterday, a client with schi$ophrenia began treatment with haloperidol B+aldolC. 0oday, the nurse notices that the client is holding his head to one side and complaining of nec and 6aw spasms. What should the nurse do? A. Assume that the client is posturing. ,. 0ell the client to lie down and rela-. ). :valuate the client for adverse reactions to haloperidol. 7. *ut the client on the list for the physician to see tomorrow. 3.. 0he nurse nows that the physician has ordered the li=uid form of the drug chlorproma$ine B0hora$ineC rather than the tablet form because the li=uid & A. has a more predictable onset of action. ,. produces fewer anticholinergic effects. ). produces fewer drug interactions. 7. has a longer duration of action. 33. ,en$tropine B)ogentinC is used to treat the e-trapyramidal effects induced by antipsychotics. 0his drug e-erts its effect by& A. decreasing the an-iety causing muscle rigidity. ,. bloc ing the cholinergic activity in the central nervous system B)#2C. ). increasing the level of acetylcholine in the )#2. 7. increasing norepinephrine in the )#2. 34. A dopamine receptor agonist such as bromocriptine B*arlodelC relieves muscle rigidity caused by antipsychotic medication by& A. bloc ing dopamine receptors in the central nervous system B)#2C. ,. bloc ing acetylcholine in the )#2. ). activating norepinephrine in the )#2. 7. activating dopamine receptors in the )#2. 38. 5ost antipsychotic medications e-ert which of following effects on the central nervous system B)#2C? A. 2timulate the )#2 by bloc ing postsynaptic dopamine, norepinephrine, and serotonin receptors. ,. 2edate the )#2 by stimulating serotonin at the synaptic cleft. ). 7epress the )#2 by bloc ing the postsynaptic transmission of dopamine, serotonin, and norepinephrine. 7. 7epress the )#2 by stimulating the release of acetylcholine. 39. Which of the following medications would the nurse e-pect the physician to order to reverse a dystonic reaction? A. prochlorpera$ine B)ompa$ineC ,. diphenhydramine B,enadrylC ). haloperidol B+aldolC 7. mida$olam B!ersedC 3;. A client has been receiving chlorproma$ine B0hora$ineC, an antipsychotic, to treat his psychosis. Whichfindings should alert the nurse that the client is e-periencing pseudopar insonism? A. 1estlessness, difficulty sitting still, and pacing ,. %nvoluntary rolling of the eyes ). 0remors, shuffling gait, and mas li e face 7. :-tremity and nec spasms, facial grimacing, and 6er y movements.

4<. What medication would probably be ordered for the acutely aggressive schi$ophrenic client? A. chlorproma$ine B0hora$ineC ,. haloperidol B+aldolC ). lithium carbonate BLithonateC 7. amitriptyline B:lavilC 41. 0he nurse must administer a medication to reverse or prevent *ar inson/type symptoms in a client receiving an antipsychotic. 0he medication the client will li ely receive is& A. ,en$tropine B)ogentinC. ,. diphenhydramine B,enadrylC. ). propranolol B%nderalC. 7. haloperidol B+aldolC. 4". A client with paranoid type schi$ophrenia becomes angry and tells the nurse to leave him alone. 0he nurse should? A. tell him that sheLll leave for now but will return soon. ,. as him if itLs o ay if she sits =uietly with him. ). as him why he wants to be left alone. 7. tell him that she wonLt let anything happen to him. 43. a. b. c. d. A male patient has a suc ing stab wound to the chest. Which action should the nurse ta e first? 7rawing blood for a hematocrit and hemoglobin level Applying a dressing over the wound and taping it on three sides *reparing a chest tube insertion tray *reparing to start an %.!. line

4.. Mor a patient with advance chronic obstructive pulmonary disease B)(*7C, which nursing action best promotes ade=uate gas e-change? a. :ncouraging the patient to drin three glasses of fluid daily b. Ieeping the patient in semi/fowlers position c. 'sing a high/flow venture mas to deliver o-ygen as prescribe d. Administering a sedative, as prescribe 43. A male patients D/ray result reveals bilateral white/outs, indicating adult respiratory distress syndrome BA172C. 0his syndrome results from& a. )ardiogenic pulmonary edema b. 1espiratory al alosis c. %ncreased pulmonary capillary permeability d. 1enal failure