PediatricsA

1. Totakethevitalsignsofa4montholdchild,whichorderprovidesthemostaccurate
results?
A.

Respiratoryrate,heartrate,thenrectaltemperature. Correct

B.

Heartrate,rectaltemperature,thenrespiratoryrate.

C.

Rectaltemperature,heartrate,thenrespiratoryrate.

D.

Rectaltemperature,respiratoryrate,thenheartrate.

ID:310947676

Therespiratoryrateshouldbetakenfirst(A)ininfants,sincetouchingthemorperforming
unpleasantproceduresusuallymakesthemcry,elevatingtheheartrateandmaking
respirationsdifficulttocount(B).Rectaltemperatureisthemostinvasiveprocedure,andis
mostlikelytoprecipitatecrying,soshouldbedonelast(CandD).
Awarded1.0pointsoutof1.0possiblepoints.

ID:311013607
2. A16yearoldisbroughttotheEmergencyCenterwithacrushedlegafterfallingoffa
horse.Theadolescent'slasttetanustoxoidboosterwasreceivedeightyearsago.Whatactionshould
thenursetake?

A.

Dispenseatetanusantitoxin.

B.

Preparehumantetanusimmuneglobulin.

C.

Administertetanustoxoidbooster. Correct

D.

Delaythetetanustoxoidboosteruntildue.

Afterthecompletionoftheinitialtetanusimmunizationschedule,therecommendedboosterfor
anadolescentoradultiseverytenyearsorlessifatraumaticinjuryoccursthatiscontaminated
bydirt,feces,soil,orsaliva,suchaspunctureorcrushinginjuries,avulsions,woundsfrom
missiles,burns,orfrostbite.Theadolescent'sinjuryisconsideredacontaminatedwound
requiringprophylactictherapy,sothetetanustoxoidboostershouldbeadministered(C).(A,B,
andD)arenotindicated.
Awarded1.0pointsoutof1.0possiblepoints.

ID:310946642
3. Themotherofa6montholdasksthenursewhenherbabywillgetthefirstmeasles,
mumps,andrubella(MMR)vaccine.Basedontherecommendedchildhoodimmunizationschedule
publishedbytheCentersforDiseaseControl,whichresponseisaccurate?

A.

3to6months.

B.

12to15months. Correct

C.

18to24months.

D.

4to6years.

Thefirstmeasles,mumps,andrubella(MMR)vaccineshouldbegivennosoonerthan12
monthsofage,andideallybetween12and15monthsofage(B).(A)shouldnotreceivethe
MMRvaccineduetothepresenceofmaternalantibodies.MMRisnotroutinelyadministeredat
(C),butotherimmunizations,suchasDTaPandHepatitisBmaybegivenatthattime.The
seconddoseofMMRisroutinelyadministeredat(D),providedthatatleast4weekshave
elapsedsincethefirstdose,andifbothdoseswereadministeredbeginningatorafter12
months.
Awarded1.0pointsoutof1.0possiblepoints.

ID:310945284
4. A2yearoldchildwithDownsyndromeisbroughttotheclinicforhisregularphysical
examination.ThenurseknowswhichproblemisfrequentlyassociatedwithDownsyndrome?

A.

Congenitalheartdisease. Correct

B.

FragileXchromosome.

C.

Trisomy13.

D.

Pyloricstenosis.

Congenitalheartdisease(A)isthemostcommonassociateddefectinchildrenwithDown
syndrome.(C)mighthaveseemedpossiblesinceDownsyndromeisatrisomalchromosomal
abnormalityofchromosome21.(B)isasexlinkedabnormalityalsocausingmentalretardation.
(D)isnotassociatedwithDownsyndrome.
Awarded1.0pointsoutof1.0possiblepoints.

5. A14yearoldfemaleclienttellsthenursethatsheisconcernedabouttheacneshehas
recentlydeveloped.Whichrecommendationshouldthenurseprovide?
A.

Removeallblackheadsandfollowwithanalcoholscrub.

B.

Usemedicatedcosmeticsonlytohelphidetheblemishes.

C.

Washthehairandskinfrequentlywithsoapandhotwater. Correct

D.

Encouragehertoseeadermatologistassoonaspossible. Incorrect

ID:310985655

Washingthehairandskinwithsoapandhotwater(C)removesoilanddebrisfromtheskinand
helpspreventandtreatacne.Oilyskinisespeciallybothersomeduringadolescencewhen
hormonescauseenlargementofsebaceousglandsandincreasedglandularsecretionswhich
predisposetheteenagertoacne.(A)iscontraindicated.Cosmetics("medicated"ornot)should
beusedsparinglytoavoidfurtherblockingsebaceousglandducts(B).(D)mightbeindicatedat
alatertime,ifhealthcarerecommendationsarenotsuccessful.
Awarded0.0pointsoutof1.0possiblepoints.

6. Thenurseiscaringfora12yearoldwithSyndromeofInappropriateAntidiuretic
Hormone(SIADH).Thischildshouldbecarefullyassessedforwhichcomplication?
A.

Poorskinturgorresultingfromdehydration.

B.

Changesinlevelofconsciousness. Correct

C.

Prematureagingasthediseaseprogresses.

D.

Severeedemafromanexcessofwaterandsodium. Incorrect

ID:310950702

Thechildmustbemonitoredforsignsandsymptomsofhyponatremia,whichcreatessecondary
centralnervoussystemalterationssuchaschangesinlevelofconsciousness,seizure,and
coma(B).FluidoverloadoccurswithSIADH,not(A)(whichoccurswithdiabetesinsipidus).(C)
iscausedbyhypersecretionofgrowthhormone,notSIADH.(D)isnotfoundinchildrenwith
SIADHbecauseedemaiscausedbyanexcessofbothwaterandsodium.
Awarded0.0pointsoutof1.0possiblepoints.

7. Athreemontholdboyweighing10lbs15ozhasanaxillarytemperatureof98.9F.The
nursedeterminesthedailycaloricneedforthischildisapproximately
A.

400caloriesperday.

B.

500caloriesperday.

C.

600caloriesperday. Correct

D.

700caloriesperday.

ID:310993975

10lbs15oz=10.9lbs.Convertlbstokgbydividingpoundsby2.210.9/2.2=4.954kg,
roundedto5kg.Aninfantrequires108calories/kg/day(1085=540calories/day).However,
thisinfantrequires10%morecaloriesbecausehehasonedegreetemperatureelevation.10%
of540is54and540+54=594.Thisinfantwillrequireapproximately600calories/day.Tough
question!Youknowthat400caloriesaretoofewand700aretoomuch,andatemperature
elevationnecessitatesconsumptionofmorecalories,sochoosethehigherofthetwochoices
left!
Awarded1.0pointsoutof1.0possiblepoints.

8. A6yearoldisadmittedtothepediatricunitafterfallingoffabicycle.Whichintervention
shouldthenurseimplementtoassistthechild'sadjustmenttohospitalization?
A.

Explainhospitalschedulestothechild,suchasmealtimes. Correct

B.

Useterms,suchas"honey"and"dear,"toshowacaringattitude.

C.

Providealistofrulesthatlimitsvisitationofsiblingsinthehospital.

D.

Orienttheparentstothehospitalunitandrefreshmentareas.

ID:310950708

Altereddailyschedulesandlossofritualsareupsettingtochildrenandincreaseseparation
anxiety,andactivesensitivitytotheneedsofchildrencanminimizethenegativeeffectsof
hospitalization.Explainingthehospitalschedules(A)andestablishinganindividualschedule
familiarizesthechildtothehospitalenvironmentanddecreasesanxiety.(B)depersonalizesthe
childwhoshouldbeaddressedbyname.Familyandsiblingvisitationshouldberecommended
andencouragedwithoutlimitation(C).Although(D)shouldbeimplemented,thedirect

involvementoftheschoolagedchildincorporatesthechild'ssenseofinitiateandcooperation.
Awarded1.0pointsoutof1.0possiblepoints.

9. Achildfallsontheplaygroundandisbroughttotheschoolnursewithasmalllaceration
ontheforearm.Whichactionshouldthenurseimplementfirst?
A.

Slowlypourhydrogenperoxideovertheopenwound.

B.

Applyicetotheareabeforerinsingwithcoldwater.

C.

Washthewoundgentlywithmildsoapandwater. Correct

D.

Gentlycleansewithasterilepadusingpovidoneiodine. Incorrect

ID:310965939

Asmall,superficiallacerationtotheskinshouldbewashedgentlywithmildsoapandwater(C)
forseveralminutes,followedbythoroughrinsing.(AandD)areantisepticsthatcanbe
traumatic(painful)whencleaningfresh,openwounds.Applyingice(B)mayreduceorprevent
furtheredema,butthewoundshouldbewashedwithmildsoapandwaterfirst.
Awarded0.0pointsoutof1.0possiblepoints.

10. Whatpreoperativenursinginterventionshouldbeincludedintheplanofcareforaninfant ID:310951938

withpyloricstenosis?
A.

Monitorforsignsofmetabolicacidosis.

B.

Estimatethequantityofdiarrheastools.

C.

Placeinasupinepositionafterfeeding.

D.

Observeforprojectilevomiting. Correct

Projectilevomiting(D),whichcontributestometabolicalkalosis(A),istheclassicsignofpyloric
stenosis.(B)isnotindicated.(C)isdangerous,duetothepotentialforaspirationwithfrequent
vomiting.
Awarded1.0pointsoutof1.0possiblepoints.

11. Whichclassofantiinfectivedrugsiscontraindicatedforuseinchildrenunder8yearsof
age?
A.

Aminoglycosides.

B.

Tetracyclines. Correct

C.

Penicillins.

D.

Quinolones.

ID:310959873

Tetracyclines(B)causeenamelhypoplasiaandtoothdiscolorationinchildrenunder8yearsof
age.(A,C,andD)arenotcontraindicatedforuseinchildren.
Awarded1.0pointsoutof1.0possiblepoints.

ID:310957463
12. Thenurseispreparingahealthteachingprogramforparentsoftoddlersand
preschoolersandplanstoincludeinformationaboutpreventionofaccidentalpoisonings.Itismost
importantforthenursetoincludewhichinstruction?

A.

Tellchildrentheyshouldnottasteanythingbutfood.

B.

Storealltoxicagentsandmedicinesinlockedcabinets. Correct

C.

Providespecialplayareasinthehouseandrestrictplayinotherareas.

D.

Punishchildreniftheyopencabinetsthatcontainhouseholdchemicals.

Theonlyreliablewaytopreventpoisoningsinyoungchildrenistomaketheminaccessible(B).
Teachingchildrennottotasteisimportant(A),butineffectiveforyoungchildren.(CandD)will
notcontrolachild'scuriosity.
Awarded1.0pointsoutof1.0possiblepoints.

ID:311041550
13. Thenursereviewsthelatestlaboratoryresultsforachildwhoreceivedchemotherapy
lastweekandidentifiesareducedneutrophilcount.Whichnursingdiagnosishasthehighestpriorityfor
thischild?

A.

Riskforinfection. Correct

B.

Riskforhemorrhage.

C.

Alteredskinintegrity.

D.

Disturbanceinbodyimage.

Chemotherapy(CT)suppressesphagocytoticneutrophilsandplacesthechildatriskfor
infection(A),whichistheprioritynursingdiagnosis.(B,C,andD)mayberelatedtothecareof
achildreceivingCTarenotrelatedtoneutropenia.
Awarded1.0pointsoutof1.0possiblepoints.

14. Whichmenuselectionbyachildwithceliacdiseaseindicatestothenursethatthechild
understandsnecessarydietaryconsiderations?
A.

Ovenbakedpotatochipsandcola. Correct

B.

Peanutbutterandbananasandwich.

C.

Oatmealraisincookiesandmilk.

D.

Grahamcrackersandfruitjuice.

ID:310962721

Celiacdiseasecausesanintolerancetotheproteinglutenfoundinoats,rye,wheat,andbarley.
Thechildshouldavoidanyproductscontainingtheseingredientstoavoidsymptomssuchas
diarrhea.(A)istheselectionwhichavoidsalloftheseingredients.(B,C,andD)containgluten
inoneformoranother.
Awarded1.0pointsoutof1.0possiblepoints.

ID:310955047
15. A12montholdboyisadmittedwitharespiratoryinfectionandpossiblepneumonia.He
isplacedinamisttentwithoxygen.Whichnursinginterventionhasthegreatestpriorityforthisinfant?

A.

Givesmall,frequentfeedingsoffluids.

B.

Accuratelychartobservationsregardingbreathsounds.

C.

Haveabulbsyringereadilyavailabletoremovesecretions. Correct

D.

Encourageoldersiblingstovisit.

Apatentairwayhasthehighestpriority.Humidificationwillliquefythenasalsecretionsthereby

increasingtheamountofsecretionsandmaking(C)thehighestpriority.(A)maintainshydration
andpreventtiring,butanopenairwayhasahigherpriority!(B)isimportantforevaluationof
therapy.Whenasked"priority"questions,REMEMBERMASLOW!Physicalneedsusuallyhave
ahigherprioritythanpsychosocialneeds(D)andanopenairwayisthehighestphysiological
need!
Awarded1.0pointsoutof1.0possiblepoints.

16. A6montholdinfantwithcongestiveheartfailure(CHF)isreceivingdigoxinelixir.Which
observationbythenursewarrantsimmediateintervention?
A.

Apicalheartrateof60. Correct

B.

Sweatingacrosstheforehead.

C.

Doesn'tsuckwell.

D.

Respiratoryrateof30breathsperminute.

ID:311018771

Aheartrateof60(A)ismuchlowerthannormalfora6montholdandwarrantsimmediate
intervention.Thenormalheartratefora6montholdis80to150BPMwhenawake,andarate
of70whilesleepingisconsideredwithinnormallimits.(BandC)areexpectedsymptomsof
heartfailureinaninfant.(D)iswithinnormallimitsforaninfant.
Awarded1.0pointsoutof1.0possiblepoints.

17. Whenassessingachildwithasthma,thenurseshouldexpectintercostalretractions
during
A.

inspiration. Correct

B.

coughing. Incorrect

C.

apneicepisodes.

D.

expiration.

Intercostalretractionsresultfromrespiratoryefforttodrawairintorestrictedairways(A).
Awarded0.0pointsoutof1.0possiblepoints.

ID:310947664

18. Achildwithcysticfibrosisishavingstoolsthatfloatandarefoulsmelling.Which
descriptivetermshouldthenurseusetodocumentthefinding?
A.

Diarrhea.

B.

Rhinorrhea.

C.

Galactorrhea.

D.

Steatorrhea. Correct

ID:311041544

Steatorrhea(D)isdefinedasstoolswithanabnormallyhighfatcontentthatareusuallyfoul
smellingandfloatonwater.(A,B,andC)donotdescribethisfinding.
Awarded1.0pointsoutof1.0possiblepoints.

19. Thenursereceivesalabreportstatingachildwithasthmahasatheophyllinelevelof15
mcg/dl.Whatactionwillthenursetake?
A.

Passtheinformationoninthereport. Correct

B.

Notifythehealthcareproviderbecausethevalueishigh.

C.

Repeatthelabstudybecausethevalueistoohigh.

D.

Holdthenextdoseoftheophylline.

ID:311018767

Thetherapeuticleveloftheophyllineis10to20mcg/dl,sothechild'sleveliswithinthe
therapeuticrange.Thisinformationevaluatestheprescribedtherapyandshouldbe
communicatedinthenurse'sreport(A).(B,C,andD)wouldbeinappropriateactionsinviewof
thelaboratoryfinding.
Awarded1.0pointsoutof1.0possiblepoints.

20. Allofthefollowinginterventionscanbeusedtoevaluatetheeffectivenessofnursingand ID:310944504

medicalinterventionsusedtotreatdiarrhea.Whichinterventionisleastusefulinthenurse'sevaluation
ofa20montholdchild?
A.

Weighingdiapers.

B.

Assessingfontanels. Correct

C.

Checkingskinturgor.

D.

Observingmucousmembranesformoisture.

Alloftheseinterventionsevaluatefluidstatusininfants.But,howoldisthischild?Posterior
fontanelclosesat2monthsandanteriorfontanelclosesby18monthsofage(B)!Remember
normalgrowthanddevelopment!
Awarded1.0pointsoutof1.0possiblepoints.

21. Thenurseisplanningcareforschoolagedchildrenatacommunitycarecenter.Which
activityisbestforthechildren?
A.

Buildingmodelairplanes. Incorrect

B.

Playingfollowtheleader. Correct

C.

Stringinglargeandsmallbeads.

D.

PlayingwithPlaydoughandclay.

ID:310946672

Schoolagedchildrenstriveforindependenceandproductivity(Erikson'sIndustryvs.Inferiority)
andenjoyindividualandgroupactivitiesrelatedtoreallifesituations,suchasplayingfollow
theleader(B).(A)isanindividualactivitythatcouldcontributetofeelingsofinferiorityand
inadequacyifthetaskistoocomplex.Althoughschoolagedchildrenenjoycrafts,(CandD)are
moreappropriateforpreschoolchildren.
Awarded0.0pointsoutof1.0possiblepoints.

22. Whichrestraintshouldbeusedforatoddlerafteracleftpalaterepair?
A.

Clovehitch.

B.

Mummy.

C.

Elbow. Correct

D.

Jacket.

ID:310955019

Elbowrestraintspreventchildrenfrombendingtheirarmsandbringingtheirhandstotheoral
surgicalsite.(A)restrainsthehands,butthechildcanbendandbringtheirheadtotheirhands.
(B)isusedduringprocedures.(D)restrainsthebodytorsoandisnotappropriate.
Awarded1.0pointsoutof1.0possiblepoints.

ID:310999069
23. Aburnedchildisbroughttotheemergencyroom.Inestimatingthepercentageofthe
bodyburned,thenurseusesamodified"RuleofNines."Whichpartofachild'sbodyiscalculatedasa
largerpercentageoftotalbodysurfacethananadult's?

A.

Headandneck. Correct

B.

Armsandchest.

C.

Legsandabdomen.

D.

Backandabdomen. Incorrect

Achild'sheadandneckareproportionatelylargertotheirbodythananadult's(A).The
standard"RuleofNines"isinaccuratefordeterminingburnedbodysurfaceareaswithchildren,
andmustbemodifiedforusewithchildren.Speciallydesignedchartsforchildrenarecommonly
usedtodeterminebodysurfaceareainvolvement.(B,C,andD)arenotproportionately
different.
Awarded0.0pointsoutof1.0possiblepoints.

ID:310950716
24. Thevitalsignsofa4yearoldchildwithpolyuriaare:BP80/40,Pulse118,and
Respirations24.Thechild'spedalpulsesarepresentwithavolumeof+1,andnoedemaisobserved.
Whatactionshouldthenurseimplementfirst?

A.

Insertanindwellingurinarycatheter.

B.

StartanIVinfusionofnormalsaline. Correct

C.

Sendaspecimentothelabforurinalysis.

D.

Documentthechild'svitalsignsandpulses. Incorrect

Thecurrentvitalsignreadingsandthedecreasedperipheralpulsevolumeindicatethatthe
childisexperiencingfluidvolumedeficitduetothepolyuria,sothepriorityactionistorestore
fluidvolume(B).(A)isusefulinobtainingapreciseurineoutputmeasure,butisalowerpriority
thanrestoringfluidvolumeatthistime.(C)isnotindicatedbasedonthecurrentassessment
data,and(D)doesnotrecognizetheneedforimmediateactiontocombatthefluidvolume
deficit.
Awarded0.0pointsoutof1.0possiblepoints.

25. Thenurseisteachingamothertogive4mlofaliquidantibiotictoa10montholdinfant.
Whichstatementbytheparentindicatesaneedforfurtherteaching?
A.

Iwillgivethisantibiotictomychilduntilitisfinished.

B.

Usingateaspoonwillhelpmemeasurethiscorrectly. Correct

C.

Iwillcalltheclinicifmychilddevelopsarashoritching.

D.

Mybabyshouldbegintofeelbetterwithinafewdays. Incorrect

ID:310957445

Theprescribedmedicationis4mlperdosageandismeasuredwiththemostaccuracyusinga
syringe,soiftheparentusesateaspoon(B),whichisequivalentto5ml,furtherteachingis
indicated.(A,C,andD)indicatecorrectunderstandingandrequirenofurtherinterventionbythe
nurse.
Awarded0.0pointsoutof1.0possiblepoints.

ID:310945716
26. A4yearoldboywasadmittedtotheemergencyroomwithafracturedrightulnaanda
shortarmcastisapplied.Whenpreparingtheparentstotakethechildhome,whichdischarge
instructionhasthehighestpriority?

A.

B.

Callthehealthcareproviderimmediatelyifhisnailbedsappearblue. Correct

Checkhisfingershourlyforthefirst48hourstoseethatheisabletomovethemwithout
pain.

C.

Besurehisarmremainsabovehisheartforthefirst24hours.

D.

Takehistemperatureq4hforthenexttwodaysandcallifanelevationisnoted.

Cyanosis(A)indicatesimpairedcirculationtofingersandshouldbereportedimmediately.
Althoughtheactionsdescribedin(B,C,andD)maybeindicated,theyareimplementedrather
excessivelyandmighttendtofrightentheparents.Itisnotnecessarytocheckthechild's
abilitytomovehisfingershourlyfor2days(B).Elevatingthearmabovetheheartwillhelpto
decreaseswellingbut(C)isstatedinafrighteningway.Itisnotnecessarytotakethechild's
temperatureq4hunlessindicatedbyothersymptoms.
Awarded1.0pointsoutof1.0possiblepoints.

27. A3yearoldboyisbroughttotheemergencyroombecauseheswallowedanentire
bottleofchildren'svitaminpills.Whichinterventionshouldthenurseimplementfirst?
A.

InsertN/Gtubeforgastriclavage.

B.

Determinethechild'spulseandrespirations. Correct

C.

Assessthechild'slevelofconsciousness. Incorrect

D.

AdministeranIVD5/0.25NSasprescribed.

ID:311018743

Themostimportantprincipleindealingwithapoisoningistotreatthechildfirst,notthepoison.
Initiateimmediatelifesupportmeasureswithassessmentofvitalsigns(B),inparticular,
respirations.Insertinganairwayorinitiatingmechanicalventilationmaybenecessary.
Assessmentandidentificationofthepoisonshouldoccurpriorto(A).(CandD)shouldoccur
afterassessingtheairway.
Awarded0.0pointsoutof1.0possiblepoints.

28. A3yearoldclientwithsicklecellanemiaisadmittedtotheEmergencyDepartmentwith ID:310978607

abdominalpain.Thenursepalpatesanenlargedliver,anxrayrevealsanenlargedspleen,andaCBC
revealsanemia.Thesefindingsindicatewhichtypeofcrisis?
A.

Aplastic.

B.

Sequestration. Correct

C.

Hyperhemolytic. Incorrect

D.

Vasoocclusive.

Thefindingssupportasequestrationcrisis(B),wherebloodpoolsinthespleen,andis
characterizedbyabdominalpainandanemia.(AandC)crisesproduceanemiabutno
abdominalpainorsplenicenlargement.(D)crisismayproduceabdominalpain,butnosplenic
enlargementorexacerbationofanemia.
Awarded0.0pointsoutof1.0possiblepoints.

29. A2yearoldchildwithgastroesophagealrefluxhasdevelopedafearofeating.What
instructionshouldthenurseincludeintheparents'teachingplan?
A.

Inviteotherchildrenhometosharemeals.

B.

Acceptthathewilleatwhenheishungry.

C.

Rewardthechildwithanapaftereating.

D.

Consistentlyfollowasetmealtimeroutine. Correct

ID:311018749

A2yearoldchildiscomfortedbyconsistency(D).(A)iscontraindicatedbecausetwoyearolds
mayparticipateinparallelactivitieswithotherchildrenbutaretooyoungtofeelcomfortand
supportbythepresenceofotherchildrenwhenanxiousorafraid.(B)mayormaynotbetrue
anddoesnotaddressthechild'sfears.Thechildwithrefluxshouldremainuprightatleasttwo
hoursaftereating(C)toreducesymptoms.
Awarded1.0pointsoutof1.0possiblepoints.

ID:310972799
30. Thenurseisgivingpreoperativeinstructionstoa14yearoldfemaleclientwhois
scheduledforsurgerytocorrectaspinalcurvature.Whichstatementbytheclientbestdemonstrates
thatlearninghastakenplace?

A.

Iwillreadalltheliteratureyougavemebeforesurgery.

B.

IhavehadsurgerybeforewhenIbrokemywristinabikeaccident,soIknowwhattoexpect.

C.

Allthethingspeoplehavetoldmewillhelpmetakecareofmyback.

D.

IunderstandthatIwillbeinabodycastandIwillshowyouhowyoutaughtmeto
turn. Correct

Outcomeoflearningisbestdemonstratedwhentheclientnotonlyverbalizesanunderstanding
butcanalsoprovideareturndemonstration(D).A14yearoldmayormaynotfollowthrough
with(A),andthereisnomeasurementofthatlearning.Havingprevioussurgery(B)mayhelp
theclientunderstandthesurgicalprocess,butwristsurgeryisverydifferentfromspinalsurgery
andemergencysurgeryisdifferentfromelectivesurgery.In(C),theclientmaybesayingwhat
thenursewantstohear,withoutexpressinganyrealunderstandingofwhattodoaftersurgery.
Awarded1.0pointsoutof1.0possiblepoints.

31. A2yearoldchildrecentlydiagnosedwithhemophiliaAisdischargedhome.What
informationshouldthenurseincludeinateachingplanabouthomecare?

ID:311041548

A.

Minimizeinteractiveplaywithotherchildrentolessenchancesforinjury.

B.

Givelowdosechildren'schewableaspirininorangeflavorforjointdiscomfort.

C.

Useafirmanddrytoothbrushtocleanteethatleasttwiceperday.

D.

Applypressureandiceforbleedingwhileelevatingandrestingtheextremity. Correct

Hemophilia,ablooddisorder,causesjointbleedingwhichistreatedwithrest,ice,compression,
andelevation(RICE)(D).(A,B,andC)areinaccurate.
Awarded1.0pointsoutof1.0possiblepoints.

32. Thenurseisassessingan8montholdchildwhohasamedicaldiagnosisofTetrologyof
Fallot.Whichsymptomisthisclientmostlikelytoexhibit?
A.

Bradycardia.

B.

Machinerymurmur.

C.

Weakpedalpulses.

D.

Clubbedfingers. Correct

ID:311002933

TetrologyofFallot,acyanoticheartdefect,causesclubbingoffingersandtoes(D)dueto
tissuehypoxia.Tachycardia,not(A),isamanifestationofcongenitalheartdisease.(B)isa
classicsignofventricularseptaldefect.(C)ischaracteristicofcoarctationoftheaorta.
Awarded1.0pointsoutof1.0possiblepoints.

ID:311028943
33. Aprematurenewborngirl,born24hoursago,isdiagnosedwithapatentductus
arteriosus(PDA)andplacedunderanoxygenhoodat35%.Theparentsvisitthenurseryandaskto
holdher.Whichresponseshouldthenurseprovidetotheparents?

A.

Studieshaveshownthathandlingasicknewbornisnotgoodforthebabyandupsetsthe
parents.

B.

Theoxygenhoodisholdingthebaby'soxygenleveljustatthepointwhichisneeded.You
maystrokeandtalktoher. Correct

C.

Sinceyourbabyhasbeendoingwellunderoxygenfor24hours,Icanletyouholdthebaby
withoutoxygen.

D.

Youcanholdthebabywiththeoxygenblowinginthebaby'sfacesincethelevelisvery
closetoroomair.

Thebabyisat35%whichismuchmorethanroomair(21%)andatthistimethebabyshould
notbemovedfromunderthehood.Thenurseshouldoffertheparentsanalternativesuchasto
strokeandreassuretheinfant(B).Holdingsickbabiesbenefitstheinfantandtheparents(A).
Thefirstconsiderationnowhastobetheinfant'soxygenation.Thenurseshouldnottakethe
babyoutfromunderthehoodwithoutaprescriptionfromthehealthcareprovider,asthiscould
severelycompromisetheinfant(C).APO2of35%cannotbereadilyachievedwith"blowby"
oxygen(D).
Awarded1.0pointsoutof1.0possiblepoints.

34. Toassesstheeffectivenessofananalgesicadministeredtoa4yearold,what
interventionisbestforthenursetoimplement?
A.

Useahappyface/sadfacepainscale. Correct

B.

Askthemotherifshethinkstheanalgesicisworking.

C.

Assessforchangesinthechild'svitalsigns.

D.

Teachthechildtopointtoanumericpainscale.

ID:310965949

A4yearoldcanreadilyidentifywithsimplepictures(A)toshowthenursehowhe/sheis
feeling.(B)couldbeusedtovalidatewhatthechildistellingthenurseviathe"faces"pain
scale,butitisbesttoelicitthechild'sassessmentofhis/herpainlevel.(C)maynotaccurately
reflecttheeffectivenessofpainmedicationastheycanalsobeaffectedbyothervariables,

suchasfear.(D)requiresabstractnumberskillsbeyondthelevelofa4yearold.
Awarded1.0pointsoutof1.0possiblepoints.

35. Whendiscussingdisciplinewiththemotherofa4yearoldchild,thenurseshouldinclude ID:311008987

whichguideline?
A.

Parentalcontrolshouldbeconsistent. Correct

B.

Childrenasyoungas4yearsrarelyneedreprimandorpunishment.

C.

Withdrawalofapprovaliseffective.

D.

Parentsshouldenforcerigidrulestobefollowedwithoutquestion.

Disciplineshouldbeapositiveandnecessarycomponentofchildrearingthatisstartedin
infancyandshouldteachsociallyacceptablebehavior,helpchildrenprotectthemselvesfrom
danger,andchannelundesirablebehaviorintoconstructiveactivity.Misbehaviormayresult
frominconsistentrulesormessages,soparentalattentionshouldbeclear,reasonable,and
consistent(A).(BandC)arenothelpfultothechild.Childrenneedboundariesthatarefirmbut
notrigid(D).
Awarded1.0pointsoutof1.0possiblepoints.

36. Thenurseisassessinga13yearoldgirlwithsuspectedhyperthyroidism.Which
questionismostimportantforthenursetoaskherduringtheadmissioninterview?
A.

Haveyoulostanyweightinthelastmonth?

B.

Areyouexperiencinganytypeofnervousness? Correct

C.

Whenwasthelasttimeyoutookyoursynthroid?

D.

Areyouhavinganyproblemswithyourvision?

ID:310947670

Assessingtheclient'sphysiologicalstateuponadmissionisapriority,andnervousness,
apprehension,hyperexcitability,andpalpitationsaresignsofhyperthyroidism(B).Weightloss
(evenwithaheartyappetite)(A)occursinthosewithhyperthyroidism,butassessingtheclient's
neurologicalstatehasahigherpriority.Hormonereplacementisnotadministeredtoaclient
whoisalreadyproducingtoomuchthyroid(C).Theclientmayhaveexophthalmus(bulging
eyes)buthyperthyroidismdoesnotcausevisionproblems(D).

Awarded1.0pointsoutof1.0possiblepoints.

ID:310965995
37. Ahospitalized16yearoldmalerefusesallvisitsfromhisclassmatesbecauseheis
concernedabouthisdistortedappearance.Toincreasetheclient'ssocialinteraction,whatintervention
isbestforthenursetoinitiate?

A.

Encouragetheclienttouseahandheldvideogamethatispopularwithallhisfriends.

B.

Assigna25yearoldfemalenursingstudenttooffersupporttotheclient.

C.

ArrangeforanInternetconnectionintheclient'sroomforemailcommunication. Correct

D.

Encouragetheclient'smothertoarrangeasurprisegettogetherinthecafeteria.

Bodyimageandpeeracceptancearekeyconcernsfortheadolescent.(C)allowsforsocial
interactionwithoutfacetofacecontact,thusprotectinghisselfimagewhilealsopromoting
socialinteraction.(A)doesnotpromotesocialinteraction.(B)doesnotencourageinteraction
withhisownpeergroup,whichisofgreaterimportance.(D)doesnotrespecttheclient's
concernabouthisbodyimage.
Awarded1.0pointsoutof1.0possiblepoints.

38. Thenurseisassessinga2yearold.Whatbehaviorindicatesthatthechild'slanguage
developmentiswithinnormallimits?
A.

Isabletonamefourcolors.

B.

Cancountfiveblocks.

C.

Iscapableofmakingathreewordsentence. Incorrect

D.

Halfofchild'sspeechisunderstandable. Correct

ID:310993913

Betweenapproximately15and24monthsofage,achild'sspeechisonlyhalfunderstandable
(D).(AandB)usuallyoccurbetween3and5yearsofage.(C)isusuallyaccomplishedby18
monthsofage.
Awarded0.0pointsoutof1.0possiblepoints.

ID:310950766
39. Whenevaluatingtheeffectivenessofinterventionstoimprovethenutritionalstatusofan
infantwithgastroesophagealreflux,whichinterventionismostimportantforthenursetoimplement?

A.

Recordweightdaily. Correct

B.

Assessforsignsofanemia.

C.

Documentsleepingpatterns.

D.

Teachparentingskills.

Themostdefinitivemeasureofimprovednutritioninaninfantisobtainingthechild'sdaily
weight(A).(B,C,andD)mayalsobeuseful,buttheyarenotasdefinitiveasadailyweight
measurement.
Awarded1.0pointsoutof1.0possiblepoints.

40. A4yearoldgirlcontinuestointerrupthermotherduringaroutineclinicvisit.Themother ID:310989301

appearsirritatedwiththechildandasksthenurse,"Isthisnormalbehaviorforachildthisage?"The
nurse'sresponseshouldbebasedonwhichinformation?
A.

B.

Childrenneedtoretainasenseofinitiativewithoutimpingingontherightsandprivilegesof
others. Correct

Negativefeelingsofdoubtandshamearecharacteristicof4yearoldchildren.

C.

Roleconflictisacommonproblemofchildrenthisage.Sheisjustwonderingwhereshefits
intosociety.

D.

Atthisagechildrencompeteandliketoproduceandcarrythroughwithtasks.Sheisjust
competingwithhermother. Incorrect

Childrenaged3to6areinErickson's"Initiativevs.Guilt"stage,whichischaracterizedby
vigorous,intrusivebehavior,enterprise,andstrongimagination.Atthisage,childrendevelopa
conscienceandmustlearntoretainasenseofinitiativewithoutimpingingontherightsof
others(A).(B)describesthe"Autonomyvs.ShameandDoubt,"stage(1to3yearsofage).(C)
describesanadolescent(12to18yearsofage),the"Identityvs.RoleConfusion"stage.(D)
describesachild6to12yearsofage,the"Industryvs.Inferiority"stage.

Awarded0.0pointsoutof1.0possiblepoints.

ID:310953425
41. Aninfantisbornwithaventricularseptaldefect(VSD)andsurgeryisplannedtocorrect
thedefect.Thenurserecognizesthatsurgicalcorrectionisdesignedtoachievewhichoutcome?

A.

Stoptheflowofunoxygenatedbloodintosystemiccirculation.

B.

Increasetheflowofunoxygenatedbloodtothelungs.

C.

Preventthereturnofoxygenatedbloodtothelungs. Correct

D.

Reduceperipheraltissuehypoxiaandnailbedclubbing.

ClosureofVSDsstopsoxygenatedbloodfrombeingshuntedfromtheleftventricletotheright
ventricle(C).VSDsareacyanoticdefects,whichmeansthatnounoxygenatedbloodentersthe
systemiccirculation(AandB).(D)iscommonwithTetrologyofFallot,whichisacyanotic
defect.
Awarded1.0pointsoutof1.0possiblepoints.

ID:310946616
42. A5montholdisadmittedtothehospitalwithvomitinganddiarrhea.Thepediatrician
prescribesdextrose5%and0.25%normalsalinewith2mEqKCl/100mltobeinfusedat25ml/hour.
Priortoinitiatingtheinfusion,thenurseshouldobtainwhichassessmentfinding?

A.

Frequencyofemesisinthelast8hours.

B.

SerumBUNandcreatininelevels. Correct

C.

Currentbloodsugarlevel. Incorrect

D.

Appearanceofthestool.

Regardlessofaclient'sage,adequaterenalfunctionmustbepresentbeforeaddingpotassium
toIVfluids(B).(A)isimportantindeterminingtheneedforfluidreplacement.(C)isnot
indicated.(D)isusefulinformation,butwillnotimpactadministrationoftheprescribedIV
solution.
Awarded0.0pointsoutof1.0possiblepoints.

ID:310969421
43. A6montholdboyandhismotherareatthehealthcareprovider'sofficeforawellbaby
checkupandroutineimmunizations.Thehealthcareproviderrecommendstothemotherthatthechild
receiveaninfluenzavaccine.Whatmedicationsshouldthenurseplantoadministertoday?

A.

Theroutineimmunizationsandscheduleanotherappointmenttoadministertheinfluenza
vaccine.

B.

Alltheimmunizationswiththeinfluenzavaccinegivenataseparatesitefromanyother
injection. Correct

C.

Theinfluenzavaccineandscheduleanotherappointmenttoadministertheimmunizations.

D.

Theinfluenzavaccineandthepoliovaccineandscheduleanotherappointmenttoadminister
theremainingimmunizations.

At6monthsofage,theroutineimmunizationsincludeHepatitisB,DTaP,Hib(Haemophilus
influenzatypeb),PCV(Pneumococcal),IPV(inactivatedpoliovirus)andinfluenza.The
influenzavaccineshouldbegivenataseparatesitefromanyotherinjection(B).Schedulinga
returnvisit(A,B,orC)increasestheriskthatthemotherwillnotbringthechildbackforthe
immunizations.
Awarded1.0pointsoutof1.0possiblepoints.

44. Duringdischargeteachingofachildwithjuvenilerheumatoidarthritis,thenurseshould
stresstotheparentstheimportanceofobtainingwhichdiagnostictesting?
A.

Hearingtests.

B.

Eyeexams. Correct

C.

Chestxrays.

D.

Fastingbloodglucosetests. Incorrect

ID:310993917

VisualchangesleadingtoblindnesscanoccurinchildrenwithJRA.Regulareyeexams(B)can
helptopreventthiscomplication.(A,C,andD)arenotroutinelynecessaryformanagementof
JRA.

Awarded0.0pointsoutof1.0possiblepoints.

45. Whentakingthehealthhistoryofachild,thenurseknowsthatwhichfindingisanearly
indicationofhypothyroidisminchildren?
A.

Hyperactivebehavioraltraits.

B.

Delayintheeruptionofpermanentteeth.

C.

Slowsexualdevelopment,butwithinnormalrange. Incorrect

D.

Cessationofgrowthinachildthathadbeennormal. Correct

ID:311018707

Sincethethyroidglandisresponsibleformetabolism,cessationofgrowth(D)whichwas
previouslywithinnormalrange,isthemostcommonsignforhypothyroidisminchildren.The
childwithhypothyroidismislikelytobeHYPOactive,not(A).Although(BandC)mayoccurwith
hypothyroidism,theyarelatesigns(notearlyindications)andaresignsmoreoftenassociated
withalackofgrowthhormone.
Awarded0.0pointsoutof1.0possiblepoints.

46. Aspartofthephysicalassessmentofchildren,thenurseobservesandpalpatesthe
fontanels.Whichchild'sfontanelfindingshouldbereportedtothehealthcareprovider?
A.

A6montholdwithfailuretothrivethathasaclosedanteriorfontanel. Correct

B.

A24montholdwithgastroenteritisthathasaclosedposteriorfontanel.

C.

A2montholdwithchickenpoxthathasanopenposteriorfontanel.

D.

A28montholdwithhydrocephalusthathasanopenanteriorfontanel. Incorrect

ID:311023645

Atsixmonthsofagetheanteriorfontanelshouldbeopen,anditshouldnotbecloseduntil
approximately18monthsofage.(BandC)arenormalfindings.Achildwithhydrocephalusmay
haveadelayedclosingofthefontanel(D).
Awarded0.0pointsoutof1.0possiblepoints.

ID:310999065
47. Thenurseisteachinga12yearoldmaleadolescentandhisfamilyabouttaking
injectionsofgrowthhormoneforidiopathichypopituitarism.Whichadversesymptoms,commonly
associatedwithgrowthhormonetherapy,shouldthenurseplantodescribetothechildandhisfamily?

A.

Polyuriaandpolydipsia. Correct

B.

Lethargyandfatigue.

C.

Increasedfacialhair. Incorrect

D.

Facialbonestructurechanges.

Signsandsymptomsofdiabetesorhyperglycemia(A)needtobereported.Thosereceiving
growthhormoneshouldbemonitoredtodetectelevatedbloodsugarsandglucoseintolerance.
(B)isassociatedwithanynumberofheathalterations,butisnotassociatedwiththegrowth
hormonetherapy.(CandD)arenormalchangesthatoccurwith12yearoldmales.
Awarded0.0pointsoutof1.0possiblepoints.

48. Theparentsofa3weekoldinfantreportthatthechildeatswellbutvomitsaftereach
feeding.Whatinformationismostimportantforthenursetoobtain?
A.

Descriptionofvomitingepisodesinpast24hours. Correct

B.

Numberofwetdiapersinlast24hours. Incorrect

C.

Feedingandsleepschedule.

D.

Amountofformulaconsumedduringthepast24hours.

ID:310999043

Adescriptionofthevomitingepisodes(A)willassistthenurseindeterminingthereasonforthe
symptoms,whichmaybehelpfulindevelopingaplanofcareforthisinfant.(BandC)provide
relatedinformationbutarenotashelpfulas(A).(D)mayberelatedtothevomiting,butthe
nurseshouldfirstobtainabetterdescriptionofthevomitingepisodes.
Awarded0.0pointsoutof1.0possiblepoints.

ID:310950768
49. An18montholdisadmittedtothehospitalwithpossibleHirschsprungsdisease.When
obtaininganursinghistory,thenurseasksaboutbowelhabits.Whatdescriptionofthedisease?

A.

Foulsmellingandfatty.

B.

Bilecoloredandwatery. Incorrect

C.

Semisolidandyellow.

D.

Ribbonlikeandbrown. Correct

Hirschsprungsdiseaseisamechanicalobstructioncausedbyinadequatemotilityinapartof
theintestines.Theconditionresultsfromfailureofganglioncellstomigratecraniocaudally
alongtheGItractduringgestation.Thelackofperistalsisintheaffectedbowelsegmentcauses
constipationandsmalldiameter,browncoloredstools(D).(A)isassociatedwithcysticfibrosis.
(B)iscommoningastroenteritis.(C)isnormalinbreastfedneonates.
Awarded0.0pointsoutof1.0possiblepoints.

ID:310944082
50. A17yearoldmalestudentreportstotheschoolcliniconemorningforascheduled
healthexam.Hetellsthenursethathejustfinishedfootballpracticeandisonhiswaytoclass.The
nurseassesseshisvitalsigns:temperature100F,pulse80,respirations20,andbloodpressure
122/82.Whatisthebestactionforthenursetotake?

A.

Tellthestudenttoproceeddirectlytohisregularlyscheduledclass. Correct

B.

Calltheparentandsuggestretakingthestudent'stemperatureathome.

C.

Givethestudentaglassofcoolfluids,thenretakehistemperature.

D.

Sendthestudenttoclass,butreverifyhistemperatureafterlunch.

Thisstudenthasjustcompletedfootballpractice,andincreasedmuscleactivityincreasesbody
heatproduction.Atemperatureof100Fisnormalforthisstudentatthistime.Thestudent
shouldattendclass(A)sincenofurthernursingactionisrequired.(B)wouldalarmtheparents
unnecessarily.(C)wouldprovideafalsereadingofbodytemperature.(D)isunnecessarysince
thesefindingsarewithinnormallimits.
Awarded1.0pointsoutof1.0possiblepoints.

51. Whichfindingina19yearoldfemaleclientshouldtriggerfurtherassessmentbythe
nurse?
A.

Menstruationhasnotoccurred. Correct

B.

Reportsnotetanusimmunizationsincechildhood.

C.

Denieshavinganywisdomteeth.

D.

Historyofpainful,inwardgrowthonbottomoffoot.

ID:311008915

Menstruationisanexpectedsecondarysexcharacteristicthatoccurswithpubescenceand
typicallyoccursbyage18,so(A)shouldpromptfurtherinvestigationtodeterminethecauseof
thisprimaryamenorrhea.ChildrenreceivetetanusaspartoftheDPTchildhoodimmunization
series,andaboosterisnottypicallygivenuntilage16(B).Wisdomteetharethethirdmolar
teethofthepermanentdentitionandarethelasttoerupt,so(C)isanormalfinding.(D)
describesaplantarsurfacewart,harmlessbutpainfulbecauseofthepressurewithwalkingor
standing.
Awarded1.0pointsoutof1.0possiblepoints.

52. Duringadministrationofabloodtransfusion,achildcomplainsofchills,headache,and
nausea.Whichactionshouldthenurseimplement?
A.

StartanotherIVofdextrosesolutionandstaywiththechild.

B.

Continuethetransfusionandmonitorthechildsvitalsigns.

C.

Stoptheinfusionimmediatelyandnotifythehealthcareprovider. Correct

D.

Slowthetransfusionandassessforcessationofsymptoms.

ID:310953451

Thechildisexhibitingsignsofareactiontothebloodtransfusion.Thebloodtransfusionshould
bestoppedimmediatelyandthehealthcareprovidernotified(C).Afterthetransfusionis
discontinued,IVaccessshouldbemaintained(A)withfluidsthatdonotintroduceanymore
cellularproducts.(BandD)placethechildatriskforfurtherbloodreactions.
Awarded1.0pointsoutof1.0possiblepoints.

ID:310972757
53. Themotherofa2yearoldboyconsultsthenurseaboutherson'sincreasedtemper
tantrums.Themotherstates,"Yesterdayhethrewafitinthegrocerystore,andIdidnotknowwhatto
do.Iwassoembarrassed.WhatcanIdoifthisoccursagain?"Whichrecommendationisbestforthe

nursetoprovidethismother?
A.

Paddlehimgentlyassoonasthebehaviorisinitiated. Incorrect

B.

Immediatelyputhimin"timeout."

C.

Quietlyremindhimthatothersarewatchinghim.

D.

Walkawayfromhimandignorethebehavior. Correct

Thebestapproachforatoddleristoignoretheattentionseekingbehavior(D).Theparent
shouldbesomewhatnearby,withinviewofthechildbutshouldavoidreinforcingthebehaviorin
anyway.Tantrumscansometimesbeavoidedbytalkingtothechildbeforethesituation
occurs.(A,B,andC)wouldallprovideattentionfortheinappropriatebehavior.
Awarded0.0pointsoutof1.0possiblepoints.

ID:311041542
54. Anurseprovidestheparentswithinformationonhealthmaintenancefortheirchildwith
sicklecelldisease.Whichinformationreflectedbytheparentsindicatesunderstandingofthechild's
care?

A.

Dailyironsupplementsshouldbegiven. Incorrect

B.

Plentyoffluidsshouldbeconsumeddaily. Correct

C.

Immunizationsshouldbedelayedforafewyears.

D.

Protectiveequipmentshouldbewornforcontactsports.

Adequatefluidintake(B)decreasestheviscosityofthebloodwhichaffectstheincidenceof
vasocclusivecrisis.(AandD)arenotcommonlyindicatedforachildwithsicklecelldisease.A
routineimmunizationschedule(C)isrecommendedforachildrenwithSCDbecauseoftheir
increasedsusceptibilitytoinfectionthatpredisposestosicklingphenomena.
Awarded0.0pointsoutof1.0possiblepoints.

55. Whichmeasurementsshouldbeusedtoaccuratelycalculateapediatricmedication
dosage?(Selectallthatapply.)
A.

Child'sheightandweight. Correct

B.

Adultdosageofmedication. Incorrect

ID:310965927

C.

Bodysurfaceareaofchild. Correct

D.

Averageadult'sbodysurfacearea. Incorrect

E.

Averagepediatricdosageofmedication.

F.

Nomogramdeterminedmathematicalconstant. Correct

Correctselectionsare(A,C,andF).Themostaccuratecalculationsofpediatricdosagesuse
thechild'sheightandweight(A).Thechild'sBSAiscalculatedusingthesquarerootofweight
inkgtimesheightincmdividedby3600orthesquarerootofweightinlbtimesheightininches
dividedby3131(C),thenthechild'sBSAismultipliedbytherecommendedpublisheddoseper
BSA.Thenomogram(F)isusedtoplotthechild'sheightandweight,andthepointatwhich
theyintersectistheBSAmathematicalconstantusedtocalculatethechild'sdose.(B,D,andE)
arenotusedtocalculatepediatricdosages.
Awarded0.0pointsoutof1.0002possiblepoints.

56. Indevelopingateachingplanfora5yearoldchildwithdiabetes,whichcomponentof
diabeticmanagementshouldthenurseplanforthechildtomanagefirst?
A.

Foodplanningandselection.

B.

Administeringinsulininjections.

C.

Processofglucosetesting. Correct

D.

Drawingupthecorrectinsulindose.

ID:310950724

Developmentally,a5yearoldhasthecognitiveandpsychomotorskillstouseaglucometer(C)
andtoreadthenumber(itisespeciallyhelpfulifthenursepresentsthisactivityasagame).(A,
B,andD)requiremoreadvancedcognitiveandpsychomotorskillsandhavegreaterpotential
forerrors.
Awarded1.0pointsoutof1.0possiblepoints.

57. Apreschoolagechildwhoishospitalizedforhypospadiasrepairismoststrongly
influencedbywhichbehavior?

ID:310949434

A.

Abilitytocommunicateverbally.

B.

Responsetoseparationfromfamily. Incorrect

C.

Concernforbodyintegrity. Correct

D.

Socializationwithotherchildren.

Thepreschooler'smajorstressorisconcernforhisbodyintegrity(C).Hefearsthathis"insides
willleakout."Achildundergoingsurgerytohisgenitaliaisevenmoreconcernedaboutbody
integrity.Thepreschoolerisquiteverbal,socomprehensionofthewordsheusesorhearsmay
beinaccurate,whilehisimaginationandfearsmayfantasizethereality(A).(B)isaconcernfor
allchildren,butofmostconcerntothetoddler.(D)isnotaprimeconcerninthissituation.
Awarded0.0pointsoutof1.0possiblepoints.

58. AfemaleteenageristakingoraltetracyclineHCL(AchromycinV)foracnevulgaris.What
isthemostimportantinstructionforthenursetoincludeinthisclient'steachingplan?
A.

Usesunscreenwhenlyingbythepool. Correct

B.

Cleansetheskinatleast4timesaday.

C.

Takethemedicationwithaglassofmilk.

D.

Menstrualperiodsmaybecomeirregular.

ID:310978603

PhotosensitivityisacommonsideeffectoftetracyclineHCL(AchromycinV)therapy.Severe
sunburncanoccurwithminimalsunexposureandclientsshouldbeinstructedtoavoidsunlight
andtousesunscreen(A).(BandD)arenotrelatedtotetracyclineHCL(AchromycinV)therapy.
(C)shouldbeavoidedbecausedairyproductsinterferewiththeabsorptionoftetracyclines.
Awarded1.0pointsoutof1.0possiblepoints.

59. ThenurseisassessingtheneurovascularstatusofachildinRussell'straction.Which
findingshouldthenursereporttothehealthcareprovider?

ID:310955065

A.

Palebluishcolorationofthetoes. Correct

B.

Skiniswarmanddrytothetouch.

C.

Toesarewiggleduponcommand.

D.

Capillaryrefilllessthan3seconds.

Russell'sskintractionisusedforfracturesofthefemurinyoungchildrenandadolescents
whosegrowthplatesremainopenandisappliedtothelowerlegusingmoleskinandelastic
wrapbandages,whichcancompresstheperonealnerveandarteriesthatsupplythefoot.
Assessmentofadequarecirculation,movement,andsensationofthetoesandskindistaltothe
applicationismadetoidentifycompromisedbloodflow,socyanosis(A)shouldbereported
immediately.(B,CandD)arenormalfindings.
Awarded1.0pointsoutof1.0possiblepoints.

60. Theclinicnurseistakingthehistoryforanew6montholdclient.Themotherreportsthat ID:310946652

shetookagreatdealofaspirinwhilepregnant.Whichassessmentshouldthenurseobtain?
A.

Typeofreactiontoloudnoises. Correct

B.

Anysurgeriesontheearssincebirth.

C.

Drainagefromtheinfant'sears.

D.

Numberofearinfectionssincebirth.

Ototoxicitydiminisheshearingacuityandcausessymptomsoftinnitusandvertigoinolder
childrenwhocanexpresssubjectivesymptoms,soassessinganinfant'sreactiontoloudnoises
(A)helpstodetermineaninfant'sriskforahearingdeficitrelatedtoahistoryofthemother
takinganototoxicdrug,suchasaspirin,whilepregnant.(B,C,andD)arenotassociatedwith
exposuretoaspirininutero.
Awarded1.0pointsoutof1.0possiblepoints.

ID:311023669
61. At8a.m.theunlicensedassistivepersonnel(UAP)informsthechargenursethata
femaleadolescentclientwithacuteglomerulonephritishasabloodpressureof210/110.The4a.m.
bloodpressurereadingwas170/88.TheclientreportstotheUAPthatsheisupsetbecauseher
boyfrienddidnotvisitlastnight.Whatactionshouldthenursetakefirst?

A.

Givetheclienther9a.m.prescriptionforanoraldiureticearly.

B.

AdministerPRNprescriptionofnifedipine(Procardia)sublingually. Correct

C.

Notifythehealthcareproviderandinformthenursingsupervisoroftheclient'scondition.

D.

Attempttocalmtheclientandretakethebloodpressureinthirtyminutes. Incorrect

SublingualProcardia(B)lowersbloodpressureveryquickly,andthisshouldbedonefirst.(A)
mayalsobedone,butoraldiureticsdonotworkasrapidlyasthesublingualantihypertensive.
Whennotifyingthehealthcareprovider,thefirstthinghe/shewillwanttoknowisifthePRN
antihypertensivehasbeenadministered(C).(D)doesnotconsidertheseriousnessofthis
finding.Thenurseshouldstaywiththeclientuntilthebloodpressureisreduced.
Awarded0.0pointsoutof1.0possiblepoints.

62. Afullterminfantisadmittedtothenewbornnursery.Aftercarefulassessment,thenurse ID:310949406

suspectsthattheinfantmayhaveanesophagealatresia.Whichsymptomsarethisnewbornlikelyto
exhibit?
A.

Choking,coughing,andcyanosis. Correct

B.

Projectilevomitingandcyanosis.

C.

Apneicspellsandgrunting.

D.

Scaphoidabdomenandanorexia.

(A)includesthe"3Cs"ofesophagealatresiacausedbytheoverflowofsecretionsintothe
trachea.Projectilevomiting(B)ischaracteristicofpyloricstenosisintheinfant.Apneicspells
oftenoccurwithprematurityorsepsis,andgrunting(C)isasignofrespiratorydistress.A
scaphoidabdomen(D)ischaracteristicofdiaphragmatichernia.
Awarded1.0pointsoutof1.0possiblepoints.

63. Surgeryisbeingdelayedforaninfantwithundescendedtestes.Incollaborationwiththe
healthcareproviderandthefamily,whichprescriptionshouldthenurseanticipate?
A.

Atrialofadrenocorticotrophichormoneinjections.

B.

Frequentstimulationofthecremastericreflex.

ID:310946678

C.

Atrialofhumanchorionicgonadotrophichormone. Correct

D.

Frequentwarmbathstogentlydilatethescrotalarea. Incorrect

AtrialofHCG(humanchorionicgonadotrophichormone)(C)mayaidintesticulardescent,but
doesnotreplacesurgicalrepairfortrueundescendedtestes.Undescendedtestes
(cryptorchidism)maybefoundintheinguinalcanalduetoexaggeratedcremastericreflex.(A)
isnotindicated.Stimulationofthecremastericreflexcausesthetestestoascendratherthan
descendinthescrotum(B).(D)mayrelaxthecremastericmuscle,butmaynotcausethetestes
todescend.
Awarded0.0pointsoutof1.0possiblepoints.

64. Whichgrowthanddevelopmentcharacteristicshouldthenurseconsiderwhenmonitoring ID:311041552

theeffectsofatopicalmedicationforaninfant?
A.

Alowersensitivityreactionstoskinirritants.

B.

Athinstratumcorneumthatincreasestopicalabsorption. Correct

C.

Asmallerpercentageofmusclemass.

D.

Agreaterbodysurfaceareathatrequireslargerdosages.

Infantshaveathinouterskinlayer(stratumcorneum),sothenurseshouldmonitortheinfantfor
apromptonsetandresponsetotheapplicationoftopicalmedication(B).(A,C,andD)are
unrelatedtotopicalmedicationadministration.
Awarded1.0pointsoutof1.0possiblepoints.

ID:310947636
65. Themotherofa4yearoldchildasksthenursewhatshecandotohelpherother
childrencopewiththeirsiblingsrepeatedhospitalizations.Whichisthebestresponsethatthenurse
shouldoffer?

A.

Informtheparentthatthechildistooyoungtovisitthehospital.

B.

Suggestthatthechildvisitagrandmotheruntilthesiblingreturnshome.

C.

Askthemotherifthechildaskswhenthesiblingwillbedischarged.

D.

Encouragethemothertohavethechildrenvisitthehospitalizedsibling. Correct

Needsofasiblingwillbebettermetwithfactualinformationandcontactwiththeillchild,so

siblingvisitationshouldbeencouraged(D).Parentsareexpertsontheirchildrenandshould
determinewhentheirchildrenareoldenoughtovisit(A)inthehospital.Separationfromfamily
andhome(B)mayintensifyfearandanxiety.Childrenmayhavedifficultyexpressingquestions
(C),sothesupportofparentsandothercaregiversareneededtohelpalleviatetheirfears.
Awarded1.0pointsoutof1.0possiblepoints.

66. Thenurseisplanningthecareofa2yearoldwithsevereeczemaontheface,neck,and ID:310945282

scalpfromscratchingtheaffectedareas.Whichnursinginterventionismosteffectiveinpreventing
furtherexcoriationduetothepruritis?
A.

Obtainglovesforthechild'shands.

B.

Applyfingercotsonthechild'sfingers. Incorrect

C.

Placeelbowrestraintsonthechild'sarms. Correct

D.

Applysoftrestraintstothechild'swrists.

Elbowrestraints(C)preventarmflexionandscratchingofinvolvedareas,butdonotinhibituse
ofthehandsforplayactivities.(AandB)canbeeasilyremovedbythechildandwouldrestrict
handmovement.(D)wouldbeineffectiveinpreventingthechildfromscratchingbecausethe
upperbodycouldbemovedwithinreachofrestrainedhands,andwouldalsocreatethe
greatestrestrictionofhandmovement.
Awarded0.0pointsoutof1.0possiblepoints.

67. Whenplanningthecareforachildwhohashadacleftliprepair,thenurseknowsthat
cryingshouldbeminimizedbecauseit
A.

increasessalivation.

B.

increasestherespiratoryrate.

C.

leadstovomiting.

D.

stressesthesutureline. Correct

ID:310953497

Preventionofstressonthelipsutureline(D)isessentialforoptimumhealingandthecosmetic

appearanceofacleftliprepair.Althoughcryingalsocauses(A,B,andC),theseconditionsdo
notcreateaproblemforthechildwithacleftliprepair.
Awarded1.0pointsoutof1.0possiblepoints.

68. A3weekoldnewbornisbroughttotheclinicforfollowupafterahomebirth.Themother ID:310989347

reportsthatherchildbottlefeedsfor5minutesonlyandthenfallsasleep.Thenurseauscultatesaloud
murmurcharacteristicofaventricularseptaldefect(VSD),andfindsthenewbornisacyanoticwitha
respiratoryrateof64breathsperminute.Whatinstructionshouldthenurseprovidethemotherto
ensuretheinfantisreceivingadequateintake?(Selectallthatapply.)
A.

Monitorthetheinfant'sweightandnumberofwetdiapersperday. Correct

B.

Increasetheinfant'sintakeperfeedingby1to2ouncesperweek. Correct

C.

Mixthedoseofprophylacticantibioticinafullbottleofformula.

D.

Allowtheinfanttorestandrefeedondemandorevery2hours. Correct

E.

Useasofternippleorincreasethesizeofthenippleopening. Correct

Correctresponsesare(A,B,D,andE).NeonateswhohaveVSDmayfatiguequicklyduring
feedingandingestinadequateamounts.Theyshouldbemonitoredforweightgainandatleast
6wetdiapersperday(A).Aonemontholdinfantshouldingest2to4ouncesofformulaper
feedingandprogresstoabout30ouncesperdayby4monthsofage(B).Duetofatigue,the
infantshouldrest,butfeedatleastevery2hourstoensureadequateintake(D).Asofter
(preemie)nippleoralargerslitinthenipple(E)helpstoreducethesuckingeffortandenergy
expenditure,thusallowingtheinfanttoingestmorewithlesseffort.Antibioticprophylaxisis
recommendedforinfantswithVSDs,butshouldnotbemixedinabottleofformula(C)because
itisdifficulttoensurethatthetotaldoseisconsumed.
Awarded0.0pointsoutof1.0possiblepoints.

69. Thenurseishavingdifficultycommunicatingwithahospitalized6yearoldchild.Which
approachbythenurseismosthelpfulinestablishingcommunication?
A.

Engagethechildthroughdrawingpictures. Correct

B.

Suggestthattheparentreadabooktothechild.

ID:310944556

C.

Providepaperandpencilforthechildtokeepadiary.

D.

Asktheparentifthechildisalwaysuncommunicative.

Drawingpictures(A)isavaluableformofnonverbalcommunication.Asthenurseandchild
lookatthedrawings,averbalstorycanbetoldthatprojectsthechild'sthinking.(B)maydistract
thechild,butdoesnotestablishcommunicationwiththenurse.(C)isusefulforanolderchild
whoisabletowrite.(D)isimportant,butengagingthechildismoreeffectiveinestablishing
communicationpatterns.
Awarded1.0pointsoutof1.0possiblepoints.

ID:310993943
70. Duringroutinescreeningataschoolclinic,anotoscopeexaminationofachild'sear
revealsatympanicmembranethatispearlygray,slightlybulging,andnotmovable.Whatactionshould
thenursetakenext?

A.

Noactionrequired,asthisisanexpectedfindingforaschoolagedchild. Incorrect

B.

Askthechildifhe/shehashadacold,runnynose,oranyearpainlately. Correct

C.

D.

Sendanotehomeadvisingtheparentstohavethechildevaluatedbyahealthcareprovider
assoonaspossible.

Calltheparentsandhavethemtakethechildhomefromschoolfortherestoftheday.

Moreinformationisneededtointerpretthesefindings(B).Thetympanicmembraneisnormally
pearlygray,notbulging,andmoveswhentheclientblowsagainstresistanceorasmallpuffof
airisblownintotheearcanal.Sincethischild'sfindingsarenotcompletelynormal,further
assessmentofhistoryandrelatedsignsandsymptomsisindicatedforaccurateinterpretationof
thefindings.(A,C,andD)areinappropriateactionsbasedonthedataobtainedfromthe
otoscopeexamination.
Awarded0.0pointsoutof1.0possiblepoints.

ID:310949404
71. A15yearoldgirltellstheschoolnursethatallofherfriendshavestartedtheirperiods
andshefeelsabnormalbecauseshehasnot.Whichresponseisbestforthenurseprovide?

A.

Refertheadolescenttothehealthcareproviderforapregnancyscreen.

B.

Scheduleaconferencewithherparentstorecommendhormonetherapy.

C.

Explainthatmenarchevariesandoccursbetweentheagesof12and18years. Correct

D.

Suggestthatsheusediversionstohelphernotworryaboutdelayedmenarche.

Thenurseshouldprovideafactualandreassuringexplanationthatfocusesonindividual
variationsofmenarche,whichcannormallyoccurbetween12and18yearsofage(C).(A)
doesnotaddresstheadolescent'sconcernandisjudgmental.Menarcheisinfluencedby
hereditary,generalhealth,andnutritionalstatus,so(B)isnotindicated.(D)dismissesthe
adolescent'sconcernsanddoesnotofferfactualinformation.
Awarded1.0pointsoutof1.0possiblepoints.

72. Thenurseisteachingtheparentsofa5yearoldwithcysticfibrosisaboutrespiratory
treatments.Whichstatementindicatestothenursethattheparentsunderstand?
A.

Performposturaldrainagebeforestartingaerosoltherapy.

B.

Giverespiratorytreatmentswhenthechildiscoughingalot.

C.

Administeraerosoltherapyfollowedbyposturaldrainagebeforemeals. Correct

D.

Ensurerespiratorytherapyisdonedailyduringanyrespiratoryinfection.

ID:310978647

Posturaldrainageforachildwithcysticfibrosisismosteffectivewhenperformedafter
nebulizationandbeforemeals(C)oratleast1houraftereatingtopreventnauseaand
vomiting.Posturaldrainageusesgravitytopromotemucousremovalafternebulization(A)
treatmentswhichopentheairways.Pulmonarytoiletingorrespiratorytreatmentsshouldbe
given3to4timesdaily,notepisodically(BandD).
Awarded1.0pointsoutof1.0possiblepoints.

73. Thenurseobservesa4yearoldboyinadaycaresetting.Whichbehaviorwouldthe
nurseconsidernormalforthischild?
A.

Hasatempertantrumwhentoldhemustsharehistoys. Incorrect

ID:311028909

B.

Playsbyhimselfmostoftheday.

C.

Demonstratesaggressivenessbyboastingwhentellingastory. Correct

D.

Beginstocryandisfearfulwhenseparatedfromhisparents.

Fouryearoldchildrenareaggressiveintheirbehaviorandenjoy"taletelling"(C).Behaviorsin
(AandD)aretypicaloftoddlers.Theplayofapreschooleriscooperative,soplayingalone(B)
isnottypical.
Awarded0.0pointsoutof1.0possiblepoints.

74. PreoperativenursingcareforachildwithWilms'tumorshouldincludewhich
intervention?
A.

Gentlypercusstheabdomenforevidenceoftrappedair.

B.

Observetheabdomenforanynoticeablediscolorations. Incorrect

C.

Applycoldcompressestotheabdomentoreduceedema.

D.

Putasignonthebedreading,"DONOTPALPATEABDOMEN." Correct

ID:311008997

Preventionofabdominalpalpation(D)minimizestheriskofrupturingtheencapsulatedtumor
andsubsequentmetastasis.(A)isunnecessary,andthisactioncouldtraumatizethetumorin
thesamemanneraspalpation.(BandC)areincorrectsincetheabdomenisnotdiscoloredand
coldcompressesarenotindicated.
Awarded0.0pointsoutof1.0possiblepoints.

ID:310944586
75. Thenurseisdevelopingaplanofcarefora3yearoldwhoisscheduledforacardiac
catheterization.Toassistindecreasinganxietyforthechildonthedayoftheprocedure,which
interventionisbestforthenursetoimplement?

A.
B.
C.

Reassuretheparentsthat3yearoldsarecooperativeandthereforearelesslikelytobe
anxious.
Obtainavideofilmofacardiaccatheterizationtoshowtothechildpriortotheprocedure.
Givethechildarideonagurneytovisitthecardiaccatheterizationlabandmeetanurse
whoworksthere. Correct

D.

Obtainacardiaccatheteranddemonstratetheprocedurebypretendingtoputthecatheterin
adollorstuffedanimal.

Familiarizingthechildandmotherwiththedepartment(C)willhelpdecreaseanxietyofthechild
andmother(whomayhavemoreanxietythanthechild).Threeisadifficultagetoundergoa
procedurethatrequirescooperation.Restraintsandpossiblysedationmayberequired(A).At
three,thechildistooyoungtounderstandwhythismustbedone,and(B)isnotindicated.(D)
isalsonotindicatedbecauseitislikelytobeinterpretedaspainful.
Awarded1.0pointsoutof1.0possiblepoints.

76. A3montholdinfantdevelopsoralthrush.Whichpharmacologicagentshouldthenurse
plantoadministerfortreatmentofthisdisorder?
A.

Nystatin(Mycostatin). Correct

B.

Nitrofurantoin(Macrodantin).

C.

Norfloxacin(Noroxin). Incorrect

D.

Neomycinsulfate(Mycifradin).

ID:310972743

Nystatin(Mycostatin)(A)isanantifungaldrugthatiseffectiveintreatingthrush,anoralfungal
infection.(B,C,andD)arenotindicatedforthetreatmentoforalthrush.
Awarded0.0pointsoutof1.0possiblepoints.

ID:311013613
77. Thenurseisassigningcarefora4yearoldchildwithotitismediaandisconcerned
aboutthechild'sincreasingtemperatureoverthepast24hours.Whenplanningcareforthischild,itis
importantforthenursetoconsiderthat

A.

onlyanRNshouldbeassignedtomonitorthischild'stemperature.

B.

atympanicmeasurementoftemperaturewillprovidethemostaccuratereading. Correct

C.

thelicensedpracticalnurseshouldbeinstructedtoobtainrectaltemperaturesonthischild.

D.

thehealthcareprovidershouldbeaskedtoprescribethemethodformeasurementofthe
child'stemperatures.

(B)Atympanicmembranesensorisanexcellentsitebecauseboththeeardrumand
hypothalamus(temperatureregulatingcenter)areperfusedbythesamecirculation.Thesensor
isunaffectedbycerumenandthepresenceofsuppurativeorunsuppurativeotitismediadoes
noteffectmeasurement.RULEOFTHUMB:formanagementsterileproceduresshouldbe
assignedtolicensedpersonnel.ManagementskillswillbetestedontheNCLEX!AnRNisnot
required(A).Rectaltemperaturemeasurement(C)islessaccuratebecauseofthepossibilityof
stoolintherectum.(D)isunnecessary.
Awarded1.0pointsoutof1.0possiblepoints.

78. Whichbehaviorwouldthenurseexpecta2yearoldchildtoexhibit?
A.

Buildahousewithblocks.

B.

Rideatricycle.

C.

Displaypossessivenessoftoys. Correct

D.

Lookatapicturebookfor15minutes.

ID:311018755

2yearoldchildrenareegocentricandunabletosharewithotherchildren.(A,B,andD)are
behaviorsofapreschooler.
Awarded1.0pointsoutof1.0possiblepoints.

79. Achildisrescuedfromaburninghouseandbroughttotheemergencyroomwithpartial
thicknessburnsonthefaceandchest.Whichactionshouldthenurseimplementedfirst?
A.

Insertanindwellingurinarycatheter.

B.

AdministerIVpainmedication.

C.

Collectbloodspecimenforlaboratorystudies.

D.

Assessthechild'srespiratorystatus. Correct

ID:311041554

Assessingtheairwayandtherespiratorystatusisthehighestpriority(D)sinceburnstotheface
andchestplacethechildatriskforsmokeinhalationinjuryandcompromisedairway.(A,B,and
C)areimplementedafter(D).
Awarded1.0pointsoutof1.0possiblepoints.

ID:310957405
80. ThemotherofapreschoolagedchildasksthenurseifitisallrighttoadministerPepto
Bismoltohersonwhenhe"hasatummyache."Afterremindingthemothertocheckthelabelofall
overthecounterdrugsforthepresenceofaspirin,whichinstructionshouldthenurseincludewhen
replyingtothismother'squestion?

A.

Ifthechild'stonguedarkens,discontinuethePeptoBismolimmediately.

B.

Donotgiveifthechildhaschickenpox,theflu,oranyotherviralillness. Correct

C.

AvoidtheuseofPeptoBismoluntilthechildisatleast16yearsold. Incorrect

D.

PeptoBismolmaycauseareboundhyperacidity,worseningthe"tummyache."

PeptoBismolcontainsaspirinandthereisthepotentialofReye'ssyndrome(B).(A)isa
commoneffectofPeptoBismolanddoesnotwarrantdiscontinuation.PeptoBismolcanbe
usedbychildren(C).PeptoBismoldoesnotcausereboundhyperacidity(D),whichisa
complicationofantacidscontainingcalcium.
Awarded0.0pointsoutof1.0possiblepoints.

81. Asixmontholdreturnsfromsurgerywithelbowrestraintsinplace.Whatnursingcare
shouldbeincludedwhencaringforanyrestrainedchild?
A.

Keeprestraintsonatalltimes.

B.

Removerestraintsoneatatimeandproviderangeofmotionexercises. Correct

C.

Removeallrestraintssimultaneouslyandprovideplayactivities.

D.

Renewthehealthcareprovider'sprescriptionforrestraintsevery72hours.

ID:311028901

Removingrestraintsoneatatime(B)issaferthanremovingallofthematonce(C).Thechild
needstoexerciseandshouldnotbekeptinrestraintsatalltimes(A).Therenewalofthe
healthcareprovider'sprescriptionvarieswithhospitals(D),anditdoesnotreallyanswerthe
question.
Awarded1.0pointsoutof1.0possiblepoints.

ID:310945250
82. Thenurseassigningcarefora5yearoldchildwithotitismediaisconcernedaboutthe
child'sincreasingtemperatureoverthepast24hours.Whichstatementisaccurateandshouldbe
consideredwhenplanningcarefortheremainderoftheshift?

A.

AnRNshouldbeassignedtotaketemperaturesfrequently.

B.

Tympanicandoraltemperaturesareequallyaccurate. Correct

C.

ThePNshouldtakerectaltemperaturesonthischild.

D.

Thepediatricianshoulddecidehowtoassessthetemperature.

Atympanicmembranesensorapproximatescoretemperaturesbecausethehypothalamusand
eardrumareperfusedbythesamecirculation.Tympanicreadingsobtainedusingproper
techniquecorrelatedmoderatelytostronglywithoraltemperaturesinrecentresearchstudies
(B).Thesensorisunaffectedbycerumenorthepresenceofsuppurativeorunsuppurativeotitis
media.AnRNisnotrequiredtotakethechild'stemperature,butmustassessreadingsreceived
fromassistivepersonnel(A).Althoughrectalreadingsarehighlyaccurate(C),suchaninvasive
procedureisunnecessary.(D)isnotrequired.
Awarded1.0pointsoutof1.0possiblepoints.

83. Thenurseisgivingaliquidironpreparationtoa3yearoldchild.Whichtechniqueshould
thenurseimplementtoengagethechild'scooperation?
A.

Useacolorfulstraw. Correct

B.

Mixthemedicationinwater.

C.

Administerthemedicationusinganoralsyringe.

D.

Askthepharmacytoprovideanenterictablet.

ID:311041546

Aliquidironpreparationadministeredthroughastrawmayhelpthechildtoacceptthe
medicationsinceyoungchildrenconsiderdrinkingfromacolorfulstrawfun(A).(B)maycause
stainingofthechild'steeth.(C)isoftenusedifthechildisuncooperative.(D)isineffectiveand
shouldberequestedfromthehealthcareprovider.
Awarded1.0pointsoutof1.0possiblepoints.

84. Whichactionbythenurseismosthelpfulincommunicatingwithapreschoolagedchild?

ID:310972767

A.

Speakclearlyanddirectlytothechild.

B.

Useadolltoplayandcommunicate. Correct

C.

Approachwhenaparentisnotpresent.

D.

Playaboardgamewiththechild.

Communicatingthroughplaywithadoll(B)orothertoygivestimeforthechildtofeel
comfortablewithastranger.(A)mayfrightensomechildrenandisusuallynotaseffectiveas
(B).Toprovidesecurityandcomfort,preschoolagedchildrenshouldbeapproachedwhena
parentispresent,not(C).(D)istooadvancedforapreschooler.