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Q:
A six-year-old child is hypokalemic. The nurse is helping the child complete the menu. The nurse would encourage this child to select which menu items?
1. Pizza with a fruit plate
2. Chicken strips with chips
3. Fajita with rice
4. A hamburger with French fries
Q:
The nurse is expecting the admission of a child with severe isotonic dehydration. Which intravenous fluid should the nurse anticipate the doctor to order initially to replace fluids?1. 0.9% normal saline (NS)2. D5 0.2% (¼) normal saline3. D5W4. Albumin
Q:
A child with croup has an increased pCO2, a decreased pH, and a normal HCO3 blood gas value. The nurse interprets this as uncompensated:
1. Metabolic alkalosis.
2. Metabolic acidosis.
3. Respiratory acidosis.
4. Respiratory alkalosis.
Q:
A nurse is planning care for a child with hyperkalemia. The nurse explains to the parents that an adverse outcome of hyperkalemia is:
1. Hyperthermia
2. Respiratory distress
3. Seizures
4. Cardiac arrhythmias
Q:
A nurse is planning care for a child with hyponatremia. The nurse, delegating care of this child to a licensed vocational nurse (LVN), cautions the LVN to watch for which clinical manifestation?
1. Seizures
2. Respiratory distress
3. Hyperthermia
4. Bradycardia
Q:
The nurse is caring for a child on bed rest who has severe edema in a left lower leg due to blocked lymphatic drainage. Which nursing diagnosis would take priority?
1. Risk for impaired skin integrity
2. Risk for altered body image
3. Risk for imbalanced nutrition: less than body requirements
4. Risk for activity intolerance
Q:
In the morning, a nurse receives a report on four pediatric clients, each of whom has some form of fluid-volume excess. Which of the children should the nurse see first?
1. The child with tachypnea and pulmonary congestion
2. The child with hepatomegaly and normal respiratory rate
3. The child with dependent and sacral edema and regular pulse
4. The child with periorbital edema and normal respiratory rate
Q:
The nurse is assessing an infant brought to the clinic because of diarrhea. The infant is alert but has dry mucous membranes. Which other sign indicates the infant is still in the early to moderate stage of dehydration?
1. Bradycardia
2. Tachycardia
3. Increased blood pressure
4. Normal fontanels
Q:
The nurse has just finished a parent teaching session on preventing heat-related illnesses for children who exercise. Which statement by a parent indicates understanding of preventive techniques taught?
1. Wearing dark clothing during exercise is recommended
2. Water is the drink of choice to replenish fluids.
3. During activity, stop for fluids every 15 to 20 minutes.
4. Hydration should occur at the end of an exercise session.
Q:
A nurse is taking care of four different pediatric clients. Which of the following children is at greatest risk for dehydration?
1. Seven-year-old child with migraine headaches
2. Four-year-old child with a broken arm
3. Two-year-old child with cellulitis of the left leg
4. 18-month-old child with tachypnea
Q:
A four-year-old child is admitted to the hospital secondary to dehydration. Lab tests indicate a high hemoglobin and hematocrit, and the serum sodium is below normal levels. This fluid loss is indicative of which condition?
1. Hypernatremia
2. Metabolic acidosis
3. Hypotonic dehydration
4. Isotonic dehydration
Q:
The school nurse wants to protect the students from Reye disease. To this end, the nurse creates a pamphlet that advises the parents to avoid giving which medication to a sick child?
1. Antibiotics
2. Acetaminophen
3. Ibuprofen
4. Aspirin
Q:
There has been an outbreak of communicable diseases in the community. To reduce parental anxiety, the nurse presents information about disease at the school's Parent Teacher Association meeting. The nurse explains that children cannot acquire vector-borne diseases from other children. The nurse explains that vector-borne diseases include:
Standard Text: Select all that apply.
1. Measles (Rubeola).
2. Pertussis (whooping cough).
3. Rocky Mountain Spotted Fever.
4. West Nile Virus.
5. Lyme disease.
Q:
The nurse administers the flu vaccine to a school age child. After administering the vaccine, the nurse will document:
Standard Text: Select all that apply.
1. The date of the last flu vaccine.
2. The site of the vaccination.
3. The lot and serial number of the vaccine.
4. The date and time of administration.
5. Who assisted in restraining the child.
Q:
After her child receives a vaccination, the mother calls the clinic to report the child's reaction to the immunization. The nurse will recommend the mother call 911 when the mother reports:
1. A few hives are noted around the injection site.
2. The child is running a slight temperature.
3. The child has swelling of the face.
4. Fever and joint pains occurring within hours of the vaccination.
Q:
The clinic nurse is checking the potency of the vaccine. Which finding may have rendered the vaccine ineffective?
1. The vaccine was frozen as labeled.
2. The vaccines have been stored in a refrigerator where the temperature has been maintained between 35 to 46F.
3. The vaccine's expiration date expires within the next month.
4. The vaccine is stored in the door of the refrigerator.
Q:
The nurse is preparing to administer a vaccine to a 14-month-old infant. Which finding would require that the nurse delay the vaccination until the next well-child visit?
1. The child is allergic to a substance in the vaccine.
2. The child has a low-grade fever and a runny nose.
3. The child received a dose of immune globulin two months ago.
4. The child is on antibiotics.
Q:
The nurse is evaluating the immunization status of a child. The nurse recognizes that the child can acquire active immunity against a disease by:
Standard Text: Select all that apply.
1. Receiving a dose of immunoglobulins.
2. Immunization with a killed virus vaccine.
3. Immunization with a toxoid.
4. Antibiotic therapy.
5. Acquiring the disease.
Q:
The mother of an immunocompromised child brings her child to the clinic for a routine check-up and recommended immunizations. The mother expresses concern that her child will "catch" the disease from the vaccination. The nurse would explain that which of the following carry no risk of acquiring the infection?
Standard Text: Select all that apply.
1. Toxoid
2. Killed virus vaccine
3. Live virus vaccine
4. Attenuated vaccine
5. Immunoglobulins
Q:
The school nurse is trying to prevent the spread of a flu virus through the school. Infection-control strategies that could be employed include:
1. Sanitizing toys, telephones, and doorknobs to kill pathogens.
2. Teaching parents safe food preparation and storage.
3. Withholding immunizations for children with compromised immune systems.
4. Not separating children with infections from well children.
Q:
The hospital admitting nurse is taking a history on a child's illness from the parents. The nurse concludes that the parents treated their six-year-old child appropriately for a fever related to otitis media when they report that they:
1. Put the child in a tub of cold water to reduce the fever.
2. Alternated acetaminophen with ibuprofen every two hours.
3. Offered generous amounts of fluids frequently.
4. Used aspirin every four hours to reduce the fever.
Q:
The hospital has instructed its nurses that they must participate in disease surveillance associated with infectious agents. The nurses are warned that which of the following disease(s) are likely to be the weapons of terrorists?
1. Rocky Mountain spotted fever and Lyme disease
2. Plague, anthrax, and smallpox
3. Rubella, mumps, and chickenpox
4. Severe acute respiratory syndrome (SARS)
Q:
The hospital has just provided its nurses with information about biologic threats and terrorism. After completing the course, a group of nurses are discussing their responsibility in relation to terrorism. The nurse who correctly understood the presentation is the one who identifies their action to be:
1. Initiating isolation precautions for a hospitalized client with methicillin-resistant staphylococcus aureus (MRSA).
2. Notifying the Centers for Disease Control and Prevention (CDC) if a large number of persons with the same life-threatening infection present to the emergency department.
3. Separating clients according to age and illness to prevent the spread of disease.
4. Disposing of blood-contaminated needles in the lead-lined container.
Q:
A two-year-old child with a fever is prescribed amoxicillin clavulanate 250 mg/5 ml three times daily by mouth for ten days for otitis media. To guard against antibiotic resistance, the nurse instructs the parent to:
1. Give the antibiotic for the full ten days.
2. Measure the prescribed dose in a household teaspoon.
3. Spread the dose evenly during daylight hours.
4. Stop the antibiotic when the child is afebrile.
Q:
The nurse is teaching a class on infectious disease; the nurse understands that zoonosis is only transmitted by:
1. Person to person.
2. Animals to person.
3. Adult to child.
4. Person to insects.
Q:
A parent reports that her five-year-old child, who has had all recommended immunizations, had a mild fever one week ago and now has bright red cheeks and a lacy red maculopapular rash on the trunk and arms. The nurse recognizes that this child might have:
1. Rubeola (measles).
2. German measles (rubella).
3. Chickenpox (varicella).
4. Fifth disease (erythema infectiosum).
Q:
A three-year-old child is lying in a fetal position. The child has pale skin, glassy eyes, and a flat affect. The child is irritable and refuses food and fluids. The child's vital signs are temperature 40.1°C (104.2°F), pulse 120/minute, respirations 28/minute. The best, most comprehensive description of this child's condition is:1. Tired.2. Feverish.3. Flushed.4. Toxic.
Q:
Which should the nurse use when reconstituting vaccines?
1. The diluents provided
2. Normal saline
3. Any solution available
4. Sterile water
Q:
A mother brings her four-month-old infant in for a routine checkup and vaccinations. The mother reports that the four-month-old was exposed to a brother who has the flu. In this case, the nurse will:
1. Withhold the DTaP vaccination but give the others as scheduled.
2. Give the infant the flu vaccination but withhold the others.
3. Give the vaccinations as scheduled.
4. Withhold the vaccinations.
Q:
The pediatric clinic has set a goal that 95% or more of the children attending the clinic will be fully immunized. To reach this goal, clinic nurses will teach the families that:
1. The benefits of immunizations outweigh the risks of communicable diseases.
2. Immunizations should be completed by the time the child starts school.
3. Once a child receives a vaccination, that individual has lifelong immunity against that disease.
4. Vaccinations are 100% safe.
Q:
A mother refuses to have her child immunized with the measles, mumps, and rubella (MMR) vaccine because she believes that letting her infant get these diseases will help him fight off other diseases later in life. The nurse's most appropriate response to this mother is to:
1. Tell the mother that by not immunizing her child she may be exposing pregnant women to the virus, which could cause fetal harm.
2. Honor her request because she is the parent.
3. Tell the mother that she is wrong and should have her child immunized.
4. Explain the potential complications of measles, mumps, and rubella infections.
Q:
The nurse prepares a DTaP (diphtheria, tetanus toxoid, and acellular pertussis) immunization for a six-month-old infant. To administer this injection safely, the nurse chooses which of the following needles (size and length), injection type, and injection site?
1. 25-gauge, 5/8-inch needle; IM (intramuscular); anterolateral thigh
2. 25-gauge, 5/8-inch needle; ID (intradermal); deltoid
3. 22-gauge, 1/2-inch needle; IM (intramuscular); dorsogluteal
4. 25-gauge, 3/4-inch needle; SQ (subcutaneous); anterolateral thigh
Q:
A child who has not had a tetanus immunization steps on a rusty nail. The child needs immediate protection from tetanus. Which of the following should be given to the child at this time?
1. Toxoid
2. Antigen
3. Killed virus
4. Passive immunity
Q:
The nurse is teaching parents how to prevent the spread of infectious disease. Which of the following is the most important health promotion strategy for all age groups of children?
1. Keeping child free from colds
2. Proper hand hygiene
3. Keeping all toys clean and free from germs
4. Keeping child away from sick adults
Q:
The nurse is explaining the importance of hand washing after using the toilet to parents of young children. Which is the most important reason for this practice?
1. Children's immune systems are not fully developed.
2. Hand washing is the main way to limit the transmission of disease.
3. Not all bathrooms are clean.
4. Children do not like to have dirty hands.
Q:
The nurse is teaching a child care class for mothers of young children. The nurse tells the parent that the most common mode of transmission of infectious disease is:
1. Children who are playing with the same toy.
2. Children who are coughing.
3. Children who are sitting together eating meals.
4. Children who are playing board games.
Q:
The nurse explains to new parents that as healthy children are exposed to more infections, they:
1. Naturally develop antibodies.
2. Are found to be healthier.
3. Will acquire terminal illnesses.
4. Will weaken their immune systems.
Q:
A nurse is providing education to a group of young mothers. The nurse would explain that as children grow, they develop immunity through:
1. Immunization or exposure to the natural disease.
2. Acquiring diseases from family members who had the disease.
3. Acquiring diseases from other children.
4. Being born with diseases already in their systems.
Q:
A nurse is providing information to a group of new mothers. The nurse would explain that newborns and young infants are more susceptible to infection because they have:
1. Low levels of antibodies.
2. High levels of maternal antibodies to diseases to which the mother has been exposed.
3. Passive transplacental immunity from maternal immunoglobulin G.
4. Been exposed to microorganisms during the birth process.
Q:
In responding to the needs of pediatric patients in pain, the nurse has numerous nonpharmacologic interventions available. These interventions include:
Standard Text: Select all that apply.
1. Regional nerve block.
2. Cutaneous stimulation.
3. Application of heat.
4. Electroanalgesia.
5. Use of EMLA cream.
Q:
The clinical nurse specialist is concerned about children's reactions to painful invasive procedures such as intravenous starts. The nurse has decided to use distraction as a means to comfort the school-age child. Depending on the age of the school-age child, which technique might the nurse use to distract the child?
Standard Text: Select all that apply.
1. Blowing bubbles
2. Music therapy
3. Guided imagery
4. Hypnosis
5. Sucrose solution
Q:
The 17-month-old infant is terminally ill with cancer and is in constant pain. The nurse recognizes that the best way to control pain in this child would be for the physician to order:
1. Patient-controlled analgesia with the parents controlling the button that administers the dosage.
2. Intravenously administered opioids on a scheduled basis.
3. Intravenously administered opioids on a prn basis.
4. Parenteral administration controls pain more effectively than oral medication as oral absorption may be modified by stomach activities. In addition, providing analgesics on a scheduled basis is preferred over prn.
Q:
During shift report, the night nurse reports that the child who is terminally ill has developed tolerance to the morphine that the child has been receiving. The oncoming nurse realizes that the child:
1. Is physically dependent on morphine.
2. Is addicted to morphine.
3. Is showing physical signs of withdrawal.
4. Will need more medication to achieve the same effect.
Q:
The physician has ordered the postoperative four-year-old child to receive hydromorphine (Dilaudid) intravenously. The drug book lists a therapeutic range for Dilaudid to be 0.01 to 0.015 mg/kg/dose every three to four hours. What would be the maximum therapeutic dose of Dilaudid if the child weighs 30 pounds? Round your answer to the nearest hundredth.
Standard Text:
Q:
The nurse administered morphine intravenously to a four-year-old postoperative patient. Thirty minutes later, the nurse assesses the child. Which assessment finding requires further evaluation?
1. Pulse decreased from 136 to 104
2. Blood pressure dropped from 110/72 to 90/55
3. Respiratory rate went from 42 to 16
4. Child pulls away from nurse who wants to assess surgical site
Q:
The nurse is caring for a four-year-old child who is intellectually disabled and is scheduled for surgery tomorrow. The nurse wants to plan postoperative care and pain relief. The nurse will determine the best pain assessment tool by observing the child's:
Standard Text: Select all that apply.
1. Language skills.
2. Understanding of the concept of more and less or otherwise has the ability to quantify pain.
3. Ability to sit for a ten minute evaluation.
4. Ability to perceive pain.
5. Ability to understand pain.
Q:
The mother of a child who is recovering from surgery says to the nurse, "I don"t understand why that other nurse told me to stroke his forehead when he is in pain. Why will that make him feel better?" The nurse's response will be based on the knowledge that:
1. Stroking the child's forehead reminds the child of the mother's continued presence, which is reassuring to the child.
2. Stroking causes a non-pain transmission to the brain that competes with the pain transmission and inhibits the pain message from reaching the brain.
3. Stroking causes the release of biochemicals, such as prostaglandins, which block pain transmission.
4. Stroking causes the release of endorphins, which reduce the perception of pain.
Q:
The nurse is caring for a child who has been sedated for a painful procedure. What is the priority nursing activity for this child?
1. Place the child on a cardiac monitor.
2. Allow parents to stay with the child.
3. Monitor pulse oximetry.
4. Assess the child's respiratory effort.
Q:
A five-year-old child is being discharged from the outpatient surgical center. Which statement by the parent would indicate the need for further teaching?
1. "I will call the office tomorrow if the pain medicine is not relieving the pain."
2. "I can expect my child to have some pain for the next few days."
3. "Because my child just had surgery today, I can expect the pain level to be higher tomorrow."
4. "I will plan to give my child pain medicine around the clock for the next day or so."
Q:
The nurse is working in a pediatric surgical unit. The nurse would expect that patient-controlled analgesia would be most appropriate for which patient?
1. Twelve-year-old who is postoperative for spinal fusion for scoliosis
2. Ten-year-old who has a fractured femur and concussion from a bike accident
3. Five-year-old who is postoperative for tonsillectomy
4. Developmentally delayed 16-year-old who is postoperative for bone surgery.
Q:
A child who has chronic pain of long duration will exhibit which behavior?
1. Increased respiratory rate
2. Normal temperature
3. Normal heart rate
4. Decreased blood pressure
Q:
A six-year-old postoperative patient IV has infiltrated and has to be restarted immediately for medication. There is no time for placing local anesthetic cream on the skin. What other complementary therapies would be most helpful when placing this IV?
1. Restraints
2. Moderate sedation
3. Anesthesia
4. Distraction
Q:
The nurse is preparing to perform a heel stick on a neonate. The most appropriate complementary therapy for the nurse to plan to use in the neonate to decrease pain during this quick but painful procedure is:
1. Holding the infant.
2. Sucrose pacifier.
3. Massage.
4. Swaddling.
Q:
A parent asks the nurse if there is anything that can be done to reduce pain that his three-year-old experiences each morning when blood is drawn for lab studies. The most appropriate method the nurse can suggest to relieve pain associated with the venipuncture is:
1. Intravenous sedation 15 minutes prior to the procedure.
2. Use of guided imagery during the procedure.
3. EMLA cream (lidocaine 2.5% and prilocaine 2.5%) applied to the skin at least one hour prior to the procedure.
4. Use of muscle-relaxation techniques.
Q:
An analgesic is ordered for a post-surgical patient to be given every three to four hours. The nurse knows that a delay in giving the medication will cause a(n):
1. Decrease in the chance of withdrawal symptoms.
2. Decrease in the chance of addiction.
3. Increase in the chance of breakthrough pain.
4. Increase in the child's pain tolerance.
Q:
A nurse is taking care of a patient in the ICU who has been on opioids for an extended period of time. The nurse understands that the child has to slowly wean from the medication over a period of time. While weaning, the nurse will observe the child for symptoms of too rapid withdrawal, including:
1. Hyperactive deep tendon reflexes, vomiting, and abdominal cramps.
2. Bradycardia and pallor.
3. Decreased blood pressure and drowsiness.
4. Voracious appetite and hypotonicity.
Q:
A hospitalized three-year-old needs to have an IV restarted. The child begins to cry when carried into the treatment room by the mother. Which is the most appropriate nursing diagnosis?
1. Knowledge deficit of the procedure
2. Fear related to the unfamiliar environment
3. Anxiety related to anticipated painful procedure
4. Ineffective individual coping related to an invasive procedure
Q:
During the nurse's initial assessment of a school-age child, the child reports a pain level of 6 out of 10. The child is lying quietly in bed watching television. The nurse should:
1. Reassess the child in 15 minutes to see if the pain rating has changed.
2. Administer the prescribed analgesic.
3. Do nothing, since the child appears to be resting.
4. Ask the child's parents if they think the child is hurting.
Q:
A five-year-old is hospitalized with a fractured femur. Which assessment tool is appropriate for this child?
1. CRIES Scale
2. Faces Pain Rating Scale
3. SUN Scale
4. PIPP Scale
Q:
The nurse is caring for a two-year-old child in the postoperative period. The pain assessment tool most appropriate for assessment of pain intensity in a two-year-old is the:
1. Poker Chip Tool.
2. Oucher Scale.
3. Faces Pain Rating Scale.
4. FLACC Behavioral Pain Assessment Scale.
Q:
The nurse is taking care of a seven-year-old child who is postoperative. The child's mother requests that the child not receive narcotics in the postoperative period because she is afraid the child will become addicted. The nurse would explain to the mother that children who do not receive adequate pain control will be at risk for:
1. Respiratory complications.
2. Urinary complications.
3. Cardiac complications.
4. Bowel complications.
Q:
The postoperative unit of the pediatric hospital has several children who had surgery this morning. While making rounds, the nurse observes all of the following behaviors. Which child should be further evaluated as to postoperative pain?
1. The six-month-old in deep sleep
2. The two-year-old who is cooperative when the nurse takes his vital signs
3. The four-year-old who is actively watching cartoons
4. The 14-month-old who is thrashing his arms and legs
Q:
The nurse is teaching the parents of a child with idiopathic rheumatoid arthritis about chronic pain. Which statement by the parent indicates teaching has been successful?
1. "When children have chronic pain, they may not have the same behavior as those in acute pain."
2. "It is associated with a single event."
3. "Chronic pain can be managed successfully with NSAIDs."
4. "It is sudden and of short duration."
Q:
The nurse recognizes that the person guilty of child abuse may have which symptoms?
1. Physical illness
2. Alcoholism
3. Many friends and families nearby
4. Unrealistic expectations for their child
5. The abuser has no relationship to the child.
Q:
A child is admitted for scald burns to his buttocks and thighs. According to the mother, she was preparing the child's bath and before she could test the water, the child fell in and was scalded. The nurse would suspect child abuse because:
1. The burns are uneven, with some burns deeper than others.
2. The child's hands and feet are free of burns.
3. In addition to the main burn site, there are splash burns surrounding the area.
4. The mother was home alone with the child.
Q:
The school nurse in the high school recognizes that teenage pregnancy is a major problem in the school. The nurse recognizes that many high school girls hide their pregnancy to prevent adults from knowing they are pregnant. Therefore, it is important that the nurse insure that all pregnant teenagers are aware of:
1. Safe haven laws.
2. Birth control available to all teenagers.
3. Domestic abuse protection.
4. The father's financial responsibility for the infant.
Q:
The child is admitted to the hospital unit for injuries. The mother's boyfriend is suspected of child abuse. The nurse's primary role, in addition to reporting to the proper authorities, is:
1. Gathering information about how the injuries occurred.
2. Collecting evidence against the suspected abuser.
3. Encouraging the child to talk about his experience.
4. Protecting the child from further injury.
Q:
A child is admitted to the hospital with a diagnosis of lead poisoning. The health department nurse is investigating the child's home to locate the source of the lead that the child has ingested. Which possibilities will the nurse investigate?
Standard Text: Select all that apply.
1. The home's foundation for a possible radon leak
2. The home's water pipes
3. The dirt surrounding the house
4. The presence of imported toys or antique baby furniture
5. Gas stored in cans
Q:
A child is brought to the emergency department in a coma. The mother thinks the child may have ingested a poison. The nurse will assess:
Standard Text: Select all that apply.
1. For burns around the mouth.
2. The child's breath.
3. The child's vomitus.
4. Hair samples.
5. Blood and urine toxicology screens.
Q:
The pediatric public health nurse visits a facility for the homeless. The nurse would evaluate the children staying at the facility for what type of medical/health issues?
Standard Text: Select all that apply.
1. Dental caries
2. Infections secondary to tattoos
3. Lack of immunizations
4. Nutritional deficits
5. Munchausen syndrome by proxy
Q:
The mother tells the nurse that her maternity leave is almost over and she will be returning to work soon. She will need to place her infant in a day care, and she asks the nurse how to know which day care is best. The nurse will tell the mother to investigate day care programs that:
Standard Text: Select all that apply.
1. Are close to her work in the event of an emergency
2. Require all staff have criminal background checks
3. Are attractive in appearance, with bright colors and interesting visual stimulation
4. Provide regular training of the staff and administration
5. Have policies regarding child health and emergencies, such as immunization requirements and emergency medical forms
Q:
While working at a weekend "free clinic," the nurse is assessing a three-year-old when the mother of the child confides that it has been very difficult providing for her family of four children on her limited budget. She is not sure that she has enough money to buy both food for the rest of the month and the antibiotic that is needed for the child's ear infection. Which intervention by the nurse would be most beneficial for the child and this family?
1. Talking with the mother about keeping the child's ear clean by using a Q-tip
2. Putting the mother in contact with a local agency that provides food on a regular basis to needy families and helps them access other resources in the community
3. Providing the mother with samples of food and food stamps for the child
4. Giving the mother free samples of an antibiotic.
Q:
While the nurse is taking the history of a 10-year-old child, the parents admit to owning firearms. An appropriate safety measure for the nurse to suggest would be which of the following?
1. Keeping all the guns put away and out of the child's reach
2. Taking the child to a shooting range for lessons on how to use a gun properly
3. Storing the guns and ammunition in the same place
4. Using a gun lock on all firearms in the house
Q:
A young infant is admitted to the hospital unit with physical injuries. The nurse is taking the child's history. The statement by the parent that would be most suspicious for abuse is:
1. "I was walking up the steps and slipped on the ice, falling while carrying my baby."
2. "The baby's 18-month-old brother was trying to pull the baby out of the crib and dropped the baby on the floor."
3. "I placed the baby in the infant swing. His six-year-old brother was running through the house and tripped over the swing, causing it to fall."
4. "I did not realize that my baby was able to roll over yet, and I was just gone a minute to check on dinner when the baby rolled off of the couch and onto our tile floor."
Q:
The nurse works in a pediatric unit. In working with a parent who is suspected of Munchausen syndrome by proxy, it is very important for the nurse to:
1. Try to keep the parent separated from the child as much as possible.
2. Explain to the child that the parent is causing the illness and that the health care team will prevent the child from being harmed
3. Carefully document parent-child interactions.
4. Confront the parent with concerns of possible abuse.
Q:
The school nurse is planning a smoking prevention program for middle school students. All of the following activities will be utilized. Which is likely to be the most effective in preventing middle school children from smoking?
1. A demonstration of the pathophysiology of the effects of smoking tobacco on the body given by the school's biology teacher
2. A talk on the importance of not smoking given by a local high school basketball star
3. Colorful posters with catchy slogans displayed throughout the school
4. A pledge campaign during which students sign contracts saying that they will not use tobacco products
Q:
A high school student calls to ask the nurse for advice on how to care for a new navel piercing. How should the nurse respond?
1. "Avoid contact with another person's bodily fluids until the area is well healed."
2. "Do not move or turn the jewelry for the first three days."
3. "Apply lotion to the area, rubbing gently, to prevent skin from becoming dry and irritated."
4. "Apply warm soaks to the area for the first two days to minimize swelling."
Q:
A parent is concerned about her eight-year-old child's recent behavior and calls the nurse for advice. According to the parent, her child is constantly crying, is not sleeping well, and has withdrawn from activities. The nurse should recognize that this behavior could be a response to:
1. Bullying.
2. Normal behavior for the age.
3. Lead poisoning.
4. Drug abuse.
Q:
The nurse is providing care to homeless teens at an outreach clinic. Which of the following is most important for the nurse to understand?
1. Teens who are homeless will get a job and somewhere to live.
2. Teens who are homeless will seek help when needed.
3. Teens who are homeless will not be fearful of authority figures.
4. Teens who are homeless are most likely to have unprotected sex.
Q:
A seven-year-old child has been seen in the pediatric clinic three times in the last two months for complaints of abdominal pain. On each occasion, the physical exam and all ordered lab work have been normal. The most important information to assess at this time would be:1. The child's normal eating habits.2. Recent viral illnesses or other infectious symptoms.3. Review of the child's immunization history.4. Changes in school or home life.