1)The best position for the delivery room nurse to place a newborn with myelomeningocele at the lumbosacral area in is:
1. Prone
2. Supine
3. Side-lying
4. Trendelenburg
2)A school-age child with rheumatic fever complains of sever joint pains in the knees and ankles. The best method to provide relief would be for the nurse to:
1. Give a warm bath or shower
2. Apply splints to the affected joints
3. Refer the child to physical therapy
4. Place a bed cradle over the child’s legs
3)A hospitalized school-age child is very quiet and seldom talks to the staff. The nurse can best communicate with this child by saying:
1. I’ve noticed you seem very quiet. Is anything troubling you?
2. Let’s tell each other a secret; you start by telling me what you are thinking
3. It must be awfully hard to be away from home. Let’s call your mom
4. Draw me some pictures of the things you’ve seen and done while you’ve been in the hospital
4)Which is the most common complaint by parents about infants with heart disease?
1. Frequent, severe respiratory infections
2. “Slower” development
3. Stunted growth
4. Difficult to feed
5)The nurse in the newborn nursery should plan any interventions with a newborn with myelomeningocele based on the knowledge that the major short-term complication the child is most likely to suffer is:
1. Hydrocephalus
2. Meningitis
3. Mental retardation
4. Paraplegia
6)The physician order Tylenol elixir for a 14-month-old with a fever of 102°F. Considering this child’s developmental level and diagnosis, which would be the best approach by the nurse?
1. Use the medicine cup and tell the child the “pretty red syrup” will taste sweet like candy
2. Mix the medication with 4 oz of apple juice and allow the child to drink it through a “crazy straw”
3. Put the medication into a brightly colored plastic cup and give the child a chance to drink it
4. Raise the child to a sitting position, bring the medicine cup to the lips, and tell the child kindly but firmly to drink it
7)A mother asks the nurse about the normal time for the onset of menstruation. The nurse would be most correct in advising her that menses usually begin at age:
1. 11.2years
2. 12years
3. 12.8years
4. 13.5years
8)A toddler is admitted to the hospital with acute bilateral otitis media, with a temperature of 103F and tremors in arms and legs. In addition to a spinal tap to rule out bacterial meningitis, the doctor orders all the following. Which order should the nurse perform first?
1. Respiratory isolation
2. IV 5% dextrose in 0.45 normal saline solution at 35 mL/hr
3. Tylenol 120mg Po q4h
4. Seizure precautions
9)Two hospitalized school-age children complain that they are bored. The nurse should offer them:
1. A game of Monopoly or life
2. Workbooks, paper, and pencils
3. Some books from the hospital library
4. A chance to stay up late and watch TV
10)A 12-year-old is admitted to the hospital in status asthmaticus, for the second time. In planning care for this child, the nurse must first assess:
1. What she knows about asthma
2. How she usually cares for herself
3. What she knows about hospitalization
4. How she feels about becoming a teenager
11)The nurse performs a Denver Developmental Screening Test on a 3-year-old. Which behavior should the nurse expect this child to be capable of doing?
1. Going up stairs on alternate feet
2. Pedaling a bicycle
3. Dressing without supervision
4. Tying shoelaces
12)The best way for a nurse to perform a DDST on a 9-month-old is to:
1. Take the infant from the mother and ask her to wait in the child’s room
2. Take the infant from the mother and ask her to come with them to the testing area
3. Briefly talk first with the mother, then take the infant to the testing area alone
4. Ask the infant’s mother to carry the child to the testing area
13)For an infant with severe chronic CHF, the formula the nurse should plan to offer would be:
1. Isomil
2. Lofenalac
3. Lonalac
4. Similac 27 with iron
14)The parents of a school-age child with leukemia tell the nurse that their daughter frequently has nightmares, and they wonder how to handle this. The nurse would be most correct in advising them to:
1. Comfort her, but leave her in her own bed
2. Comfort her by bringing her into their bed
3. Consult a child psychologist to determine why she has recurring sleep disturbances
4. Encourage the child to keep a written record of her dreams and discuss them with her primary nurse during hospitalization
15)The patents of a school-age child with leukemia tell the nurse that their daughter frequently has nightmares, and they wonder how to handle this. The nurse would be most correct in advising them to
1. Comfort her, but leave her in her own bed
2. Comfort her by bringing her into their bed
3. Consult a child psychologist to determine why shi has recurring sleep disturbances
4. Encourage the child to keep a written record of her dreams and discuss them with her primary nurse during hospitalization
16)A 20-month-old is admitted to the pediatrics unit for the third, and final, surgical procedure to correct his congenital hypospadias. When admitting this toddler to hospital, the nurse should assess all of the following. Which information will be the most important to the nursing plan of care for this toddler?
1. His developmental level
2. The parents, knowledge level regarding hypospadias
3. His previous experience with illness and hospitalization
4. The parents’ plans for rooming-in
17)A hospitalized preschooler wakes up crying at 2 AM and says, I want my mommy now. the nurse should:
1. Pick the child up and rock the child for a little while
2. Talk softly to the child while rubbing the back, but leave the child in the crib
3. Gently but firmly tell the child to go back to sleep
4. Call the mother and ask her to come to the hospital
18)A toddler tries to pull the IV out, and the nurse determines that the child must be restrained to maintain the IV site. Which restraint would the nurse be most correct in applying?
1. Posey jacket
2. Elbow
3. Mummy
4. Clove-hitch
19)When the patents of a newborn with myelomeningocele visit the nursery for the first time, they make no comments about the baby’s spinal sac. Instead, they offer many positive observations about size, color, hair, and appearance. The nurse would be most correct in interpreting the parents’ behavior as:
1. Attachment
2. Denial
3. Immaturity
4. Love
20)The mother of a toddler who will have his third, and final, surgical procedure to correct congenital hypospadias questions the need for another surgical procedure while he is still so young. The nurse should stress that:
1. It is the mother’s right to refuse surgery at any time
2. It is in her son’s best interest to follow the doctor’s recommendations
3. He can have this third, and final, surgery any time before the onset of puberry
4. This type of surgery is usually timed to take place
21)The mother of a hospitalized 3-year-old tells the nurse that he is a very poor eater at home. The best recommendation the nurse can make to increase his nutritional intake would be to:
1. Provide him with a child-size table\
2. Use plastic cups and plates with cartoon characters he likes
3. Offer him small portions of his favorite foods
4. Allow him to feed himself
22)An infant with CHFtakes1.25ozof formula in 20 minutes. The doctor ordered 2 oz of formula q3h. the best action for the nurse to take at this time would be to:
1. Ask the mother to feed the infant when she arrives
2. Burp the infant and try to stimulate sucking
3. Continue feeding slowly, allowing as much time as the infant needs to finish
4. Stop the feeding, and request an order for gavage feedings prn
23)On admission, a preschooler is carrying a soiled and worn-looking stuffed animal. His mother states that this is his favorite toy. The most appropriate action for the nurse to take at this time is to:
1. Offer him a choice of another stuffed animal from the hospital playroom
2. Place this stuffed animal somewhere in his room where he can see it but not touch it
3. Suggest his mother bring him a new stuffed animal
4. Tell him that he can keep this stuffed animal in the bed with him
24)A 7-month-old infant is admitted to the pediatrics unit with moderate dehydration secondary to acute gastroenteritis(AGE). The physician writes all the following orders for this infant. Which one should the nurse implement first?
1. Contact precautions
2. IV of 5% dextrose in 1/3 normal saline solution at 25 mL/hr
3. Urine specific gravity stat and q4h
4. Stool culture every shift×3
25)The best advice the nurse can give to parents to handle a toddler’s temper tantrums would be to:
1. Allow the toddler to make own choice
2. Ignore this behavior
3. Change the setting in which they occur
4. Give in to the toddler’s demands, to nurture autonomy
26)A toddler is admitted to the hospital with classic hemophilia(factor VIII deficiency). Which admission procedure by the nurse will probably be the most frightening for this child?
1. Blood pressure
2. Rectal temperature
3. Urine specimen
4. Weight
27)The physician orders sterile moist soaks to a myelomeningocele sac. The major reason for this treatment is to:
1. Promote comfort
2. Prevent infection
3. Relieve pressure
4. Stimulate neural development
28)The night before surgery, as he is getting ready for bed, a preschooler asks his father to “check under the bed for monsters”. The nurse would be most correct in advising his father to:
1. Ask the child to talk more about these monsters
2. Leave a light on and let the child check for himself
3. Make a game of checking under his bed
4. Tell him that monsters are only make-believe
29)The best roommate for a 9-year-old girl with rheumatic fever would be:
1. An 8-year-old girl with impetigo
2. A 9-year-old girl with a tonsillectomy
3. A 10-year-old girl with a concussion
4. An 11-year-old girl with a fractured elbow in skeletal traction
30)An infant with myelomeningocele is scheduled to have surgery to close the sac. The mother asks the nurse if the baby will be able to move the legs following this operation. The best response for the nurse to make would be:
1. Not usually, although we can always hope for a miracle
2. There is no way to predict. All we can do is watch the baby closely
3. No, the surgery is done mainly to prevent infection
4. Yes, the surgery will restore the ability to move the legs
31)At 7 month of age, an infant exhibits the following skills. The nurse should know that the most recently acquired skill is probably the ability to:
1. Roll over
2. Sit up
3. Bear some weight on legs
4. Pick up objects with palmar grasp
32)The most appropriate person to administer a preoperative series of cleansing enemas to a 9-month-old with Hirschprung’s disease would be the:
1. Primary nurse
2. Mother
3. Nursing student
4. Nursing assistant
33)In planning a roommate for a hospitalized 12-year-old girl, the nurse should realize that a child of this developmental level will:
1. Probably prefer another girl her own age
2. Most likely seek out opportunities to socialize with teenagers
3. Enjoy being with either a girl or boy, as long as they are the same age
4. Feel helpful if given the opportunity to look after a slightly younger child
34)Abort a week after discharge, a teenager newly diagnosed with diabetes and his mother return to the clinic for a checkup. His mother states, I’m worried he will make a mistake, so I’ve been giving him his insulin. The nurse should:
1. Allow the teenager and his mother to work this out on their own
2. Assist his mother to understand that he must assume this responsibility
3. Encourage hid mother to continue working closely with him
4. Realize that this is an appropriate response by the mother
35)Which one behavior should the nurse expect a 5-month-old with CHF to be capable of demonstrating?
1. Rolling over from stomach to back
2. Sitting with support
3. Pincer grasp
4. Bearing some weight on legs
36)Parents of an infant with Hirchsprung’s disease ask the nurse hoe their baby got the disease. The nurse would be most correct in advising them that:
1. Their baby was born with this condition
2. It is the result of the meconium ileus the baby experienced as a newborn
3. Their baby spontaneously developed this condition
4. It often occurs following the introduction of solid foods due to a genetically inherited metabolic
37)The mother of a child hospitalized with asthma asks the nurse what causes asthma. The murse would be most correct in telling her the cause is:
1. Unknown
2. Allergies
3. Stress
4. Multiple factors
38)A toddler who is being placed in a croupette cries and tries to cling to the mother. The mother asks the nurse if she can climb into the crib and lie in the tent with the toddler. The nurse’s best response would be:
1. Do you always let your child behave this way
2. I’ll have to check with the doctor first
3. No, that would not be safe for you or the child
4. It may help the child calm down; let’s give it a try
39)Normally, an infant’s birth weight doubles buy age 6 months and triples by age 1year. By what age should the nurse expect the birth weight to quadruple?
1. 18 months
2. 2 years
3. 2.5years
4. 3 years
40)a mother asks the nurse how tall her child will be when grown up. What answer should the nurse offer?
1. This is virtually impossible to predict
2. It will be double the child’s height at 2years of age
3. It will be triple the child’s height at 18 months of age
4. Add 2 feet to the child’s at 4 years of age
41)The following four children are patients in the pediatrics unit. Which one should the nurse anticipate will be most affected by separation from parents?
1. A 6-week-old with pyloric stenosis
2. A 19-month-old with salicylate poisoning
3. A 3.5-year-old with hypospadias
4. A 5-year-old with hemophilia
42)In assessing the development of a 5-year-old, the nurse would not expect the child to be able to:
1. Name primary colors
2. Count to 100
3. Know the days of the week
4. Give telephone number and address
43)An RN from the telemetry unit is floated to the pediatrics unit. The charge nurse must assign three patients to her. Which patient should not be assigned to the telemetry nurse?
1. A 5-month-old with Kawasaki disease
2. A 9-year-old with rheumatid fever
3. A 4-year-old with VSD after cardiac cathererization
4. A 3-week-old after pyloromyotomy
44)The RN is supervising a nurse’s aide who is caring for a child with a multidrug-resistant respiratory infection. Which action by the aide would be unsafe and would require the nurse’s immediate attention?
1. The aide wears a gown and gloves when entering the child’s room
2. The aide removes a gown and gloves before leaving the child’s room
3. The aide leaves the sphygmomanometer, thermometer, and stethoscope in the child’s room, ort of the child’s reach
4. The aide washer her hands after removing her gloves, and then leaves the child’s room to care for anther child in the next room
45)The RN assigns an LPN/LVN to care for a child with Hirschsprung’s disease; the child’s abdomen is grossly distended. The RN directs the LPN/LVN to measure the child’s abdominal girth. Which action by the LPN/LVN would require the RN’s intervention and further direction? The LPN/LVN:
1. Uses a cloth tape to measure the child’s abdominal girth
2. Leaves the tape in place after measuring the child’s abdominal girth
3. Measures the child’s abdominal girth at the umbilicus
4. Pulls the tape snug, but not tight, around the abdomen when measuring girth
46)The RN instructs the aide to give a child with eczema her bath. Which action by the aide would require the RN to provide additional supervision? The aide:
1. Adds bath oil to the water
2. Bathes the child for 15 to 20 minutes
3. Provides toys for water play
4. Applies Lubriderm to the skin immediately after the bath
47)The RN should instruct the LPN/LVN or UAP caring for a child with PKU to be sure not to give this child:
1. Green grapes
2. Diet soda
3. Cheerios
4. Cranberry apple juice
48)An RN can safely delegate three of the following tasks to an LPN/LVN caring for a child with Down syndrome. Which one task should the RN perform personally and not delegate to an LPN/LVN?
1. Transporting the child to the cardiac catheterization lab
2. Taking the child’s vital signs, including blood pressure
3. Listening to the child’s breath sounds bilaterally
4. Assisting the child to eat meals and snacks
49)A nurse’s aide is working with a group of children in the playroom. Which action by the aide would require the RN to intervene?
1. The aide offers a pacifier to an infant who is NPO
2. The aide opens a can of Play-Doh and gives it to a toddler
3. The aide stops a preschooler with terminal cancer from pulling on the braids of another child who is ready to be discharged
4. The aide tells a school-age child that he is too big to be crying for his parents
50)A nursing student has been assigned to plan the prehospitalization teaching for a group of preschoolers having elective surgery. The preceptor should correct the teaching plan if it included which of the following?
1. Make a list of the things the children could bring from home
2. Show the children a video describing activities that will take place during their hospital stay
3. Provide a detailed explanation to the children of what they will experience during preadmission testing
4. Give the children a tour of the ambulatory surgery unit, followed by a light snack and a chance to talk with the staff
51)A child with severe pain asks for pain medication. The team caring for this child includes an RN, an LPN/LVN, and a medication. Who should subsequently evaluate the effectiveness of the pain medication?
1. The RN only
2. The RN and the LPN/LVN
3. The LPN/LVN and UAP
4. All of the members of the team caring for this child
