...On My Mind
An adolescent has meningitis and is receiving I.V. and oral fluids. The nurse should monitor this client’s fluid intake because fluid overload may cause:
A. Heart failure
B. Cerebral edema
C. Dehydration
D. Hypovolemic shock
What is B. Cerebral edema
A mother brings her child in the office for a follow-up appointment and voices concern that her child has started urinating more than normal and is constantly thirsty & hungry. As the RN, you suspect?
A. Diabetes Mellitus
B. Phenylkentonuria
C. Hypoglyemia
D. Tret's syndrome
What is A. Diabetes Mellitus?
An adolescent who sustained a tibia fracture in a motor vehicle accident has a cast. What should the nurse do to help relieve the itching?
A. Use sterile applicators to scratch the itch
B. Apply hydrocortisone cream under the cast using sterile applicator.
C. Apply cool water under the cast
D. Apply cool air under the cast with a blow-dryer
What is d apply cool air under the cast with a blow-dryer?
A 15 month old, is recovering from surgery to remove Wilms’ tumor. Which findings best indicates that the child is free from pain?
A. Decreased urine output
B. Decreased appetite
C. Increased interest in play
D. Increased heart rate
What is C. Increased interest in play?
Antidote for Acetaminophen (Tylenol)?
What is Acetylycysteine (Mucomyst)?
A nurse is caring for an infant with spina bifida. Which technique is most important in recognizing possible hydrocephalus?
A. Measuring head circumference
B. Obtaining skull X-ray
C. Performing a lumbar puncture
D. Magnetic resonance imaging (MRI)
What is a measuring the head circumference?
The nurse is preparing to admit a 7-year-old child with type 2 diabetes. What clinical features of type 2 diabetes should the nurse recognize? (Select all that apply.)
a. Oral agents are effective.
b. Insulin is usually needed.
c. Ketoacidosis is infrequent.
d. Diet only is often effective
e. Chronic complications frequently occur.
What is A,C,D
When infants are seen for fractures, which nursing intervention is a priority?
a. No intervention is necessary. It is not uncommon for infants to fracture bones.
b. Assess the family's safety practices. Fractures in infants usually result from falls.
c. Assess for child abuse. Fractures in infants are often nonaccidental.
d. Assess for genetic factors.
What is c Assess for child abuse. Fractures in infants are often nonaccidental?
Which of the following would the nurse identify as the initial priority for a child with acute lymphocytic leukemia?
A. Encouraging adequate intake of iron-rich foods
B. Administering medications via IM injections
C. Assisting with coping with chronic illness
D. Instituting infection control precautions
What is D. Instituting infection control precautions?
A nurse is teaching the parents of a young child how to handle poisoning. If the child ingests poison, what should the parents do first?
A. Administer ipecac syrup
B. Call an ambulance immediately
C. Punish the child for being bad
D. Call the poison control center
What is d call the poison control center?
A parent brings a toddler, age 19 months, to the clinic for a regular check-up. When palpating the toddler’s fontanels, what should the nurse expects to find?
A. Open anterior and posterior fontanels
B. Closed anterior and posterior fontanels
C. Open anterior and fontanel and closed posterior fontanel
D. Closed anterior fontanel and open posterior fontanel
What is b closed anterior and posterior fontanels?
The clinic nurse is assessing a child with hypopituitarism. Hypopituitarism can lead to which disorder?
a. Gigantism
b. Hyperthyroidism
c. Cushing syndrome
d. Growth hormone deficiency
What is d Growth hormone deficiency?
A child was diagnosed with Duchenne's muscular dystrophy; which of the following usually is the first indication of the condition?
A. Inability to suck in the newborn
B. Lateness in walking in the toddler
C. Difficulty running in the preschooler
D. Decreasing coordination in the school-age child
What is C. Difficulty running in the preschooler?
A 4-year-old is admitted with acute leukemia. It will be most important to monitor the child for:
A. Abdominal pain and anorexia
B. Bleeding and pallor
C. Petechiae and mucosal ulcers
D. Fatigue and bruising
What is B. Bleeding and pallor?
A child has third-degree burns of the hands, face, and chest. Which nursing diagnosis takes priority?
A. Ineffective airway clearance related to edema
B. Impaired urinary elimination related to fluid loss
C. Disturbed body image related to physical appearance
D. Risk for infection related to epidermal disruption
What is a ineffective airway clearance related to edema?
A 5 year old a has temperature of 103.6 'F and is brought into the emergency room by his mother. Which statement by the mother causes concern?
A. "I administered Aspirin to help with the fever a few hours ago."
B. "I re-took his temperature 30 minutes after I gave the medication and it was still high."
C. "I've tried to encourage fluid intake every hour."
D. "I gave him a sponge bath to help witht he fever."
What is a "I administered Aspirin to help with the fever a few hours ago."?
An autosomal recessive disorder that results that results in CNS damage from toxic levels of phenylalanine in the blood.
What is PKU( phenylketonuria)?
A spica cast was put on a baby girl after an unfortunate incident to immobilize her hips and thighs; which of the following is the priority nursing action immediately after application?
A. Keep the cast dry and clean.
B. Cover the perineal area.
C. Elevate the cast.
D. Perform neurovascular checks.
What is D. Perform neurovascular checks?
The treatment protocol for a client with acute lymphatic leukemia includes prednisone, methotrexate, and cimetidine. The purpose of the cimetidine is to:
A. Promote peristalsis
B. Enhance the effectiveness of methotrexate
C. Decrease the secretion of pancreatic enzymes
D. Prevent a common side effect of prednisone
What is D. Prevent a common side effect of prednisone?
Infants less than 1 year of age who present with apnea, seizures, lethargy, respiratory difficulty, coma, or death should be suspected of:
1) Maltreatment.
2)Physical abuse.
3)Shaken baby syndrome.
4)Child neglect.
What is 3 Shaken baby syndrome?
The nurse is caring for a year old patient who has returned to the PICU after the insertion of a VP shunt to correct hydrocephalus. Which assessment finding is most important to communicate to the surgeon?
A. The child is crying and says, "it hurts!"
B. The head dressing has a 2cm area of bloody drainage.
C. The right pupil is 1mm larger than the left.
D. The cardiac monitor shows a heart rate of 130bpm.
What is c. the right pupil is 1mm larger than the left?
A nurse is teaching the parent of a child who has a growth hormone deficiency. Which of the following
are complications of untreated growth hormone deficiency? (Select all that apply.)
A. Delayed sexual development
B. Premature aging
C. Advanced bone age
D. Short stature
E. Increased epiphyseal closure
What is A,B,D?
A 14-year-old girl who wears a brace for structural scoliosis; which of the following statements indicate effective use of the brace?
A. “I sure am glad that I only have to wear this awful thing at night.”
B. “I’m really glad that I can take this thing off whenever I get tired.”
C. “I wonder if I can take the brace off when I go to the homecoming dance.”
D. “I’ll look forward to taking this thing off to take my bath every day.”
What is D. “I’ll look forward to taking this thing off to take my bath every day.”?
In taking care of a pediatric oncology patient, which diagnostic finding would indicate a critical concern for the development of infection?
A. Absolute neutrophil count of 250 mm3
B. Temperature of 99.2 degrees Fahrenheit
C. White blood cell count 7,000 mm3
D. Platelet count 100,000 mm3
What is a Absolute neutrophil count?
A kindergarten student is frequently violent toward other children. A school nurse notices bruises and burns on the child's face and arms. What other symptom should indicate to the nurse that the child may have been physically abused?
1. The child shrinks at the approach of adults.
2. The child begs or steals food or money.
3. The child is frequently absent from school.
4. The child is delayed in physical and emotional development.
What is 1 The child shrinks at the approach of adults?