YOU
A 2 1/2-year-old ventilator-dependent child will be discharged home soon. The family expresses concern that their child might change the ventilator settings by exploring the control knobs and buttons. Based on the nurse’s knowledge of child development, the most appropriate intervention by the nurse is to:
A. teach the child not to touch controls.
B. explain that the child cannot be left alone because of the risk of the child changing the settings.
C. recommend ways to cover the controls to reduce the risk of the child changing the settings.
D. reassure the family that developmentally the child is unable to change the ventilator settings.
C. recommend ways to cover the controls to reduce the risk of the child changing the settings.
A 10-year-old child requires daily medications for a chronic illness. The mother tells the nurse that she is always nagging the child to take the medicine before school. The most appropriate nursing intervention to promote the child’s compliance is to
A. establish a contract with the child, including rewards.
B. suggest time-outs when the child forgets her medicine.
C. discuss with the child’s mother the damaging effects of nagging.
D. ask the child to bring her medicine containers to each appointment so that the pills can be counted.
A. establish a contract with the child, including rewards.
The nurse observes erythema, pain, and edema at a child’s intravenous (IV) infusion site with streaking along the vein. The nurse’s priority action is to
A. immediately stop the infusion.
B. check for a good blood return.
C. ask another nurse to check the IV site.
D. increase IV drip with normal saline for 1 minute and recheck.
A. immediately stop the infusion.
In order to determine if a child’s “toy” does not present a choking hazard while in the hospital, which type of process would the nurse utilize?
A. Use a toilet paper roll to indicate whether the toy will pass the choke test.
B. Have the child agree to not place the toy in his/her mouth while in the hospital.
C. Drop the toy on the floor to see if any parts break off.
D. Have the parents bring a “new” toy that is just bought from the store as that is the best indicator that there will be no loose parts.
A. Use a toilet paper roll to indicate whether the toy will pass the choke test.
The nurse needs to give an injection to a 4-year-old in the deltoid muscle. Based on the nurse’s knowledge of preschool development, the most appropriate approach by the nurse is to
A. smile while giving the injection to help the child relax.
B. tell the child that you will be so quick, the injection won’t even hurt.
C. explain that child will experience “a little stick in the arm.”
D. explain with concrete terms such as “putting medicine under the skin.”
D. explain with concrete terms such as “putting medicine under the skin.”
A child, age 7 years, is being treated at home and has a fever associated with a viral illness. The principal reason for treating the child’s fever is
A. reassurance that illness is temporary.
B. relief of discomfort.
C. prevention of secondary bacterial infection.
D. prevention of life-threatening complications.
B. relief of discomfort.
The best explanation for using pulse oximetry on young children is that it
A. is noninvasive.
B. is better than capnography.
C. is more accurate than arterial blood gas measurements.
D. provides intermittent measurements of oxygen.
A. is noninvasive.
A nurse is preparing to administer a gavage feeding to an infant. Which type of restraining method would be indicated?
A. Jacket restraint
B. Arm restraints
C. Mummy restraint
D. Car seat restraint
C. Mummy restraint
The nurse needs to take the blood pressure of a preschooler for the first time. What action would be best for gaining the child’s cooperation?
A. Take the blood pressure when a parent is there to comfort the child.
B. Tell the child that this procedure will help the child to get well faster.
C. Explain to the child how blood flows through the arm and why taking the blood pressure is important.
D. Permit the child to handle equipment and see the dial move before putting the cuff in place.
D. Permit the child to handle equipment and see the dial move before putting the cuff in place.
Standard precautions for infection control include
A. gloves are worn anytime a patient is touched.
B. needles are capped immediately after use and disposed of in a special container.
C. gloves are worn to change diapers when there are loose or explosive stools.
D. masks are needed only when caring for patients with airborne infections.
C. gloves are worn to change diapers when there are loose or explosive stools.
The nurse is caring for an infant with a tracheostomy when accidental decannulation occurs. The nurse is unable to reinsert the tube. What priority action should the nurse take next?
A. Notify the surgeon.
B. Perform oral intubation.
C. Try inserting a larger tracheostomy tube.
D. Try inserting a smaller tracheostomy tube.
D. Try inserting a smaller tracheostomy tube.
Several types of long-term central venous access devices are used in practice. The benefit of using a long-term central venous access device such as a Port-a-Cath is that
A. implanted devices are easy to use for self-administered infusions.
B. implanted devices do not require piercing the skin for access.
C. implanted devices do not require limiting regular physical activity, including swimming.
D. implanted devices cannot dislodge, even if child “plays” with the port site.
C. implanted devices do not require limiting regular physical activity, including swimming.
It is time to give a 3-year-old medication. What approach is most likely to receive a positive response from the child?
A. “It’s time for your medication now. Would you like water or apple juice afterward?”
B. “Wouldn’t you like to take your medicine now?”
C. “You must take your medicine because the doctor says it will make you better.”
D. “See how nicely your roommate took medicine? Now take yours.”
A. “It’s time for your medication now. Would you like water or apple juice afterward?”
The nurse is preparing a plan to teach a mother how to administer 1 and 1/2 teaspoons of medicine to her 6-month-old child. Based on the nurse’s knowledge of administering pediatric medications, the nurse teaches the parent to use a
A. plastic syringe (without needle) calibrated in milliliters.
B. regular silverware teaspoon.
C. household measuring spoon.
D. paper cup measure in 5-ml increments.
A. plastic syringe (without needle) calibrated in milliliters.
A neonate had corrective surgery 3 days ago for esophageal atresia. The nurse notices that after gastrostomy feedings, there is often a backup of feeding into the tube. The most appropriate intervention by the nurse is to
A. position the child in a supine position after feedings.
B. position the child on the left side after feedings.
C. leave the gastrostomy tube open and suspended after feedings.
D. leave the gastrostomy tube clamped after feedings.
C. leave the gastrostomy tube open and suspended after feedings.
A physiologic benefit of fever in a child is that it
A. indicative of the infectious process being viral in origin.
B. increases interferon production.
C. prevents spread of infection due to decrease in release of chemical mediators.
D. correlates with overall prognosis of medical event.
B. increases interferon production.
The nurse is doing preoperative teaching with a child and the parents. The parents say the child “is dreading the shot for before surgery.” On which of the following facts should the nurse’s response be based?
A. Preanesthetic medication can only be given intramuscularly.
B. In children, the intramuscular (IM) route is safer than the intravenous (IV) route.
C. The child will have no memory of the injection because of amnesia.
D. Preanesthetic medication should be “atraumatic,” using oral, existing IV, or rectal routes.
D. Preanesthetic medication should be “atraumatic,” using oral, existing IV, or rectal routes.
Informed consent is valid when (Select all that apply.)
A. universal consent is used.
B. it is completed only for major surgery.
C. a person is over the age of majority and competent.
D. information is provided to make an intelligent decision.
E. the choice exercised is free of force, fraud, duress, or coercion.
C. a person is over the age of majority and competent.
D. information is provided to make an intelligent decision.
When caring for a child with an intravenous (IV) infusion, the most appropriate nursing interventions are to (Select all that apply.)
A. use an infusion pump with a microdropper to ensure the prescribed infusion rate.
B. monitor rate by checking infusion pump programming.
C. avoid restraining the child to prevent undue emotional stress.
D. observe the insertion site frequently for signs of infiltration.
E. change the insertion site every 24 hours.
A. use an infusion pump with a microdropper to ensure the prescribed infusion rate.
B. monitor rate by checking infusion pump programming.
C. avoid restraining the child to prevent undue emotional stress.
Which hospitalized children should have their intake and output (I&O) recorded as part of the plan of care? (Select all that apply.)
A. 14-year-old postoperative for laparoscopic appendectomy with IV access but not receiving any fluids at this time
B. 3-year-old receiving parenteral therapy along with antibiotics
C. 16-year-old admitted for treatment of diabetes mellitus
D. 14-year-old admitted for observation of concussion as a result of motor vehicle accident
E. 8-year-old admitted with dehydration
A. 14-year-old postoperative for laparoscopic appendectomy with IV access but not receiving any fluids at this time
B. 3-year-old receiving parenteral therapy along with antibiotics
C. 16-year-old admitted for treatment of diabetes mellitus
D. 14-year-old admitted for observation of concussion as a result of motor vehicle accident
E. 8-year-old admitted with dehydration