Patient Education
The nurse is educating a mother and her teenager about the human papillomavirus (HPV) vaccine. Which statement by the mother indicates a need for further education?
1) “HPV is a sexually transmitted infection.”
2) “The vaccine is recommended for females only.”
3) “The vaccine consists of three doses.”
4) “HPV is associated with the development of several types of cancer.”
2. The HPV vaccine is recommended for both males and females.
Which nursing intervention is appropriate to enhance safety for the parents of a hospitalized toddler?
1) Allow the toddler to walk barefoot.
2) Allow the supplies to be kept at the bedside table.
3) Teach the parents how to use the call bell.
4) Encourage the parents to sleep with the toddler in the big bed.
3. Teach the parents how and when to use the call bell to enhance safety.
The Pediatric Early Warning System (PEWS) scoring tool allows nurses to do which of the following?
1) Move a child with a high PEWS score to a lower level of care.
2) Assess a child’s behavior and clinical status.
3) Have practice code blue scenarios.
4) Assess patients with low PEWS scores more frequently.
2. Assess a child's behavior and clinical status.
The overproduction and excretion of antidiuretic hormone (ADH) from the posterior pituitary results in which symptoms?
1) Kidneys absorb less water
2) Decreased fluid retention
3) Hypernatremia
4) Decreased urine output
4. Decreased urine output.
Infants are born with some intact sensory organs and some that mature over time. Which of the following senses is NOT considered intact at birth?
1) Visual acuity
2) Hearing
3) Touch
4) Smell
1. Visual acuity is dependent on nerve maturation. An infant’s visual acuity is thought to range between 20/200 and 20/300 and is not fully intact until close to the child’s fifth birthday.
The nurse is teaching a pediatric patient and the patient’s parents how to expectorate secretions and promote respiratory activity. Which instruction should the nurse include?
1) Take several short breaths and then cough.
2) Cough forcefully and then take a deep breath and hold it.
3) Take a few deep breaths and then cough forcefully several times.
4) Breathe out and then cough forcefully.
3. Taking a few deep breaths and then coughing forcefully several times is the correct instruction for promoting the expectoration of secretions and respiratory activity.
Which nursing intervention is most appropriate when providing care to a child on neutropenic precautions?
1) Provide masks for all visitors.
2) Maintain airborne precautions.
3) Use hand sanitizer only.
4) Avoid fresh fruits and vegetables.
1. Screen visitors for symptoms of illness and prevent caregivers with any mild illnesses or infections from giving care to the child with neutropenia.
A 10-year-old child presents to the school nurse with a migraine. Which information collected by the nurse is MOST important in determining the type of headache this child is experiencing?
1) Health history, diet, caffeine intake
2) Health history, physical examination, associated symptoms
3) Physical examination, CT scan, diet
4) Health history, diet, last eye examination
2. A healthy history and physical examination, including the location, severity, intensity, and description of pain as well as associated symptoms such as nausea, vomiting, behavioral changes, photophobia, sound phobia, and congestion will be most beneficial in helping the nurse determine the type of headache.
Which pattern of breathing is characterized by slow, deep, labored respirations?
1) Cheyne-Stokes breathing
2) Kussmaul’s breathing
3) Bradypnea
4) Hyperventilation
2. Kussmaul's breathing.
Which rationale for why young children are more prone to otitis media should the nurse include in the teaching session with a parent?
1) The eustachian tube is longer, wider, and vertical in younger children.
2) The eustachian tube is shorter, wider, and horizontal in younger children.
3) The eustachian tube is longer, more narrow, and vertical in younger children.
4) The eustachian tube is shorter, more narrow, and horizontal in younger children.
2. This statement accurately reflects why young children are prone to otitis media.
The nurse is teaching the parents of an infant diagnosed with candidiasis in the diaper area how to treat it and decrease the risk for future occurrences. Which teaching point does the nurse include in the teaching session?
1) Finishing all of the antiviral medication as prescribed
2) Keeping the diaper area as dry as possible
3) Changing to a lactose-free formula
4) Administering an oral antifungal liquid for prevention of future occurrences
2. An infant diagnosed with a candidiasis skin infection in the diaper area is prescribed an antifungal cream to treat the current infection. The nurse educates the parents to keep the diaper area as dry and clean as possible and to use a moisture barrier cream.
While assessing a child who presented with a sore throat, the nurse notices that the child has begun drooling. What is the nurse’s priority action?
1) Call the provider.
2) Assess the child’s airway with a tongue blade.
3) Administer oxygen.
4) Begin CPR.
1. Calling the provider is the priority intervention. Drooling is a sign that the child has worsening symptoms of epiglottitis.
A pediatric nurse is performing a respiratory assessment on an 18-month-old child. The nurse most likely uses which recommended techniques?
1) Assess breath sounds by listening to all lung fields and alternating sides for comparison.
2) Assess the resonance of the lungs and underlying organs by using auscultation.
3) Assess the child’s respiratory status when fully awake and active.
4) Assess for normal breath sounds using palpation.
1. The nurse should assess breath sounds by listening to all lung fields and alternating sides for comparison.
An infant is admitted with an enlarged head circumference, bulging fontanelles, and sunset eyes. Which neurological condition does the nurse suspect?
1) Microcephaly
2) Intraventricular hemorrhage (IVH)
3) Reye syndrome
4) Hydrocephalus
4. An infant with hydrocephalus may demonstrate increased head circumference, a bulging anterior fontanel, and sunset eyes.
Upon entering a patient’s room, the nurse witnesses a brief episode of sudden, spasmodic movement of the child’s entire body. Which term best describes the type of seizure that this child is experiencing?
1) Complex partial seizure
2) Tonic-clonic seizure
3) Febrile seizure
4) Myoclonic seizure
4. A child will demonstrate sudden whole-body or limited body part massive jerking. The child may or may not lose consciousness.
An infant who is diagnosed with a mild heart defect will not have surgical correction for at least 2 years. Which information should the nurse include in the discharge teaching regarding management in the home environment?
1) “Your child is not at risk for congestive heart failure.”
2) “It is important for your child to maintain normal activity.”
3) “It is important to avoid antipyretics for the treatment of fever.”
4) “Your child will have a low-grade fever until the defect is repaired.”
2. It is important for parents to encourage activities that will foster growth and development.
Which is the priority nursing intervention when caring for a neonate who is born with bladder exstrophy?
1) Measuring intake and output
2) Inserting a Foley catheter
3) Covering the defect with sterile plastic wrap
4) Palpating the bladder mass to ensure that urine is expelled
3. This reduces the contamination of the bladder, which should be sterile.
DAILY DOUBLE!!!
An adolescent patient presents in the emergency department (ED) with confusion. The health-care provider suspects diabetic ketoacidosis (DKA). A STAT serum glucose is done, and the result is 715 mg/dL. Which clinical manifestations does the nurse anticipate upon assessment of this patient?
1) Tachycardia, dehydration, and abdominal pain
2) Sweating, photophobia, and tremors
3) Dry mucous membranes, blurred vision, and weakness
4) Dry skin, shallow rapid breathing, and dehydration
3. Dry mucous membranes, blurred vision, and weakness are seen with hyperglycemia.
The nurse is providing care to an infant who presents with a fever, sore throat, and a nonitching rash on the trunk and the surfaces of the extremities. Which cardiac disease process does the nurse suspect?
1) Subacute bacterial endocarditis (SBE)
2) Rheumatic fever
3) Kawasaki disease
4) Congestive heart failure
2. The nurse suspects rheumatic fever based on these symptoms.
Which statement accurately describes the structures of the heart?
1) The right atrium and ventricle circulate deoxygenated blood to the lungs.
2) The atria, ventricles, heart valves, and cardiac vessels are formed and begin primitive functioning around the sixth week of pregnancy.
3) The left atrium and ventricle circulate deoxygenated blood to the lungs.
4) Oxygenated blood cycles to the right atrium and ventricle to be pumped to the rest of the body.
1. The right atrium and ventricle circulate deoxygenated blood to the lungs. Then the oxygenated blood cycles to the left atrium and ventricle to be pumped to the rest of the body.
A nurse is educating parents about varicella infections. What statement by the parent needs further education?
1) “Severe complications are rare in healthy people.”
2) “Once someone gets primary varicella, he or she has immunity for life.”
3) “I can give my child aspirin for the discomfort of the varicella infection.”
4) “I can give my child Tylenol for the discomfort of the varicella infection.”
3. This statement needs further education. Children who have viral infections such as varicella should not be given aspirin because there is an association leading to the development of Reye’s syndrome.
Which is the priority nursing action when providing care for a school-aged child admitted to the hospital experiencing an adrenal crisis?
1) Administering prescribed fluids and electrolytes
2) Clustering care to enhance rest
3) Monitoring stool output
4) Providing pain relief and tepid baths
1. When a child is hospitalized in an adrenal crisis, the focus of nursing care is on fluid and electrolyte replacement. The pediatric nurse must monitor closely for signs of hypovolemic shock. The nurse understands that peripheral circulation must be checked often (capillary refill, color, pulses, and extremity temperature).
Which nursing action is appropriate to assist in the assessment of CN VI?
1) Asking the patient to smile
2) Asking the patient to identify different tastes
3) Asking the patient to follow finger commands to move the eyes left and right
4) Testing the patient’s response to cotton ball sensations on the face
3. Asking the patient to follow finger commands to move the eyes left and right is appropriate when assessing CN VI, the abducens nerve.
Which cardiac condition should the nurse suspect for a neonate who is experiencing a pressure gradient between the arms and legs when blood pressure is assessed?
1) Tricuspid atresia
2) Conal truncal defects
3) Coarctation of the aorta (CoA)
4) Transposition of the great arteries
3. A pressure gradient is anticipated with CoA.
Which statement by the nurse accurately describes the difference between the respiratory systems of a child and an adult?
1) The nares in children are larger in size, shallow in depth, underdeveloped, and less easily occluded.
2) The larynx and the glottis are lower in the younger child’s neck, which makes the child more prone to aspiration.
3) The epiglottis in the younger child is longer and flaccid, making it more susceptible to swelling that may lead to airway occlusion.
4) There are fewer functional muscles in the neck, and the decreased amount of soft tissue makes the child more susceptible to infection and edema.
3. The pediatric epiglottis is longer and flaccid, which makes it more susceptible to swelling and increasing the risk for airway occlusion. This statement is accurate