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Pediatric Nursing The Critical Components of Nursing Care 1st Edition, Kathryn Test Bank

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Test Bank Pediatric Nursing Critical Components Nursing Care 1st Edition, Kathryn

Multiple Choice
Chapter 1: Issues and Trends
1. A 3-year-old is an inpatient on an orthopedic floor. The mother is participating in care as much as possible. The nurse knows that the participation of parents with the care of a child is known as:
1. 1. Family-Centered Care Model.
2. 2. Medical Care Model of Care.
3. 3. Patient-Centered Care Model.
4. 4. Illness Care Model.
2. A nurse is explaining the physical maturity of a 12-year-old boy to a nursing student. The nursing student knows that all except one the following areincluded in assessing physical maturity:
1. 1. Mastering fine motor skills.
2. 2. Language development.
3. 3. Immunizations.
4. 4. Linear growth.
3. Promotion for family-centered care consists of all except one of the following strategies:
1. Emphasizing family strengths.
2. Identifying family coping skills.
3. Developing unidirectional communication.
4. Promotion of family empowerment.
4. Culturally sensitive care is noted when a nurse:
1. Asks the family what time they should prepare the child for prayer.
2. Enters the room during prayer time to deliver a medication because it is due.
3. Provides a Muslim family with meal trays that contain pork.
4. Comments on the lack of personal hygiene for the child and siblings.
5. Levi’s mother has requested a priest to baptize him during his hospitalization. Baptism in the Christian faith is seen as:
1. A rite of passage for all people.
2. A ritual performed before the death of a child.
3. A prayer service.
4. A ritual for persons to be followers of Jesus Christ.
6. The leading infant mortality risk in the United States is:
1. Birth defects.
2. Prematurity/low birth weight.
3. Sudden Infant Death Syndrome (SIDS).
4. Unintentional injury.
7. The nurse is speaking to a group of teenagers about health promotion. The nurse knows the leading cause of mortality for this age range is:
1. Cancer.
2. Homicide.
3. Unintentional injury.
4. Suicide.
8. A staff nurse explains relationship-based care to an inpatient daughter’s father as:
1. “Your family is one of many on this unit. We will work to take care of your daughter to the best of our ability.”
2. “You and your family are part of the plan of care so we all, staff and doctors, can meet the needs of your daughter.”
3. “I am sorry, but I do not have time to speak with you right now. I will have the charge nurse come answer your questions.”
4. “The staff values input and will ask you when we have questions about your daughter.”
9. In the last 10 years in pediatric nursing, there has been an increase in:
1. Obesity.
2. Diabetes.
3. Hypertension.
4. All of the above.
10. The purpose of the Best Pharmaceuticals for Children Act of 2007 was:
1. To regulate the types of medications given to children.
2. To require manufacturers to test medication on children if the intention is for use with children.
3. To provide safety caps on all medications with children in the household.
4. To increase awareness of medication use in children.
Chapter 2: Standards of Practice/Ethical Considerations
1. Leah is a new graduate nurse and has questions about her scope of practice. The best place to review would be:
1. The code of ethics.
2. The standards of practice and professional performance.
3. The NCLEX exam.
4. The state licensing body.
2. The Code of Ethics for Nurses is characterized by all of the following except:
1. It serves as a guide to empower individuals.
2. It upholds ethics, principles, rights, duties and virtues.
3. It is a private statement for nurses only.
4. It is a public statement for nurses and their patients.
3. A nurse has discussed the plan of care, asked for parental input, and has spoken with the doctor about the needs of the family and patient. This nurse is exhibiting which characteristics of therapeutic relationships in pediatric medicine?
1. Goals, mutual respect/trust, and advocacy
2. Empowerment, sympathy, and empathy
3. Goals, advocacy, and sympathy
4. Respect/trust, disengagement, and sympathy
4. A primary source for the standards of practice for pediatric nurses is:
1. Pediatric Nursing Scope and Standards of Practice.
2. Code of Ethics.
3. Nightingale’s Pledge.
4. None of the above.
5. Sarah is a 4-year-old patient with cystic fibrosis. She has been having increased hospitalizations and prefers to have Leah as her nurse as an inpatient. Leah has been assigned to care for a different set of patients today, yet Sarah’s mother insists on having Leah as their nurse. Which action would be best for Leah to take with Sarah and her mother?
1. Ignore the situation.
2. Speak to Sarah and her mother to discuss the importance of having another nurse, who also knows the case, care for her.
3. Let Sarah’s mother and Sarah voice their reasoning for wanting Leah, and then explain the need for Leah to have a different assignment.
4. Let the charge nurse deal with the situation.
6. Which of the following situations would be considered a therapeutic communication challenge in pediatric nursing?
1. 1. A street-smart teenager
2. 2. A noncompliant patient and family
3. 3. A culture that the nurse has not been previously exposed to
4. 4. All of the above
7. The purpose of a Child Life Department for Family-Centered Care is:
1. To prepare the child for procedures.
2. To offer time to be a “kid”.
3. To provide the staff with information about child development.
4. To be the liaison between the hospital and the school system for a child.
5. 1, 2, 4
8. A nurse is discussing pain management of a 3 year-old with the parents. An important factor the nurse should mention is:
1. “A child is like a mini-adult, so they cope with pain the same way.”
2. “Effective pain management for a child may require pharmacological and non-pharmacological methods.”
3. “Children use the pain scale of 0-10.”
4. “Pain is subjective, and all children cry when they are in pain.”
9. A 6-year-old boy is to receive a dose of morphine to aid in pain management after an open appendectomy. The nurse knows the correct dose for the morphine is calculated based on:
1. Age.
2. Height.
3. Body weight.
4. All of the above.
10. A nurse at the clinic is teaching a new mother how to give Tylenol drops to her infant. The nurse knows that the mother has an understanding of medication administration when the mother states:
1. “I will give the medication as prescribed and use a teaspoon to measure the correct amount.”
2. “I will use a syringe to measure the correct amount and place the syringe in the side of his cheek to take the medicine.”
3. “I will measure the medication in a cup and place it into the bottle.”
4. “I will make sure he only takes the medicine until he acts like he feels better.”
Chapter 3: Family Dynamics and Communicating with Children and Families
1. Latrisha is a 15-year-old girl who is in the clinic for her school physical. Latrisha’s mother informs the nurse that the forms for her school physical must be filled out by the nurse or the doctor so that Latrisha can play on the volleyball team. When speaking with Latrisha and her mom, the nurse knows it is important to:
1. Be mindful of letting the patient answer questions.
2. Give attention to the doctor’s schedule and make sure the visit goes as quickly as possible.
3. Respond quickly to Latrisha’s questions so there are no long pauses in conversation.
4. Speak loudly so Latrisha and her mother can hear the conversation clearly.
2. According to Title III of the Americans with Disabilities Act (ADA), health-care providers must supply:
1. Quality care for all patients.
2. Quality care for patients and families.
3. Auxiliary aids and services for communication with people who are deaf or hard of hearing.
4. Auxiliary aids and services for communication with people who are blind or have difficulty seeing.
3. A new mother is receiving information about the newborn hearing screens for her baby girl. The nurse knows that the mother understands the reason for the screening when she states:
1. “My daughter will need this screen, and then a follow-up in three months.”
2. “My daughter will need the screen done now. It should be repeated if we note she is not meeting developmental milestones.”
3. “It is my decision to participate in this hearing screen, so I am going to decline the screening because I do not know if my insurance will cover it.”
4. “I should have a hearing screen done again when she enters school.”
4. When speaking with a family about the plan of care for the day, Leslie knows she should avoid using:
1. Medical jargon.
2. Time for questions.
3. Active listening skills.
4. All of the answers should be used for effective communication.
5. When speaking with a family who is experiencing a medical emergency with their child, it is important for the nurse to:
1. Allow time for questions.
2. Avoid false hope.
3. Allow for a quiet environment.
4. Be empathetic and sincere.
5. All of the above are correct.
6. None of the above are correct.
6. Trevon, a 4-year-old has been admitted to the emergency room via ambulance after a motor vehicle accident. Trevon is unconscious and is being given life-sustaining treatment. When the family arrives, the charge nurse takes Trevon’s parents to a family room. It is important that the nurse:
1. Provides clear information.
2. Does not provide promises.
3. Calls a member of the clergy and a social worker to be with the family.
4. All of the above should be addressed for Trevon’s family.
5. None of the above should be addressed for Trevon’s family.
7. Ellie was adopted at the age of two. Her adoptive family is known as her:
1. Family of choice.
2. Family of origin.
3. Nuclear family.
4. Nontraditional family.
8. The nurse is reviewing Keirnan’s extended family tree to help the family identify genetic makeup due to Kiernan’s diagnosis of cystic fibrosis. The nurse knows that when looking at the extended family, it usually reviews:
1. One set of grandparents from the paternal and maternal side.
2. Three generations of family members from the paternal and maternal sides.
3. Nontraditional family patterns.
4. Nuclear family patterns.
9. Alec, a 7-year-old, lives with his biological parents, but they are not married. This type of family would be considered:
1. A dyad family.
2. An adoptive family.
3. A cohabitating family.
4. An extended family.
10. Family dynamics for children can impact:
1. Interactions with all family members.
2. Communication patterns.
3. Sibling rivalry.
4. 1 and 2 only.
5. All of the above.
Chapter 4: Cultural, Spiritual, and Environmental Influences on the Child
1. Elsa is working with an 11-year-old patient in the outpatient pediatric clinic. As Elsa reviews the chart, she reads that the patient follows the Muslim tradition. When Elsa enters the room, she notes that the child is wearing a hijab on her head. Elsa has never worked with this tradition before. Elsa should:
1. Realize that her verbal and non-verbal communication will impact the care she gives the child.
2. Not ask the parent for input on the care of the child because this would disrespect the family and child.
3. Have another nurse, who has experience with this culture, take care of the patient.
4. Realize that the patient is uncomfortable and seek a fellow nurse to help her.
2. A pediatric nursing class has been assigned to use the Giger and Davidhizar Transcultural Assessment Model. The students are assigned to families they do not have a prior relationship with. When performing the assessment, one of the students is given a seat in close proximity to a grandmother on the couch. The student should know that according to this model:
1. Visiting a family is considered a privilege.
2. It is important to identify the family lifestyle.
3. Sitting close to the grandmother can affect the communication.
4. Only the interpersonal relationships of the individuals are emphasized.
3. A staff educational day has been planned for the pediatric unit of a major hospital. The goal is to make the staff culturally competent. This is important because:
1. This competency meets JCAHO requirements.
2. This competency meets cultural care requirements for the hospital system.
3. This allows nurses to tailor their care to the patient and provide holistic care.
4. This education is needed to reach Magnet status.
4. Hussain’s parents have a language barrier with the nursing staff on the pediatric floor. When working with communication barriers, it is important to:
1. Use pictures when an interpreter is not available.
2. Use hand gestures to attempt to communicate.
3. Ask the interpreter to speak to the family over the phone.
4. Require the family to provide a family member to interpret.
5. Social skills between different cultures are important for a pediatric nurse to understand. All of the following are part of social skills except:
1. Personal space.
2. Eye contact.
3. Diet.
4. Exercise.
6. The community pediatric nurse is conducting a home visit with a new family. The nurse knows when she is in the home, it will be important to get a thorough assessment. The assessment should consist of:
1. The number of family members living in the home.
2. The employment of the adults in the home.
3. How personal space is perceived.
4. All of the above should be considered in the assessment.
7. Culturally competent care includes:
1. 1. Treating others exactly how you would like to be treated.
2. 2. Seeing individuals as unique.
3. 3. Treating individuals within the same cultural group the same.
4. 4. Providing care without concern of your own values.
8. A nurse is caring for a 12-year-old patient who has recently been hospitalized. Which statement by the patient proves that the nurse did not perform a complete cultural assessment?
1. “I’m glad that my prayer times work around my care.”
2. “I feel better when my mom stays with me.”
3. “I’m not allowed to eat pork, and it is on my lunch tray.”
4. “My mom does not like it when my room is messy.”
9. Pediatric visitations should:
1. Be 24 hours a day for parents and grandparents.
2. Be semi-structured for other visitors.
3. Provide time for socialization and playing.
4. All of the above.
10. A nurse promotes family-centered care when:
1. Caregivers can room in and provide care to their child.
2. The nurse provides the care as the physician orders.
3. Care is provided after the family steps out of the room.
4. Visitation guidelines are strictly followed.
Chapter 5: End of Life Care
1. The pediatric nurse is having a conversation with parents who have children that have recently passed away. The nurse knows the parents understand the difference between bereavement and grief when the participants state:
1. “I am trying to prepare for my daughter’s death, but I just am not ready to do so.”
2. “Bereavement has caused me to experience sorrow for the loss of my daughter.”
3. “I can’t believe my daughter is gone.”
4. “If I make a deal that God takes me, then my daughter could come back to my family.”
2. The medical chart states that the parents are requesting “withdrawal of care” for a child with terminal leukemia. The nurse understands this request to mean:
1. To keep support measures which sustain life for the child.
2. To keep providing comfort care for the child.
3. To stop life-saving measures and allow the child to die naturally.
4. To stop providing comfort measures for the child.
3. Ashley is a 5-year-old girl who is severely mentally handicapped and has been bedridden for the last 3 years after a near-drowning accident. Ashley has developed pneumonia and sustaining her life would require ventilator support. The staff nurse is to obtain information about legal guardianship because her parents have abandoned her at the hospital. The nurse knows that:
1. Legal guardianship is needed for a person to have medical information released to him/her.
2. The legal guardian must be present to care for the child.
3. Legal guardianship can only be obtained by her parents.
4. The legal guardian must take physical responsibility for the child.
4. Identify a developmentally-appropriate activity that can be used to speak to a 6 year old about the terminal illness of his sibling.
1. Playing checkers and speaking about the illness.
2. Playing with action figures and discussing how death occurs.
3. Playing with crayons and drawing pictures of how a child views his sibling at this time.
4. All of the above are correct.
5. Palliative care should be considered for a terminally-ill child:
1. Within 1 year of death.
2. Within 2 months of death.
3. When a terminal illness is present.
4. At no time. It is not appropriate for children.
6. Palliative care allows the child to:
1. Have a graceful, natural death.
2. Attempt to use every type of medical process possible to sustain life.
3. Abruptly end life.
4. Comfort the family before death.
7. One of the best indicators of pain in a child is:
1. A change in the baseline vital signs.
2. Parents’ input.
3. Restlessness.
4. All of the above can be seen in children with pain.
8. A nurse is discussing pain management for a child near death. The child does not have an IV, and the parents do not want their child to suffer more pain. The nurse knows medication at this point in the child’s life should:
1. Be given by the quickest route for maximum relief.
2. Be delivered in the most invasive manner.
3. Be given through IV.
4. Be discussed with the doctor because a child near death cannot feel pain.
9. Identify an activity that is an alternative pain management technique.
1. Blowing bubbles
2. Holding and rocking the child
3. Playing with puzzles
4. All of the above can be used as alternative pain management techniques.
10. A staff nurse knows a child’s view of death is influenced by _____________ and __________.
1. Developmental age, mental status
2. Cognition, mental status
3. Developmental age, cognition
4. Physical status, age
Chapter 6: Theoretical Foundations of Growth and Development
1. The nurse is beginning to administer the Denver II to a small child when his mother says, “Can you tell me again what this Denver II is?” The nurse’s best response is which of the following?
1. “It’s a simple intelligence test for young children.”
2. “It tells us what a child can do at a particular age.”
3. “It determines a child’s visual acuity.”
4. “It is a test to screen for hearing abnormalities.”
2. Which of the following characteristics best describes the fine motor skills of a 5-month-old infant?
1. Neat pincer grasp
2. Strong grasp reflex
3. Builds a tower of two cubes
4. Able to grasp objects voluntarily
3. Antonio is assessing an adolescent. Identify the top priority.
1. Converse about peers
2. Allow time to express feelings
3. Use the same language as the adolescent
4. Emphasize that confidentiality will be maintained
4. A new mother is asking about when her baby daughter should be learning to sit. The nurse knows that a baby will sit at approximately which age?
1. 8 months
2. 4 months
3. 5 months
4. 1 year
5. A nurse is assessing a 2-and-one-half-month-old infant at the outpatient clinic. The nurse would anticipate that the baby should:
1. Smile when presented with pleasurable stimuli.
2. Cry at seeing a stranger’s face.
3. Reach for the primary care giver.
4. Hold a bottle.
6. The developmental task that a toddler between the ages of 15 to 30 months is likely to be struggling with is a sense of:
1. Trust.
2. Initiative.
3. Autonomy.
4. Intimacy.
7. Parents of a 2 year old are attempting to toilet train. The nurse has spoken to the family and should encourage which of the following to occur for successful toilet training?
1. Anticipate that the bladder will be trained before the bowel.
2. The child will respond more if the parents are encouraging.
3. Having the child watch an older sibling use the toilet will cause confusion.
4. The child must be forced to sit on the toilet when first learning.
8. The nurse is attempting to obtain a physical assessment of a 15-month-old child. The nurse knows that the most appropriate approach to performing the physical assessment includes all of the following except:
1. Demonstrating the use of the blood pressure cuff on a teddy bear.
2. Performing the most invasive assessments first.
3. Letting the child exam the nurse first.
4. Taking the blood pressure first, which will allow the child to ease into the full exam.
9. The purpose of the Tanner Stages is:
1. To identify the five stages of sexual development in adolescents.
2. To identify the cognitive stages of adolescents.
3. To identify the five stages of sexual development for a school-age child.
4. To identify the cognitive development of a school-age child.
10. Which of the following statements regarding failure to thrive is true?
1. Height or weight is less than 3% to 5% for age on more than one occasion.
2. Failure to thrive is always caused by child abuse or poor parenting.
3. Height or weight falling two major percentile lines on the NCHS growth charts is indicative of failure to thrive.
4. Smoking and alcohol use during pregnancy are linked to failure to thrive.
Chapter 7: Newborn and Infants
1. A mother brings her 9 month infant in for a routine visit. What milestone would be appropriate for the doctor to ask if the infant is meeting?
1. Walking
2. Speaking in two word phrases
3. Rolls back to stomach and stomach to back
4. All of the above
2. A 5 day old infant comes in for a newborn checkup. On assessment of the newborn, you note that the skin is jaundice in color. The anterior fontanel is slightly sunken. Per mom, the infant has only had 2 diapers today. The infant is strictly breastfed and this is mom’s first child. She states baby is having trouble latching on. A bilirubin level is sent and comes back at 18. You identify this newborn to be dehydrated and is most likely to have breast milk jaundice. Which nursing intervention(s) will be required for this baby?
1. Phototherapy
2. Providing support and education for the lactating mother
3. Strict monitoring of intake and output
4. All of the above
3. Apgar scores measure heart rate, respiratory rate, reflex irritability, color and :
1. Rigidity
2. Muscle tone
3. Birth weight
4. Capillary refill
4. A mother on the postpartum unit asked to have her infant back from the nursery so that she can breastfeed. The nurse brings the newborn to the room and hands the baby to the mother. She asks the mother to let her know how long the baby feeds. What vital step did the nurse forget to take before giving the baby to the mother?
1. The nurse should have made sure that the baby was latching correctly
2. The nurse should have identified the baby’s ID band with the mother’s
3. The nurse should have the mother speak with a lactation consultant
4. The nurse should have asked the mother how long she planned to feed
5. Excessive heat loss results in which of these?
1. RDS
2. Depletion of glucose levels
3. Jaundice
4. Increase in surfactant levels
6. A mother has just delivered her new baby a few hours ago. She asks the nurse if she can bathe the baby because he has blood on him. The best response from the nurse would be.
1. “Sure, let me get you some soap and washcloths”
2. “Why don’t you get some rest, there will be lots of time for bathing”
3. “It’s important that we not bathe the baby too soon after birth. Let’s wait till later in the day.”
4. “Sure, but why don’t you feed the baby”
7. A 4 week old infant is brought to the ED. Mom states that the baby hasn’t been eating well and has had decreased diapers for 2 days. The baby has been sleeping more and has been hard to wake up. On assessment, you find that the baby is difficult to arouse, is hypotonic and temperature is 35.4 rectally. What is an important lab value to check? Choose the best answer.
1. Complete metabolic panel
2. Liver panel
3. Blood glucose
4. PTT
8. A pregnant woman with a history of a clotting disorder is required to self-administer heparin during her pregnancy. After delivery, the infant will be at greater risk for:
1. Low blood sugar
2. Decrease Vitamin K
3. Increased Vitamin K
4. High blood sugar
9. A part of injury prevention is making and keeping infant appointments. The required checkups and vaccinations are at:
1. 3 months, 6 months, 9 months
2. 2 months, 4 months, 6 months and 1 year
3. 2 months, 4 months, 6 month, 9 months and 1 year
4. 2 months, 4 months, 9 months and 1 year
10. You are taking care of an infant who was admitted with dehydration. His weight is 6kg. You have been watching his I & O’s. What would you expect the infant’s urinary output to be in order to maintain adequate hydration?
1. 0.5–2 ml/kg/hr
2. 0.5–2.5 ml/kg/hr
3. 1–3 ml/kg/hr
4. As long as he is having wet diapers it doesn’t matter
Chapter 8: From Toddler to Preschool
1. When assessing a toddler, it is important to remember that:
1. Their heads are naturally larger than the rest of their body.
2. Their abdomens are usually slightly distended.
3. They have a lower fluid requirement.
4. They have small tongues in proportion to their airways.
2. A nursing student is assessing a 15 month old. The student knows that the child is well nourished if all except __________ are present.
1. Even hair distribution
2. Dry skin
3. Balanced weight and height
4. Dirty fingernails
3. A mother is concerned because her 3-year-old son likes to sit close to a television screen. The nurse knows that:
1. This is normal behavior, and as the child grows, this will stop.
2. The child should be told to sit way from the television.
3. The child is using the television to avoid interactions with parents.
4. The child is expressing himself and exerting independence.
4. A 3-year-old boy is having his blood pressure checked at the well-child clinic. A systolic blood pressure for a child of this age would be:
1. 84-104.
2. 50-84.
3. 100-120.
4. 90-110.
5. The leading cause of death for toddlers and preschoolers is:
1. Motor vehicle accidents.
2. Homicide.
3. Falls.
4. Unintentional injuries.
6. A family states to the home health nurse that they were given a used crib for their son, who is 14 months old. The parents describe the crib as having a drop-side rail. The nurse should educate the parents about:
1. Making sure the bedding is well washed because of bacteria from another child using it.
2. Checking all the parts of the crib to make sure it is not missing anything.
3. Drop-sided cribs are now banned from being sold because they can increase injury since a child can push the railing down.
4. Making sure to place all bedding around the crib so that the child does not get a foot caught out of the railing.
7. A hospital is providing a babysitters’ education class for teens. The nurse who is preparing the information should include which of the following in her presentation?
1. Not carrying hot liquids around children
2. Keeping all cords out of reach of children
3. Not placing a child in a high chair, then leaving the room
4. All should be part of the education for babysitters
8. A father is discussing the new swimming pool the family has put in for the children to use. The nurse should provide education on:
1. Placing a gate around the pool with a child safety lock.
2. Keeping the chlorine balanced.
3. Keeping the water temperature above 80 degrees.
4. Placing lights around the pool.
9. A new nurse asks a 4 year old, “Do you want to take your medicine?” The child refuses to do so. The new nurse should have stated:
1. “If you take your medicine now, you can have a popsicle afterwards.”
2. “It is important to take your medicine, so open up.”
3. “You can have your medicine as a chewable or liquid. Which would you like?”
4. “Will you take the medicine from your father?”
10. The best approach when assessing a toddler in a clinic would include which element(s)?
1. Assess the child in his or her comfort zone, usually in a parent’s lap.
2. Ask the parent to step out of the room in order to ask the child sensitive questions.
3. Do the most invasive element(s) of the assessment first to get the scary parts out of the way.
4. All of the above
Chapter 9: School-Age Children
1. A school-age child has been weighed at the well-child checkup. He has gained 6 pounds since the previous year. This is:
1. An average weight gain for a child of this age.
2. Too much of a weight gain for a child of this age.
3. Too little of a weight gain for a child of this age.
4. None of the above.
2. A mother is being educated about the changes puberty will have on her daughter. The nurse knows the mother understands the beginning changes for puberty when the mother states:
1. “She will have underarm hair development.”
2. “She will have an increase in body odor.”
3. “She will start to have breast buds.”
4. “She will have acne issues.”
3. As puberty starts to occur for a boy, the scrotal sac will:
1. Increase in size.
2. Decrease in size.
3. Grow at a slower rate than the penis
4. Become loosened and the testicles will enlarge.
4. A 9-year-old boy is going to have a lumbar puncture performed. The nurse asks if he would like his mother present for the procedure. The boy states, “I can do this on my own.” The nurse knows:
1. A child of this age wants to be independent and does not need assistance.
2. A child of this age is independent.
3. This child’s statement is normal for a child of his age.
4. In reality, this child wants the parent to come with him, but does not want to be seen as weak.
5. The difficulty in using the FACES pain scale with school-age children is:
1. The child does not understand it.
2. A child is not old enough to learn what the faces indicate.
3. A child will choose the smile because it is desired.
4. The pain scale is the most appropriate scale for children and does not have any difficulties.
6. Evan has been brought to the outpatient pediatric clinic because he has complained of a headache for the past two days with no known cause. What would be an appropriate assessment question for Evan?
1. “How long have the headaches been going on?”
2. “Where does your head hurt?”
3. “Have you been having trouble will school?”
4. All of the above are correct.
7. A classroom of 8- and 9-year-old girls are discussing rules for their secret club. These children are demonstrating _____________ development.
1. Pre-Conventional
2. Psychosocial
3. Formal operational
4. Moral
8. Dante, a fifth grader, has come to the school nurse’s office because he has a stomachache. The nurse assesses Dante and sees no physiological reason for a stomachache. The nurse attempts to send him back to class, but Dante asks if he can stay until after the spelling test. The nurse knows:
1. Dante is attempting to avoid the exam because of fear of failure.
2. Dante needs more time to rest.
3. Dante knows he will not get better and needs to go home.
4. Dante is worried he will get sick in the classroom.
9. Middle school is a time for children to:
1. Attempt to find areas they excel in.
2. Place a value on social and peer relations.
3. Have a large amount of interests.
4. All of the above are correct.
10. Identify an action that a school-age child would do to demonstrate concrete-operational development.
1. A child follows the directions from the teacher to write his name on the board.
2. A child is playing dodgeball and decides to throw the ball at a person with a ball.
3. A child takes her friend’s pencil because she wanted it.
4. A child is able to think through a math problem and check the work for a correct answer.
Chapter 10: Adolescents
1. A mother and daughter are at the well-child clinic for the daughter’s yearly checkup. The daughter is concerned because she is of shorter stature than most of her friends. She asks the nurse if she will continue to grow like her friends. A question the nurse should ask the girl to identify if growth will continue is:
1. “What was the date of your last menstrual cycle?”
2. “At what age did you start menarche?”
3. “What is the height of your mother?”
4. “What type of food do you like to eat in a 24-hour period?”
2. A mother of a 16-year-old boy states that her son is sleeping all the time. The nurse knows that at this age, an adolescent tends to increase in all of the following areas except:
1. Metabolism.
2. Rapid growth.
3. Staying up later at night.
4. Academic requirements.
3. Identify a characteristic of formal operations in a teenager.
1. Believes that they are the center of the world
2. Whatever I want, I get.
3. Planning on attending a university after graduation
4. Wants to feel accepted by the teachers
4. An age-appropriate activity for an adolescent would be all of the following except:
1. Coloring.
2. Creating music.
3. A job.
4. Reading.
5. A teenage girl is trying on a skirt that her mother does not approve of wearing. The girl is exhibiting:
1. Intimacy vs Isolation.
2. Identity vs Role Confusion.
3. Industry vs Inferiority.
4. None of the above.
6. Parents of a 15-year-old girl are speaking about the difficulties their daughter has in following the household rules. Which response by the nurse would be the most appropriate?
1. “Mood swings are more common in boys than girls, so this is normal.”
2. “Your daughter is testing the limits. This is a part of normal development. Make sure that you are consistent with your rules, and she will learn to follow them.”
3. “Girls tend to be more difficult than boys because they want to be the center of attention.”
4. “She is attempting to get your attention because something is bothering her.”
7. A nurse is evaluating a 17-year-old boy’s comprehensive cholesterol laboratory work. The result is 132 mg/dl. The nurse knows that:
1. This is too high, and the boy should get a referral for a nutritionist.
2. This is too high because of the types of foods teens prefer to eat.
3. This is within normal limits, and the boy should continue with the same eating style.
4. This is within normal limits because of the higher level of metabolism in teens.
8. A 15 year old has been an inpatient for the last 24 hours due to dehydration and vomiting. The nurse calculates the adolescents urine output for the shift at 0.3 ml/kg/hour. What does this result indicate?
1. The result is low for this age range, and the patient needs more fluid intake.
2. The result is normal, and the patient needs to maintain the level of fluid intake.
3. The result is high, and an order for fluid restriction should be received.
4. The result is higher than normal, but because of the diagnosis, the same fluid intake is adequate.
9. A 14-year-old girl is speaking to the school nurse about getting a belly button piercing. The nurse should educate the girl on:
1. Getting permission from her parents.
2. State laws for piercings.
3. The influence this may have on peers.
4. The nerve damage and infection that can occur with piercings.
10. During puberty, all of the following hormones are secreted at an increased rate except for:
1. Estrogen.
2. Androgens.
3. Progesterone.
4. ADH.
Chapter 11: Respiratory Disorders
1. An 8-year-old child with a history of cystic fibrosis has a chest that is larger than normal. This type of feature on a child is known as:
1. A concaved chest.
2. A barrel chest.
3. An asymmetrical chest.
4. All of the above are correct.
2. When a nurse enters the room of a child with chronic lung disease, she notes that the child is sitting in a tripod position. Identify the reason for this positioning by the child.
1. The child feels more comfortable playing in this position.
2. The child is attempting to have a bowel movement.
3. The child is having trouble breathing, and the position is comfortable
4. The child is in a resting position after walking in the hallway.
3. When a child exhibits difficulty breathing, the best positioning would be:
1. Having the head of the bed at 45 degrees.
2. Placing the child in a 90 degree angle on the parent’s lap.
3. Placing the child in a side lying position.
4. Having the child sit in a chair.
4. A father is concerned that his newborn baby girl is cold because her hands are blue. The nurse explains to the father that:
1. This is a sign of respiratory distress, and the baby needs to return to the nursery.
2. Most newborns have trouble regulating their body temperature.
3. This is acrocyanosis and should go away within 48 hours after her birth.
4. This is bruising the baby received during the birth process.
5. A nurse is attempting to assess the skin color of a child with dark skin. The nurse knows the best place to assess the child’s skin color is:
1. The nailbeds.
2. Inside the mouth in the cheek area.
3. The eyes.
4. On the chest.
6. A child with respiratory distress can experience dehydration because:
1. The child is not drinking enough fluids.
2. The body requires an increased amount of fluids when sick.
3. The child is retaining water in the kidneys since the body is using all the oxygen in the lungs.
4. Mouth breathing occurs when in distress, so the child is losing hydration.
7. When performing an assessment on an 8-year-old boy who is hospitalized for pneumonia, the nurse would anticipate what type of lung sounds?
1. Crackles
2. Stridor
3. Normal
4. Wheezes
8. A 5-year-old child has been admitted for complications related to asthma. When the nurse auscultates the child’s lungs, she would anticipate hearing:
1. Wheezes because the bronchioles have been restricted.
2. Rhonchi because of thick secretions from the flare-up.
3. Crackles because there is fluid in the alveoli.
4. All of the above may be heard.
9. When assessing a 12-year-old girl with the diagnosis of pneumonia, the nurse performs percussion. The lower left lobe is noted to have a dull sound. What should the nurse do next?
1. Call the doctor with the assessment.
2. Check the orders and start chest physiotherapy.
3. Palpate the chest to check for tactile fremitus.
4. Place the child on oxygen.
10. A child has the following ABG results:
pH: 7.38
pCO2: 52.6
HCO3: 32.5
The nurse interprets these results as:
1. Compensated Respiratory Acidosis.
2. Uncompensated Respiratory Alkalosis.
3. Compensated Respiratory Alkalosis.
4. Uncompensated Respiratory Acidosis.
Chapter 12: Cardiovascular Disorders
1. The right ventricle is responsible for:
1. Pumping blood to the left atrium.
2. Pumping deoxygenated blood to the lungs.
3. Pumping oxygenated blood to the body.
4. Returning oxygenated blood from the lungs.
2. The heart valve that connects the left atria and the left ventricle is:
1. The tricuspid valve.
2. The bicuspid valve.
3. The pulmonic valve.
4. The aortic valve.
3. In fetal development, the _________ is open to allow blood to flow in the heart.
1. Patent ductus arteriosus
2. Pulmonic valve
3. Aortic valve
4. Bicuspid valve
4. A nurse is assessing a 4-year-old child with a known atrial septal defect. Identify what the nurse should expect to see in the assessment.
1. An increased heart rate
2. An increased respiratory rate
3. Lower oxygen saturation
4. A lower heart rate
5. A nurse is discussing heart disorders that cause the mixing of oxygenated and deoxygenated blood with a new nurse. The nurse should explain that the mixed disorders consist of all of the following except:
1. Tetralogy of Fallot.
2. Hypoplastic left heart.
3. Truncus afteriosus.
4. Transposition of the great vessels.
6. When assessing a newborn, a nurse should check capillary refill:
1. On the fingernail beds.
2. On the sternum.
3. On the arm.
4. On the hand.
7. Weak peripheral pulses can indicate:
1. A weak heart.
2. Poor cardiac output.
3. Hypertension.
4. Patent ductus arteriosus.
8. Identify the child that is demonstrating acrocyanosis.
1. A newborn shows slow capillary refill.
2. A newborn’s hands are blue following delivery.
3. A newborn with a fever has red hands.
4. A newborn with a lack of oxygen has blue hands.
9. A newborn is born with patent ductus arteriosus. If the patent ductus arteriosus does not close during this time, the newborn will exhibit:
1. Narrowing pulse pressures.
2. Widening pulse pressures.
3. A decreased heart rate.
4. Quick capillary refill.
10. A nurse is assessing a newborn with a known patent ductus arteriosus defect of the heart. The mother asks when she can start breastfeeding her infant. The best explanation by the nurse would be:
1. “The newborn will need to have the defect repaired before oral feedings can start.”
2. “The newborn will need to have extensive rest time between feedings, so plan on breastfeeding one time, then we will give a nasogastric feeding the next time.”
3. “The nursing staff will monitor the newborn during feedings because she may sweat and have increased difficulty breathing.”
4. “The newborn should have no issues while breastfeeding.”
Chapter 13: Neurological Disorders and Sensory Disorders
1. The autonomic nervous system is responsible for:
1. Digesting a meal of hotdogs and chips.
2. Monitoring the heart rate while running.
3. Causing the body to perspire in the hot sun.
4. All of the above are part of the autonomic nervous system.
2. The responsibilities of the central nervous system include:
1. Deciding to walk instead of run.
2. Helping to understand a math problem.
3. Digesting the food in the stomach.
4. Keeping the hand on a hot stove.
3. The blood-brain barrier of an infant is:
1. Less permeable than that of an adult.
2. Impermeable for glucose.
3. Permeable for large proteins.
4. Permeable for large molecules.
4. The first assessment a child receives to identify neurological development is:
1. APGAR scores.
2. Scoliosis testing.
3. The Denver II study.
4. Kindergarten testing.
5. Questions about neurological function are raised when a child:
1. Snores.
2. Shows aggression when previously none was shown.
3. Wants attention from a parent.
4. Refuses to follow adult instruction.
6. A neonate is born with anencephaly. The prognosis for a neonate with this condition is:
1. A normal outcome.
2. A high risk for hydrocephaly.
3. Can be death.
4. Mental handicap.
7. A child with severe mental and physical handicaps is at risk for:
1. Developing neurocutaneous lesions.
2. A dysmorphic nose and ears.
3. Abnormal cranial nerve function.
4. All of the above are correct.
8. Neural tube defects can be linked to:
1. A mother’s drug habit while pregnant.
2. A mother’s lack of folic acid while pregnant.
3. A fetus’s exposure to environmental toxins.
4. A mother’s alcohol consumption while pregnant.
9. A nurse is attempting to position a newborn with a myelomeningocele in the lower lumbar region. The best position for the newborn would be:
1. Prone.
2. Laying the newborn on his/her side with support provided to the myelomeningocele.
3. Supine.
4. Any position is acceptable for a neonate with a myelomeningocele.
10. A neonate was born to a 28-year-old mother with an uneventful pregnancy two hours ago. The baby was delivered via cesarean section and taken directly to the neonatal intensive care unit because of an encephalocele. The mother is coming to see the baby. The nurse should:
1. Be prepared to answer questions about the baby’s care and condition.
2. Leave the room and give the family time with the neonate.
3. Prepare the mother prior to entering the room about the dysmorphic features and discuss the supportive care being provided.
4. Not let the mother see the child at this point.
Chapter 14: Mental Health Disorders
1. Mental illness in children can be defined as:
1. A distorted view of self.
2. A personal inability to respond to the environmental norms.
3. Lack of insight about one’s abilities and consequences of actions.
4. All of the above define mental illness.
2. Risk factors for a child to develop a mental illness include all of the following except:
1. Low birth weight.
2. Family history.
3. Caregiver neglect.
4. A wealthy family.
3. Children with positive social environments:
1. Are at risk for mental illnesses.
2. Have less of a risk for developing mental illnesses.
3. Do not adjust to other cultures easily.
4. Must have control over their personal environment.
4. A teenager with a known deficit of norepinephrine may exhibit problems with which of the following?
1. Concentration
2. Social relationships
3. Self-confidence
4. Physical motor skills
5. Serotonin deficiencies can cause ________ in children.
1. Panic
2. Obsessions
3. Bulimia
4. All of the above are correct
6. A child has been diagnosed with having dopamine deficiencies. The nurse would anticipate signs of _________ during an assessment.
1. Fatigue
2. Compulsions
3. Decreased motivation
4. A depressed mood
7. The purpose of emotion intelligence is to measure:
1. A child’s behavior pattern.
2. A child’s mood changes.
3. A child’s ability to be motivated.
4. A child’s ability to ask for help.
8. A mother states that her 11-year-old son has really started to change in his understanding of concepts. The nurse knows that this could be true because:
1. Puberty has started to occur.
2. The increase in testosterone at this age causes the brain to mature.
3. The boy is modeling older boys.
4. Brain connections at this age are rewired to be more like an adult brain.
9. A mental health nurse is seeing a patient for the first time. It will be important for the nurse to assess:
1. The child’s family, social, cultural and psychological aspects.
2. The child’s psychological aspects.
3. The child’s reasons for attending the therapy session.
4. The dynamics between the family members and the psychological factors.
10. A 14-year-old boy reports that he has been seeing and hearing things. His friends tell him it is like he goes to another world sometimes. The teen does not understand what is happening to him. The mental health nurse is aware that the teen could be experiencing:
1. Suicidal ideations.
2. Obsessive-compulsive behaviors.
3. Hallucinations.
4. Stress.
Chapter 15: Gastrointestinal Disorders
1. What is being assessed when auscultating the gastrointestinal system?
1. Changes in the abdominal appearance
2. Presence or absence of bowel sounds
3. Distension as well as spleen and liver size
4. Presence of a hernia
2. Which of the following symptoms may be found in Celiac Disease?
1. Abdominal pain with bloating
2. Weight gain with very skinny extremities
3. Small, hard stools
4. Normal growth
3. When teaching the family about a gluten-free diet, what are the recommendations for the family about diet?
1. Many gluten-free products are available, so it is important to read labels.
2. Participation in a support group may help with identifying stores that carry gluten-free food.
3. Communion wafers contain gluten and may need to be avoided.
4. All of the above.
4. Appendicitis may have abdominal pain as a symptom. Where does the abdominal pain occur?
1. Left upper quadrant
2. Right lower quadrant
3. Periumbilical
4. 2 and 3 only
5. The most commonly used measure to diagnose obesity is:
1. Body mass index.
2. Ultrasound.
3. Weight measurement.
4. Cholesterol measurement.
6. Gallstones are occurring more often in children. Which of the following is not a treatment for children with gallstones?
1. Surgery is always the treatment for gallstones.
2. Infants do not need treatment.
3. Crohn’s patients may have an ERCP, only without surgery.
4. Laser lithotripsy may be an effective option.
7. The first symptom in an infant of the gastrointestinal manifestation of cystic fibrosis is:
1. Constipation.
2. Meconium ileus.
3. Rapid weight gain.
4. Inability to breastfeed.
8. Treatment for a child with cystic fibrosis with gastrointestinal symptoms may include:
1. Pancreatic enzymes.
2. Fat-soluble vitamins.
3. No immunizations.
4. 1 and 2.
9. Symptoms of Biliary Atresia would include which of the following?
1. Prolonged jaundice (appearing for longer than two weeks)
2. Elevated direct bilirubin (greater than 20 percent of the total bilirubin measurement)
3. Very dark stools
4. 1 and 2
10. The main complication of neonatal jaundice is:
1. Lack of voiding and stooling.
2. Bilirubin encephalopathy.
3. The need to immediately stop breastfeeding.
4. Increased risk of infection.
Chapter 16: Renal Disorders
1. The father of a child with acute glomerulonephritis asks the nurse why blood pressure readings are being taken so often. The nurse knows that:
1. The antibiotic therapy the child is receiving can influence increases in blood pressure.
2. The child can develop hypotension at any time because of the damage to the kidneys.
3. A child with this illness can have sudden increases in blood pressure without warning.
4. Blood pressure must be maintained within normal limits to make sure that the kidneys do not stop working.
2. Which of the following is the goal of care for a child with minimal change nephrotic syndrome?
1. Reducing the blood pressure
2. Decreasing the amount of protein in the urine
3. Lowering the sodium level within the blood
4. Increasing the permeability of the kidneys
3. A child with end-stage renal disease should have a diet consisting of:
1. High protein.
2. Ketogenics.
3. Low sodium and low protein.
4. Low carbohydrates and low potassium.
4. A child is having a cystoscopy procedure to:
1. Check kidney function.
2. Identify malformations of the ureters.
3. Visualize the bladder.
4. Measure urine output.
5. A child has been scheduled for a cystourethrography. The nurse prepares the child by:
1. Following the order of NPO until after the procedure.
2. Assessing the child’s allergies.
3. Discussing the IV insertion.
4. Discussing the placement of a Foley catheter.
6. A child with end-stage renal disease is being assessed by the nurse. The nurse notes crackles in the patient’s lungs. The nurse should:
1. Documents the lungs sounds.
2. Assess for shortness of breath and the respiratory rate.
3. Obtain a pulse oximetry reading.
4. All of the above should be done.
7. The nurse is assessing a child with end-stage renal disease would anticipate the cardiac system to:
1. Be functioning as well as a child who is not ill.
2. Have decreased blood pressure.
3. Have a lower pulse in the lower extremities.
4. All of the above are correct.
8. Vomiting in a child with chronic kidney disease can indicate:
1. Gastroenteritis.
2. A urinary tract infection.
3. Fluid volume depletion.
4. Food poisoning.
9. A teenage girl has come to the nurse’s office at school because the last three times she has urinated, the urine has had a lot of bubbles. The nurse should:
1. Assess the amount of protein the girl has consumed within the last 24 hours.
2. Assess the fluid intake of the last 24 hours.
3. Question the girl about recent sexual activity.
4. Call the parents immediately because the girl needs medical attention.
10. A mother has called the triage nurse to find out which fluids she should give her son that has been vomiting for the last 12 hours. Identify the fluid that would be appropriate to give the child.
1. Water
2. Red Kool-Aid
3. Diet Cola
4. Red or orange Gatorade
Chapter 17: Endocrine Disorders
1. An example of the body’s response to the endocrine system includes all of the following except:
1. A growth spurt for a 12-year-old boy.
2. Development of breast buds for a 10-year-old girl.
3. A teen reacting quickly, hitting another car while driving.
4. A teen answering a question on a biology test.
2. The release of the luteinizing hormone causes __________ in teen girls.
1. Primary sexual organ growth
2. The release of the ovum for fertilization
3. Rapid growth
4. Pubic hair growth
3. A nurse is discussing the production of the somatotropic hormone. Its primary responsibility is best described as:
1. A hormone that regulates bone growth in children.
2. A hormone that increase the rate of sexual/reproductive organ development.
3. A hormone that causes fight-or-flight mechanisms.
4. A hormone that causes the body to fight infections.
4. The anterior portion of the pituitary gland secretes all of the following hormones except:
1. The growth hormone.
2. Adrenocorticotrophic hormones.
3. The antidiuretic hormone.
4. The luteinizing hormone.
5. The pineal body is being discussed with a parent. The parent demonstrates the proper understanding of the pineal body’s purpose when the parent states:
1. “The pineal body helps my child sleep.”
2. “The pineal body can improve my child’s cognitive ability as he grows.”
3. “The pineal body will regulate the height of my child.”
4. “The pineal body can affect the timing of my child’s puberty.”
6. Overproduction of the anterior pituitary hormones can cause all of the following except:
1. Hyperthyroidism.
2. Hypercorticosolism.
3. Precocious puberty.
4. Diabetes.
7. One of the most common causes for thyroid disease in adolescents is:
1. Grave’s Disease.
2. Goiter.
3. Hashimoto disease.
4. Kawasaki’s disease.
8. A child has a history of hypoparathyroidism. While assessing the child, a nurse would expect to find:
1. A short, thick neck for a girl.
2. A malnourished child.
3. A small-statured boy.
4. A tall-statured girl.
9. An example of the medulla of the adrenal glands working properly would be:
1. A child having an increase in heart rate and dilated pupils when scared.
2. A child relaxing and watching a video.
3. A child running a race with an increased respiratory rate.
4. A child having constricted pupils and a rapid heart rate after jumping rope.
10. The purpose of exocrine release is to:
1. Restore energy while sleeping.
2. Provide a fight-or-flight response when scared.
3. Increase the release of glycogen to the muscles when running.
4. Aid in the digestion of pizza.
Chapter18: Genetic and Reproductive Disorders
1. The thin fold of skin that lies between the labia minora and can be ruptured as a result of sexual intercourse is known as the:
1. Clitoris.
2. Cervix.
3. Hymen.
4. Uterus.
2. The female organ that produces the ova and sex hormones is known as the:
1. Ovum.
2. Ovary.
3. Ovule.
4. Oviform.
3. The endometrium is a layer of cells that lines the:
1. Ovary.
2. Perineum.
3. Urethra.
4. Uterus.
4. Common injuries to pediatric and adolescent female genital tract include “straddle” injuries. These injuries result from a fall on a:
1. Bicycle.
2. Wagon.
3. Sidewalk.
4. Step.
5. “Clue cells” are an indication of:
1. A change in the normal organisms in the mouth.
2. A change in the normal organisms in the stomach.
3. A change in the normal organisms on the skin.
4. A change in the normal organisms in the vagina.
6. Amenorrhea in adolescents becomes a concern if there is no menses by age:
1. 12.
2. 13.
3. 14.
4. 16.
7. Planning care for a patient with Menorrhagia would include education on all except:
1. Blood count, iron level, and platelet count levels.
2. Blood loss of greater than 80mL is considered a heavy volume.
3. Encouraging a diet of food rich in iron during menses.
4. Avoiding fluid intake with episodes of Menorrhagia.
8. Common causes of abnormal uterine bleeding in adolescents include pregnancy, use of hormonal contraceptives, hypothyroidism, and infection. Other causes include:
1. Psychogenic causes.
2. Exercise.
3. A polycystic ovary.
4. All the above.
9. The prepuce is the skin that covers:
1. The glans.
2. The vas deferens.
3. The testicles.
4. The epididymis.
10. A varicocele is a collection of dilated and tortuous veins in the plexus surrounding the spermatic cord in the scrotum. When planning education for the family on this particular disorder, it is important to include information, such as the fact that varicoceles can:
1. Have increased incidence infertility.
2. Cause pain or feeling of fullness in the scrotum.
3. Have the texture of a bag of worms.
4. All of the above.
Chapter19: Hematologic, Immunologic, and Neoplastic Disorders
1. Which of the following is a condition in which the normal hemoglobin is partially or completely replaced by abnormal hemoglobin?
1. Iron deficiency anemia
2. Sickle Cell anemia
3. Leukemia
4. Aplastic anemia
2. Classic hemophilia (hemophilia A) involves a deficiency in:
1. Factor V.
2. Factor VIII.
3. Factor IX.
4. Factor XIII.
3. Acquired thrombocytopenia involves antibodies against:
1. Platelets.
2. Basophils.
3. Neutrophils.
4. Eosinophils.
4. A definitive diagnosis for leukemia is based on results of:
1. Fatigue and pallor.
2. A urinalysis.
3. A bone marrow aspirate.
4. A history and a physical.
5. When caring for a child with Wilm’s tumor, which of the following nursing interventions would be most important?
1. Place child on neutropenic precautions.
2. Monitor bowel sounds in order to detect ileus.
3. Position in the high fowler’s position in order to increase lung capacity.
4. Avoid palpation of the abdomen.
6. Which of the following events places a preschool child at high risk for lead poisoning?
1. Using pencils and pens
2. Living in a home built before 1965
3. Drinking from the water fountain at school
4. Climbing on playground equipment
7. What factor contributes to a vaso-occlusive crisis in a child with Sickle Cell anemia?
1. Dehydration
2. Alkalosis
3. Infection
4. Stress
8. What is included in neurologic checks for children of all ages with a brain tumor?
1. Papillary response, head circumference, vital signs
2. Motor activity, papillary response, vital signs
3. Level of consciousness, palpate fontanels, motor activity
4. Blood pressure, head circumference, level of consciousness
9. What is the most common opportunistic infection in children with the Human Immunodeficiency Virus?
1. Pneumocystic pneumonia
2. CMV
3. Meningitis
4. Encephalitis
10. Which of the following diagnostic tests confirms Hodgkin’s disease?
1. Reed-Sternberg cells in the lymph nodes
2. Lymphocytes in the bone marrow
3. Neutrophils in the blood
4. Bacteria in the urine
Chapter 20: Musculoskeletal Disorders
1. A mother brings into the emergency department a frail-looking infant with blue sclera and arm and leg deformities. The mom said she was changing her diaper and heard a “snap.” She put her shirt on and she heard another “snap.” She says that the baby has been crying, but eating a little. Mom reports a clavicle fracture in the delivery room, but the doctors told her it was nothing and would heal fine. The nurse notes a small lump on her right clavicle. It is not painful to the touch. The infants’ left forearm and right femur appear swollen and deformed. Based on your clinical knowledge of birth defects, your best answer to the mother would be:
1. “We will call the doctor to do a skeletal survey.”
2. “We will call the Child Protective Services team to rule out abuse.”
3. “We will call Genetics to see if any genetic birth defects run in your family.”
4. All of the above.
2. A 13-year-old boy, who has played baseball for three years, comes in complaining of left elbow pain and swelling. He is a pitcher. He plays baseball all year. X-rays reveal medial epicondyle irritation. There is no avulsion fracture. Based on these findings, you explain to the child that he can:
1. Swim. It’s a safer sport.
2. Resume baseball gradually with pain-free motion.
3. Change positions in baseball for the season.
4. Protect, rest, ice, compress, and elevate the injury as well as stop baseball for three weeks.
3. A 16-year-old soccer player comes into the ER with left knee effusion and extreme pain. The child claims that while kicking the ball away from an opponent, she felt a “pop” and fell to the ground. She had to be assisted off the field. She is in the playoffs and wants to play again. X-rays are normal, but as the nurse, you know which of the following about sports injuries?
1. X-rays can help classify fractures, but cannot classify tissue, tendons, and ligaments.
2. She probably has an ACL tear based on the symptoms of swelling, pain, inability to bear weight, and hearing a “pop” before she went down.
3. She will need an MRI.
4. She will need crutches and a knee immobilizer as well as to rest, ice, compress, and elevate the injury.
4. A 21-one-year old basketball player comes to the emergency department with a swollen, ecchymotic, painful right ankle. He states he went up for a jump shot and twisted it. He reports pain over the medial malleolus. He cannot walk on it and was assisted off the court at the game. He reports that he has done this before, but it is different this time. He wants an air cast splint and crutches, but no x-rays. What statement indicates that this young athlete may not understand the difference between a fracture and a sprain?
1. “I will be fine in 3 days.”
2. “I can play if you give me the splint.”
3. “I don’t need x-rays today. I’ve done this before.”
4. All of the above.
5. A 5-year-old boy presents to the emergency department with a history of a motor vehicle accident. He was restrained in the backseat, and the car was hit head on. He has a swollen and deformed left thigh. He is in extreme pain. He has frequent muscle spasms. X-rays reveal a midshaft femur fracture. As you prepare the child prior to surgery, you will assist with anticipatory guidance as well as show and discuss a spica cast. What information will be helpful to this young boy?
1. A hard cast from your waist to your toes will protect your leg so it can heal.
2. We can put a cast like yours on your bear.
3. The IV will give you medicine to make you sleep, wake up, and help with the pain.
4. All of the above.
6. An 11-year-old boy with a tibia shaft fracture presents for his first follow-up visit after an injury. He is placed into a non-weight bearing, long leg cast with instructions about cast care. Your knowledge about cast care reveals that you should include which of the following statements in your instructions?
1. Keep the cast clean and dry, do not insert objects into the cast, and call the doctor if the cast becomes loose, cracked, or ill fitting.
2. You may take a shower in the cast, just don’t put weight on it.
3. It’s okay to put coins down the cast.
4. Do not call the office for a foul smell or skin irritation.

7. A 2-week-old infant with Developmental Dislocated Hips (DDH) is currently being treated in a Pavlick harness. The mom calls and is concerned that the child is not kicking like before and seems to be in pain. She has a history of colic. Although the harness seemed to fit well in clinic last week, you are concerned. Therefore, the proper statement to the mother would be:
1. “Try some Tylenol and call her pediatrician.”
2. “Remove the harness and we will see you in clinic ASAP.”
3. “Go to the nearest emergency department to have the child seen.”
4. “Remove the harness and call for an appointment in three months.”
8. A 2-year-old with Down’s syndrome presents to the clinic with a chief complaint of unsteady walking. The physical therapist wants to use orthotics to help with ambulation. The main uses of assistive aids in neuromuscular conditions are:
1. To prevent deformity and improve function.
2. To stop mobility and use a stroller.
3. To cover their feet and keep them warm.
4. To relax muscles in a child with ligament laxity.
9. A 7-year-old is having on and off knee, ankle, wrist, and hip pain. The family history is positive for rheumatoid arthritis. No injury has taken place, and the child has occasional swelling of joints. Pain resolves with rest, ice, and NSAIDs. The primary care physician ran labs with positive rheumatoid factor ANA and ESR. This child is a soccer player and a violinist. Your differential diagnosis would be:
1. Juvenile Idiopathic Arthritis (JIA), septic arthritis, osteomyelitis, and fracture.
2. Juvenile Idiopathic Arthritis (JIA), toxic synovitis, osteomyelitis, and Developmental Dislocated Hips (DDH).
3. Juvenile Idiopathic Arthritis (JIA), chronic inflammatory arthritis, chronic osteomyelitis, and Developmental Dislocated Hips (DDH).
4. Juvenile Idiopathic Arthritis (JIA) only.
10. If a child is diagnosed with Juvenile Idiopathic Arthritis (JIA), which of the following statements is true?
1. Usually, a child outgrows the disorder.
2. NSAIDs are the treatment of choice.
3. The child should not participate in sports.
4. All of the children of these parents will have the disorder.

AND MUCH MORE