the Point; Pediatrics Benchmark II

Question 1

the Point; Pediatrics Benchmark II. A teen client enters the family planning clinic and asks about contraception. The client does not feel comfortable with her body, does not want her partner to know she is seeking birth control and does not feel she will remember to take medication each day.

In planning the teaching session, which methods would be most appropriate for this client? Select all that apply.

• Birth control pills
• ==Medroxyprogesterone injections==
• Condoms
• ==An intrauterine device==
• ==An implant==
• The diaphragm

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Question 2

A 12-year-old with cystic fibrosis is admitted to the hospital and presents with fatigue, signs of dehydration, and frequent urination. The blood glucose on admission is 425 mg/dL. The client is diagnosed with cystic fibrosis-related diabetes.

Which interventions would be involved in care? Select all that apply.

• ==Assessing hemoglobin A1c at recommended intervals.==
• Refraining from exercise that elevates blood glucose levels.
• A diet low in fat and protein, high in carbohydrates.
• Limiting fluids within restricted volumes.
• ==Administering insulin as needed.==
• ==Assessing blood glucose at least three times per day.==

Question 3 of 50

A 4-year-old client is to have a bone marrow aspiration under conscious sedation. The nurse plans to provide pre-procedural instruction with this child.

Which fears of preschool children should the nurse consider when preparing for client teaching? Select all that apply.

• [X] The unknown
• [X] The dark
• [ ] Threats to privacy
• [X] Pain
• [X] Separation from parents

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Question 4 of 50

A nurse reviews the priority assessments for infants suspected of having shaken baby syndrome with emergency department nurses.

Which of these are priority assessments to be included in teaching? Select all that apply.

• [X] Level of consciousness
• [X] Monitor for vomiting
• [X] Assess for seizure activity
• [X] Breathing patterns
• [ ] Assess for tachycardia
• [X] Condition of the fontanel

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Question 1 of 1 (Case Study Part 1)

The nurse is administering medications to a 7-year-old client prescribed in the electronic health record.

Vital Signs (1130):

• Blood Pressure: 110/70
• Heart Rate: 122
• Respiratory Rate: 24
• Temperature: 99.9°F (37.6°C)
• SpO2: 96% on Room Air (RA)

Orders:

• Acetaminophen 160 mg oral suspension every 6 hours prn fever over 100°F (37.8°C)
• Amoxicillin 250 mg oral suspension 3 times per day
• Prednisolone 2 mg/kg/day oral suspension x 5 days

For each nursing action, click to specify if the action is appropriate or not appropriate.

Nursing Action	Appropriate	Not Appropriate
Offer the child a flavored ice pop, then give the acetaminophen.		[X]
Ask the pharmacist to add flavoring to the amoxicillin.	[X]
Allow the child to drink apple juice after taking the prednisolone.	[X]
Use a pacifier with a reservoir to administer the amoxicillin.		[X]

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Question 6 of 50

The nurse is planning cares for a school-age child hospitalized for seizure control. Which behavior would the nurse anticipate seeing in the child?

• [ ] Crying and clinging to parents.
• [X] Anger and hostility toward parents.
• [ ] Violent temper tantrums.
• [ ] A need to be alone.

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Question 7 of 50

A client with cystic fibrosis presents with signs and symptoms of retained respiratory secretions.

Which interventions should the nurse recommend to facilitate airway clearance in this client? Select all that apply.

• [X] Chest percussion vests
• [X] Mucolytics
• [X] Intake of fluids in the diet
• [X] Exercise
• [X] Percussion and postural drainage
• [ ] Antitussives

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School Nurse Case Study (Drag and Drop)

The nurse works in a local school at a Special Needs Child Care Center. the Point; Pediatrics Benchmark II

Nursing Notes (1130): Client presents to school nurse office with paraprofessional (para) in personal wheelchair. Client non-verbal. Paraprofessional states “They are acting funny and feel really hot. They were cool two hours ago.” Vital signs completed. Client noted to begin tonic-clonic movements of arms and legs. Head diverted to the right side, eye deviated to right. Marked nystagmus noted. Client has no known history of seizure activity. Seizure occurred for 95 seconds before resolution.

Vital Signs:

• Blood Pressure: 98/76
• Heart Rate: 140
• Respiratory Rate: 32
• Temperature: 104.8°F (40.4°C)
• SpO2: 98% on Room Air (RA)

Complete the diagram by specifying the condition the client is most likely experiencing, two actions the nurse should take to address that condition, and two parameters the nurse should monitor to assess the client’s progress.

Condition Most Likely Experiencing:

• [X] Febrile seizure
• [ ] Focus seizure
• [ ] Status epilepticus
• [ ] Petit Mal seizure

Actions to Take (Select Two):

• [ ] Initiate rectal diazepam
• [ ] Place oxygen mask on with elastic strap around client’s head
• [ ] Administer oral antipyretic
• [X] Loosen tight belts
• [X] Ensure client safe in wheelchair

Parameters to Monitor (Select Two):

• [X] Timing and characteristics of client’s behaviors
• [ ] Incontinence of urine and stool
• [ ] Post-ictal restlessness
• [X] Airway patency, oxygenation, and ventilation
• [ ] Ability to swallow

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Preoperative Safety Checklist Question

A nurse is completing the preoperative checklist for a 6-year-old client scheduled for surgery.

Which assessment data contains a priority finding that must be reported to the health care provider immediately?

• [ ] Vital Signs: Temp 37.0°C (98.6°F), HR 98, RR 22, BP 102/64
• [ ] Lab Values: Hgb 11.1 g/dL, Hct 42%
• [X] Dental Assessment: Loose Teeth Yes (3 loose: 2 upper, 1 lower)
• [ ] Documentation: Signed informed consent on chart, ID and allergy bands intact

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Tracheoesophageal Fistula Question

A nurse is teaching the parents of a child with a significant tracheoesophageal fistula and a gastrostomy tube. The child will be fed via the tube once bowel sounds return.

Which statement should the nurse include in the teaching?

• [ ] “Your child will be able to be fed by mouth after the esophagus is repaired.”
• [ ] “The child’s defect means that the child will never be able to eat by mouth.”
• [X] “The gastrostomy tube will be used to drain the stomach fluid until the next surgery.”
• [ ] “Your child cannot eat initially and will need to be on total parenteral nutrition.”

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Toddler Developmental Delay Question

A 221​-year-old child living in significant poverty in a very old house is evaluated for developmental delays, speech delays, and not walking well.

Which assessment should the nurse recommend initially?

• [ ] Assessment of CBC for anemia.
• [X] Assess serum lead levels to monitor for exposure.
• [ ] Determine nutritional patterns.
• [ ] Measure protein levels.

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Meningitis Case Study Question

A 3-year-old client presents with a high fever, lethargy, nuchal rigidity, and a disseminated macular rash. A lumbar puncture is performed.

Which nursing action is the priority?

• [ ] Await results of culture.
• [X] Anticipate administering a broad-spectrum antibiotic.
• [ ] Determine which antibiotic was given before the LP.
• [ ] Restrict oral and intravenous fluids.

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Pediatric Oncology Care Plan Question

A nurse is reviewing the plan of care and clinical notes for an admission assessment of a pediatric oncology patient.

Collaborative Care Notes: Parent reports giving child St. John’s wort daily. Instructed parent to avoid bringing fresh fruits into the room. Monitored temperature regularly.

Which finding is most concerning to the nurse?

• [ ] Instructing the parent to avoid bringing fresh fruits into the room. the Point; Pediatrics Benchmark II.
• [ ] Monitoring temperature regularly.
• [X] Giving child St. John’s wort daily.

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Sickle Cell Crisis Question

A nurse is providing care for a child who is experiencing a sickle cell crisis.

Which interventions should the nurse include in the client’s plan of care? Select all that apply.

• [X] Administering intravenous fluids
• [X] Monitoring the child’s intake and output
• [X] Applying warm compresses to the affected joints
• [X] Administering an analgesic for pain
• [ ] Applying cold compresses to the affected joints

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Nephrotic Syndrome Question

A nurse is assessing a child with nephrotic syndrome.

Which clinical manifestations should the nurse expect to find? Select all that apply.

• [X] Proteinuria
• [X] Edema
• [X] Hyperlipidemia
• [ ] Weight loss
• [ ] Decreased specific gravity

Question 8

A 6-month-old with respiratory syncytial virus bronchiolitis is admitted to the unit. The nurses provide care as pictured.

Which component of the image indicates a need for more education for the nurses?

• The nurses need to be in surgical gowns and caps.
• The nurses need to use high particulate masks.
• Two nurses should not be providing care.
• Gowns are required when providing client care.

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Question 9

The nurse provides teaching to the parents of a 4-year-old who is being treated for strabismus.

Which would the nurse teach the family member about this treatment?

• “Surgery will be needed to treat strabismus initially.”
• “Patching the unaffected eye will exercise the weaker eye.”
• “Your child will take medications to treat this condition.”
• “Your child will have their affected eye patched.”

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Question 10

A 6-year-old has a history of surgical resection of a brain tumor and insertion of a ventriculoperitoneal shunt. The child presents in the emergency department with vomiting, lethargy, and sluggish pupils.

Which action should the nurse implement first?

• Elevate the head of the bed.
• Prepare for a lumbar puncture.
• Obtain intravenous access.
• Apply oxygen via mask.

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Question 11

A 12-month-old client weighing 8.2 kg (18 lbs.) is cared for in the acute care setting. Child arrives with her parent experiencing fatigue, weakness, tachycardia. She is inconsolable with pale, cool extremities. The parent states she was previously diagnosed with heart failure. Vital signs: BP 80/56, HR 164, RR 34, Temp 102.8°F (39.3°C), SpO2 98% on Room Air.

Identify whether the clinical findings are related or unrelated to the primary diagnosis of heart failure.

• Pale, cool extremities: Related
• Heart rate: Related
• Inconsolable: Related
• Weakness: Related
• Temperature: Unrelated

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Question 12

A 13-year-old client usually seen in the nephrology clinic for nephrotic syndrome has received many courses of steroids to deal with disease flare-ups over the last three years. Referred to the endocrine clinic. Dietician note: weight 88 lb/40 kg (20th percentile); height 54 inches/137 cm (1st percentile). Order: somatotropin (genotropin) subcutaneous 0.2 mg/kg/week in seven divided doses.

Complete the diagram by specifying the condition the client is experiencing, two actions the nurse should take, and two parameters to monitor.

• Condition Most Likely Experiencing: Steroid induced growth retardation
• Actions to Take (Select two): Teach client and family subcutaneous injection techniques AND Anticipate administering prescribed somatotropin 1.14 mg/dose
• Parameters to Monitor (Select two): Linear growth AND Blood glucose levels

Question 13

The nurse teaches an 8-year-old client with spina bifida how to do home urinary catheterization as part of a bladder program. The nurse assesses the client’s ability to list the equipment needed for this procedure.

What equipment is needed for this procedure? Select all that apply.

• Sterile urinary catheter
• Petroleum jelly lubricant
• Water-soluble lubricant
• Urine basin or urinal to collect urine
• Clean catheter
• Hand antiseptic

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Question 14

An adolescent client is having surgery tomorrow to create a colostomy. The nurse provides client instruction.

Which statement by the client indicates a need for more teaching?

• “They will teach me how to change my bag and all.”
• “The new bags are very difficult to see under clothes.”
• “I need to avoid tight clothes around the bag.”
• “I will only have to empty the bag every few days.”

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Question 15

A parent enters the urgent care center with their 15-month-old. The child was eating grapes and began to “breathe heavy and got very red.” Upon assessment, the child is noted to be tachypneic and short of breath.

Which additional findings would the nurse anticipate in this client? Select all that apply.

• Respiratory wheeze or stridor
• Vomiting
• Drooling and dysphagia
• Refusal to eat or drink
• Diarrhea
• Gagging

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Question 16

The nurse is to provide a toddler amoxicillin. The elixir is available 250 mg/5 mL. The child weighs 30 pounds. The recommended dosage is 20-40 mg/kg/24 hours in 3 divided doses. The client has been prescribed the maximum dose.

How much should the nurse administer in each dose? Answer in milliliters to the nearest tenth.

• 3.6 mL

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Question 17

The nurse cares for a school-age child with attention deficit hyperactivity disorder. The client is to receive methylphenidate. The nurse teaches the parents about the administration of this medication.

Which statements, if made by the parents, indicates a good understanding of the teaching? Select all that apply.

• “I know the medication will decrease the appetite, so I will give to my child before meals.”
• “The medication will alleviate my child’s restlessness and lack of attention.”
• “I should give the medication to my child early in the day to avoid sleeplessness.”
• “Methylphenidate may be given once or twice per day as needed.” the Point; Pediatrics Benchmark II.
• “I need to watch my child for slowed growth.”
• “I need to strictly limit sugar in my child’s diet.”

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Question 18

A nurse works in a school for children with special needs, including those with cerebral palsy. The nurse researches strategies to reduce spasticity to add to their standard of care.

Which would represent these interventions? Select all that apply.

• Restraining movement to train muscles.
• Surgical release of tendons.
• Exercises to reinforce purposeful actions.
• Administration of baclofen.
• Providing sedative medications.
• Administering the prescribed analgesia.

Item 2 of 6

A 12-month-old client weighing 8.2 kg (18 lbs.) is cared for in the acute care setting.

Nursing Notes (3/5, 0645): Child arrives with her parent experiencing fatigue, weakness, tachycardia. She is inconsolable with pale, cool extremities. The parent states she was previously diagnosed with heart failure.

Vital Signs (3/5, 0630):

• Blood Pressure: 80/56
• Heart Rate: 164
• Respiratory Rate: 34
• Temperature: 102.8°F (39.3°C)
• SpO2: 98% on Room Air (RA)

The client is brought to the emergency department for evaluation. What does the nurse expect to observe in a child of this age? Select all that apply.

• Weight has doubled since birth.
• Unable to stand with support.
• Experiences frustration.
• Gets fatigued easily when crawling.
• Can crawl on hands and knees.
• Can move from prone to sitting position.
• Has separation anxiety.
• Sits unsupported.
• Says “mama” and “dada.”

Pediatric Heart Failure Case Study

Item 3 of 6

A 12-month-old client weighing 8.2 kg (18 lbs.) is cared for in the acute care setting.

Orders (3/5, 0715):

• Furosemide 1 mg/kg IV x1; then 3 mg/kg PO every 6 hours
• Weigh at same time daily
• Vital signs every shift
• Maintain feeding schedule every 3 hours
• Potassium 1 mEq/kg/day PO
• Ensure uninterrupted rest periods
• Acetaminophen 120 mg PO every 6 hours prn fever

The nurse reviews the provider orders for the pediatric client and plans the client’s care. Drag words from the choices below to fill in each blank in the following sentence.

The nurse should implement the order for ______ first. The nurse should question the order for ______ .

• Choices for blank 1: rest periods, furosemide, the feeding schedule
• Choices for blank 2: the feeding schedule, potassium, vital signs, daily weights

Correct Sentence: The nurse should implement the order for furosemide first. The nurse should question the order for the feeding schedule.

Question 19

The nurse reviews the provider orders for the pediatric client and plans the client’s care.

Drag words from the choices below to fill in each blank in the following sentence.

The nurse should implement the order for furosemide first. The nurse should question the order for vital signs.

• First Blank Choices:
  • rest periods
  • furosemide
  • the feeding schedule
• Second Blank Choices:
  • potassium
  • vital signs
  • daily weights

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Question 20

The nurse has reviewed the provider orders and plans care for the client. Select whether the following nursing actions should be implemented or not implemented.

• Monitor serum potassium level: IMPLEMENT
• Administer 10 mg furosemide IV: DO NOT IMPLEMENT
• Maintain strict intake and output: IMPLEMENT
• Request a sodium-restricted diet: IMPLEMENT

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Question 21

The nurse plans the client’s care. Complete the following sentence by choosing from the drop-down lists.

The nurse should assess the client’s apical pulse prior to administering digoxin and holds the medication if bradycardia is present.

• First Blank Choices:
  • apical pulse
  • respiratory rate
  • blood pressure
• Second Blank Choices:
  • acetaminophen
  • digoxin
  • furosemide
• Third Blank Choices:
  • bradycardia
  • tachypnea
  • fever

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Question 22

The nurse is reviewing the client’s progress at 1100. Click to select whether the clinical findings indicate the client’s condition has improved or declined.

• Bilateral breath sounds clear to auscultation: Indicates Condition Improved
• Capillary refill of 4 seconds: Indicates Condition Declined
• Urine output of 25 mL over the last 4 hours: Indicates Condition Declined
• Temperature of 100.8°F (38.2°C): Indicates Condition Improved

Question 47 of 50

After several days of inpatient treatment for heart failure, the nurse prepares to discharge the client.

Which statements made by the child’s parent indicate an understanding of the treatment plan? Select all that apply.

• “I do not need to worry about tracking her weight at home.”
• “We will need to follow up with the cardiologist.”
• “I need to check my child’s pulse before giving the digoxin.”
• “This is a genetic condition, and all of our future kids will also have it.”
• “I will need to continue the medication once we are home.”
• “Since I am seeing the cardiologist, I can skip the well visit with the pediatrician.” the Point; Pediatrics Benchmark II.
• “My child may need more rest than other children her age.”
• “My child will grow out of this disease process.”

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Question 48 of 50

The nurse cares for a 2-year-old client weighing 10 kg (22 lbs.) in the emergency department.

Nursing Notes 3/15 1800 Child arrived in the emergency department via personal vehicle after sustaining a burn. Clothes were removed. Some blistering noticed. Child is anxious and crying. 1900 Client has 7% total body surface area burns. 2% are full thickness. No inhalation injury. Both feet and lower legs are burned with both feet involving full thickness burns. Caregiver states the child was burned by getting too close to the barbeque grill.

For each nursing action, click to specify if the action is indicated or not indicated for the client.

• Obtain arterial blood gases (ABGs): NOT INDICATED
• Palpate peripheral pulses: INDICATED
• Open any blisters that are present: NOT INDICATED
• Contact hospital social worker: INDICATED
• Monitor vital signs every 4 hours: NOT INDICATED
• Calculate intravenous fluid needs: INDICATED

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Question 49 of 50

The nurse assesses an 11-year-old weighing 70 pounds who sustained a femoral fracture. The client returns from the operating room following pinning of the fracture and is expressing that he is in severe pain. The nurse plans to administer morphine sulfate to the client. The health care provider prescribes 200 mcg/kg/dose every 4 hours as needed for severe pain. Available dosage is 250 mg/10 mL (25 mg/mL).

How many milliliters (mL) should the nurse administer per dose? Round to the nearest hundredth.

• 0.25 mL

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Question 50 of 50

A 13-year-old is admitted to the adolescent unit with acute bleeding with hemarthrosis in the right knee secondary to hemophilia. The client reports getting injured during soccer practice. The nurse provides instruction to the client.

Which statement by the client indicates a good understanding of the teaching?

• “I need to keep moving my knee to allow the blood to absorb.”
• “Soccer is a good sport for me since there is a lot of running.”
• “I need to avoid getting hurt when I play soccer and football.”
• “Perhaps I should try swimming or tennis as a sport.”