Carolinas college. Children and Adolescent Test 1

Question 1

Carolinas college. Children and Adolescent Test 1. The nurse understands that treatment for most children with Hirschsprung’s disease primarily includes which of the following?

• Surgical removal of affected section of bowel.
• Education for a permanent colostomy
• Management of persistent diarrhea
• Low fiber foods to decrease irritation

Question 2

A 9-month-old is admitted to the pediatric unit for a 3-week course of antibiotics and her parents are only able to visit on weekends. Which action by the nurse exhibits an understanding of the emotional needs of a young infant?

• Require a parent to remain at the bedside 24 hours daily.
• Arrange for a Child Life specialist to stay throughout the day.
• Assign consistent caregivers to provide daily care when possible Carolinas college. Children and Adolescent Test 1
• Place the infant in a semi-private room for social interaction.

Question 3

A nurse is caring for an infant with suspected pyloric stenosis. Select the most appropriate nursing action for this infant.

• Avoid palpation of the abdomen
• Monitor for signs/symptoms of fluid volume deficit
• Obtain a stool sample for cultures
• Provide pain medication as ordered

Question 4

What is an appropriate nursing intervention when caring for an infant with an upper respiratory infection and elevated temperature?

• Give small amounts of fluids frequently to prevent dehydration.
• Encourage food intake to maintain caloric needs and strength.
• Give tepid water baths to reduce fever and relax airway.
• Apply sweaters and blankets to prevent chilling and coughing.

Question 5

The nurse is caring for a 6-year-old child with asthma. Which assessment finding requires immediate action by the nurse?

• Hacking, paroxysmal, irritative, and nonproductive cough
• Absent breath sounds
• Wheezes throughout the lung fields
• Prolonged expiration

Question 6

The medication order: clindamycin (Cleocin) 900 mg IV q6. Pharmacy supplied the medication in a concentration of 10 mg/mL. In a medication resource the nurse has identified the following information: clindamycin (Cleocin) must be administered over 30 minutes. The nurse has decided to administer this medication on the Alaris pump. What is the medication VTBI, medication rate, flush VTBI, and flush rate to safely administer this medication? Please place your answers in the following format: Med VTBI (mL)/Med rate (mL/hr)/Flush VTBI (mL)/Flush rate (mL/hr) (Round to the nearest whole number. Use a numerical answer only, separated by one (1) space).

• 98 196 20 196

Question 7

The parent of a 2-month-old infant tells the nurse, “I am worried because my infant is not able to sit independently.” Which response by the nurse is appropriate?

• “That is not unusual because most infants do not sit by themselves until about 8 months.”
• “It is a bit too soon. Most infants sit steadily at 4 months.”
• “That is interesting because most infants sit steadily at 3 months.”
• “Once the first tooth comes in, sitting independently will soon follow.”

Question 8

A 10-year-old child is admitted to the emergency department. The nurse observes that the child is short of breath with circumoral cyanosis and sweating. Nebulized epinephrine with room air via mask has been ordered and is currently being given to the child. Which action by the nurse would be most effective at this time?

• Reassure the child that the medication will begin working soon.
• Notify the physician immediately while consulting respiratory therapy.
• Have the child lie down, give oxygen, and place a cool cloth on their forehead.
• Encourage the child to sit upright and administer oxygen.

Question 9

A 3-month-old infant is seen in the clinic with the following symptoms: irritability, crying, refusal to nurse for more than 2 to 3 minutes, rhinitis and a rectal temp of 101.8°F (38.8°C). The nurse anticipates a diagnosis of

• Otitis media with effusion
• Acute Spasmodic Laryngitis
• Acute laryngotracheobronchitis
• Acute otitis media

Question 10

Which task would be appropriate for the nurse to delegate to the Unlicensed Assistive Personnel (UAP)?

• complete a medical history on a newly admitted patient
• educate the parent on how to prepare formula
• complete vital signs every hour for a patient receiving a blood product
• modifying oxygen delivery rates based on oxygen saturations

Question 11

The nurse is caring for a client who has been diagnosed with appendicitis and is scheduled for surgery later today. Which of the following assessment findings is the MOST concerning?

• Increased WBCs on lab work
• Abdominal pain at McBurney’s point
• Sudden relief of pain
• Low grade temperature

Question 12

The nurse develops a teaching plan for the parent of an asthmatic child concerning measures to reduce allergic triggers. Which suggestion should the nurse include?

• Keep windows open to allow fresh air circulation.
• Vacuum the carpet in their bedroom every other week to reduce allergens.
• If using bunk beds, have the child sleep on the bottom.
• Have the child bring their own pillow when sleeping away from home.

Question 13

The nurse has just received report on four pediatric clients assigned to the unit. Which client should the nurse assess first?

• A 12-year-old admitted yesterday with vomiting and a temperature of 101°F
• A 3-year-old admitted overnight with new-onset seizures and no caregiver present
• A 2-month-old recovering from respiratory distress with discharge orders for today
• A 10-year-old with a fractured humerus awaiting surgery later today

Question 14

The nurse assesses a FLACC score of 8 on a 4-month-old infant. When parents are informed of the findings they say that their infant is okay and does not need any pain medication. What is the nurse’s best initial response?

• Provide diversional activity to distract the infant from pain.
• Reinforce to parents that the infant is most likely crying due to hunger because infants do not experience pain.
• Discuss with parents the signs/symptoms of pain in an infant and encourage medication for this pain score.
• Accept the parents’ decision and reassess in 1 hour.

Question 15

The nurse reviews the client’s assessment findings and recognizes signs and symptoms that require follow-up. Indicate whether or not the assessment finding requires follow-up.

• Fever of 102°F: Requires follow-up
• Skin is warm to touch: Does not require follow-up
• Oral mucosa appear dry: Requires follow-up
• Heart rate: 140 beats/min: Does not require follow-up
• Poor appetite for the past 12 hours: Requires follow-up
• Capillary refill is less than 4 seconds: Requires follow-up
• Increased fussiness: Requires follow-up
• Received several vaccinations: Does not require follow-upCarolinas college. Children and Adolescent Test 1
• Lungs are clear to auscultation: Does not require follow-up
• Blood pressure: 80/42 mm Hg: Does not require follow-up

Question 16

The nurse reviews the assessment findings. For each assessment finding, click to specify if the finding indicates a common side effect of immunizations or an underlying infection. Each finding may associate with more than 1 cause.

• Rectal temperature: Associates with Common Side Effect & Underlying Infection
• Increased fussiness: Associates with Common Side Effect & Underlying Infection
• Sleepier than usual: Associates with Common Side Effect & Underlying Infection
• Increased crying that is consolable: Associates with Common Side Effect & Underlying Infection
• White blood cell count: Associates with Underlying Infection only

Question 17 (Case Study Part 1)

Carolinas college. Children and Adolescent Test 1. The infant is most likely experiencing [choose your answer…] due to [choose your answer…].

• First Blank Choices:
  • dehydration (Correct Answer)
  • a compromised immune system
  • recent exposure to sick contacts
• Second Blank Choices:
  • an infection
  • side effects (Correct Answer)
  • rhinovirus
  • gastroenteritis

Question 18 (Case Study Part 2)

The nurse should first address the infant’s [choose your answer…] followed by the infant’s [choose your answer…].

• First Blank Choices:
  • fussiness
  • respiratory status
  • blood pressure
  • temperature (Correct Answer)
• Second Blank Choices:
  • heart rate
  • skin turgor
  • fluid status (Correct Answer)
  • urinary retention

Question 19 (Case Study Part 3)

The nurse collaborates with the health care provider using SBAR (situation, background, assessment and recommendations). Select the 4 recommendations that the nurse will make.

• Start an oral pediatric electrolyte solution (Correct Answer)
• Administer oxygen therapy
• Admit to the hospital for observation
• Administer acetaminophen (Tylenol) suppository (Correct Answer)
• Educate parents on vaccine side effects (Correct Answer)
• Hold all future vaccinations
• Start an IV bolus at 50mL/kg
• Initiate IV antibiotics
• Apply cooling blankets
• Educate parents on fever management (Correct Answer)

Question 20 (Case Study Part 4)

Which statements by the parents would indicate effective teaching by the nurse? Select all that apply.

• “It is normal for an infant to have slight swelling at the injection site.” (Correct Answer)
• “If my infant starts to have jerking of the extremities, I will need to seek additional medical care.” (Correct Answer)
• “I should place heavy blankets on my infant and turn up the room temperature to prevent chills”
• “I can administer ibuprofen for fever”
• “I should encourage fluid intake” (Correct Answer)
• “If my infant has inconsolable crying for 3 hours or more, I will need to seek additional medical care” (Correct Answer)
• “I can administer acetaminophen for fever.” (Correct Answer)
• “I need to bring my infant back to the emergency room if the infant develops a fever of 103°F” Carolinas college. Children and Adolescent Test 1(Correct Answer)

Question 21

The nurse is trying to pick a method to teach a 4-year-old with cystic fibrosis a good way to exercise her lungs. Which would be the developmentally correct strategy to help this client?

• Teach the child to ride a bike.
• Teach the child to blow bubbles. (Correct Answer)
• Teach the child to hop on one foot.
• Teach the child to jump rope.

Question 22

The nurse is collaborating with the interdisciplinary team to support an infant with short bowel syndrome. Which interventions support optimal long-term outcomes? Select all that apply.

• Monitoring for vitamin and mineral deficiencies (Correct Answer)
• Limiting all oral experiences to reduce GI stress
• Consulting speech therapy for feeding development (Correct Answer)
• Encouraging exclusive reliance on parenteral nutrition
• Changing central line dressings only when visibly soiled
• Reporting any signs of infection or fever to the provider (Correct Answer)
• Gradually advancing enteral feeding as tolerated (Correct Answer)
• Initiating early oral stimulation and nonnutritive sucking (Correct Answer)

Question 23

Which statement would the nurse include when teaching a group of day care providers about acute otitis media?

• “It is contagious, so affected children should stay home until symptom-free.”
• “Pain medication may be utilized for the first 24-48 hours.” (Correct Answer)
• “Most children get otitis media so there is nothing you can do to prevent it.”
• “Permanent hearing loss often results so most children will be placed on antibiotics.”

Question 24

Based on the label above, what volume (mL) of amoxicillin would the nurse administer to the patient if the ordered dose was 95 mg? (If < 1 round to hundredth, if > 1 round to the tenth. Use numerical answer only.)

• 3.8 (Correct Answer)

Question 25

The nurse reads on the eMAR, cefepime HCl (Maxipime) (50mg/2mL) 480 mg IV every 8 hr. In a resource it states that this medication must be diluted to a concentration of 11 mg/mL. What would be the total volume of medication that the nurse would administer to the patient? (If < 1 round to hundredth, if > 1 round to tenth. Use numerical answer only.)

• 43.6 (Correct Answer)

Question 26

The nurse is preparing a discharge teaching plan for the parents of a 7-month-old infant. Which of the following safety interventions is the priority to include in the plan?

• Preventing burns and reducing suffocation risks
• Reviewing medication storage and car seat installation guidelines (Correct Answer)
• Promoting water safety measures and blocking access to stairways
• Teaching playground safety and securing firearms in the home

Question 27

A nurse is providing teaching to the parent of a 4-month-old infant who has gastroesophageal reflux. Which of the following statements by the parent indicates an understanding of the teaching?

• Delay burping until the end of each feeding.
• Thicken feedings as directed by the provider. (Correct Answer)
• Offer larger volumes at each scheduled feeding time.
• Allow the infant to sit in a car seat after feedings.

Question 28

The nurse is caring for a school-aged child who has suspected appendicitis. Which of the following assessment parameters indicate appendicitis? Select all that apply.

• Irritation and pain in the right lower quadrant (Correct Answer)
• Distended abdomen with unperforated appendicitis Carolinas college. Children and Adolescent Test 1
• Rebound tenderness present with palpation in the left upper quadrant
• Hypoactive bowel sounds with perforation (Correct Answer)
• Normal to hyperactive bowel sounds early (Correct Answer)
• Low-grade fever, nausea, and anorexia (Correct Answer)

Question 29

The nurse is caring for a toddler who has a new diagnosis of pneumonia. Which of the following interventions should the nurse perform?

• Provide high-protein snacks to increase energy Carolinas college. Children and Adolescent Test 1
• Encourage rest and limit fluid intake
• Administer cough suppressants every 4 hours
• Monitor oxygen saturation and provide humidified oxygen (Correct Answer)

Question 30

The nurse is providing discharge home care instructions to the parents of a 3-month-old infant who is recovering from respiratory syncytial virus (RSV). Which instructions should the nurse include? Select all that apply.

• Continue breastfeeding. (Correct Answer)
• Place the infant in a prone sleeping position to promote breathing.
• Instill normal saline drops in both nares and suction thoroughly before feeding and before placing to sleep. (Correct Answer)
• Administer over-the-counter cough suppressant as needed.
• Keep the infant out of daycare or nursery until symptoms resolve. (Correct Answer)
• Place the infant to sleep on his side to minimize risk of aspiration.
• Discontinue breastfeeding and administer Pedialyte for 24 hours.
• Observe the infant for labored breathing or apnea. (Correct Answer)

Question 31

A nurse is caring for a 5-year-old child who has an elevated temperature of 103.4°F, abdominal cramping, and 12 watery stools within the past 24 hours. The child’s laboratory results reveal a WBC count of 17,500 cells/mcL. Which of the following actions should the nurse take?

• Administer loperamide
• Initiate an intravenous infusion of 0.45% normal saline Carolinas college. Children and Adolescent Test 1
• Encourage the intake of clear liquids or gelatin
• Obtain a stool culture (Correct Answer)

Question 31

The physician has ordered dexamethasone sodium phosphate (Decadron) 8 mg (24mg/mL) IV every 6 hours. The nurse identifies that the patient weighs 36 pounds and the safe dose for dexamethasone sodium phosphate (Decadron) is 0.6 mg/kg/dose. What is the calculated safe dose per dose for dexamethasone sodium phosphate (Decadron)? (If <1 round to hundredth, if >1 round to tenth. Use a numerical answer only.)

• 9.8

Question 32

A 4-year-old with bronchiolitis has been admitted to the hospital with respiratory compromise. The father asks the nurse why the physician won’t prescribe an antibiotic, “My child just keeps getting worse.” What is the best response by the nurse?

• “Bronchiolitis is quite often caused by the respiratory syncytial virus (RSV). Unfortunately, antibiotics don’t work on viruses.”
• “Your physician probably doesn’t want to take a chance of your child building up an immunity to the antibiotic in case the condition worsens and more antibiotics are needed.”
• “Oftentimes it is more beneficial to treat the symptoms of bronchiolitis rather than try to kill the bacteria with an antibiotic.”
• “You have a very good physician who I trust completely. I’m sure everything possible is being done for your child.”

Question 33

In planning care for a child with cystic fibrosis, the nurse should provide an aerosolized bronchodilator in correlation to which action?

• give one hour prior to meals
• administer after sputum specimens have been collected
• deliver with 15L of oxygen via mask
• administer before chest physiotherapy

Question 34

At the end of an 8-hour shift, the nurse has the following totals on the I&O record for a child weighing 12 kg: Intake total = 370 mL, Output total = 40 mL What is the nurse’s best action?

• Force fluids to improve intake.
• Verify all intake and output has been recorded.
• Complete an in and out catheterization.
• Report to the next shift nurse to continue watching the I&O.

Question 35

The nurse at a well baby clinic is assessing a 1-year-old infant girl. The child weighed 8 pounds at birth and was 21 inches long. At this visit, the child weighed 16 pounds 8 ounces. Based on an understanding of growth and development, these findings indicate which of the following?

• This weight indicates maternal deprivation.
• This weight indicates above-average weight gain for an infant.
• This weight indicates normal weight gain for an infant.
• This weight indicates low weight for an infant.

Question 36

When completing morning assessments, the nurse determines an infant is apneic, pulseless and pale in the crib. What is the correct order of the next three nursing interventions?

• determine unresponsiveness, give chest compressions, give rescue breaths
• give chest compressions, give rescue breaths, call for help
• call for help, give chest compressions, give rescue breaths
• call for help, give rescue breaths, determine unresponsiveness Carolinas college. Children and Adolescent Test 1.

Question 37

A parent whose adolescent child has asthma asks the nurse what precaution is needed during sports participation. The nurse should recommend which of the following?

• He should ensure his short-acting Beta agonist inhaler is always nearby.
• Exercise is fine if his peak expiratory flow rate is in the yellow or green zones.
• Swimming should be avoided due to chemicals in the air.
• He should limit strenuous exercise to no greater than 15 minute increments.

Question 38

The nurse would expect a 5-month-old to have accomplished which developmental milestone?

• stand without support
• sit erect without support
• move from prone to sitting position
• roll from abdomen to back

Question 39

The physician has ordered ampicillin/sulbactam (Unasyn) 1 gm IV every 12 hours. The pharmacy has supplied a 1000 mg/100 mL minibag and the resource states that ampicillin/sulbactam (Unasyn) should be administered over 20 mins. What medication rate (mL/hr) would the nurse calculate to administer ampicillin/sulbactam (Unasyn)? (Round to the nearest whole number. Use a numerical answer only.)

• 300

Question 40

The nurse understands that frequent developmental assessments during infancy are important for what reason?

• Critical periods of development occur during infancy.
• Infants need stimulation specific to the stage of development.
• Infant development is unpredictable and needs monitoring.
• Infancy is a slow developmental period with subtle changes.

Question 41

A 16 year old has been diagnosed with gastroesophageal reflux disease (GERD). Which statements by the adolescent indicate that adequate learning has occurred? Select All that apply.

• “The famotidine (Pepcid) may make me dizzy.”
• “I will probably need a laxative because of the lansoprazole (Prevacid).”
• “The lansoprazole (Prevacid) could give me a headache.”
• “Famotidine (Pepcid) is a stimulant that speeds up digestion.”
• “Lansoprazole (Prevacid) is a medicine that helps to decrease stomach acid.”
• “I should keep a food diary to help identify foods that trigger my reflux.”
• “I should try to lie down right after I eat.”

Question 42

The nurse suspects that a 2½-year-old child may be experiencing neglect. Which assessment finding would most strongly support this concern?

• The child stays close to the parent during the assessment
• Continued use of diapers beyond 2 years of age
• No documented well-child visit in the past 18 months
• Bruises on both shins in different stages of healing

Question 43

The nurse is caring for a child with history of asthma who presents to the emergency department with wheezing, tachypnea, and dyspnea. What will the nurse do first?

• Place the child in high-Fowler position.
• Assess the child’s pulse oximetry reading.
• Apply oxygen via nasal cannula at 2 liters.
• Ask what may have triggered the attack.

Question 44

The nurse is assessing a 12-year-old child with multiple bruises in different stages of healing. When questioned, the child appears fearful and gives inconsistent explanations about the cause of the injuries. The nurse suspects possible abuse. Which initial nursing action is most appropriate?

• Ask the child to write a detailed account of the injuries
• Photograph the bruises for the medical record
• Question the parents about how the injuries occurred
• Document the bruises and any statements made by the child

Question 45

The mother of a 9-month-old infant is concerned because the infant cries when she leaves him. Which of the following is the best response for the nurse to say to the mother?

• “Stranger anxiety should not be evident at this age.”
• “This can be a healthy sign of attachment.”
• “You might consider taking him to the doctor because he may be ill.”
• “You could consider leaving the infant more often so he can adjust.” Carolinas college. Children and Adolescent Test 1.

Question 46

A child is admitted with a diagnosis of intussusception. The medical team has ordered an air enema for reduction. Which of the following would indicate successful reduction of the intussusception?

• Intermittent signs of abdominal pain
• Passage of loose, watery stools
• Palpation of loops of bowel
• Passage of brown stool

Question 47

The nurse is conducting a developmental assessment on a 4-month-old infant at a well-child visit. Which finding would warrant further evaluation and referral for potential developmental delay?

• Requires support to sit in an upright position
• Unable to maintain head control when upright
• Rolls from front to back without assistance
• Grasps or reaches toward nearby objects during play

Question 48

A 10-month-old infant weighing 8 kg is brought to the emergency department with a 3-day history of severe vomiting and diarrhea. On assessment, the infant is lethargic, has a heart rate of 200 bpm, respiratory rate of 48 rpm, blood pressure of 72/36 mmHg, capillary refill time > 4 seconds, and a sunken anterior fontanel. The infant does not cry during the insertion of an intravenous (IV) line. Which action should the nurse prioritize first?

• Begin oral rehydration therapy with Pedialyte
• Administer IV fluids at 20 mL/hr
• Place a NG tube and start formula at 50 mL/kg
• Administer a bolus of 20 mL/kg of normal saline

Question 49

A doctor orders ceftriaxone (Rocephin) 750 mg IV every 12 hours for a child who weighs 32 kg. The safe pediatric dosage parameters are 50 mg/kg/day, not to exceed 2 g/day. What is the calculated safe dose per day (mg/day) for this patient? (Round to the nearest whole number. Use a numerical answer only.)

• 1600

Question 50

A nurse is reinforcing teaching about starting a new prescription for an anti-epileptic drug with the parents of a child who has a seizure disorder. Which statement by the parents indicates understanding?

• The drug will be stopped immediately if the child develops a rash.
• The medication should be stopped if the child is seizure-free for one month. Carolinas college. Children and Adolescent Test 1.
• We will give him a double dose of the drug if he has a breakthrough seizure.
• He will need to have his blood drawn every week to check therapeutic drug levels.

Question 50

A nurse is teaching a parent about the use of albuterol for their child with asthma. Which instruction should the nurse include?

• “This medication works by reducing airway inflammation.”
• “Give this medication daily to prevent asthma attacks.”
• “Call the provider if your child coughs after using the inhaler.”
• “Monitor for increased heart rate and tremors after administration.”

Question 51

A newborn admitted with pyloric stenosis is lethargic and has poor skin turgor. The provider has prescribed IV fluids of dextrose water with sodium and potassium. The baby’s admission potassium level is 3.4 mEq/L. What should the nurse do first?

• Notify the provider.
• Verify that the infant is voiding.
• Administer the prescribed fluids.
• Have the potassium level redrawn.

Question 52

The doctor has ordered amoxicillin/clavulanate (Augmentin) 600 mg PO q4h. Amoxicillin/clavulanate (Augmentin) is available 400 mg/tsp. What volume (mL) of medication would the nurse administer per dose? (If <1 round to hundredth, if >1 round to tenth. Use numerical answer only.)

7.5

Question 53

During a clinic visit, the nurse hides a toy under a blanket while observing an 10-month-old infant. The infant does not attempt to find the toy. How should the nurse interpret this finding?

• This indicates delayed gross motor development
• This suggests a delay in cognitive development
• This is an expected response for this age
• This reflects normal separation anxiety

Question 54

Promethazine hydrochloride (Phenergan) is supplied in a 12 mg/2 mL vial from the pharmacy. The nurse needs to deliver 24 mg at a concentration of 2 mg/mL. How many mL of diluent is needed to properly dilute this medication? (Round to the nearest whole number. Use numerical answer only.)

8

Question 55

The physician has ordered cefepime HCl (Maxipime) 980 mg IV every 8 hours. The pharmacy has supplied 70 mg/mL. The resource states that this medication must be diluted to a concentration of 40 mg/mL. How much diluent would the nurse add to properly dilute this medication? (If <1 round to hundredth, if >1 round to tenth. Use numerical answer only.)

10.5

Question 56

A parent calls the “on call” line stating that her infant has had a bark-like cough for the past three nights. The parent states no fever or cold symptoms. Which suggestions may save a trip to the emergency department? (Select all that apply.)

• Use the coolness of the night air.
• Use a cool mist humidifier in the infant’s room.
• Wake the infant every 2 hours overnight to monitor breathing.
• Assess throat for throat obstruction.
• Give honey to soothe the throat and reduce coughing.
• Encourage rest.
• Provide the infant cold oral fluids.
• Take the infant into a steamy bathroom.

Question 57

The nurse is caring for a child with severe gastroenteritis who has been receiving IV therapy for the past several hours. Which finding would alert the nurse to suspect that a child may be developing circulatory overload?

• Breath sounds reveal moist crackles.
• Respirations become slow and deep.
• Urine output shows a marked increase.
• A drop in blood pressure occurs.

Question 58

A 5-year-old is seen in the urgent care clinic with the following history and symptoms: sudden onset of severe sore throat after going to bed, drooling and difficulty swallowing, axillary temperature of 101.8°F (38.8°C), clear breath sounds, and absence of cough. The child appears anxious and flushed. Based on these symptoms and history, the nurse anticipates a diagnosis of:

• Acute tonsillitis
• Group A beta-hemolytic streptococcus (GABHS) pharyngitis
• Acute epiglottitis
• Acute laryngotracheobronchitis (LTB)

Question 59

Which goal is most important for the nurse to include when teaching the parents of a child diagnosed with celiac disease?

• Introduce the parents and child to other children with celiac disease. Carolinas college. Children and Adolescent Test 1
• Stress the importance of good health and preventing infection.
• Promote a normal life for the child.
• Help the parents and child adhere to dietary restrictions.

Question 60

The nurse is prioritizing care for four pediatric patients. Which patient should be seen first?

• A 7-year-old with asthma who is restless and has diminished breath sounds
• A 6-month-old with bronchiolitis who is feeding poorly and irritable
• A 3-year-old post-tonsillectomy who reports moderate throat pain
• A 4-year-old with croup who has a barking cough and mild stridor when agitated

Question 61

The nurse is teaching a class about nutrition to mothers of school-age children. Which suggestion should be included to decrease constipation?

• Encourage whole-grain breads and brown rice.
• Provide 20 ounces of fluid each day.
• Use over-the-counter bowel stimulant medications.
• Increase protein intake with every meal.

Question 62

When assessing the respiratory status of a 2-year-old, which finding would require further monitoring?

• respiratory rate of 6 breaths/15 seconds
• substernal and intercostal retractions
• absence of adventitious breath sounds
• extremely anxious and uncooperative

Question 63

Which snack food should the nurse recommend for a child with cystic fibrosis?

• peanut-butter crackers
• graham crackers
• raisins and juice
• sugar-free pudding

Question 64

Nurses’ Notes 0800: Presents to emergency department (ED) with parents who report child has had two episodes of severe abdominal pain causing child to pull knees to chest and become inconsolable. Parents also report that the child has passed red, jelly-like stools this morning. Child is lying on bed with knees drawn to chest and crying. Abdomen distended, tender with a small palpable mass in right upper quadrant of abdomen. Assessment findings reported to provider.

Vital Signs 0815: Temperature: 98.2° F, Heart rate: 120/min, Respiratory rate: 28/min, Blood pressure: 87/46 mm Hg, Oxygen saturation: 98% on room air.

The nurse has completed the child’s admission assessment. Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address this condition, and 2 parameters the nurse should monitor to assess the client’s progress.

• Potential Condition: Intussusception Carolinas college. Children and Adolescent Test 1
• Actions to Take (Pick 2): Maintain NPO status | Prepare the child for a contrast, air, or saline enema
• Parameters to Monitor (Pick 2): Passage of a normal, brown stool | Signs of abdominal peritonitis/perforation

Question 65

Which nursing intervention is most descriptive of atraumatic care for children?

• Allow the child to choose all aspects of medical care provided.
• Separate the parent from the child during stressful procedures.
• Explain that experiencing some pain during care is unavoidable.
• Prepare the child before unfamiliar treatments or procedures occur.

Question 66

The patient has the following orders: famotidine (Pepcid) 12 mg IV every 12 hours. Pharmacy supplied the medication in a concentration of 10 mg/mL. Continuous IV fluid D5 0.225 NS @ 15 mL/hr. In a medication resource the nurse has identified the following information: famotidine (Pepcid) must be further diluted to a concentration of 1 mg/mL. famotidine (Pepcid) must be administered over 15 minutes. famotidine (Pepcid) is compatible with the ordered IV fluid. The nurse has decided to administer this medication on a syringe pump. What is the medication VTBI, medication rate, flush volume, and flush rate to safely administer this medication? Please place your answers in the following format: Med VTBI (mL)/Med rate (mL/hr)/Flush volume (mL)/Flush rate (mL/hr). (If <1 round to hundredth, if >1 round to tenth. Use a numerical answer only, separated by one (1) space).

12 48 12 48