Question 1

The nurse is triaging a 7-year-old with sickle cell crisis.  The client is short of breath and vomiting and has severe generalized body and joint pains.  Which assessment finding requires the most immediate intervention?

Accepted Answer

A) Blood work showing anemia 
B) Enlarged spleen on palpation 
C) Right arm weakness 
D) Swelling of hands and feet

Question 2

Several 12-month-old infants are brought to the clinic for routine immunizations.  Which situation would be most important for the nurse to clarify with the provider before administering the vaccination?

Accepted Answer

A) Haemophilus influenzae type b vaccine for client allergic to penicillin 
B) Hepatitis A vaccine for a client with a "cold" and temperature of 99.0 F (37.2 
C)  
C) Pneumococcal vaccine for client with local swelling after last immunization 
D) Varicella-zoster vaccine for client recently diagnosed with leukemia

Question 3

A nurse on a pediatric unit is admitting a school-aged child with suspected Reye syndrome.  Which information obtained during the history taking is most consistent with this condition?

Accepted Answer

A) No history of varicella vaccine administration 
B) Recent exposure to bats 
C) Recent influenza infection 
D) Recent use of acetaminophen for fever

Question 4

When performing developmental screenings in the well-child clinic, the registered nurse understands that which child is at highest risk of developing autism spectrum disorder?

Accepted Answer

A) 2-year-old who has a vocabulary of 10 words 
B) 3-year-old who received measles, mumps, and rubella immunization at age 1 year 
C) 4-year-old whose 10-year-old sibling has the disorder 
D) 5-year-old whose parents were age 42 at the time of birth

Question 5

The nurse assists with a staff education conference about appropriate nonpharmacological pain-management interventions for newborns and infants.  Which of the following strategies should be included in the presentation?  Select all that apply.

Accepted Answer

A) Administer an oral sucrose solution to a newborn during a circumcision procedure 
B) Apply a cold pack to a newborn's heel 30 minutes before performing a heel stick 
C) Assist the parent to hold a newborn skin-to-skin during an immunization injection 
D) Offer a pacifier to an infant while performing venipuncture 
E) Swaddle an infant while leaving one arm unwrapped during an IV dressing change

Question 6

A nurse is giving instructions related to antibiotic eye drops to the parent of a 5-year-old with bacterial conjunctivitis.  Which instruction is most important?

Accepted Answer

A) Discard tissues used to blot excess medication from the eye immediately 
B) Have your child lie down before you instill the eye drops 
C) Use warm, moist compresses to remove crusting on eyelids 
D) Wash hands before and after eye drop instillation

Question 7

A 7-month-old infant is admitted to the unit with suspected bacterial meningitis after receiving an initial dose of antibiotics in the emergency department.  Frequent assessment of which of the following is most important in the plan of care?

Accepted Answer

A) Babinski reflex 
B) Fontanel assessment 
C) Pulse pressure 
D) Pupillary light response

Question 8

The parent of a newborn is concerned about the possibility of the child developing hip dysplasia.  Which intervention should the nurse encourage to help reduce the risk in this newborn?

Accepted Answer

A) Choose an infant carrier with a narrow seat 
B) Place 2 diapers on the infant at all times 
C) Swaddle the infant with hips flexed and abducted 
D) Use an infant swing that keeps both legs straight

Question 9

A parent brings a 6-month-old child to the primary health care provider after the child abruptly started crying and grabbing intermittently at the abdomen.  The client's stool has a red, currant jelly appearance.  What intervention does the nurse anticipate?

Accepted Answer

A) Administer epoetin alfa (erythropoietin) 
B) Give air (pneumatic) enema 
C) Have the parent give 2 ounces of extra juice a day for constipation 
D) Perform hemoccult test on stool

Question 10

An 8-month-old infant is scheduled for a femorally inserted balloon angioplasty of a congenital pulmonic stenosis in the cardiac catheterization laboratory.  Which finding should the nurse report to the health care provider that could possibly delay the procedure?

Accepted Answer

A) Auscultation of a loud heart murmur 
B) Infant has been NPO for 4 hours 
C) Infant has severe diaper rash 
D) Slight cyanosis of the nail beds

Exam 2: Child Health

The nurse is triaging a 7-year-old with sickle cell crisis. The client is short of breath and vomiting and has severe generalized body and joint pains. Which assessment finding requires the most immediate intervention?

Several 12-month-old infants are brought to the clinic for routine immunizations. Which situation would be most important for the nurse to clarify with the provider before administering the vaccination?

A nurse on a pediatric unit is admitting a school-aged child with suspected Reye syndrome. Which information obtained during the history taking is most consistent with this condition?

When performing developmental screenings in the well-child clinic, the registered nurse understands that which child is at highest risk of developing autism spectrum disorder?

The nurse assists with a staff education conference about appropriate nonpharmacological pain-management interventions for newborns and infants. Which of the following strategies should be included in the presentation? Select all that apply.

A nurse is giving instructions related to antibiotic eye drops to the parent of a 5-year-old with bacterial conjunctivitis. Which instruction is most important?

A 7-month-old infant is admitted to the unit with suspected bacterial meningitis after receiving an initial dose of antibiotics in the emergency department. Frequent assessment of which of the following is most important in the plan of care?

The parent of a newborn is concerned about the possibility of the child developing hip dysplasia. Which intervention should the nurse encourage to help reduce the risk in this newborn?

A parent brings a 6-month-old child to the primary health care provider after the child abruptly started crying and grabbing intermittently at the abdomen. The client's stool has a red, currant jelly appearance. What intervention does the nurse anticipate?

An 8-month-old infant is scheduled for a femorally inserted balloon angioplasty of a congenital pulmonic stenosis in the cardiac catheterization laboratory. Which finding should the nurse report to the health care provider that could possibly delay the procedure?