Question 1

What communication strategies would the nurse have in place when establishing rapport with the caregiver and an 8-year-old during a health history interview?  Select all that apply.

Accepted Answer

A) Ask only closed-ended questions to obtain information 
B) Allow the child to describe their current issue 
C) Isolate the child from the parents and interview them separately 
D) Maintain an eye level position when speaking with the child 
E) Use language that both the child and caregiver can understand

Question 2

A 5-year-old child is receiving morphine sulfate for pain.  Which statement by the caregiver indicates that further teaching is necessary?

Accepted Answer

A) "I will call the nurse if my child begins to act aggressively." 
B) "I'm concerned that my child thinks the pain is punishment." 
C) "My child is playing and so does not need pain medication." 
D) "The FACES pain scale seems to be working very well."

Question 3

A nurse in a clinic is talking with a parent about the onset of puberty in boys.  What is the first sign of pubertal change that occurs?

Accepted Answer

A) Appearance of upper lip hair 
B) Increase in height 
C) Presence of axillary hair 
D) Testicular enlargement

Question 4

The registered nurse is teaching the parent of a 6-year-old about behavioral strategies for treating fecal incontinence due to functional constipation.  Which statement by the parent indicates a need for further teaching?

Accepted Answer

A) "I will give my child a picture book to look at during toilet time." 
B) "I will give my child a reward for each bowel movement while sitting on the toilet." 
C) "I will keep a log of my child's bowel movements, laxative use, and episodes of soiling." 
D) "I will schedule regular toilet sitting time for my child."

Question 5

The parent of a 15-month-old calls the nurse and says that the child developed a rash and mild fever after receiving a routine measles, mumps, rubella, and varicella (MMRV) vaccine in the pediatric clinic 5 days ago.  What is the best response by the nurse?

Accepted Answer

A) "Apply over-the-counter hydrocortisone cream to the rash." 
B) "Bring your child to the clinic this afternoon." 
C) "This is a common reaction to the MMRV vaccine." 
D) "What is your child's temperature right now?"

Question 6

The parent of a 5-year-old child calls the clinic to report the recurrence of a nosebleed for which the child was seen a week ago.  Which of the following instructions should the nurse reinforce?  Select all that apply.

Accepted Answer

A) Apply a cold cloth to the bridge of the nose 
B) Apply pressure by pinching the nostrils together 
C) Attempt to keep the child calm and quiet 
D) Have the child lie down and turn to the left side 
E) Take the child to the emergency department

Question 7

A nurse is discussing parallel play with the parent of a 2-year-old.  Which statement by the parent indicates understanding of the discussion?

Accepted Answer

A) "I encourage working in a group to build towers with large blocks." 
B) "I have a chalk board available to teach the alphabet and numbers." 
C) "I set out a basket of various balls in the backyard when other children come to play." 
D) "I try to organize games that involve a team approach."

Question 8

The summer camp nurse and parent of a 9-year-old with juvenile idiopathic arthritis (JIA) are discussing appropriate physical activities for the child.  Which of the following activities should be included?  Select all that apply.

Accepted Answer

A) Dodgeball 
B) Reading a book 
C) Stationary bicycling 
D) Swimming 
E) Yoga

Question 9

A nurse is performing an assessment of a 12-month-old child.  Which of the following findings would the nurse expect?  Select all that apply.

Accepted Answer

A) Approaches strangers with ease 
B) Birth weight is tripled 
C) Can skip and hop on one foot 
D) Fully developed pincer grasp 
E) Sits from a standing position

Question 10

What is the best activity for a school-aged child hospitalized for vaso-occlusive sickle cell crisis?

Accepted Answer

A) Finger painting 
B) Playing a game of Chinese checkers in the activity room 
C) Playing video games 
D) Watching a favorite movie

Question 11

What play behavior would the nurse be most likely to observe in a group of 4-year-old children?

Accepted Answer

A) Children playing and borrowing blocks from each other without directing others 
B) Children playing and working together to build a castle out of blocks 
C) Children playing next to each other with blocks, but not interacting 
D) Children playing with blocks by themselves in separate areas of the room

Question 12

A 3-month-old who weighs 8.8 lb (4 kg) has just returned to the intensive care unit after surgical repair of a congenital heart defect.  Which finding by the nurse should be reported immediately to the health care provider?

Accepted Answer

A) Chest tube output of 50 mL in the past hour 
B) Heart rate of 150/min 
C) Temperature of 97.5 F (36.4 
C)  
D) Urine output of 8 mL in the past hour

Question 13

The nurse is teaching a group of new parents about oral hygiene for their children.  One of the parents asks, "When should I take my child to the dentist?"  What would be the best response from the nurse?

Accepted Answer

A) "It is recommended that your child's first dental visit be after age 1." 
B) "The first visit should be when all of your child's baby teeth have come in." 
C) "The initial dentist visit should be soon after the child's first tooth appears." 
D) "Your child will need to be taken to the dentist before starting preschool."

Question 14

A 12-month-old client has a high blood lead level of 18 mcg/dL (0.87 µmol/L).  The nurse educates the parents about lead poisoning.  Which statements made by the parent indicate that teaching is successful?  Select all that apply.

Accepted Answer

A) "I should get our home inspected for the source of the lead." 
B) "I will vacuum our hard-surface floors daily." 
C) "I will wash my child's hands often, especially before eating." 
D) "We should use hot tap water for cooking." 
E) "We will have to return for a follow-up lead level."

Question 15

A 15-month-old begins to seize during assessment for a high-grade fever.  What is the most appropriate nursing action?

Accepted Answer

A) Administer aspirin to lower the client's body temperature 
B) Prepare client for administration of anti-seizure medication 
C) Stay with the client and monitor oxygen saturation levels 
D) Use a bag valve mask to ensure proper ventilation

Question 16

The nurse is providing education to the parents of a child diagnosed with chronic allergic rhinitis that is triggered by dust and pollen.  Which of the following statements by the parents indicate that the teaching has been effective?  Select all that apply.

Accepted Answer

A) "We are planning to purchase a vacuum with a high-efficiency particulate air filter." 
B) "We must find a new home for our two family dogs." 
C) "We should place hypoallergenic covers on our child's mattress and pillow." 
D) "We will dust our furniture with a damp washcloth every week." 
E) "We will keep the windows open during warm weather to air out the house."

Question 17

Which discharge teaching instructions should the nurse provide to the parents of a 2-year-old with group A streptococcal pharyngitis?  Select all that apply.

Accepted Answer

A) Complete all the antibiotics even if your child is feeling better 
B) Cool liquids and soft diet are recommended 
C) Keep your child home from daycare for at least a week 
D) Replace your child's toothbrush 24 hours after starting antibiotics 
E) Throat lozenges may soothe your child's sore throat

Question 18

A teenage client with sickle cell disease is admitted with a diagnosis of crisis.  The client's current prescription is morphine 2 mg intravenous push every 4 hours prn.  The client appears comfortable while watching television and tells the nurse "I have severe intolerable pain," and rates it a "10."  What action should the nurse take?

Accepted Answer

A) Call the client's health care provider (HCP) to obtain a ibuprofen prescription for pain relief 
B) Call the HCP for patient-control analgesia (PC
A)  at a higher dose of the same drug 
C) Contact the HCP who issued the prescription to switch to meperidine 
D) Realize the client is exhibiting signs of addictive behavior and needs an appropriate consult

Question 19

A 1-year-old child who goes to day care is recovering from an episode of otitis media.  Which intervention is most important for the nurse to recommend to the parents in order to prevent recurrence?

Accepted Answer

A) Exclusive breastfeeding 
B) Not sending the child to day care 
C) Preventing water from entering the ear 
D) Smoking cessation by the parents

Question 20

The nurse assesses 4 infants.  Which assessment finding would require follow-up by the health care provider?

Accepted Answer

A) 3-week-old whose anterior fontanelle bulges with crying 
B) 4-week-old whose posterior fontanelle is soft 
C) 6-month-old with birth weight of 7 lb 3 oz (3.3 kg) who now weighs 12 lb (5.4 kg) 
D) 12-month-old with birth weight of 6 lb 4 oz (2.8 kg) who now weighs 20 lb (9.1 kg)

Exam 2: Child Health

What communication strategies would the nurse have in place when establishing rapport with the caregiver and an 8-year-old during a health history interview? Select all that apply.

A 5-year-old child is receiving morphine sulfate for pain. Which statement by the caregiver indicates that further teaching is necessary?

A nurse in a clinic is talking with a parent about the onset of puberty in boys. What is the first sign of pubertal change that occurs?

The registered nurse is teaching the parent of a 6-year-old about behavioral strategies for treating fecal incontinence due to functional constipation. Which statement by the parent indicates a need for further teaching?

The parent of a 15-month-old calls the nurse and says that the child developed a rash and mild fever after receiving a routine measles, mumps, rubella, and varicella (MMRV) vaccine in the pediatric clinic 5 days ago. What is the best response by the nurse?

The parent of a 5-year-old child calls the clinic to report the recurrence of a nosebleed for which the child was seen a week ago. Which of the following instructions should the nurse reinforce? Select all that apply.

A nurse is discussing parallel play with the parent of a 2-year-old. Which statement by the parent indicates understanding of the discussion?

The summer camp nurse and parent of a 9-year-old with juvenile idiopathic arthritis (JIA) are discussing appropriate physical activities for the child. Which of the following activities should be included? Select all that apply.

A nurse is performing an assessment of a 12-month-old child. Which of the following findings would the nurse expect? Select all that apply.

What is the best activity for a school-aged child hospitalized for vaso-occlusive sickle cell crisis?

What play behavior would the nurse be most likely to observe in a group of 4-year-old children?

A 3-month-old who weighs 8.8 lb (4 kg) has just returned to the intensive care unit after surgical repair of a congenital heart defect. Which finding by the nurse should be reported immediately to the health care provider?

The nurse is teaching a group of new parents about oral hygiene for their children. One of the parents asks, "When should I take my child to the dentist?" What would be the best response from the nurse?

A 12-month-old client has a high blood lead level of 18 mcg/dL (0.87 µmol/L) . The nurse educates the parents about lead poisoning. Which statements made by the parent indicate that teaching is successful? Select all that apply.

A 15-month-old begins to seize during assessment for a high-grade fever. What is the most appropriate nursing action?

The nurse is providing education to the parents of a child diagnosed with chronic allergic rhinitis that is triggered by dust and pollen. Which of the following statements by the parents indicate that the teaching has been effective? Select all that apply.

Which discharge teaching instructions should the nurse provide to the parents of a 2-year-old with group A streptococcal pharyngitis? Select all that apply.

A 1-year-old child who goes to day care is recovering from an episode of otitis media. Which intervention is most important for the nurse to recommend to the parents in order to prevent recurrence?

The nurse assesses 4 infants. Which assessment finding would require follow-up by the health care provider?