Question 1

The clinic nurse is reviewing self-care management of acne vulgaris with an adolescent client.  Which client statement indicates a need for further instruction?

Accepted Answer

A) "I have been scrubbing my face twice daily with antibacterial soap." 
B) "I should buy skin care products that are labeled noncomedogenic." 
C) "Maintaining a nutritious diet will help my skin heal." 
D) "Picking or squeezing the lesions will worsen my acne."

Question 2

A child is scheduled to have an electroencephalogram (EEG).  Which statement by the parent indicates understanding of the teaching?

Accepted Answer

A) "I will let my child drink cocoa as usual the morning of the procedure." 
B) "I will wash my child's hair using shampoo the morning of the procedure." 
C) "My child may have scalp tenderness where the electrodes were applied." 
D) "My child will not remember the procedure."

Question 3

The nurse is performing an assessment on a 2-year-old with otitis media.  Which of the following actions would be appropriate?  Select all that apply.

Accepted Answer

A) Do not insert the speculum into the bony interior part of the ear canal 
B) Encourage the parents to have the child vaccinated against influenza and pneumonia 
C) Inspect the tympanic membrane for redness, bulging, and perforation 
D) Pull the pinna up and back during the otoscopic examination 
E) Wait until the end of the assessment to perform the otoscopic examination

Question 4

The clinic nurse performs assessments on four infants.  The nurse should alert the health care provider to see which client first?

Accepted Answer

A) 3-month-old whose posterior occiput appears flattened 
B) 4-month-old who has sclera visible above the iris (sunset eyes) 
C) 6-month-old who has vomited twice and has had 8 wet diapers in the last 24 hours 
D) 9-month-old whose toes fan out and big toe dorsiflexes when plantar surface is stroked

Question 5

The clinic nurse is caring for a 3-year-old client.  Which task, if not observed or reported by the parents as accomplished, will cause the nurse concern?

Accepted Answer

A) Catches a ball at least 50% of the time 
B) Copies a square with a pencil or crayon 
C) Eats with a spoon 
D) Hops on one foot

Question 6

The pediatric nurse cares for a 16-year-old client who is scheduled for an appendectomy in the morning.  Which of the following interventions are appropriate to support the client's psychosocial needs?  Select all that apply.

Accepted Answer

A) Create a strict daily schedule for the client while hospitalized 
B) Encourage the client to have peers visit while hospitalized 
C) Ensure parental presence during any client procedure 
D) Include the client as an active participant when planning care 
E) Support the client in discussing concerns about body image changes

Question 7

A 6-year-old client was diagnosed with type 1 diabetes mellitus 2 years ago.  The nurse would like to encourage the client to participate in disease management.  Which of the following diabetes care tasks are appropriate for the child to perform?  Select all that apply.

Accepted Answer

A) Choose insulin injection site with parental oversight of rotation schedule 
B) Push plunger of insulin syringe after a parent inserts and stabilizes the needle 
C) Select and clean the site for finger-stick blood glucose testing 
D) Use a chart to determine insulin dose based on glucometer reading 
E) Verbalize two or three signs and symptoms of hypoglycemia

Question 8

The nurse provides teaching for the parents of a 6-year-old client diagnosed with nocturnal enuresis.  Which of the following instructions will the nurse include?  Select all that apply.

Accepted Answer

A) Allow the child to wear a diaper at bedtime to avoid accidents 
B) Encourage the child to help change soiled pajamas and linens 
C) Prepare a calendar with the child for logging wet and dry nights 
D) Restrict the child's fluids to 8 oz (240 mL) with each meal 
E) Wake the child at a specified time each night to void

Question 9

The nurse is educating a group of parents about ways to decrease the risk of sudden infant death syndrome.  Which of the following recommendations should the nurse suggest?  Select all that apply.

Accepted Answer

A) Breastfeed the infant 
B) Cosleep with the infant in the parent's bed 
C) Ensure the infant's vaccinations are updated 
D) Maintain a smoke-free environment 
E) Place the infant to sleep in a side-lying position
F)Provide a firm sleep surface for the infant

Question 10

The school nurse is conducting an educational session for middle school teachers that is designed to heighten awareness of school bullying.  The nurse recognizes that further instruction is needed when one of the teachers makes which comment?

Accepted Answer

A) "Bullying is a normal part of childhood growth and development." 
B) "Children with physical disabilities are more vulnerable to bullying." 
C) "Most children who are victims of a school bully do not tell an adult about it." 
D) "The most common form of bullying is verbal aggression, such as insults and intimidation."

Question 11

The nurse is assessing an 8-month-old client during a well-child visit.  Which assessment finding should the nurse report to the health care provider?

Accepted Answer

A) Infant responds to their name when called but has not spoken any words 
B) Infant was gaining 5 oz (140 g) per week at age 6 months and is now gaining 3 oz (84 g) per week 
C) Infant's head stays behind the shoulders when raised from a supine to a sitting position 
D) Infant's posterior fontanel is not palpable when performing assessment of the head

Question 12

The parents of a 4-year-old tell the nurse that the child won't go to sleep at night due to fear of tigers living under the bed.  Which response by the nurse is most helpful?

Accepted Answer

A) "Have you recently visited the zoo?  Maybe the tigers looked scary." 
B) "If you agree with your child, the fears could continue through this developmental stage." 
C) "Night fears are common at this age.  Look under the bed with your child." 
D) "This is very unusual.  Maybe the child saw something scary on TV."

Question 13

An adolescent client with a sore throat is diagnosed with infectious mononucleosis.  Which comment by the caregiver would alert the nurse that additional instruction is necessary?

Accepted Answer

A) "I need to go to the pharmacy to pick up an antibiotic prescription." 
B) "It is acceptable for my child to have ibuprofen for discomfort or fever." 
C) "My child will be on bed rest with few activities for the next 2 weeks." 
D) "Participation in soccer practice will not be allowed for the next month."

Question 14

The nurse cares for a 4-year-old who is on long-term, strict bed rest.  Which toy is most appropriate to provide diversion and minimize developmental delays?

Accepted Answer

A) Board games 
B) Puppets 
C) Soap bubbles 
D) Stacking and nesting toys

Question 15

The nurse is performing well-child examinations in a pediatric clinic.  Which finding requires further evaluation?

Accepted Answer

A) Bilateral bowlegs (genu varum) in a 15-month-old 
B) Chest rounded with the anteroposterior diameter equal to the lateral diameter in an infant 
C) Lateral curvature to the spine noted on examination of a 10-year-old girl 
D) Presence of an S3 heart sound in a 2-year-old

Question 16

The health care provider (HCP) prescribes a 10-day course of amoxicillin for a 1-year-old diagnosed with acute otitis media (AOM).  Which instruction is most important for the nurse to review with the child's parents?

Accepted Answer

A) Return to the office if the child does not improve within 48-72 hours 
B) Stop the antibiotic if the child develops diarrhea 
C) Stop the antibiotic if the child feels better after 72 hours 
D) Use over-the-counter decongestants to help with recovery

Question 17

A nurse is planning to test the visual acuity of a 7-year-old.  Which is the best way to test visual acuity in this child?

Accepted Answer

A) Have the child focus on a bright object and follow the target 
B) Have the child view a set of cards one at a time 
C) Position the child at a distance of 10 ft (3 m) from a chart 
D) Shine a light into the child's eyes at a distance of 16 in (40.6 cm)

Question 18

A school-age child is brought to the emergency department due to nausea, vomiting, and severe right lower quadrant pain.  The child's white blood cell count is 17,000/mm3 (17.0 x 109/L).  Which statement by the child is of most concern to the nurse?

Accepted Answer

A) "I am hungry and they will not let me eat." 
B) "I don't like hospitals and I want to go home." 
C) "I'm so tired." 
D) "My belly doesn't hurt anymore."

Question 19

The nurse is caring for a preschool-age child whose grandparent died 3 days ago.  Which intervention is inappropriate?

Accepted Answer

A) Assign the same nurses and caregivers to the child each day 
B) Avoid mentioning the loved one's death in the child's presence 
C) Explain the importance of being with the child to the parents 
D) Schedule time each day for age-appropriate play

Question 20

A newborn has a large myelomeningocele.  What nursing intervention is priority?

Accepted Answer

A) Assess the anus for muscle tone 
B) Cover the area with a sterile, moist dressing 
C) Measure the occipital frontal circumference 
D) Place the newborn supine with the head of the bed elevated

Exam 2: Child Health

The clinic nurse is reviewing self-care management of acne vulgaris with an adolescent client. Which client statement indicates a need for further instruction?

A child is scheduled to have an electroencephalogram (EEG) . Which statement by the parent indicates understanding of the teaching?

The nurse is performing an assessment on a 2-year-old with otitis media. Which of the following actions would be appropriate? Select all that apply.

The clinic nurse performs assessments on four infants. The nurse should alert the health care provider to see which client first?

The clinic nurse is caring for a 3-year-old client. Which task, if not observed or reported by the parents as accomplished, will cause the nurse concern?

The pediatric nurse cares for a 16-year-old client who is scheduled for an appendectomy in the morning. Which of the following interventions are appropriate to support the client's psychosocial needs? Select all that apply.

A 6-year-old client was diagnosed with type 1 diabetes mellitus 2 years ago. The nurse would like to encourage the client to participate in disease management. Which of the following diabetes care tasks are appropriate for the child to perform? Select all that apply.

The nurse provides teaching for the parents of a 6-year-old client diagnosed with nocturnal enuresis. Which of the following instructions will the nurse include? Select all that apply.

The nurse is educating a group of parents about ways to decrease the risk of sudden infant death syndrome. Which of the following recommendations should the nurse suggest? Select all that apply.

The school nurse is conducting an educational session for middle school teachers that is designed to heighten awareness of school bullying. The nurse recognizes that further instruction is needed when one of the teachers makes which comment?

The nurse is assessing an 8-month-old client during a well-child visit. Which assessment finding should the nurse report to the health care provider?

The parents of a 4-year-old tell the nurse that the child won't go to sleep at night due to fear of tigers living under the bed. Which response by the nurse is most helpful?

An adolescent client with a sore throat is diagnosed with infectious mononucleosis. Which comment by the caregiver would alert the nurse that additional instruction is necessary?

The nurse cares for a 4-year-old who is on long-term, strict bed rest. Which toy is most appropriate to provide diversion and minimize developmental delays?

The nurse is performing well-child examinations in a pediatric clinic. Which finding requires further evaluation?

The health care provider (HCP) prescribes a 10-day course of amoxicillin for a 1-year-old diagnosed with acute otitis media (AOM) . Which instruction is most important for the nurse to review with the child's parents?

A nurse is planning to test the visual acuity of a 7-year-old. Which is the best way to test visual acuity in this child?

A school-age child is brought to the emergency department due to nausea, vomiting, and severe right lower quadrant pain. The child's white blood cell count is 17,000/mm³ (17.0 x 10⁹/L) . Which statement by the child is of most concern to the nurse?

The nurse is caring for a preschool-age child whose grandparent died 3 days ago. Which intervention is inappropriate?

A newborn has a large myelomeningocele. What nursing intervention is priority?