NR 328 Final Exam 1 Test Bank (Questions / Answers)
Chapter 01: Perspectives of Pediatric Nursing
1. The clinic nurse is reviewing statistics on infant mortality for the United States versus other countries. Compared with other countries that have a population of at least 25 million, the nurse makes which determination?
a. The United States is ranked last among 27 countries.
b. The United States is ranked similar to 20 other developed countries.
c. The United States is ranked in the middle of 20 other developed countries.
d. The United States is ranked highest among 27 other industrialized countries.
2. Which is the leading cause of death in infants younger than 1 year in the United States?
a. Congenital anomalies
b. Sudden infant death syndrome
c. Disorders related to short gestation and low birth weight
d. Maternal complications specific to the perinatal period
3. What is the major cause of death for children older than 1 year in the United States?
a. Heart disease
b. Childhood cancer
c. Unintentional injuries
d. Congenital anomalies
4. In addition to injuries, what are the leading causes of death in adolescents ages 15 to 19 years?
a. Suicide and cancer
b. Suicide and homicide
c. Drowning and cancer
d. Homicide and heart disease
5. The nurse is planning a teaching session to adolescents about deaths by unintentional injuries. Which should the nurse include in the session with regard to deaths caused by injuries?
a. More deaths occur in males.
b. More deaths occur in females.
c. The pattern of deaths does not vary according to age and sex.
d. The pattern of deaths does not vary widely among different ethnic groups.
6. What do mortality statistics describe?
a. Disease occurring regularly within a geographic location
b. The number of individuals who have died over a specific period
c. The prevalence of specific illness in the population at a particular time
d. Disease occurring in more than the number of expected cases in a community
7. The nurse should assess which age group for suicide ideation since suicide in which age group is the third leading cause of death?
b. Young school age
c. Middle school age
d. Late school age and adolescents
8. Parents of a hospitalized toddler ask the nurse, “What is meant by family-centered care?” The nurse should respond with which statement?
a. Family-centered care reduces the effect of cultural diversity on the family.
b. Family-centered care encourages family dependence on the health care system.
c. Family-centered care recognizes that the family is the constant in a child’s life.
d. Family-centered care avoids expecting families to be part of the decision-making process.
9. The nurse is describing clinical reasoning to a group of nursing students. Which is most descriptive of clinical reasoning?
a. Purposeful and goal directed
b. A simple developmental process
c. Based on deliberate and irrational thought
d. Assists individuals in guessing what is most appropriate
10. Evidence-based practice (EBP), a decision-making model, is best described as which?
a. Using information in textbooks to guide care
b. Combining knowledge with clinical experience and intuition
c. Using a professional code of ethics as a means for decision making
d. Gathering all evidence that applies to the child’s health and family situation
11. Which best describes signs and symptoms as part of a nursing diagnosis?
a. Description of potential risk factors
b. Identification of actual health problems
c. Human response to state of illness or health
d. Cues and clusters derived from patient assessment
12. The nurse is talking to a group of parents of school-age children at an after-school program about childhood health problems. Which statement should the nurse include in the teaching?
a. Childhood obesity is the most common nutritional problem among children.
b. Immunization rates are the same among children of different races and ethnicity.
c. Dental caries is not a problem commonly seen in children since the introduction of fluoridated water.
d. Mental health problems are typically not seen in school-age children but may be diagnosed in adolescents.
13. The nurse is planning care for a hospitalized preschool-aged child. Which should the nurse plan to ensure atraumatic care?
a. Limit explanation of procedures because the child is preschool aged.
b. Ask that all family members leave the room when performing procedures.
c. Allow the child to choose the type of juice to drink with the administration of oral medications.
d. Explain that EMLA cream cannot be used for the morning lab draw because there is not time for it to be effective.
14. Which situation denotes a nontherapeutic nurse–patient–family relationship?
a. The nurse is planning to read a favorite fairy tale to a patient.
b. During shift report, the nurse is criticizing parents for not visiting their child.
c. The nurse is discussing with a fellow nurse the emotional draw to a certain patient.
d. The nurse is working with a family to find ways to decrease the family’s dependence on health care providers.
15. The nurse is aware that which age group is at risk for childhood injury because of the cognitive characteristic of magical and egocentric thinking?
b. Young school age
c. Middle school age
16. The school nurse is assessing children for risk factors related to childhood injuries. Which child has the most risk factors related to childhood injury?
a. Female, multiple siblings, stable home life
b. Male, high activity level, stressful home life
c. Male, even tempered, history of previous injuries
d. Female, reacts negatively to new situations, no serious previous injuries
17. The school nurse is evaluating the number of school-age children classified as obese. The nurse recognizes that the percentile of body mass index that classifies a child as obese is greater than which?
a. 50th percentile
b. 75th percentile
c. 80th percentile
d. 95th percentile
18. The nurse is teaching parents about the types of behaviors children exhibit when living with chronic violence. Which statement made by the parents indicates further teaching is needed?
a. “We should watch for aggressive play.”
b. “Our child may show lasting symptoms of stress.”
c. “We know that our child will show caring behaviors.”
d. “Our child may have difficulty concentrating in school.”
19. The nurse is evaluating research studies according to the GRADE criteria and has determined the quality of evidence on the subject is moderate. Which type of evidence does this determination indicate?
a. Strong evidence from unbiased observational studies
b. Evidence from randomized clinical trials showed inconsistent results
c. Consistent evidence from well-performed randomized clinical trials
d. Evidence for at least one critical outcome from randomized clinical trials had serious flaws
20. An adolescent patient wants to make decisions about treatment options, along with his parents. Which moral value is the nurse displaying when supporting the adolescent to make decisions?
21. The nurse manager is compiling a report for a hospital committee on the quality of nursing-sensitive indicators for a nursing unit. Which does the nurse manager include in the report?
a. The average age of the nurses on the unit
b. The salary ranges for the nurses on the unit
c. The education and certification of the nurses on the unit
d. The number of nurses who have applied but were not hired for the unit
1. Which responsibilities are included in the pediatric nurse’s promotion of the health and well-being of children? (Select all that apply.)
a. Promoting disease prevention
b. Providing financial assistance
c. Providing support and counseling
d. Establishing lifelong friendships
e. Establishing a therapeutic relationship
f. Participating in ethical decision making
2. The nurse is conducting a teaching session for parents on nutrition. Which characteristics of families should the nurse consider that can cause families to struggle in providing adequate nutrition? (Select all that apply.)
b. Lower income
c. Migrant status
d. Working parents
e. Single parent status
3. The nurse is preparing to complete documentation on a patient’s chart. Which should be included in documentation of nursing care? (Select all that apply.)
b. Incident reports
c. Initial assessments
d. Nursing care provided
e. Patient’s response of care provided
4. Which actions by the nurse demonstrate overinvolvement with patients and their families? (Select all that apply.)
a. Buying clothes for the patients
b. Showing favoritism toward a patient
c. Focusing on technical aspects of care
d. Spending off-duty time with patients and families
e. Asking questions if families are not participating in care
5. Which are included in the evaluation step of the nursing process? (Select all that apply.)
a. Determination if the outcome has been met
b. Ascertaining if the plan requires modification
c. Establish priorities and selecting expected patient goals
d. Selecting alternative interventions if the outcome has not been met
e. Determining if a risk or actual dysfunctional health problem exists
6. Which should the nurse teach to parents regarding oral health of children? (Select all that apply.)
a. Fluoridated water should be used.
b. Early childhood caries is a preventable disease.
c. Dental caries is a rare chronic disease of childhood.
d. Dental hygiene should begin with the first tooth eruption.
e. Childhood caries does not happen until after 2 years of age.
7. The school nurse is explaining to older school children that obesity increases the risk for which disorders? (Select all that apply.)
d. Irritable bowel disease
e. Altered glucose metabolism
8. The nurse is reviewing the Healthy People 2020 leading health indicators for a child health promotion program. Which are included in the leading health indicators? (Select all that apply.)
a. Decrease tobacco use.
b. Improve immunization rates.
c. Reduce incidences of cancer.
d. Increase access to health care.
e. Decrease the number of eating disorders.
9. Which actions by the nurse demonstrate clinical reasoning? (Select all that apply.)
a. Basing decisions on intuition
b. Considering alternative action
c. Using formal and informal thinking to gather data
d. Giving deliberate thought to a patient’s problem
e. Developing an outcome focused on optimum patient care
1. The nurse is determining if a newborn is classified in the low birth weight (LBW) category of less than 2500 g. The newborn’s weight is 5 lb, 4 oz. What is the newborn’s weight in grams? Record your answer in a whole number.
The nursing process is a method of problem identification and problem solving that describes what the nurse actually does. Match each step of the nursing process with its definition.
c. Outcomes identification
Ethical dilemmas arise when competing moral considerations underlie various alternatives. Match each competing moral value with its definition.
Chapter 02: Social, Cultural, Religious, and Family Influences on Child Health Promotion
1. Children are taught the values of their culture through observation and feedback relative to their own behavior. In teaching a class on cultural competence, the nurse should be aware that which factor may be culturally determined?
b. Racial variation
d. Geographic boundaries
2. The nurse is aware that if patients’ different cultures are implied to be inferior, the emotional attitude the nurse is displaying is what?
c. Cultural shock
d. Cultural sensitivity
3. Which term best describes the sharing of common characteristics that differentiates one group from other groups in a society?
4. After the family, which has the greatest influence on providing continuity between generations?
c. Social class
5. The nurse is planning care for a patient with a different ethnic background. Which should be an appropriate goal?
a. Adapt, as necessary, ethnic practices to health needs.
b. Attempt, in a nonjudgmental way, to change ethnic beliefs.
c. Encourage continuation of ethnic practices in the hospital setting.
d. Strive to keep ethnic background from influencing health needs.
6. The nurse discovers welts on the back of a Vietnamese child during a home health visit. The child’s mother says she has rubbed the edge of a coin on her child’s oiled skin. The nurse should recognize this as what?
a. Child abuse
b. Cultural practice to rid the body of disease
c. Cultural practice to treat enuresis or temper tantrums
d. Child discipline measure common in the Vietnamese culture
7. A Hispanic toddler has pneumonia. The nurse notices that the parent consistently feeds the child only the broth that comes on the clear liquid tray. Food items, such as Jell-O, Popsicles, and juices, are left. Which statement best explains this?
a. The parent is trying to feed the child only what the child likes most.
b. Hispanics believe the “evil eye” enters when a person gets cold.
c. The parent is trying to restore normal balance through appropriate “hot” remedies.
d. Hispanics believe an innate energy called chi is strengthened by eating soup.
8. How is family systems theory best described?
a. The family is viewed as the sum of individual members.
b. A change in one family member cannot create a change in other members.
c. Individual family members are readily identified as the source of a problem.
d. When the family system is disrupted, change can occur at any point in the system.
9. Which family theory is described as a series of tasks for the family throughout its life span?
a. Exchange theory
b. Developmental theory
c. Structural-functional theory
d. Symbolic interactional theory
10. Which family theory explains how families react to stressful events and suggests factors that promote adaptation to these events?
a. Interactional theory
b. Family stress theory
c. Erikson’s psychosocial theory
d. Developmental systems theory
11. Which type of family should the nurse recognize when the paternal grandmother, the parents, and two minor children live together?
12. Which type of family should the nurse recognize when a mother, her children, and a stepfather live together?
a. Traditional nuclear
13. Which is an accurate description of homosexual (or gay-lesbian) families?
a. A nurturing environment is lacking.
b. The children become homosexual like their parents.
c. The stability needed to raise healthy children is lacking.
d. The quality of parenting is equivalent to that of nongay parents.
14. The nurse is teaching a group of new nursing graduates about identifiable qualities of strong families that help them function effectively. Which quality should be included in the teaching?
a. Lack of congruence among family members
b. Clear set of family values, rules, and beliefs
c. Adoption of one coping strategy that always promotes positive functioning in dealing with life events
d. Sense of commitment toward growth of individual family members as opposed to that of the family unit
15. When assessing a family, the nurse determines that the parents exert little or no control over their children. This style of parenting is called which?
16. When discussing discipline with the mother of a 4-year-old child, which should the nurse include?
a. Parental control should be consistent.
b. Withdrawal of love and approval is effective at this age.
c. Children as young as 4 years rarely need to be disciplined.
d. One should expect rules to be followed rigidly and unquestioningly.
17. Which is a consequence of the physical punishment of children, such as spanking?
a. The psychologic impact is usually minimal.
b. The child’s development of reasoning increases.
c. Children rarely become accustomed to spanking.
d. Misbehavior is likely to occur when parents are not present.
18. The parents of a young child ask the nurse for suggestions about discipline. When discussing the use of time-outs, which should the nurse include?
a. Send the child to his or her room if the child has one.
b. A general rule for length of time is 1 hour per year of age.
c. Select an area that is safe and nonstimulating, such as a hallway.
d. If the child cries, refuses, or is more disruptive, try another approach.
19. A 3-year-old child was adopted immediately after birth. The parents have just asked the nurse how they should tell the child that she is adopted. Which guideline concerning adoption should the nurse use in planning a response?
a. It is best to wait until the child asks about it.
b. The best time to tell the child is between the ages of 7 and 10 years.
c. It is not necessary to tell a child who was adopted so young.
d. Telling the child is an important aspect of their parental responsibilities.
20. Children may believe that they are responsible for their parents’ divorce and interpret the separation as punishment. At which age is this most likely to occur?
a. 1 year
b. 4 years
c. 8 years
d. 13 years
21. A parent of a school-age child tells the school nurse that the parents are going through a divorce. The child has not been doing well in school and sometimes has trouble sleeping. The nurse should recognize this as what?
a. Indicative of maladjustment
b. A common reaction to divorce
c. Suggestive of a lack of adequate parenting
d. An unusual response that indicates a need for referral
22. A mother brings 6-month-old Eric to the clinic for a well-baby checkup. She comments, “I want to go back to work, but I don’t want Eric to suffer because I’ll have less time with him.” Which is the nurse’s most appropriate answer?
a. “I’m sure he’ll be fine if you get a good babysitter.”
b. “You will need to stay home until Eric starts school.”
c. “Let’s talk about the child care options that will be best for Eric.”
d. “You should go back to work so Eric will get used to being with others.”
23. A foster parent is talking to the nurse about the health care needs for the child who has been placed in the parent’s care. Which statement best describes the health care needs of foster children?
a. Foster children always come from abusive households and are emotionally fragile.
b. Foster children tend to have a higher than normal incidence of acute and chronic health problems.
c. Foster children are usually born prematurely and require technologically advanced health care.
d. Foster children will not stay in the home for an extended period, so health care needs are not as important as emotional fulfillment.
24. The nurse is planning to counsel family members as a group to assess the family’s group dynamics. Which theoretic family model is the nurse using as a framework?
a. Feminist theory
b. Family stress theory
c. Family systems theory
d. Developmental theory
25. The nurse is reviewing the importance of role learning for children. The nurse understands that children’s roles are primarily shaped by which members?
26. The nurse is caring for an adolescent hospitalized for asthma. The adolescent belongs to a large family. The nurse recognizes that the adolescent is likely to relate to which group?
27. The nurse is explaining different parenting styles to a group of parents. The nurse explains that an authoritative parenting style can lead to which child behavior?
28. Parents of a preschool child ask the nurse, “Should we set rules for our child as part of a discipline plan?” Which is an accurate response by the nurse?
a. “It is best to delay the punishment if a rule is broken.”
b. “The child is too young for rules. At this age, unrestricted freedom is best.”
c. “It is best to set the rules and reason with the child when the rules are broken.”
d. “Set clear and reasonable rules and expect the same behavior regardless of the circumstances.”
29. The nurse is discussing issues that are important with parents considering a cross-racial adoption. Which statement made by the parents indicates further teaching is needed?
a. “We will try to preserve the adopted child’s racial heritage.”
b. “We are glad we will be getting full medical information when we adopt our child.”
c. “We will make sure to have everyone realize this is our child and a member of the family.”
d. “We understand strangers may make thoughtless comments about our child being different from us.”
30. The school nurse understands that children are impacted by divorce. Which has the most impact on the positive outcome of a divorce?
a. Age of the child
b. Gender of the child
c. Family characteristics
d. Ongoing family conflict
31. The nurse is discussing parenting in reconstituted families with a new stepparent. The nurse is aware that the new stepparent understands the teaching when which statement is made?
a. “I am glad there will be no disruption in my lifestyle.”
b. “I don’t think children really want to live in a two-parent home.”
c. “I realize there may be power conflicts bringing two households together.”
d. “I understand contact between grandparents should be kept to a minimum.”
1. The nurse is presenting a staff development program about understanding culture in the health care encounter. Which components should the nurse include in the program? (Select all that apply.)
a. Cultural humility
b. Cultural research
c. Cultural sensitivity
d. Cultural competency
2. The parents of a 5-year-old child ask the nurse how they can minimize misbehavior. Which responses should the nurse give? (Select all that apply.)
a. Set clear and reasonable goals.
b. Praise your child for desirable behavior.
c. Don’t call attention to unacceptable behavior.
d. Teach desirable behavior through your own example.
e. Don’t provide an opportunity for your child to have any control.
3. Which describe the feelings and behaviors of early preschool children related to divorce? (Select all that apply.)
a. Regressive behavior
b. Fear of abandonment
c. Fear regarding the future
d. Blame themselves for the divorce
e. Intense desire for reconciliation of parents
4. Which describe the feelings and behaviors of adolescents related to divorce? (Select all that apply.)
a. Disturbed concept of sexuality
b. May withdraw from family and friends
c. Worry about themselves, parents, or siblings
d. Expression of anger, sadness, shame, or embarrassment
e. Engage in fantasy to seek understanding of the divorce
5. The nurse is teaching parents about the effects of media on childhood obesity. The nurse realizes the parents understand the teaching if they make which statements? (Select all that apply.)
a. “Advertising of unhealthy food can increase snacking.”
b. “Increased screen time may be related to unhealthy sleep.”
c. “There is a link between the amount of screen time and obesity.”
d. “Increased screen time can lead to better knowledge of nutrition.”
e. “Physical activity increases when children increase the amount of screen time.”
Culture characterizes a particular group with its values, beliefs, norms, patterns, and practices that are learned, shared, and transmitted from one generation to another. Match the terms used to describe groups with shared values, beliefs, norms, patterns, and practices.
d. Social class
Chapter 04: Communication, Physical, and Developmental Assessment
1. The nurse is seeing an adolescent and the parents in the clinic for the first time. Which should the nurse do first?
a. Introduce him- or herself.
b. Make the family comfortable.
c. Give assurance of privacy.
d. Explain the purpose of the interview.
2. Which is considered a block to effective communication?
a. Using silence
b. Using clichés
c. Directing the focus
d. Defining the problem
3. Which is the single most important factor to consider when communicating with children?
a. Presence of the child’s parent
b. Child’s physical condition
c. Child’s developmental level
d. Child’s nonverbal behaviors
4. Because children younger than 5 years are egocentric, the nurse should do which when communicating with them?
a. Focus communication on the child.
b. Use easy analogies when possible.
c. Explain experiences of others to the child.
d. Assure the child that communication is private.
5. The nurse’s approach when introducing hospital equipment to a preschooler who seems afraid should be based on which principle?
a. The child may think the equipment is alive.
b. Explaining the equipment will only increase the child’s fear.
c. One brief explanation will be enough to reduce the child’s fear.
d. The child is too young to understand what the equipment does.
6. When the nurse interviews an adolescent, which is especially important?
a. Focus the discussion on the peer group.
b. Allow an opportunity to express feelings.
c. Use the same type of language as the adolescent.
d. Emphasize that confidentiality will always be maintained.
7. The nurse is preparing to assess a 10-month-old infant. He is sitting on his father’s lap and appears to be afraid of the nurse and of what might happen next. Which initial actions by the nurse should be most appropriate?
a. Initiate a game of peek-a-boo.
b. Ask the infant’s father to place the infant on the examination table.
c. Talk softly to the infant while taking him from his father.
d. Undress the infant while he is still sitting on his father’s lap.
8. An 8-year-old girl asks the nurse how the blood pressure apparatus works. The most appropriate nursing action is which?
a. Ask her why she wants to know.
b. Determine why she is so anxious.
c. Explain in simple terms how it works.
d. Tell her she will see how it works as it is used.
9. The nurse is having difficulty communicating with a hospitalized 6-year-old child. Which technique should be most helpful?
a. Recommend that the child keep a diary.
b. Provide supplies for the child to draw a picture.
c. Suggest that the parent read fairy tales to the child.
d. Ask the parent if the child is always uncommunicative.
10. Which data should be included in a health history?
a. Review of systems
b. Physical assessment
c. Growth measurements
d. Record of vital signs
11. The nurse is taking a health history of an adolescent. Which best describes how the chief complaint should be determined?
a. Request a detailed listing of symptoms.
b. Ask the adolescent, “Why did you come here today?”
c. Interview the parent away from the adolescent to determine the chief complaint.
d. Use what the adolescent says to determine, in correct medical terminology, what the problem is.
12. The nurse is interviewing the mother of an infant. The mother reports, “I had a difficult delivery, and my baby was born prematurely.” This information should be recorded under which heading?
b. Present illness
c. Chief complaint
d. Review of systems
13. Where in the health history does a record of immunizations belong?
b. Present illness
c. Review of systems
d. Physical assessment
14. The nurse is taking a sexual history on an adolescent girl. Which is the best way to determine whether she is sexually active?
a. Ask her, “Are you sexually active?”
b. Ask her, “Are you having sex with anyone?”
c. Ask her, “Are you having sex with a boyfriend?”
d. Ask both the girl and her parent if she is sexually active.
15. When doing a nutritional assessment on a Hispanic family, the nurse learns that their diet consists mainly of vegetables, legumes, and starches. The nurse should recognize that this diet is which?
a. Lacking in protein
b. Indicating they live in poverty
c. Providing sufficient amino acids
d. Needing enrichment with meat and milk
16. Which parameter correlates best with measurements of total muscle mass?
c. Skinfold thickness
d. Upper arm circumference
17. The nurse is preparing to perform a physical assessment on a 10-year-old girl. The nurse gives her the option of her mother staying in the room or leaving. This action should be considered which?
a. Appropriate because of child’s age
b. Appropriate, but the mother may be uncomfortable
c. Inappropriate because of child’s age
d. Inappropriate because child is same sex as mother
18. With the National Center for Health Statistics criteria, which body mass index (BMI)–for-age percentiles should indicate the patient is at risk for being overweight?
a. 10th percentile
b. 75th percentile
c. 85th percentile
d. 95th percentile
19. Rectal temperatures are indicated in which situation?
a. In the newborn period
b. Whenever accuracy is essential
c. Rectal temperatures are never indicated
d. When rapid temperature changes are occurring
20. What is the earliest age at which a satisfactory radial pulse can be taken in children?
a. 1 year
b. 2 years
c. 3 years
d. 6 years
21. The nurse needs to take the blood pressure of a small child. Of the cuffs available, one is too large and one is too small. The best nursing action is which?
a. Use the small cuff.
b. Use the large cuff.
c. Use either cuff using the palpation method.
d. Wait to take the blood pressure until a proper cuff can be located.
22. Where is the best place to observe for the presence of petechiae in dark-skinned individuals?
c. Oral mucosa
d. Palms and soles
23. During a routine health assessment, the nurse notes that an 8-month-old infant has a significant head lag. Which is the most appropriate action?
a. Recheck head control at next visit.
b. Teach the parents appropriate exercises.
c. Schedule the child for further evaluation.
d. Refer the child for further evaluation if the anterior fontanel is still open.
24. The nurse has just started assessing a young child who is febrile and appears ill. There is hyperextension of the child’s head (opisthotonos) with pain on flexion. Which is the most appropriate action?
a. Ask the parent when the neck was injured.
b. Refer for immediate medical evaluation.
c. Continue assessment to determine the cause of the neck pain.
d. Record “head lag” on the assessment record and continue the assessment of the child.
25. During a funduscopic examination of a school-age child, the nurse notes a brilliant, uniform red reflex in both eyes. The nurse should recognize that this is which?
a. A normal finding
b. A sign of a possible visual defect and a need for vision screening
c. An abnormal finding requiring referral to an ophthalmologist
d. A sign of small hemorrhages, which usually resolve spontaneously
26. Which explains the importance of detecting strabismus in young children?
a. Color vision deficit may result.
b. Amblyopia, a type of blindness, may result.
c. Epicanthal folds may develop in the affected eye.
d. Corneal light reflexes may fall symmetrically within each pupil.
27. Which is the most frequently used test for measuring visual acuity?
a. Snellen letter chart
b. Ishihara vision test
c. Allen picture card test
d. Denver eye screening test
28. The nurse is testing an infant’s visual acuity. By which age should the infant be able to fix on and follow a target?
a. 1 month
b. 1 to 2 months
c. 3 to 4 months
d. 6 months
29. During an otoscopic examination on an infant, in which direction is the pinna pulled?
a. Up and back
b. Up and forward
c. Down and back
d. Down and forward
30. What is an appropriate screening test for hearing that the nurse can administer to a 5-year-old child?
a. Rinne test
b. Weber test
c. Pure tone audiometry
d. Eliciting the startle reflex
31. What is the appropriate placement of a tongue blade for assessment of the mouth and throat?
a. On the lower jaw
b. Side of the tongue
c. Against the soft palate
d. Center back area of the tongue
32. When assessing a preschooler’s chest, what should the nurse expect?
a. Respiratory movements to be chiefly thoracic
b. Anteroposterior diameter to be equal to the transverse diameter
c. Retraction of the muscles between the ribs on respiratory movement
d. Movement of the chest wall to be symmetric bilaterally and coordinated with breathing
33. When auscultating an infant’s lungs, the nurse detects diminished breath sounds. What should the nurse interpret this as?
a. Suggestive of chronic pulmonary disease
b. Suggestive of impending respiratory failure
c. An abnormal finding warranting investigation
d. A normal finding in infants younger than 1 year of age
34. Which type of breath sound is normally heard over the entire surface of the lungs except for the upper intrascapular area and the area beneath the manubrium?
35. The nurse is assessing a child’s capillary refill time. This can be accomplished by doing what?
a. Inspect the chest.
b. Auscultate the heart.
c. Palpate the apical pulse.
d. Palpate the nail bed with pressure to produce a slight blanching.
36. Which heart sound is produced by vibrations within the heart chambers or in the major arteries from the back-and-forth flow of blood?
a. S1 and S2
b. S3 and S4
d. Physiologic splitting
37. Examination of the abdomen is performed correctly by the nurse in which order?
a. Inspection, palpation, percussion, and auscultation
b. Inspection, percussion, auscultation, and palpation
c. Palpation, percussion, auscultation, and inspection
d. Inspection, auscultation, percussion, and palpation
38. Superficial palpation of the abdomen is often perceived by the child as tickling. Which measure by the nurse is most likely to minimize this sensation and promote relaxation?
a. Palpate another area simultaneously.
b. Ask the child not to laugh or move if it tickles.
c. Begin with deeper palpation and gradually progress to superficial palpation.
d. Have the child “help” with palpation by placing his or her hand over the palpating hand.
39. During examination of a toddler’s extremities, the nurse notes that the child is bowlegged. The nurse should recognize that this finding is which?
a. Abnormal and requires further investigation
b. Abnormal unless it occurs in conjunction with knock-knee
c. Normal if the condition is unilateral or asymmetric
d. Normal because the lower back and leg muscles are not yet well developed
40. The nurse is caring for a non–English-speaking child and family. Which should the nurse consider when using an interpreter?
a. Pose several questions at a time.
b. Use medical jargon when possible.
c. Communicate directly with family members when asking questions.
d. Carry on some communication in English with the interpreter about the family’s needs.
1. Which action should the nurse implement when taking an axillary temperature?
a. Take the temperature through one layer of clothing.
b. Add a degree to the result when recording the temperature.
c. Place the tip of the thermometer under the arm in the center of the axilla.
d. Hold the child’s arm away from the body while taking the temperature.
42. The nurse is aware that skin turgor best estimates what?
b. Adequate hydration
c. Amount of body fat
d. Amount of anemia
43. The Asian parent of a child being seen in the clinic avoids eye contact with the nurse. What is the best explanation for this considering cultural differences?
a. The parent feels inferior to the nurse.
b. The parent is showing respect for the nurse.
c. The parent is embarrassed to seek health care.
d. The parent feels responsible for her child’s illness.
1. The nurse is performing an otoscopic examination on a child. Which are normal findings the nurse should expect? (Select all that apply.)
a. Ashen gray areas
b. A well-defined light reflex
c. A small, round, concave spot near the center of the drum
d. The tympanic membrane is a nontransparent grayish color
e. A whitish line extending from the umbo upward to the margin of the membrane
2. The nurse is assessing breath sounds on a child. Which are expected auscultated breath sounds? (Select all that apply.)
3. The nurse is performing an oral examination on a preschool child. Which strategies should the nurse use to encourage the child to open the mouth for the examination? (Select all that apply.)
a. Lightly brush the palate with a cotton swab.
b. Perform the examination in front of a mirror.
c. Let the child examine someone else’s mouth first.
d. Have the child breathe deeply and hold his or her breath.
e. Use a tongue blade to help the child open his or her mouth.
4. Which are effective auscultation techniques? (Select all that apply.)
a. Ask the child to breathe shallowly.
b. Apply light pressure on the chest piece.
c. Use a symmetric and orderly approach.
d. Place the stethoscope over one layer of clothing.
e. Warm the stethoscope before placing it on the skin.
5. The nurse is assessing heart sounds on a school-age child. Which should the nurse document as abnormal findings if found on the assessment? (Select all that apply.)
a. S4 heart sound
b. S3 heart sound
c. Grade II murmur
d. S1 louder at the apex of the heart
e. S2 louder than S1 in the aortic area
6. The nurse understands that blocks to therapeutic communication include what? (Select all that apply.)
b. Use of silence
c. Using clichés
d. Defending a situation
e. Using open-ended questions
Chapter 05: Pain Assessment and Management in Children
1. Which is the most consistent and commonly used data for assessment of pain in infants?
d. Parental report
2. Children as young as age 3 years can use facial scales for discrimination. What are some suggested anchor words for the preschool age group?
a. “No hurt.”
b. “Red pain.”
c. “Zero hurt.”
d. “Least pain.”
3. What is an important consideration when using the FACES pain rating scale with children?
a. Children color the face with the color they choose to best describe their pain.
b. The scale can be used with most children as young as 3 years.
c. The scale is not appropriate for use with adolescents.
d. The FACES scale is useful in pain assessment but is not as accurate as physiologic responses.
4. What describes nonpharmacologic techniques for pain management?
a. They may reduce pain perception.
b. They usually take too long to implement.
c. They make pharmacologic strategies unnecessary.
d. They trick children into believing they do not have pain.
5. Which nonpharmacologic intervention appears to be effective in decreasing neonatal procedural pain?
a. Tactile stimulation
b. Commercial warm packs
c. Doing procedure during infant sleep
d. Oral sucrose and nonnutritive sucking
6. A 6-year-old child has patient-controlled analgesia (PCA) for pain management after orthopedic surgery. The parents are worried that their child will be in pain. What should your explanation to the parents include?
a. The child will continue to sleep and be pain free.
b. Parents cannot administer additional medication with the button.
c. The pump can deliver baseline and bolus dosages.
d. There is a high risk of overdose, so monitoring is done every 15 minutes.
7. Which drug is usually the best choice for patient-controlled analgesia (PCA) for a child in the immediate postoperative period?
a. Codeine sulfate (Codeine)
b. Morphine (Roxanol)
c. Methadone (Dolophine)
d. Meperidine (Demerol)
8. A child is in the intensive care unit after a motor vehicle collision. The child has numerous fractures and is in pain that is rated 9 or 10 on a 10-point scale. In planning care, the nurse recognizes that the indicated action is which?
a. Give only an opioid analgesic at this time.
b. Increase dosage of analgesic until the child is adequately sedated.
c. Plan a preventive schedule of pain medication around the clock.
d. Give the child a clock and explain when she or he can have pain medications.
9. The parents of a preterm infant in a neonatal intensive care unit are concerned about their infant experiencing pain from so many procedures. The nurse’s response should be based on which characteristic about preterm infants’ pain?
a. They may react to painful stimuli but are unable to remember the pain experience.
b. They perceive and react to pain in much the same manner as children and adults.
c. They do not have the cortical and subcortical centers that are needed for pain perception.
d. They lack neurochemical systems associated with pain transmission and modulation.
10. A preterm infant has just been admitted to the neonatal intensive care unit. The infant’s parents ask the nurse about anesthesia and analgesia when painful procedures are necessary. What should the nurse’s explanation be?
a. Nerve pathways of neonates are not sufficiently myelinated to transmit painful stimuli.
b. The risks accompanying anesthesia and analgesia are too great to justify any possible benefit of pain relief.
c. Neonates do not possess sufficiently integrated cortical function to interpret or recall pain experiences.
d. Pain pathways and neurochemical systems associated with pain transmission are intact and functional in neonates.
11. A bone marrow aspiration and biopsy are needed on a school-age child. The most appropriate action to provide analgesia during the procedure is which?
a. Administer TAC (tetracaine, adrenalin, and cocaine) 15 minutes before the procedure.
b. Use a combination of fentanyl and midazolam for conscious sedation.
c. Apply EMLA (eutectic mixture of local anesthetics) 1 hour before the procedure.
d. Apply a transdermal fentanyl (Duragesic) “patch” immediately before the procedure.
12. What is a significant common side effect that occurs with opioid administration?
d. Allergic reactions
13. The nurse is caring for a child receiving a continuous intravenous (IV) low-dose infusion of morphine for severe postoperative pain. The nurse observes a slower respiratory rate, and the child cannot be aroused. The most appropriate management of this child is for the nurse to do which first?
a. Administer naloxone (Narcan).
b. Discontinue the IV infusion.
c. Discontinue morphine until the child is fully awake.
d. Stimulate the child by calling his or her name, shaking gently, and asking the child to breathe deeply.
14. The nurse is teaching a staff development program about levels of sedation in the pediatric population. Which statement by one of the participants should indicate a correct understanding of the teaching?
a. “With minimal sedation, the patient’s respiratory efforts are affected, and cognitive function is not impaired.”
b. “With general anesthesia, the patient’s airway cannot be maintained, but cardiovascular function is maintained.”
c. “During deep sedation, the patient can be easily aroused by loud verbal commands and tactile stimulation.”
d. “During moderate sedation, the patient responds to verbal commands but may not respond to light tactile stimulation.”
15. The nurse is planning to administer a nonopioid for pain relief to a child. Which timing should the nurse plan so the nonopioid takes effect?
a. 15 minutes until maximum effect
b. 30 minutes until maximum effect
c. 1 hour until maximum effect
d. 1 1/2 hours until maximum effect
16. The nurse is planning pain control for a child. Which is the advantage of administering pain medication by the intravenous (IV) bolus route?
a. Less expensive than oral medications
b. Produces a first-pass effect through the liver
c. Does not need to be administered frequently
d. Provides most rapid onset of effect, usually in about 5 minutes
17. The nurse is teaching the parents of a child with recurrent headaches methods to modify behavior patterns that increase the risk of headache. Which statement by the parents indicates understanding the teaching?
a. “We will allow the child to miss school if a headache occurs.”
b. “We will respond matter-of-factly to requests for special attention.”
c. “We will be sure to give much attention to our child when a headache occurs.”
d. “We will be sure our child doesn’t have to perform at a band concert if a headache occurs.”
18. Which is a complication that can occur after abdominal surgery if pain is not managed?
c. Decrease in heart rate
d. Increase in cardiac output
19. A burn patient is experiencing anxiety over dressing changes. Which prescription should the nurse expect to be ordered to control anxiety?
a. Lorazepam (Ativan)
b. Oxycodone (OxyContin)
c. Fentanyl (Sublimaze)
d. Morphine Sulfate (Morphine)
20. A cancer patient is experiencing neuropathic cancer pain. Which prescription should the nurse expect to be ordered to control anxiety?
a. Lorazepam (Ativan)
b. Gabapentin (Neurontin)
c. Hydromorphone (Dilaudid)
d. Morphine sulfate (MS Contin)
1. Which are components of the FLACC scale? (Select all that apply.)
b. Capillary refill time
c. Leg position
d. Facial expression
Facial expression, consolability, cry, activity, and leg position are components of the FLACC scale. Color is a component of the Apgar scoring system. Capillary refill time is a physiologic measure that is not a component of the FLACC scale.
2. The nurse is using the CRIES pain assessment tool on a preterm infant in the neonatal intensive care unit. Which are the components of this tool? (Select all that apply.)
b. Moro reflex
c. Oxygen saturation
d. Posture of arms and legs
f. Facial expression
Need for increased oxygen, crying, increased vital signs, expression, and sleeplessness are components of the CRIES pain assessment tool used with neonates. Color, Moro reflex, and posture of arms and legs are not components of the CRIES scale.
3. Which coanalgesics should the nurse expect to be prescribed for pruritus? (Select all that apply.)
a. Naloxone (Narcan)
b. Inapsine (Droperidol)
c. Hydroxyzine (Atarax)
d. Promethazine (Phenergan)
e. Diphenhydramine (Benadryl)
The coanalgesics prescribed for pruritus include naloxone, hydroxyzine, and diphenhydramine. Inapsine and promethazine are administered as antiemetics.
4. A child receiving chemotherapy is experiencing mucositis. Which prescriptions should the nurse plan to administer for initial treatment? (Select all that apply.)
a. Scope mouth rinse
b. Listerine antiseptic mouth rinse
c. Carafate suspension (Sucralfate)
d. Nystatin oral suspension (Nystatin)
e. Lidocaine viscous (Lidocaine hydrochloride solution)
Initial treatment of stomatitis includes single agents (sucralfate suspension, nystatin, and viscous lidocaine). Scope and Listerine are plaque and gingivitis control mouth rinses that would have a drying effect and are not used with mucositis.
1. A health care provider prescribes promethazine (Phenergan), 9 mg IV every 6 to 8 hours as needed for pruritus. The medication label states: “Promethazine 25 mg/1 mL.” The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer using two decimal places.
2. A health care provider prescribes diphenhydramine (Benadryl), 1 mg/kg PO every 4 to 6 hours as needed for pruritus. The child weighs 10 kg. The medication label states: “Diphenhydramine 12.5 mg/5 mL.” The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer in a whole number.
3. A health care provider prescribes hydroxyzine (Atarax), 0.6 mg/kg PO every 4 to 6 hours as needed for pruritus. The medication label states: “Hydroxyzine 10 mg/5 mL.” The child weighs 20 kg. The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer in a whole number.
Follow the formula for dosage calculation.
4. A child receiving morphine sulfate (Morphine) is experiencing respiratory depression. A health care provider prescribes naloxone (Narcan), 0.5 mcg/kg IV in 2-minute increments until breathing improves. The medication label states: “Naloxone 400 mcg/1 mL.” The child weighs 40 kg. The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer using two decimal places.
5. A health care provider prescribes haloperidol (Haldol), 0.15 mg/kg IV every 4 to 6 hours as needed for confusion. The medication label states: “Haloperidol 2 mg/1 mL.” The child weighs 30 kg. The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer rounding to one decimal place.
6. A health care provider prescribes Kytril (granisetron), 10 mcg/kg IV every 4 to 6 hours as needed for nausea. The medication label states: “Kytril 100 mcg/1 mL.” The child weighs 15 kg. The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer to one decimal place.
7. A health care provider prescribes OxyContin (oxycodone), 3 mg PO every 4 to 6 hours as needed for pain. The medication label states: “OxyContin 5 mg/1 mL.” The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer using one decimal place.
8. A health care provider prescribes acetaminophen (Tylenol) gtt, 10 mg/kg/dose PO every 4 to 6 hours as needed for pain. The infant weighs 8 kg. The medication label states: “Acetaminophen 80 mg/0.8 mL.” The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer to one decimal place.
9. A health care provider prescribes naproxen (Naprosyn), 7 mg/kg PO every 12 hours for pain. The child weighs 25 kg. The medication label states: “Naproxen 125 mg/5 mL.” The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer in a whole number.
10. A health care provider prescribes choline magnesium trisalicylate (Trilisate), 15 mg/kg PO every 8 to 12 hours as needed for pain. The child weighs 10 kg. The medication label states: “Choline magnesium trisalicylate 500 mg/5 mL.” The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer to one decimal place.
11. A health care provider prescribes ibuprofen (Motrin), 5 mg/kg PO every 6 to 8 hours as needed for pain. The child weighs 8 kg. The medication label states: “Ibuprofen 100 mg/5 mL.” The nurse prepares to administer one dose. How many milliliters will the nurse prepare to administer one dose? Fill in the blank. Record your answer in a whole number.
Complementary and alternative medicine therapies are grouped into five classes. Match the complementary or alternative therapy to its classification.
Chapter 06: Childhood Communicable and Infectious Diseases
1. Pertussis vaccination should begin at which age?
b. 2 months
c. 6 months
d. 12 months
2. A mother tells the nurse that she does not want her infant immunized because of the discomfort associated with injections. What should the nurse explain?
a. This cannot be prevented.
b. Infants do not feel pain as adults do.
c. This is not a good reason for refusing immunizations.
d. A topical anesthetic can be applied before injections are given.
3. A 4-month-old infant comes to the clinic for a well-infant checkup. Immunizations she should receive are DTaP (diphtheria, tetanus, acellular pertussis) and IPV (inactivated poliovirus vaccine). She is recovering from a cold but is otherwise healthy and afebrile. Her older sister has cancer and is receiving chemotherapy. Nursing considerations should include which?
a. DTaP and IPV can be safely given.
b. DTaP and IPV are contraindicated because she has a cold.
c. IPV is contraindicated because her sister is immunocompromised.
d. DTaP and IPV are contraindicated because her sister is immunocompromised.
4. Which serious reaction should the nurse be alert for when administering vaccines?
b. Skin irritation
c. Allergic reaction
d. Pain at injection site
5. Which muscle is contraindicated for the administration of immunizations in infants and young children?
d. Anterolateral thigh
6. Which is described as an elevated, circumscribed skin lesion that is less than 1 cm in diameter and filled with serous fluid?
7. Which vitamin supplementation has been found to reduce both morbidity and mortality in measles?
8. What does impetigo ordinarily results in?
a. No scarring
b. Pigmented spots
c. Atrophic white scars
d. Slightly depressed scars
9. What often causes cellulitis?
a. Herpes zoster
b. Candida albicans
c. Human papillomavirus
d. Streptococci or staphylococci
10. Lymphangitis (streaking) is frequently seen in what?
c. Impetigo contagiosa
d. Staphylococcal scalded skin
11. What is most important in the management of cellulitis?
a. Burow solution compresses
b. Oral or parenteral antibiotics
c. Topical application of an antibiotic
d. Incision and drainage of severe lesions
12. What causes warts?
a. A virus
b. A fungus
c. A parasite
13. What is the primary treatment for warts?
b. Local destruction
d. Specific antibiotic therapy
14. Herpes zoster is caused by the varicella virus and has an affinity for which?
a. Sympathetic nerve fibers
b. Parasympathetic nerve fibers
c. Lateral and dorsal columns of the spinal cord
d. Posterior root ganglia and posterior horn of the spinal cord
15. Treatment for herpes simplex virus (type 1 or 2) includes which?
b. Oral griseofulvin
c. Oral antiviral agent
d. Topical or systemic antibiotic
16. What should the nurse explain about ringworm?
a. It is not contagious.
b. It is a sign of uncleanliness.
c. It is expected to resolve spontaneously.
d. It is spread by both direct and indirect contact.
17. When giving instructions to a parent whose child has scabies, what should the nurse include?
a. Treat all family members if symptoms develop.
b. Be prepared for symptoms to last 2 to 3 weeks.
c. Carefully treat only areas where there is a rash.
d. Notify practitioner so an antibiotic can be prescribed.
18. Which is usually the only symptom of pediculosis capitis (head lice)?
c. Scalp rash
d. Localized inflammatory response
19. The school reviewed the pediculosis capitis (head lice) policy and removed the “no nit” requirement. The nurse explains that now, when a child is found to have nits, the parents must do which before the child can return to school?
a. No treatment is necessary with the policy change.
b. Shampoo and then trim the child’s hair to prevent reinfestation.
c. The child can remain in school with treatment done at home.
d. Treat the child with a shampoo to treat lice and comb with a fine-tooth comb every day until nits are eliminated.
20. The nurse should know what about Lyme disease?
a. Very difficult to prevent
b. Easily treated with oral antibiotics in stages 1, 2, and 3
c. Caused by a spirochete that enters the skin through a tick bite
d. Common in geographic areas where the soil contains the mycotic spores that cause the disease
21. The nurse is teaching a nursing student about standard precautions. Which statement made by the student indicates a need for further teaching?
a. “I will use precautions when I give an infant oral care.”
b. “I will use precautions when I change an infant’s diaper.”
c. “I will use precautions when I come in contact with blood and body fluids.”
d. “I will use precautions when administering oral medications to a school-age child.”
22. The nurse is preparing an airborne infection isolation room for a patient. Which communicable disease does the patient likely have?
d. Scarlet fever
23. An infant with respiratory syncytial virus (RSV) is being admitted to the hospital. The nurse should plan to place the infant on which precaution?
24. The nurse is administering the first hepatitis A vaccine to an 18-month-old child. When should the child return to the clinic for the second dose of hepatitis A vaccination?
a. After 2 months
b. After 3 months
c. After 4 months
d. After 6 months
25. The nurse is preparing to administer a measles, mumps, rubella, and varicella (MMRV) vaccine. Which is a contraindication associated with administering this vaccine?
a. The child has recently been exposed to an infectious disease.
b. The child has symptoms of a cold but no fever.
c. The child is having intermittent episodes of diarrhea.
d. The child has a disorder that causes a deficient immune system.
26. An immunocompromised child has been exposed to chickenpox. What should the nurse anticipate to be prescribed to the exposed child?
a. Acyclovir (Zovirax)
b. Valacyclovir (Valtrex)
c. Amantadine (Symmetrel)
d. Varicella-zoster immune globulin
27. The clinic nurse is instructing parents about caring for a toddler with ascariasis (common roundworm). Which statement made by the parents indicates a need for further teaching?
a. “We will wash our hands often, especially after diaper changes.”
b. “We know that roundworm can be transmitted from person to person.”
c. “We will be sure to continue the nitazoxanide (Alinia) orally for 3 days.”
d. “We will bring a stool sample to the clinic for examination in 2 weeks.”
28. The nurse is assessing a child suspected of having pinworms. Which is the most common symptom the nurse expects to assess?
c. Rectal discharge
d. Intense perianal itching
29. A child has been diagnosed with giardiasis. Which prescribed medication should the nurse expect to administer?
a. Acyclovir (Zovirax)
b. Metronidazole (Flagyl)
c. Erythromycin (Pediazole)
d. Azithromycin (Zithromax)
30. A child has been diagnosed with scabies. Which statement by the parent indicates understanding of the nurse’s teaching about scabies?
a. “The itching will stop after the cream is applied.”
b. “We will complete extensive aggressive housecleaning.”
c. “We will apply the cream to only the affected areas as directed.”
d. “Everyone who has been in close contact with my child will need to be treated.”
31. An 18-month-old child has been diagnosed with pediculosis capitis (head lice). Which prescription should the nurse question if ordered for the child?
a. Malathion (Ovide)
b. Permethrin 1% (Nix)
c. Benzyl alcohol 5% lotion
d. Pyrethrin with piperonyl butoxide (RID)
32. A child has been diagnosed with cat scratch disease. The nurse explains which characteristics about this disease?
a. “The disease is usually a benign, self-limiting illness.”
b. “The animal that transmitted the disease will also be ill.”
c. “The disease is treated with a 5-day course of oral azithromycin.”
d. “Symptoms include pruritus, especially at the site of inoculation.”
1. The nurse is planning care for a child with chickenpox (varicella). Which prescribed supportive measures should the nurse plan to implement? (Select all that apply.)
a. Administration of acyclovir (Zovirax)
b. Administration of azithromycin (Zithromax)
c. Administration of Vitamin A supplementation
d. Administration of acetaminophen (Tylenol) for fever
e. Administration of diphenhydramine (Benadryl) for itching
2. The nurse is planning care for an infant with candidiasis (moniliasis) diaper dermatitis. Which topical ointments may be prescribed for the patient? (Select all that apply.)
3. The nurse is conducting discharge teaching to an adolescent with a methicillin-resistant staphylococcus aureus (MRSA) infection. What should the nurse include in the instructions? (Select all that apply.)
a. Avoid sharing of towels and washcloths.
b. Launder clothes and bedding in cold water.
c. Use bleach when laundering towels and washcloths.
d. Take a daily bath or shower with an antibacterial soap.
e. Apply mupirocin (Bactroban) to the nares twice a day for 2 to 4 weeks.
4. The clinic nurse is reviewing the immunization guidelines for hepatitis B. Which are true of the guidelines for this vaccine? (Select all that apply.)
a. The hepatitis B vaccination series should be begun at birth.
b. The adolescent not vaccinated at birth does not have a need to be vaccinated.
c. Any child not vaccinated at birth should receive two doses at least 4 months apart.
d. An unimmunized 10-year-old child should receive three doses administered 4 weeks apart.
5. The nurse is planning to administer immunizations to a 6-month-old infant. Which interventions should the nurse implement to minimize local reactions from the vaccines? (Select all that apply.)
a. Select a needle length of 1 inch.
b. Administer in the deltoid muscle.
c. Inject the vaccine into the vastus lateralis.
d. Draw the vaccine up from a vial with a filter needle.
e. Change the needle on the syringe after drawing up the vaccine and before injecting.
6. The nurse is preparing to admit a 5-year-old child who developed lesions of varicella (chickenpox) 3 days ago. Which clinical manifestations of varicella should the nurse expect to observe? (Select all that apply.)
a. Nonpruritic rash
b. Elevated temperature
c. Discrete rose pink rash
d. Vesicles surrounded by an erythematous base
e. Centripetal rash in all three stages (papule, vesicle, and crust)
7. The nurse is preparing to admit a 1-year-old child with pertussis (whooping cough). Which clinical manifestations of pertussis should the nurse expect to observe? (Select all that apply.)
d. Low-grade fever
e. Dry hacking cough
8. The nurse is preparing to admit a 2-year-old child with rubella (German measles). Which clinical manifestations of rubella should the nurse expect to observe? (Select all that apply.)
a. Sore throat
c. Koplik spots
e. Discrete, pinkish red maculopapular exanthema
9. The clinic nurse is assessing a child with bacterial conjunctivitis (pink eye). Which assessment findings should the nurse expect? (Select all that apply.)
b. Swollen eyelids
c. Inflamed conjunctiva
d. Purulent ey
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