A child is sent to the school nurse by a teacher who has a written note that fifth disease is
suspected. Which characteristic would the nurse expect to find?
A) Macule that rapidly progresses to papule and then vesicles
B) Erythema on the face, primarily on cheeks giving a "slapped face" appearance
C) Discrete rose pink macules will appear first on the trunk and fade when
pressure is applied
D) Koplik spots appear first followed by a rash that appears first on the face and
spreads downward
The correct answer is B: Erythema on the face, primarily on cheeks giving a "slapped face"
appearance
Fifth disease is also referred to it as parvovirus infection or erythema infectiosum. Some
people may call it slapped-cheek disease because of the face rash that develops resembling
slap marks. It is also commonly called fifth disease because it was fifth of a group of once-
common childhood diseases that all have similar rashes. The other 4 diseases are measles,
rubella, scarlet fever, and Dukes'' disease. People will not know that a child has parvovirus
infection until the rash appears, and by that time the child is no longer contagious.
Hockenberry, M.J., Wilson, D., Winklestein, M.L., & Kline, N.E. (2003). Wongs Nursing Care of
Infants and Children, (7th ed). St. Louis: Mosby.
Ashwill, J., Droske, S. & James, S. (2002). Nursing care of children: principles and practice
(2nd ed.). Philadelphia: Saunders.
Question Number 2 of 40
The nurse is caring for a pre-adolescent client in skeletal Dunlop traction. Which nursing
intervention is appropriate for this child?
The correct answer is A: Make certain the child is maintained in correct body alignment.
Observe for correct body positioning with emphasis on alignment of shoulders, hips, and legs.
McCampbell, L.S. & Rentro, A.R. (2002). Wongs Nursing Care of Infants and Children. (7th
edition). St. Louis, Missouri: Mosby.
Potts, N.L. and Mandleco, B.L. (2002). Pediatric nursing, caring for children and their families.
USA: Thompson, Delmar, Learning.
Question Number 3 of 40
The nurse is planning care for a client during the acute phase of a sickle cell vaso-occlusive
crisis. Which of the following actions would be most appropriate?
A) Fluid restriction 1000cc per day
B) Ambulate in hallway 4 times a day
C) Administer analgesic therapy as ordered
D) Encourage increased caloric intake
Lewis, S.M., Heitkemper, M.M., & Dirksen, S. R. (2004). Medical-Surgical Nursing: Assessment &
management of clinical problems. St. Louis: Mosby.
Smeltzer, S.C. and Bare, B.G. (2004). Medical surgical nursing. (10th edition). Philadelphia, PA.
Lippincott Williams & Wilkins.
Question Number 4 of 40
The nurse is assessing a client in the emergency room. Which statement suggests that the
problem is acute angina?
A) "My pain is deep in my chest behind my breast bone."
B) "When I sit up the pain gets worse."
C) "As I take a deep breath the pain gets worse."
D) "The pain is right here in my stomach area."
The correct answer is A: "My pain is deep in my chest behind my breast bone."
The pain of angina is usually localized chest pain.
Ignatavicius, D., and Workman, L. (2002). Medical-Surgical Nursing Critical Thinking for
Collaborative Care (4th ed.). Philadelphia: Saunders.
Black, J, Hawk, J, Keene, A. (2001). Medical-Surgical Nursing ( 6th ed). Philadelphia: Saunders.
Question Number 5 of 40
Hospital staff requests that the parents with a Greek heritage of a hospitalized infant remove
the amulet from around the child's neck. The parents refuse. The nurse understands that the
parents may be concerned about
Question Number 6 of 40
Parents of a 6 month-old breast fed baby ask the nurse about increasing the baby's diet. Which
of the following should be added first?
A) Cereal
B) Eggs
C) Meat
D) Juice
Question Number 7 of 40
The nurse should initiate discharge planning for a client
A) when the client or family demonstrate readiness to learn self care modalities
B) when informed that a date for discharge has been determined
C) upon admission to a hospital unit or the emergency room
D) when the client's condition is stabilized on the assigned unit
The correct answer is C: upon admission to a hospital unit or the emergency room
With decreased lengths of stay, discharge plans must be incorporated into the initial plan of
care upon admission to an emergency room or hospital unit.
Black, J, Hawk, J, Keene, A. (2001). Medical-Surgical Nursing ( 6th ed). Philadelphia: Saunders.
Lewis, S.M., Heitkemper, M.M., & Dirksen, S. R. (2004). Medical-Surgical Nursing: Assessment &
management of clinical problems. St. Louis: Mosby.
Question Number 8 of 40
The parents of a 2 year-old child report that he has been holding his breath whenever he has
temper tantrums. What is the best action by the nurse?
The correct answer is C: Advise the parents to ignore breath holding because breathing will
begin as a reflex
If temper tantrums are accompanied by breath holding, the parents need to know that this
behavior will not result in harm to the child. Ignoring the breath holding is the best response to
this benign behavior.
Wong, D.L., Perry, S.E., & Hockenberry, M.J. (2002). Maternal Child Nursing. (2nd edition).
Mosby: St. Louis, Missouri.
Potts, N.L. and Mandleco, B.L. (2002). Pediatric nursing, caring for children and their families.
USA: Thompson, Delmar, Learning.
Question Number 9 of 40
A nurse admits a 3 week-old infant to the special care nursery with a diagnosis of
bronchopulmonary dysplasia. As the nurse reviews the birth history, which data would be most
consistent with this diagnosis?
The correct answer is D: The infant received mechanical ventilation for 2 weeks
Bronchopulmonary dysplasia is an iatrogenic disease caused by therapies such as use of
positive-pressure ventilation used to treat lung disease.
Ashwill, J., Droske, S. & James, S. (2002). Nursing care of children: principles and practice
(2nd ed.). Philadelphia: Saunders.
McCampbell, L.S. & Rentro, A.R. (2002). Wongs Nursing Care of Infants and Children. (7th
edition). St. Louis, Missouri: Mosby.
Question Number 10 of 40
In planning care for a 6 month-old infant, what must the nurse provide to assist in the
development of trust?
A) Food
B) Warmth
C) Security
D) Comfort
Question Number 11 of 40
While caring for a toddler with croup, which initial sign of croup requires the nurse's immediate
attention?
A) Respiratory rate of 42
B) Lethargy for the past hour
C) Apical pulse of 54
D) Coughing up copious secretions
Question Number 12 of 40
A client has been admitted with complaints of lower abdominal pain, difficulty swallowing,
nausea, dizziness, headache and fatigue. The client is agitated, fearful, tachycardic and
complains of being "too sick to return to work." The client is diagnosed as having somatoform
disorder. In formulating a plan of care, the nurse must consider that the client's behavior
Question Number 13 of 40
A nurse has just received a medication order which is not legible. Which statement best
reflects assertive communication?
A) "I cannot give this medication as it is written. I have no idea of what you
mean."
B) "Would you please clarify what you have written so I am sure I am reading it
correctly?"
C) "I am having difficulty reading your handwriting. It would save me time if you
would be more careful."
D) "Please print in the future so I do not have to spend extra time attempting to
read your writing."
The correct answer is B: "Would you please clarify what you have written so I am sure I am
reading it correctly?"
Assertive communication respects the rights and responsibilities of both parties. This statement
is an honest expression of concern for safe practice and a request for clarification without self-
depreciation. It reflects the right of the professional to give and receive information.
Potter P. and Perry, A. (2005). Fundamental of Nursing. (6th Edition). St. Louis, Missouri:
Mosby.
Marquis, B. & Huston, C. (2002). Leadership roles and Management Functions in Nursing.
Philadelphia: Lippincott williams and Wilkins.
Question Number 14 of 40
A new nurse manager is seeking a mentor in the administrative realm. Which of these
characteristics is a priority for the outcome of a positive experience with a mentor?
Question Number 15 of 40
Following surgery for placement of a ventriculoperitoneal (VP) shunt as treatment for
hydrocephalus, the parents question why the infant has a small abdominal incision. The best
response by the nurse would be to explain that the incision was made in order to
The correct answer is A: pass the catheter into the abdominal cavity
The preferred procedure in the surgical treatment of hydrocephalus is placement of a
ventriculoperitoneal shunt. This shunt procedure provides primary drainage of the
cerebrospinal fluid from the ventricles to an extracranial compartment, usually the
peritoneum. A small incision is made in the upper quadrant of the abdomen so the shunt can be
guided into the peritoneal cavity.
Hockenberry, M.J., Wilson, D., Winklestein, M.L., & Kline, N.E. (2003). Wongs Nursing Care of
Infants and Children, (7th ed). St. Louis: Mosby.
Potts, N.L. and Mandleco, B.L. (2002). Pediatric nursing, caring for children and their families.
USA: Thompson, Delmar, Learning.
Question Number 16 of 40
The nurse is caring for a pre-adolescent client in skeletal Dunlop traction. Which nursing
intervention is appropriate for this child?
The correct answer is A: Make certain the child is maintained in correct body alignment.
Observe for correct body positioning with emphasis on alignment of shoulders, hips, and legs.
McCampbell, L.S. & Rentro, A.R. (2002). Wongs Nursing Care of Infants and Children. (7th
edition). St. Louis, Missouri: Mosby.
Potts, N.L. and Mandleco, B.L. (2002). Pediatric nursing, caring for children and their families.
USA: Thompson, Delmar, Learning.
Question Number 17 of 40
A client is admitted with low T3 and T4 levels and an elevated thyroid stimulating hormone
(TSH) level. On initial assessment, the nurse would anticipate which of the following findings?
A) Lethargy
B) Heat intolerance
C) Diarrhea
D) Skin eruptions
Question Number 18 of 40
Which statement by a parent would alert the nurse to assess for iron deficiency anemia in a 14
month-old child?
The correct answer is B: "My child doesn''t like many fruits and vegetables, but she really loves
her milk."
About 2 to 3 cups of milk a day are sufficient for the young child''s needs. Sometimes excess
milk intake, a habit carried over from infancy, may exclude many solid foods from the diet. As
a result, the child may lack iron and develop a so-called milk anemia. Although the majority of
infants with iron deficiency are underweight, many are overweight because of excessive milk
ingestion.
Hockenberry, M.J., Wilson, D., Winklestein, M.L., & Kline, N.E. (2003). Wongs Nursing Care of
Infants and Children, (7th ed). St. Louis: Mosby.
Ashwill, J., Droske, S. & James, S. (2002). Nursing care of children: principles and pr actice
(2nd ed.). Philadelphia: Saunders.
Question Number 19 of 40
When providing nursing measures to relieve a 102-degree Fahrenheit fever in a toddler with an
infection, what is the most effective intervention?
The correct answer is A: Use medications to lower the temperature set point
Conditions such as infection, malignancy, allergy, central nervous system lesion and radiation
cause the temperature set-point to be raised. Because the temperature set point is normal in
hyperthermia and elevated in fever, different measures must be taken in order to be effective.
The most effective intervention in the management of fever is the administration of
antipyretics which lower the set point. Too rapid cooling of a febrile child can lead to seizure
activity.
Wong, D.L., Perry, S.E., & Hockenberry, M.J. (2002). Maternal Child Nursing. (2nd edition).
Mosby: St. Louis, Missouri.
Potts, N.L. and Mandleco, B.L. (2002). Pediatric nursing, caring for children and their families.
USA: Thompson, Delmar, Learning.
Question Number 20 of 40
The nurse is assessing a client in the emergency room. Which statement suggests that the
problem is acute angina?
The correct answer is A: "My pain is deep in my chest behind my breast bone."
The pain of angina is usually localized chest pain.
Ignatavicius, D., and Workman, L. (2002). Medical-Surgical Nursing Critical Thinking for
Collaborative Care (4th ed.). Philadelphia: Saunders.
Black, J, Hawk, J, Keene, A. (2001). Medical-Surgical Nursing ( 6th ed). Philadelphia: Saunders.
Question Number 21 of 40
The nursing care plan for a toddler diagnosed with Kawasaki disease (mucocutaneous lymph
node syndrome) should be based on the high risk for development of which problem?
Question Number 22 of 40
The nurse should initiate discharge planning for a client
A) when the client or family demonstrate readiness to learn self care modalities
B) when informed that a date for discharge has been determined
C) upon admission to a hospital unit or the emergency room
D) when the client's condition is stabilized on the assigned unit
The correct answer is C: upon admission to a hospital unit or the emergency room
With decreased lengths of stay, discharge plans must be incorporated into the initial plan of
care upon admission to an emergency room or hospital unit.
Black, J, Hawk, J, Keene, A. (2001). Medical-Surgical Nursing ( 6th ed). Philadelphia: Saunders.
Lewis, S.M., Heitkemper, M.M., & Dirksen, S. R. (2004). Medical-Surgical Nursing: Assessment &
management of clinical problems. St. Louis: Mosby.
Question Number 23 of 40
While working with an obese adolescent, it is important for the nurse to recognize that obesity
in adolescence is most often associated with what other finding?
A) Sexual promiscuity
B) Poor body image
C) Dropping out of school
D) Drug experimentation
Question Number 24 of 40
What is the most important consideration when teaching parents how to reduce risks in the
home?
Question Number 25 of 40
Hospital staff requests that the parents with a Greek heritage of a hospitalized infant remove
the amulet from around the child's neck. The parents refuse. The nurse understands that the
parents may be concerned about
Question Number 26 of 40
Alcohol and drug abuse impairs judgment and increases risk taking behavior. What nursing
diagnosis best applies?
Question Number 27 of 40
A nurse admits a 3 week-old infant to the special care nursery with a diagnosis of
bronchopulmonary dysplasia. As the nurse reviews the birth history, which data would be most
consistent with this diagnosis?
The correct answer is D: The infant received mechanical ventilation for 2 weeks
Bronchopulmonary dysplasia is an iatrogenic disease caused by therapies such as use of
positive-pressure ventilation used to treat lung disease.
Ashwill, J., Droske, S. & James, S. (2002). Nursing care of children: principles and practice
(2nd ed.). Philadelphia: Saunders.
McCampbell, L.S. & Rentro, A.R. (2002). Wongs Nursing Care of Infants and Children. (7th
edition). St. Louis, Missouri: Mosby.
Question Number 28 of 40
A nurse is eating in the hospital cafeteria when a toddler at a nearby table chokes on a piece
of food and appears slightly blue. The appropriate initial action should be to
Question Number 29 of 40
Delirium tremens could best be described as
Question Number 30 of 40
The nurse is discussing negativity with the parents of a 30 month-old child. How should the
nurse tell the parents to best respond to this behavior?
The correct answer is C: Use patience and a sense of humor to deal with this behavior
The nurse should help the parents see that negativity as a normal part of growth of autonomy
in the toddler. They can best handle the negative toddler by using patience and humor.
Weber, J., and Kelley, J. (2003). Health Assessment in Nursing. (2nd edition). Philadelphia, PA:
Lippincott Williams & Wilkins.
Wong, D.L., Perry, S.E., & Hockenberry, M.J. (2002). Maternal Child Nursing. (2nd edition).
Mosby: St. Louis, Missouri.
Question Number 31 of 40
The nurse is talking by telephone with a parent of a 4 year-old child who has chickenpox.
Which of the following demonstrates appropriate teaching by the nurse?
The correct answer is C: Papules, vesicles, and crusts will be present at one time
All 3 stages of the chicken pox lesions will be present on the child''s body at the same time.
Wong, D.L., Perry, S.E., & Hockenberry, M.J. (2002). Maternal Child Nursing. (2nd edition).
Mosby: St. Louis, Missouri.
Potts, N.L. and Mandleco, B.L. (2002). Pediatric nursing, caring for children and their families.
USA: Thompson, Delmar, Learning.
Question Number 32 of 40
The nurse is planning care for a client during the acute phase of a sickle cell vaso-occlusive
crisis. Which of the following actions would be most appropriate?
Question Number 33 of 40
The nurse is assessing a healthy child at the 2 year check up. Which of the following should the
nurse report immediately to the health care provider?
Question Number 34 of 40
The nurse is caring for a client with a pressure ulcer on the heel that is covered with black hard
tissue. Which would be an appropriate goal in planning care for this client?
Question Number 35 of 40
A victim of domestic violence states, "If I were better, I would not have been beat." Which
feeling best describes what the victim may be experiencing?
A) Fear
B) Helplessness
C) Self-blame
D) Rejection
Question Number 36 of 40
The emergency room nurse admits a child who experienced a seizure at school. The parent
comments that this is the first occurrence and denies any family history of epilepsy. What is
the best response by the nurse?
The correct answer is B: "The seizure may or may not mean your child has epilepsy."
There are many possible causes for a childhood seizure. These include fever, central nervous
system conditions, trauma, metabolic alterations and idiopathic (unknown) etiologies.
Ashwill, J., Droske, S. & James, S. (2002). Nursing care of children: principles and practice
(2nd ed.). Philadelphia: Saunders.
McCampbell, L.S. & Rentro, A.R. (2002). Wongs Nursing Care of Infants and Children. (7th
edition). St. Louis, Missouri: Mosby.
Question Number 37 of 40
A child is sent to the school nurse by a teacher who has a written note that fifth disease is
suspected. Which characteristic would the nurse expect to find?
Question Number 38 of 40
Parents of a 6 month-old breast fed baby ask the nurse about increasing the baby's diet. Which
of the following should be added first?
A) Cereal
B) Eggs
C) Meat
D) Juice
Question Number 39 of 40
The nurse is assessing the mental status of a client admitted with possible organic brain
disorder. Which of these questions will best assess the functioning of the client's recent
memory?
A) "Name the year." "What season is this?" (pause for answer after each question)
B) "Subtract 7 from 100 and then subtract 7 from that." (pause for answer) "Now
continue to subtract 7 from the new number."
C) "I am going to say the names of three things and I want you to repeat them
after me: blue, ball, pen."
D) "What is this on my wrist?" (point to your watch) Then ask, "What is the purpose
of it?"
The correct answer is C: "I am going to say the names of three things and I want you to repeat
them after me: blue, ball, pen."
Recent memory is the ability to recall events in the immediate past and up to 2 weeks
previously.
Estes, M.E.Z. (2002). Health Assessment and Physical Examination, (2nd Ed). Albany, NY:
Delmar.
Phipps, W., Monahan, F., Sands, J., Marke, J., Neighbors, N. (2003). Medical-Surgical Nursing:
Health and Illness Perspectives. (7th Edition). Mosby: St. Louis, Missouri.
Question Number 40 of 40
The nurse sees a substance abusing client occasionally in the outpatient clinic. In evaluating
the client's progress, the nurse recognizes that the most revealing resistant behavior is
A) recurring crises
B) continuing drug use
C) rationalizing comments
D) missing appointments