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Question Number 1 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?
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?

A) Make certain the child is maintained in correct body alignment.


B) Be sure the traction weights touch the end of the bed.
C) Adjust the head and foot of the bed for the child's comfort
D) Release the traction for 15-20 minutes every 6 hours PRN.

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

The correct answer is C: Administer analgesic therapy as ordered


The main general interventions in the treatment of a sickle cell crisis are bed rest, hydration,
electrolyte replacement, analgesics for pain, blood replacement, and antibiotics to treat any
existing infection.

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

A) mental development delays


B) evil eye or envy of others
C) fright from spiritual beings
D) balance in body systems

The correct answer is B: evil eye or envy of others


Matiasma, "Bad eye" or "evil eye, " results from the envy or admiration of others. The belief is
that the eye is able to harm a wide variety of things, including inanimate objects, but children
are particularly susceptible to attack. Persons of Greek heritage employ a variety of preventive
mechanisms to thwart the effects of envy, including protective charms in the form of amulets
consisting of blessed wood or incense.
Leininger, M. & McFarland, M. (2002). Transcultural Nursing: Concepts, Theories, Research and
Practice. New York: McGraw Hill/ Appleton and Long.
Potter P. and Perry, A. (2005). Fundamental of Nursing. (6th Edition). St. Louis, Missouri:
Mosby.

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

The correct answer is A: Cereal


The guidelines of the American Academy of Pediatrics recommend that one new food be
introduced at a time, beginning with strained cereal.
Lutz, C.A. and Prytulski, K.R. (2001). Nutrition and diet therapy. (3rd edition). Philadelphia:
F.A. Davis Company.
Wong, D.L., Perry, S.E., & Hockenberry, M.J. (2002). Maternal Child Nursing. (2nd edition).
Mosby: St. Louis, Missouri.

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?

A) Teach the parents how to perform cardiopulmonary resuscitation


B) Recommend that the parents give in when he holds his breath to prevent
anoxia
C) Advise the parents to ignore breath holding because breathing will begin as a
reflex
D) Instruct the parents on how to reason with the child about possible harmful
effects

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?

A) Gestational age assessment suggested growth retardation


B) Meconium was cleared from the airway at delivery
C) Phototherapy was used to treat Rh incompatibility
D) The infant received mechanical ventilation for 2 weeks

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

The correct answer is C: Security


While the infant has many physical needs, it must be touched, loved, and stimulated to
develop security and trust.
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 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

The correct answer is A: Respiratory rate of 42


Signs of impending airway obstruction include increased respiratory rate and pulse; substernal,
suprasternal and intercostal retractions; flaring nares; and increased restlessness or agitation.
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 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

A) is controlled by their subconscious mind


B) is manipulative to avoid work responsibilities
C) would respond to psychoeducational strategies
D) could be modified through reality therapy

The correct answer is A: is controlled by their subconscious mind


Persons with somatoform disorder do not intend to feign illness; their complaints are not under
their conscious control. Showing intention to use feigned physical complaints to accomplish
some goal is called "malingering" or a factitious disorder.
Fontaine, K.L. (2003). Mental Health Nursing, (5th ed.). Upper Saddle River, NJ: Prentice-Hall.
Varcarolis, E. (2002). Foundations of Psychiatry Mental Health Nursing A Clinical Approach (4th
ed.). Philadelphia: Saunders.

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?

A) Information is clarified as needed


B) A teacher-coach role is taken by the mentor
C) The mentee accepts feedback objectively
D) The mentor is randomly assigned by administration

The correct answer is B: A teacher-coach role is taken by the mentor


Both the mentor and mentee, the nurse manager, initially need to be open to a positive
learning experience. The teacher-coach is the priority for the outcome of an ideal relationship.
Marquis, B. & Huston, C. (2002). Leadership roles and Management Functions in Nursing.
Philadelphia: Lippincott williams and Wilkins.
Yoder Wise, P. (2002). Leading and Managing in Nursing. St. Louis: Mosby.

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

A) pass the catheter into the abdominal cavity


B) place the tubing into the urinary bladder
C) visualize abdominal organs for catheter placement
D) insert the catheter into the stomach

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?

A) Make certain the child is maintained in correct body alignment.


B) Be sure the traction weights touch the end of the bed.
C) Adjust the head and foot of the bed for the child's comfort
D) Release the traction for 15-20 minutes every 6 hours PRN.

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

The correct answer is A: Lethargy


In hypothyroidism the metabolic activity of all cells of the body decreases, reducing oxygen
consumption, decreasing oxidation of nutrients for energy, and producing less body heat.
Therefore, the nurse can expect the client to complain of constipation, lethargy and an
inability to get warm.
Ignatavicius, D., and Workman, L. (2002). Medical-Surgical Nursing Critical Thinking for
Collaborative Care (4th ed.). Philadelphia: Saunders.
Potter P. and Perry, A. (2005). Fundamental of Nursing. (6th Edition). St. Louis, Missouri:
Mosby.

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?

A) "I know there is a problem since my baby is always constipated."


B) "My child doesn't like many fruits and vegetables, but she really loves her milk."
C) "I can't understand why my child is not eating as much as she did 4 months
ago."
D) "My child doesn't drink a whole glass of juice or water at 1 time."

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?

A) Use medications to lower the temperature set point


B) Apply extra layers of clothing to prevent shivering
C) Immerse the child in a tub containing cool water
D) Give a tepid sponge bath prior to giving an antipyretic

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?

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 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?

A) Chronic vessel plaque formation


B) Pulmonary embolism
C) Occlusions at the vessel bifurcations
D) Coronary artery aneurysms

The correct answer is D: Coronary artery aneurysms


Kawasaki disease involves all the small and medium-sized blood vessels. There is progressive
inflammation of the small vessels which progresses to the medium-sized muscular arteries,
potentially damaging the walls and leading to coronary artery aneurysms.
Ball, J. & Bindler, R. (2003). Pediatric Nursing. Upper Saddle River, N.J.: Pearson Education.
Hockenberry, M.J., Wilson, D., Winklestein, M.L., & Kline, N.E. (2003). Wongs Nursing Care of
Infants and Children, (7th ed). St. Louis: Mosby.

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

The correct answer is B: Poor body image


As the adolescent gains weight, there is a lessening sense of self esteem and poor body image.
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 24 of 40
What is the most important consideration when teaching parents how to reduce risks in the
home?

A) Age and knowledge level of the parents


B) Proximity to emergency services
C) Number of children in the home
D) Age of children in the home

The correct answer is D: Age of children in the home


Age and developmental level of the child are most important considerations in providing a
framework for anticipatory guidance.
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 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

A) mental development delays


B) evil eye or envy of others
C) fright from spiritual beings
D) balance in body systems

The correct answer is B: evil eye or envy of others


Matiasma, "Bad eye" or "evil eye, " results from the envy or admiration of others. The belief is
that the eye is able to harm a wide variety of things, including inanimate objects, but children
are particularly susceptible to attack. Persons of Greek heritage employ a variety of preventive
mechanisms to thwart the effects of envy, including protective charms in the form of amulets
consisting of blessed wood or incense.
Leininger, M. & McFarland, M. (2002). Transcultural Nursing: Concepts, Theories, Research and
Practice. New York: McGraw Hill/ Appleton and Long.
Potter P. and Perry, A. (2005). Fundamental of Nursing. (6th Edition). St. Louis, Missouri:
Mosby.

Question Number 26 of 40
Alcohol and drug abuse impairs judgment and increases risk taking behavior. What nursing
diagnosis best applies?

Risk for injury


Risk for knowledge deficit
Altered thought process
Disturbance in self-esteem

The correct answer is A: Risk for injury


Accidents increase as a result of intoxication. Studies indicate alcohol is a factor in 50% of
motor vehicle fatalities, 53% of all deaths from accidental falls, 64% of fatal fires, and 80% of
suicides.
Fontaine, K.L. (2003). Mental Health Nursing, (5th ed.). Upper Saddle River, NJ: Prentice-Hall.
Varcarolis, E. (2002). Foundations of Psychiatry Mental Health Nursing A Clinical Approach (4th
ed.). Philadelphia: Saunders.

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?

Gestational age assessment suggested growth retardation


Meconium was cleared from the airway at delivery
Phototherapy was used to treat Rh incompatibility
The infant received mechanical ventilation for 2 weeks

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

A) begin mouth to mouth resuscitation


B) give the child water to help in swallowing
C) perform 5 abdominal thrusts
D) call for the emergency response team

The correct answer is C: perform 5 abdominal thrusts


At this age, the most effective way to clear the airway of food is to perform abdominal thrusts.
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 29 of 40
Delirium tremens could best be described as

A) disorganized thinking, feelings of terror and non-purposeful behavior


B) a generalized shaking of the body accompanied by repetitive thoughts
C) an excited state accompanied by disorientation, hallucination and tachycardia
D) single or multiple jerks caused by rapid contracting muscles

The correct answer is C: an excited state accompanied by disorientation, hallucination and


tachycardia
During delirium tremens syndrome (DTS), the client experiences confusion, disorientation,
hallucinations, tachycardia, hypertension, extreme tremors, agitation, diaphoresis, and fever.
Fontaine, K.L. (2003). Mental Health Nursing, (5th ed.). Upper Saddle River, NJ: Prentice-Hall.
Varcarolis, E. (2002). Foundations of Psychiatry Mental Health Nursing A Clinical Approach (4th
ed.). Philadelphia: Saunders.

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?

A) Reprimand the child and give a 15 minute "time out"


B) Maintain a permissive attitude for this behavior
C) Use patience and a sense of humor to deal with this behavior
D) Assert authority over the child through limit setting

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?

A) Chewable aspirin is the preferred analgesic


B) Topical cortisone ointment relieves itching
C) Papules, vesicles, and crusts will be present at one time
D) The illness is only contagious prior to lesion eruption

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?

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

The correct answer is C: Administer analgesic therapy as ordered


The main general interventions in the treatment of a sickle cell crisis are bed rest, hydration,
electrolyte replacement, analgesics for pain, blood replacement, and antibiotics to treat any
existing infection.
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 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?

A) Height and weight percentiles vary widely


B) Growth pattern appears to have slowed
C) Recumbent and standing height are different
D) Short term weight changes are uneven

The correct answer is A: Height and weight percentiles vary widely


On the growth curve, height and weight should be close in percentiles at this age. A wide
difference may indicate a problem.
Potts, N.L. and Mandleco, B.L. (2002). Pediatric nursing, caring for children and their families.
USA: Thompson, Delmar, Learning.
Wong, D.L., Perry, S.E., & Hockenberry, M.J. (2002). Maternal Child Nursing. (2nd edition).
Mosby: St. Louis, Missouri.

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?

A) Protection for the granulation tissue


B) Heal infection
C) Debride eschar
D) Keep the tissue intact

The correct answer is D: Keep the tissue intact


If the black tissue, (eschar) is dry and intact no treatment is necessary. If the area changes
(cellulitis, pain) this is a sign of infection, requiring debridement.
Ignatavicius, D., and Workman, L. (2002). Medical-Surgical Nursing Critical Thinking for
Collaborative Care (4th 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 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

The correct answer is C: Self-blame


Domestic violence victims may be immobilized by a variety of affective responses, one being
self-blame. The victim believes that a change in their behavior will cause the abuser to
become nonviolent, and may even have been told this by their abuser. This is an untrue but not
uncommon myth.
Fontaine, K.L. (2003). Mental Health Nursing, (5th ed.). Upper Saddle River, NJ: Prentice-Hall.
Varcarolis, E. (2002). Foundations of Psychiatry Mental Health Nursing A Clinical Approach (4th
ed.). Philadelphia: Saunders.

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?

A) "Do not worry. Epilepsy can be treated with medications."


B) "The seizure may or may not mean your child has epilepsy."
C) "Since this was the first convulsion, it may not happen again."
D) "Long term treatment will prevent future seizures."

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?

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 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

The correct answer is A: Cereal


The guidelines of the American Academy of Pediatrics recommend that one new food be
introduced at a time, beginning with strained cereal.
Lutz, C.A. and Prytulski, K.R. (2001). Nutrition and diet therapy. (3rd edition). Philadelphia:
F.A. Davis Company.
Wong, D.L., Perry, S.E., & Hockenberry, M.J. (2002). Maternal Child Nursing. (2nd edition).
Mosby: St. Louis, Missouri.

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

The correct answer is B: continuing drug use


Continuing to use the drug demonstrates lack of commitment to the treatment program. This
fact must be understood by the nurse as part of the disease of addiction.
Fontaine, K.L. (2003). Mental Health Nursing, (5th ed.). Upper Saddle River, NJ: Prentice-Hall.
Varcarolis, E. (2002). Foundations of Psychiatry Mental Health Nursing A Clinical Approach (4th
ed.). Philadelphia: Saunders.

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