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    Exam Review

    1. A home health nurse is doing the first intake visit for a child who has hemiplegic cerebral palsy. When developing a plan of care for this child, which of the following goals is the priority for the nurse to include in the plan of care?
      A)
      Provide activities of daily living for the child
      B)
      Modify the home for safety
      C)
      Provide respite services for the parents
      D)
      Improve the client's communication skills
    2. The nurse is caring for a school-age girl who had an arterial cardiac catheterization. The child tells the nurse that the bandage is "wet." On assessment, the bandage and bed are soaked with blood. The nurse must do which of the following FIRST?
      A)
      Apply direct pressure at the site and one inch above the catheterization site
      B)
      Notify the interventional cardiologist and the catheterization lab
      C)
      Place the bed in the Trendelenburg position
      D)
      Reinforce the bandage by applying a new bandage, over the present dressing
    3. The nurse is caring for a preschool aged child immediately following an open repair of a Ventricular Septal Defect. There has been no drainage from the mediastinal chest tubes in the last 2 hours. Based on this finding what will be the nurse's priority intervention?
      A)
      Document the Information as this is an expected finding.
      B)
      Encourage the child to cough, and deep breathe
      C)
      Immediately report this finding as this is life threatening
      D)
      Assist the child to a sitting position to prove drainage
    4. A nurse is speaking with the parents of a 4-year-old boy who has a cerebral palsy. The parents tell the nurse they have taken their son's name off the list for baseball next season. Which of the following is the BEST response for the nurse to make?
      A)
      "Baseball cannot be adapted and it is best if he does not participate."
      B)
      "Could you try enrolling him in a music or arts based activity?"
      C)
      "Would you like to talk about your decision and discuss alternatives?"
      D)
      “That was a good choice. I'm sure he is upset that he cannot play baseball anymore.”
    Page 1 of 9

    Exam Review

    1. A school aged child is being evaluated for possible glomerulonephritis. During the physical exam the nurse recognizes that which of the following, is a possible cause?
      A)
      History of a runny nose and itchy eyes within the last week
      B)
      Treatment for a viral illness within the last seven days
      C)
      Treatment for a urinary tract infection within the last ten days
      D)
      Treatment for strep throat within the last two weeks
    2. A home health nurse is doing the first intake visit for a child who has hemiplegic cerebral palsy. When developing a plan of care for this child, which of the following goals is the priority for the nurse to include in the plan of care?
      A)
      Provide all activities of daily living for the child
      B)
      Modify the home for safety
      C)
      Provide respite services for the parents
      D)
      Improve the client's communication skills
    3. The nurse is admitting a 6-year-old child with Sickle Cell Anemia who is being admitted for vaso-occlusive crisis. Exhibits The nurse is planning the nursing care for this child and anticipates which of the following to be a part of the plan of care for a child in vaso-occlusive crisis? For each potential intervention, click to specify if the intervention is anticipated or contraindicated.
      AnticipatedContraindicated
      Monitor RLE pulses with vital signs✓
      Administer Oxycodone 3 mg Q3-4 hours PRN for pain✓
      Continue IV NSS bolus @ 67 ml/hour✓
      Decrease 02 to 2 L/min
    4. A 2-year-old child is diagnosed with neuroblastoma. The nurse understands that which of the following tests help to determine the extent of tumor metastasis?
      A)
      Basic Metabolic Lab Panel
      B)
      Lumbar puncture
      C)
      Head CT
      D)
      Biopsy
    Page 2 of 9

    Exam Review

    1. A 3-year-old child with congestive heart failure resulting from an underlying congenital heart defect, is prescribed digoxin and furosemide. Which of the following assessment findings are MOST concerning?
      A)
      A blood pressure of 100/56 and a small weight gain
      B)
      A heart rate of 150 beats/minute with crying
      C)
      An apical pulse of 70 beats/minute and vomiting
      D)
      An hourly urine output of 45mL/hour
    2. The nurse understands that in the preoperative period the infant with a myelomeningocele must be placed in which of the following positions?
      A)
      Prone and in full Trendelenburg
      B)
      Supine with head slightly elevated
      C)
      Side-lying with head slightly elevated
      D)
      Prone with hips flexed and legs abducted
    3. The nurse is reviewing 24-hour Holter monitor diaries of various patients. Which of the following entries is the MOST complete?
      A)
      VS at 0900: T-37.3, P-102, R-20
      B)
      1400: Basketball practice, dizzy, no loss of consciousness, no caffeine today.
      C)
      Electrodes on upper left and right chest and lower left rib area.
      D)
      Breakfast: Eggs and Toast, Lunch: Chicken Noodle Soup, Dinner: Chicken nuggets and fries.
    4. The mother of a newborn child does not wish for her child to receive immunizations because she has read that immunizations, especially MMR vaccine, cause autism. Which of the following statements by the nurse is the FIRST response?
      A)
      "I understand, the studies have shown a link between Autism and immunizations."
      B)
      "OK, but you must sign an Against Medical Advise Form releasing us from responsibility."
      C)
      "It is your right to choose to immunize or not to immunize your child."
      D)
      "Current studies support that there is no link between immunizations and Autism."
    Page 3 of 9

    Exam Review

    1. The nurse is caring for a child post bone marrow transplantation who has been diagnosed with graft versus host disease. The parents ask the nurse how this will be treated. Which of the following would be the nurse's BEST response?
      A)
      "There is currently no treatment available for graft vs host disease."
      B)
      "Your child will need to undergo a full cycle of high dose chemotherapy again."
      C)
      "It is the responsibility of the oncologist to determine the treatment plan."
      D)
      Typically we start by giving steroids and immunosuppressive drugs."
    2. The nurse must administer the following antibiotic via syringe pump. (SEE IMAGE). The infusion is to run over 90 minutes. The nurse calculates the infusion rate and sets the pump for the following rate
    3. The nurse is assessing a school aged child with ADHD. The child is prescribed dexamethylphenidate 10mg before breakfast and lunch. Which of the following findings is of MOST concern to the nurse?
      A)
      Sleeping 8 to 10 hours a night
      B)
      Heart rate 90 beats per minute at rest
      C)
      Blood pressure reading of 140/90
      D)
      Weight gain of 2 kgs since last visit
    4. For a child diagnosed with a Wilm's tumor. The nurse recognizes that which of the following is MOST important intervention when planning care for this child?
      A)
      Avoiding further palpation of the abdomen
      B)
      Obtaining an accurate height and weight
      C)
      Monitoring vital signs
      D)
      Assessing the urine for the presence of blood
    Page 4 of 9

    Exam Review

    1. The nurse is discussing the importance of immunizations with the mother of a child with Cystic Fibrosis (CF) for immunizations. Which statement is the best response?
      A)
      "Your child should not receive any hepatitis vaccine, but all other vaccines are fine"
      B)
      "Your child needs all typical immunizations as well as a yearly pneumococcal and influenza vaccine."
      C)
      "We will not be able to give all the required immunizations to your child."
      D)
      "Your child will can receive all immunizations except for the polio vaccine."
    2. The nurse is preparing to administer the daily maintenance dose of digoxin to an infant: Infant's Weight: 5kg Order: Administer 4mcg/kg/day Safe Dose: 3.4 to 5.1 mcg/kg/day Label: 0.25 mg/5mL
    3. A school aged child with ADHD was recently switched from a methylphenidate to atomoxetine. The nurse recognizes a need for further teaching when the parents make which of the following statements?
      A)
      "We can open the capsule and sprinkle it on food."
      B)
      "We will be able to stop the medication on weekends and holidays."
      C)
      This medication may cause drowsiness, fatigue and dry mouth."
      D)
      "It will take 2 to 3 weeks to see the positive effects of this medication."
    4. The nurse understands that which of the following interventions is the MOST effective at relieving pain and discomfort during a bone marrow aspiration and biopsy for a school-aged child?
      A)
      Applying lidocaine cream over the site immediately before the procedure
      B)
      Utilizing relaxation techniques.
      C)
      Assisting with conscious/unconscious sedation
      D)
      Administering Acetaminophen.
    Page 5 of 9

    Exam Review

    1. An emergency room nurse is assessing a toddler with multiple bruises and burns in various stages of healing. The nurse suspects that the toddler has been abused, however the physician disagrees. What is the nurse's priority at this time?
      A)
      Nothing, as toddler's frequently fall and have multiple injuries in the home
      B)
      Report the suspicions about abuse to the proper authorities (Child Protective Services)
      C)
      Discuss the findings with the physician to collaborate and initiate a plan of care
      D)
      Immediately verbally confront the caregivers about the suspicious injuries
    2. A nurse working in an immunization clinic is caring for a 12-month-old infant who is receiving chemotherapy for neuroblastoma. Which of the following immunizations CANNOT be given to this infant at this time?
      A)
      HIB
      B)
      IPV
      C)
      Varicella
      D)
      DTaP
    3. A nurse is planning care for a 5-month-old infant who is scheduled for a lumbar puncture to rule out meningitis. Which of the following actions is the MOST important for the nurse to include in the plan of care?
      A)
      Keep the infant NPO for 6 hours prior the procedure
      B)
      Prepare to insert Foley catheter for urine collection
      C)
      Hold the infant's chin to his chest and knees to his abdomen during the procedure.
      D)
      Place the infant in an infant seat for 2 hours following the procedure.
    4. The nurse is providing anticipatory guidance teaching to the parents of a newborn infant geared toward reducing child abuse. Which of the following would be the priority topic of discussion to meet this goal?
      A)
      Amount of clothing appropriate; avoiding exposure to hot and cold temperatures
      B)
      Skin and nail care, tub bathing, use of soaps, lotions, and care of diaper area
      C)
      Recognition of increased crying during the 1st month and a need for emotional support person
      D)
      Recognition of normal feeding patterns and steps in the order of food introduction
    Page 6 of 9