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    Exam Review

    1. A nurse is preparing to administer a prescribed medication to a toddler whose parent is nearby. Which of the following actions should the nurse take to identify the toddler?
      A)
      Ask another nurse to confirm the toddler's identity.
      B)
      Ask the parent to confirm the toddler's identity.
      C)
      Check the toddler's room number against their ID band.
      D)
      Check the toddler's ID band against the medical record.
    2. A nurse is caring for a group of clients. Which of the following clients should the nurse assess first?
      A)
      A 12-year-old child who reports pain as 8 on a scale of 0 to 10
      B)
      A 3-week-old infant who has substernal retractions
      C)
      A 6-year-old child who has hypokalemia
      D)
      A 4-month-old infant who has plagiocephaly
    3. A nurse is caring for a 15-year-old adolescent who is receiving a transfusion of packed RBCs. Complete the diagram by dragging from the choices below to specify what condition the adolescent is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the adolescent's progress.
      ✓Stop the transfusion and keep IV line open with normal saline
      ✓Notify the healthcare provider immediately
      ✓Acute hemolytic transfusion reaction
      ✓Temperature changes
      ✓Urine output and urine color
      Action to Take Choices
      ✕Plan to administer epinephrine.
      ✕insert an indwelling urinary catheter with urometer
      ✓Stop the transfusion and keep IV line open with normal saline
      ✓Notify the healthcare provider immediately
      ✕Administer antihistamine (diphenhydramine) IV
      Condition Most Likely Experiencing
      ✕Circulatory overload transfusion reaction
      ✕Allergic transfusion reaction
      ✓Acute hemolytic transfusion reaction
      ✕Septic transfusion reaction
      Parameter to Monitor
      ✕Presence of Jugular vein distension
      ✕Blood calcium levels
      ✕Oxygen saturation
      ✓Temperature changes
      ✓Urine output and urine color
    4. A nurse on the pediatric unit is caring for an Infant. Drag words from the choices below to fill in each blank in the following sentence. It would be a priority for the nurse to ▾ apply 100% oxygen via facemask and ▾ initiate a peripheral IV.  
      Dropdown 1:
      Option 1: administer acetaminophen
      Option 2: apply 100% oxygen via facemask
      Option 3: auscultate breath sounds
      Option 4: reassure the parent
      Dropdown 2:
      Option 1: administer acetaminophen
      Option 2: initiate a peripheral IV
      Option 3: auscultate breath sounds
      Option 4: reassure the parent
    Page 1 of 18

    Exam Review

    1. A nurse is caring for a child in the emergency department. For each of the child's findings, click to specify if the finding is consistent with rheumatic fever or Kawasaki disease. Each finding may support mor e than 1 disease process or none at all. There must be at least 1 selection in every column. There does not need to be a selection in every row.
      Rheumatic FeverKawasaki Disease
      Temperature✓✓
      Laboratory results✓
      Skin findings✓✓
      Pain characteristics✓
      Mucous membranes✓
      Findings on hands and feet✓
    2. A nurse is providing fluid replacement for a preschool aged child who is dehydrated. Which of the following findings should indicate that the treatment has been effective?
      A)
      Tachycardia
      B)
      Increased urine output
      C)
      Child reports being thirsty
      D)
      Capillary refill 3 seconds
    3. A nurse is providing teaching to the guardian of an infant who has heart failure. Which of the following instructions should the nurse include?
      A)
      Minimize the infant's environmental stimuli.
      B)
      Place the infant in a supine position.
      C)
      Bathe the infant every day
      D)
      Allow the infant to sleep through night feedings
    4. A nurse is caring for a group of children on a pediatric unit. The nurse should identify that which of the following diagnoses may increase the risk of falls?
      A)
      An infant who has constipation
      B)
      A child who has asthma
      C)
      An adolescent who has neutropenia
      D)
      A toddler who has strabismus
    Page 2 of 18

    Exam Review

    1. A nurse is planning care for an infant following a cardiac catheterization. Which of the following interventions should the nurse include in the plan?
      A)
      Monitor the color of the affected extremity.
      B)
      Maintain NPO status for 8 hr.
      C)
      Assess vital signs every 4 hr.
      D)
      Keep the affected extremity fixed.
    2. A nurse is assessing a preschooler who has Kawasaki disease. Which of the following findings should the nurse expect?
      A)
      Pale conjunctiva
      B)
      Swollen lymph nodes in the groin
      C)
      Strawberry tongue
      D)
      Vesicular rash on the axilla
    3. A nurse is communicating with a child who has hearing loss. Which of the following actions should the nurse take?
      A)
      Change positions frequently to maintain the child's attention.
      B)
      Exaggerate the pronunciation of words.
      C)
      Use light touch when initiating conversation.
      D)
      Maintain a neutral facial expression when speaking to the child.
    4. A nurse is caring for a school-age child who is postoperative following surgical removal of their tonsils. Which of the following manifestations should the nurse identify as a potential complication?
      A)
      Continuous swallowing
      B)
      Inflamed throat
      C)
      impaired taste
      D)
      Dark blood in emesis
    Page 3 of 18

    Exam Review

    1. A nurse is caring for a school-age child who has a new prescription for Buck's traction. Which of the following actions should the nurse take?
      A)
      Adjust the weights to allow the child to turn.
      B)
      Perform pin care every 24 hr.
      C)
      Ensure the pulley mechanism is attached to the child' skin.
      D)
      Offer opioid medications frequently to reduce pain.
    2. A nurse is caring for a child who has impetigo contagiosa that developed in the hospital. Which of the following actions should the nurse take?
      A)
      Administer amphotericin B IV.
      B)
      Initiate contact isolation precautions.
      C)
      Apply lidocaine ointment topically.
      D)
      Report the disease to the state health department.
    3. A nurse is assessing a client who is receiving radiation therapy to the chest. The client reports having an area of dry skin where they received radiation. Which of the following interventions should the nurse suggest to the client?
      A)
      Apply an over-the-counter skin lotion to the area as needed.
      B)
      Clean the area daily with a solution of chlorhexidine and water.
      C)
      Cover the area with protective clothing if exposed to the sun.
      D)
      Remove skin markings for the radiation fields following therapy.
    4. A nurse in the emergency department is assessing a preschooler who was brought in by a parent and has injuries consistent with physical maltreatment. Which of the following actions should the nurse take when interviewing the child?
      A)
      Document subjective information after the interview.
      B)
      Encourage the parent to remain with the child.
      C)
      Conduct the interview in a semi-private room.
      D)
      Allow the child to have their favorite stuffed animal.
    Page 4 of 18

    Exam Review

    1. A nurse is caring for a child who is terminally ill and whose guardians tell the nurse, "Our child will be fine. After all, we have heard of other children who have survived this same illness." Which of the following responses should the nurse make?
      A)
      "It is possible that your child will beat this illness."
      B)
      "Let's talk about some happy memories with your child."
      C)
      "Your child will survive this illness if it is God's will."
      D)
      "Tell me what you know about your child's illness."
    2. A nurse is caring for a school-age child who is 1hr postoperative following a tonsillectomy. Which of the following actions should the nurse take? (Select all that apply.)
      A)
      Maintain the child in a supine position.
      B)
      Observe the child for frequent swallowing.
      C)
      Discourage the child from coughing.
      D)
      Provide cranberry juice to the child.
      E)
      Administer an analgesic to the child on a scheduled basis.
    3. A school nurse is providing teaching to the guardian of a child who has pediculosis. Which of the following statements by the guardian indicates an understanding of the teaching?
      A)
      "I will place hairbrushes, combs, and hair accessories in boiling water for 10 minutes."
      B)
      "I will seal nonwashable items in a plastic bag for 1 week."
      C)
      "I will use the medicated shampoo on my child's hair daily for 3 days."
      D)
      "I will wash my child's clothing and bedding using a double rinse."
    4. A nurse in the emergency department is caring for a preschooler who has acetaminophen toxicity. The nurse should expect the provider to prescribe which of the following medications?
      A)
      Acetylcysteine
      B)
      Disulfiram
      C)
      Deferoxamine
      D)
      Naloxone
    Page 5 of 18

    Exam Review

    1. A nurse is providing teaching to a parent about sudden unexpected infant death (SUID). Which of the following statements should the nurse include?
      A)
      "Place your infant on a soft crib mattress after they are 4 months old."
      B)
      "Use bumper pads around the interior of your infant's crib."
      C)
      "Share a bedroom with your infant for the first 6 months."
      D)
      Cover your infant with a nonflammable blanket at bedtime."
    2. A nurse is caring for a preschool-age child who is postoperative following a tonsillectomy and is clearing her throat frequently. Which of the following actions should the nurse take first?
      A)
      Give the child small sips of water.
      B)
      Administer an analgesic
      C)
      Observe the child's throat with a flashlight.
      D)
      Offer the child an ice collar.
    3. A home health nurse is providing teaching to the guardian of a preschooler who is neutropenic. Which of the following instructions should the nurse include?
      A)
      Allow the child to have frequent playdates.
      B)
      Provide the child with a soft toothbrush.
      C)
      Encourage the child to eat fresh vegetables.
      D)
      Bathe the child every other day.
    4. A nurse is caring for a 2-year-old child who is postoperative and experiencing pain. Which of the following actions should the nurse take?
      A)
      Instruct the child to use bubbles to blow the hurt away.
      B)
      Develop a behavioral contract plan with the child.
      C)
      Encourage the child to remain calm and quiet.
      D)
      Tell the parent to bounce the child softly on their knee.
    Page 6 of 18