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    Exam Review

    1. The nurse is assessing the lung sounds of a preschooler. Which action should the nurse implement to ensure the child's cooperation?
      A)
      Have the child blow a cotton ball and have the parent catch it.
      B)
      Allow the child to use a stethoscope on a stuffed animal.
      C)
      Offer the child bubbles before the stethoscope is placed.
      D)
      Place a toy in the child's hands while listening to the breath sounds.
    2. A child diagnosed with Kawasaki disease is brought to the clinic. The mother reports that her child is irritable, refuses to eat, and has skin peeling on both hands and feet. Which intervention should the nurse instruct the mother to implement first?
      A)
      Encourage the parents to rest when possible.
      B)
      Make a list of foods that the child likes.
      C)
      Place the child in a quiet environment.
      D)
      Apply lotion to hands and feet.
    3. During a follow-up clinic visit, a mother tells the nurse that her 5-month-old son who had surgical correction for tetralogy of Fallot (TOF) has rapid breathing, often takes a long time to eat, and requires frequent rest periods. The infant is not crying while being held and his growth is in the expected range. Which intervention should the nurse implement?
      A)
      Obtain a 12-lead electrocardiogram.
      B)
      Stimulate the infant to cry to produce cyanosis.
      C)
      Auscultate heart and lungs while the infant is held.
      D)
      Evaluate the infant for failure to thrive (FTT).
    4. The mother of a one-month-old infant calls the clinic to report that the back of her infant's head is flat. How should the nurse respond?
      A)
      Position the infant on the stomach occasionally when awake and active.
      B)
      Turn the infant on the left side braced against the crib when sleeping.
      C)
      Place a small pillow under the infant's head while lying on the back.
      D)
      Prop the infant in a sitting position with a cushion when not sleeping.
    Page 1 of 10

    Exam Review

    1. The nurse is caring for a one-month-old infant admitted for suspected congenital hypothyroidism. Which diagnostic test results should the nurse report to the healthcare provider?
      A)
      Luteinizing hormone (LH) levels.
      B)
      Thyroxine (T4).
      C)
      Growth hormone (GH) levels.
      D)
      Follicle stimulating hormone (FSH) levels.
    2. An adolescent with a congenital heart defect is admitted for diagnostic testing with surgery scheduled in 3 days. Which intervention should the nurse implement to best support the client's psychosocial needs?
      A)
      Enable limited time for cell phone use.
      B)
      Provide an activity room to spend time with other adolescents.
      C)
      Deliver 3 meals and snacks each day upon request.
      D)
      Allow family and friends to be present during assessments.
    3. An infant who is developmentally delayed has a ventricular peritoneal (VP) shunt for hydrocephalus. The nurse makes a postoperative home visit to assess the child's progress. During the visit, the mother tells the nurse, "When the shunt is removed, the pressure in my baby's head will be gone." Which response should the nurse provide?
      A)
      "Many infants outgrow the need for a shunt after the neonatal period."
      B)
      "The shunt will be replaced as your child grows to reduce pressure in the brain."
      C)
      "Other pathways in the brain will drain fluid after the shunt is removed."
      D)
      "The shunt will have to be reinserted only if an infection or blockage develops."
    4. An infant who has a Wilms' tumor is admitted for surgery. Which intervention should the nurse implement during the preoperative period?
      A)
      Careful bathing and handling that avoids abdominal manipulation.
      B)
      Administer pain medication based on the FACES pain scale.
      C)
      Include the prone position in the every 2 hour turning schedule.
      D)
      Give antiemetic medications to prevent nausea and vomiting.
    Page 2 of 10

    Exam Review

    1. An infant born 2 days ago has not passed a meconium stool and begins to vomit bilious secretions. Which action should the nurse take first?
      A)
      Measure abdominal circumference.
      B)
      Gather supplies for an intravenous (IV) infusion.
      C)
      Monitor strict urinary output.
      D)
      Prepare for anorectal manometry.
    2. The nurse is conducting an admission assessment of an infant with heart failure who is scheduled for repair of restenosis of coarctation of the aorta that was repaired 4 days after birth. Findings include blood pressure higher in the arms than the lower extremities, pounding brachial pulses, and slightly palpable femoral pulses. Which pathophysiologic mechanism supports these findings?
      A)
      The lumen of the aorta reduces the volume of blood flow to the lower extremities.
      B)
      The aortic semilunar valve obstructs blood flow into the systemic circulation.
      C)
      The pulmonic valve prevents adequate blood volume into the pulmonary circulation.
      D)
      An opening in the atrial septum causes a murmur due to a turbulent left to right shunt.
    3. A 10-year-old boy has been seen frequently by the school nurse over the past three weeks after school begins in the fall. He reports headaches, stomach aches, and difficulty sleeping. Which intervention should the nurse implement?
      A)
      Ask the boy to describe a typical day at school.
      B)
      Conduct a complete neurological assessment.
      C)
      Counsel the parents to pay more attention to the child.
      D)
      Compare the child's vital signs over the past three weeks.
    4. The clinic nurse receives a call from a parent of a 10-year-old who reports that their child just returned from summer camp and has developed an expanding circular red rash on the arm. The parent asks the nurse which over-the-counter (OTC) product is safe to use. How should the nurse respond?
      A)
      Encourage the parent to come to the clinic if the child develops a fever.
      B)
      Instruct the parent to apply an antihistamine ointment for one week.
      C)
      Offer reassurance that OTC corticosteroid creams are safe and effective.
      D)
      Explain the need for the child to have an immediate medical evaluation.
    Page 3 of 10

    Exam Review

    1. An adolescent client reports to the nurse of walking with a limp due to pain localized in the right knee which worsens at night but denies any recent injury or trauma. The nurse observes swelling and tenderness in the right lower thigh and imaging results reveal radial ossification in the soft tissues. Which condition should the nurse consider as the probable cause of the findings?
      A)
      Rhabdomyolysis.
      B)
      Osteosarcoma.
      C)
      Growing pains.
      D)
      Hemosiderosis.
    2. When providing care for a child who is in balanced suspension skeletal traction using a Thomas splint and Pearson attachment to the right femur, which intervention is most important for the nurse to implement?
      A)
      Change position every 2 hours.
      B)
      Assess skin for redness and signs of tissue breakdown.
      C)
      Cleanse pin sites as prescribed.
      D)
      Monitor peripheral pulses and sensation in the right leg.
    3. A school-aged child is admitted to the hospital with a diagnosis of acute rheumatic fever. In obtaining a health history from the child's parent, the recent occurrence of which illness is most significant?
      A)
      Chickenpox.
      B)
      Sore throat.
      C)
      Mumps.
      D)
      Influenza.
    4. The nurse is caring for an infant admitted with dehydration, irritability, signs of extreme hunger, and a palpable olive-like mass in the upper right abdominal quadrant. When feeding the infant, the nurse should monitor for which development?
      A)
      Coffee-ground emesis.
      B)
      Frequent pauses.
      C)
      Projectile vomiting.
      D)
      Arched back.
    Page 4 of 10

    Exam Review

    1. An 8-year-old girl with precocious sexual development is being treated medically with injections of luteinizing hormone-releasing hormone (LHRH) to regulate the pituitary gland. Which statement by the parents indicates that they understand the treatment?
      A)
      "We should be sure to start our daughter on birth control pills."
      B)
      "We should encourage her to dress in clothing that suits her sexual maturity level."
      C)
      "Our daughter will be on this hormone treatment the rest of her life."
      D)
      "Sexual maturity differences between my daughter and her peers will disappear within a few years."
    2. A 9-year-old admitted to the unit with severe abdominal pain and fever is diagnosed with appendicitis and is placed on the surgery schedule for an appendectomy. The child reports to the nurse of experiencing sudden relief in abdominal pain. Which action should the nurse take first?
      A)
      Give prescribed intravenous antibiotics.
      B)
      Inquire about the client's last meal.
      C)
      Contact the healthcare provider.
      D)
      Document the client's relief of pain.
    3. A school-age child with bronchial asthma has a prescription for albuterol. The child's parent tells the nurse that the medication is used when the child is having difficulty breathing. Which is the best response by the nurse?
      A)
      Recommend that the parent bring the child in for immediate evaluation.
      B)
      Advise the parent that over-use of the medication may cause chronic bronchitis.
      C)
      Confirm that the medication helps to reduce airway inflammation.
      D)
      Assure the parent that they are using the medication correctly.
    4. The nurse is preparing to administer medications for an eight-month-old infant with heart failure. The infant has a blood pressure of 114/66 mm Hg, apical pulse of 88 beats/minute, and respirations of 30 breaths/minute. Which medication should the nurse withhold until the health care provider is notified?
      A)
      Enalapril.
      B)
      Digoxin.
      C)
      Hydralazine.
      D)
      Furosemide.
    Page 5 of 10

    Exam Review

    1. The nurse is teaching the parents about important dietary changes for their child who is newly diagnosed with celiac disease. Which foods should the nurse include in the list of allowed foods for this child?
      A)
      Rice.
      B)
      Oats.
      C)
      Barley.
      D)
      Rye.
    2. The nurse is performing a routine assessment of a 3-year-old at a community health center. Which behavior by the child should alert the nurse to request a follow-up for a possible autism spectrum disorder (ASD)?
      A)
      Shows indifference to verbal stimulation.
      B)
      Has a history of temper tantrums.
      C)
      Strokes the hair of a handheld doll.
      D)
      Performs odd repetitive behaviors.
    3. The nurse is assessing a 6-month-old infant. Which response requires further evaluation by the nurse?
      A)
      Plays "peek-a-boo."
      B)
      Turns head to locate sound.
      C)
      Has doubled birth weight.
      D)
      Demonstrates startle reflex.
    4. A 9-month-old with Tay-Sachs disease is admitted due to seizures. Which assessment is most important for the nurse to obtain?
      A)
      Ability to crawl.
      B)
      Eyes with cherry-red spot.
      C)
      Difficulty with swallowing.
      D)
      Exaggerated startle reaction
    Page 6 of 10