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    Exam Review

    1. A nurse is called to attend a delivery of a Gravida 2 Term 0 Preterm 1 Abortion 0 Living 1 patient at 10 centimeters, 100 percent effacement, and plus 4 station. The mother has had minimal prenatal care during this pregnancy and thinks she is 38 weeks gestation. The Labor and Delivery nurse states the only significant issues during labor are: spontaneous rupture of membranes 19 hours ago with clear fluid. Vital signs stable. Required augmentation with Pitocin for the past 10 hours. The patient experienced a 20 minute episode of uterine tachysystole 2 hours ago. Pitocin was turned off, the patient was turned, an intravenous bolus was given, and oxygen was started, and the uterine tachysystole resolved. The fetal heart rate during that time had a prolonged deceleration lasting 4 minutes but returned to the baseline of 140 with intrauterine resuscitative measures. The fetal heart rate is currently 145, with moderate variability, accelerations, and early decelerations present. The nursery nurse would anticipate which of the following? Select all that apply:
      (SATA)
      A)
      Drying infant on mother's chest.
      B)
      Routine drying and warming.
      C)
      Infant with hyperbilirubinemia.
      D)
      Newborn to the Neonatal Intensive Care Unit immediately after delivery.
      E)
      Ensure suction and oxygen are ready.
      F)
      Probable respiratory depression.
      G)
      Immediate need for positive pressure ventilation.
      H)
      Stat Cesarean Section.
    2. Using the following formula, calculate the daily fluid requirement in milliliters for a child who weighs 46 pounds. 100 mL/kg for the first 10 kg 50 mL/kg for the next 10 kg 20 mL/kg for the remaining kg Please enter the numeric value only. Round to the nearest whole number.
      Correct Answer:1518 mL
    3. Ordered: Metronidazole 140 mg IV to be infused over 60 minutes. Available: Metronidazole in a syringe pre-mixed with normal saline. Correct concentration: 5 mg/mL. Patient's weight: 43 lb. Based on the correct concentration, the pre-mixed syringe contains how many mL? Round to the nearest whole number.
      Correct Answer:28 mL
    4. A 15-year-old boy presents to the emergency department after a straddle injury with complaints of testicular pain and swelling. Which of the following interventions is the priority for the nurse?
      A)
      Begin preoperative orders for emergency surgery.
      B)
      Administer acetaminophen for pain.
      C)
      Initiate a consult for a urologist.
      D)
      Obtain a urine specimen.
    Page 1 of 13

    Exam Review

    1. An 8-year-old boy and his father visit the pediatrician’s office with reports of a sudden onset of abdominal pain and reddish-brown urine. A urinalysis shows 4+ protein. On taking the boy’s health history, the nurse learns that he had strep throat a little over a week ago. Which condition should the nurse suspect?
      A)
      Acute post-streptococcal glomerulonephritis.
      B)
      Kidney agenesis.
      C)
      Urinary tract infection.
      D)
      Polycystic kidney disease.
    2. The nurse is caring for a child diagnosed with a urinary tract infection. The caregiver asks the nurse why it is so important for the child to have so much fluid. What is the most important reason the child needs increased fluids?
      A)
      To decrease the pain of urination.
      B)
      To fill the bladder so a specimen can be obtained.
      C)
      To dilute the urine and flush the bladder.
      D)
      To prevent the child from developing a fever.
    3. A voiding cystourethrogram (VCUG) is prescribed for a child. What education should be provided to the parents?
      A)
      The VCUG will detect if the infection is gone.
      B)
      The VCUG will rule out kidney stones.
      C)
      The VCUG will prevent further complications of the urinary tract infection (UTI).
      D)
      The VCUG will rule out vesicoureteral reflux.
    4. A nurse is caring for an infant with a temperature of 102.5°F (39.1°C). The health care provider has prescribed acetaminophen 10 mg/kg every 4 to 6 hours for a temperature of 101.4°F (38.6°C) or higher. The infant weighs 14 pounds. How many milligrams should the nurse administer? Please enter the numeric value only. Round to the nearest whole number.
      Correct Answer:64 mg
    Page 2 of 13

    Exam Review

    1. The nurse is caring for a child diagnosed with a urinary tract infection. The caregiver asks the nurse why it is so important for the child to have so much fluid. What is the most important reason the child needs increased fluids?
      A)
      To decrease the pain of urination
      B)
      To fill the bladder so a specimen can be obtained
      C)
      To dilute the urine and flush the bladder
      D)
      To prevent the child from developing a fever
    2. An 8-year-old boy and his father visit the pediatrician's office with reports of a sudden onset of abdominal pain and reddish-brown urine. A urinalysis shows 4+ protein. On taking the boy’s health history, the nurse learns that he had strep throat a little over a week ago. Which condition should the nurse suspect?
      A)
      Acute post-streptococcal glomerulonephritis
      B)
      Kidney agenesis
      C)
      Urinary tract infection
      D)
      Polycystic kidney disease
    3. A 15-year-old boy presents to the emergency department after a straddle injury with complaints of testicular pain and swelling. Which of the following interventions is the priority for the nurse?
      A)
      Begin preoperative orders for emergency surgery
      B)
      Administering acetaminophen for pain
      C)
      Initiating a consult for a urologist
      D)
      Obtaining a urine specimen
    4. The mother of a child with chronic renal failure asks the nurse why her son is getting an injection of erythropoietin. When responding to the mother, the nurse incorporates understanding of which of the following as the rationale?
      A)
      To stimulate red blood cell growth
      B)
      To correct metabolic acidosis
      C)
      To stimulate growth in stature
      D)
      To treat low calcium levels
    Page 3 of 13

    Exam Review

    1. Which of the following is not one of the Cs found with feeding attempts in infants with tracheoesophageal fistula?
      A)
      Cyanosis
      B)
      Choking
      C)
      Choanal atresia
      D)
      Coughing
    2. The parents of a child diagnosed with celiac disease ask the nurse what types of food they can offer their child. Which of the following would the nurse include in the teaching plan?
      A)
      Beef fajitas on corn tortillas
      B)
      Turkey sandwich on rye bread
      C)
      Vegetable beef and barley soup
      D)
      Biscuits and cream gravy
    3. The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the pathophysiology of gastroesophageal reflux?
      A)
      A partial or complete intestinal obstruction occurs.
      B)
      A thickened elongated muscle causes an obstruction at the end of the stomach.
      C)
      There are recurrent paroxysmal bouts of abdominal pain.
      D)
      In this disorder, the sphincter that leads into the stomach is relaxed.
    4. The nurse is caring for a newborn with a cleft palate. What finding in the maternal medical record is considered to be contributing factors?
      A)
      Moderate maternal alcohol use prior to pregnancy
      B)
      Reports of marijuana use prior to pregnancy
      C)
      Maternal age less than 18 years
      D)
      Anticonvulsant therapy used to manage a seizure disorder
    Page 4 of 13

    Exam Review

    1. A parent brings a child to the health clinic with reports of RLQ pain, fever, and decreased appetite. His pain is a "6" on the pain scale on arrival. After 15 minutes the patient reports his pain as a "0". What condition might the nurse expect?
      A)
      Constipation
      B)
      Ruptured appendix
      C)
      Urinary tract infection
      D)
      Intussusception
    2. The nurse caring for a patient with Crohn’s disease determines that the teaching was successful when, after teaching the patient and her family about this condition, the nurse sees they identify which of the following as a possible complication?
      A)
      Reduced liver function
      B)
      Pancreatitis
      C)
      Stricture
      D)
      Gallstones
    3. A 2-year-old child is hospitalized with a diagnosis of severe dehydration. The child has had several episodes of watery diarrhea and has vomited three times since admission. The child has a temperature of 104°F (40°C). The parents are worried that the child has not eaten anything or urinated since the day before. What should be the priority focus of the child's care?
      A)
      Fluid status
      B)
      Parental education
      C)
      Urine output
      D)
      Febrile state
    4. The nurse is providing care to a child with an intussusception. The child has a bowel movement and the nurse inspects the stool. The nurse would document the stool's appearance most likely as which of the following?
      A)
      Greasy
      B)
      Currant jelly-like
      C)
      Bloody
      D)
      Clay-colored
    Page 5 of 13

    Exam Review

    1. A mother is alarmed because her 6-week-old boy has begun vomiting almost immediately after every feeding. In the past week, the vomiting has grown more forceful with the vomit projecting several feet from his mouth. He is always hungry again just after vomiting. At the physician’s office, the nurse holds the child and gives him a bottle of water. While he drinks, she notes an olive-size lump in his right abdomen. Which condition should the nurse suspect in this child?
      A)
      Gastroesophageal reflux
      B)
      Pyloric stenosis
      C)
      Appendicitis
      D)
      Peptic ulcer disease
    2. A nurse manages the interdisciplinary care for an infant born with an omphalocele. What is an accurate description of the care plan for an omphalocele?
      A)
      At birth, protect the exposed bowel by gently manipulating it back into the abdominal cavity
      B)
      Administer corticosteroids as prescribed—either oral prednisone or prednisolone or as IV methylprednisolone
      C)
      Obtain IV access to give fluid resuscitation and keep patient NPO
      D)
      Insert an NG tube to decompress the stomach and to prevent gastric distention
    3. The nurse determines that a 20-month-old is in Piaget’s sensorimotor stage of cognitive development. Which actions support this assessment?
      A)
      The child uses a spoon to stir in an empty bowl and says, “I’m making soup!”
      B)
      The child offers their toy to a crying adult believing it will make the adult feel better
      C)
      The child insists on sitting in the same chair every day at lunch
      D)
      The child stacks blocks and claps when they fall over
    4. The nurse assesses a 2-year-old toddler for a normal checkup. The chart is accompanied by a parent. Which action is appropriate for the assessment?
      A)
      Ask the toddler to rate the pain on a scale from 1 to 10
      B)
      Let the toddler play with a stethoscope before auscultating breath sounds
      C)
      Begin with a brief animated video that explains the purpose of an assessment
      D)
      Instruct the child to move from the parent's lap to the examination table
    Page 6 of 13