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    Exam Review

    1. A child has been diagnosed with acute lymphoblastic leukemia and is being treated with chemotherapy. Because many chemotherapeutic agents cause bone marrow suppression, the nurse, before administering the chemotherapy, will determine if this child has any infection-fighting capability by monitoring the:
      A)
      Absolute neutrophil count (ANC)
      B)
      Eosinophils
      C)
      Red blood cell count (RBC)
      D)
      Hemoglobin (Hgb)
    2. A nurse is caring for a child who has been diagnosed with a concussion. Which of the following findings should the nurse identify as causing this type of injury?
      A)
      A deep wound that caused external bleeding on the head and face
      B)
      Trauma from contact sports that caused the brain to twist or bounce against the skull
      C)
      A blow to the head that caused diffuse bleeding between the skull and brain
      D)
      A fall that caused blood from a ruptured artery to pool in the brain
    3. A nurse is providing education to a 12-year-old child who has been newly diagnosed with celiac disease. Which of the following statements by the client indicates a need for further teaching?
      A)
      "Processed foods are acceptable, as long as they don't contain flour."
      B)
      "I need to check food labels for hidden sources of gluten, like barley and rye."
      C)
      "I need to avoid foods like bread, pasta, and cereal."
      D)
      "My family should use separate serving utensils for gluten-free foods."
    4. A nurse in an emergency department is caring for an infant who has a 2-day history of vomiting and an elevated temperature. Which of the following should the nurse recognize as the most reliable indicator of fluid loss?
      A)
      Respiratory rate
      B)
      Blood pressure
      C)
      Body weight
      D)
      Skin integrity
    Page 1 of 15

    Exam Review

    1. Which assessment finding would the nurse expect in an infant with Hirschsprung's disease?
      A)
      Constipation with foul-smelling, ribbon-like stool.
      B)
      "Currant jelly" stool.
      C)
      Passage of foul-smelling, fatty stools.
      D)
      Mucoid, bloody diarrhea.
    2. A nurse is caring for a client who presents to the emergency room in sickle cell crisis. Which of the following medications should the nurse anticipate administering?
      A)
      Laxatives
      B)
      Thyroid replacement medications
      C)
      Diuretics
      D)
      Pain medications
    3. Which of the following is a risk factor for iron deficiency anemia in toddlers?
      A)
      Consuming a diet high in iron-rich foods
      B)
      Regular consumption of fortified cereals
      C)
      Excessive intake of cow's milk
      D)
      Participating in physical activities
    4. The nurse is monitoring an infant for signs of increased intracranial pressure (ICP). Which are late signs of increased intracranial pressure (ICP) in an infant?
      A)
      Alteration in pupil size and reactivity and increased motor response
      B)
      Extension or flexion posturing and weight gain
      C)
      Tachycardia and alteration in pupil size and reactivity
      D)
      Cheyne-Stokes respirations and alteration in pupil size
    Page 2 of 15

    Exam Review

    1. When administering oral iron supplements to a client with anemia, which nursing action is most important to ensure optimal absorption of the medication?
      A)
      Crush the iron supplement and mix it with applesauce.
      B)
      Administer the iron supplement with a glass of milk.
      C)
      Discontinue and contact provider if client's stools become a tarry green color.
      D)
      Administer the iron supplement with a vitamin C-rich drink.
    2. A nurse is planning care for a 6-year-old child who has bacterial meningitis. Which of the following nursing interventions is unnecessary in the client's plan of care?
      A)
      Place the client in a semi-Fowler's position.
      B)
      Admit the client to a private room.
      C)
      Implement seizure precautions.
      D)
      Measure head circumference every shift.
    3. A nurse enters a client's room and finds the client on the floor having a seizure. Which of the following actions should the nurse take?
      A)
      Place the client on his side.
      B)
      Hold the client's arms and legs from moving.
      C)
      Place the client back in bed.
      D)
      Insert a tongue blade in the client's mouth.
    4. A 6-year-old child is admitted to the hospital with suspected bacterial meningitis. What is the nursing priority in the care of this child? Select all that apply.
      A)
      Ensure the child is placed on droplet precautions.
      B)
      Encouraging the child to drink plenty of fluids.
      C)
      Administering intravenous antibiotics as prescribed.
      D)
      Providing comfort measures such as dimming the lights.
      E)
      Prepare the child for a CT scan of the head.
    Page 3 of 15

    Exam Review

    1. How do preschool-aged children typically understand death? (Select All that Apply.)
      A)
      They may believe that death is punishment for bad behavior.
      B)
      They may believe that death is temporary or reversible.
      C)
      They may have a fear of death and view it as something to be avoided.
      D)
      They understand death as a natural part of the life cycle.
      E)
      They may believe that death is caused by their thoughts.
      F)
      They have a concrete understanding of death as a permanent cessation of life.
    2. A nurse working on a medical unit is caring for a client who is prescribed seizure precautions. Which of the following interventions should the nurse include in the client's plan of care?
      A)
      Obtain IV access.
      B)
      Keep a padded tongue blade available at the client's bedside.
      C)
      Keep the lights on when the client is sleeping.
      D)
      Place the client's bed in the high position.
    3. A school-age child with leukemia experienced severe nausea and vomiting when receiving chemotherapy for the first time. Which is the most appropriate nursing action to prevent or minimize these reactions with subsequent treatments?
      A)
      Administer an antiemetic before chemotherapy begins
      B)
      Encourage drinking large amounts of favorite fluids
      C)
      Offer frequent small meals before and after chemotherapy
      D)
      Provide the child's favorite music as a distraction
    4. A nurse is creating a plan of care for a pediatric client who has been diagnosed with osteosarcoma and will be receiving chemotherapy with radiation interventions. The nurse should monitor the client for which of the following expected adverse effects? (Select All that Apply.)
      A)
      Nausea
      B)
      Hair loss
      C)
      Diarrhea
      D)
      Skin Sensitivity
      E)
      Weight gain
    Page 4 of 15

    Exam Review

    1. A nurse is assessing a pediatric client who is exhibiting manifestations of rhabdomyosarcoma. In which area of the body should the nurse expect to find a tumor?
      A)
      Ribs
      B)
      Upper leg
      C)
      Head
      D)
      Spine
    2. Which of the following is a complication of hemophilia?
      A)
      Hematuria
      B)
      Hemarthrosis
      C)
      Hemoptysis
      D)
      Hematemesis
    3. A nurse is assessing an infant following a motor vehicle crash. Which of the following findings should the nurse monitor to identify increased intracranial pressure?
      A)
      Brisk pupillary reaction to light.
      B)
      Increased sleepiness
      C)
      Tachycardia
      D)
      Depressed fontanels
    4. The nurse and a new nurse (graduate nurse) are caring for a child who will require palliative care. Which statement made by the new nurse would indicate a correct understanding of palliative care?
      A)
      "Palliative care serves to hasten death and make the process easier for the family."
      B)
      "Palliative care provides pain and symptom management and best quality of life for the child."
      C)
      "The goal of palliative care is to place the child in a hospice setting at the end of life."
      D)
      "The goal of palliative care is to act as the liaison between the family, child, and other health care professionals."
    Page 5 of 15

    Exam Review

    1. At what age is it generally recommended to perform palatoplasty for a child with a cleft palate?
      A)
      2-3 months
      B)
      18-24 months
      C)
      6-12 months
      D)
      4-5 years
    2. The nurse is providing discharge teaching to the parents of a toddler who experienced a febrile seizure. The nurse knows that the parents understand the teaching when the parents make which statement(s)? (Select All that Apply.)
      A)
      Most children with febrile seizures do not require seizure medicine
      B)
      My child's 4-year-old sibling is also at high risk for febrile seizures
      C)
      I will give my child acetaminophen when she has a fever to prevent her temperature from rising rapidly
      D)
      My child will now take anticonvulsants every day to prevent seizures
      E)
      My child could have another febrile seizure
    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 should the nurse include in the plan of care?
      A)
      Hold the infant's chin to his chest and knees to his abdomen during the procedure.
      B)
      No sedation is needed, due to application of anesthetic cream.
      C)
      Apply an anesthetic mixture of lidocaine and prilocaine cream topically 15 min prior to the procedure.
      D)
      Keep the infant NPO for 6 hr prior the procedure.
    4. A nurse is caring for a 3-year-old child who was admitted with acute diarrhea and dehydration. Which of the following findings indicates that oral rehydration therapy has been effective?
      A)
      Urine specific gravity 1.015
      B)
      Respiratory rate 24/min
      C)
      Heart rate 130/min
      D)
      Capillary refill greater than 3 seconds
    Page 6 of 15