Exam Review
- A 9-year-old presents with scalp pruritus. The nurse finds oval white capsules attached to hair shafts within ¼ inch of the scalp. What is the best interpretation?A)Scabies mite infestationB)Evidence of fungal infectionC)Presence of viable head lice nitsD)Presence of dandruff
- Identify which burns count toward total body surface area (TBSA) calculation. Select all that apply.(SATA)A)Deep partial-thicknessB)Full-thicknessC)Superficial partial-thicknessD)Superficial/epidermal
- An infant with GERD presents with frequent post-feed vomiting, irritability, and poor weight gain. Which nursing interventions are appropriate? Select all that apply.(SATA)A)Place infant in supine position immediately after feedingB)Encourage large, less frequent feedingsC)Keep infant upright for 20-30 minutes after feedsD)Monitor weight closelyE)Thicken feeds with rice cereal
- An infant with classic salt-wasting congenital adrenal hyperplasia is admitted with vomiting and lethargy.Which findings should the nurse expect? Select all that apply.(SATA)A)HyponatremiaB)HyperkalemiaC)HypertensionD)HypernatremiaE)Hypotension
Exam Review
- Children with head lice should be ________A)restricted from sharing all classroom materials.B)hospitalized until infestation clears.C)allowed to stay in school since lice may be present for weeks before detection.D)excluded from school until nits are gone to prevent transmission.
- A 2-month-old infant is diagnosed with a unilateral cleft lip. Which nursing interventions are appropriate to support feeding? Select all that apply.(SATA)A)Provide frequent burpingB)Continue breastfeeding or chest-feeding as possibleC)Feed in supine position to promote restD)Use a specialty bottle such as a Pigeon or Haberman feederE)Position the infant semi-upright during feed
- A 10-year-old burn patient with 30% TBSA shows the following changes in since the start of your shift three hours ago: Parameter Start of shift Current Heart rate (bpm) 105 145 Blood pressure (mm Hg) 110/70 88/54 Urine output 1.2 mL/kg/hr 0.3 mL/kg/hr Which interpretation is most accurate?A)The child is developing burn shock due to inadequate fluid resuscitation.B)The child is showing signs of fluid overload from excessive IV fluid administrationC)The child's low urine output is expected in the first 24 hours after burnD)The child is experiencing adequate fluid resuscitation.
- A 12-year-old with type 1 diabetes mellitus is preparing to eat lunch. Their meal tray includes: 1 slice of bread = 15 g carbohydrates 1 medium apple = 25 g carbohydrates 1 cup milk = 12 g carbohydrates 1 granola bar = 23 g carbohydrates Their pre-meal blood glucose is 193 g/dL. Insulin parameters are as follows: Target blood glucose: 80-120 mg/dL Insulin-to-carbohydrate ratio: 1 unit of insulin per 15 grams of carbohydrate (1:15) Correction dose of insulin: Pre-meal blood glucose 121-180 mg/dL: 1 unit Pre meal blood glucose 181-200 mg/dL: 2 units What is the total amount of insulin the patient will require?Correct Answer:7 units
Exam Review
- During patient and family teaching, the nurse explains that the most common cause of hemolytic uremic syndrome (HUS) in children is exposure to ▾ E. coli and that long-term follow-up is important because children may later develop ▾ chronic kidney disease.Dropdown 1:Option 1: vesicoureteral reflux (VUR)Option 2: staphylococcus aureusOption 3: enuresis influenzaOption 4: E. coliOption 5: appendicitisOption 6: varicellaDropdown 2:Option 1: vesicoureteral reflux (VUR)Option 2: staphylococcus aureusOption 3: enuresis influenzaOption 4: appendicitisOption 5: chronic kidney diseaseOption 6: varicella
- A 2-year-old presents with fever, vomiting, poor appetite, and foul-smelling urine. Which additional findings support a likely diagnosis of a urinary tract infection?(SATA)A)HepatomegalyB)Straining or crying with urinationC)Persistent diaper rashD)Cloudy urine with foul odorE)Frequent urination
- A 1-year-old with suspected intussusception presents with HR 178, BP 72/38, RR 44, T 38.5°C.The abdomen is distended, and the child is lethargic. What is the priority action?A)Apply warm compresses to abdomen to decrease painB)Prepare for urgent pneumatic (air) enema reductionC)Administer oral rehydration solution (ORS) to treat dehydrationD)Place child in Trendelenburg position to decrease swelling in the gastrointestinal tract
- A school-aged child with acute glomerulonephritis (AGN) has a blood-pressure 136/90 mm Hg, oliguria, and periorbital edema. Which intervention is the nurse's priority?A)Encourage oral fluids to maintain hydrationB)Elevate the head of the bed to ease breathing due to pulmonary edemaC)Restrict sodium intake as orderedD)Monitor daily weight at the same time each day to assess for fluid retention
Exam Review
- For a child who is post-surgical correction of vesicoureteral reflux (VUR), indicate whether each nursing action is Recommended or Not Recommended.A)Assess for fever and flank painB)Monitor urine output hourlyC)Encourage low fluid intake to reduce bladder stressD)Monitor blood pressure regularly
- A 6-year-old child with enuresis has the following vital signs at their follow-up pediatrician visit to address enuresis: HR 92, BP 100/64, RR 20, temperature 37.2° C. The nurse discusses first-line management with the family. Which recommendation is most appropriate?A)Insert an indwelling catheter at nightB)Restrict or eliminate fluids and snacks after evening mealC)Begin desmopressin acetate (DDAVP) therapy immediatelyD)Punish the child when bedwetting occurs to reinforce responsibility
- Over six hours,a 12-year-old with newly diagnosed type 1 diabetes mellitus shows the following trends: Parameter 1000 1600 Serum blood glucose (mg/dL) 180 460 Heart rate (bpm) 113 154 Blood pressure 105/65 82/50 Respiratory rate 22 41 Respiratory pattern Regular Deep irregular What is the priority nursing action?A)Provide oral rehydration with electrolyte solutionB)Restrict oral fluids until blood sugar stabilizesC)Begin IV fluid resuscitation and prepare for continuous insulin infusionD)Administer subcutaneous rapid-acting insulin
- A 4-year-old is diagnosed with scabies. Which nursing interventions are appropriate? Select all that apply.A)Wash bedding and clothing used in past 3 days in hot water and dry on high heat.B)Apply permethrin 5% cream to the entire body and repeat application in 1 week.C)Isolate the child until all itching resolves.D)Treat only the symptomatic child, not close contacts.E)Provide oral antihistamines for nighttime pruritus
Exam Review
- A 9-year-old with diabetes mellitus type 2 becomes pale and shaky during gym class. Their blood glucose level is 52 mg/dL. What is the school nurse's best first action?A)Give 10-15 grams of a fast-acting carbohydrateB)Give a subcutaneous insulin injectionC)Restrict fluids until blood glucose risesD)Administer intramuscular glucagon immediately
- An infant with pyloric stenosis presents with: HR 180 bpm, BP 70/38 mmHg, RR 62, temperature 37.8°C. The infant has sunken fontanels, poor skin turgor, and their labs are consistent with metabolic alkalosis. What is the nurse's priority?A)Administer IV fluids to correct dehydration and electrolyte imbalanceB)Place infant prone to improve gastric emptyingC)Offer small, frequent feeds of oral rehydration solutionD)Prepare infant for immediate surgical pyloromyotomy
- The primary goal of conservative therapy in children with vesicoureteral reflux is to _________A)increase bladder capacityB)prevent dehydrationC)decrease recurrent urinaryD)decrease recurrent urinary tract infectionsE)decrease urine production
- The nurse reviews the following notes on an infant with cleft palate preparing for surgery: Visit 1:Weight 4.8 kg, pulse 140, RR 40, afebrile, moderate feeding difficulties Visit 2 (2 weeks later): Weight 4.6 kg, pulse 148, RR 42, intermittent respiratory congestion after feeds Visit 3 (2 weeks later): Weight 4.4 kg, pulse 156, RR 44, frequent otitis media What is the nurse's priority interpretation?A)The infant requires no intervention beyond routine follow-upB)The infant is experiencing complications affecting nutrition and growthC)The infant requires emergency surgery cleft palate repairD)The infant is meeting expected developmental milestones
Exam Review
- An adolescent patient weighing 43 kilograms has 24% total body surface area (TBSA) affected by partial- and full-thickness burns. Calculate initial fluid resuscitation needs using the Parkland formula (4 mL x kg x %TBSA). How many milliliters of Lactated Ringers should the patient receive in the first 24 hours after the burn injury? Round your answer to the nearest tenth if applicable and enter only digits.
- A 12-year-old (40 kg) presents to the emergency department after a fireworks explosion during a neighborhood celebration. The child has: Deep partial-thickness burns on the posterior surface of the right thigh Full-thickness burns on the posterior trunk Superficial partial-thickness burns on the left forearm and hand (anterior surface only) Using the modified Lund-Browder chart for a 12-year-old, calculate the Total Body Surface Area (TBSA) burned. Round your answer to the nearest tenth if applicable and enter digits only. Modified Lund-Browder chart for assessing percentage total body surface area burn in children and adults Area Birth to 1 year 1 to 4 years 5 to 9 years 10 to 14 years Adult Head 9.5 8.5 6.5 5.5 4.5 Neck 1 1 1 1 1 Trunk 13 13 13 13 13 Upper arm 2 2 2 2 2 Forearm 1.5 1.5 1.5 1.5 1.5 Hand 1.25 1.25 1.25 1.25 1.25 Thigh 2.75 3.25 4 4.25 4.5 Leg 2.5 2.5 2.5 3 3.25 Foot 1.75 1.75 1.75 1.75 1.75 Buttock 2.5 2.5 2.5 2.5 2.5 Genitalia 1 1 1 1 1 Values listed are for one surface area and each individual extremity. Anterior and posterior surface area values are equivalent in estimating total body surface area (TBSA). For circumferential burns, multiply surface area burned by two.
- The nurse is caring for a child hospitalized with an acute IBD flare. Which interventions are appropriate? Select all that apply.A)Maintain NPO status and administer IV fludis during severe exacerbationsB)Administer IV corticosteroids as orderedC)Offer probiotic supplements instead of prescribed medicationsD)Provide a high-protein, high-calorie diet when toleratedE)Monitor weight and growth trends closely
- A 6-year-old girl with a urinary tract infection has the following vital signs: HR 118, BP 102/68, RR 22, temperature 39.1°C (102.4°F). What is the nurse's priority action?A)Obtain a urine specimen for cultureB)Administer prescribed broad-spectrum IV antibioticsC)Encourage increased fluid intakeD)Administer prescribed antipyretic for fever