Transcript NCLEX TIDBITS

Pediatric NCLEX
Review
Carla Nye, MN, RN
Doctoral Student
University of South Florida
The nurse in an adolescent clinic is assessing
the growth and development of the four
following clients. Which of the four
clients would require a referral?
a) A 12-year old female who started her menses
6 months ago who is complaining of cramps.
b) A 15-year old male with in Tanner stage 4 who
is complaining of slight breast enlargement.
c) A 16-year old female asking for birth control
information.
d) A 14-year old male in Tanner stage 1, who
grew one inch last year.
March 2007
Enterobius (pinworms) is diagnosed in a child.
The treatment will most likely include
which of the following pharmacological
treatment plan?
a)
Mebendazole (Vermox) for all family members
simultaneously
b) Metronidazole (Flagyl) for all family members
simultaneously
c) Metronidazole (Flagyl) for the child only
d) Mebendazole (Vermox) for the child only
March 2007
The primary reason for screening of young
children for lead poisoning is that
a)
Children with lead poisoning rarely have
symptoms
b) Lead is a hidden component of the U.S. water
supply
c) Children are exposed to lead through cigarette
smoke
d) Lead poisoning is the leading cause of mental
retardation in the U.S.
March 2007
A nurse is educating a mother on the care of
her child with impetigo. Which statement
by the mother indicates that she needs
further instructions?
a)
Impetigo can be caused by group A beta-hemolytic
streptococcus
b) Impetigo can be spread by scratching and direct
skin-to-skin contact
c) Impetigo pustules that rupture have a
characteristic honey-colored crust
d) Crusts should be allowed to dry and should not
be removed.
March 2007
The appropriate treatment for an initial acute
otitis media may include all of the
following except
a) Ten day course of oral amoxicillin
b) Single IM injection of ceftriaxone
c) Wait and see prescription of an oral
antibiotic
d) Long term prophylactic antibiotics
March 2007
Discharge teaching for a child diagnosed with
viral pneumonia include all of the
following except
a) Antipyretics for fever management
b) Adequate fluid intake
c) Antibiotic therapy
d) Chest physiotherapy and postural drainage
March 2007
An experienced nurse is discussing best
practices for IV insertion and management
in children with a new nurse. Which of
the following statements by the new nurse
a)
“I should use a 24 gauge catheter when inserting
an IV in an infant.”
b) “Antecubital veins are the preferred veins to use
for IV insertion in children.”
c) “Scalp veins can be used in infants.”
d) “I should start with the most distal site of an
extremity vein.”
March 2007
A mother expresses concern over how her 4year old is responding to the death of the
child’s father. Which of the following
statement best describes how a preschooler
comprehends death? A preschooler
a)
sees death as temporary and gradual, life and
death can change places with one another
b) understands that death is permanent, inevitable
and universal
c) responds well to logical explanations of death
d) has a vague separation between fantasy and
reality and therefore, has no concept of death.
March 2007
A nurse is reviewing the immunizations that a
4-month-old will receive during a well baby
visit. Which of the following is the correct
list of immunizations for this infant?
a)
b)
c)
d)
MMR, DTaP, Hib, IPV
DTaP, Hib, IPV, PCV
Varicella, DTaP, Hib, IPV, PCV
Hepatitis A, DTaP, Hib, IPV, PCV
DTaP – Diptheria, tetanus, pertussis
Hib- Haemophilus influenzae B
IPV – inactivated poliovirus
PCV – Pneumococcal
MMR – measles, mumps, rubella
March 2007
Which of the following interventions would
be most helpful in helping a family cope
with the stress of the hospitalization of
their child?
a)
Relating the health care teams plan for the child’s
care.
b) Explaining the daily schedule the child will follow
in the hospital.
c) Encouraging the family to go home at night in
order to rest.
d) Listening to the family’s concerns about the
child’s progress
March 2007
In working with children with cystic fibrosis,
the nurse expects to provide teaching on
which of the following treatment plans?
a)
Dietary modification including low protein, high
fat, and low carbohydrate diet
b) Daily range of motion exercises
c) Renal dialysis and a strict intake and output
d) Chest physiotherapy and postural drainage
March 2007
General guidelines for medication
management for children with asthma
include:
a)
Use inhaled corticosteroids prophylactically
before exercise
b) Use inhaled B-adrenergic agonist prophylactically
before exercise
c) Use cromolyn sodium to treat acute
exacerbations
d) Use oral corticosteroids to treat acute
exacerbations
March 2007
A nurse is caring for a sleeping child who is
post-op from abdominal surgery. The
child’s pulse oximetry reading drops from
96% saturation to 89% saturation. What is
the first thing the nurse should do?
a)
b)
c)
d)
Call the doctor
Prepare for intubation
Have the child cough and deep breathe
Assess for pain
March 2007
A mother asks a nurse about the causes of
juvenile rheumatoid arthritis (JRA). The
most appropriate response would be
a)
“JRA is caused by a bacterial infection of the
joint, often preceded by cellulitis or
osteomyelitis.”
b) “JRA is an inherited genetic disorder which is
usually diagnosed in the first year of life.”
c) “JRA is an autoimmune disease that occurs in a
child with a genetic predisposition who is
exposed to an environmental stimuli.”
d) “ JRA is a skeletal disorder that appears during
the growth spurt of puberty.”
March 2007
In discussing the diagnosis of cerebral palsy
with parents, a nurse informs the parents
that
a)
Children with cerebral palsy have decreased
intelligence.
b) Cerebral palsy is a progressive neuromuscular
disease
c) Children with cerebral palsy are wheelchair
dependent
d) Children with cerebral palsy may have difficulties
with speech.
March 2007
Which of the following is a correct principle
on which to base diabetic teaching for a
school aged child?
a)
School aged children should be taught to selfadminister their insulin injections.
b) Use the same site for insulin injections in order
to ensure stable absorption.
c) Exercise makes the body less sensitive to insulin,
and increases the insulin requirement.
d) Follow a regimented diabetic diet from a known
diabetic expert.
March 2007
An infant arrives in the clinic to receive her 4
month DPT immunization. What is the
appropriate method of administration?
a) Oral
b) Deltoid injection
c) Vastus Lateralis injection
d) Nasal
March 2007
A 10 month old infant underwent a surgical
repair of a cleft palate. What feeding
strategies should the parent use for the
first week post-operatively to feed the
infant?
a) Liquids from a cup
b) Soft food from a spoon
c) Liquid from a straw
d) Soft finger foods
March 2007
The nurse is monitoring a child who hit his
head after a fall. Which of the following is
a sign that requires immediate attention?
a) A Glasgow Coma score of 15
b) Fluid leaking from the nose and ears
c) A loss of consciousness for 2 minutes
d) Severe headache and vomiting
March 2007
Which of the following does NOT put an
infant at risk for congenital heart disease?
a) Family history of congenital heart disease
b) Maternal Alcoholism
c) Maternal Type 1 diabetes
d) Maternal age less than 20
March 2007
The school nurse encourages the parents of a student
with a severe sore throat to take the child to a
provider. The nurse is concerned because of
which of the following?
a) If strep tonsillitis is not treated with
antibiotics it may lead to scarlet fever, otitis, or
acute glomerulonephritis
b) The student will miss a lot of school and fall
behind in school work.
c) Other children may also get sore throats if the
child is not treated aggressively
d) If untreated, strep may cause anemia, weight
loss, and lethargy
March 2007
The parents of a child hospitalized with acute
glomerulonephritis asks the nurse why
blood pressures readings are being taken
so often. The nurse’s reply should be
based on which of the following?
a) Blood pressure fluctuations are a common
side effect of antibiotic therapy
b) Blood pressure fluctuations are a sign the
condition has become chronic
c) Acute hypertension must be anticipated and
identified
d) Hypotension leading to sudden shock can
occur at any time.
March 2007
After tonsillectomy surgery, a 4-year old child
is brought to the recovery room. Which
of the following actions should the nurse
include in his plan of care?
a)
b)
c)
d)
Institute measures to minimize crying.
Perform postural drainage every two hours.
Cough and deep breathe every hour.
Give ice cream as tolerated.
March 2007
A 12 year old is admitted to the ICU in
diabetic ketoacidosis. Her parents are in
the waiting room and are frantic. Which
of the nursing diagnosis is the highest
priority?
a) Risk for impaired skin integrity
b) Interrupted family processes related to
situational crisis
c) Fluid volume deficit
d) Risk for injury related to hypoglycemia
March 2007
Which of the following symptoms would the
RN expect to observe during the physical
assessment of the adolescent girl anorexia
nervosa?
a)
b)
c)
d)
Dysmenorrhea
Tachycardia
Heat intolerance
Decreased temperature
March 2007
A 17 year-old adolescent is treated in the emergency
room for acute alcohol intoxication. He is
agitated and verbally abusive. His admission
orders include chlordiazepoxide (Librium) 50mg
IM or PO every 4-6 hours for agitation. The
nurse should take which of the following
precautions after Librium is administered?
a) Place the patient in restraints.
b) Leave the patient in a room by himself until
the tranquilizer takes effect.
c) Assign a practical nurse to stay with the
patient.
d) Ask the security guard to stay with the patient.
March 2007
A 7 year-old boy with a compound fracture of
the left femur is being admitted to a pediatric
unit. Which of the following actions is best for
the nurse to take?
a. Ask the nursing assistant to obtain the child’s
vital signs while the nurse obtains a history
from the parents.
b. Ask the LPN to assess the peripheral pulses
of the child’s left leg while the nurse
completes the admission forms.
c. Ask the LPN to stay with the child and his
parents while the nurse obtains phone orders
from the physician.
d. Ask the nursing assistant to obtain equipment
for the child’s care while the nurse talks with
2007
the child and hisMarch
parents.
Which of the following patients should the nurse on
a pediatric unit assign to a LPN?
a) A 3 year-old girl admitted yesterday with
larnygotracheobronchitis who has a
tracheostomy.
b) A 5 year-old girl admitted after gastric lavage
for Tylenol ingestion.
c) A 6 year-old boy admitted for a fracture of the
femur in balanced suspension traction.
d) A 10 year-old boy admitted for observation
after an acute asthmatic attack.
March 2007