Peds proctored exam 2022-2023 verified exam answers

1. A nurse is preparing to assess a 4-year-old child’s visual acuity. Which of the following actions should the nurse plan first?

   1. Use a tumbling E chartf or the assessment

   2. Position the child 4.6 meters (15 feet) from the chart

   3. Asses both eyes together first, then each eye separately

   4. Test the child without glasses before testing with glasses

2. A nurse is providing discharge teaching to a parent of a child who has juvenile idiopathic arthritis and a new prescription of prednisone/etanercept. Which of the following statements should the nurse include in the teaching?

   1. Monitor your child for indications of infection

   2. Discontinue this medication if gastrointestinal upset occurs

   3. Expect that this medication will stimulate growth spurt

   4. Limityourchild’sintakeofpotassium-richfoods

3. A nurse on a pediatric unit is caring for four children. The nurse should use droplet precautions for which of the following children?

   1. AnadolescentwhohashepatitisA

   2. A toddler who has seasonal influenza

   3. A preschool-age child who has pediculosis capitis

   4. Aschool-agechildwhohasviralconjunctivitis

4. A nurse is providing teaching to an adolescent who has vulvovaginitis. Which of the following statements should the nurse include in the teaching?

   1. Applyawarm,moistcompressthreetimesaday

   2. Apply a scent baby powder to absorb residual moisture

   3. Wear a feminine deodorant pad for vaginal drainage

   4. Wearanylonunderwearatnight

5. A nurse is creating a plan of care for a school-age child who has nephrotic syndrome. Which of the following interventions should the nurse include? (SATA)

   1. Providealowsodiumdiet

   2. Encourage increased fluid intake

   3. Assess for protein in the urine

   4. Initiatecontactprecautions

   5. Obtain a daily weight

6. A nurse in a pediatric unit is caring for a school-age child following a cardiac catheterization. Which of the following interventions would the nurse take?

   1. MaintainNPOstatusfor24hoursfollowingtheprocedure

   2. Administer meperidine for pain every 4 hours

   3. Perform a sterile dressing change 8 hours after the procedure

   4. Keeptheaffectedextremitystraightfor6hours.

7. A nurse is teaching a parent of a toddler about administering digoxin. Which of the following statements by the parent indicates understanding of the teaching?

   1. Ishouldmixthemedicationwith4ouncesofchild’sfavoritejuice

   2. I should give me child water after giving the medication

   3. I should give my child another dose if he vomits right after taking the medication

   4. Ishouldgivethemedicationwithfoodsthatarehighinfiber

8. A nurse is caring for a 9-year-old child who has major burns to her face and upper torso. Which of the following actions should the nurse take first?

   1. Administeratetanusvaccine

   2. Give pain medication

   3. Begin enteral feedings

   4. InitiateacrystalloidIVbolus

9. A nurse is planning care for a toddler who has developed oral ulcers in response to chemotherapy. Which of the following should the nurse include in the plan of care?

   1. Scheduleroutineoralcareevery8hours

   2. Administer oral viscous lidocaine

   3. Moisten the mucous with lemon glycerin swabs

   4. Cleansethegumswithsalinesoakedgauze

10. A nurse in a community health clinic is assessing the needs of a single parent who has three young children and works full time. Which of the following resources should the nurse recommend?

    1. 12-stepsupportgroup

    2. Respite child-care

    3. Child home health care

    4. Counselingfordepression

11. A nurse is caring for a child who has prescription for fluticasone and has developed white patches and sores in his mouth. Which of the following is an appropriate action for the nurse to take?

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1. Encouragetheuseofaspacer

2. Withhold the medication until the lesions heal

3. Obtain a prescription for oral prednisone

4. Collectaculturefromthelesions

12. A nurse is providing teaching to the parents of a child who has impetigo. Which of the following instructions should the nurse include in the teaching?

    1. Sealsofttoysinaplasticbagfor14days

    2. Apply bacterial ointment for lesions

    3. Administer acyclovir PO two times per day

    4. Soakhairbrushesinboilingwaterfor10minutes

13. A nurse in an emergency department is caring for a child who is epiglottis. Which of the following actions should the nurse take?

    1. Providenebulizeraerosoltherapy

    2. Administer IV antibiotics

    3. Inspect the tonsils using a tongue depressor

    4. Collectathroatculture

14. A nurse is planning care for a child who is placed in skin traction. Which of the following is the priority action for the nurse to take?

    1. Increasefluidintake

    2. Maintain a proper body alignment

    3. Use an alternate pressure mattress

    4. Monitorpedalpulses

15. A nurse is preparing to administer ondansetron 0.15 mg/kg IV to a child who is receiving chemotherapy and weighs 29.4 kg. available is ondansetron 4mg/2mL solution. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero).

    Answer: 2.2 mL

16. A nurse is performing a physical assessment of a school-age child who has acute glomerulonephritis. Which of the following findings should the nurse expect?

    1. Hypotension

    2. Increased urinary output

    3. Flushed skin

    4. Facialedema

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17. A nurse in an emergency department is assessing an adolescent who reports inhalation of gasoline. Which of the following findings should the nurse expect?

1. Hypothermia

2. Pinpoint pupils

3. Hyperactive reflexes

4. Ataxia

18. A nurse in the emergency department is assessing a toddler who has hyperpyrexia, severe dyspnea, and is drooling. Which of the following actions should the nurse take first?

    1. Preparethetoddlefornasotrachealintubation

    2. Insert an IV catheter for the toddler

    3. Obtain a blood culture from the toddler

    4. Administeranantibiotictothetoddler

19. A nurse is caring for an infant who has a patent ductus arteriosus. The nurse should identify that the defect is at which of the following locations of the heart? (you will find hot spots to select in the artwork below. Select only the hot spot that corresponds to your assessment)

    Answer:

20. A nurse is caring for an infant who has hydrocephalus and ventriculoperitoneal shunt malfunction. Which of the following assessment findings indicates that the infant is experiencing increased intracranial pressure?

    1. Increasedappetite

    2. Irritability

    3. Flat fontanel

    4. Tachycardia

21. A nurse is assessing an infant who has iron deficiency anemia. Which of the following findings should the nurse expect?

    1. Increasedhemoglobinlevel

    2. Hyperactive muscle tone

    3. Bradycardia

    4. Paleconjunctiva

22. A nurse is caring for a child who received partial thickness burns to over 50% of his body 10 days ago and has splints over his joints to prevent contractions. Which of the following actions should the nurse take? (SATA)
    A. Provideahigh-caloriediet

B. Administer analgesics IM

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C. Remove splints during sleep D.
E.

23. A school nurse is assessing a 7-year-old student. The nurse should identify which of the following findings as a potential indicator of physical abuse?

    1. Bruisingaroundthewrists

    2. Abrasions on the knees

    3. Weight in 45th percentile

    4. Frontdeciduousteethmissing

24. A nurse is assessing an 18-month-old child during a well-child visit. Which of the following findings should the nurse report to the provider?

    1. Thechildcrawlstonavigatetheroom

    2. The child has frequent temper tantrums

    3. The child consistently throws items to the floor

    4. Thechildscribblesonthewallwithacrayon

25. A nurse is caring for an infant who has rotavirus. Which of the following findings indicates that the infant is inadequately dehydrated?

    1. Weightloss7%

    2. Capillary refill 1 second

    3. Bradycardia

    4. Respiratoryrate26/min

26. A nurse is providing teaching about injury prevention to the parents of a toddler. Which

Change dressing using aseptic technique

Monitor intake and output

of A. B. C. D.

the following safety measures should the nurse include in the teaching? Adjustthewaterhearttemperatureto54C(129.2F)
Check clothing for loose buttons
Provide balloons for play

Placescreensonallwindows

27. A
following actions should the nurse take?

1. Releasethetractiontoallowthechildtobathe

2. Place the child on an alternating pressure mattress

3. Adjust the weights to allow the child to turn

4. Ensurethatthepulleymechanismisattachedtotheskin

nurse is caring for a school-age child who is in 90/90 skeletal traction. Which of the

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28. A nurse is caring for a child who has increased intracranial pressure and is unconscious due to a closed head injury. Which of the following actions should the nurse take?

    1. Maintainthechild’sneckinaflexedposition

    2. Turn the child side to side every 2 hours

    3. Initiate seizure precautions

    4. Performchestpercussionasneeded

29. A nurse is providing teaching to the parents of a school-age child newly diagnosed with seizure disorder. The nurse should teach the parents to take which of the following actions during a seizure?

    1. Cleartheareaofhardobjects

    2. Minimize movement of the limbs

    3. Insert a tongue blade between the teeth

    4. Placethechildinaproneposition

30. A nurse is providing teaching to a parent of an infant who has diaper rash. Which of the following statements by the parent indicates an understanding of the teaching?

    1. Iwilluseantibacterialsoaptowashtherashwitheachdiaperchange

    2. I will keep the area warm and moist

    3. I will use super-absorbent disposable diapers

    4. Iwillsprinkletalcumpowderovertheaffectedareatwicedaily

31. A nurse in a provider’s office is assessing the vital signs of a 1-year-old toddler. Which of the following findings should the nurse report to the provider?

    1. Bloodpressure88/42mmHg

    2. Heart rate 110/min

    3. Respiratory rate 54/min

    4. Temperature37.7C(99.9F)

32. A nurse is teaching about growth and development to a parent of a 12-year-old child. The nurse should instruct the parent to expect a child to exhibit which of the following characteristics during early adolescence?

    1. Emotionalseparationfromparents

    2. Mood swings

    3. Increased self-esteem

    4. Deceleratinggrowthrate

33. A nurse is caring for a child who is 2 hours postoperative. Which of the following actions should the nurse take first? (Click the “exhibit” button for additional information about the client. There are three tabs that contain separate categories of data).
    A. Recheckthechild’stemperature

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2. Determine the child’s sedation level

3. Assess the child’s pain level

4. Comparethechild’spedalpulses

34. A nurse is assessing an adolescent who has Cushing’s syndrome. Which of the following findings should the nurse expect?

    1. Potassium4.2mEq/L

    2. Blood glucose 320 mg/dL

    3. Advanced bone age

    4. Cachecticappearance

35. A nurse is caring for a preschool-age child who is 2 hours postoperative following a tonsillectomy and adenoidectomy. Which of the following manifestations should the nurse report to the provider?

    1. Tachycardia

    2. Blood-tinged mucus

    3. Dark brown emesis

    4. Halitosis

36. A nurse is assessing a 6-month-old infant who has respiratory syncytial virus. The nurse should immediately report which of the findings to the provider?
    A. Coughing
    B. Tachypnea

    C. Pharyngitis

    D. Rhinorrhea

37. A nurse is admitting an infant who has GERD. Which of the following is the priority

    assessment finding?

    1. Weightloss

    2. Excessive crying

    3. Wheezing

    4. Regurgitation

38. A nurse is planning care for a child who is experiencing sickle cell crisis. Which of the following interventions should the nurse include in the plan of care?

    1. Administermeperidineasneededforpain

    2. Initiate bed rest

    3. Limit fluid intake

    4. Applycordcompressestoaffectedjoints

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39. A nurse is providing teaching to a parent of a child who has cystic fibrosis and a new prescription for dornase alfa. Which of the following instructions should the nurse include in the teaching?

    1. Storethemedicationintherefrigerator

    2. Use a spacer with this medication

    3. Administer every 4 hours as needed for cough

    4. Mixthemedicationwithalbuterolsolutionpriortoadministration

40. A nurse is caring for a preschool-age-child who has a terminal illness. Which of the following findings should the nurse expect?

    1. Believestheconditionisapunishment

    2. Expresses interests in the funeral arrangements

    3. Accepts death is inevitable

    4. Feelsexcessiveanxietyaboutphysicalchanges

41. A nurse is reviewing the laboratory values of a school-age child who has nephrotic syndrome. Which of the following laboratory results should the nurse expect?

    1. Serumsodium144mg/dL

    2. Serum protein 4.2 g/dL

    3. Hgb 12 g/dL

    4. BUN15mg/dL

42. A nurse is planning care for a school-age child who has autism spectrum disorder. Which

of the following actions should the nurse include in the plan?

1. Givethechildthreeoptionswhenmakingchoices

2. Stay with the child for long periods of time

3. Explain procedures in detail to the child

4. Introducethechildtonewsituationsslowly

43. A nurse is preparing to administer morphine 0.2 mg/kg IV to a child who is postoperative and in pain. The child weighs 34 kg. Available is morphine 1 mg/mL solution. How many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero)

    Answer: 6.8 mL

44. A nurse is providing teaching to a parent of an 11-month-old infant who has acute diarrhea and dehydration. Which of the following fluids should the nurse instruct the parent to provide to the infant?

    1. Chickenbroth

    2. Oral electrolyte solution

    3. Glucose water

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D. Half-strengthapplejuice

45. A nurse is providing teaching to a parent of a child who has HIV. Which of the following statements by the parent indicates an understanding of the teaching?

    1. Theriskoftransmissiondecreasessincemychildisonzidovudinefor2weeks

    2. My child will need to repeat his childhood immunizations since he is in remission

    3. My child will need to double his medications for the next 6 months

    4. Iwillensurethatmychildistestedfortuberculosiseveryyear

46. A nurse is caring for a school-age child who has diabetes mellitus. Which of the following findings should the nurse recognize as being consistent with hyperglycemia?
    A. Pallor
    B. Thirst

    C. Sweating D. Tremors

47. A nurse in an urgent care clinic is prioritizing care for four children. Which of the following children should the nurse assess first?

    1. Apreschool-agechildwhohasmuffledvoiceandspontaneouscough

    2. An adolescent who has Crohn’s disease and a recent weight loss of 5 kg (11 lbs)

    3. A toddler who has nephrotic syndrome and facial edema

    4. Aschool-agechildwhohasdiabetesmellitusandabloodglucoseof200mg/dL

48. A nurse is prioritizing care for four clients. Which of the following clients should the nurse assess first?

    1. Anadolescentwhohassicklecellanemiaandslurredspeech

    2. A toddler who has a new diagnosis of osteomyelitis and is to receive an IV bolus of

       nafcillin

    3. An adolescent who is in skin traction and reports a pain level of 7 on a scale from 0

       to 10

    4. Atoddlerwhohasapartial-thicknessburnonhisrighthandandrequiresadressing

       change

49. A nurse is preparing to administer immunization to a 3-month-old infant. Which of the

    following is an appropriate method to take to deliver atraumatic care?

    1. Usea20-gaugeneedlefortheinjection

    2. Apply eutectic mixture of local anesthetics (EMLA) cream immediately before the

       injections

    3. Inject the immunization into the deltoid muscle

    4. Provideapacifiercoatedwithanoralsucrosesolutionpriortotheinjections

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50. A nurse is reviewing the laboratory results of a child who was recently admitted for suspected rheumatic fever. The nurse should expect that which of the following laboratory tests can contribute to confirming this diagnosis? (SATA)

    1. AntistreptolysinO(ASO)titer

    2. Blood urea nitrogen (BUN)

    3. Partial thromboplastin (PTT)

    D. E.

51. A nurse is reviewing the laboratory report of a school-age child who has bacterial pneumonia. Which of the following laboratory values should the nurse expect?

    1. WBC18,000/mm3

    2. Ph 7.40

    3. Hgb 14 g/dL

    4. Creatinine0.5mg/dL

52. A nurse is providing teaching about medication administration to the parents of a toddler who has a new prescription for liquid ferrous sulfate. Which of the following instructions should the nurse include in the teaching?

    1. Reporttarry,greenstoolstotheprovider

    2. Administer the drops with milk

    3. Dilute the drops with water prior to administration

    4. Provideanantacidpriortoadministration

53. A nurse in an emergency department is caring for a child following an overdose of acetylsalicylic acid. Which of the following medications should the nurse plan to administer?
    A. Flumazenil

    B. Phytonadione C. Midazolam
    D. Naloxone

54. A nurse is planning care for a newly admitted child who has rotavirus. Which of the following precautions should be implemented?
    A. Airborne
    B. Contact

    C. Protective D. Droplet

55. A nurse is developing a plan of care for child who is dying. Which of the following measures should the nurse implement to the child and his family?

Erythrocyte sedimentation rates (ESR)

C-reactive protein (CRP)

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1. Maintainconsistentnursingstaffassignments

2. Ask the parents to leave the room for the procedures

3. Select one family member to receive information

4. Limitthenumberofvisitorsintheclient’sroom

56. A nurse is planning to perform tracheostomy care for a toddler. Which of the following is an appropriate action for the nurse to take?
A. Havethechildflexhisheadwhensecuringtheties
B. Place the child in Trendelenburg position when performing care

C. Clean around the stoma with full-strength hydrogen peroxide D. Usecleantechniquetochangethetracheostomytube

57. A nurse in the emergency department is caring for a child who has a temperature of 39.1 C (102.4 F) and a suspected diagnosis of bacterial meningitis. Which of the following actions should the nurse take first?

1. Preparethechildforalumbarpuncture

2. Administer an antipyretic to the child

3. Dim the lights in the child’s room

4. Implementdropletprecautionsforthechild

58. A nurse is caring for a toddler who has a shirt leg cast. Which of the following findings should the nurse report to the provider?

    1. Positivepedalpulseinthedistalextremity

    2. Pallor of the distal extremity

    3. Mobility of the distal extremity

    4. Warmtemperatureofthedistalextremity

59. A nurse is caring for a newly admitted toddler who has acute diarrhea. Which of the following actions should the nurse take first?

    1. Initiatecontactprecautions

    2. Administer an antibiotic

    3. Obtain a stool specimen for culture

    4. Give0.9%sodiumchlorideIVbolus

60. A nurse is planning to teach an adolescent who is lactose intolerant about dietary guidelines. Which of the following instructions should the nurse include in the teaching?

    1. Youmaytolerateplainmilkbetterthanchocolatemilk

    2. You can drink milk on an empty stomach

    3. You can replace milk with nondairy sources of calcium

    4. Youshouldconsumeflavoredyogurtinsteadofplainyogurt

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61. A nurse is providing discharge teaching to the parents of a school-age child following placement of a ventriculoperitoneal shunt. The nurse should determine that the teaching was effective when the parents identify which of the following as an indication the shunt has been displaced?

    1. Hyperactivebowelsounds

    2. Elevated temperature

    3. Increased sleeping

    4. Decreasedurineoutput

62. A nurse is providing teaching to a parent of a 2-month-old infant about immunization schedules. Which of the following statements by the parent indicates an understanding

of the teaching?

1. MychildneedstogettheMMRimmunizationwhenshe’s12monthsold

2. My child needs to get the varicella immunization when she’s 6 months old

3. My child will receive the influenza immunization today

4. MychildwillreceivethehepatitisAimmunizationtoday

63. A nurse is performing a cranial nerve assessment on a school-age child. Which of the following findings indicates proper functioning of the child’s trigeminal nerve?

    1. Thechildmaintainsbalancewhenstandingwitheyesclosed

    2. The child has symmetrical jaw strength when biting down

    3. The child exhibits a gag reflex when stimulated with tongue blade

    4. Thechildcorrectlyidentifiesspecificexams

64. A nurse is planning care for a child immediately following the insertion of a chest tube for continuous suction with a closed drainage system. Which of the following interventions should the nurse include in the plan of care?

    1. Ensurecontinuousbubblingispresentinthesuctioncontrolchamber

    2. Report the presence of tiddling of fluid in the water seal chamber

    3. Change the chest tube insertion site dressing every 12 hrs

    4. Recordtheamountofchesttubedrainageevery2hrs

65. A nurse is educating an adolescent following the application of an arm cast. Which of the following statements by the client indicates an understanding of the teaching?

    1. Iwillsprinklebabypowderintothecastifmyarmitches

    2. I should limit the use of the fingers of my broken arm

    3. I will elevate my forearm on pillows at night

    4. Ishouldexpectmyfingerstobeswollenforseveraldays

66. A nurse in a community center is providing an in-service for parents about nutritional guidelines. Which of the following guidelines should the nurse include in the teaching?

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1. Encouragea15-year-oldtoincreasecalciumintake

2. Provide 35 oz of milk per day to a toddler

3. Offer 8 to 10 oz of juice per day to a preschooler

4. Introducepopcornasahealthsnackat12monthsofage

67. A nurse is caring for a school-aged child who is experiencing pain. Which of the following assessment teachings would be the most accurate information regarding the child’s pain?

    1. AskthechildtouseaFACESratingscale

    2. Monitor the child’s involuntary movements

    3. Observe the child’s facial expressions

    4. Assessthechild’spulseandrespirations

68. A nurse in an emergency department is assessing a school-age child who has asthma. Which of the following should the nurse identify as the priority?

    1. Decreasedbreathsounds

    2. Hyperresonance on percussion

    3. Nonproductive cough

    4. Pulserate118/min

69. A nurse is caring for a child who is postoperative following surgical correction of tetralogy of Fallot. Which of the following is a manifestation of heart failure?

    1. Exerciseintolerance

    2. Bradycardia

    3. Weight loss

    4. Decreasedrespirations

70. A nurse is caring for a 4-year-old child who has meningitis and is receiving gentamycin. Which of the following laboratory results should the nurse report to the provider?

    1. Creatinine1.4mg/dL

    2. BUN 12 mg/dL

    3. BUN 6 mg/dL

    4. Creatinine0.2mg/dL

71. A nurse is providing teaching to guardians off a school-aged child who has a seizure disorder. Which of the following factors should the nurse include as a common trigger that increases the risk of seizures?

    1. Prolongedheadache

    2. Lack of sleep

    3. Decreased temperature

    4. Exposuretosecondhandsmoke

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72. A nurse planning care for an 8-month-old infant who has heart failure. Which of the following actions should the nurse include in the plan of care?

    1. Placetheinfantinaproneposition

    2. Repeat a digoxin dosage if the infant vomits within 1 hour administration

    3. Provide less frequent, higher volume feedings

    4. Administercool,humidifiedoxygenvianasalcanula

73. A nurse is caring for an adolescent who is 1 hour postoperative following an appendectomy which of the following findings should the nurse report to the provider?

    1. Temperatureof36.4C(97.5F)

    2. Muscle rigidity

    3. Abdominal pain

    4. Heartrateof63min

74. A nurse is providing teaching about the effects of sun exposure to a parent of a toddler. Which of the following responses by the parent indicates an understanding of the teaching?

    1. Mychildshouldremainunderabeachumbrelladuringmorninghours

    2. My child should wear a wide-brimmed hat

    3. I should apply a 10 spf sunscreen to my child’s entire body

    4. Ishoulddressmychildinloose-weaveclothing

75. A nurse is reviewing the laboratory results of a preschooler who has gastroenteritis and notes the child’s potassium level is 3.2 mEq/L. which of the following assessment findings should the nurse expect?

    1. Oliguria

    2. Hyperactive bowel sounds

    3. Hypertension

    4. Hyporeflexia

76. A nurse is assessing a school age child’s cranial nerve function. Which of the following actions should the nurse assess the child to take when assisting the accessory nerve?

    1. Showtheirteethwhilesmiling

    2. Shrug their shoulders against mild pressure

    3. Move their tongue in all directions

    4. Followalightinthesixcranialpositions

77. A nurse is teaching a group of female adolescents about health eating. Which of the following instructions should the nurse include in the teaching?

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1. Consume1500to1700calperday

2. Limit your sodium intake to 3000 milligrams per day

3. Decrease your vitamin D intake once you start to menstruate

4. Increasetheamountofyourdietaryironintake

78. A nurse in a provider’s office is preparing to administer immunizations to a 12-year-old client during a well child visit. Which of the following immunizations should the nurse plan to administer?

    1. Humanpapillomavirus(HPV)

    2. Hepatitis a

    3. Diphtheria, tetanus, and pertussis (DTaP)

    4. Varicella

79. A nurse is assessing a school age child who has heart failure and is taking furosemide. Which of the following findings should the nurse identify as an indication that the medication is effective?

    1. Adecreaseinperipheraledema

    2. An increase in venous pressure

    3. A decrease in cardiac output

    4. Anincreaseinpotassiumlevels

80. A nurse is teaching home care to the parents of a preschool-age child who has heart failure. Which of the following information should the nurse include in the teaching?

    1. Increasethechild’soxygenflowrareuntilthechildnolongerhascyanosis

    2. Withhold the digoxin if the child’s pulse is greater than 100/min

    3. Provide periods of rest

    4. Weightthechildonceamonth

81. A nurse is planning care for a child who has varicella. Which of the following interventions should the nurse plan to include?

    1. Initiateairborneprecautions

    2. Administer aspirin for fever

    3. Provide the child with a warm blanket

    4. Assesstheoralcavityforkolpikspots

82. A nurse in the emergency department is assessing a toddler who has hyperpyrexia, severe dyspnea, and is drooling. Which of the following actions should the nurse take first?

    1. Preparethetoddlerfornasaltrachealintubation

    2. Administer an antibiotic to the toddler

    3. Insert an IV catheter for the toddler

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D. Obtainabloodculturefromthetoddler

83. A nurse in a pediatric clinic is providing teaching to the guardian of an infant who has a new prescription for digoxin. Which of the following manifestation should the nurse include as an indication for digoxin toxicity?
    A. Polyuria

    B. Diaphoresis C. Jaundice
    D. Bradycardia

84. A nurse is preparing to collect a urine specimen from a female infant using a urine collection bag. Which of the following action should the nurse take first?

    1. Applylidocainegeltotheperineumbeforeattachingthebag

    2. Position the opening of the bag over the urethra and the anus

    3. Place a snug-fitting diaper over the drainage bag

    4. Stretchtheperineumtautwhenapplyingthebag

85. A nurse is caring for a school age child following the application of a cast to a fractured right tibia. Which of the following actions should the nurse take first?

    1. Administerpainmedication

    2. Elevate the child’s leg

    3. Pedal the edges of the cast

    4. Teachthechildaboutcastcare

86. A nurse is preparing to administer prescribed medication to a toddler whose parent is nearby. Which of the following actions should the nurse take to identify the toddler?

    1. Askanothernursetoconfirmthetoddler’sindent

    2. Check the toddler’s ID band against medical record

    3. Ask the parent to confirm the toddler’s identity

    4. Checkthetoddler’sroomnumberagainsttheirIDbracelet

87. A nurse is assessing an infant who has severe dehydration due to gastroenteritis. Which

of the following findings should the nurse expect?

1. Increasedurineoutput

2. Increased respiratory rate

3. Capillary refill of 2 seconds

4. Hypertension

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88. A nurse is caring for a three-month-old infant who has a cleft of soft palate. Which of the following actions should the nurse take?

    1. Postponeburpingtheinfantuntilaftercompletingeachfeeding

    2. Feed the infant 177.4 mL (6 oz) of formula three times each day

    3. Discontinue feeding if the client’s eyes become watery

    4. Elevatetheinfantsheadtoa10-degreeangleduringfeedings

89. A nurse is providing teaching about home care to the parents of a child who has scabies. Which of the following instructions should the nurse include in the teaching?

A. Applypetroleumjellytotheaffectedareas B.

C.
D. Washthechild’shairwithshampoocontainingketoconazole

90. A nurse is planning care for a child who has osteomyelitis. Which of the following interventions should the nurse include in the plan of care?
A.
B.

C. Encourage frequent physical activity to increase bone mass D. Provideahighcalorie,lowproteindiet

91. A nurse is assisting an infant who has acute otitis media. Which of the following findings should the nurse expect? (SATA)

    1. Fever

    2. Increased appetite

    C. D. E.

92. A nurse is admitting a child who has acute epiglottis. Which of the following actions should the nurse take?

    1. Obtainathroatculture

    2. Assist the child into supine position

    3. Check oxygen saturation every 4 hours

    4. Initiatedropletisolationprecautions

93. A nurse in a provider’s office is assisting the vital signs of a two-year-old child at a well child visit. Which of the following findings should the nurse report to the provider?
    A. Bloodpressure118/74mmHg

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Soak combs and brushes in boiling water for 10 mins

Treat everyone who came into close contact with the child

Initiate contact precautions for the child

Maintain a patent intravenous catheter

Crying

Enlarged sub clavicular lymph node

Restlessness

2. Respiratory rate 26/min

3. Temperature 37.2 (99 F)

4. Pulserate98/min

94. A nurse is providing teaching to a 10-year-old child who is scheduled for an arterial cardiac catheterization. Which of the following information should the nurse include in the teaching?

    1. Youwillhaveyourdressingremoved12hoursaftertheprocedure

    2. You will need to keep your leg straight for 8 hours following the procedure

    3. You will be on bed rest for 2 days after the procedure

    4. Youwillbeonclearliquiddietfor24hoursfollowingtheprocedure

95. A nurse in an emergency department is caring for a preschool age child who has acute acetylsalicylic acid poisoning. Which of the following should the nurse expect?

    1. Hyperpyrexia

    2. Polyuria

    3. Neck vein distention

    4. Jaundice

96. A nurse is reviewing the medical record of a 15-month-old child who is scheduled to receive the measles, mumps, and rubella (MMR) vaccine. Which of the following findings should the nurse identify as a contraindication of receiving this vaccine?

    1. Temperatureof37.2(99F)

    2. Upper respiratory infection 2 days ago

    3. Allergy to neomycin

    4. Familyhistoryofseizures

97. A nurse is planning care for a 6-month-old infant who has bacterial meningitis. Which of the following interventions should the nurse include in the plan of care?

    1. Keepthetelevisiononintheroomtoprovidebackgroundnoise

    2. Provide frequent range of motion to the neck and shoulders

    C. D.

98. A nurse is providing teaching to the parents of an infant who is to undergo pilocarpine iontophoresis testing for cystic fibrosis. Which of the following statements should the nurse include in the teaching?

    1. Thetestwillmeasuretheamountofchlorideinyourbaby’ssweat

    2. We will measure the amount of protein in your baby’s urine over a 24-hour period.

    3. A nurse will insert an IV prior to the test

    4. Yourbabywillneedtofastfor8hourspriortothetest

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Pad the side rails of the crib

Place the infant in a semiprivate room

99. A nurse is caring for a 10-month-old child who was brought to the emergency department by his parents following a head injury. Which of the following actions should the nurse take first?

1. Checkpupilreactions

2. Inspect for fluid leaking from the ears

3. Examined scalp for lacerations

4. Assessrespiratorystatus

100. A nurse is assessing a 5-month-old infant. Which of the following findings should the nurse report to the provider?

1. Exhibitaheadlagwhenpullingtoasittingposition

2. Absent gag reflex

3. Unable to roll from back to abdomen

4. Unabletoholdabottle

101. A nurse in a PACU is caring for a school-age child immediately following a tonsillectomy. Which of the following actions should the nurse take?

1. Offerthechildicecreamwhenalert

2. Place the child in a side-lying position

3. Encourage the child to deep breaths and cough

4. Instructthechildtodrinkfluidsthroughastraw

102. A nurse is providing discharge teaching to the parents of an infant who is at risk for sudden death syndrome (SIDS). Which of the following statements by the parent indicates and understanding of the teaching?

1. Iwillhavemybabysleepnexttomeinbedduringthenight

2. I will move my babies stuffed animals to the corner of her crib while she sleeps

3. I will dress my baby in lightweight clothing to sleep

4. Iwilllaymebabyonhersidetosleepfornaps

103. A charge nurse is planning care for an infant who has failure to thrive. Which of the following actions should the nurse include in the plan of care?

1. Usehalf-strengthformulawhenfeedingtheinfant

2. Assign consistent nursing staff to care for the infant

3. Keep the infant in a visually stimulating environment

4. Givetheinfantfruitjuicebetweenfeedings

104. A nurse is to administer amoxicillin 80 mg/kg/day divided into two doses to a 2- year-old client who weighs 10 kg (22lb). available amoxicillin suspension is 400 mg/5 mL.

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how many mL of amoxicillin should the nurse administer per dose? (Round the answer to the nearest whole number. Using a leading zero if it applies. Do not use a trailing zero) Answer: 10 ML

105. A nurse is doing an evaluation of a 4-year-old child who has cystic fibrosis and has been receiving chest physiotherapy treatments. The nurse should identify which of the following findings as an indication that the therapy has been effective?

1. Increasedurineoutput

2. Increased expectoration

3. Increased heart rate

4. Reducedpain

106. A nurse is caring for a preschooler who refuses to take a stat dose of oral diphenhydramine. Which of the following statements should the nurse make?

1. Themedicationwilltreatyourhypersensitivityreaction

2. Sometimes when a child has to take medication, they feel sad

3. Let me know when you want to take the medication

4. Themedicationisn’tbadittasteslikecandy

107. A nurse is monitoring an infant who is receiving opioids for pain. Which of the following findings should indicate to the nurse that the medication is having a therapeutic effect?

1. Increasedbloodpressure

2. Bradycardia

3. Limb withdrawal

4. Relaxedfacialexpression

108. A nurse is providing support to a family whose infant died from sudden infant death syndrome (SIDS). Which of the following actions should the nurse take?

1. Avoiddiscussingdetailsoftheattempttorevivetheinfant

2. Provide a follow up phone call 1 week following the infant’s death

3. Acknowledge the family members feelings of guilt

4. Discouragetheparentsfromallowingsiblingstoviewthebody

109. A nurse is teaching a group of parents about childhood immunizations. The nurse should identify that the infant should receive the first dose of which of the following immunizations at 12 months of age?

1. Humanpapillomavirus

2. Hepatitis B

3. Varicella

4. InactivatedPoliovirus

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110. A nurse is caring for a school-age child who is 1 hour postoperative following a tonsillectomy. Which of the following actions should the nurse take? (SATA)

1. Administeredananalgesictothechildonascheduledbasis

2. Maintain the child in a supine position

3. Provide cranberry juice to the child

D. E.

111. A nurse is communicating with a child who has hearing loss. Which of the following actions should the nurse take?

1. Exaggeratethepronunciationofwords

2. Use light tough when initiating conversation

3. Maintain a neutral facial expression when speaking to the ch8ild

4. Changepositionsfrequentlytomaintainthechild’sattention

112. A nurse is teaching the parent of a toddler who has phenylketonuria about meal planning. Which of the following information should the nurse include in the teaching?

1. Increasethetoddler’sproteinconsumption

2. Avoid foods containing milk products

3. Limit foods high in iron

4. Useaspartameasasugarsubstitute

113. A nurse is assessing a toddler who has a history of lead poisoning. Which of the following actions should the nurse take?

1. Obtainastoolspecimenforleadlevels

2. Inspect the skin for discoloration

3. Perform developmental testing for delays

4. Initiatealow-irondietforleadabsorption

114. A nurse is caring for a school-age child who is experiencing a sickle cell crisis. Which of the following actions should the nurse take?

1. Decreasethechild’sfluidintake

2. Administer furosemide IV twice per day

3. Apply warm compresses to the affected areas

4. Initiatecontactprecautions

115. A nurse is assessing a child who has multiple closed fractures of the lower extremities due to a motor-vehicle accident. The nurse should monitor the child for which of the following complications during the first 24 hours after the injury occurred?

Observe the child for frequent swallowing

Discourage the child from coughing

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1. Compartmentsyndrome

2. Renal calculi

3. Osteomyelitis

4. Volkmannischemiccontracture

116. A nurse is teaching the guardian of a 5-year-old child who has encopresis about management of the condition. Which of the following statements by the guardian indicates an understanding of the teaching?

1. Iwillhavemychildtrytodefecate15minutesaftereachmeal

2. I will increase my child’s dairy intake

3. I will have my child sit on the toilet for 20 minutes at a time

4. Iwilllimitmychild’sfluidintake

117. A nurse is planning care for an adolescent who has sickle cell anemia. Which of the following immunizations should the nurse include in the plan?

1. Pneumococcalconjugate(PCV13)

2. Rotavirus

3. Respiratory syncytial virus (RSV)

4. Measles,mumps,andrubella(MMR)

118. A nurse in the emergency department is caring for a school-age child who has developed respiratory stridor, wheezing and urticaria after receiving an IV medication. Which of the following actions should the nurse take first?

1. Administerepinephrine

2. Administer oxygen

3. Administer methylprednisolone

4. Administeranebulizedbronchodilator

119. A nurse in an emergency department is caring for a child who has experienced a submersion injury. Which of the following is the priority action for the nurse to take?

1. ObtainanABGsample

2. Administer an IV bolus

3. Apply warning blankets

4. Assistwithintubation

120. A nurse is assessing an adolescent who has type 1 diabetes mellitus. Which of the following findings is the nurse’s priority?

1. HbA1c11.5%

2. Glycosuria

3. Pre-prandial blood glucose 124 mg/dL

4. Cholesterol189mg/dL

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121. of

A. B. C. D.

A nurse is planning to administer immunizations to a 2-month-old infant. Which the following actions should the burse take to decrease the infant’s pain?

Administertheinjectionswhiletheinfantisbreastfeeding

Ask the parents to leave the room during the injections Administer the injections in the deltoid muscle Applyawarmpacktotheinjectionsitepriortoadministration

122.
vest to manage a cervical vertebral fracture. Which of the following actions should the nurse take?

1. Assesthepinsitesforinjectiononceeveryotherday

2. Encourage flexion and extension of the neck

3. Reposition the client using a turning sheet

4. Tightenthescrewsonthehalodeviceonequarterturnevery48hours

123. A nurse is teaching the parent of a school-age child about bicycle safety. Which of the following instructions should the nurse include in the teaching?

1. Yourchildshouldkeepthebicycleatleast3feetfromthecurbwhileridinginthe

   street

2. Your child should walk the bicycle through intersections

3. Your child should ride the bicycle against the flow of traffic

4. Yourchild’sfeetshouldbe3to6inchesoffthegroundwhenseatedonthebicycle

124. A nurse is assessing an adolescent client who has Hodgkin’s lymphoma. Which of the following findings should the nurse expect?

1. Nightsweats

2. Unexplained weight gain

3. Decreased body temperature

4. Flushedskin

125. A nurse is preparing to perform a venipuncture to collect a blood sample from an infant. Which of the following restraints should the nurse plan to use for this procedure? A. Elbow
B. Jacket

C. Mummy D. Mitten

126. A nurse is assessing a child who has heart failure. Which of the following findings is a clinical manifestation associated with this diagnosis?

A nurse is caring for a client who is postoperative following placement of a halo

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1. Tachypnea

2. Bradycardia

3. Increased appetite

4. Tremors

127. A nurse is providing teaching to the parents of a child who has varicella about management of the disease. Which of the following instructions should the nurse include in the teaching?

1. Applycalaminelotiontovesiclesonthechild’sskin

2. Dress the child in warm clothing to promote healing of vesicles

3. Avoid giving the child a bath while vesicles are present

4. Keepthechildawayfromothersuntiltheskinisclearofscabs

128. A charge nurse is teaching a group of nurses about identifying child abuse. Which of the following findings should the nurse identify as a potential indicator of child abuse?

1. Atoddlerhasbruisesonhisknees

2. A mother is hesitant to comfort her 6-month-old infant

3. An 8-month-old infant cries when his parents leave the room

4. Atoddlerrepeatedlyrefusestoletanurseauscultatehislungs

129. A nurse is caring for a child in the PACU following a tonsillectomy. Which of the following findings requires immediate intervention by the nurse?

1. Axillarytemperature38C(100F)

2. Child reports pain level of 5 on the FACES scale

3. Dark brown blood noted in emesis

4. Frequentswallowing

130. A nurse is caring for an adolescent who has major depressive disorder. Which of the following actions should the nurse take first?

1. Encouragetheclienttoattendagrouptherapysession

2. Assist the client if he is considering harming himself

3. Administer an antidepressant to the client

4. AssisttheclientincompletinghisADLs

131. A nurse is teaching a group of male adolescents about testicular self- examination. Which of the following statements should the nurse include in the teaching?

1. Youshouldperformtheexaminationonceeveryothermonth

2. If you feel a hard lump, wait 1 month and retest yourself

3. Perform the examination following a warm shower

4. Youshouldnotifyyourproviderifyourtestesarefirm,andeggshaped

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132. A nurse at an inpatient facility is planning care for a child who has autism spectrum disorder. Which of the following interventions should the nurse include in the plan of care?

1. Placethechildinasemiprivateroom

2. Keep the staff visits with the child brief

3. Keep the television on in the child’s room for background noise

4. Varydailyroutineswhenprovidingcareforthechild

133. A nurse is caring for a school-age child who has pertussis. Which of the following actions should the nurse take?

1. Placethechildinaprotectedenvironmentfor48hours

2. Restrict oral fluids to 500 ml per day

3. Administer the pertussis vaccine

4. Reportthediagnosistothepublichealthdepartment

134. A nurse is planning to admit a preschooler from the PACU following removal of a Wilm’s tumor. Which of the following children should the nurse identify as an appropriate roommate for the preschooler?

1. Achildwhohasviralpneumonia

2. A child who has impetigo

3. A child who has a fractured left femur

4. Achildwhohascellulitisoftherightradius

135. A nurse is planning care for an adolescent following repair of Meckel diverticulum. Which of the following actions should the nurse include in the plan of care?

1. Teachtheclientaboutostomycare

2. Administer total parenteral nutrition

3. Initiate long term antibiotic therapy

4. MaintainanNGtubefordecompression

136. A nurse is caring for a preschooler who has a brain tumor. Which of the following findings is the priority for the nurse to report to the provider?
A. Puritus
B. Nightmares

C. Hyperactivity D. Diplopia

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137. A nurse in a community clinic is reviewing the laboratory results of four clients. The nurse should identify that which of the following sexually transmitted infections is nationally notifiable?

1. Genitalherpessimplexvirus

2. Bacterial vaginosis trichomoniasis

3. Gonorrhea

4. Humanpapillomavirus

138. A nurse is assessing a toddler who is 8 hours postoperative following a cardiac catheterization procedure. Which of the following findings should the nurse report to the provider?

1. Bilateralcoolextremities

2. Serum glucose 90 mg/dL

3. Blood pressure 102/58 mm Hg

4. Weakpedalpulsedistaltothesite

139. A nurse is preparing to apply lidocaine and prilocaine cream to a child prior to the insertion of an IV catheter. Which of the following actions should the nurse plan to take?

1. Gentlyrubthecreamintotheskin

2. Wash the site with alcohol prior to applying the cream

3. Apply the cream 1 hour before the procedure

4. Avoidremovingthecreampriortotheprocedure

140. A nurse is preparing to initiate IV antibiotic therapy for a newly admitted 12- month-old infant. Which of the following actions should the nurse plan to take?

1. ChangetheIVsiteevery3days

2. Start the IV in the infant’s foot

3. Use a 24-gauge catheter to start the IV

4. Covertheinsertionsitewithanopaquedressing

141. A nurse is teaching a parent about home interventions for a preschooler who is experiencing night terrors. Which of the following instructions should the nurse include in the teaching?

1. Allowyourchildtowatchananimatedmovierightbeforebedtime

2. Wait until your child indicates that he is tired before putting him to bed

3. Avoid allowing your child to sleep in your bed

4. Wakeyourchildupduringthenightterror

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142. A nurse is educating an adolescent following the application of an arm cast. Which of the following statements by the client indicates an understanding of the teaching?

1. Iwillsprinklebabypowderintothecastifmyarmitches

2. I should expect my fingers to be swollen for several days

3. I will elevate my broken arm on pillows at night

4. Ishouldlimittheuseofthefingersofmybrokenarm

143. A nurse is providing teaching to the parents of a toddler who is to undergo a sweat chloride test. Which of the following statements should the nurse include?

1. ThepurposeofthetestistodetermineifyourchildhasCrohn’sdisease

2. The technician will use a device to produce an electrical current during the test

3. During the test, your child will be in a room that is cold

4. Yourchild’ssweatwillbecollectedover24hours

144. A nurse is caring for a preschooler who is post-operative following a tonsillectomy. The child is now ready to resume oral intake which of the following dietary choices should the nurse offer the child?

1. Sugar-freecherrygelatin

2. Vanilla ice cream

3. Chocolate milk

4. Limeflavoredicepop

145. A nurse is preparing a school-age child for an invasive procedure. Which of the following actions should the nurse plan to take?

1. Planfor30-minuteteachingsessionabouttheprocedure

2. Use vague language to describe the procedure

3. Explain the procedure to the child when they are in the playroom

4. Demonstratedeepbreathingandcountingexercises

146. A nurse is caring for a child who has hyponatremia. Which of the following findings should the nurse expect?

1. Tetany

2. Weight gain

3. Elevated heart rate

4. Excessivediaphoresis

147. A nurse is planning care for a school-age child who is admitted from the emergency department 12-hours-ago. Which of the following interventions should the nurse include to promote adequate sleep for the child?
A. Providethechildwithvideogamespriortobedtimetoreducestress

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2. Allow the child to adjust their bedtime to promote autonomy

3. Leave the lights on in the child’s room to promote safety

4. Followthechild’shomesleeproutinetoreduceanxiety

148. A nurse is caring for an infant who receives intermittent enteral feeding through a gastrostomy tube. Which of the following actions should the nurse take when administering a feeding? (SATA)

1. Offertheinfantapacifierduringreadings

2. Formula to 39 C (102 F) prior to administration

3. Check for residual volume by aspirating stomach contents

4. Instilltheformulaoveraperiodof30to45minutes

149. A nurse is providing teaching to the guardian of a school-age child who has sickle cell disease about management of the illness. Which of the following instructions should the nurse include?

1. Applycoldcompresstopainfulareas

2. But I shall wear a surgical mask to school

3. Encourage physical activity as tolerated

4. Offerfluidsofbedtime

150. A nurse is discussing coping mechanism with a parent of a three-month-old infant which of the following therapeutic questions should the nurse ask the parent?

1. Whatdoyoudowhenyourinfantisfussy?

2. Are you willing to take a new parenting classes?

3. Does parenting cause you stress?

4. Isitoverwhelmingwhenyourinfantishavingabadday?

151. A nurse is reviewing the medical record of a child with cystic fibrosis which of the following should the nurse report to the provider? Click the exhibit button for additional information about the client.

1. Heartrate

2. HbA1c

3. Oxygen saturation

4. WBC48

152. A nurse is assessing an infant who has intussusception. Which of the following findings should the nurse expect?

1. Sausage-shapedabdominalmass

2. Board like abdomen

3. Constipation

4. Increasedurinaryoutput

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153. A nurse is caring for a 14-year-old adolescent who has a cast on the right arm and swelling of their right hand. The nurse elevates the adolescents affected extremity. The nurse should identify that which of the following findings is an indication that the intervention has been effective?

1. Theadolescentreportofthecastfeelstight

2. The adolescent hands feel cool to touch

3. The adolescent is able to move their fingers freely

4. Theadolescentreportsfeelingtinglingintheirarms

154. A nurse is planning care for a school-age child who has a new diagnosis of Legg calve perthes disease. Which of the following interventions should the nurse include in the plan of care?

1. Instructachildtoperformweightbearingexercises

2. Explain to the child that the disease will last 3 to 6 months

3. Encourage the guardian to keep their child home from school for one month

4. Administeribuprofentothechildfordiscomfort

155. A nurse is caring for a two-year-old who has cystic fibrosis and is being discharge from the hospital. The nurse should ensure that which of the following pieces of equipment is available for the child’s home?

1. Steamvaporizer

2. Suction machine

3. Continuous positive airway pressure machine

4. Highfrequencychestcompressionvest

156. A nurse is providing teaching for the parent of a child who has measles. Which of the following information should the nurse include?

1. Bathethechildusingtepidwater

2. Remove loose crust from the lesions

3. Give the child aspirin for a fever

4. Withholdlivevaccinesfor3months

157. A nurse is assessing a toddler who has cystic fibrosis. Which of the following findings should the nurse expect?

1. Steatorrhea

2. Rhinorrhea

3. Weight gain

4. Visibleperistalsis

158. A nurse is planning to administer diphenhydramine 1.25 mg/kg IV to a school-age child who weighs 55lb. available is diphenhydramine 50 mg/mL. how many mL should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero that applies. Do not use a trailing zero).