1 >>The nurse is caring for clients in a pediatric emergency department (ED). Which client should the nurse assess first? ?
- (A) The child with a dog bite on the left hand who is bleeding.
- (B) The child who has a laceration on the right side of the forehead.
- (C) The child with a fractured tibia who will not move the foot.
- (D) The child who has ingested a bottle of prenatal vitamins.
2 >>The nurse is caring for a client in a children’s medical center. Which behavior indicates the nurse understands the pediatric client’s rights? ?
- (A) The nurse administers an injection without talking to the child.
- (B) The nurse covers the 5-year-old child’s genitalia during a code.
- (C) The nurse discusses the child’s condition with the grandparents.
- (D) The nurse leaves an uncapped needle at the client’s bedside.
3 >>The home health nurse is planning the care of a 14-year-old client diagnosed with leukemia who is receiving chemotherapy. Which psychosocial problem is priority for this client? ?
- (A) Diversional activity deficit.
- (B) High risk for infection.
- (C) Social isolation.
- (D) Hopelessness.
4 >>The nurse is caring for clients on a psychiatric pediatric unit. Which action by the nurse is reportable to the state board of nursing? ?
- (A) The nurse leaves for lunch and does not return to complete the shift.
- (B) The nurse fails to check the ID band when administering medications.
- (C) The nurse has had three documented medication errors in the last 3 months.
- (D) The nurse has admitted to having an affair with another staff member.
5 >>The nurse is working in a free healthcare clinic. Which client situation warrants further investigation? ?
- (A) The child diagnosed with rheumatoid arthritis who is wearing a copper bracelet.
- (B) The mother of a child with a sunburn who is using juice from an aloe vera plant on the burn.
- (C) The grandmother who reports rubbing Vick’s Vapo-Rub on the child’s chest for a cold.
- (D) The father who tells the nurse that the child receives a variety of herbs every day.
6 >>The unlicensed assistive personnel (UAP) tells the primary nurse that the 4-year-old child is alone in the room because the mother went to the cafeteria to get something to eat. Which action should the nurse implement first? ?
- (A) Arrange for the mother to have a tray sent to the room.
- (B) Go to the cafeteria and ask the mother to return to the room.
- (C) Tell the UAP to stay with the child until the mother returns.
- (D) Notify social services that the mother left the child alone.
7 >>The nurse is evaluating an 18-month-old child in the pediatric clinic. Which data would indicate to the nurse that the child is not meeting tasks according to Erikson’s Stages of Psychosocial Development? ?
- (A) The child stamps his or her foot and says “no” frequently.
- (B) The child does not interact with the mother.
- (C) The child cries when the mother leaves the room.
- (D) The child responds when called by name.
8 >>Which statement by the female charge nurse indicates she has an autocratic leadership style? ?
- (A) “You must complete all the a.m. care before you take your morning break.”
- (B) “I don’t care how the work is done as long as it is completed on time.”
- (C) “I would like to talk to you about your ideas on a new staffing mix.”
- (D) “I think we should have a pot luck lunch tomorrow because it is Saturday.”
9 >>The nurse is evaluating the care of a 5-year-old client with a cyanotic congenital heart defect. Which client outcome would support that discharge teaching has been effective? ?
- (A) The mother makes the child get up when squatting.
- (B) The child is playing in the dayroom without oxygen.
- (C) The father buys the child a baseball and a bat.
- (D) The nurse finds unopened packs of salt on the meal tray.
10 >>The unconscious 4-year-old child is brought to the emergency department by paramedics; the child has bruises covering the torso in varying stages of healing. The nurse notes small burn marks on the child’s genitalia. Which actions should the nurse implement? Select all that apply. ?
- (A) Notify Child Protective Services.
- (B) Ask the parent how the child was injured.
- (C) Perform a thorough examination for more injuries.
- (D) Tell the parents that the police have been called.
11 >>The 24-month-old toddler is admitted to the pediatric unit with vomiting and diarrhea. Which interventions should the nurse implement? Rank in order of performance. ?
- (A) Teach the parent about weighing diapers to determine output status.
- (B) Show the parent the call light and explain safety regimens.
- (C) Assess the toddler’s tissue turgor.
- (D) Take the toddler’s vital signs.
12 >>Which child should Ms. Laura assess first? ?
- (A) The 1-month-old infant who crying, is inconsolable, and has inspiratory retractions.
- (B) The 4-year-old toddler with cystic fibrosis who has a pulse oximeter reading of 93%.
- (C) The 6-year-old child with gastroenteritis who has a potassium level of 3.6 mEq/L.
- (D) The 14-year-old child with type 2 diabetes with a blood glucose level of 210 mg/dL.
13 >>Which task should Ms. Laura delegate to Ms. Michelle, the UAP? ?
- (A) Take the vital signs of a child who is having a sickle cell crisis.
- (B) Place oxygen via nasal cannula on a child diagnosed with cystic fibrosis.
- (C) Obtain the weight of the child who is diagnosed with nephrotic syndrome.
- (D) Escort the child diagnosed with traumatic brain injury (TBI) to the intensive care unit (ICU).
14 >>Ms. Laura is observing Mr. Aaron administer an intramuscular (IM) injection to a 2-year-old toddler. Which action by Mr. Aaron warrants intervention by Ms. Laura? ?
- (A) He immobilizes the child’s leg.
- (B) He explains the procedure to the child.
- (C) He places the syringe in the sharps container.
- (D) He recaps the needle after administering the medication.
15 >>Which client should Ms. Laura assign to Ms. Polly, the most experienced pediatric emergency department nurse? ?
- (A) The 1-year-old child who is tugging at the right ear and has a temperature of 100.4�F.
- (B) The 6-year-old child who is wheezing and complaining of chest tightness.
- (C) The 8-year-old female child who is complaining of burning when she urinates.
- (D) The 11-year-old child with bilateral crackles and a productive cough.
16 >>The 13-year-old child is admitted to the emergency department with nucal rigidity, a positive Kernig’s sign, a positive Brudzinki’s sign, and an elevated temperature. Which intervention should Ms. Laura implement first? ?
- (A) Administer acetaminophen (Tylenol) PO with water.
- (B) Place the child in droplet isolation.
- (C) Prepare the child for a lumbar puncture.
- (D) Notify the hospital infection control nurse.
17 >>Mr. Aaron answers the phone and a distraught woman says, “My daughter just drank a bottle of cleaning solution.” Which intervention should Mr. Aaron implement first? ?
- (A) Tell the mother to bring the child to the emergency department immediately.
- (B) Ask the mother how old the child is and how much the child weighs.
- (C) Ask the mother if she has syrup of ipecac that could be given to the child.
- (D) Tell Ms. Laura to call poison control immediately.
18 >>The 8-year-old child is brought to the emergency department by his parents with a pencil penetrating the right eye. Which intervention should Ms. Laura implement first? ?
- (A) Remove the object with a lightly moistened gauze pad.
- (B) Ask the parents about child medical history and any known allergies.
- (C) Stabilize the pencil in place and patch the left eye.
- (D) Assess the child’s vital signs and pulse oximeter reading.
19 >>Which client should Ms. Laura assign to Mr. Aaron, the least experienced nurse in the emergency department? ?
- (A) The child whose parent reports the child had a sore throat and is now drooling.
- (B) The child who has a distended abdomen and absent bowel sounds.
- (C) The child who has an edematous and contused right ankle.
- (D) The child whose parent reports the child has blood in his urine.
20 >>Which nursing task should Ms. Ruth delegate to Ms. Michelle, the UAP? ?
- (A) Escort the child who is being discharged via wheelchair out to the parent’s car.
- (B) Determine if a child’s growth and developmental level is on target.
- (C) Explain how to care for the below-the-knee cast to the parents.
- (D) Assist the healthcare provider to suture a child’s leg laceration.