1 >>A blood culture will be performed shortly on Cooper. Based on an understanding of a toddler’s growth and development, Alexis should: ?
- (A) Perform the procedure in the child’s room to decrease anxiety-NO, the child’s hospital room and the play room should be safe havens from invasive or intrusive treatments.
- (B) Give the child a choice in which arm to use-NO, although fostering a sense of autonomy is important, choices related to painful procedures are unrealistic.
- (C) Give short explanations as the procedure is done-YES
- (D) Prepare the child well in advance of the procedure-NO, a toddler’s cognitive skills enable the child to understand steps immediately before the procedure
2 >>Cooper weighs 30 pounds on admission. He is ordered to receive the following IV medication: Ceftriaxone 50 mg/kg/day every 12 hours. What dose should be administered every 12 hours? ?
- (A) 40mg for every 12 hours
- (B) 10mg for every 10 hours
- (C) 90mg for every 7 hours
- (D) 30mg for every 8 hours
3 >>Alexis wants to utilize play therapy to explain application of a cast to a preschool child. Which of the following interventions would meet the developmental needs of the preschooler? ?
- (A) Use a doll to demonstrate the casting procedure
- (B) Offer a tape recording that describes the procedure-NO, play therapy using a visual doll enables the child to see that the procedure is not harmful.
- (C) Utilize a diagram to explain the procedure-NO, this mode of instruction is more appropriate to the learning needs of the school-age child.
- (D) Simply explain the procedure as it is performed-NO, the opportunity to see the procedure will minimize any fears of body mutilation or loss of body integrity, which is common during this period of development.
4 >>Which of the following interventions is most appropriate for the needs of a 7-year-old child who is hospitalized for an extended period of time? ?
- (A) Bring security items such as a blanket
- (B) Provide play activities that foster industry
- (C) Allow the child to make all decisions in treatment
- (D) Complete all treatments in the play room
5 >>Leah, age 2 years, presents at the emergency department (ED) with an earache and fever and is diagnosed with otitis media. The health care provider orders amoxicillin 40 mg/kg/day orally, three times a day. She weighs 28 pounds. What dosage should be administered every 8 hours? ?
- (A) 170 mg three times a day
- (B) 110 mg three times a day
- (C) 130 mg three times a day
- (D) 150 mg three times a day
6 >>A nasopharyngeal swab will be done to determine if the respiratory syncytial virus is the causative organism of Jack’s illness. Which of the following interventions is most important when performing this procedure on the child? ?
- (A) Explain the procedure to the child immediately prior to the procedure
- (B) Ask his parents to restrain him during the procedure
- (C) Complete the procedure in the infant’s crib
- (D) Immobilize the child securely but gently
7 >>Which of the following play therapy activities would encourage growth and development in the hospitalized infant? ?
- (A) Explain techniques using a puppet
- (B) Place a brightly colored mobile over the crib
- (C) Suspend brightly colored latex balloons over the crib
- (D) Allow the child to play with hospital equipment
8 >>On admission of the 1-year-old infant, Alexis obtains a weight of 22 pounds. In order to calculate the correct dosage of medication for this infant, you must convert the weight to kilograms. What is his weight in kilograms? ?
- (A) 52.2 pounds
- (B) 59.2 pounds
- (C) 32.2 pounds
- (D) 20.2 pounds
9 >>Francesca, a preschooler, recently underwent chelating therapy for lead poisoning. Her play therapist wants to gain insight into her reaction to the experience. Which of the following interventions would be helpful to meet this goal? ?
- (A) Ask the child to explain how she felt after the treatment
- (B) Engage the child in an interactive skit using puppets
- (C) Ask her parents about her reaction to the chelating treatment
- (D) Tell the child to draw a picture of herself receiving the chelating agent
10 >>Louise, age 4, received an intramuscular injection in her vastus lateralis. Although it did not bleed, she insists that she “needs a Band-Aid.” Based on an understanding of growth and development, Alexis should: ?
- (A) Show her the injection site to reinforce there is no active bleeding
- (B) Apply a brightly colored Band-Aid on the injection site
- (C) Try to distract her with her favorite toy
- (D) Explain to her that a Band-Aid is unnecessary following injections
11 >>Which of the following nursing diagnoses is the priority for a child who has just been admitted to the postanesthesia care unit following a tonsillectomy? ?
- (A) Risk for fl uid volume deficit
- (B) Acute pain
- (C) Gas exchange impaired
- (D) Bleeding
12 >>Alexis is called to assist with a 6-year-old girl who has just been admitted to the postanesthesia recovery room following an appendectomy. She is crying and guarding the right lower quadrant of her abdomen in the area of her surgical site. Which of the following measures would be most useful to determine the severity of her pain? ?
- (A) Assess her behavioral cues such as guarding, crying, and immobilization of the operative site
- (B) Ask her to rate her pain on a 5 to 10 Likert scale
- (C) Utilize an age-appropriate pain assessment tool to rate her pain
- (D) Ask her parents if this is her typical response to severe pain
13 >>The 6-year-old girl was moved to the pediatric unit and is 3 days postoperative appendectomy and requests medication for pain. The doctor orders Tylenol 15 mg/kg orally every 4 to 6 hours, as needed. Her morning weight was 53 pounds. How much should she receive per dose? ?
- (A) 360 mg every 4 to 6 hours
- (B) 300 mg every 4 to 6 hours
- (C) 200 mg every 2to 9 hours
- (D) 130 mg every 5 to 10 hours
14 >>Alexis is also caring for a child who is receiving maintenance intravenous therapy during her hospitalization. Her weight is documented at 63 pounds. What is her maintenance rate? ?
- (A) 69.6 mL/hr
- (B) 12.5 mL/hr
- (C) 18.3 ml/hr
- (D) 10.1 ml/hr
15 >>An 8-year-old child is about to be discharged following application of a cast to a fractured femur. Which behavior by the child’s parent would be a good indicator that cast care is understood? ?
- (A) The parent states, “I had a cast about a year ago and know how to take care of it.”
- (B) The parent signs the discharge instruction sheet which states, “I understand all instructions as documented.”
- (C) The parent satisfactorily demonstrates cast care to you
- (D) None of the above
16 >>Which of the following strategies would be most effective in the nursing care of the hospitalized adolescent? ?
- (A) Use age-appropriate crafts to provide diversion and a sense of industry
- (B) Encourage interactions with other hospitalized adolescents to prevent isolation
- (C) Use projective techniques such as “Draw Me a Person”
- (D) Encourage the parent to be present during all nursing care
17 >>When educating them about nutrient-rich meals and snacks, which foods should you recommend to Logan’s family? ?
- (A) Increase intake of fruits, vegetables, and lean protein products
- (B) Increase intake of sweetened beverages, sodium, and low-fat foods
- (C) Decrease intake of fruits, vegetables, and whole grains
- (D) Decrease intake of fruits, vegetables, and meat products
18 >>When a pediatric patient has a ventriculoperitoneal shunt, when should you become concerned the shunt may be malfunctioning? ?
- (A) When the child’s blood pressure decreases
- (B) When the child starts having febrile seizures
- (C) When the child has lethargy and a low-grade temperature
- (D) When the child becomes nauseated and begins vomiting
19 >>Juvenile idiopathic arthritis affects girls more than boys. ?
- (A) True
- (B) False
- (C) Acute pain
- (D) Bleeding
20 >>Acetaminophen (Tylenol) is the drug of choice for treatment of juvenile idiopathic arthritis. ?
- (A) True
- (B) False
- (C) Acute pain
- (D) Beans
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