Questions on Nursing Care and Application

Question 1             

What is the priority nursing diagnosis for a child with a cleft lip and palate PRIOR to surgery?

Imbalanced nutrition, Less than body requirements

Attachment, Risk for Impaired

Caregiver Role Strain

Aspiration, RIsk for

Question 2

The nurse is caring for an infant who has had a cleft lip and palate repair.  What is included in this child's care?  (CHECK ALL THAT APPLY)

Use a cotton tip applicator to clean the child's gums, tongue and oral cavity

Use elbow restraints to prevent injury to the surgical site

Provide adequate pain management

Gently clean the surgical site with normal saline

Advise the parents to provide a pacifier to calm the infant

Question 3

A newborn sneeze, coughs excessive fluids, and becomes cyanotic at the first feeding.  What should the nurse do FIRST?

Initate oxygen therapy and notify the physician

Stop the feeding and suction the infant

Call NICU to arrange a transfer

Call respiratory therapy for an impending respiratory arrest

Question 4

The nurse is doing preop teaching to parents of a six week old scheduled for a pyloromyotomy (surgery for pyloric stenosis).  What is the nurse's BEST response when they ask "What can our baby eat after surgery?)

We'll have to see how he tolerates the surgery

He can start on clear liquids or dilute breast milk

We will give him thickened formula ,

He won't be able to eat anything for 48 hours

Question 5

The underlying pathology of Hirschsprung's Disease is:

Chronic bacterial infection in the large intestine

Absence of ganglion cells in the colon/rectum

Damage to the celia in the small intestine

Absence of digestive enzymes

Question 6

What is the most significant history question that would help diagnose intussusception in an infant?

How many stools a day is your baby having?

Is your baby eating?

What do your baby's stools look like?

Is your baby vomiting forcefully?

Question 7

A twelve year old is admitted for possible appendicitis.  When the nurse enters the room to start an IV of maintenance fluids,  the child says that his "stomach is still very upset and he feels like throwing up, but his belly doesn't hurt anymore."  What is the nurse's NEXT action?

Administer the ordered antiemetic

Call the provider and start the IV

Chart his pain rating

Explain that the pain meds he received are causing the nausea

Question 8

What are  concerns regarding G-tube care that warrant prompt medical follow up in the clinic?  (CHECK ALL THAT APPLY)

Macerated skin >two finger breadths in any direction from stoma

Displacement of a new button tube in first six months after placement

Small space between skin surface and G-tube

Excessive leakage of feedings onto clothing or bedding

Slight serous drainage and crusting around stoma

Question 9

Which of the following is included in care for an infant with GERD?

Dilute the infant's formula for easier digestion

Position the infant on his left side after feeding to prevent aspiration

Feed your infant in an upright position

Start pureed baby food at four months to increase absorption of nutrients

Question 10

The nurse is teaching the family about nutrition for their five year old who has just been diagnosed with celiac disease.  What statement by the mother indicates she understands the teaching?

We can introduce this diet gradually so he will get used to it

We will be careful about reading food labels

It's good that it's just wheat products we need to avoid.

Our child will develop a tolerance for gluten over tim 

Question 11

Which statement by a parent indicates she understand brace care for her child receiving an ankle foot orthosis (AFO)?

I will lotion my child's skin well before applying the brace

If the brace is tight, I can mold it carefully by using a hair dryer

I will need to purchase cotton socks to wear under the brace

My child should initially be able to wear the brace for four hours at a time

Question 12

A newborn has been referred for treatment for talipes equinovarus (club foot).  What materials should the nurse expect to assemble for this infants plan of care?

An admission check list for surgery tomorrow

A Pavlik harness

Casting supplies

Fitting for corrective shoes

Question 13

The nursing role when working with a NEWLY diagnosed hip dislocation in a newborn is:

Group of answer choices

Explain the surgery for an open hip reduction

Teach the parents how to tightly swaddle the infant

Teach the parents about spica cast care

Teach the use of a Pavlik harness

Question 14

A two and a half year old is in a spica cast post operatively for a reduction of a congenitally dislocated hip.  What is an appropriate play activity for this child while they are in the cast?

Colored macaroni art project

Paint by number art project

Large piece wooden puzzles

Legos

Question 15

A fifteen year old male with scoliosis is just returning to the unit from PACU after a spinal fusion with instrumentation.  Besides respiratory and pain management, which of the following is the nursing PRIORITY at this time?

Neurovascular assessment of his extremities

Assessment of bowel tones

Monitoring electrolytes

Monitoring intake and output

Question 16

What is a PRIORITY  nursing diagnosis for children with osteogenesis imperfecta? 

Injury, RIsk for

Infection, risk for

Mobility, impaired

Self image, altered

Question 17

A first grader with diagnosed Legg Perthes disease presents in the school nurse's office after recess limping and complaining of knee pain.  Assuming the assessment of his knee is unremarkable, what is the nurse's BEST response to this child?

Let's put some ice on your knee for a few minutes

I bet if you go back to class, you will feel better.

It's normal for your knee to hurt.

Let's have you rest, and we'll call your paren 

Question 18

 A two year old is admitted with JIA.  During the nurse's focused assessment she notes:

Group of answer choices

Increased irritability and unwillingness to bear weight on the affected extremity

Pallor, coolness and swelling of the joints

The child's complaints of joint tenderness and stiffness

The child's description of how hard it is to get around in the morning

Question 19

The nurse on the orthopedic unit receives morning report on the following patients.  Which patient should the nurse check FIRST?

Fifteen year old male six hours post op pinning for slipped femoral capital epiphysis complaining of an eight on the pain scale. Vitals signs are BP 110/60, P 76, RR 16. Toes pink and warm with cap refill < 2 seconds. Dressings dry and intact. Full sensation on operative side

Ten year old 18 hours post op with open reduction of fractured humerus. Brachial nerve block with bupivacaine on continuous pump. BP 102/60. P 80 RR 18. Reports pain as a 2 on the pain scale. Taking fluids well. No drainage on his dressing. Fingers on operative side slightly swollen and slightly pale. Sensation has diminished on the operative side since 0400.

Stable two year old female post op application of a spica cast with discharge planned when parent teaching completed. Mom notes there is some redness around the top of the cast, and her toddler is irritable. Toes pink and warm and move when tickled. No swelling noted in lower extremities. Tolerating fluids p.o. and voiding q.s.

Question 20

Common misconceptions about children and sports include:  (Check all that apply)

Children can vigorously exercise without conditioning

Children are very flexible and don't need much warm up activity

Some skills in sports are developmentally inappropriate for younger age groups.

School aged children in contact sports usually don't get injured if using protective gear

It is safe to assume that all coaches are prepared to deal with sports related injuries.

Question 21

Match the term on the right to the corresponding term on the left.  There is only one answer for each item.

1. Non infections oily scalp lesions
2. Results in severe itching that can last after treatment is complete
3. Nuisance insect infestation that usually does not cause illness
4. Fungal infection that necessitates the use of antibiotics
5. Infection that necessitates the use of antibiotics
6. Common infection immune suppressed individuals or children who use steroid inhalers
7. viral infection that often resolves on its own.

1. Lice
2. Scabies
3. Impetigo
4. Ringworm
5. Seborrhea

Question 22

The nurse's neighbor's child came home with a case of head lice.   What would be included in the nurse's teaching to the neighbor?  (CHECK ALL THAT APPLY)

Head lice usually doesn't cause any disease

Shampoo your child's hair daily with an insecticide shampoo for one week

Send all the child's blankets and pillows to the cleaners to be dry cleaned

Spend time removing nits from your child's hair with a fine toothed comb

Throw away any of your child's stuffed animals

Question 23

The nurse is teaching new parents about diaper rash (diaper dermatitis) in infants.  Which statement by the parent indicates a need for more teaching?

a) Any commercially made wipes are good to prevent diaper rash.

b) I should keep OTC cortisone cream on hand for any diaper rash

c) I can use Butt Paste or Desitin to protect my baby's diaper area

d) Exposure to air will help if my baby gets a diaper rash.

c & d

Question 24

Which of the following history questions is the MOST important when the provider is considering isotretinoin (Accutane) for a fifteen year old female with acne?

What have you done in the past to treat your acne?

Are you sexually active and/or pregnant?

What is your expectation about the results of this medication?

How often are you willing to get blood tests?

Question 25

Prevention of impetigo includes:  (CHECK ALL THAT APPLY)

Treating ALL exposed individuals with systemic antibiotics

Careful cleaning of contact sports equipment and clothing

Excluding infected athletes from participation until adequately treated

Teach coaches and athletes to recognize impetigo

Avoid sharing towels and toiletries with infected individuals

Question 26

The nurse is teaching new parents about sun protection in infants.  Which of the following statements would be included in the teaching?

Group of answer choices

A light covering of sunscreen over exposed parts is enough sun protection for infants.

It is important that you keep your baby covered with light clothing and a hat when in the sun

Sun screen is unconditionally approved by the AAP for infants and children of all ages

There are sunscreen preparations specific for infants under six months of age

Question 27

Initial assessment of a severely burned child includes ABC's.  What other important assessment findings are significant in this initial assessment?  (CHECK ALL THAT APPLY)

Singed facial and nasal hair

Sooty sputum

Hypothermia

Neurologic impairment

Circumferential burns

Question 281 pts 

Care for children with major burns include which of the following? (CHECK ALL THAT APPLY)

Physical therapy to prevent contractures

Administration of hypertonic IV fluids

Infection control

Nutrition management

Psychosocial support

 Question 291 pts

What are characteristics of a full thickness burn that differentiates it from partial thickness burns?

Full thickness burns are unable to regenerate normal tissue

Full thickness burns are extremely more painful

Full thickness burns are more susceptible to infection

Full thickness burns generally involve more body surface are 

Question 30

A middle schooler was severely burned on his hands and lower arms when setting off fireworks.  In the healing process, what snacks would the nurse recommend to this child?

Carrots, celery sticks, raw snow peas

Apples, oranges, melon slices

Cheese slices, peanut butter, yogurt

Raisins and other dried fruits