Question 1

A six-year-old patient is diagnosed with acute lymphocytic leukaemia and induction therapy includes Vincristine. The nurse recognizes that side effect unique to this medication is:

Accepted Answer

The nurse recognizes that the side effect unique to this medication is paresthesia. Paresthesia is a major, unique side effect because of the medication's neurotoxic effects on the cranial and peripheral nerves.

Question 2

A fifteen-month-old toddler has had large frothy foul-smelling stools since the introduction of table food in the diet and has become irritable and apathetic. The child is diagnosed with celiac disease and is placed on a gluten-free diet. When evaluating the child's response to the diet after two days, the nurse anticipates the change will be:

Accepted Answer

When evaluating the child's response to the diet after two days, the nurse anticipates the change will be an improved personality. A favorable personality change within one to two days attests to the effectiveness of the diet; other improvements take longer.

Question 3

A nine-year-old child is being discharged after recovery from a sickle cell vaso-occlusive episode. The nurse teaches the parents the "do's and don'ts" concerning the child's care. The nurse is satisfied that the parents understand the principles of care when they state that they are:

Accepted Answer

The nurse is satisfied that the parents understand the principles of care when they state that they are not permitting the child to engage in strenuous activities. Strenuous activities lead to increased cellular metabolism, causing tissue hypoxia, which can precipitate sickling.

Question 4

A child with asthma is being discharged from the hospital on inhaled corticosteroids. The nurse recognizes that the parents understand the discharge teaching when they tell the nurse that they will monitor the child for the side effect of:

Accepted Answer

The nurse recognizes that the parents understand the discharge teaching when they tell the nurse that they will monitor the child for the side effect of candidiasis in the mouth. Oral candidiasis is a potential side effect of inhaled steroids; the child should be taught to rinse the mouth after each inhalation.

Question 5

A four-year-old child who has lead poisoning is admitted for chelation therapy. The child's father asks the nurse how the child got lead poisoning. The nurse bases the teaching on the knowledge that this problem is:

Accepted Answer

The nurse bases the teaching on the knowledge that this problem is associated with high-risk groups, including those with pica and those exposed to hazards present in the environment. Three factors appear to be related to lead poisoning: lead in the environment, toxins in the environment, and characteristics of the child and the parents.

Question 6

A nurse manager teaches a group of newly hired pediatric unit staff members. She said that from a nurse's knowledge of preschoolers, a nurse can predict that a four-year-old child's reaction to illness and hospitalization may be characterized by:

Accepted Answer

She said that from a nurse's knowledge of preschoolers, a nurse can predict that a four-year-old child's reaction to illness and hospitalization may be characterized by being out of control, regressing to over dependency, and fearing bodily mutilation. Piaget's preoperational stage focuses on egocentricity and concrete thoughts and Freud's phallic stage supports this response.

Question 7

Parents of an overweight female patient tell the nurse that they are concerned that their daughter feels inferior to her sister who is an attractive, successful college student. They ask the nurse what they can do about this problem. The nurse should:

Accepted Answer

The nurse should encourage them to give the patient recognition for her strong points. This action should foster the development of an improved self-esteem.

Question 8

A nurse provides discharge instructions to a fourteen-year-old patient with hepatitis B. Which of the following statements, if made by the patient, would indicate the need for further teaching?

Accepted Answer

The statement, if made by the patient, that would indicate the need for further teaching is, "I should avoid drugs and alcohol." The disease is an inflammation of the liver by a virus that results in degeneration and necrosis of the liver. The patient's statement indicates the need for further teaching. He should be instructed that in order to avoid complications, alcohol should be avoided for 6-12 months. Illicit drugs and toxic chemicals should be avoided.

Question 9

When teaching a caregiver in the home about flushing a child's central venous catheter, the nurse should instruct the caregiver to:

Accepted Answer

When teaching a caregiver in the home about flushing a child's central venous catheter, the nurse should instruct the caregiver to use good hand-washing techniques before and after the procedure. Hand-washing prior to accessing the device, as well as maintaining aseptic technique when accessing the device, will help to decrease the incidence of infection.

Question 10

A patient is receiving Total Parenteral Nutrition secondary to acute pancreatitis. The nurse is about to administer insulin when the patient states, "Why am I getting insulin? I'm not diabetic." To facilitate learning and understanding, the nurse should respond correctly by stating:

Accepted Answer

To facilitate learning and understanding, the nurse should respond correctly by stating "The TPN solution contains a high amount of glucose." TPN is used to maintain nutritional status and prevent malnutrition when the patient is unable to be fed orally by tube feeding. Glucose is used to supply energy and caloric needs and usually accounts for 50% to 70% of the nutrient prescription.

Question 11

A school-aged patient with asthma is scheduled to return to school. Which question by the nurse assesses the patient's self-care knowledge?

Accepted Answer

A question by the nurse that assesses the patient's self-care knowledge is "Do you use peak expiratory flow meter daily?" PEFM is an objective measure of forced expiratory volume at one second. This device is used by patients to monitor their degree of airway narrowing.

Question 12

A new mother asks the nurse about milk formula for her baby. The nurse should stress that the most important source of nutrition for infants during the first year is:

Accepted Answer

The nurse should stress that the most important source of nutrition for infants during the first year is commercial iron-fortified infant formula. It is comparable to human milk, which supplies all the nutrients needed by the infant for the first six months of life.

Question 13

A nurse is teaching a mother of a ventilator-dependent patient, who will be discharged in few days, about preventing complications. Which of the following measures should be included in the plan?

Accepted Answer

A measure that should be included in the plan is instituting infection control methods. Because of respiratory infections, half of all children discharged on mechanical ventilation require re-hospitalization.

Question 14

A ten-year old patient with a leg length discrepancy is being discharged with an Ilizarov external fixator (IEF). Which of the following instructions should the nurse include in the discharge teaching?

Accepted Answer

The instruction that the nurse should include in the discharge teaching is daily observations of the color and movement in both lower extremities. Capillary blood flow to the transacted area is essential for proper bone growth. Circulation must be checked daily.

Question 15

A sixteen-year-old patient who speaks a little English has emergency gallbladder surgery. During discharge preparation, which nursing action would best help this patient understand wound care instruction?

Accepted Answer

During discharge preparation, the nursing action that would best help this patient understand wound care instruction is demonstrating the procedure and having the patient return the demonstration. This ensures that the patient can perform wound care correctly. The patient may claim to understand discharge instructions when they do not. An interpreter or family member may communicate verbal or written instructions inaccurately.

Question 16

A seventeen-year-old female patient is receiving furosemide, 40 mg P.O. twice daily. In the plan of care, the nurse should emphasize teaching the patient about the importance of consuming:

Accepted Answer

In the plan of care, the nurse should emphasize teaching the patient about the importance of consuming bananas and oranges. Because furosemide is a potassium-wasting diuretic, the nurse should plan to teach the patient to increase intake of potassium-rich foods, such as bananas and oranges. Fresh, green vegetables; lean red meat; and creamed corn are not good sources of potassium.

Question 17

A physician ordered a corticosteroid inhaler four puffs twice a day for a patient with asthma. Which of the following actions by the patient would indicate to the nurse that the patient needs further teaching?

Accepted Answer

Action by the patient that would indicate to the nurse that the patient needs further teaching is taking four puffs in rapid succession. The patient should be taught to inhale slowly and deeply through the mouth while pressing down on the inhaler and to continue to breathe in slowly and holding the breath for ten seconds, or as long as possible. The patient should wait at least one minute between puffs.

Question 18

A parent makes all of the following statements about her fourteen-month-old sons behavior. Which of the following behavior should a nurse discourage?

Accepted Answer

Behavior that a nurse should discourage is "my son takes a bottle of juice to bed with him and sucks on it if he wakes during the night." This behavior would precipitate dental caries. Water would be a better choice of solution rather than a glucose-based fluid.

Question 19

A ten-year-old patient has a long leg cast applied to her left leg. She is being instructed in crutch-walking with no weight bearing on her left leg. Which of the following observations indicates that the patient needs further teaching?

Accepted Answer

Observation that indicates the patient needs further teaching is when she is supporting her weight on the axillary bar and hand pieces of the crutches. The axilla should not rest on the crutches. Such pressure may cause discomfort and nerve damage. The weight of the body should be borne by the hands.

Question 20

Staff nurses learn that a seventeen-year-old male patient they have been caring for during the last few days has just been diagnosed with tuberculosis. When the nurses express concern about contracting the disease themselves, the nurse supervisor's response should be based on which statements?

Accepted Answer

When the nurses express concern about contracting the disease themselves, the nurse supervisor's response should be based on statement that tuberculosis is not highly infectious when standard precautions are followed. The infectious stage of the disease declines immediately after effective chemotherapy.

Quiz 3: Pediatrics