Unit 4B Practice Questions

Front

In which position should a new infant be placed for sleep to prevent sudden infant death syndrome (SIDS)?

Back

Back rather than on the stomach

Answer explanation

SIDS is the unexpected death of an apparently healthy infant younger than 1 year for whom an investigation of the death and a thorough autopsy fail to show an adequate cause of death. Several theories are proposed regarding the cause, but the exact cause is unknown. Nurses need to encourage parents to place the infant on the back (supine) for sleep. Infants in the prone position (on the stomach) may be unable to move their heads to the side, increasing the risk of suffocation. The infant may have the ability to turn to a prone position from the side-lying position.

Front

Permethrin is prescribed for a child with a diagnosis of scabies. The nurse would give which instruction to the parents regarding the use of this treatment?

Back

Apply the lotion to cool, dry skin at least 30 minutes after bathing.

Answer explanation

Permethrin is massaged thoroughly and gently into all skin surfaces (not just the areas that have the rash) from the head to the soles of the feet. Care needs to be taken to avoid contact with the eyes. The lotion would not be applied until at least 30 minutes after bathing and would be applied only to cool, dry skin. The lotion would be kept on for 8 to 14 hours, and then the child would be given a bath. The child would be clothed during the 8 to 14 hours of treatment contact time.

Front

The school nurse has provided an instructional session about impetigo to parents of the children attending the school. Which statement, if made by a parent, indicates a need for further instruction? A. “It is extremely contagious.” B. “It is most common in humid weather.” D. “It might show up in an area of broken skin, such as an insect bite.”

Back

Lesions most often are located on the arms and chest.

Answer explanation

Rationale: Impetigo is a contagious bacterial infection of the skin caused by group A streptococcus (GAS; Streptococcus pyogenes) and Staphylococcus aureus. Impetigo is most common during hot, humid summer months. Impetigo may begin in an area of broken skin, such as an insect bite or atopic dermatitis. Impetigo is extremely contagious. Lesions usually are located around the mouth and nose but may be present on the hands and extremities.

Front

The school nurse is performing pediculosis capitis (head lice) assessments. Which assessment finding indicates that a child has a “positive” head check for lice? Options: Maculopapular lesions behind the ears, Lesions in the scalp that extend to the hairline or neck, White flaky particles throughout the entire scalp region, White sacs attached to the hair shafts in the occipital area

Back

White sacs attached to the hair shafts in the occipital area

Answer explanation

Rationale: Pediculosis capitis is an infestation of the hair and scalp with lice. The nits are visible and attached firmly to the hair shaft near the scalp. The occiput is an area in which nits can be seen. Maculopapular lesions behind the ears or lesions that extend to the hairline or neck are indicative of an infectious process, not pediculosis. White flaky particles are indicative of dandruff.

Front

A nurse is assessing a 12-month-old infant during a well-child visit. Which of the following finds should the nurse report to the provider? Closed anterior fontanel. Eruption of six teeth. Birth weight doubled. Birth length increased by 50%.

Back

Birth weight doubled

Answer explanation

By 12-months of age, the child’s birth weight should have tripled not doubled, therefore warranting reporting to the provider. The other three options are considered normal for a child that is 12-months of age.

Front

The nurse is providing medication instructions to a parent. Which statement by the parent indicates a need for further instruction? Options: I need to cuddle my child after giving the medication. I can give my child a frozen juice bar after my child swallows the medication. If my child does not like the taste of the medicine, I need to encourage my child to pinch the nose and drink the medication through a straw.

Back

I need to mix the medication in the baby food and give it when I feed my child.

Answer explanation

The nurse would teach the parent to avoid putting medications in foods because it may give an unpleasant taste to the food, and the child may refuse to accept the same food in the future. In addition, the child may not consume the entire serving and would not receive the required medication dosage. The parent needs to provide comfort measures—such as touching, holding, cuddling, or providing a favorite toy—immediately after medication administration. The parent could offer juice, or a frozen juice bar to the child after the child swallows the medication. If the taste of the medication is unpleasant, the child would pinch the nose and drink the medication through a straw.

Front

A pediatric client with ventricular septal defect repair is placed on a maintenance dosage of digoxin. The dosage is 8 mcg/kg/day, and the client’s weight is 7.2 kg. The pediatrician prescribes the digoxin to be given twice daily. How many mcg of digoxin to administer at each dose?

Back

28.8 mcg

Answer explanation

review your drug math :)

Front

The nurse is monitoring a 3-month-old infant for signs of increased intracranial pressure. On palpation of the fontanels, the nurse notes that the anterior fontanel is soft and flat. What is the most appropriate nursing action?

Back

Document the finding.

Answer explanation

Rationale: Since the finding of a soft and flat anterior fontanel is within normal limits for an infant of this age, the appropriate nursing action is to document the finding and continue monitoring the infant.

Front

If an 18-month-old client were apprehensive about being examined, what technique would be most appropriate?

Back

Begin the exam with him in his mother’s lap.

Answer explanation

Children feel most comfortable with their parent, so allow a child to beginning an exam with the child comfortably seated in a parent’s lap can reduce anxiety. This child is likely too young to have his expectations set.

Front

To assess the child’s abdomen, you should begin with what assessment technique?

Back

Inspection

Answer explanation

Health assessment usually begins with inspection. Auscultate the abdomen before palpating or percussing, or else bowel sounds will be suppressed.