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EXAM 4 LADIESSSS!!!!

Total questions: 59

Worksheet time: 34mins

Name
Class
Date
1.

A nurse is caring for a child with sickle cell disease. Which of the following findings should the nurse recognize as a trigger for a vaso-occlusive crisis?

a)

Dehydration

b)

Hyperglycemia

c)

High-protein diet

d)

Allergic reaction

2.

A nurse is teaching the parents of an infant prescribed oral iron supplements. Which of the following statements by the parent indicates A NEED FOR FURTHER TEACHING?

a)

“I should avoid giving the iron with milk because it interferes with absorption.”

b)

“I will give the iron between meals to help it absorb better.”

c)

“I’ll expect my baby’s stools to turn greenish-black while on iron.”

d)

“If my baby’s stools remain normal in color, it means the iron is being absorbed well.”

3.

A child is admitted with a diagnosis of Wilms tumor. Which nursing action is the priority?

a)

Encourage frequent abdominal massages to relieve discomfort.

b)

Place a sign above the bed that reads “Do not palpate abdomen.”

c)

Monitor for hematuria and report findings to the provider.

d)

Encourage fluid intake to promote urinary output.

4.

A nurse is assessing a child suspected of having a blood dyscrasia. Which skin findings should alert the nurse to this condition?

a)

Ecchymosis and jaundice

b)

Petechiae and purpura

c)

Pallor and cyanosis

d)

Urticaria and erythema

5.

A nurse is teaching parents about strategies for therapeutic communication with their child. Which statement by the parents indicates correct understanding?

a)

“We should focus on giving strict instructions to maintain control.”

b)

“We will use the HELP strategy by offering hope, showing empathy and loyalty, and participating in a consistent plan of care.”

c)

“We should avoid discussing the plan of care in front of our child.”

d)

“It’s best not to show emotions so our child does not become upset.”

6.

A child with neutropenia is at greatest risk for which complication?

a)

Infection

b)

Hemorrhage

c)

Electrolyte imbalance

d)

Hypertension

7.

A nurse is reviewing causes of iron-deficiency anemia with the parents of a young child. Which of the following are potential causes? Select all that apply.

a)

Severe hemorrhage

b)

Inability to absorb iron

c)

Excessive growth requirements

d)

Inadequate diet

e)

Feeding whole cow’s milk to infants

8.

A nurse is assessing a child with thalassemia major. Which manifestations should the nurse expect? Select all that apply.

a)

Pale appearance and hypoxia

b)

Enlarged liver and spleen

c)

Protruding teeth and changes in facial contour

d)

Abdominal distention with pressure on chest organs

e)

Thin, fragile bones prone to fracture

9.

A nurse is providing dietary teaching to the parents of a child with iron-deficiency anemia. Which of the following foods are good sources of iron? Select all that apply.

a)

Boiled egg yolk

b)

Leafy green vegetables

c)

Whole-grain bread

d)

Liver

e)

Cream of Wheat

10.

A nurse is reviewing hemophilia with the parents of a child recently diagnosed. Which statement correctly describes the most common type and cause of hemophilia?

a)

Hemophilia B is the most common type and is caused by a deficiency of factor VIII.

b)

Hemophilia A is the most common type and is caused by a deficiency of factor VIII.

c)

Hemophilia A is caused by a deficiency of factor IX and accounts for 85% of cases.

d)

Hemophilia B is the most common type and is caused by a deficiency of factor IX.

11.

A nurse is reviewing sickle cell crises with a group of new pediatric nurses. Which type of crisis is characterized by obstruction of blood flow, infarctions, and pain, making it the most common type?

a)

Hyperhemolytic crisis

b)

Aplastic crisis

c)

Splenic sequestration

d)

Vaso-occlusive crisis

12.

A nurse is monitoring a child receiving a blood transfusion. Which of the following signs should alert the nurse to a possible transfusion reaction? Select all that apply.

a)

Chills

b)

Itching/rash

c)

Fever

d)

Headache

e)

Back pain

13.

A nurse is teaching parents about testing for sickle cell. Which test confirms sickle cell disease, rather than just the trait?

a)

Sickling test (Sickledex)

b)

Hemoglobin electrophoresis

c)

Complete blood count (CBC)

d)

Reticulocyte count

e)

Peripheral smear

14.

A nurse is reviewing the formed elements of blood with a student nurse. Which of the following are considered formed elements? Select all that apply.

a)

Red blood cells

b)

White blood cells

c)

Platelets

d)

Plasma

e)

Electrolytes

15.

A nurse is assessing a newborn for esophageal atresia. Which manifestations should the nurse expect? Select all that apply.

a)

Coughing and choking during the first feeding

b)

Cyanosis and apnea

c)

Abdominal distention

d)

Jaundice

e)

Diarrhea

16.

A nurse is teaching parents about lead poisoning in children. What is the most common source of lead exposure?

a)

Old household paint

b)

Contaminated water

c)

Gasoline fumes

d)

Solder in food cans

e)

toys made of plastic

17.

A nurse is teaching the parents of a child diagnosed with celiac disease. Which type of diet should the nurse recommend?

a)

Gluten-free

b)

Low-fat

c)

Low-sodium

d)

High-protein

e)

Dairy-free

18.

A nurse is teaching parents about the treatment of a chronic hydrocele in their child. Which statement is correct?

a)

Chronic hydroceles usually resolve without intervention after 6 months.

b)

Surgery is indicated if the hydrocele persists beyond 1 year.

c)

Hydroceles are treated with antibiotics to reduce swelling.

d)

Postoperative care is not necessary after hydrocele repair.

19.

A nurse is assessing a child with suspected acute glomerulonephritis. Which manifestations should the nurse expect? Select all that apply.

a)

Periorbital edema in the morning

b)

Smoky brown or bloody urine

c)

Increased urine output

d)

Elevated BUN and creatinine

e)

Reduced serum complement (C3)

20.

A nurse is teaching parents ways to prevent urinary tract infections in their child. Which instructions should the nurse include? Select all that apply.

a)

Cleanse the perineum with each diaper change

b)

Wipe from front to back

c)

Avoid bubble baths

d)

Encourage the child to urinate after a bath

e)

Use tight-fitting pants

21.

A nurse is teaching parents about urinary tract infections (UTIs) in children. Which organism is the most common cause of UTIs?

a)

Escherichia coli

b)

Staphylococcus aureus

c)

Streptococcus pyogenes

d)

Pseudomonas aeruginosa

e)

Klebsiella pneumoniae

22.

A nurse is teaching parents about treating diaper dermatitis. Which instructions should the nurse include?

a)

Apply a thick layer of zinc oxide to the affected area

b)

Use an antifungal cream if a yeast infection is present

c)

Apply ointments containing vitamins A and D or lanolin for prevention

d)

Change diapers frequently to keep the area dry

e)

All of the above

23.

A nurse is teaching a female patient of childbearing age who is prescribed isotretinoin for acne. Which requirement is essential before starting therapy?

a)

Use two forms of birth control before, during, and after treatment

b)

Have two negative pregnancy tests 30 days apart

c)

Have a negative pregnancy test before each prescription refill and at treatment termination

d)

All of the above

24.

A nurse is assessing a child for head lice. Which manifestations should the nurse expect? Select all that apply.

a)

Severe itching of the scalp

b)

Matted hair with crusts and nits

c)

Pustules and excoriations on the face

d)

Foul odor from the hair

e)

Fever

25.

A nurse is reviewing the pathophysiology of diabetes insipidus. Which gland is primarily involved in this condition?

a)

Anterior pituitary

b)

Posterior pituitary

c)

Thyroid

d)

Adrenal

26.

A nurse is teaching a child with diabetes mellitus and their parents about diet. Which statements are correct regarding dietary management? Select all that apply.

a)

Intake should be 55% carbohydrates, 30% fat, and 15% protein

b)

Focus on complex carbohydrates that absorb slowly

c)

Include foods high in soluble fiber to help lower blood glucose

d)

Only track protein intake

e)

Raw fruits, vegetables, bran cereals, beans, peas, and lentils are good sources of fiber

27.

A nurse is assessing an infant for hypothyroidism. Which manifestations should the nurse expect? Select all that apply.

a)

Excessive sleepiness and sluggishness

b)

Enlarged tongue with noisy respirations

c)

Dry, cold skin and cold extremities

d)

Hypotonia and floppy muscles

e)

Chronic constipation

28.

A nurse is reviewing the functions of the endocrine system with a student nurse. Which of the following are primary responsibilities of the endocrine system? Select all that apply.

a)

Regulating growth and maturation

b)

Controlling reproduction

c)

Responding to stress

d)

Filtering blood and producing urine

e)

Regulating metabolic processes

29.

A nurse is preparing an immunization clinic. Which medication is essential to have immediately available?

a)

Diphenhydramine

b)

Acetaminophen

c)

Epinephrine

d)

Albuterol

30.

A nurse is planning care for a child with HIV/AIDS. What is the primary goal of care?

a)

Cure the infection completely

b)

Slow viral growth, prevent opportunistic infections, and provide supportive care

c)

Limit physical activity to reduce energy expenditure

d)

Avoid all vaccinations

31.

A nurse is reviewing risk factors for ADHD with a group of parents. Which factors are associated with an increased risk of ADHD? Select all that apply.

a)

Strong genetic component

b)

Maternal drug, alcohol, or tobacco use during pregnancy

c)

Exposure to lead in utero

d)

Low birth weight

e)

Structural and functional brain abnormalities

32.

A nurse is reviewing causes of post-traumatic stress disorder (PTSD) with a parent group. Which of the following can contribute to the development of PTSD? Select all that apply.

a)

Genetic predisposition

b)

Traumatic or repeated trauma

c)

Psychiatric disorders

d)

Witnessing violent acts (homicide, suicide, or assault)

e)

Natural disasters or sexual abuse

33.

The nurse is assessing a child for possible depression. Which of the following manifestations are consistent with depression? Select all that apply.

a)

Irritability

b)

Loss of appetite

c)

Social withdrawal

d)

Sudden drop in grades

e)

Feelings of worthlessness

34.

A nurse is providing support to a family whose preschool child is asking questions about death. Which of the following statements reflects how children perceive death based on their developmental stage?

a)

Preschool children often view death as reversible and may believe they caused it.

b)

School-age children under 9 years old usually understand death as permanent.

c)

Adolescents believe death is temporary and rely mainly on fantasy.

d)

Preschool children have a mature understanding that death is permanent.

35.

A nurse is teaching parents of an infant diagnosed with GERD. Which of the following instructions should be included in the teaching?

a)

Burp the infant frequently during feedings.

b)

Avoid overfeeding to prevent stomach distention.

c)

Feed the infant no more than the age in months plus 3 ounces per feeding.

d)

Position the infant properly after feeding.

36.

Which of the following are the classic triad symptoms of diabetes mellitus?

a)

Polydipsia

b)

Polyuria

c)

Polyphagia

d)

Weight gain

37.

Which skin lesion is described as a flat, discolored area such as a freckle?

a)

Papule

b)

Pustule

c)

Vesicle

d)

Macule

38.

Which term describes a disease that is constantly present in a specific region or population?

a)

Epidemic

b)

Endemic

c)

Pandemic

d)

Sporadic

39.

A nurse is caring for a patient with tuberculosis. Which type of infection control requires the use of an N95 respirator?

a)

Contact

b)

Droplet

c)

Airborne

d)

Standard

40.

A nurse is reviewing infection transmission with a student nurse. Which statement correctly differentiates the two types of transmission?

a)

Direct transmission occurs via vectors or contaminated objects, while indirect transmission is person-to-person.

b)

Direct transmission is person-to-person, while indirect transmission occurs via vectors or fomites.

c)

Both direct and indirect transmission are always airborne.

d)

Direct transmission requires a fomite, while indirect does not.

41.

After administering a vaccine to a child, how long should the nurse observe the child for potential adverse reactions?

a)

5 minutes

b)

10 minutes

c)

15 minutes

d)

20 minutes

42.

A nurse is reviewing infection transmission. Which statement correctly defines a vector and a fomite?

a)

Vector – an inanimate object that transmits infection; Fomite – a carrier that transmits an infective agent

b)

Vector – a carrier that transmits an infective agent; Fomite – an inanimate object that transmits infection

c)

Vector – a type of vaccine; Fomite – a type of antibiotic

d)

Vector – airborne particle; Fomite – person-to-person contact

43.

A nurse is reviewing diagnostic criteria for diabetes mellitus. Which finding confirms a diagnosis of diabetes?

a)

Fasting blood glucose of 100 mg/dL on two separate occasions

b)

Fasting blood glucose of 126 mg/dL after no caloric intake for 8 hours on two separate occasions

c)

Random blood glucose of 90 mg/dL

d)

HbA1c of 5%

44.

A nurse is reviewing the health history of two patients newly diagnosed with diabetes. Patient A has an autoimmune condition destroying pancreatic beta cells, and Patient B is obese, leads a sedentary lifestyle, and has dark pigmentation in the skin folds of the neck and axilla. Which type of diabetes does each patient most likely have?

a)

Patient A: Type 2 DM; Patient B: Type 1 DM

b)

Patient A: Type 1 DM; Patient B: Type 2 DM

c)

Patient A: Type 2 DM; Patient B: Type 2 DM

d)

Patient A: Type 1 DM; Patient B: Type 1 DM

45.

A nurse is educating parents about Tay-Sachs disease. Which statement accurately describes the cause and expected prognosis of this condition?

a)

Tay-Sachs disease is caused by a deficiency of lysosomal-beta-hexosaminidase, leading to fat accumulation in nerve cells; most children die before age 5.

b)

Tay-Sachs disease is caused by a bacterial infection and can be treated with antibiotics.

c)

Tay-Sachs disease is an autoimmune disorder that slows growth but allows normal lifespan.

d)

Tay-Sachs disease is caused by a deficiency of insulin and can be managed with diet and medication.

46.

A nurse is caring for a newborn diagnosed with hypospadias. The parents ask about chordee. How should the nurse explain this condition?

a)

A condition in which the foreskin is too tight and cannot be retracted

b)

An infection of the penile tissue causing swelling and redness

c)

A congenital anomaly where a fibrous strand of tissue extends from the scrotum to the penis, preventing normal elevation during urination

d)

A curvature of the penis that develops during adolescence due to trauma

47.

A nurse is educating parents about congenital penile anomalies. Which statement correctly distinguishes hypospadias from epispadias?

a)

In hypospadias, the urinary meatus is on the upper surface of the penis; in epispadias, it is on the lower shaft.

b)

Hypospadias is fairly common and involves the urinary meatus on the lower shaft, often accompanied by chordee; epispadias involves the meatus on the upper surface of the penis.

c)

Both hypospadias and epispadias are rare and always involve the urinary meatus at the tip of the penis.

d)

Epispadias is more common than hypospadias and usually resolves without surgery.

48.

A nurse is reviewing penile conditions with a parent. Which statement correctly differentiates phimosis from paraphimosis?

.

a)

Phimosis occurs when the foreskin is retracted and cannot return to its normal position; paraphimosis is when the foreskin cannot be retracted at all.

b)

Paraphimosis is common in newborns; phimosis only occurs in adults after trauma

c)

Both phimosis and paraphimosis are infections of the foreskin causing swelling and redness.

d)

Phimosis is a narrowing of the foreskin opening that prevents retraction; paraphimosis occurs when the foreskin is retracted and cannot return, which may impede circulation.

49.

A nurse is assessing a child with dehydration. Which description correctly matches the type of dehydration with its fluid and electrolyte loss?

a)

Isotonic dehydration: more water than electrolytes lost; Hypertonic dehydration: equal fluid and electrolyte loss; Hypotonic dehydration: more electrolytes lost than water.

b)

Isotonic dehydration: equal fluid and electrolyte loss; Hypertonic dehydration: more water lost than electrolytes; Hypotonic dehydration: more electrolytes lost than water.

c)

Isotonic dehydration: more electrolytes lost than water; Hypertonic dehydration: more water lost than electrolytes; Hypotonic dehydration: equal fluid and electrolyte loss.

d)

Isotonic dehydration: only water lost; Hypertonic dehydration: only electrolytes lost; Hypotonic dehydration: no fluid lost.

50.

A nurse is assessing stool characteristics in children with gastrointestinal disorders. Which pairing of disorder and stool description is correct?

A. Celiac disease: ribbonlike stools; Hirschsprung disease: large, bulky, foul-smelling stools; Intussusception: jelly-like stools
B. Celiac disease: large, bulky, foul-smelling, frothy stools; Hirschsprung disease: ribbonlike stools; Intussusception: jelly-like stools
C. Celiac disease: jelly-like stools; Hirschsprung disease: frothy stools; Intussusception: large, bulky stools
D. Celiac disease: ribbonlike stools; Hirschsprung disease: jelly-like stools; Intussusception: foul-smelling stools

a)

Celiac disease: large, bulky, foul-smelling, frothy stools; Hirschsprung disease: ribbonlike stools; Intussusception: jelly-like stools

b)

Celiac disease: jelly-like stools; Hirschsprung disease: frothy stools; Intussusception: large, bulky stools

c)

Celiac disease: ribbonlike stools; Hirschsprung disease: jelly-like stools; Intussusception: foul-smelling stools

d)

Celiac disease: ribbonlike stools; Hirschsprung disease: large, bulky, foul-smelling stools; Intussusception: jelly-like stools

51.

A nurse is assessing a child for bowel issues. Which statement best defines constipation?

a)

Frequent, watery stools with mucus

b)

Defecation that is difficult or infrequent, often with hard, dry fecal material, sometimes accompanied by abdominal discomfort or blood-streaked stools

c)

Sudden onset of jelly-like stools containing blood and mucus

d)

Passage of ribbonlike stools due to a narrowed segment of the colon

52.

A nurse is reviewing factors that may cause noninfectious diarrhea in infants. Which of the following is a common cause?

a)

Infection with rotavirus

b)

Food intolerance, overfeeding, improper formula preparation, or ingestion of high amounts of sorbitol

c)

Appendicitis

d)

Hirschsprung disease

53.

A nurse is teaching a parent about dietary management for a child with diarrhea. Which of the following should be avoided?

a)

Crackers and rice

b)

Bananas and applesauce

c)

Oral rehydration solutions

d)

Clear fluids, fruit juice without pulp, gelatin, carbonated drinks, caffeinated sodas, and chicken broth

54.

A nurse is educating parents about rickets. Which statement correctly identifies the cause of this disease?

a)

Rickets is caused by a deficiency of vitamin D, leading to improper bone mineralization in infancy and childhood.

b)

Rickets is caused by a lack of calcium intake in adults only.

c)

Rickets is an infectious disease affecting the bones.

d)

Rickets occurs due to excessive vitamin D intake.

55.

A nurse is reviewing pain management for a child experiencing a sickle cell crisis. Which medication is contraindicated for this patient?

a)

Morphine

b)

Acetaminophen

c)

Meperidine (Demerol)

d)

Ibuprofen

56.

A nurse is planning nutritional care for a patient recovering from severe burns. Which dietary recommendation is appropriate?

a)

Provide a low-protein diet to prevent kidney overload

b)

Encourage frequent feedings of foods high in calories, protein, and iron, with supplements of vitamins A, B, C, and zinc

c)

Limit meals to three per day with minimal snacks

d)

Focus only on carbohydrate intake to maintain energy

57.

A nurse is caring for a patient who sustained severe burns in a house fire. What should be the first action in the patient’s care?

a)

Apply topical antibiotic ointment to all burn areas

b)

Establish an airway, especially if facial burns or smoke inhalation are present

c)

Begin oral pain medication

d)

Take the patient’s weight and measure height

58.

A nurse is reviewing treatment options for pediatric patients with Hirschsprung disease and intussusception. Which statement correctly identifies the initial treatment for each condition?

a)

Hirschsprung disease: barium enema; Intussusception: surgical removal of impaired colon

b)

Hirschsprung disease: surgery to remove the impaired part of the colon with possible colostomy; Intussusception: barium or air enema, with surgery if unsuccessful

c)

Hirschsprung disease: high-fiber diet; Intussusception: laxatives

d)

Hirschsprung disease: watchful waiting; Intussusception: immediate surgery in all cases

59.

A nurse is assessing a child suspected of having scabies. Which manifestation is most characteristic of this condition?

a)

Large, flat, dry patches of skin with minimal itching

b)

Intense itching, especially at night, with burrows under the skin, sometimes between the fingers; vesiculopustular lesions may occur in children

c)

Red, inflamed skin with yellow crusting but no itching

d)

Painful ulcers on the mucous membranes