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137 Cards in this Set
- Front
- Back
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Which of the following terms is defined as the volume of blood ejected by the heart in 1 minute?
a) Afterload b) Cardiac cycle c) Stroke volume d) Cardiac output |
Cardiac output
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A chest x-ray examination is ordered for a child with suspected cardiac problems. The child's parent asks the nurse, "What will the x-ray show about her heart?" The nurse's response should be based on knowledge that the x-ray film will do which of the following?
a) Show bones of chest but not the heart b) Evaluate the vascular anatomy outside of the heart c) Show a graphic measure of electrical activity of the heart d) Provide information on heart size and pulmonary blood flow patterns |
Provide information on heart size and pulmonary blood flow patterns
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John is a 6 year old child scheduled for a cardiac catheterization. Preoperative teaching should be which of the following?
a) Directed at his parents because he is too young to understand b) Adapted to his level of development so that he can understand c) Done several days before the procedure so he will be prepared d) Provide details about the actual procedures so he will know what to expect |
Adapted to his level of development so that he can understand
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After returning from cardiac catheterization, the nurse monitors the child's vital signs. The heart rate should be counted for how many seconds?
a) 15 b) 30 c) 60 d) 120 |
60
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After returning from cardiac catheterization, the nurse determines that the pulse distal to the catheter insertion site is weaker. The nurse should do which of the following?
a) Elevate affected extremity b) Notify practitioner of the observation c) Record data on assessment flow sheet d) Apply warm compresses to insertion site |
Record data on assessment flow sheet
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The nurse is caring for a school-age girl who has had a cardiac catheterization. The child tells the nurse that her bandage is "too wet." The nurse finds the bandage and bed soaked with blood. The most appropriate initial nursing action is which of the following?
a) Notify the physician b) Place child in Trendelenburg position c) Apply a new bandage with more pressure d) Apply direct pressure above catheterization site |
Apply direct pressure above catheterization site
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The nurse should recognize that congestive heart failure (CHF) is which of the following?
a) Disease related to cardiac defects b) Consequence of an underlying cardiac defect c) Inherited disorder associated with a variety of defects d) Result of diminished workload imposed on an abnormal myocardium |
Consequence of an underlying cardiac defect
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The nurse finds that a 6 month old infant has an apical pulse of 166 beats/min during sleep. The nurse should do which of the following?
a) Administer oxygen b) Record data on nurses' notes c) Report data to the practitioner d) Place child in high Fowler position |
Report data to the practitioner
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A 2 year old child is receiving digoxin (Lanoxin). The nurse should notify the practitioner and withhold the medication if the apical pulse is less than which of the following?
a) 60 beats/min b) 90 beats/min c) 100 beats/min d) 120 beats/min |
90 beats/min
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Which of the following is a common sign of digoxin toxicity?
a) Seizures b) Vomiting c) Bradypnea d) Tachycardia |
Vomiting
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The parents of a young child with congestive heart failure (CHF) tell the nurse that they are nervous about giving digoxin. The nurse's response should be based on which of the following?
a) It is a safe, frequently used drug b) Parents lack the expertise necessary to administer digoxin c) It is difficult to either overmedicate or undermedicate with digoxin d) Parents need to learn specific, important guidelines for administration of digoxin |
Parents need to learn specific, important guidelines for administration of digoxin
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The infant with congestive heart failure (CHF) has a need for:
a) Decreased fat b) Increased fluids c) Decreased protein d) Increased calories |
Increased calories
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Decreasing the demands on the heart is a priority in care for the infant with congestive heart failure (CHF). In evaluating the infant's status, which of the following is indicative of achieving this goal?
a) Irritability when awake b) Capillary refill of more than 5 seconds c) Appropriate weight gain for age d) Positioned in high Fowler position to maintain oxygen saturation at 90% |
Appropriate weight gain for age
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The nurse is caring for a child with persistent hypoxia secondary to a cardiac defect. The nurse recognize the risk of cerebrovascular accidents (strokes) occurring. Which of the following is an important objective to decrease this risk?
a) Minimize seizures b) Prevent dehydration c) Promote cardiac output d) Reduce energy expenditure |
Prevent dehydration
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A 3 month old infant has a hypercyanotic spell. The nurse's first action should be which of the following?
a) Assess for neurologic defects b) Prepare family for imminent death c) Begin cardiopulmonary resuscitation d) Place child in the knee-chest position |
Place child in the knee-chest position
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A cardiac defect that allows blood to shunt from the (high pressure) left side of the heart to the (lower pressure) right side can result in:
a) Cyanosis b) Congestive heart failure c) Decreased pulmonary blood flow d) Bounding pulses in upper extremities |
Congestive heart failure
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Ventricular septal defect has the following blood flow pattern:
a) Mixed blood flow b) Increased pulmonary blood flow c) Decreased pulmonary blood flow d) Obstruction to blood flow from ventricles |
Increased pulmonary blood flow
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Which of the following defects results in obstruction to blood flow?
a) Aortic stenosis b) Tricuspid atresia c) Atrial septal defect d) Transposition of the great arteries |
Aortic stenosis
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Which of the following structural defects constitute tetralogy of Fallot?
a) Pulmonary stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy b) Aortic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy c) Aortic stenosis, ventricular septal defect, overriding aorta, left ventricular hypertrophy d) Pulmonary stenosis, ventricular septal defect, aortic hypertrophy, left ventricular hypertrophy |
Pulmonary stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy
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The parents of a 3 year old child with congenital heart disease are afraid to let their child play with other children because of possible overexertion. The nurse's reply should include which of the following?
a) Parents can meet all the child's needs b) Child needs opportunities to play with peers c) Constant parental supervision is needed to avoid overexertion d) Child needs to understand that peers' activities are too strenuous |
Child needs opportunities to play with peers
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The primary nursing intervention to prevent bacterial endocarditis is which of the following?
a) Counsel parents of high-risk children b) Institute measures to prevent dental procedures c) Encourage restricted mobility in susceptible children d) Observe children for complications, such as embolism and heart failure |
Counsel parents of high-risk children
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Which of the following is a major clinical manifestations of rheumatic fever (RF)?
a) Fever b) Polyarthritis c) Osler nodes d) Janeway spots |
Polyarthritis
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Which of the following actions by the school nurse is important in the prevention of rheumatic fever (RF)?
a) Encourage routine cholesterol screenings b) Conduct routine blood pressure screenings c) Refer children with sore throats for throat cultures d) Recommend salicylates instead of acetaminophen for minor discomforts |
Refer children with sore throats for throat cultures
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When caring for the child with Kawasaki disease, the nurse should know which of the following?
a) Aspirin is contraindicated b) Principal area of involvement is the joints c) Child's fever is usually responsive to antibiotics within 48 hours d) Therapeutic management includes administration of gamma globulin and salicylates |
Therapeutic management includes administration of gamma globulin and salicylates
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Nursing care of the child with Kawasaki disease is challenging because of:
a) The child's irritability b) Predictable disease course c) Complex antibiotic therapy d) The child's ongoing requests for food |
The child's irritability
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An injury to which of the following parts of the brain will cause a coma?
a) Brainstem b) Cerebrum c) Cerebellum d) Occipital lobe |
Brainstem
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Which of the following is a clinical manifestations of increased intracranial pressure (ICP) in children?
a) Low-pitched cry b) Sunken fontanel c) Diplopia, blurred vision d) Increased blood pressure |
Diplopia, blurred vision
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Quick, jerky, grossly uncoordinated, irregular movements that may disappear on relaxation are called which of the following?
a) Twitching b) Spasticity c) Choreiform movements d) Associated movements |
Choreiform movements
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Which of the following terms is used when a patient remains in a deep sleep, responsive only to vigorous and repeated stimulation?
a) Coma b) Stupor c) Obtundation d) Persistent vegetative state |
Stupor
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Which of the following terms is used to describe a child's level of consciousness when the child is arousable with stimulation?
a) Stupor b) Confusion c) Obtundation d) Disorientation |
Obtundation
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The nurse is closely monitoring a child who is unconscious after a fall and notices that the child suddenly has a fixed and dilated pupil. The nurse should interpret this as which of the following?
a) Eye trauma b) Indication of brain death c) Severe brainstem damage d) Neurosurgical emergency |
Neurosurgical emergency
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The nurse is caring for a child with severe head trauma after a car accident? Which of the following is an ominous sign that often precedes death?
a) Delirium b) Papilledema c) Flexion posturing d) Periodic or irregular breathing |
Periodic or irregular breathing
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The nurse is doing a neurologic assessment on a 2 month old infant after a car accident. Moro, tonic neck, and withdrawal reflexes are present. The nurse should recognize that these reflexes suggest which of the following?
a) Neurologic health b) Severe brain damage c) Decorticate posturing d) Decerebrate posturing |
Neurologic health
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The nurse is preparing a school-age child for computed tomography scan to assess cerebral function. The nurse should include which of the following statements in preparing the child?
a) The scan will not hurt b) Pain medication will be given c) You will be able to move once the equipment is in place d) Unfortunately no one can remain in the room with you during the test |
The scan will not hurt
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Which of the following is a nursing intervention to reduce the risk of increasing intracranial pressure (ICP) in an unconscious child?
a) Suction child frequently b) Turn head side to side every hour c) Provide environmental stimulation d) Avoid activities that cause pain or crying |
Avoid activities that cause pain or crying
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An appropriate nursing intervention when caring for an unconscious child would be which of the following?
a) Avoid using narcotics or sedatives to provide comfort and pain relief b) Change the child's position infrequently to minimize the chance of increased intracranial pressure (ICP) c) Monitor fluid intake and output carefully to avoid fluid overload and cerebral edema d) Give tepid sponge baths to reduce fevers above 38.3 Celcius (101 F) because antipyretics are contraindicated |
Monitor fluid intake and output carefully to avoid fluid overload and cerebral edema
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Which of the following is descriptive of a concussion?
a) Petechial hemorrhages cause amnesia b) Visible bruising and tearing of cerebral tissue occur c) It is a transient and reversible neuronal dysfunction d) It is a slight lesion that develops remote from the site of trauma |
It is a transient and reversible neuronal dysfunction
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Which of the following statements best describes a subdural hematoma?
a) Bleeding occurs between the dura and the skull b) Bleeding occurs between the dura and the cerebrum c) Bleeding is generally arterial, and brain compression occurs rapidly d) The hematoma commonly occurs in the parietotemporal region |
Bleeding occurs between the dura and cerebrum
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A 10 year old boy on a bicycle has been hit by a car in front of the school. The school nurse immediately assesses airway, breathing, and circulation. The next nursing action should be which of the following?
a) Place on side b) Take blood pressure c) Stabilize neck and spine d) Check scalp and back for bleeding |
Stabilize neck and spine
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A school-age child has sustained a head injury and multiple fractures after being thrown from a horse. The child's level of consciousness is variable. The parents tell the nurse that they think their child is in pain because of periodic crying and restlessness. The most appropriate nursing action is which of the following?
a) Explain that analgesia is contraindicated with a head injury b) Have parents describe the child's previous experiences with pain c) Consult with practitioner about what analgesia can be safely administered d) Teach parents that analgesia is unnecessary when child is not fully awake and alert |
Consult with practitioner about what analgesia can be safely administered
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The nurse is assessing a child who was just admitted to the hospital for observation after a head injury. Which of the following is the most essential part of the nursing assessment to detect early signs of a worsening condition?
a) Posturing b) Vital signs c) Focal neurologic signs d) Level of consciousness |
Level of consciousness
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A 5 year old girl sustained a concussion when she fell out of a tree. In preparation for discharge, the nurse is discussing home care with her mother. Which of the following is considered a manifestation of postconcussion syndrome and does not necessitate medical attention?
a) Vomiting b) Blurred vision c) Behavioral changes d) Temporary loss of consciousness |
Behavioral changes
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A 18 month old is brought to the emergency department after being found unconscious in the family pool. The nurse knows that the primary problem in drowning incidents is:
a) Hypoxia b) Aspiration c) Hypothermia d) Electrolyte imbalance |
Hypoxia
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A toddler is admitted to the pediatric unit with presumptive bacterial meningitis. The initial orders include isolation, intravenous access, cultures, and antimicrobial agents. The nurse knows that antibiotic therapy will begin:
a) Once the diagnosis is confirmed b) When the medication is received from pharmacy c) After the child's fluid and electrolyte balance is stabilized d) As soon as the practitioner is notified of the culture results |
When the medication is received from pharmacy
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The nurse is planning care for a school-age child with bacterial meningitis. Which of the following should be included?
a) Keep environmental stimuli to a minimum b) Have child move head from side to side at least every 2 hours c) Avoid giving pain medications that could dull sensorium d) Measure head circumference to assess developing complications |
Keep environmental stimuli to a minimum
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Which of the following terms refers to seizures that involve both hemispheres of the brain?
a) Absence b) Acquired c) Generalized d) Complex partial |
Generalized
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Which of the following is the initial clinical manifestations of generalized seizures?
a) Confusion b) Feeling frightened c) Loss of consciousness d) Seeing flashing lights |
Loss of consciousness
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Which of the following types of seizures may be difficult to detect?
a) Absence b) Generalized c) Simple partial d) Complex partial |
Absence
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An important nursing intervention when caring for a child who is experiencing a seizure would be which of the following?
a) Describe and record the seizure activity observed b) Suction the child during a seizure to prevent aspiration c) Place a tongue blade between the teeth if they become clenched d) Restrain the child when seizures occur to prevent bodily harm |
Describe and record the seizure activity observed
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A 10 year old child, without a history of previous seizures, experiences a tonic-clonic seizure at school that lasts more than 5 minutes. Breathing is not impaired. Some postictal confusion occurs. The most appropriate initial action by the school nurse is which of the following?
a) Stay with child and have someone else call emergency medical services (EMS) b) Notify parent and regular practitioner c) Notify parent that child should go home d) Stay with child, offering calm reassurance |
Stay with child and have someone else call EMS
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A child has been seizure free for 2 years. A father asks the nurse how much longer the child will need to take the antiseizure medications. The nurse includes which of the following in the response?
a) Medications can be discontinued at this time b) The child will need to take the drugs for 5 years after the last seizure c) A step-wise approach will be used to reduce the dosage gradually d) Seizure disorders are a life-long problem. Medications cannot be discontinued |
Seizure disorders are a life-long problem. Medications cannot be discontinued
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The nurse is teaching the parents of a 3 year old who has been diagnosed with tonic-clonic seizures. Which of the following statements by the parent would indicate a correct understanding of the teaching?
a) I should attempt to restrain my child during a seizure b) My child will need to avoid contact sports until adulthood c) I should place a pillow under my child's head during a seizure d) My child will need to be taken to the emergency department after each seizure |
I should place a pillow under my child's head during a seizure
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The nurse is caring for a 10 year old who has an acute head injury, has a pediatric Glascow coma score of 9, and is unconscious. Which of the following interventions should the nurse include in the child's care plan?
a) Elevate the head of the bed 15 to 30 degrees with head maintained in midline b) Maintain an active, stimulating environment c) Perform chest percussion and suctioning every 1 to 2 hours d) Perform active range of motion and nontherapeutic touch every 8 hours |
Elevate the head of the bed 15 to 30 degrees with head maintained in midline
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An adolescent has just been brought to the emergency department with a spinal cord injury an paralysis from a diving accident. The parents keep asking the nurse, "How bad is it?" The nurse's response should be based on which of the following?
a) Families adjust better to life-threatening injuries when information is given over time b) Immediate loss of function is indicative of the long-term consequences of the injury c) Extent and severity of damage cannot be determined for several weeks, or even months d) Numerous diagnostic tests will be done immediately to determine extent and severity of damage |
Extent and severity of damage cannot be determined for several weeks, or even months
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A 14 year old girl is in the intensive care unit after a spinal cord injury 2 days ago. Priority nursing interventions for this child includes which of the following?
a) Minimizing environmental stimuli b) Administering immunoglobulin c) Monitoring and maintaining systemic blood pressure d) Discussing long-term care issues with the family |
Monitoring and maintaining systemic blood pressure
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Which of the following would the nurse expect in a child with a spinal cord lesion at C7?
a) Complete respiratory paralysis b) No voluntary function of upper extremities c) Inability to roll over or attain sitting position d) Almost complete independence within limitations of wheelchair |
Almost complete independence within limitations of wheelchair
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An adolescent with a spinal cord injury is admitted to a rehabilitation center. Her parents describe her as being angry, hostile, and uncooperative. The nurse should recognize that this is suggestive of which of the following?
a) Normal phase of adolescent development b) Severe depression that will require long-term counselling c) Normal response to her situation that can be redirected in a healthy way d) Denial response to her situation that makes rehabilitative efforts more difficult |
Normal response to her situation that can be redirected in a healthy way
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Which of the following is a physiologic effect of immobilization on children?
a) Metabolic rate increases b) Venous return improves, since child is in supine position c) Circulatory stasis can lead to thrombus and embolus formation d) Bone calcium increases, releasing excess calcium into the body (hypercalcium) |
Circulatory stasis can lead to thrombus and embolus formation
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Which of the following can result from the bone demineralization associated with immobility?
a) Osteoporosis b) Pooling of blood c) Urinary retention d) Susceptibility to infection |
Osteoporosis
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Which of the following measures is important in managing hypercalcemia in a child who is immobilized?
a) Provide adequate hydration b) Change position frequently c) Encourage diet high in calcium d) Provide diet high in calories for healing |
Provide adequate hydration
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Immobilization causes which of the following effects on metabolism?
a) Hypocalcemia b) Decreased metabolic rate c) Positive nitrogen balance d) Increased levels of stress hormones |
Decreased metabolic rate
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Which of the following statements accurately describes physical development during the school-age years?
a) Child's weight almost triples b) Muscles become functionally mature c) Boys and girls double strength and physical capabilities d) Fat gradually increases, which contributes to child's heavier appearance |
Boys and girls double strength and physical capabilities
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The parents of 9 year old twin children tell the nurse, "They have filled up their bedroom with collections of rocks, shells, stamps, and bird nests." The nurse should recognize that this is which of the following?
a) Indicative of giftedness b) Indicative of typical twin behavior c) Characteristic of cognitive development at this age d) Characteristic of psychosocial development at this age |
Characteristic of cognitive development at this age
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Which of the following statements characterizes moral development in the older school-age child?
a) Rule violations are viewed in an isolated context b) Judgments and rules become more absolute and authoritarian c) The child has knowledge of the rules, but cannot understand the reasons behind them d) The child is able to judge an act by the intentions that prompted it rather than just by the consequences |
The child is able to judge an act by the intentions that promoted it rather than just by the consequences
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An 8 year old girl tells the nurse that she has cancer because God is punishing her for "being bad." The nurse should interpret this as being which of the following?
a) A common belief at this age b) Indicative of excessive family pressure c) Faith that forms the basis for most religions d) Suggestive of a failure to develop a conscience |
A common belief at this age
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What is the role of the peer group in the life of school-age children?
a) Decrease their need to learn appropriate sex roles b) Gives them an opportunity to learn dominance and hostility c) Allows them to remain dependent on their parents for a longer time d) Provides them with security as they gain independence from their parents |
Provides them with security as they gain independence from their parents
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Which of the following is descriptive of the social development of school-age children?
a) Identification with peers is minimum b) Children frequently have "best friends" c) Boys and girls play equally with each other d) Peer approval is not yet an influence for the child to conform |
Children frequently have best friends
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Which of the following statements best describes the relationship school-age children have with their families?
a) Ready to reject parental control b) Desire to spend equal time with family and peers c) Need and want restrictions placed on their behavior by the family d) Peer group replaces the family as the primary influence in setting standards of behavior rules |
Need and want restrictions placed on their behavior by the family
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A parent asks about whether a 7 year old is able to care for a dog. Based on the child's age, the nurse suggests:
a) Caring for an animal requires more maturity than the average 7 year old possesses b) This will help the parent identify the child's weaknesses c) A dog can help the child develop confidence and emotional health d) Cats are better pets for school-age children |
A dog can help the child develop confidence and emotional health
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The school nurse has been asked to begin teaching sex education in the fifth grade. The nurse should recognize that:
a) Questions need to be discouraged in this setting b) Most children in the fifth grade are too young for sex education c) Sexuality is presented as a normal part of growth and development d) Correct terminology should be reserved for children who are older |
Sexuality is presented as a normal part of growth and development
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Which of the following is descriptive of the play of school-age children?
a) They like to invent games, making up the rules as they go b) Individuality in play is better tolerated than at earlier ages c) Knowing the rules of a game gives an important sense of belonging d) Team play helps children learn the universal importance of competition and winning |
Knowing the rules of a game gives an important sense of belonging
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The school nurse is providing guidance to families of children who are entering elementary school. Essential information to include is:
a) Meet with teachers only at scheduled conferences b) Encourage growth of a sense of responsibility in children c) Provide tutoring for child to ensure mastery of material d) Homework should be done as soon as child comes home from school |
Encourage growth of a sense of responsibility in children
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Which of the following is characteristic of dishonest behavior in children ages 8 to 10 years?
a) Cheating during games is now more common b) Stealing can occur because their sense of property rights is limited c) Lying is used to meet expectations set by others that they have been unable to attain d) Dishonesty results from the inability to distinguish between fact and fantasy |
Lying is used to meet expectations set by others that they have been unable to attain
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A 9 year old girl often comes to the school nurse complaining of stomach pains. Her teacher says she is completing her school work satisfactorily, but lately has been somewhat aggressive and stubborn in the classroom. The school nurse should recognize this as which of the following?
a) Signs of stress b) Developmental delay c) Lack of adjustment to school environment d) Physical problem that needs medical intervention |
Signs of stress
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Which of the following statements best describes fear in the school-age child?
a) Increasing concerns about bodily safety overwhelm them b) They should be encouraged to hide their fears to prevent ridicule by peers c) Most of the new fears that trouble them are related to school and family d) Children with numerous fears need continuous protective behavior by parents to eliminate these fears |
Most of the new fears that trouble them are related to school and family
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A school-age child has begun to sleepwalk. The nurse advises the parents to:
a) Wake the child and help determine what is wrong b) Leave the child along unless he or she is in danger of harming self or others c) Arrange for psychologic evaluation to identify the cause of stress d) Keep the child awake later in the evening to ensure sufficient tiredness for a full night of sleep |
Leave the child alone unless he or she is in danger of harming self or others
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The school nurse is discussing after-school sports participation with parents of children age 10 years. The nurse's presentation includes which of the following important considerations?
a) Teams should be gender specific b) Organized sports are not appropriate at this age c) Competition is detrimental to the establishment of a positive self-image d) Sports participation is encouraged if the type of sport is appropriate to the child's abilities |
Sports participation is encouraged if the type of sport is appropriate to the child's abilities
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Nursing interventions to promote health during middle childhood include which of the following?
a) Stress the need for increased caloric intake to meet increased demands b) Instruct parents to defer questions about sex until the child reaches adolescence c) Advise parents that the child will need increasing amounts of rest toward the end of this period d) Educate parents about the need for good dental hygiene, since these are the years in which permanent teeth erupt |
Educate parents about the need for good dental hygiene, since these are the years in which permanent teeth erupt
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When a child requires medication in school, authorization is required from:
a) Parents b) Pharmacist c) School administrators d) Prescribing practioner |
Parents
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When teaching injury prevention during the school-age years, the nurse should include which of the following?
a) Teach child about need to fear strangers b) Teach basic rules of water safety c) Avoid letting child cook in microwave ovens d) Caution child against engaging in competitive sports |
Teach basic rules of water safety
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Which of the following is an important consideration for the school nurse who is planning a class on bicycle safety?
a) Most bicycle injuries involve collision with an automobile b) Head injuries are the major causes of bicycle-related fatalities c) Children should wear a bicycle helmet if they ride on paved streets d) Children should not ride double unless the bicycle has an extra large seat |
Head injuries are the major causes of bicycle-related fatalities
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The nurse is developing a teaching pamphlet for parents of school-age children. Which of the following anticipatory guidelines should the nurse include in the pamphlet?
a) At age 6, parents should be certain that the child is reading independently with books provided by school b) At age 8, parents should expect a decrease in involvement with peers and outside activities c) At age 10, parents should expect a decrease in admiration of the parents with little interest in parent-child activities d) At age 12, parents should be certain that the child's sex education is adequate with accurate information |
At age 12, parents should be certain that the child's sex education is adequate with accurate information
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The nurse is teaching a class on nutrition to a group of parents of 10 and 11 year old children. Which of the following statements by one of the parents would indicate a correct understanding of the teaching?
a) My child does not need to eat a variety of foods, just his favorite food groups b) My child can add salt and sugar to foods to make them taste better c) I will serve foods that are low in saturated fat and cholesterol d) I will continue to serve red meat three times per week for extra iron |
I will serve foods that are low in saturated fat and cholesterol
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Which of the following is characterized by destruction of pancreatic beta cells, resulting in insulin deficiency?
a) Type 1 diabetes b) Type 2 diabetes c) Gestational hypertension d) Maturity-onset diabetes of the young (MODY) |
Type 1 diabetes
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Which of the following is characterized of type 1 diabetes mellitus?
a) Onset of usually gradual b) Ketoacidosis is infrequent c) Peak age incidence is 10 to 15 years d) Oral agents are available for treatment |
Peak age incidence is 10 to 15 years
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Which of the following is considered a cardinal sign of diabetes mellitus?
a) Nausea b) Seizures c) Impaired vision d) Frequent urination |
Frequent urination
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The parents of a child who has just been diagnosed with type 1 diabetes ask about exercise. The nurse should explain that:
a) Exercise increases blood glucose b) Extra insulin is required during exercise c) Additional snacks are needed before exercise d) Excessive physical activity should be restricted |
Additional snacks are needed before exercise
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A 20kg (44lb) child in ketoacidosis is admitted to the pediatric intensive care unit. Which of the following orders would the nurse not implement until clarified with the physician?
a) Weigh on admission and daily b) Replace fluid volume deficit over 48 hours c) Begin intravenous line with D5 0.45% normal saline with 20 mEq potassium chloride d) Give intravenous regular insulin 2 units/kg/hr after initial rehydration bolus |
Begin intravenous line with D5 0.45% normal saline with 20 mEq potassium chloride
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Manifestations of hypoglycemia include which of the following?
a) Lethargy b) Confusion c) Nausea and vomiting d) Weakness and dizziness |
Weakness and dizziness
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A 12 year old girl is newly diagnosed with diabetes when she develops ketoacidosis. The nurse recognizes that a successful education program is structured as follows:
a) Essential information is presented initially b) Teaching should take place in the child's semi-private room c) Education is focused toward the parents, since the child is too young d) All information needed for self-management of diabetes is taught at once |
Essential information is presented initially
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The nurse is discussing with a child and family the various sites used for insulin injections. Which of the following sites usually has the fastest rate of absorption?
a) Arm b) Leg c) Buttock d) Abdomen |
Abdomen
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A preadolescent has maintained good glycemic control of his type 1 diabetes through the school year. During summer vacation, he has had repeated episodes of hypoglycemia. What additional teaching is needed?
a) Carbohydrates in diet need to be replaced with protein b) Additional snacks are needed to compensate for increased activity c) Child needs to decrease activity level to minimize episodes of hypoglycemia d) Insulin dosage should be increased to compensate for change in activity level |
Additional snacks are needed to compensate for increased activity
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To help the adolescent deal with diabetes, the nurse needs to consider which of the following characteristics of adolescence?
a) Desire to be unique b) Preoccupation with the future c) Need to be perfect and similar to peers d) Awareness of peers that diabetes is a severe disease |
Need to be perfect is a severe disease
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An important consideration in the diagnosis of attention deficit hyperactivity disorder (ADHD) is:
a) Learning disabilities are apparent at an early age b) The child will always be distracted by external stimuli c) Parental observations of the child's behavior are most relevant d) It must be determined whether the child's behavior is age appropriate or problematic |
It must be determined whether the child's behavior is age appropriate or problematic
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The nurse is facilitating a conference between the teachers and parents of a 7 year old newly diagnosed with attention deficit hyperactivity disorder (ADHD). The nurse stresses:
a) Academic subjects should be taught in the afternoon b) Low interest activities in the classroom should be minimized c) Visual references should accompany verbal instruction d) The child's environment should be visually stimulating to engage the child |
Visual references should accompany verbal instruction
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Which of the following is a characteristic of children with depression?
a) Increased range of affective response b) Tendency to prefer play instead of schoolwork c) Change in appetite, resulting in weight loss or gain d) Preoccupation with need to perform well in school |
Change in appetite, resulting in weight loss or gain
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How does the onset of the pubertal growth spurt compare in girls and boys?
a) In girls it occurs about 1 year before it appears in boys b) In girls it occurs about 3 years before it appears in boys c) In boys it occurs about 1 year before it appears in girls d) It is about the same in both boys and girls |
In girls it occurs about 1 year before it appears in boys
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In girls the initial indication of puberty is which of the following?
a) Menarche b) Growth spurt c) Breast development d) Growth of pubic hair |
Breast development
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Girls experience an increase in weight and fat deposition during puberty. Nursing considerations related to this include which of the following?
a) Give reassurance that these changes are normal b) Suggest dietary measures to control weight gain c) Encourage low-fat diet to prevent fat deposition d) Recommend increased exercise to control weight gain |
Give reassurance that these changes are normal
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In boys the initial indication of puberty is which of the following?
a) Voice changes b) Growth of pubic hair c) Testicular enlargement d) Increased size of penis |
Testicular enlargement
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According to Piaget, adolescents tend to be in which stage of cognitive development?
a) Concrete operations b) Conventional thought c) Postconventional thought d) Formal operational thought |
Formal operational thought
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Which of the following aspects of cognition develops during adolescence?
a) Ability to see things from the point of view of another b) Capability of using a future time perspective c) Capability of placing things in a sensible and logical order d) Progress from making judgments based on what they see to making judgments based on what they reason |
Capability of using a future time perspective
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Adolescents often do not use reasoned decision making when issues such as substance abuse and sexual behavior are involved. This is because they:
a) Tend to be immature b) Do not need to use reasoned decision making c) Lack cognitive skills to use reasoned decision making d) Are dealing with issues that are stressful and emotionally laden |
Are dealing with issues that are stressful and emotionally laden
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Which of the following is most descriptive of the spiritual development of the older adolescent?
a) Beliefs come more abstract b) Rituals and practices become increasingly important c) Strict observance of religious customs is common d) Emphasis is placed on external manifestations, such as whether a person goes to church |
Beliefs become more abstract
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According to Erikson, the psychosocial task of adolescence is developing which of the following?
a) Identity b) Intimacy c) Initiative d) Independence |
Identity
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A 16 year old adolescent boy tells the school nurse that he is gay. The nurse's response should be based on knowledge that:
a) He is too young to have had enough sexual activity to determine this b) The nurse should feel open to discussing his or her own beliefs about homosexuality c) Homosexual adolescents do not have concerns that differ from those of heterosexual adolescents d) It is important to provide a nonthreatening environment in which he can discuss this |
It is important to provide a nonthreatening environment in which he can discuss this
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The development of sexual orientation during adolescence?
a) Is inflexible b) Is a developmental process c) Differs for boys and girls d) Proceeds in a defined sequence |
Is a developmental process
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Which of the following is an important consideration for the school nurse planning a class on injury prevention for adolescents?
a) Adolescents generally are not risk takers b) Adolescents can anticipate the long-term consequences of serious injuries c) Adolescents need to discharge energy, often at the expense of logical thinking d) During adolescence, participation in sports should be limited to prevent permanent injuries |
Adolescents need to discharge energy, often at the expense of logical thinking
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The school nurse is teaching a class on injury prevention. Which of the following should be included when discussing firearms?
a) Adolescents are too young to use a gun properly for hunting b) Gun carrying among adolescents is on the rise, primarily among inner-city youth c) Nonpowder guns (air riffles, BB guns) are a relatively safe alternative to powder guns d) Adolescence is a peak age for being a victim or offender in the case of injury involving a firearm |
Adolescence is a peak age for being a victim or offender in the case of injury involving a firearm
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A method for conducting a health-screening interview with adolescents is "SAFE TIMES." The nurse working with adolescents should know that "SAFE" is an acronym for:
a) Social roles, apathy/anger, frustration, emotional growth b) Sexuality, affect/abuse, family, examination c) Safety issues, appropriate/inappropriate behavior, firearms, employment d) Security, acceptance/nonacceptance by peers, friends, education |
Sexuality, affect/abuse, family, examination
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The nurse is preparing a pamphlet for parents of adolescents about guidance during the adolescent years. Which of the following suggestions should the nurse include in the pamphlet?
a) Provide criticism when mistakes are made or when views are different b) Use comparisons to older siblings or extended family to promote good outcomes c) Begin to disengage from school functions to allow the adolescent to gain independence d) Provide clear, reasonable limits and define consequences when rules are broken |
Provide clear, reasonable limits and define consequences when rules are broken
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An adolescent girl calls the nurse at the clinic because she had unprotected sex the night before and does not want to be pregnant. The nurse should explain that:
a) It is too late to prevent an unwanted pregnancy b) An abortion may be the best option if she is pregnant c) The risk of pregnancy is minimum so no action is necessary d) Postcoital contraception is available to prevent implantation and therefore pregnancy |
Postcoital contraception is available to prevent implantation and therefor pregnancy
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An adolescent girl is brought to the hospital emergency department by her parents after being raped. The girl is calm and controlled throughout the interview and examination. The nurse should recognize this behavior is which of the following?
a) A sign that a rape has not actually occurred b) One of a variety of behaviors normally seen in rape victims c) Indicative of a higher than usual level of maturity in the adolescent d) Suggestive that the adolescent had severe emotional problems before the rape occured |
One of a variety of behaviors normally seen in rape victims
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A sexually active adolescent asks the school nurse about prevention of sexually transmitted infections. Which of the following should the nurse recommend?
a) Use of condoms b) Prophylactic antibiotics c) Any type of contraception method d) Withdrawal method of contraception |
Use of condoms
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Which of the following statements is true about gonorrhea?
a) It is caused by Treponema pallidum b) Treatment of all sexual contacts is essential c) Topical application of medication to the lesions is necessary d) Therapeutic management includes multidose administration of penicillin |
Treatment of all sexual contacts is essential
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Which of the following statements regarding chlamydial infections is correct?
a) Treatment of choice is oral penicillin b) Treatment of choice is nystatin and miconazole c) Both men and women may have asymptomatic infections d) Clinical manifestations include small, painful vesicles on genital areas |
Both men and women may have asymptomatic infections
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Prevention of pelvic inflammatory disease (PID) in adolescents is important because it:
a) Can be prevented by proper personal hygiene b) Is easily prevented by compliance with any form of contraception c) May have devastating effects on the reproductive tract of affected adolescents d) Can potentially cause life-threatening and serious defects in the future children of affected adolescents |
May have devastating effects on the reproductive tract of affected adolescents
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It is important that women with anogenital warts caused by the human papillomavirus (HPV) receive adequate treatment because this sexually transmitted infection increases the risk of which of the following?
a) Gonorrhea b) Cervical cancer c) Chlamydial infection d) Urinary tract infection |
Cervical cancer
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The nurse is teaching a class on obesity prevention to parents in the community. A contributing factor to childhood obesity is:
a) Birth weight b) Parental obesity c) Age of onset of puberty d) Asian ethnic background |
Parental obesity
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During a well-child visit, the nurse plots the child's BMI on the health record. The purpose of the BMI is to:
a) Determine medication dosages b) Predict adult height and weight c) Identify coping strategies used by child d) Provide a consistent measure of obesity |
Provide of consistent measure of obsesity
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During a well-child visit, the nurse practitioner provides guidance about promoting healthy eating in a child who is overweight. The nurse advises:
a) Slow down eating meals b) Avoid between-meal snacks c) Include low-fat foods in meals d) Use foods that child likes as special treats |
Slow down eating meals
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The middle school nurse is planning a behavior modification program for overweight children. An important goal for participants of the program should be:
a) Learn how to cook low-fat meals b) Improve relationships with peers c) Identify and eliminate inappropriate eating habits d) Achieve normal weight during the program |
Identify and eliminate inappropriate eating habits
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Descriptions of young people with anorexia nervosa (AN) often include which of the following?
a) Impulsive b) Extroverted c) Perfectionist d) Low achieving |
Perfectionist
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Which of the following is typical of the adolescent with anorexia nervosa (AN)?
a) Eats in secrecy b) Uses food as a coping mechanism c) Has marked preoccupation with food d) Lacks awareness of how eating affects weight loss |
Has marked preoccupation with food
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During the physical examination of an adolescent with significant weight loss, which of the following may indicate an eating disorder?
a) Diarrhea b) Amenorrhea c) Appetite suppression d) Erosion of tooth enamel |
Erosion of tooth enamel
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Which of the following is the most important goal when caring for a child with anorexia nervosa (AN)?
a) Limit fluid intake b) Prevent depression c) Correct malnutrition d) Encourage weight gain |
Correct malnutrition
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Nursing responsibilities regarding weight gain for the adoelscent with anorexia nervosa include which of the following?
a) Administer tube feedings until target weight is achieved b) Restore body weight to within 10% of adolescent's ideal weight c) Encourage continuation of strenuous exercise as long as adoelscent is not losing weight d) Facilitate as rapid a weight gain as possible with a high-calorie diet |
Restore body weight to within 10% of adolescent's ideal weight
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An important distinction in understanding substance abuse is that drug misuse, abuse, and addiction are considered:
a) Voluntary behaviors based on psychosocial needs b) Problems that occur in conjunction with addiction c) Involuntary physiologic responses to the pharmacologic characteristics of drugs d) Legal use of substances for purposes other than medicinal |
Voluntary behaviors based on psychosocial needs
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Which of the following statements is true about smoking in college students?
a) Rate of smoking cigarettes is declining b) Smokeless tobacco use is rising dramatically c) Regular cigar use is becoming more common d) Students in the health professions do not smoke |
Regular cigar use is becoming more common
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Which of the following is considered one of the best strategies for preventing smoking in teenagers?
a) Large-scale printed information campaigns b) Emphasis on long-term effects of smoking on health c) Threatening the social norms of groups most likely to smoke d) Peer-led programs emphasizing the social consequences of smoking |
Peer-led programs emphasizing the social consequences of smoking
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Many adolescents use alcohol for self-medication. The benefit of alcohol is:
a) Stimulant effect b) Increased alertness c) Sense of euphoria d) Defense against depression |
Defense against depression
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Which of the following factors is most likely to increase the likelihood that an adolescent will misuse alcohol?
a) Female gender b) School attendance c) Rural environment d) Unconventional behavior |
Unconventional behavior
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Which of the following is descriptive of central nervous system stimulants?
a) Acute intoxication can lead to coma b) They produce strong physical dependence c) Withdrawal symptoms are life threatening d) They can result in strong psychologic dependence |
They can result in strong psychologic dependence
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Which of the following statements is true concerning adolescent suicide?
a) A sense of hopelessness and despair is a normal part of adolescence b) Gay and lesbian adolescents are at a particular high risk for suicide c) Problem-solving skills are of limited value to the suicial adolescent d) Previous suicide attempts are not an indication for completed suicides |
Gay and lesbain adolescents are at a particular high risk for suicide
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Which of the following is the most commonly used method in completed suicides?
a) Firearms b) Drug overdose c) Self-inflicted laceration d) Carbon monoxide poisoning |
Firearms
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An adolescent girl tells the nurse that she is very suicidal. The nurse asks her is she has a specific plan. Asking this should be considered which of the following?
a) Not a critical part of the assessment b) An appropriate part of the assessment c) Suggesting that adoelscent needs a plan d) Encouraging adolescent to devise a plan |
An appropriate part of the assessment
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The nurse is presenting an educational program to a group of parents about differences between anorexia nervosa (AN) and bulimia nervosa (BN) at a community outreach program. Which of the following statements by a parent would indicate a need for additional teaching?
a) A child with AN will turn away from food to cope, whereas a child with BN turns to food to cope b) A child with AN maintains rigid control and is introverted, whereas a child with BN is an extrovert and frequently loses control c) A child with AN denies the illness, whereas a child with BN recognizes the illness d) A child with AN is usually sexually active and seeks intimacy, whereas a child with BN avoids intimacy and is usually not sexually active |
A child with AN is usually sexually active and seeks intimacy, whereas a child with BN avoids intimacy and is usually not sexually active
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