Review RN Nursing Care of Children 2019 with NGN

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RN Nursing Care of Children 2019 with NGN

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Total Questions : 67

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Question 1:

A nurse is assessing an adolescent who has type 1 diabetes mellitus. Which of the following findings is the nurse's priority?

A. Cholesterol 189 mg/dL B. HbA1c 11.5% C. Glycosuria D. Preprandial blood glucose 124 mg/dL

Answer and Explanation

Choice A:

While an elevated cholesterol level is a concern in diabetes, it is not the priority in this case. The elevated HbA1c level indicates a more pressing issue that requires immediate attention.

Choice B:

The correct answer is B. HbA1c 11.5%. HbA1c is a measure of the average blood glucose level over the past 2 to 3 months. A high HbA1c indicates poor glycemic control and increased risk of complications from diabetes. The nurse's priority is to address the factors that are contributing to the high HbA1c and provide education and support to improve the adolescent's self-management.

Choice C:

Glycosuria, while important to monitor, is a common finding in uncontrolled diabetes.It indicates elevated blood glucose levels and may require adjustments in the treatment plan. However, it is not as critical as addressing the elevated HbA1c level.

Choice D:

A preprandial blood glucose level of 124 mg/dL is within a reasonable range for an adolescent with diabetes. It is important to monitor blood glucose levels, but the elevated HbA1c level takes precedence in this situation.

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Question 2:

A nurse is planning to admit a preschooler from the PACU following the removal of a Wilms tumor. Which of the following children should the nurse identify as an appropriate roommate for the preschooler?

A. A child who has impetigo B. A child who has a fractured left femur C. A child who has viral pneumonia D. A child who has cellulitis of the right radius

Answer and Explanation

Choice A:

A child with impetigo has a contagious skin infection. It would not be appropriate to room them with a preschooler who has just had surgery, as this could increase the risk of post-operative infection.

Choice B:

A child with a fractured left femur does not have a contagious condition that would pose a risk to the preschooler following Wilms' tumor removal. This would be an appropriate roommate.

Choice C:

A child with viral pneumonia has a contagious respiratory infection. This could put the preschooler at risk of developing a respiratory infection, which could be especially dangerous after surgery.

Choice D:

A child with cellulitis of the right radius has a contagious skin infection. It would not be appropriate to room them with a preschooler who has just had surgery, as this could increase the risk of post-operative infection.

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Question 3:

A nurse is caring for a preschooler who has a brain tumor. Which of the following findings is the priority for the nurse to report to the provider?

A. Nightmares B. Hyperactivity C. Pruritus D. Diplopia

Answer and Explanation

Choice A:

Nightmares are common in children and may not be directly related to the brain tumor. While they should be addressed, they are not the priority in this case.

Choice B:

Hyperactivity can be a normal behavior in preschoolers. It may or may not be related to the brain tumor. Other symptoms should take precedence.

Choice C:

Pruritus (itching) is a common symptom that can have various causes, and it may not be directly related to the brain tumor. It should be addressed but is not the priority in this case.

Choice D:

Diplopia (double vision) can be a neurological symptom associated with increased
intracranial pressure or other complications related to a brain tumor. It is important to report this finding promptly to the provider for further evaluation and intervention.

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Question 4:

A nurse is reviewing the medical record of a 15-month-old child who is scheduled to receive the measles, mumps, and rubella (MMR) vaccine. Which of the following findings should the nurse identify as a contraindication for receiving this vaccine?

A. Upper respiratory infection 2 days ago B. Allergy to neomycin C. Temperature of 37.2° C (99° F) D. Family history of seizures

Answer and Explanation

Choice A:

An upper respiratory infection 2 days ago is not a contraindication for the MMR vaccine. The vaccine can be administered once the child has recovered from the acute illness.

Choice B:

An allergy to neomycin, which is an antibiotic, is a contraindication forreceiving the MMR vaccine. Neomycin is present in trace amounts in the MMR vaccine, and individuals with a severe allergy to this antibiotic should not receive the vaccine.

Choice C:

A temperature of 37.2° C (99° F) is a low-grade fever and is not a contraindication for the MMR vaccine. Mild illness without fever is not a contraindication.

Choice D:

A family history of seizures is not a contraindication for the MMR vaccine. The vaccine can be safely administered to children with a family history of seizures.

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Question 5:

A nurse is caring for an infant who has rotavirus. Which of the following findings indicates that the infant is moderately dehydrated?

A. Respiratory rate 28/min B. Capillary refill 1 second C. Weight loss 7% D. Bradycardia

Answer and Explanation

Choice A:

A respiratory rate of 28 breaths per minute indicates increased respiratory effort, which can be a sign of moderate dehydration. The infant may be trying to compensate for fluidloss.

Choice B:

Capillary refill of 1 second is within the normal range (less than 2 seconds). It is not indicative of moderate dehydration.

Choice C:

Weight loss of 7% is a significant amount of weight loss and is indicative of severe dehydration, not moderate dehydration. Moderate dehydration is usually defined as 5- 10% weight loss.

Choice D:

Bradycardia (slow heart rate) is not typically associated with dehydration. In fact, tachycardia (fast heart rate) is a more common sign of dehydration.

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Question 6:

A 15-year-old adolescent is admitted for a vaso-occlusive crisis.
The parent reports that the adolescent has a low-grade fever and has vomited for 3 days.
The adolescent reports having right-sided and low back pain.
They also report hands and right knee are painful and swollen.
The client reports pain as 8 on a scale of 0 to 10.

A nurse is caring for an adolescent who is admitted with a vaso-occlusive crisis.

Exhibits

The nurse is planning care for the adolescent. Select the 5 interventions the nurse should include.

A. Instruct the parent to ensure the pneumococcal vaccine is current. B. Give oral hydroxyurea. C. Monitor oxygen saturation continuously. D. Place the client on strict bed rest. F. Apply cold compresses to the affected joints. G. Administer meperidine IV for pain.

Answer and Explanation

Choice A:

Instruct the parent to ensure the pneumococcal vaccine is current.This is a preventive measure to reduce the risk of infections in individuals with sickle cell disease.

Choice B:

Give oral hydroxyurea.Hydroxyurea is used to decrease the frequency of pain episodes in sickle cell disease.

Choice C:

Monitor oxygen saturation continuously.Continuous monitoring of oxygen saturation is important to detect any potential respiratory complications.

Choice D:

Place the client on strict bed rest.Bed rest helps to reduce the metabolic demands on the body and promotes healing.

Choice F:

Administer meperidine IV for pain. Cold compresses may exacerbate vaso-occlusion, and meperidine is not the first-line choice for pain management in sickle cell crisis due to potential neurotoxicity.

Choice G:

Meperidine has a relatively short duration of action, which may necessitate frequent dosing. This can lead to more fluctuations in pain control.

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Question 7:

A nurse in an emergency department is assessing an adolescent who reports inhalation of gasoline. Which of the following findings should the nurse expect?

A. Pinpoint pupils B. Ataxia C. Hyperactive reflexes D. Hypothermia

Answer and Explanation

Choice A:

Pinpoint pupils are a characteristic sign of opioid overdose, not inhalation of gasoline.

Choice B:

Ataxia (lack of coordination) can be a neurological symptom associated with inhalation of gasoline or other volatile substances. These substances can affect the central nervous system and lead to impaired coordination.

Choice C:

Hyperactive reflexes are not a typical finding associated with inhalation of gasoline.This is more characteristic of conditions like hyperthyroidism or certain neurological disorders.

Choice D:

Hypothermia is not a typical finding associated with inhalation of gasoline. It is more likely to cause symptoms related to the central nervous system and respiratory system.

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Question 8:

A nurse in the emergency department is preparing to discharge a 3-year- old child.

Nurses' Notes

The child's guardian states the child has been unable to sleep recently and has been very irritable. Guardian expresses concern about the child's atopic dermatitis worsening and the child

scratching excessively, which results in the areas bleeding. Guardian states the child has a history of allergic rhinitis.
Which of the following statements should the nurse plan to include in the discharge instructions for the child's guardian? (Select all that apply.)

A. "You should apply a thick layer of pimecrolimus cream to your child's lesions." B. "You can apply gloves to your child's hands." C. "You should cut and file your child's fingernails frequently." D. "Your child will experience occasional flare-ups of this condition." F. "You should apply emollients to your child's skin after bathing." G. "Your child's condition is contagious when lesions are present."

Answer and Explanation

Choice A:

"You should apply a thick layer of pimecrolimus cream to your child's lesions."- Pimecrolimus is a topical immunomodulator that can be used to manage atopic dermatitis.

Choice B:

"You can apply gloves to your child's hands."- This can help prevent the child from scratching and causing further irritation.

Choice C:

"You should cut and file your child's fingernails frequently."- Keeping the child's fingernails short can reduce the risk of them causing skin damage from scratching.

Choice D:

"Your child will experience occasional flare-ups of this condition."- Atopic dermatitis is a chronic condition, and it's normal for there to be times when symptoms worsen.

Choice F:

Applying emollients or moisturizers helps to lock in moisture and can help manage dry skin associated with atopic dermatitis.

Choice G:

Atopic dermatitis is not contagious. It's a non-infectious skin condition.

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Question 9:

A nurse in a family practice clinic is assessing a preschool-age child who recently experienced the death of a sibling. Which of the following reactions is an age-appropriate response to death?

A. The child can give a logical explanation for the sibling's death. B. The child is curious about what happened to the sibling's body. C. The child views the sibling's death as permanent. D. The child feels responsible for the sibling's death.

Answer and Explanation

Choice A:

A preschool-age child is not expected to give a logical explanation for death. They may not fully understand the concept of death in the same way an older child or adult does.

Choice B:

It is common for preschool-age children to be curious about what happens to the body after death. This curiosity is an age-appropriate response to death.

Choice C:

A preschool-age child may not fully grasp the concept of death as permanent. They may have limited understanding of the irreversibility of death.

Choice D:

Feeling responsible for a sibling's death would be an inappropriate and potentially concerning response for a preschool-age child. It may indicate a need for further assessment and support.

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Question 10:

A nurse is assessing a 6-month-old infant who has respiratory syncytial virus. The nurse should immediately report which of the following findings to the provider?

A. Rhinorrhea B. Tachypnea C. Pharyngitis D. Coughing

Answer and Explanation

Choice A:

Rhinorrhea (runny nose) is a common symptom of respiratory syncytial virus (RSV) and may not require immediate reporting unless it is severe or associated with other concerning symptoms.

Choice B:

Tachypnea (rapid breathing) in an infant with RSV can be a sign ofrespiratory distress and may require immediate intervention or further evaluation by the provider.

Choice C:

Pharyngitis (sore throat) is a possible symptom of RSV, but it may not be as immediately concerning as tachypnea.

Choice D:

Coughing is a common symptom of RSV and may not require immediate reporting unless it is severe or associated with other concerning symptoms.

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