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Nursing Care of Hospitalized Children > Pediatrics

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Total Questions : 16

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Question 1:

A nurse is caring for a child who has chickenpox, a communicable disease caused by the varicella-zoster virus. Which of the following transmission-based precautions should the nurse implement for this patient?

A. Contact precautions B. Droplet precautions C. Airborne precautions D. Vector-borne precautions

Answer and Explanation

Choice A:

Contact precautions are used for patients who have infections that can be spread by direct or indirect contact with the patient or the patient's environment. Examples of infections that require contact precautions are scabies, impetigo, and Clostridium difficile.

Choice B:

Droplet precautions are used for patients who have infections that can be spread by large respiratory droplets that are generated by coughing, sneezing, or talking. Examples of infections that require droplet precautions are influenza, pertussis, and meningitis.

Choice C:

Airborne precautions are used for patients who have infections that can be spread by small airborne particles that can remain suspended in the air and travel over long distances. Examples of infections that require airborne precautions are tuberculosis, measles, and chickenpox.

Choice D:

Vector-borne precautions are used for patients who have infections that can be spread by insects or animals that carry the infectious agent. Examples of infections that require vector-borne precautions are malaria, Lyme disease, and rabies.

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Question 2:

A nurse is teaching a group of parents about the risk factors for infection in hospitalized children. Which of the following statements should the nurse include in the teaching? (Select all that apply.)

A. "Children who have chronic conditions such as asthma or diabetes are more prone to infection." B. "Children who receive immunizations on time are less likely to get infected." C. "Children who have invasive devices such as catheters or IV lines are at increased risk of infection." D. "Children who share a room with another patient are less exposed to infection." E. "Children who have visitors or family members who are sick should not be in contact with them."

Answer and Explanation

Choice A:

Children who have chronic conditions such as asthma or diabetes are more prone to infection because their immune system may be compromised or weakened by their underlying disease.

Choice B:

Children who receive immunizations on time are less likely to get infected because they have developed immunity against certain diseases that can be prevented by vaccines.

Choice C:

Children who have invasive devices such as catheters or IV lines are at increased risk of infection because these devices can introduce microorganisms into the body or create a portal of entry for infection.

Choice D:

Children who share a room with another patient are more exposed to infection because they may come in contact with the infectious agent from the other patient or the environment.

Choice E:

Children who have visitors or family members who are sick should not be in contact with them because they may transmit the infection to the child or vice versa.

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Question 3:

A nurse is performing hand hygiene before entering a patient's room. The nurse's hands are not visibly soiled. Which of the following statements should the nurse make to explain the rationale for hand hygiene?

A. "Hand hygiene is the most effective way to prevent the spread of infection." B. "Hand hygiene is required by the hospital policy and accreditation standards." C. "Hand hygiene is a courtesy to the patient and shows respect." D. "Hand hygiene is a personal habit that I learned from my parents."

Answer and Explanation

Choice A:

Hand hygiene is the most effective way to prevent the spread of infection because it removes or kills microorganisms that may be present on the hands and prevents their transmission to others.

Choice B:

Hand hygiene is required by the hospital policy and accreditation standards, but this is not the primary rationale for hand hygiene. The policy and standards are based on evidence and best practices that support hand hygiene as an infection control measure.

Choice C:

Hand hygiene is a courtesy to the patient and shows respect, but this is not the main reason for hand hygiene. The main reason is to protect the patient and oneself from infection.

Choice D:

Hand hygiene is a personal habit that I learned from my parents, but this is not a valid explanation for hand hygiene. Hand hygiene is based on scientific principles and guidelines, not personal preferences or traditions.

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Question 4:

A nurse is preparing to administer medication to a child who is hospitalized with an infection. The nurse scans the patient's identification bracelet and verifies the medication order. Which of the following statements should the nurse make to ensure patient safety?

A. "Can you tell me your name and date of birth?" B. "Do you have any allergies or adverse reactions to medications?" C. "How do you feel today? Do you have any pain or discomfort?" D. "What is the name of the medication and why are you taking it?"

Answer and Explanation

Choice A:

Asking the patient to tell their name and date of birth is a way to confirm their identity and match it with the medication order. This is one of the steps of the "five rights" of medication administration, which are the right patient, the right drug, the right dose, the right route, and the right time.

Choice B:

Asking the patient about their allergies or adverse reactions to medications is important, but it is not a way to ensure patient safety in terms of identification. The nurse should have checked the patient's allergy status before preparing the medication.

Choice C:

Asking the patient how they feel today and if they have any pain or discomfort is a way to assess their condition and provide comfort measures, but it is not a way to ensure patient safety in terms of identification. The nurse should have done this assessment earlier in the shift or during the medication administration process.

Choice D:

Asking the patient what is the name of the medication and why they are taking it is a way to educate them about their treatment and check their understanding, but it is not a way to ensure patient safety in terms of identification. The nurse should have done this education before or after giving the medication.

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Question 5:

A nurse is cleaning a child's room after discharge. The child had an infection that required contact precautions. Which of the following actions should the nurse take to prevent environmental contamination?

A. Wear gloves and a gown while handling the soiled linens and dispose of them in a biohazard bag. B. Wear a mask and eye protection while wiping the surfaces and equipment with a disinfectant solution. C. Wear sterile gloves and a surgical mask while removing any sharps or needles and place them in a puncture-resistant container. D. Wear a respirator and a face shield while spraying an aerosol sanitizer in the air and on the curtains.

Answer and Explanation

Choice A:

Wearing gloves and a gown while handling the soiled linens and disposing of them in a biohazard bag is an appropriate action to prevent environmental contamination. This follows the standard precautions for contact with blood or body fluids and the transmission-based precautions for contact with infectious agents.

Choice B:

Wearing a mask and eye protection while wiping the surfaces and equipment with a disinfectant solution is not necessary for contact precautions. This would be indicated for droplet or airborne precautions, where respiratory droplets or particles may be present.

Choice C:

Wearing sterile gloves and a surgical mask while removing any sharps or needles and placing them in a puncture-resistant container is not required for contact precautions. This would be indicated for situations where there is a risk of exposure to bloodborne pathogens or other infectious materials.

Choice D:

Wearing a respirator and a face shield while spraying an aerosol sanitizer in the air and on the curtains is not recommended for contact precautions. This would be indicated for airborne precautions, where small airborne particles may be present. However, spraying an aerosol sanitizer is not an effective way to disinfect the environment, as it may create aerosols that can spread infection.

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Question 6:

A nurse is caring for a child who has pertussis, also known as whooping cough, which is caused by Bordetella pertussis bacteria. Which of the following types of isolation should the nurse use for this patient?

A. Contact isolation B. Droplet isolation C. Airborne isolation D. Protective isolation

Answer and Explanation

Choice A:

Contact isolation is used for patients who have infections that can be spread by direct or indirect contact with the patient or their environment. Pertussis is not transmitted by contact, but by respiratory droplets.

Choice B:

Droplet isolation is used for patients who have infections that can be spread by large respiratory droplets that are generated by coughing, sneezing, or talking. Pertussis is transmitted by respiratory droplets, so droplet isolation is appropriate.

Choice C:

Airborne isolation is used for patients who have infections that can be spread by small airborne particles that can remain suspended in the air and travel over long distances. Pertussis is not transmitted by airborne particles, but by respiratory droplets.

Choice D:

Protective isolation is used for patients who have compromised immune systems and are at risk of acquiring infections from others. Pertussis does not require protective isolation, as it does not pose a threat to immunocompromised patients.

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Question 7:

A nurse is teaching a parent about immunizations for children. Which of the following statements by the parent indicates an understanding of the teaching?

A. "My child will receive two doses of MMR vaccine before starting school." B. "My child will receive a booster dose of DTaP vaccine at age 11." C. "My child will receive three doses of hepatitis B vaccine in the first year of life." D. "My child will receive a single dose of varicella vaccine at age 12."

Answer and Explanation

Choice A:

The MMR vaccine, which protects against measles, mumps, and rubella, is given in two doses, but not before starting school. The first dose is given at 12 to 15 months of age, and the second dose is given at 4 to 6 years of age.

Choice B:

The DTaP vaccine, which protects against diphtheria, tetanus, and pertussis, is given in five doses, but not at age 11. The first three doses are given at 2, 4, and 6 months of age, the fourth dose is given at 15 to 18 months of age, and the fifth dose is given at 4 to 6 years of age. A booster dose of Tdap, which is a similar vaccine for older children and adults, is given at 11 to 12 years of age.

Choice C:

The hepatitis B vaccine, which protects against hepatitis B virus infection, is given in three doses in the first year of life. The first dose is given at birth, the second dose is given at 1 to 2 months of age, and the third dose is given at 6 to 18 months of age.

Choice D:

The varicella vaccine, which protects against chickenpox, is given in two doses, but not at age 12. The first dose is given at 12 to 15 months of age, and the second dose is given at 4 to 6 years of age.

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Question 8:

A nurse is reviewing the laboratory results of a child who has an infection. Which of the following findings should the nurse report to the provider? (Select all that apply.)

A. White blood cell count of 12,000/mm3 B. Erythrocyte sedimentation rate of 40 mm/h C. C-reactive protein level of 8 mg/L D. Blood culture positive for Staphylococcus aureus E. Urine culture negative for Escherichia coli

Answer and Explanation

Choice A:

A white blood cell count (WBC) of 12,000/mm3 is within the normal range for children aged 2 to 6 years. A WBC count above this range may indicate an infection or inflammation.

Choice B:

An erythrocyte sedimentation rate (ESR) of 40 mm/h is elevated for children aged 2 to 6 years. The normal range for this age group is 0 to 20 mm/h. An ESR above this range may indicate an infection or inflammation.

Choice C:

A C-reactive protein (CRP) level of 8 mg/L is elevated for children aged 2 to 6 years. The normal range for this age group is less than 1 mg/L. A CRP level above this range may indicate an infection or inflammation.

Choice D:

A blood culture positive for Staphylococcus aureus indicates a bacterial infection in the bloodstream. This can be a serious condition that requires prompt treatment with antibiotics.

Choice E:

A urine culture negative for Escherichia coli indicates no bacterial infection in the urinary tract. This is a normal finding that does not require further action.

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Question 9:

A nurse is teaching a group of parents about the chain of infection. Which of the following statements by one of the parents indicates a need for further teaching?

A. "The infectious agent is the microorganism that causes the disease." B. "The reservoir is where the microorganism lives and grows." C. "The portal of exit is how the microorganism enters the body of the host." D. "The susceptible host is someone who is at risk for getting the infection."

Answer and Explanation

Choice A:

This is a correct statement. The infectious agent is the microorganism that causes the disease, such as bacteria, viruses, fungi, or parasites.

Choice B:

This is a correct statement. The reservoir is where the microorganism lives and grows, such as humans, animals, plants, soil, or water.

Choice C:

This is an incorrect statement. The portal of exit is how the microorganism leaves the body of the reservoir, not how it enters the body of the host. The portal of entry is how the microorganism enters the body of the host.

Choice D:

This is a correct statement. The susceptible host is someone who is at risk for getting the infection, such as children, elderly, immunocompromised, or malnourished people.

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Question 10:

A nurse is caring for a child who has chickenpox. Which of the following actions should the nurse take? (Select all that apply.)

A. Place the child in a private room with negative air pressure. B. Wear gloves and a gown when entering the room. C. Apply calamine lotion to the skin lesions. D. Administer acyclovir as prescribed. E. Give aspirin for fever and pain relief.

Answer and Explanation

Choice A:

This is an incorrect action. The nurse should place the child in a private room with negative air pressure only if the child has an airborne infection, such as tuberculosis or measles. Chickenpox is transmitted by both airborne and contact routes, so a private room with positive air pressure is sufficient.

Choice B:

This is a correct action. The nurse should wear gloves and a gown when entering the room to prevent contact transmission of chickenpox.

Choice C:

This is a correct action. The nurse should apply calamine lotion to the skin lesions to relieve itching and prevent scratching.

Choice D:

This is a correct action. The nurse should administer acyclovir as prescribed to reduce viral shedding and shorten the duration of symptoms.

Choice E:

This is an incorrect action. The nurse should not give aspirin for fever and pain relief to a child who has chickenpox, because it can increase the risk of Reye syndrome, a rare but serious condition that affects the liver and brain.

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Question 11:

A nurse is assessing a child who has been admitted with a urinary tract infection (UTI). Which of the following statements by the child's parent indicates a possible source of infection?

A. "She always wipes from front to back after using the toilet." B. "She drinks plenty of water and cranberry juice every day." C. "She likes to take bubble baths with her toys." D. "She wears cotton underwear and loose-fitting pants."

Answer and Explanation

Choice A:

This is not a possible source of infection. Wiping from front to back after using the toilet can prevent bacteria from entering the urinary tract and causing infection.

Choice B:

This is not a possible source of infection. Drinking plenty of water and cranberry juice every day can help flush out bacteria from the urinary tract and prevent infection.

Choice C:

This is a possible source of infection. Taking bubble baths with toys can introduce bacteria into the urinary tract and cause infection.

Choice D:

This is not a possible source of infection. Wearing cotton underwear and loose-fitting pants can allow air circulation and prevent moisture buildup in the genital area, which can reduce the risk of infection.

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Question 12:

A nurse is planning care for a child who has pertussis (whooping cough). Which of
the following interventions should be included in
the plan?

A. Encourage oral fluids and soft foods. B. Administer antitussive medication as needed. C. Provide humidified oxygen via nasal cannula. D. Monitor the child for signs of respiratory distress.

Answer and Explanation

Choice A:

This is not a priority intervention. The nurse should encourage oral fluids and soft foods to prevent dehydration and maintain nutrition, but this is not as important as monitoring the child for respiratory distress.

Choice B:

This is an incorrect intervention. The nurse should not administer antitussive medication to a child who has pertussis, because it can suppress the cough reflex and increase the risk of mucus accumulation and airway obstruction.

Choice C:

This is not a priority intervention. The nurse should provide humidified oxygen via nasal cannula to moisten the airways and ease breathing, but this is not as important as monitoring the child for respiratory distress.

Choice D:

This is a priority intervention. The nurse should monitor the child for signs of respiratory distress, such as cyanosis, tachypnea, retractions, or nasal flaring, because pertussis can cause severe coughing spells that can interfere with breathing.

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Question 13:

A nurse is evaluating the effectiveness of infection control education for a group of parents of hospitalized children. Which of the following statements by one of the parents indicates an understanding of the teaching?

A. "I will wash my hands with soap and water before and after visiting my child." B. "I will wear a mask and gloves when I enter my child's room." C. "I will bring some fresh flowers and balloons for my child." D. "I will share my child's toys with other children in the ward."

Answer and Explanation

Choice A:

This is a correct statement. The parent indicates an understanding of the teaching by stating that they will wash their hands with soap and water before and after visiting their child, which is a key component of standard precautions and infection control.

Choice B:

This is an incorrect statement. The parent does not need to wear a mask and gloves when they enter their child's room, unless their child has a known or suspected infection that requires transmission-based precautions.

Choice C:

This is an incorrect statement. The parent should not bring fresh flowers and balloons for their child, because they can harbor microorganisms and allergens that can cause infection or irritation.

Choice D:

This is an incorrect statement. The parent should not share their child's toys with other children in the ward, because they can transmit microorganisms and cause cross-infection.

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Question 14:

A nurse is caring for a 4-year-old child who has been diagnosed with rotavirus gastroenteritis. Which of the following actions should the nurse take? (Select all that apply.)

A. Administer oral rehydration solution as prescribed. B. Monitor the child's weight and intake and output. C. Isolate the child from other children in the unit. D. Collect stool specimens for culture and sensitivity. E. Teach the parents about proper hand hygiene.

Answer and Explanation

Choice A:

This is a correct action. The nurse should administer oral rehydration solution as prescribed to prevent dehydration and electrolyte imbalance.

Choice B:

This is a correct action. The nurse should monitor the child's weight and intake and output to assess fluid status and hydration level.

Choice C:

This is a correct action. The nurse should isolate the child from other children in the unit to prevent transmission of rotavirus, which is highly contagious.

Choice D:

This is an incorrect action. The nurse does not need to collect stool specimens for culture and sensitivity, because rotavirus gastroenteritis is diagnosed by antigen detection tests or polymerase chain reaction (PCR) tests.

Choice E:

This is a correct action. The nurse should teach the parents about proper hand hygiene to prevent infection and cross-contamination.

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Question 15:

A nurse is caring for a 2-year-old child who has impetigo contagiosa on his face
and hands. Which of the following actions should
the nurse take?

A. Apply topical antibiotics to the lesions twice a day. B. Cover the lesions with sterile gauze dressings. C. Wash the lesions with warm water and soap daily. D. Trim the child's fingernails and discourage scratching.

Answer and Explanation

Choice A:

This is a correct action. The nurse should apply topical antibiotics to the lesions twice a day to treat the infection and prevent its spread.

Choice B:

This is an incorrect action. The nurse should not cover the lesions with sterile gauze dressings, because this can create a moist environment that promotes bacterial growth and delays healing.

Choice C:

This is not a priority action. The nurse should wash the lesions with warm water and soap daily to remove crusts and debris, but this is not as important as applying topical antibiotics.

Choice D:

This is not a priority action. The nurse should trim the child's fingernails and discourage scratching to prevent skin damage and secondary infection, but this is not as important as applying topical antibiotics.

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Question 16:

A nurse is reviewing the immunization record of a 6-month-old infant who is due for a well-child visit. Which of the following vaccines should the nurse expect to administer? (Select all that apply.)

A. Rotavirus B. Diphtheria, tetanus, and acellular pertussis C. Haemophilus influenzae type b D. Measles, mumps, and rubella E. Pneumococcal conjugate

Answer and Explanation

Choice A:

Choice A reason: This is a correct vaccine. The nurse should expect to administer rotavirus vaccine to a 6-month-old infant, as the third dose of this vaccine is given at 6 months of age.

Choice B:

Choice B reason: This is a correct vaccine. The nurse should expect to administer diphtheria, tetanus, and acellular pertussis vaccine to a 6-month-old infant, as the third dose of this vaccine is given at 6 months of age.

Choice C:

Choice C reason: This is a correct vaccine. The nurse should expect to administer Haemophilus influenzae type b vaccine to a 6-month-old infant, as the third dose of this vaccine is given at 6 months of age.

Choice D:

Choice D reason: This is an incorrect vaccine. The nurse should not expect to administer measles, mumps, and rubella vaccine to a 6-month-old infant, as the first dose of this vaccine is given at 12 months of age.

Choice E:

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