NCLEX Review Pediatric Nursing Part 2

11. The nurse is caring for a 10-year-old child during the acute phase of rheumatic fever. Bedrest is part of the child's plan of care. Which of the following diversional activities is developmentally appropriate and meets the health needs of this child in the acute phase of rheumatic fever?
A. Playing basketball with a hoop suspended from the bed.
B. Using hand-held computer video games.
C. Sorting and organizing baseball cards in a notebook.
D. Using art supplies to make drawings about the hospital experience.

12. The nurse is caring for a 13-year-old who has been casted following spinal instrumentation surgery to correct idiopathic scoliosis. The nurse is helping the teen and family plan diversional activities while the teen is in the cast. Which of the following activities would be most appropriate to support adolescent development while the teen is casted?
A. Take the teen shopping at the mall in a wheelchair.
B. Have teen regularly attend special school activities for own class.
C. Encourage siblings to spend time with teen watching television and movies.
D. Plan family evenings playing a variety of board games.

13. A two-month-old infant is in the clinic for a well baby visit. Which of the following immunizations can the nurse expect to administer?
A. TD, Varicella, IPV.
B. DTaP, Hib, OPV, HBV.
C. DTaP, MMR, Menomune.
D. DTaP, Pneumovax.

14. An 18-month-old child with a history of falling out of his crib has been brought to the emergency room by the parents. Examination of the child reveals a skull fracture and multiple bruises on the child's body. Which of the following findings obtained by the nurse is most suggestive of child abuse?
A. Poor personal hygiene of the child.
B. Conflicting explanations about the accident from the parents.
C. Cuts and bruises on the child's lower legs in various stages of healing.
D. Inability of the parents to comfort the child.

15. The nurse is discussing the risk of sudden infant death syndrome (SIDS) in infants with the parents whose second baby died of SIDS six months ago. The parents express fear that other children will die from SIDS since they have already had one baby die. Which of the following statements made by the parents indicate their understanding of the relationship of future children and the risk of SIDS?
A. "There is a 99% chance that we will not have another baby die of SIDS."
B. "There is medicine that can be used to stimulate the heart rate while the baby is sleeping."
C. "Genetic testing is available to determine the likelihood of another baby dying from SIDS."
D. "Any new baby will be on home monitoring for one year to prevent SIDS."

16. A ten-day-old baby is admitted with 5% dehydration. The nurse notes which of the following signs?
A. Tachycardia.
B. Hyperthermia.
C. Hypothermia.
D. Bradycardia.

17. The nurse is asked why infants are more prone to fluid imbalances than adults. The response is
A. infants ingest a lesser amount of fluid per kilogram.
B. infants have functionally immature kidneys.
C. adults have a greater body surface area.
D. adults have a greater metabolic rate.

18. A 10-month-old weighs 10 kg and has voided 100 ml in the past four hours. The nurse determines normal urine output based on the fact that normal urine output is
A. 10 ml/kg/hour.
B. 1–2 ml/kg/hour.
C. 3–5 ml/kg/hour.
D. 7–9 ml/kg/hour.

19. A three-month-old is NPO for surgery. The nurse attempts to comfort him by
A. administering acetaminophen.
B. offering pacifier.
C. encouraging parents to leave so the child can rest.
D. giving 10 cc Pedialyte.

20. An 11-year-old is admitted for treatment of lead poisoning. The nurse includes which of the following in the plan of care?
A. Strict intake and output.
B. Oxygen.
C. Heme-occult stool testing.
D. Calorie counts.

Answers and Rationale:
11. Correct C
Rationale: The middle childhood years are times for collections. The collections of middle to late school-age children become orderly, selective, and neatly organized in scrapbooks. This quiet activity supports the development of industry and concrete operational thought as well as the physical restrictions related to the rheumatic fever.

12. Correct B
Rationale: Early adolescents have a strong need to fit in and be accepted by their peers. Attending school activities helps the teen continue peer relationships and develop a sense of belonging.

13. Correct B
Rationale: Healthy infants at two months of age receive diphtheria, tetanus, and pertussis (DTP); hemophilus influenza (Hib); oral polio vaccine (OPV); and hepatitis B virus (HBV).

14. Correct B
Rationale: Incompatibility between the history and the injury is probably the most important criterion on which to base the decision to report suspected abuse.

15. Correct A
Rationale: Whether subsequent siblings of the SIDS infant are at risk is unclear. Even if the increased risk is correct, families have a 99% chance that their subsequent child will not die of SIDS.

16. Correct A
Rationale: Tachycardia is associated with dehydration.

7. Correct B
Rationale: Infant kidneys are unable to concentrate or dilute urine, to conserve or secrete sodium, or to acidify urine.

8. Correct B
Rationale: Normal urine output is 1–2 ml/kg/hour.

9. Correct B
Rationale: Non-nutritive sucking will help console and pacify him.

10. Correct A
Rationale: CaNaEDTA (treatment for lead poisoning) is nephrotoxic and strict intake and output records need to be kept.

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