1.

A pediatric nurse advises a parent how to best convey the circumstances surrounding the sudden
death of an infant to a four-year-old sibling. The nurse anticipates that the sibling:

may feel guilty about the infant's death.

may mistrust the parent.

understands the permanence of death.

will role-play the infant's death.

2. At which stage of development are children apt to believe in the reversibility of death?

Adolescent.

Preschool age.

School age.

Toddler.

3. The physical manifestations of fetal alcohol syndrome include:

cleft lip and palette.

hepatomegaly, hypotonia, and microphthalmia.

hyperbilirubinemia, jaundice, and failure to thrive.

microcephaly, short philtrum, and prenatal growth retardation.

4. Which blood gas analyses are most indicative of respiratory acidosis?

pH = 7.22, PC02 = 55 mm Hg, HC03 = 30 mEq/L.

pH = 7.28, PC02 = 45 mm Hg, HC03 = 15 mEq/L.

pH = 7.34, PC02 = 35 mm Hg, HC03 = 25 mEq/L.

pH = 7.40, PC02 = 25 mm Hg, HC03 = 30 mEq/L.

5. The laboratory results of a patient with disseminated intravascular coagulation are likely to include:

decreased levels of fibrin split products.

increased levels of fibrinogen.

increased platelet counts.

prolonged prothrombin and partial thromboplastin times.

6. After receiving an immunization for diphtheria, tetanus, and pertussis, a patient develops swelling and
tenderness at the injection site, a low-grade fever, and malaise. The pediatric nurse informs the patient's
parents that:

the reaction is severe enough that they should bring the patient to an emergency department.

they should delay future immunizations until the patient sees an allergist.

this is a mild reaction, and teaches them how to manage it.

this is an appropriate reaction, and instructs them to do nothing.

7. A one-month-old female infant, who has developmental dysplasia of the hip, is placed in a hip spica
cast. The infant's mother expresses the desire to continue breastfeeding. The pediatric nurse's best
response is:

"After breastfeeding, hold your baby upright for 45 minutes."

"Due to the weight of the cast, breastfeeding is not encouraged. I recommend that you bottle-feed
expressed breast milk so your baby will get the benefits of the breast milk."

"Feed your baby 2 oz of formula to decrease her hunger frustration, and then place her upright in your
lap with her legs straddling your leg."
"To breastfeed, hold your baby under your arm, with her facing you and her legs extended behind your
back."

8. A pediatric nurse instructs parents who are concerned about the spread of illness at their children's
daycare centers to inquire about the facilities':

CPR training for staff.

infection control practices.

reported cases of diarrhea during the previous year.

staff-to-child ratios.

9. A pediatric nurse is caring for a male patient who has undergone a hydrocele repair. While assessing
the patient, the nurse notices that the scrotum is swollen and discolored. These findings are:

abnormal, and indicate the need for a cool compress.

abnormal, and indicate the presence of hemorrhaging.

normal, and indicate no need for intervention.

normal, and indicate the need for a position change.

10. To meet the emotional needs of a 10-year-old patient who is dying, the most appropriate nursing
action is to:

answer questions honestly and frankly.

avoid interruptions by coordinating nursing actions.

encourage the patient to write in a journal.

provide opportunities for the patient to interact with children of the same age.
11. A female adolescent, who has pelvic inflammatory disease (PID), inquires about the effects of the
disease on her ability to bear children. Which is the pediatric nurse's best response?

"The occurrence of spontaneous abortion during pregnancy increases with PID."

"There is an increased risk for ectopic pregnancy or infertility."

"There is an increased risk of placenta previa."

"There should be no problems with your ability to conceive."

12. In preparing a preschool-age patient for an injection, the most appropriate nursing intervention is to:

allow the patient to administer an injection to a doll.

coordinate the patient watching a peer receive an injection.

have the parents explain the process to the patient.

suggest diversionary activities like singing.

13. A four-year-old patient has been diagnosed with leukemia. The patient's parents follow the
Jehovah's Witness faith and inform the physician that they will not approve any type of blood
transfusions. The pediatric nurse is aware that:

in an emergency, a court order can be obtained for the patient to receive blood transfusions.

the patient can only receive blood that has been donated by family members.

the patient can receive volume expanders.

under no circumstances will the patient receive blood products.

14. An adolescent with chronic asthma, who has been hospitalized several times during the winter with
severe asthmatic exacerbations, confides, "I wish I could stay here in the hospital because every time
that I go home, I get sick again!" The pediatric nurse's best response is:
"I think that you should consider participating on a swim team to improve your pulmonary function."

"Let's talk about preventing and managing your asthma on a daily basis at home."

"Why don't I speak with your parents about what they are doing at home to help control your asthma?"

"Your insurance company does not pay for any additional days of hospitalization that are not medically
necessary."

15. The major pharmacologic action of albuterol (Proventil) is:

decreasing airway reactivity.

decreasing inflammation and airway obstruction.

improving the action of cilia to sweep trapped mucous upward.

relaxing constricted bronchial smooth muscle.

16. While caring for a patient who is hospitalized for acute gastroenteritis and dehydration, a pediatric
nurse notes the parent keeping packets of herbs by the patient's bedside. Suspecting that the parent
may be administering the herbs to the patient, the nurse's first action is to:

ask the parent in a nonjudgmental manner about the herbs.

coordinate a nursing care conference to discuss the patient's plan of care.

discuss the risks of using alternative therapies with the parent.

refer the family to a social worker for possible nonadherence with the healthcare regimen.

17. A pediatric nurse, who is caring for a 12-year-old patient with septic shock, perceives a potential
complication of fluid resuscitation upon noting:

a heart rate of 50 beats/min.

a temperature of 102oF (38.8oC).

complaints of leg pain.

rales and rhonchi by auscultation.

18. During the first two years of life, patients with bronchopulmonary dysplasia requiring
rehospitalization are most likely to be diagnosed with:

electrolyte disturbances.

immune deficiencies.

pulmonary hypertension.

respiratory tract infections.

19. A four-year-old patient, whose family follows a strict vegetarian diet, undergoes a prekindergarten
physical examination. The pediatric nurse is alert to the patient's potential deficiency of:

niacin.

thiamin.

vitamin B6.

vitamin B12.

20. A pediatric nurse is caring for a patient who received chemotherapy 10 days ago. Which laboratory
value requires the nurse's intervention?

A blood urea nitrogen level of 10 mg/dL.

A hemoglobin of 8.6 g/dL.

A platelet count of 18 x 103/µL.

A serum glucose of 110 mg/dL.

21. According to the Health Insurance Portability and Accountability Act, a healthcare facility may
release patient information without obtaining permission from the patient or family when there is a
request from a:

consulting physician to evaluate the patient.

lawyer regarding a child abuse case.

school nurse to update the school records.

teacher regarding behavioral issues.

22. For a patient with gastroesophageal reflux symptoms, the purpose of esophageal pH monitoring is to
evaluate for:

esophagitis from the reflux.

frequency of the reflux.

gastric emptying delays.

possible obstructions.

23. Discharge care planning has begun for a seriously injured Asian patient. The patient's parents have
refused routine home health visits. The pediatric nurse understands that Asian families:

believe that health outcomes are predetermined.

feel health is a personal responsibility and maintenance of family reputation is paramount.

regard health as a family responsibility, seeking outside aid only when resources are exhausted.

use healthcare systems infrequently and seek folk healers.

24. A pediatric nurse is preparing a newly paralyzed patient for discharge. The patient will require home
care, ancillary therapies, and complex medication regimens, and would benefit from a peer support
group. To ensure adequate preparation for discharge and transition to home life, the nurse will:
ask the social worker or case manager to organize a care conference.

assess the family for transportation needs.

call the medical supply company to ensure delivery of home care equipment.

contact the patient's school to ensure its readiness to accommodate the patient.

25. When a patient participates in a research study, the pediatric nurse's primary concern is to ensure
that the:

parent or guardian has given verbal consent for the patient's participation.

quality of care that the patient receives will not be affected if the patient chooses to withdraw from the
study.

research meets the developmental needs of the patient.

research will directly benefit the patient.

Question 1

The right answer was may feel guilty about the infant's death.

Question 2

The right answer was Preschool age.

Question 3

The right answer was microcephaly, short philtrum, and prenatal growth retardation.

Question 4

The right answer was pH = 7.22, PC02 = 55 mm Hg, HC03 = 30 mEq/L.

Question 5

The right answer was prolonged prothrombin and partial thromboplastin times.

Question 6

The right answer was this is a mild reaction, and teaches them how to manage it.

Question 7

The right answer was "To breastfeed, hold your baby under your arm, with her facing you and her legs
extended behind your back."

Question 8

The right answer was infection control practices.

Question 9

The right answer was normal, and indicate no need for intervention.

Question 10

The right answer was answer questions honestly and frankly.

Question 11

The right answer was "There is an increased risk for ectopic pregnancy or infertility."

Question 12

The right answer was allow the patient to administer an injection to a doll.

Question 13
The right answer was in an emergency, a court order can be obtained for the patient to receive blood
transfusions.

Question 14

The right answer was "Let's talk about preventing and managing your asthma on a daily basis at home."

Question 15

The right answer was relaxing constricted bronchial smooth muscle.

Question 16

The right answer was ask the parent in a nonjudgmental manner about the herbs.

Question 17

The right answer was rales and rhonchi by auscultation.

Question 18

The right answer was respiratory tract infections.

Question 19

The right answer was vitamin B12.

Question 20

The right answer was A platelet count of 18 x 103/µL.

Question 21

The right answer was consulting physician to evaluate the patient.

Question 22

The right answer was frequency of the reflux.

Question 23

The right answer was regard health as a family responsibility, seeking outside aid only when resources
are exhausted.

Question 24

The right answer was ask the social worker or case manager to organize a care conference.

Question 25

The right answer was quality of care that the patient receives will not be affected if the patient chooses
to withdraw from the study.