the nurse is caring for a child who had a tonsillectomy performed 4 hours ago. which of the following is an abnormal finding and a cause for concern

• emesis of dried blood
• increased swallowing
• pink-tinged mucus
• the child complains of a very sore throat

a 7 year old has been diagnosed as having cystic fibrosis. chest physiotherapy has been ordered. when should chest percussion be performed

• before postural drainage
• 1/2 hour before meals
• before an aerosol treatment
• after suctioning

the nurse is performing chest physiotherapy on a 6 year old child who has congestion in his left lower lobe. in which position should the nurse place the child

• left side in semi fowler' position
• right side in semi fower's positoin
• left side in trendelenburg position
• right side in trendelenburg position

an infant is being evaluated for possible cystic fibrosis. the sweat test will show an elevation of which electrolyte

• chloride
• fluoride
• potassium
• calcium

a 2 year old is admitted to the hospital with cystic fibrosis. he is small for his age. what dietary suggestions can the nurse recommend to the child's mother to enhance his growth

• low fat low residue and high poatssium diet
• low carbohydrate soft diet with no sugar products
• high carbohydrate high fat diet with extra water between meals
• high protein high calorie meals with skim milk milkshakes between meals

the nurse is caring for a 2 year old boy who has cystic fibrosis. his mother asks why the child developed cystic fibosis. what explanation will the nurse provide

• it develops due to meconium ileus at birth
• it is an autosomal recessive genetic defect
• it occurs during embryologic development
• it results from chromosomal nondisjunction that occured during conception

a 2 year old is admitted to the hospital and will need to stay for several days. the child's mother is unable to stay overnight because there is no one to care for her other children.what should the nurse recommend the mother do

• leave something of hers with the child and tell him she'll be back in the morning
• leave while he is in the playroom
• leave after he has fallen asleep
• tell him she'll be back in a few minutes after she has dinner

 the mother of a 2 year old boy who has cystic fibrosis tells the nurse that the family is planning their first summer vacation. she wants to know if there are any special precautions needed because he has cystic fibrosis. what conditoin whill the nurse state that childen with cystic fibrosis are particularly susceptible

• severe sunburn
• infectious diarrhea
• heat exhaustion
• respiratory allergies

a 4 yar old is admitted to the hospital for the treatment of an acute asthma attack. she received nebulized albuterol in the ED and was transferred to the pediatric unit with an aminophylline infusion. what significant finding will inform the nurse that the treatment is effective

• a decrease in mucus production
• a decrease in wheezing
• an increase in blood pressure
• a sleeping child

a 12 month old is hospitalized for a severe case of croup and has been placed in an oxygen tent. today the oxygen order has been reduced from 35% to 25%. his blood gases are normal. the child refuses to stay in the oxygen tent. attempts to placate him only cuaes him to become more upset. what would be an appropriate action for the nurse to perform

• restrain him in the tent and notify the physician
• take him out of the tent and notify the physician
• take him out of the tent and let him sit in the playroom
• tell him it will please his mother if he stays in the tent

the nurse should recognize which of the following respiratory findings as normal in a 10 month old infant

• respiratory rate of 60 at rest
• use of accessory muscles to assist in respiratory effort
• respiratory rate of 32 at rest
• diaphoresis with shallow respirations

an 18 month old presents with nasal flaring, intercostal and substernal retractions, and a respiratory rate of 50. what is the most appropriate nursing diagnosis

• knowledge deficit
• ineffective breathing pattern
• ineffective individual coping
• high risk for altered body temperature: hyperthermia

an 11 month old is admitted to the hospital with bronchiolitis. he is currently in a croup tent with supplemental oxygen. which toy is most appropriate for the nurse to recommend to the child's parents

• a stuffed animal made from a washable fabric
• a soft plastic stacking toy with multicolored rings
• a set of wooden blocks
• a pull toy

which of the following statements best assures the nurse that the parents understand the safety concerns related to use of a vaporizer at home

• i have a high dresser in the bedroom on which to place the vaporizer. the cord will be concealed behind the dresser
• i plan to put the vaporizer on a stool next to the bed so that my child will get the most benefit from the cool mist
• i purchased a warm mist vaporizer because i won't want my child to get chillled from the mist in her face
• i thought i could just set the vaporizer on the floor next to the bed

a 4 year old is experiencing an acute asthma attack. why should the nurse avoid client percussion with this child

• chest percussion may lead to increased bronchospasm and more respiratory distress
• chest percussion may cause mucous plugging of the alveoli
• chest percussion is useful in removing airway secretions and should be used
• chest percussion will produce increased coughing and thereby enhance respiratory distress

a 5 month old has severe nasal congestion. what is the best way for the nurse to clear his nasal passages

• administer saline nose drops and use a bulb syringe to clear passages
• ask him to blow his nose and keep tissues handy
• place him in a mist tet with 40% oxygen
• administer vasoconstrictive nose drops before meals and at bedtime

a 30 week gestation infant who had apnea of prematurity is ready for discharge and will be going  home on apnea monitoring. what should the nurse teach the parents for proper use of the monitor

• the monitor is only used when the child is awake. it is not indicated at night or during naps
• the alarms on the monitor should be turned off when an attendant is with the infant
• the monitor should be kept on at all times except when the infant is being bathed. careful attention to skin integrity and hygiene is important
• it is best for the parents to have 24 hour home health supervision to watch the infant while monitoring is required

a 3 year old underwent a tonsillectomy this morning. as the nurse giving discharge instructions, which comment by the child's mother suggests that she understands the care requirements

• i plan to take her back to her play group tomorrow. i know she won't want to stay home
• i have bought popsicles to give her later today
• i will give her aspirin if she gets irritable
• she is just waiting for the ice cream we promised her before she came to the hospital

• i have bought popsicles to give her later today

a 3 year old boy presents in the ED with dysphagia, drooling, and respiratory difficulty that has increased significantly over the past 6 hours. the nurse should know that these findings are suggestive of which of the following conditions

• croup
• pneumonia
• bronchopulmonary dysplasia
• epiglottitis

a 2 year old presents to an urgent care center with respiratory distress and cyanosis. parents report an initial episode of choking. what is the best inital action for the nurse to take

• call 911 and have parents wait for an ambulance to transport the child to a pediatric hospital
• administer oxygen by face mask and call the child's pediatrician
• perform abdominal thrusts as described in the heimlich maneuver
• start cpr after the child loses consciousness

a 2 year old child admitted to an acute care pediatric unit with a sore throat is tentatively diagnosed with epiglottitis. which diagnostic test should a nurse plant to review to confirm the diagnosis

• blood culture
• CBC
• throat culture
• lateral neck xray

• lateral neck xray

a physician orders ABGs on a 5 year old client ad mitted with severe asthma. which s/s noted during a nurse's assessment of the child are consistent with theblood gas findings of pH 7.30, PaCO2 49, HCO3 24

• diaphoresis, headache, tachycardia, confusion, restressness, apprehension, and flushed face
• rapid and deep respirations, parathesia, lightheadedness, twitching, anxiety and fear
• rapid and deep breathing, bruity breath, fatigue, headache, lethargy, drowsiness, nausea, vomiting, abdominal pain
• slow and shallow breathing, hypertonic muscle, restlessness, twitching, confusion, iritability, apathy, tetany, seizures

• diaphoresis, headache, tachycardia, confusion, restressness, apprehension, and flushed face

a triage nurse determines that a child brought to the ED is experiencing severe respiratory distress when observing

• diaphoresis, restlessnes, tachypnea, anorexia
• pallor, coughing, wheezing, and confusion
• retractions, grunting, cyanosis, and bradycardia
• agitations decreased level of conciousness, diarrhea, tachypnea

• retractions, grunting, cyanosis, and bradycardia

a clinic nurse receives a call fromt he mother of a 2 year old child. the mother states the child has a temp of 104F a sore throat and has been drooling for a few days. the child is now sleepy. which is he best advce by the nurse

• take your child to an Emergency Department immediately
• bring your child into the clinic to be seen as soon as possible
• administer acetaminophen for the temperature and allow your chid to sleep
• use a spoon to look inside our child's mouth and throat and tell me what you see

• take your child to an Emergency Department immediately

a 7 year old is hospitalized after experiencing a soer throat and difficulty swallowing for a week. lab tests reveal elevated WBCs, bands, and neutrophils. a throat culture completed a week ago showed haemophilus influenzae type B. based on the information, which tentative medical diagnosis should a nure expected to be documented in the child's chart

• tonsillitis
• bronchiolitis
• epiglottitis
• tuberculosis

• epiglottitis

a 3 year old child admitted with sudden onset of fever, lethargy, dyspnea, sore throat and difficulty swallowing has a suspected diagnosis of acute epiglottitis. a nurse's initial assessment should focus on. select all that apply

• reviewing the vital sign results
• reviewing the past emdical history
• auscultating the lungs
• obtaining a throat culture
• observing swallowing
• allaying anxiety and fear

• reviewing the vital sign results
• reviewing the past emdical history
• auscultating the lungs
• observing swallowing
• allaying anxiety and fear

a 3 month old child is hospitalized with acute laryngotracheobronchitis. in formulating a nursing care plan, which dursing diagnosis should be a nurse's priority

• anxiety
• risk for deficient fluid volume
• ineffective berathing battern
• deficient knowledge

• ineffective berathing battern

an albuterol nebulizer treatment is ordred for a 6 month old infant hospitalized with laryngotracheobronchitis. a nurse should understand that albuterol when used as a nebulizer treatment

• relaxes smooth muscles in the airways
• reduces inflammation and mucosal edema in airways
• removes excess fluid from the lungs
• loosens and thins pulmonary secretions

• relaxes smooth muscles in the airways

a nurse is formulating a plan of care for a 22 month old child with a diagnosis of laryngotracheobronchitis. which symptoms should indicate to the nurse that the child is experiencing impending respiratory failure

• restless and irritabilitiy
• retraction of the accessory chest muscles
• decreased inspiratory breath sounds
• hoarseness

• decreased inspiratory breath sounds

an 11 month infant is brought to the hospital after experiencing a respiratory infection and severe diarrhea for 5 days. the child has poor skin turgor, respirations 30, temp 101.3 F, low serum potassium levels, and watery green stools. a physician orders an antipyretic and to begin IV fluid replacement of D5NS with a potassium additive. it is most important for the nurse to

• ensure the infant had urine output before beginning the ordered IV fluids
• apply oxygen because the child is experiencing rapid respirations
• change the infant's diaper to prevent skin breakdown
• administer the antipyretic first

which goal should a nurse deem as essential when caring for a 14 month old infant with bronchiolitis

• promoting and matintaining adequate hydration
• setting up and facilitating the use of a mist tent
• ennursing that antibiotics are ordered
• providing a cough suppressant as necesary

a 5 month old infant hospitalized with a diagnosis of pneumocystitis carinii pneumonia is being treated with trimethoprim-sulfamethoxazole with no adverse effets. a nurse assesses that the infant has thick tenacious secretions and poor cough effort, diarrhea, anorexia and is diaphoretic. which nursing diagnosis should the nurse establish as the priority

• ineffective airway clearance related to increased secretions and inability to clear the respiratory tract
• altered nutrition: less than body requiremnts related to recurrent illness, diarrheal losses, los of appetite, and oral candidiasis
• risk for infection related to impaired body defenses and presence of infective oragnisms
• risk for fluid volume deficit related to difficulty taking fluids, insensible fluid losses from hyperventilation and diaphoresis

a 3 year old child is brought to an emergency department with acute pulmonary edema. the child was seen in an ED 48 hours earlier for a near drowining incident. treatment was provided at that time and the child was monitored and discharged home. current chest radiograpnh idicates diffuse bbilateral infiltrates. there is no history of cardiopulmonary disease. which pulmonary dysfunctions should a nurse think about when assessing the child.

• foreign body aspiration
• aspiration pneumonia
• bronchopneumonia
• acute respiratory distress syndrome

a child with asthma is being discharged to home and has an order for bronchodilator (albuterol) to be administered via a metered dose inhaler. which point should a nurse address for appropriate administration of this medication

• when administering medication via a MDI avoid shaking the canister before discharging the medication
• medication is ordered in two puffs, press on the canister twice in succession to discharge the medication
• there shold be a tight seal around the mouthpiece of the inhaler before discharging the medication
• there should be a 2 to 3 inch space (or spacer device) between the inhaler and the open mouth of the child

the nurse is caring for a newly admitted 4 year old client diagnosed with asthma ho is pale and has dry mucous membranes, cracked lips, and nasal flaring with inspiration. what actions should the nurse perform . select all that apply

• obtain a pulse oximetry
• obtain vital signs
• assess lung sounds
• administer a nebulizer treatment
• offer oral fluids
• elevate the head of the bed

• obtain a pulse oximetry
• obtain vital signs
• assess lung sounds
• elevate the head of the bed

a nurse determines that a mother understands the benefits of using a peak flow meter when the mother states

• i will have my child lie flat and obtain the meter reading each morning before getting out of bed with the meter set on the averagepeak flow
• i will have my child obtain the meter reading after completing a morning exercise routine to encourage better airflow before testing the peak flow
• i will encourage my child to test the peak flow meter every day and set the meter at zero before testing the peak flow and record the reading once a month
• i will have my child stand and huff and cough two or three times to clear the airway and set the meter guage on zero before beginning to test the peak flow

a 4 year old child is hospitalized and diagnoses with intermittent asthma. oxygen is ordered via simple facemask. a nurse should plan to instruct the parents that which items can be harmful wile oxygen is being administered

• plastic blocks and handheld toys
• electronic educational toys and books
• cotton filled toys and clothing
• synthetic toys and clothing

a nurse is caring for a 5 year old child diagnosed with bronchial asthma. which statement is most important for the nurse to make when teaching the parents

• bronchial asthma is also called hyperactive airway disease
• frequent occurences of bronchiolitis before 5 years of age could be a sign of asthma
• severe repiratory alkalosis can result from respiratory failure in asthma
• severe bronchoconstriction can occur when exposed to cold air and irritating odors

which nursing assessment findings and therapy should a nurse expect for a child diagnosed with cystic fibrosis

• pic appettite, increasing nutritional choices
• abdnormal accumulation of mucus in respiratory and other mucous duct tracts, managing infection
• steatorrhea, increasing oral fluids
• decreased sodium and chloride secretin, vitamin and mineral supplements

the nurse is preparing to perform chest physiotherapy on a 7 year old client diagnosed with cyctic fibrosis. when should the nurse plan to perform the treatment

• before bperforming postural drainage
• before a nebulized aerosol treatment
• after suctioning the upper respiratory tract
• one hour before meals

a nurse is preparing a 4 year old child with cystic fibrosis for discharge to home. the nurse determines that a parent needs further education when the parent states

• playing on the backyard swings and hanging upside down are exercises our child will enjoy
• if childen at the day care center have a cough, fever, or flu symptoms we should keep our child home
• no pancreatic enzyme supplements will be necessary if our child has a good appetite and regular bowel movements
• three to four times every day we will perform chest therapy and postural drainage even if our child doesnt seem congested

which specific expected outcomes should a nurse establish for a child diagnosed with cycstic fibrosis

• adequate urine output, absence of injury, and normal growth and development
• absence of pulmonary infection, adequate nutrition, and skin remains intact
• adequate hydration, absence of diarrhea, and eats at least 75% of meals
• absence of dehydration, maintians cleanliness, and adheres to medication regimen

• absence of pulmonary infection, adequate nutrition, and skin remains intact

a community health nurse is planning a follow up visit to a family ater their firstborn child died from SIDS. which action is most important for the nurse to include in the initial visit

• help the family in making a plan for future children
• allow time for the parents to express their anger and grief
• make a referral for genetic counseling and education
• educate the family on the causes of SIDS

a child of african descent has a positive acid fast bacillus sputum culture after returning to the US from a trip to africa to visit relatives. during a nursing assessment a nrse observes that the parent refers to the child's diagnosis by using the imprsonal pronoun "it". which statement by the nurse is best

• tell me how you feel about your child's diagnosis
• if your child takes the prescribed medications, "it" can be ured
• why do you call your child's tuberculosis "it" rather than referring to the daignosi of tuberculosis
• i need to find out more information about "it". how long has your child been having night sweats and productive cough

which nursing diagnosis should have the gighest priority for an infant newly diagnosed with transesophageal fistula

• rusk for impaired infant attachement
• risk for infection
• risk for imbalanced nutrition
• risk for aspiration

in which position should a nurse place a child post operative tonsil and adenoidectomy

• semi-fowler with the head turned to the side
• high fowler head slightly forward and to the side
• side lying
• supine

a nurse is formulating a preoperative plan of care for a 5 year old child who is scheduled for a tonsil and adenoidectomy. which nursing diagnosis is priority

• imbalanced nutrition: less than body requirements related to surgery
• pain related to surgery
• ineffective airway clearance related to hesitation or reluctance to cough secondary to pain
• anxiety related to surgery

a nurse is caring for a 3 year old client who is postoperative tonil and adenoidectomy surgery. the nurse should suspect complications when assessing

• complaints of sore throat and difficulty swallowing
• secretions and dried blood at the corners of the mouth
• frequent swallowing and clearing of the throat
• the presence of dark coffee ground emesis

Which therapy appropirate to the child based on age and disorder: an infant born with a congenital heart defect

• oxygen provided via a nasal cannula
• mist/oxygen tent
• plastic oxygen hood over the head
• oxygen administration via face mask or nasal cannula

Which therapy appropirate to the child based on age and disorder: an active toddler with pneumonia

• oxygen provided via a nasal cannula
• mist/oxygen tent
• plastic oxygen hood over the head
• oxygen administration via face mask or nasal cannula

Which therapy appropirate to the child based on age and disorder: a school age child with an asthma exacerbation

• oxygen provided via a nasal cannula
• mist/oxygen tent
• plastic oxygen hood over the head
• oxygen administration via face mask or nasal cannula

Which therapy appropirate to the child based on age and disorder: an adolescent who is postoperative following a reduction of a fracturd left femur

• oxygen provided via a nasal cannula
• mist/oxygen tent
• plastic oxygen hood over the head
• oxygen administration via face mask or nasal cannula

nursing interventions for a child receiving inhalation therapy in an oxygen tent include which of the following

• tuck the tent snugly around the bottom perimeter of the bed
• keep the top of the tent closed or covered
• allow soft toys such as stuffed animals inside the tent
• once prescribed temperature is set do not readjust

when assessing a child removed from an oxygen tent a nurse should recognize that which of the following findings is an early indication of hypoxemia

• nonproductive cough
• hypoventilation
• nasal flaring
• nasal sutffiness

which of the following is a function of the tonsils

• contribute tot he functioning of the eustachian tube
• filter and protect against invading pathogens
• play a role in the formation of antigens
• promote nasal and sinus drainage

a nurse is caring for a child who is in the postoperative period following a tonsillectomy. when assessing the child, the nurse should recognize which of the following findings as consistent with prostoperative bleeding

• hbg of 11.6 and hct of 37
• inflamed and reddened throat
• frequent swallowing and clearing of the throat
• blood tinged mucus

which of the following nursing interventions should be included in the postoperative care for a child following a tonsillectomy

• encourace the child to blow her nose gently to clear the sinuses
• notify the provider if clots or blood tinged mucus are observed in emesis
• avoid red colored liquids and milk based foods initially
• position the child supine during the intial postoperative period

a nurse is assessing a child who is suspectd to have bacterial epiglottitis. which of the following manifestations support the suspected illness. select all that apply

• hoarseness and difficulty speaking
• difficulty swallowing
• low grade fever
• drooling
• dry barking cough
• stridor

• hoarseness and difficulty speaking
• difficulty swallowing
• drooling
• stridor

which of the following parameters indicate deterioration in a child's respiratory status. select all that apply

• SaO2 95%
• wheezing
• retraction of sternal muscles
• warm extremities
• premature ventricular complexes (PVCs)
• respiratory rate of 34
• anxiety

• wheezing
• retraction of sternal muscles
• premature ventricular complexes (PVCs)
• respiratory rate of 34
• anxiety

who hours after arriving in a med-surg unity a child develops dyspnea. the child's SaO2 is 91% and the child is exhibiting audible wheezing and use of accessory muscles. which of the following medications should the nurse expect to administer

• fluticasone (Flovent)
• montelukast (Singulair)
• cromolyn sodium (Intal)
• albuterol (Proventil)

a child is exhibiting suspected clinical manifestations of asthma. the mother asks the nurse what tests will be necessary to diagnose her child. which of the following diagnostic procedures should the nurse tell the mother is used to diagnose athma

• ABGs
• Chest Xray
• Pulmonary function tests
• Allergy tests

a nurse is caring for a child who is supected of having cystic fibrosis. which of the following tests should the nurse prepare to administer to confirm this diagnosis

• sweat chloride
• blood blucose
• arterial blood gases
• ultrasound

a nurse should expect the stools of a child who has cystic fibrosis to be

• hard and dry with difficult evacuation
• dark colored and tarry
• blood streaked with mucus strands
• fatty and foul smelling

which of the following are assessment findings seen in a child who has cystic fibrosis. select all that apply

• shortness of breath
• clubbing of fingers and toes
• barrel shaped chest
• ting watery mucus drainage
• rapid growth spurts

• shortness of breath
• clubbing of fingers and toes
• barrel shaped chest

which of the following is an appropriate nursing intervention for a child with cystic fibrosis

• administer fat soluble forms of vitamin A, D, E, K
• give pancreatic enzymes with food and snacks
• place the child on a low calorie, low protein diet
• limit fluids throughout the day

the nurse is inspecting the child's throat. the nurse should

• remove the tongue blade from the child's heads after he has experienced what it feels like in his mouth
• ask the child to hold the tongue blade with both hands in his lap while the nurse uses another tongue blade
• have the parent hold the child with arms restrained
• guide the tongue blade while the child is holding it to depress the tongue to visualized the throat

the nurse has identified a problem of anxiety for a 4 year old preparing for a tonsillectomy. the nurse should tell the child

• you won't have so many sore throats after your tonsils are removed
• the doctor will put you to sleep so you don't feel anything
• how me how to give the doll an iv
• when it is done you will get to see your mommy and get a popsicle

after a tonsillectomy and adenoidectomy, which of the following findings should alert the nurse to suspect early hemorrhage in a 5 year old child

• drooling of bright red secretions
• pulse rate of 95 bpm
• vomiting of 25 ml of dark brown emesis
• blood pressure of 95/36

after teaching the parents of a preschooler who has undergone a tonsillectomy and adenoidectomy about appropriate foods to give the child after discharge which of the following if stated by the parents as appropriate foods indicates successful teaching

• meat loaf and uncooked carrots
• pork and noodle casserole
• cream of chicken soup and orange sherbet
• hot dog and potato chips

a nurse is teaching the parents of a preschooler about the possibility of postoperative hemorrhage after a tonsillectomy and adenoidectomy. the nurse should explain that the risk is greatest at which of the following times

• 1 to 3 days after surgery
• 4 to 6 days after surgery
• 7 to 10 days after surgery
• 11 to 14 days after surgery

an adolescent female is prescribed amoxicillin for an ear infection. the nurse should teach the adolescent about the risks associated with her concurrent use of

• antacids
• oral contraceptives
• multiple vitamins
• protein shakes

a toddler is scheduled to have tympanostomy tubes inserted. when approaching the toddler for the first time, which of the following should the nurse do

• talk to the mother first so that the toddler can get used to the new person
• hold the toddler so that the toddler becomes more comfortable
• walk over and pick the toddler up right away so that the mother can relax
• pick up the toddler and take the child to the play area so that the mother can rest

after insertion of bilateral tympanostomy tubes in a toddler which of the following instrucions should the nurse include in the child's discahrge plan for the paretns

• insert ear plugs in to the canals when the child bathes
• blow the nose forcibly during a cold
• administer the prescribed antibiotic whle the tubes are in place
• disregard any drainage from the ear after 1 week

after teaching the parents of a toddler about commonly aspirated foods, which of the following foods if identified by the parents as easily aspirated would indicate the need for additional teaching

• popcorn
• raw vegetables
• round candy
• crackers

a toddler who has been treated for a foreign body aspiration  begins to fuss and cry when the parents attempt to leave the hospital for an hour. the parents will be returning to take the toddler home. as the nurse tries to take the child out of the crib, the child pushes the nurse away. the nurse inerprets this behavior as indicating sepration anxiety involving which of the following

• protest
• despair
• regression
• detatchment

after teaching the parents of an 18 month old who was treated for a foreign body obstruction about the three cardinal signs indicative of choking, the nurse determines that the teaching has been successul when the parents state that a child is choking when he or she cannot speak, turns blue, and does which of the following

• vomits
• gasps
• gags
• collapses

the father of a 2 year old phones the emergency room on a sunday evening and informs the nurse that his son put a bead in his nose. what is the most appropriate recommendation made by the nurse

• try to remove the bead at home as soon as possible; you might try using a pair of tweezers
• be sure to take your child to the pdiatrician in the morning so the pediatrician can remove the bead in the office
• you should bring your child to the emergency room tonight so the bead can be removed as soon as possible
• ask your child to blow his nose several times, this should dislodge the bead

an 11 year old is admitted for treatment of an asthma attack. which of the following indicates immediate intervention is needed

• thin opious mucous secretions
• productive cough
• intercostal retractions
• respiratory rate of 20

a 12 year old with asthma wants to exercise. which of the following activities should the nurse suggest to improve breathing

• soccer
• swimming
• track
• gymnastics

when preparing the teaching plan for the mother of a child with asthma which of the following should the nurse include as signs to alert the mother that her child is having an asthma attack

• secretion of thing copious mucus
• tight, productive cough
• wheezing on expiration
• temperature of 99.4 F

which assessment findings hould lead the nurse to suspect that a toddler is experiencing respiratory distress. select all that apply

• coughing
• respiratory rate of 35
• heart rate of 95
• restlessness
• malaise
• diaphoresis

• coughing
• respiratory rate of 35
• restlessness
• diaphoresis

a 10 year old child who is 5'4" tall with a history of asthma uses an inhaled bronchodilator only when needed. he takes no other medications routinely. his best peak expiratory flow rate is 270 L/min. the child's current peak flow reading is 180 L/min. the nurse interprets this reading as indicating which of the following

• the child's asthma is under good control, so the routine treatment plan should ocntinue
• the child needs to use his short acting inhaled beta2 agonist medication
• this is a medical emergency requiring a trip to the ED for treatment
• the child needs to use his inhaled cromolyn sodium

an adoleschent with chest pain goes to the school nurse. the nurse determines that the teenager has a history of asthma but has had no problems for years. which of the following should the nurse do next

• call the adolescent's parent
• have the adolescent lie down for 30 minutes
• obtain a peak flow reading
• give two puffs of a short acting bronchodilator

a 7 year old with a history asthma controlled without medications is referred to the school nurse by the teacher because of persistent coughing. which of the following should the nurse do first

• obtain the child's heart rate
• give the child a nebulizer treatment
• call a parent to obtain more information
• have a parent come and pick up the child

when developing a teaching plan for the mother of an asthmatic child concerning measures to reduce allergic triggers, which of the following suggestions should the nurse include

• keep the humidity in the home between 50% and 60%
• have the child sleep in the bottom bunk bed
• use a scented room deodorizer to keep the room fresh
• vacuum the carpet once or twice a week

after discussing asthma as a chronic condition, which of the following statements by the father of a child with asthma best reflects the family's positive adjustment to this aspect of the child's disease

• we try to keep him happy at all costs, otherwise, he has an asthma attack
• we keep our child away from other children to help cut down on infections
• although our child's diease is serious, we try not to let it be the focus of our family
• i'm afraid that when my child gets older he won't be able to care for himself like i do

an 8 year old child with asthma states, i want to ply some sports like my friends. what can i do. the nurse responds to the child based on the understanding of which of the following

• physical activities are inappropriate for children with asthma
• children with asthma must be excluded from team sports
• vigorous physical exercise frequently precipitates an asthmatic episode
• most children with asthma can participate in sports if the asthma is controlled

a 9 month old child with cystic fibrosis does not like taking pancreatic enzyme supplement with meals and snacks. the mothr does not like to force the child to take the supplement. the most important reason for the child to take the pancreatic enzyme supplement with meals and snacks is

• the child will become dehydrated if the supplement is not take with meals and snacks
• the child needs these pancreatic enzymes to help the digestive system absorb fats, carbohydrates, and proteins
• the child needs the pancreaatic enzymes to aid in liquefying mucus to keep the lungs clear
• the child will experience severe diarrhea if the supplement is not taken as prescribed

a client's diagnosis of cystic fibrosis was made 13 years ago and he has since een hospitalized several times. on the latest admission, the client has labored respirations, fatigue, malnutrition, and failure to thrive. which nursing actions are most important initially

• placing the client on bed rest an d prescribing a blood gas analysis
• prescribing a high calorie, high protein, low fat, viatmin enriched diet and pancreatic granules
• applying an oximeter and initiating respiratory therapy
• inserting an IV line and initiating antibiotic therapy

a child with cystic fibrosis is receiving gentamicin. which of the following nursing actions is most important

• monitoring intake and output
• obtaining daily weights
• monitoring the client for indications of constipation
• obtaining stool samples for hemoccult testing

when developing the plan of care for a chlid with cystic fibrosis who is scheduled to receive postural drainage, the nurse should anticipate performing postural drainage at which of the following times

• after meals
• before meals
• after rest periods
• before inhalation treatments

when teaching the parents of an older infant with cystic fibrosis about the type of  diet the child should consume which of the following would be appropriate

• low protein diet
• high fat diet
• low carbohydrate diet
• high calorie diet

• high calorie diet

at a follow up appointment after being hospitalized and adolescent with a history of cystic fibrosis describes his stools to the nurse. which of the following descriptions should the nurse interpret as indicative of continued problems with malabsorption

• soft with little odor
• large and foul smelling
• loose with bits of food
• hard with streaks of blood

when developing a recreational therapy plan of care for a 3 year old child hospitalized with pneumonia and cystic fibrosis which of the following toys would be appropriate

• 100 piece jigsaw puzzle
• child's favorite doll
• fuzzy stuffed animal
• scissors, paper, and paste

which of the following if described by the parents of a child with cystic fibrosis indicates that the parents understand the underlying problem of the disease

• an abnormality in the body's mucus secreting glands
• formation of fibrous cysts in various body organs
• failure of the pancreatic ducts to develop properly
• reaction to the formation of antibodies agiainst streptococcus

which of the following outcome criteria would the nurse devleop for a child with cystic fibrosis who has ineffective aiway clearance related to increased pulmonary secretions and inability to expectorate

• respiratory rate and rhythm within expected range
• absence of chills and fever
• ability to engage in age related activities
• ability to tolerate usual diet without vomiting

a school age child with cystic fibrosis asks the nurse what sports she can become inovlved in as she becomes older. which of the following activities would be appropriate for the nurse to suggest

• swimming
• track
• baseball
• javelin throwing

when explaining to parents how to reduce the risk of SIDS the nurse shold teach about which of the following measures. select all that apply

• maintain a smoke free environment
• use a wedge for side lying positions
• breast feed the baby
• place the baby on his back to sleep
• use bumper pads over the bed rails
• have the baby sleep in the parents bed

• maintain a smoke free environment
• breast feed the baby
• place the baby on his back to sleep

which one of the following children is at most risk for SIDS

• infant who is 3 months old
• 2 year old who has apnea lasting up to 5 seconds
• first born child whose parents are in their early forties
• 6 month old who has had two bouts of pneumonia

parents bring their child to the ED because the child has stopped breathing. a nurse obtains a brief history of events occurring before and after the parents found the infant not breathing. which of the following quesions should the nurse ask the parents first

• was the infant sleeping while wrapped in a blanket
• was the infant lying on his stomach
• what did the infant look like when you found him
• when had you last checked on the infant

when planning a visit to the parents of an infant who died of SIDS at home the nurse should visit the parents at which of the following times

• a few days after the funeral
• two weeks after the funeral
• as soon as the parents are ready to talk
• as soon after the infant's death as possible

when developing the ongoing plan of care for the parents whose infant died of SIDS the nurse should plan to accomplish which of the following on the second home visit

• allow the parents to express their feelings
• have the parents gain an understanding of the diease
• assess the impact of the infant's death on their other children
• deal with issues such as having other children

on finding a child who is not breathing the nurse has someone activate the emergency medical system and then does which of the following first

• clear the airway
• begin mouth to mouth resuscitation
• initiate oxygen therapy
• start chest compressions

which of the following breathing rates should the nurse use when performing resuce breathing during CPR for a 5 year old

• 10 breaths/min
• 12 breaths/min
• 15 breaths/min
• 20 breaths/min

the nurse begins CPR on a 5 year old unresponsive client. when the emergency response team arrives, the child continues to have no respirtory effort but has a heart rate of 50 with cyanotic legs

• discontinue compressions but continue adminitering breaths with a bag mask device
• establish a iv line with a large bore needle while preparing the defibrillator
• begin 2 person CPR at a ratio of 2 breaths to 15 compressions
• begin 2 person CPR at a ratio of 2 breaths to 30 compressions

as part of a health education program the nurse teaches a group of parents CPR. the nurse determines that the teaching had been effective when a parent state

• if i am by myself i should call for help before starting CPR
• i should compress the chest using 2 to 3 fingers
• i should deliver chest compression at a rate of 100 per minute
• if i can't get the breahs to make the chest rise i should administer abdominal thrusts

when performing CPR which of the following indicates that external chest compressions are effective

• mottling of the skin
• pupillary dilation
• palpable pulse
• cool, dry skin

a nurse walks into the room just as a 10 month old infant places an object in his mouth and starts to choke. after opening the infant's mouth which of the following should the nurse do next to clear the airway

• use blind finger sweeps
• deliver back slaps and chest thrusts
• apply four sub diaphragmatic abdominal thrusts
• attempt to visualize the object

when preparing to deliver back slaps to an infant who is choking on a foreign body in which of the following positions should the nurse position the infant

• head down and lower than the trunk
• head up and raised above the trunk
• head to one side and even with the trunk lower than thte head
• head parallel to the nure and supported at the buttocks

a 6 month old infant has had a cardiac arrest and the rapid response team has ben paged. the nurse arrives in the client's room and observes the PA administering CPR to an infant. to assist the PA with CPR the nurse should

• take over rescue breaths using a bag mask device at a rate of 1 breath per 5 compressions
• take over compressions using encircling hands technique while the PA uses a bag mask device to administer rescue breaths
• take over rescue breaths using a bag mask device at a rate of 2 breaths per 30 compressions
• take over compressions using two fingers on the breastbone while the PA uses a bag mask device to administer rescue breaths

when teaching the parents of an infant how to perform back slaps to dislodge a foreign body which of the following should the nurse tell the parents to use to deliver the blows

• palm of the hand
• heel of the hand
• fingertips
• entire hand

while the nurse is delivering abdominal thrusts to a 6 year old who is choking on a foreign body the child begins to cry. which of the following should the nurse do next

• tap or gently shake the shoulders
• deliver back slaps
• perform a blind finger sweep of the mouth
• observe the child closely

a 3 year old is brought into the ED in her mother's arms. the child's mouth is open and she is drooling and lethargic. her mothre states that she became ill suddenly withing the past 2 hours. what should the nurse do first

• draw blood cultures for a CBC
• start an IV line
• inspect the child's throat with a tongue blade
• maintain the child in an undisturbed, upright position

the father of a 16 month child calls the clinic because the child has a low grade fever, cold symptoms, and a hoarse cough. which of the following should the nurse suggest that the father do

• offer extra fluids frequently
• bring the child to the clinic immediately
• count the child's respiratory rate
• use a hot air vaporizer

a 21 month old child admitted with the dx of croup now has a respiratory rate of 48 breaths/min a hr of 120, and a temp of 100.8 rectally. the nurse is having difficulty calming the child. which of the following should the nurse do next

• administer acetaminophen
• notify the primary care provider immediately
• allow the toddler to continue to cry
• offer clear fluids every few minutes

a client has viral phryngitis. the nurse should advise the parents to do which of the following. select all that apply

• use a cool mist vaporizer
• offer a soft to liquid diet
• administer amoxicillin
• administer acetaminophen
• place the child on secretion precautions

• use a cool mist vaporizer
• offer a soft-to-liquid diet
• administer acetaminophen

a father brings his 3 month old infant to the clinic, reporting that the infant has a cold, is having trouble breathing, and just doesn't seem to be acting right. which of the following actions hould the nurse do first

• check the infant's heart rate
• weigh the infant
• assess the infant's oxygen saturation
• obtain more information from the father

while while the nurse is working in a homeless shelter assessment of a 6 month old infant reveals a respiratory rate of 52 breaths/min, retractions, and wheezing. the mother states that her infant was doing fine until yesterday. which of the following actions would be most appropriate

• administer a nebulizer treatment
• send the infant for a chest radiograph
• refer the infant to the emergency department
• provide teaching about cold care to the mother

an infant is being treated at home for bronchiolitis. which of the following should the nurse teach the parent habout home care. select all that apply

• offering small amounts of fluids frequently
• allowing the infant to sleep prone
• calling the clinic if the infant vomits
• writing down how much the infant drinks
• performing chest physiotherapy every 4 hours
• watching for difficulty breathing

• offering small amounts of fluids frequently
• watching for difficulty breathing

in preparation for discharge the nurse teaches the mother of an infant diagnosed with bronchiolitis about the condition and its treatment. which of the following statements by the mother indicate successful teaching

• i need to be sure to take my child's temperature every day
• i hope i dont get a cold from my child
• next time my child gets a cold i need to listen to the chest
• i need to wash my hands more often

a teaching care plan to preent the transmission of RSV should include which of the following. select all that apply

• the virus can be spread by direct contact
• the virus can be spread by indirect contact
• Palivizumab (Synagis) is recommended to prevent RSV for all toddlers in day care
• the virus is typically contagious for 3 weeks
• older children seldom spread RSV
• frequent handwashing helps reduce the spread of RSV

• the virus can be spread by direct contact
• the virus can be spread by indirect contact
• frequent handwashing helps reduce the spread of RSV

a charge nurse is making assignments for a group of chldren on a pediatric unit. the nurse should most avoid assigning the same nurse to care for a 2 year old with RSV and

• an 18 month old with RSV
• a 9 year old 8 hours post appenectomy
• a 1 year old with a heart defect
• a 6 year olf with sickle cell crisis

the nurse is preparing to administer the last dose of ceftriaxone (Rocephin) before discharge to a 1 year old but finds the IV has occluded. the nurse should

• restart the IV
• administer the mediation intramuscularly
• arrange for early discharge
• contact the prescriber to request a prescription change

a nurse administers ranitidine (Zantac) instead of cetirizine (Zyrtec) to an 8 year old with asthma. the client has suffered no adverse effets. the nurse tells the charge nurse of the incident but fears disciplinary action from reporting the error. the charge nurse should tell the nurse

• if you do not report the error i will have to
• reporting the error helps to identify system problems to improve client safety
• notify the client's primary care provider to see if she wants this reported
• this is not a serious mistake so reporting it will not affect your position

a 12 year old with cystic fibrosis is being treated in the hospital for pneumonia. the primary care provider is calling in a telephone prescription for ampicillin. the nurse should do which of the following. select all that apply

• ask the unit clerk to listen on the speaker phone with the nurse and write down the prescription
• ask the primary care provider to come to the pospital and write the prescription on the chart
• repeat the prescription to the primary care provider
• ask the primary care provider to confirm that the prescription is correct as understood by the nurse
• ask the nursing supervisor to cosign the telephone prescription as transcribed by the nurse

• repeat the prescription to the primary care provider
• ask the primary care provider to confirm that the prescription is correct as understood by the nurse

the triage nurse in the ED ust pioritize the children waiting to be seen. which of the following children is in the greatest need of emergency medical treatment

• a 6 year old with a fever of 104 F, a muffled voice, no spontaneous cough, and drooling
• a 3 year old with a fever of 100 F, a barky-cough, and mild intercostal retractions
• a 4 year old with a fever of 101 F, a hoarse cough, inspiratory stridor, and restlessness
• a 13 year old with a fever of 104 F chills, and a cough with thick yellow secretions

a 6 month old on the pediatric floor has a respiratory rate of 68, mild intercostal retractions, and oxygen saturation of 89%. the infant has not been feeding well for the last 24 hours and is restless. using the SBAR technique for communication, the nurse calls the primary health care provider with the recommendation for

• starting oxygen
• providing sedation
• transferring to PICU
• prescribing a chest CT scan