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Child Health Nursing is designed to equip students with foundational knowledge and practical skills essential for delivering holistic nursing care to infants, children, and adolescents. The course covers the developmental stages of childhood, health promotion strategies, common pediatric illnesses, and family-centered care approaches. Emphasis is placed on growth and development assessment, immunization, nutrition, pediatric pharmacology, and the management of acute and chronic conditions in children. Students also learn to address the unique psychosocial needs of children and their families, promote well-being, and advocate for childrens health at individual, family, and community levels.
Recommended Textbook
Wongs Essentials of Pediatric Nursing 10th Edition by Hockenberry
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Q1) A school nurse is conducting vision and hearing testing on fifth-grade children. Which level of prevention is the nurse demonstrating?
A) Primary
B) Secondary
C) Tertiary
D) Health promotion
Answer: B
Q2) Which is the leading cause of death in infants younger than 1 year?
A) Congenital anomalies
B) Sudden infant death syndrome
C) Respiratory distress syndrome
D) Bacterial sepsis of the newborn
Answer: A
Q3) When communicating with other professionals, what is important for the nurse to do?
A) Ask others what they want to know.
B) Share everything known about the family.
C) Restrict communication to clinically relevant information.
D) Recognize that confidentiality is not possible.
Answer: C
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Q1) Which is most characteristic of the physical punishment of children, such as spanking?
A) Psychological impact is usually minimal.
B) Children rarely become accustomed to spanking.
C) Children's development of reasoning increases.
D) Misbehavior is likely to occur when parents are not present.
Answer: D
Q2) A 3-year-old girl was adopted immediately after birth. The parents have just asked the nurse how they should tell the child that she is adopted. Which guidelines concerning adoption should the nurse use in planning a response?
A) Telling the child is an important aspect of their parental responsibilities.
B) The best time to tell the child is between ages 7 and 10 years.
C) It is not necessary to tell the child who was adopted so young.
D) It is best to wait until the child asks about it.
Answer: A
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4

Health Promotion
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Q1) The nurse observes some children in the playroom. Which play situation exhibits the characteristics of parallel play?
A) Kimberly and Amanda sharing clay to each make things
B) Brian playing with his truck next to Kristina playing with her truck
C) Adam playing a board game with Kyle, Steven, and Erich
D) Danielle playing with a music box on her mother's lap
Answer: B
Q2) What factors indicate parents should seek genetic counseling for their child? (Select all that apply.)
A) Abnormal newborn screen
B) Family history of a hereditary disease
C) History of hypertension in the family
D) Severe colic as an infant
E) Metabolic disorder
Answer: A, B, E
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Sample Questions
Q1) The nurse is meeting a 5-year-old child for the first time and would like the child to cooperate during a dressing change. The nurse decides to do a simple magic trick using gauze. How should this action be interpreted?
A) Inappropriate, because of child's age
B) A way to establish rapport
C) Too distracting, when cooperation is important
D) Acceptable, if there is adequate time
Q2) When interviewing the mother of a 3-year-old child, the nurse asks about developmental milestones such as the age of walking without assistance. How should this question be considered?
A) Unnecessary information because child is age 3 years
B) An important part of the family history
C) An important part of the child's past history
D) An important part of the child's review of systems
Q3) At about what age does the Babinski sign disappear?
A) 4 months
B) 6 months
C) 1 year
D) 2 years

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Q1) Which drug is usually the best choice for patient-controlled analgesia (PCA) for a child in the immediate postoperative period?
A) Codeine
B) Morphine
C) Methadone
D) Meperidine
Q2) A dose of oxycodone (OxyContin) 2 mg/kg has been ordered for a child weighing 33 lb. How many milligrams of OxyContin should the nurse administer? (Record your answer as a whole number.)
Q3) A nurse is monitoring a patient for side effects associated with opioid analgesics. Which side effects should the nurse expect to monitor for? (Select all that apply.)
A) Diarrhea
B) Respiratory depression
C) Hypertension
D) Pruritus
E) Sweating
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Q1) Which is usually the only symptom of pediculosis capitis (head lice)?
A) Itching
B) Vesicles
C) Scalp rash
D) Localized inflammatory response
Q2) The community health nurse is teaching parents about prevention of the spread and reoccurrence of pediculosis (head lice). Which should the nurse include in the teaching session? (Select all that apply.)
A) Dryclean nonwashable items.
B) Spray the environment with an insecticide.
C) Seal nonwashable items in a plastic bag for 5 days.
D) Boil combs and brushes for 10 minutes.
E) Discourage sharing of personal items.
Q3) What is cellulitis often caused by?
A) Herpes zoster
B) Candida albicans
C) Human papillomavirus
D) Streptococcus or Staphylococcus organisms
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Q1) On what is successful breastfeeding most dependent?
A) Mother's socioeconomic level
B) Size of mother's breasts
C) Mother's desire to breastfeed
D) Birth weight of newborn
Q2) The nurse is presenting an in-service session on assessing gestational age in newborns. Which information should be included?
A) The newborn's length and weight are the most accurate indicators of gestational age.
B) The newborn's Apgar score and the mother's estimated date of confinement (EDC) are combined to determine gestational age.
C) The newborn's posture at rest and arm recoil are two physical signs used to determine gestational age.
D) The newborn's chest circumference compared to the head circumference is the determinant for gestational age.
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Q1) Which is most descriptive of the clinical manifestations observed in neonatal sepsis?
A) Seizures and sunken fontanels
B) Sudden hyperthermia and profuse sweating
C) Decreased urinary output and frequent stools
D) Nonspecific physical signs with hypothermia
Q2) Which is the most appropriate nursing intervention for the newborn who is jittery and twitching and has a high-pitched cry?
A) Monitor blood pressure closely.
B) Obtain urine sample to detect glycosuria.
C) Obtain serum glucose and serum calcium levels.
D) Administer oral glucose or, if newborn refuses to suck, IV dextrose.
Q3) Which refers to a newborn whose rate of intrauterine growth was slowed and whose birth weight falls below the 10th percentile on intrauterine growth charts?
A) Postterm
B) Postmature
C) Low birth weight
D) Small for gestational age
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Q1) In terms of fine motor development, what should the infant of 7 months be able to do?
A) Transfer objects from one hand to the other and bang cubes on a table.
B) Use thumb and index finger in crude pincer grasp and release an object at will.
C) Hold a crayon between the fingers and make a mark on paper.
D) Release cubes into a cup and build a tower of two blocks.
Q2) A parent asks the nurse "at what age do most infants begin to fear strangers?" The nurse should give which response?
A) 2 months
B) 4 months
C) 6 months
D) 12 months
Q3) Which is an appropriate play activity for a 7-month-old infant to encourage visual stimulation?
A) Playing peek-a-boo
B) Playing pat-a-cake
C) Imitating animal sounds
D) Showing how to clap hands
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Q1) The nurse is helping parents achieve a more nutritionally adequate vegetarian diet for their child. Which is most likely lacking in their particular diet?
A) Fat
B) Protein
C) Vitamins C and A
D) Complete protein
Q2) A nurse is assessing a child with kwashiorkor disease. Which assessment findings should the nurse expect?
A) Thin wasted extremities with a prominent abdomen
B) Constipation
C) Elevated hemoglobin
D) High levels of protein
Q3) Parent guidelines for relieving colic in an infant include:
A) avoiding touching abdomen.
B) avoiding using a pacifier.
C) changing infant's position frequently.
D) placing infant where family cannot hear the crying.
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Sample Questions
Q1) A toddler's parent asks the nurse for suggestions on dealing with temper tantrums. Which is the most appropriate recommendation?
A) Punish the child.
B) Leave the child alone until the tantrum is over.
C) Remain close by the child but without eye contact.
D) Explain to child that this is wrong.
Q2) Which factor is most important in predisposing toddlers to frequent infections?
A) Respirations are abdominal.
B) Pulse and respiratory rates are slower than those in infancy.
C) Defense mechanisms are less efficient than those during infancy.
D) Toddlers have a short, straight internal ear canal and large lymph tissue.
Q3) Which should the nurse expect for a toddler's language development at age 18 months?
A) Vocabulary of 25 words
B) Increasing level of comprehension
C) Use of holophrases
D) Approximately one third of speech understandable
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Q1) A 4-year-old child is hospitalized with a serious bacterial infection. The child tells the nurse that he is sick because he was "bad." Which is the nurse's best interpretation of this comment?
A) Sign of stress
B) Common at this age
C) Suggestive of maladaptation
D) Suggestive of excessive discipline at home
Q2) In terms of language and cognitive development, a 4-year-old child would be expected to have which traits? (Select all that apply.)
A) Think in abstract terms.
B) Follow directional commands.
C) Understand conservation of matter.
D) Use sentences of eight words.
E) Tell exaggerated stories.
F) Comprehend another person's perspective.
Q3) The recommendation for calcium for children 1 to 3 years of age is _____ milligrams. (Record your answer in a whole number.)
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Q1) Which is probably the most important criterion on which to base the decision to report suspected child abuse?
A) Inappropriate parental concern for the degree of injury
B) Absence of parents for questioning about child's injuries
C) Inappropriate response of child
D) Incompatibility between the history and injury observed
Q2) Which describes a child who is abused by the parent(s)?
A) Unintentionally contributes to the abusing situation
B) Belongs to a low socioeconomic population
C) Is healthier than the nonabused siblings
D) Abuses siblings in the same way as child is abused by the parent(s)
Q3) A child has been admitted to the emergency department with an acetaminophen (Tylenol) poisoning. An antidote is being prescribed by the health care provider. Which antidote should the nurse prepare to administer?
A) Naloxone (Narcan)
B) N-acetylcysteine (Mucomyst)
C) Flumazenil (Romazicon)
D) Digoxin immune Fab (Digibind)
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Q1) The school nurse is conducting a class on bicycle safety. Which statement made by a participant indicates a need for further teaching?
A) "Most bicycle injuries occur from a fall off the bicycle."
B) "Head injuries are the major causes of bicycle-related fatalities."
C) "I should replace my helmet every 5 years."
D) "I can ride double with a friend if the bicycle has an extra-large seat."
Q2) A school nurse observes school-age children playing at recess. Which is descriptive of the play the nurse expects to observe?
A) Individuality in play is better tolerated than at earlier ages.
B) Knowing the rules of a game gives an important sense of belonging.
C) They like to invent games, making up the rules as they go.
D) Team play helps children learn the universal importance of competition and winning.
Q3) What is the earliest age at which puberty begins?
A) 9
B) 10
C) 11
D) 12
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Q1) An adolescent boy tells the nurse that he has recently had homosexual feelings. What knowledge should the nurse's response be based on?
A) This indicates the adolescent is homosexual.
B) This indicates the adolescent will become homosexual as an adult.
C) The adolescent should be referred for psychotherapy.
D) The adolescent should be encouraged to share his feelings and experiences.
Q2) A nurse is planning a teaching session for a group of adolescents. The nurse understands that by adolescence the individual is in which stage of cognitive development?
A) Formal operations
B) Concrete operations
C) Conventional thought
D) Postconventional thought
Q3) A school nurse is teaching a group of preadolescent boys about puberty. By which age should concerns about pubertal delay be considered?
A) 12 years
B) 13 years
C) 14 years
D) 15 years
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Q1) Which is descriptive of central nervous system stimulants?
A) They produce strong physical dependence.
B) They can result in strong psychological dependence.
C) Withdrawal symptoms are life threatening.
D) Acute intoxication can lead to coma.
Q2) Which is descriptive of bulimia during adolescence?
A) Strong sense of control over eating behavior
B) Feelings of elation after the binge-purge cycle
C) Profound lack of awareness that the eating pattern is abnormal
D) Weight that can be normal, slightly above normal, or below normal
Q3) A school nurse is conducting a class with adolescents on suicide. Which true statement about suicide should the nurse include in the teaching session?
A) A sense of hopelessness and despair are a normal part of adolescence.
B) Gay and lesbian adolescents are at a particularly high risk for suicide.
C) Problem-solving skills are of limited value to the suicidal adolescent.
D) Previous suicide attempts are not an indication of risk for completed suicides.
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Q1) Which are adaptive coping patterns used by children with special needs? (Select all that apply.)
A) Feels different and withdraws
B) Is irritable, moody, and acts out
C) Seeks support
D) Develops optimism
Q2) Parents are asking about an early intervention program for their child who has special needs. The nurse relates that this program is for which age of child?
A) Birth to 1 year of age
B) Birth to 3 years of age
C) Ages 1 to 4
D) Ages 4 and 5
Q3) At what developmental period do children have the most difficulty coping with death, particularly if it is their own?
A) Toddlerhood
B) Preschool
C) School-age
D) Adolescence
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Q1) A nurse should suspect possible visual impairment in a child who displays which characteristic?
A) Excessive rubbing of the eyes
B) Rapid lateral movement of the eyes
C) Delay in speech development
D) Lack of interest in casual conversation with peers
Q2) A child with autism spectrum disorder (ASD) is admitted to the hospital with pneumonia. The nurse should plan which priority intervention when caring for the child?
A) Maintain a structured routine and keep stimulation to a minimum.
B) Place child in a room with a roommate of the same age.
C) Maintain frequent touch and eye contact with the child.
D) Take the child frequently to the playroom to play with other children.
Q3) Which of the following terms refers to opacity of the crystalline lens that prevents light rays from entering the eye and refracting on the retina?
A) Myopia
B) Amblyopia
C) Cataract
D) Glaucoma
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Q1) A child is being discharged from an ambulatory care center after an inguinal hernia repair. Which discharge interventions should the nurse implement? (Select all that apply.)
A) Discuss dietary restrictions.
B) Hold any analgesic medications until the child is home.
C) Send a pain scale home with the family.
D) Suggest the parents fill the prescriptions on the way home.
E) Discuss complications that may occur.
Q2) A nurse plans therapeutic play time for a hospitalized child. What are the benefits of play? (Select all that apply.)
A) Serves as method to assist disturbed children
B) Allows the child to express feelings
C) The nurse can gain insight into the child's feelings.
D) The child can deal with concerns and feelings.
E) Gives the child a structured play environment
Q3) Which is an effective strategy to reduce the stress of burn dressing procedures?
A) Give the child as many choices as possible.
B) Reassure the child that dressing changes are not painful.
C) Explain to the child why analgesics cannot be used.
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D) Encourage the child to master stress with controlled passivity.
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Q1) A child is receiving total parenteral nutrition (TPN; hyperalimentation). At the end of 8 hours, the nurse observes the solution and notes that 200 ml/8 hr is being infused rather than the ordered amount of 300 ml/8 hr. The nurse should adjust the rate so that how much will infuse during the next 8 hours?
A) 200 ml
B) 300 ml
C) 350 ml
D) 400 ml
Q2) A 3-year-old child has a fever associated with a viral illness. Her mother calls the nurse, reporting a fever of 102° F even though she had acetaminophen 2 hours ago. The nurse's action should be based on which statement?
A) Fevers such as this are common with viral illnesses.
B) Seizures are common in children when antipyretics are ineffective.
C) Fever over 102° F indicates greater severity of illness.
D) Fever over 102° F indicates a probable bacterial infection.
Q3) A physician's prescription reads, "ampicillin sodium 125 mg IV every 6 hours." The medication label reads, "1 g = 7.4 ml." A nurse prepares to draw up _____ milliliters to administer one dose. (Round your answer to two decimal places.)
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Q1) Which is an appropriate nursing intervention when caring for an infant with an upper respiratory tract infection and elevated temperature?
A) Give tepid water baths to reduce fever.
B) Encourage food intake to maintain caloric needs.
C) Have child wear heavy clothing to prevent chilling.
D) Give small amounts of favorite fluids frequently to prevent dehydration.
Q2) Cardiopulmonary resuscitation (CPR) is begun on a toddler. Which pulse is usually palpated because it is the most central and accessible?
A) Radial
B) Carotid
C) Femoral
D) Brachial
Q3) A child is diagnosed with influenza. Management includes which recommendation?
A) Clear liquid diet for hydration
B) Aspirin to control fever
C) Oseltamivie (Tamiflu)
D) Antibiotics to prevent bacterial infection
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Q1) Enemas are ordered to empty the bowel preoperatively for a child with Hirschsprung disease. What enema solution should be used?
A) Tap water
B) Normal saline
C) Oil retention
D) Phosphate preparation
Q2) A child is admitted with bacterial gastroenteritis. Which lab results of a stool specimen confirm this diagnosis?
A) Eosinophils
B) Occult blood
C) pH less than 6
D) Neutrophils and red blood cells
Q3) Which clinical manifestation would be the most suggestive of acute appendicitis?
A) Rebound tenderness
B) Bright red or dark red rectal bleeding
C) Abdominal pain that is relieved by eating
D) Abdominal pain that is most intense at McBurney point
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Q1) The nurse is conducting a staff in-service on congenital heart defects. Which structural defect constitutes tetralogy of Fallot?
A) Pulmonic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy
B) Aortic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy
C) Aortic stenosis, atrial septal defect, overriding aorta, left ventricular hypertrophy
D) Pulmonic stenosis, ventricular septal defect, aortic hypertrophy, left ventricular hypertrophy
Q2) José is a 4-year-old child scheduled for a cardiac catheterization. What should be included in preoperative teaching?
A) Directed at his parents because he is too young to understand
B) Detailed in regard to the actual procedures so he will know what to expect
C) Done several days before the procedure so that he will be prepared
D) Adapted to his level of development so that he can understand
Q3) Which is the highest acceptable mg/dl level of low density lipoprotein (LDL) cholesterol for a child from a family with heart disease? (Record your answer in a whole number.)
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Q1) The nurse is conducting a staff in-service on childhood blood disorders. Which describes the pathology of idiopathic thrombocytopenic purpura?
A) Bone marrow failure in which all elements are suppressed
B) Deficiency in the production rate of globin chains
C) Diffuse fibrin deposition in the microvasculature
D) An excessive destruction of platelets
Q2) Which should the nurse include when teaching the mother of a 9-month-old infant about administering liquid iron preparations?
A) They should be given with meals.
B) They should be stopped immediately if nausea and vomiting occur.
C) Adequate dosage will turn the stools a tarry green color.
D) Allow preparation to mix with saliva and bathe the teeth before swallowing.
Q3) The school nurse is informed that a child with human immunodeficiency virus (HIV) will be attending school soon. Which is an important nursing intervention?
A) Carefully follow universal precautions.
B) Determine how the child became infected.
C) Inform the parents of the other children.
D) Reassure other children that they will not become infected.
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Q1) The nurse is teaching nursing students about childhood nervous system tumors. Which best describes a neuroblastoma?
A) Diagnosis is usually made after metastasis occurs.
B) Early diagnosis is usually possible because of the obvious clinical manifestations.
C) It is the most common brain tumor in young children.
D) It is the most common benign tumor in young children.
Q2) A mother of a 5-year-old child, with complex health care needs and cared for at home, expresses anxiety about attending a kindergarten graduation exercise of a neighbor's child. The mother says, "I wish it could be my child graduating from kindergarten." The nurse recognizes that the mother is experiencing:
A) abnormal anxiety.
B) ineffective coping.
C) chronic sorrow.
D) denial.
Q3) A toddler with leukemia is on intravenous chemotherapy treatments. The toddler's lab results are WBC: 1000; neutrophils: 7%; nonsegmented neutrophils (bands): 7%. What is this child's absolute neutrophil count (ANC)? (Record your answer in a whole number.)
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Q1) The nurse is conducting teaching for an adolescent being discharged to home after a renal transplant. The adolescent needs further teaching if which statement is made?
A) "I will report any fever to my primary health care provider."
B) "I am glad I only have to take the immunosuppressant medication for two weeks."
C) "I will observe my incision for any redness or swelling."
D) "I won't miss doing kidney dialysis every week."
Q2) What is an advantage of peritoneal dialysis?
A) Treatments are done in hospitals.
B) Protein loss is less extensive.
C) Dietary limitations are not necessary.
D) Parents and older children can perform treatments.
Q3) Which statement is descriptive of renal transplantation in children?
A) It is an acceptable means of treatment after age 10 years.
B) It is the preferred means of renal replacement therapy in children.
C) Children can receive kidneys only from other children.
D) The decision for transplantation is difficult because a relatively normal lifestyle is not possible.
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Q1) The nurse is assessing a child who was just admitted to the hospital for observation after a head injury. Which is the most essential part of the nursing assessment to detect early signs of a worsening condition?
A) Posturing
B) Vital signs
C) Focal neurologic signs
D) Level of consciousness
Q2) The mother of a 1-month-old infant tells the nurse she worries that her baby will get meningitis like her oldest son did when he was an infant. The nurse should base her response on which statement?
A) Meningitis rarely occurs during infancy.
B) Often a genetic predisposition to meningitis is found.
C) Vaccination to prevent all types of meningitis is now available.
D) Vaccination to prevent Haemophilus influenzae type B meningitis has decreased the frequency of this disease in children.
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Q1) A neonate born with ambiguous genitalia is diagnosed with congenital adrenogenital hyperplasia. What does therapeutic management include?
A) Administration of vitamin D
B) Administration of cortisone
C) Administration of stool softeners
D) Administration of calcium carbonate
Q2) To help the adolescent deal with diabetes, the nurse must consider which characteristic of adolescence?
A) Desire to be unique
B) Preoccupation with the future
C) Need to be perfect and similar to peers
D) Need to make peers aware of the seriousness of hypoglycemic reactions
Q3) What condition may cause exophthalmos (protruding eyeballs) in children?
A) Hypothyroidism
B) Hyperthyroidism
C) Hypoparathyroidism
D) Hyperparathyroidism
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Q1) The nurse is taking care of an adolescent diagnosed with kyphosis. Which describes this condition?
A) Lateral curvature of the spine
B) Immobility of the shoulder joint
C) Exaggerated concave lumbar curvature of the spine
D) Increased convex angulation in the curve of the thoracic spine
Q2) A young girl has just injured her ankle at school. In addition to calling the child's parents, what is the most appropriate immediate action by the school nurse?
A) Apply ice.
B) Observe for edema and discoloration.
C) Encourage child to assume a position of comfort.
D) Obtain parental permission for administration of acetaminophen or aspirin.
Q3) A 4-year-old child is newly diagnosed with Legg-Calvé-Perthes disease. Nursing considerations should include which action?
A) Encouraging normal activity for as long as is possible
B) Explaining the cause of the disease to the child and family
C) Preparing the child and family for long-term, permanent disabilities
D) Teaching the family the care and management of the corrective appliance
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Sample Questions
Q1) The nurse is admitting a school-age child with suspected Guillain-Barré syndrome (GBS). Which is a priority in the care for this child?
A) Monitoring intake and output
B) Assessing respiratory efforts
C) Placing on a telemetry monitor
D) Obtaining laboratory studies
Q2) The nurse is caring for an infant with myelomeningocele scheduled for surgical closure in the morning. Which intervention should the nurse plan for the care of the myelomeningocele sac?
A) Open to air
B) Covered with a sterile, moist, nonadherent dressing
C) Reinforcement of the original dressing if drainage noted
D) A diaper secured over the dressing
Q3) The nurse is reviewing prenatal vitamin supplements with an expectant client. Which supplement should be included in the teaching?
A) Vitamin A throughout pregnancy
B) Multivitamin preparations as soon as pregnancy is suspected
C) Folic acid for all women of childbearing age
D) Folic acid during the first and second trimesters of pregnancy
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