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RN Nursing Care of Children Online Practice 2019 A
1. The nurse on a pediatric unit is writing guidelines for age-specific preparation of children for procedures based on developmental characteristics. What guideline is accurate?
- A. Inform toddlers about an upcoming procedure 2 hours before the procedure is to be performed.
- B. Inform school-age children about an upcoming procedure immediately before the procedure is scheduled to occur.
- C. Discourage parent presence during procedures on infants and toddlers.
- D. Use simple diagrams of anatomy and physiology to explain a procedure to a school-age child.
Correct answer: D
Rationale: Using simple diagrams helps school-age children understand what to expect in a procedure, catering to their developmental level and reducing anxiety. Informing toddlers too early can increase anxiety, and parents' presence is generally comforting, not discouraging.
2. Several types of long-term central venous access devices are used. What is a benefit of using an implanted port (e.g., Port-a-Cath)?
- A. You do not need to pierce the skin for access.
- B. It is easy to use for self-administered infusions.
- C. The patient does not need to limit regular physical activity, including swimming.
- D. The catheter cannot dislodge from the port even if the child plays with the port site.
Correct answer: C
Rationale: Implanted ports like the Port-a-Cath are fully implanted under the skin, allowing the child to maintain regular physical activities, including swimming, without the risk of dislodging the catheter. Piercing the skin is still required for access, and self-administration is more complex.
3. When teaching a mother how to administer eye drops, where should the nurse tell her to place them?
- A. At the lacrimal duct
- B. On the sclera while the child looks to the outside
- C. In the conjunctival sac when the lower eyelid is pulled down
- D. Carefully under the eyelid while it is gently pulled upward
Correct answer: C
Rationale: Eye drops should be placed in the conjunctival sac, which allows the medication to be absorbed properly without causing irritation. Placing drops directly on the sclera or near the lacrimal duct is less effective and can cause discomfort.
4. What type of shock is characterized by a hypersensitivity reaction causing massive vasodilation and capillary leaks, which may occur with drug or latex allergy?
- A. Neurogenic shock
- B. Cardiogenic shock
- C. Hypovolemic shock
- D. Anaphylactic shock
Correct answer: D
Rationale: Anaphylactic shock is a severe allergic reaction that causes massive vasodilation and increased capillary permeability, leading to rapid fluid shifts and circulatory collapse if not treated promptly. Neurogenic, cardiogenic, and hypovolemic shocks have different etiologies.
5. What laboratory finding should the nurse expect in a child with an excess of water?
- A. Decreased hematocrit
- B. High serum osmolality
- C. High urine specific gravity
- D. Increased blood urea nitrogen (BUN)
Correct answer: A
Rationale: Water excess typically leads to hemodilution, resulting in a decreased hematocrit. High serum osmolality and specific gravity would indicate dehydration, while elevated BUN could suggest renal impairment or dehydration, not fluid overload.
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