Which of the following instructions should the nurse include in the teaching

1) A nurse is assessing a toddler who is 8 hr. postoperative following a cardiac catheterization procedure. Which of the following findings should the nurse report to the provider?
a. Weak pedal pulse distal to the site
b. Blood pressure 102/58mm Hg
c. Bilateral cool extremities
d. Serum glucose 90mg/dL
2) A nurse is providing teaching to the parents of a child who has varicella about management of the disease. Which of the following instructions should the nurse include in the teaching?
a. Avoid giving the child a bath while vesicles are present
b. Keep the child away from others until the skin is clever of scabs
c. Apply calamine lotion to vesicles on the child’s skin
d. Dress the child in warm clothing to promote healing of the vesicles
3) A nurse is planning care for a child who is experiencing a sickle cell crisis. Which of the following interventions should the nurse include in the plan of care?
a. Administer meperidine as needed for plan
b. Initiate bed rest
c. Limit fluid intake
d. Apply cold compresses to affected joints
4) A charge nurses teaching a group of nurses about identifying child abuse. Which of the following findings should the nurse identify as a potential indicator of child abuse?
a. An 8 month old infant cries when his parents leave the room
b. A toddler repeatedly refuses to let a nurse auscultate his lungs
c. A toddler has bruises on his knees
d. A mother is hesitant to comfort her 6 month old infant
5) A nurse is teaching the guardian of a 5 year old child who has encopresis about management of the condition. Which of the following statements by the guardian indicates an understanding of the teaching?
a. I will limit my child’s fluid intake
b. I will increase my child’s dairy intake
c. I will have my child sit in the toilet for 2o minutes at a time
d. I will have my child try to defecate 15 minutes after each meal
6) A nurse is assisting an infant who has respiratory syncytial virus. For which of the following findings should the nurse intervene?
a. Brisk capillary refill
b. Tachypnea
c. Rhinorrhea
d. Coughing
7) A nurse is performing a health assessment for a 6 month old infant. The nurse should begin the assessment by performing which of the following actions while the infant is quiet and sitting on the guardians lap?
a. Obtaining the infant’s health history from the guardian
b. Checking the infant reflexes
c. Listening to the infinite heart and lung sounds
d. Looking in the infants eyes
8) A nurse is caring for an adolescent who has major depressive disorder. Which of the following actions should the nurse take first
a. Administer an antidepressant to the client
b. As the client if he is considering harming himself
c. Encourage the client to attend a group therapy session
d. assist the client in completing his ADLs
9) A nurse is caring for a child in the PACU following a tonsillectomy. Which of the following findings requires immediate intervention by the nurse?
a. Dark brown blood noted in emesis
b. Axillary temperature 38 C (100 F)
c. Child resorts pain level 5 on FACES scale
d. Frequent swallowing
10) A nurse in the emergency department is caring for a school age child who has developed respiratory stridor, wheezing, and urticarial after receiving an IV medication. Which of the following actions should the nurse take first?
a. Administer oxygen
b. Ad mister methylprednisolone
c. Administer a nebulized bronchodilator
d. Administer epinephrine
11) A nurse is caring for an infant who has a patent ductus arteriosus. The nurse should identify that the defect is at which of the following locations of the heart? ( You will find hot spots to select in the artwork below. Select only the hot spot that corresponds to your answer.)
B
A
C
D
The correct answer is =
12) A nurse is caring for a school aged child who is 1hr postoperative following a tonsillectomy. Which of the following actions should the nurse take first? ( Select all that apply)
a. Maintain the child in a supine position
b. Observe the child for frequent swallowing
c. Discourage the child from coughing
d. Administer an analgesic to the child on a scheduled basis
e. Provide cranberry juice to the child
13) a nurse is teaching the guardian of an infant who has congestive heart failure about methods to preserve energy during bottle feeding. Which of the following statements by the guardian indicates a clear understanding of the teaching?
a. I will feed my baby every 2 hours
b. I will allow my baby to suck for 45 minutes during each feeding
c. I will use a low calorie formula for my baby’s feeding
d. I will stroke my baby’s cheek during feeding
14) A nurse in a family practice clinic is assessing a preschool age child who recently experienced the death of a sibling. Which of the following reactions in an age appropriate response to death?
a. The child view the siblings death as permanent
b. The child feels responsible for the siblings death
c. The child can give a logical explanation for the siblings death
d. The child is curious about what happened to the siblings body
15) A nurse is teaching a parent of a toddler about administering digoxin. Which of the following statements by the parent indicates a clear understanding of the teaching?
a. I should mix the medication with 4 ounces of my child’s favorite juice
b. I should give my child another dose if he vomits right after taking the medication
c. I should give my child water after giving the medication
d. I should give the medication with foods that are high in fiber
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