When planning care for an 8-year-old boy with down syndrome, the nurse should:

Question 39:When planning care for a 7-year-old boy with Down syndrome, the nurse should:a)assess the child's current developmental level and plan care accordingly.b)plan interventions at the developmental level of a 7-year-old because that is the child's age.c)plan interventions at the developmental level of a 5-year-old because the child will havedevelopmental delays.d)direct all teaching to the parents because the child can't understand.You selected:assess the child's current developmental level and plan care accordingly.CorrectExplanation:

Nursing care should be planned at the developmental age of a child with Down syndrome, not thechronological age. Because children with Down syndrome can vary from mildly to severe ... (more)

• 1. 

  The parents of a child, age 6, who will begin school in the fall ask the nurse for anticipatory guidance. The nurse should explain that a child of this age:

  • A. 

    Still depends on the parents

  • B. 

    Rebels against scheduled activities

  • C. 

    Is highly sensitive to criticism

  • D. 

    Loves to tattle

• 2. 

  While preparing to discharge an 8-month-old infant who is recovering from gastroenteritis and dehydration, the nurse teaches the parents about their infant’s dietary and fluid requirements. The nurse should include which other topic in the teaching session? 

  • A. 

    Nursery schools

  • B. 

    Toilet Training

  • C. 

    Safety guidelines

  • D. 

    Preparation for surgery

• 3. 

  Nurse Betina should begin screening for lead poisoning when a child reaches which age? 

  • A. 

    6 months

  • B. 

    12 months

  • C. 

    18 months

  • D. 

    24 months

• 4. 

  When caring for an 11-month-old infant with dehydration and metabolic acidosis, the nurse expects to see which of the following? 

  • A. 

    A reduced white blood cell count

  • B. 

    A decreased platelet count

  • C. 

    Shallow respirations

  • D. 

    Tachypnea

• 5. 

  After the nurse provides dietary restrictions to the parents of a child with celiac disease, which statement by the parents indicates effective teaching? 

  • A. 

    Well follow these instructions until our child’s symptoms disappear.”

  • B. 

    “Our child must maintain these dietary restrictions until adulthood.”

  • C. 

    “Our child must maintain these dietary restrictions lifelong.”

  • D. 

    “We’ll follow these instructions until our child has completely grown and developed.”

• 6. 

  A parent brings a toddler, age 19 months, to the clinic for a regular check-up. When palpating the toddler’s fontanels, what should the nurse expects to find?

  • A. 

    Closed anterior fontanel and open posterior fontanel

  • B. 

    Open anterior and fontanel and closed posterior fontanel

  • C. 

    Closed anterior and posterior fontanels

  • D. 

    Open anterior and posterior fontanels

• 7. 

  Patrick, a healthy adolescent has meningitis and is receiving I.V. and oral fluids. The nurse should monitor this client’s fluid intake because fluid overload may cause:

  • A. 

    Cerebral edema

  • B. 

    Dehydration

  • C. 

    Heart failure

  • D. 

    Hypovolemic shock

• 8. 

  An infant is hospitalized for treatment of nonorganic failure to thrive. Which nursing action is most appropriate for this infant?

  • A. 

    Encouraging the infant to hold a bottle

  • B. 

    Keeping the infant on bed rest to conserve energy

  • C. 

    Rotating caregivers to provide more stimulation

  • D. 

    Maintaining a consistent, structured environment

• 9. 

  The mother of Gian, a preschooler with spina bifida tells the nurse that her daughter sneezes and gets a rash when playing with brightly colored balloons, and that she recently had an allergic reaction after eating kiwifruit and bananas. The nurse would suspect that the child may have an allergy to: 

  • A. 

    Bananas

  • B. 

    Latex

  • C. 

    Kiwifruit

  • D. 

    Color dyes

• 10. 

  Cristina, a mother of a 4-year-old child tells the nurse that her child is a very poor eater. What’s the nurse’s best recommendation for helping the mother increase her child’s nutritional intake? 

  • A. 

    Allow the child to feed herself

  • B. 

    Se specially designed dishes for children – for example, a plate with the child’s favorite cartoon character

  • C. 

    Only serve the child’s favorite foods

  • D. 

    Allow the child to eat at a small table and chair by herself

• 11. 

  Nurse Roy is administering total parental nutrition (TPN) through a peripheral I.V. line to a school-age child. What’s the smallest amount of glucose that’s considered safe and not caustic to small veins, while also providing adequate TPN? 

  • A. 

    5% glucose

  • B. 

    10% glucose

  • C. 

    15% glucose

  • D. 

    17% glucose

• 12. 

  David, age 15 months, is recovering from surgery to remove Wilms’ tumor. Which findings best indicates that the child is free from pain? 

  • A. 

    Decreased appetite

  • B. 

    Increased heart rate

  • C. 

    Decreased urine output

  • D. 

    Increased interest in play

• 13. 

  When planning care for a 8-year-old boy with Down syndrome, the nurse should: 

  • A. 

    Plan interventions according to the developmental level of a 7-year-old child because that’s the child’s age

  • B. 

    Plan interventions according to the developmental levels of a 5-year-old because the child will have developmental delays

  • C. 

    Assess the child’s current developmental level and plan care accordingly

  • D. 

    Direct all teaching to the parents because the child can’t understand

• 14. 

  Nurse Victoria is teaching the parents of a school-age child. Which teaching topic should take priority? 

  • A. 

    Prevent accidents

  • B. 

    Keeping a night light on to allay fears

  • C. 

    Explaining normalcy of fears about body integrity

  • D. 

    Encouraging the child to dress without help

• 15. 

  The nurse is finishing her shift on the pediatric unit. Because her shift is ending, which intervention takes top priority? 

  • A. 

    Changing the linens on the clients’ beds

  • B. 

    Restocking the bedside supplies needed for a dressing change on the upcoming shift

  • C. 

    Documenting the care provided during her shift

  • D. 

    Emptying the trash cans in the assigned client room

• 16. 

  Nurse Alice is providing cardiopulmonary resuscitation (CPR) to a child, age 4. the nurse should: 

  • A. 

    Compress the sternum with both hands at a depth of 1½ to 2” (4 to 5 cm)

  • B. 

    Deliver 12 breaths/minute

  • C. 

    Perform only two-person CPR

  • D. 

    Use the heel of one hand for sternal compressions

• 17. 

  A 4-month-old with meningococcal meningitis has just been admitted to the pediatric unit. Which nursing intervention has the highest priority? 

  • A. 

    Instituting droplet precautions

  • B. 

    Administering acetaminophen (Tylenol)

  • C. 

    Obtaining history information from the parents

  • D. 

    Orienting the parents to the pediatric unit

• 18. 

  Sheena, tells the nurse that she wants to begin toilet training her 22-month-old child. The most important factor for the nurse to stress to the mother is: 

  • A. 

    Developmental readiness of the child

  • B. 

    Consistency in approach

  • C. 

    The mother’s positive attitude

  • D. 

    Developmental level of the child’s peers

• 19. 

  An infant who has been in foster care since birth requires a blood transfusion. Who is authorized to give written, informed consent for the procedure? 

  • A. 

    The foster mother

  • B. 

    The social worker who placed the infant in the foster home

  • C. 

    The registered nurse caring for the infant

  • D. 

    The nurse-manager

• 20. 

  A child is undergoing remission induction therapy to treat leukemia. Allopurinol is included in the regimen. The main reason for administering allopurinol as part of the client’s chemotherapy regimen is to:

  • A. 

    Prevent metabolic breakdown of xanthine to uric acid

  • B. 

    Prevent uric acid from precipitating in the ureters

  • C. 

    Enhance the production of uric acid to ensure adequate excretion of urine

  • D. 

    Ensure that the chemotherapy doesn’t adversely affect the bone marrow

• 21. 

  A 10-year-old client contracted severe acute respiratory syndrome (SARS) when traveling abroad with her parents. The nurse knows she must put on personal protective equipment to protect herself while providing care. Based on the mode of SARS transmission, which personal protective should the nurse wear? 

  • A. 

    Gloves

  • B. 

    Gown and gloves

  • C. 

    Gown, gloves, and mask

  • D. 

    Gown, gloves, mask, and eye goggles or eye shield

• 22. 

  A tuberculosis intradermal skin test to detect tuberculosis infection is given to a high-risk adolescent. How long after the test is administered should the result be evaluated? 

  • A. 

    Immediately

  • B. 

    Within 24 hours

  • C. 

    In 48 to 72 hours

  • D. 

    After 5 days

• 23. 

  Nurse Oliver s teaching a mother who plans to discontinue breast-feeding after 5 months. The nurse should advise her to include which foods in her infant’s diet? 

  • A. 

    Iron-rich formula and baby food

  • B. 

    Whole milk and baby food

  • C. 

    Skim milk and baby food

  • D. 

    Iron-rich formula only

• 24. 

  Gracie, the mother of a 3-month-old infant calls the clinic and states that her child has a diaper rash. What should the nurse advise? 

  • A. 

    "Switch to cloth diapers until the rash is gone”

  • B. 

    “Use baby wipes with each diaper change.”

  • C. 

    “Leave the diaper off while the infant sleeps.”

  • D. 

    “Offer extra fluids to the infant until the rash improves.”

• 25. 

  Nurse Kelly is teaching the parents of a young child how to handle poisoning. If the child ingests poison, what should the parents do first? 

  • A. 

    Administer ipecac syrup

  • B. 

    Call an ambulance immediately

  • C. 

    Call the poison control center

  • D. 

    Punish the child for being bad