NCLEX Practice Test 2" From: JobForNursing.

Com Here are some practice test on Pediatric Nursing, try to answer them before look ing at the answer sheet below: 1. What is the recommended treatment for scabies in a child who is under 1 year old? a. lindane (Kwell) b. tolnaftate (Tinactin) c. thiabendazole (Mintezol) d. permethrin (Elimite) 2. When a preschoolers family is exhibiting high levels of mistrust, checks eve ryones performance, asks to change rules and demands high level of information, which action or strategy is inappropriate? a. Ask their opinion and use their suggestions b. Be positive about building a trusting relationship c. Be flexible regarding rules. d. Show support while controlling the child care. 3. The Nurse is performing CPR on an infant. Where should the nurse assess for p ulse? a. Brachial Pulse b. Carotid Pulse c. Radial Pulse d. femoral Pulse 4. A Physician prescribes acetaminophen (Tylenol) elixir, 120 mg every 4 hours f or a 14 month old child who weighs 20 lb (9.08 kg) The drug is supplied in a bottle labeled 160 mg/tsp and has a safe dosage of 10 mg/kg/dose. The nurse should administer how many ml? a. None b. 2.5 ml c. 5 ml d. 7.5 ml 5. What is the correct initial bolus of crystalloid fluid replacement for a pedi atric client in shock? a. 20 ml/kg b. 10 ml/kg c. 30 ml/kg d. 35 ml/kg 6. A nurse is preparing for the admission of a child with a diagnosis of acute-s tage Kawasaki disease. On assessment of the child, the nurse expects to note which clinical manifestati on of the acute stage of the disease? a. b. c. d. cracked lips conjunctival hyperemia a normal appearance desquamation of the skin

7. Which statement that a family of a dying 4 year old maybe ready to consider o rgan donation? a. My Wife and I feel that that our real child has moved on even though his bod

y is still functioning. b. Those physicians are not doing everything they could for our child, I know h es still i n there. c. When will our child wake up and be with us. d. How can some parents all their child to be cut up like a piece of meat and b e given away. 8. A nurse is caring for a child with a suspected diagnosis of rheumatic fever. The nurse reviews the laboratory results, knowing that which laboratory study wo uld assist in confirming the diagnosis? a. b. c. d. immunoglobulin red blood cell count white blood cell count antistreptolysin O titer

9. A nurse admits a child to the hospital with a diagnosis of pyloric stenosis. On admission assessment, which data would the nurse expect to obtain when asking the mother about the childs symptoms? a. watery diarrhea b. projectile vomiting c. increased urine output d. vomiting large amounts of bile 10. A parent asks the nurse for advice on disciplining a 3 year old child. Durin g the teaching sessions, which fact should nurse empahsize? a. b. c. d. Children under age 3 or 4 rarely need to be punished. Parental control should be firm and consistent. Withdrawing affection is a highly effective strategy. Parent should enforce rules rigidly.

11. A 2 year old girl is brought into the clinic with an upper respiratory tract infection. During the assessment, the nurse notes some bruising on the arm, leg s and trunk. Which findings would prompt the nurse to evaluate for suspected chi ld abuse? Select all that apply a. b. c. d. e. f. A few superficial scrapes on the lower leg. Welts or bruises in various stages on healing on the truck A deep blue-black bruise on the buttocks One large bruise on the childs thigh Circular, symmetrical burns on the lower legs A parent who is hysterical of the child and pushes the frightened child away

12. An emergency room nurse is caring for a child diagnosed with epiglotitis. As sessing the child, the nurse monitors for which indication that the child may be experiencing airway obstruction? a. b. c. d. nd The child The child The child The child arms exhibits nasal flaring and bradycardia is leaning forward, with the chin thrust out has low-grade fever and complains of sore throat is leaning backward, supporting himself or herself with the hands a

13. A student nurse is caring for a 2-year old child diagnosed with croup and th e nursing instructor asks the student about the clinical manifestations associat ed with the illness. Which statement by the student indicates a need for further research?

a. b. c. d.

The cough is harsh and brassy Inspiratory stridor and a low-grad fever may be present Symptoms usually worsen at night and are better during the day Symptoms usually worsen during the day and are relieved during sleep

14. A nurse is performing an admission assessment on a newborn infant with a dia gnosis of spina bifida (myelomeningocele). A priority nursing assessment for thi s newborn is: a. b. c. d. Pulse rate Palpation of the abdomen Specific gravity of the urine Head circumference measurement

15. A nurse is assigned to care for an 8-year old child with basilar skull fract ure. The nurse reviews the physicians orders and contacts the physician to ques tion which order? a. b. c. d. Obtain daily weight Suction as needed Provide clear liquid diet Maintain a patent intravenous line

"Answers to NCLEX Practice Test 2" 1. ANSWER: D RATIONALE: Permethrin is supplied as a cream. It should be massaged into the ski

n from the head to the soles. Although lindane is also a treatment for scabies, it is not recommended for children younger than age 1 and it should not be used on clients older than age 1 without supervision. Remember that the hands and fee t should be covered during treatment to prevent the child from sucking the cream or lotion.

2. ANSWER: D RATIONALE: When a family is exhibiting high levels of mistrust, checks everyone s performance, asks to change rules and demands high level of information, the nurse should attempt to build a partnership with the family to reach the goal of mutually caring for the child. Attempting to control care will alienate the fam ily, stress the relationship and will be counter productive for the child.

3. ANSWER: A RATIONALE: Brachial pulse should be used to assess for pulse when performing CPR to infant. Carotid pulse is difficult to locate in infants because of their sho rt neck.

4. ANSWER: A RATIONALE: For this child, the safe drug dosage is 90.8 mg (9.08 kg x 10mg/kg = 90.8mg) Therefore the prescribed dose is not safe.

5. ANSWER: A RATIONALE: Initial fluid bolus is administered at 20 ml/kg. If there is no impro vement in the child s fluid status, another 20 mg/kg bolus should be given. 6. ANSWER: B RATIONALE: In the ACUTE STAGE of Kawasaki disease, the child has a fever, conjun ctival hyperemia, red throat, swollen hands, rash, and enlargement of the cervic al lymph nodes. In the SUB-ACUTE STAGE, cracking lips and fissures, desquamation of the skin on the tips of the fingers and toes, joint pain, cardiac manifestat ions, and thrombocytosis occur. In the CONVALESCENT STAGE, the child appears nor mal, but signs of inflammation may be present. 7. ANSWER: A RATIONALE: Statements that indicates the family s acceptance about the grave con dition of their child is a go signal to approach them about organ donation. 8. ANSWER: D RATIONALE: A diagnosis of rheumatic fever is confirmed by the presence of two ma jor manifestations or one major and two minor manifestations from the Jones crit eria. In addition, evidence of a recent streptococcal infection is confirmed by a positive antistreptolysin O titer, Streptozyme assay, or an anti-DNase B assay . Options A, B, and C will not help to confirm the diagnosis of rheumatic fever. 9. ANSWER: B RATIONALE:Clinical manifestations of pyloric stenosis include projectile vomitin

g, irritability, hunger and crying, constipation, and signs of dehydration, incl uding a decrease in urine output. 10. ANSWER: A RATIONALE: To successfully deal with misbehavior, parents should be firm and con sistent when taking appropriate disciplinary action. Usually, parents should sta rt setting limits and implementing discipline around age 1, or when a child begi ns to crawl and explore the environment. Rigidly implementing rules would not al low the development of autonomy and will result to self doubt. Parents should ne ver be encouraged to withdraw affection. 11. ANSWER: B,E,F RATIONALE: Injuries at various stages of healing in protected or padded areas ca n be sign of inflicted trauma and should alert the nurse for possible abuse. Bur ns that are bilateral as well as symmetrical and regular are typical of child ab use. The shape of the burn may resemble the item used to create it. Pushing away the child and being hysterical are are typical behaviors of abusive parents. Superficial scrapes and bruises on the lower extremities are normal in a healthy and active child. A deep blue-black macular patch on the buttocks is a Mongolia n spot. 12. ANSWER: B RATIONALE: Clinical manifestations suggestive of airway obstruction include trip od positioning (leaning forward while supported by arms, chin thrust out, mouth open), nasal flaring, tachycardia, a high fever, and a sore throat. Option D is an incorrect position. Options A and C are incorrect because epiglottitis causes a high fever and tachycardia. 13. ANSWER: C RATIONALE: Croup often begins at night and may be preceded by several days of up per respiratory infection symptoms. Croup is characterized by a sudden onset of a harsh, brassy cough, sore throat, and inspiratory stridor. Symptoms usually wo rsen at night and are better in the day. Croup usually is accompanied by a low-g rade fever, but occasionally the temperature may be as high as 104 F. 14. ANSWER: D RATIONALE: Newborn infants with spina bifida (myelomeningocele type) are at risk for hydrocephalus; therefore, the head circumference should be measured to obta in a baseline. Options A, B, and C are incorrect because pulse rate will not be affected with this disorder, the specific gravity can indicate hydration status but it is not priority at this time, and abdominal masses do not occur with this disorder. 15. ANSWER: B RATIONALE: Nasotracheal suctioning is contraindicated in a child with a basilar skull fracture. Because of the nature of the injury, there is a high risk of sec ondary infection and the probability of the catheter entering the brain through the fracture. Fluid balance is monitored closely by daily weight, intake and out put measurement, and serum osmolality, determination to detect early signs of wa ter retention, excessive dehydration, and states of hypertonicity or hypotonicit y. The child is maintained on an NPO status or restricted to clear fluids until it is determined that vomiting will not occur. An intravenous line is maintained to administer fluids or medications if necessary.