1.A 6-year-old has been complaining of joint pain and stiffness for several months.

Now his
mother has noticed swelling and warmth in these joints. What are some of the laboratory tests the
nurse should prepare to obtain? (Select all that apply.)
1) Antinuclear antibodies
2) C-reactive protein
3) Erythrocyte sedimentation rate
4) Urinalysis
5) Complete blood count (CBC)

2.The nurse precepts a new graduate while caring for a child in skeletal traction. Which
statement by the new nurse indicates understanding of the teaching given by the experienced
nurse?

1) "Once a shift, I need to check under him for small toys that may be hurting his skin."

2) "I'll give skin care once every shift."

3) "I need to check CCSMT with every assessment."

4) "Pin assessment is done once a day."

3.What are some of the components of a holistic assessment conducted to rule out a
musculoskeletal disorder? (Select all that apply.)
1) Integrity of cranial nerve function
2) Function of the affected part
3) Presence of abnormal sensations in affected part
4) Autonomy of movement
5) Body size and weight

4.A 6-year-old is hospitalized in 90/90 traction for a lower limb fracture. What is one thing the
nurse must provide?

1) Flexible visiting hours

2) A diet rich in protein and vitamins

3) At least 30 minutes per day out of traction

4) Indwelling catheter care

5.An 18-month-old is brought into the emergency department with a slightly complex leg
fracture. Which should the nurse prepare for?
 1) Casting the leg

2) Application of an Ilizarov external fixator

3) Sending the child to surgery

4) Application of Bryant's traction

6.The nurse has just finished instructing parents in the use of the Pavlik harness. Which
statement by a parent indicates the need for remedial instructions by the nurse?

1) "We'll call the doctor if it chafes his skin."

2) "If the straps start slipping, I'll tighten them up."

3) "If it gets too tight, I'll call the health-care provider."

4) "I wish he could take it off at night for a while, but I understand why not."
7.Which are the two most common types of fractures in children?

1) Bend and spiral

2) Comminuted and impacted

3) Clavicular and greenstick

4) Complete and buckle

8.A 3-year-old boy presents to the health-care provider with difficulty running, going up steps,
and riding his tricycle. Laboratory test results indicate a very high creatine phosphokinase (CPK)
level. What is one point of anticipatory guidance the nurse should give this family?

1) Instruction in injury prevention

2) Helping him rest by doing everything for him

3) Referral to a juvenile rheumatoid arthritis support group

4) Reinforcing instructions for medical treatment

9.On average, how fast do children's bones heal?

1) At a rate of 1 week for every year of life up to age 10

2) At a rate of 2 weeks for every year of life up to age 12

3) At a rate of one-half week for every year of life up to age 11

 4) At a rate of 2 weeks for every 2 years of life up to age 9
10.An infant who was born vaginally is found to have suffered several bone fractures during the
delivery. For which long-term risks does the nurse anticipate having to reinforce teaching?

1) Death in childhood

2) Life in bed

3) Loss of vision

4) Bone deformities

Chapter 37
1.An infant is born with a large red mass on the lower abdomen that continuously leaks urine.
What does the nurse recognize the parents will need to be told about this anomaly?

1) "It will have to be removed surgically."

2) "Unfortunately, it is a cancerous lesion."

3) "It will go back inside by itself."

4) "The baby will need several surgeries."

2.A 3-year-old girl is brought to the clinic by her mother with complaints of slight fever, poor
appetite, urinary frequency, and dysuria. The nurse needs to instruct the child's mother about
which?

1) No bubble baths

2) Wipe back to front after bowel movements

3) Signs/symptoms of enuresis

4) Use strong soap for cleansing

3.A 16-year-old girl has come to the gynecologist's office for her first pelvic examination. She
denies sexual activity. Examination findings include itchy, painful blisters on her labia. Which
will the nurse discuss with this patient?

1) Sexual promiscuity

2) Chicken pox

3) Perineal hygiene
 4) Barrier methods of birth control
4.What is one obvious difference between acute glomerulonephritis (AGN) and nephrotic
syndrome that could point toward a diagnosis?

1) Type of rash

2) Type of therapeutic diet

3) Urine color

4) Fatigue
5.The nurse caring for a child in metabolic acidosis explains which compensatory mechanism to
the new nurse?

1) Increase in respiratory rate and depth of respirations

2) Increased urine output

3) Apnea resulting in cardiac arrest

4) Kidney failure
6.A 15-year-old girl weighing 123 lb is hospitalized with acute renal failure. Calculate her daily
half-maintenance fluid requirement. __________

7.A mother has brought her 15-year-old son to the health-care provider, concerned that he has
not started to go through puberty yet. The boy is clearly embarrassed but also anxious and
somewhat angry. The nurse notes that the boy is busying himself by tearing items off a nearby
bulletin board and dropping them to the floor. Further, the nurse notes that he has quietly picked
up a nearby small piece of equipment and put it inside his shirt. Given these data, which should
the nurse be prepared to do?

1) Confront the child about the item he has put inside his shirt

2) Draw blood for genetic testing

3) Take the mother aside to discuss the son's condition

4) Send them home, telling them to return when the boy can behave himself
8.Which are acceptable ways of obtaining a clean-catch urine sample from infants and toddlers?
(Select all that apply.)
1) Cotton balls in a diaper
 2) Catch urine in a "hat" placed in the toilet
3) Midstream collection
4) Uro bags
5) Straight catheterization
9. A 4-year-old is admitted to the emergency department (ED) following a motor vehicle
accident. He has lost a large amount of blood, is pale, and is lethargic, with sluggish capillary
refill. Vital signs are T – 97.2° F, P – 124 beats per minute, R – 28 breaths per minute, and BP
76/44 mm. Hg. The child has poor skin turgor, and his mucous membranes are dry. Which IV
solution should the nurse expect to hang?

1) Dextrose 5% in normal saline

2) Normal saline with 20 mEq potassium

3) Dextrose 5% in lactated Ringer's

4) Normal saline
10. A 4-year-old is admitted to the pediatric unit for an upper respiratory infection. The nursing
staff notes that the child has enuresis. When the nurse tells the child's mother, she states, "Oh,
yes, she's been doing that for a while. She's so naughty. I just spank her in the morning and make
her help me change the bed; but nothing seems to work because she's still doing it." Which is the
nurse's best response?

1) "You should try using a star chart with her. Let me show you."

2) "This is a common problem and usually goes away. It's important that you don't punish
her."

3) "That's a real problem. She may need surgery at some point."

4) "That's pretty common. Don't worry about it, though. It sounds like you're doing all the
right things."

Chapter 38
1.During a routine physical, a 15-year-old boy asks the nurse about long-term effects of
tattoos. Which is the nurse's best response?

1) "If you ever regret it and want it removed, you may need surgery or skin grafting."

2) "I'm sure you will regret it when you get older."

3) "All I know is that girls don't like them very much."

4) "By law, you are too young to get a tattoo now, so why worry about it?"
2. A 6-year-old is brought to the ED with a high fever, malaise, red eyes, cracked lips, red
tongue, and bright macules and papules on the palms of his hands and soles of his feet.
Which organ does the nurse need to monitor closely?

1) Brain

2) Heart

3) Liver

4) Skin
3.The father of a 3-year-old with contact dermatitis calls the nurse to ask what he should do
to relieve the itching. What are some things the nurse will suggest? (Select all that apply.)
1) Rub powder or cornstarch on the rash.
2) Cool compresses, rinses, or baths
3) Give liquid diphenhydramine.
4) Calamine lotion
5) Playful distraction

4. Which statement by a mother indicates the need for further instruction about caring for
her newborn's skin?

1) "She can lose heat faster because her skin is thin, so I need to keep her wrapped."

2) "If she gets a diaper rash. I can use over-the-counter hydrocortisone cream."

3) "Babies lose extra water through their skin because they have a lot of body water."

4) "She looks so chubby and cute but doesn't have a lot of fat under her skin to keep her warm."
5. Which anticipatory guidance can the nurse give the mother of a 6-month-old regarding
sun exposure?

1) Start putting a thin layer of sunscreen on every couple of hours.

2) Provide at least an hour a day in the sun so he gets vitamin D.

3) Allow sun exposure only between 10 a.m. and 4 p.m.

4) Dress in protective clothing and a wide-brimmed hat when exposed to the sun.
6. A small child is brought to the emergency department (ED) with small, round lesions on
the face and extremities, which the parent states "just showed up." Which must be ruled
out?

1) Varicella
 2) Scabies

3) Ringworm

4) Abuse
7. What are some of the potential complications of major burns in children? (Select all that
apply.)
1) Shock
2) Liver failure
3) Protein loss
4) Hyperkalemia
5) Renal failure

8. An 8-year-old with sickle cell disease has sustained a large laceration on his leg when he
fell off his bike. Which challenge does the nurse know this child faces related to his wound?

1) The wound is dirty, so it will become infected.

2) At his age, children resist wound care.

3) He will have slower wound healing.

4) He will need to be hospitalized for wound care.

9. Which does the nurse need to teach adolescents about acne?

1) Daily skin hygiene is imperative.

2) It is caused by foods such as chocolate and fatty foods.

3) Only pop the closed comedones.

4) Do not stress about acne because all teens get it.

10. An 8-year-old is brought into the clinic with a generalized rash. The nurse notes that the
lesions are raised and solid with circumscribed borders and color changes. Which type of
rash is this?

1) Vesicular

2) Macular

3) Papular

4) Urticaria
Chapter 39
1. The nurse working in an emergency department admits a 4-year-old child who is eventually
diagnosed with epiglottitis. Which specific information will the nurse want to question?

1) Family history of epiglottitis

2) Immunization history

3) Child's surgical history

4) Exposure to others with epiglottitis

2. The nurse administers an intramuscular (IM) vaccination prior to discharge from the clinic.
Which is the priority teaching that must be provided to the parent?

1) When the next vaccination is due

2) The purpose of the vaccination

3) Need to sit in the waiting room for 30 minutes

4) Apply ice to the injection site

3. The pediatric nurse admits an unvaccinated child to the pediatric intensive care unit with
varicella encephalopathy. Which type of isolation does this child require?

1) Contact isolation

2) Droplet precaution

3) Standard isolation

4) Airborne isolation
4. The mother of a 6-year-old who is up-to-date on immunizations calls to report her child has a
fever with lesions that look like blisters that began on the chest and are spreading to other body
parts. The mother asks to make an appointment at the pediatric clinic. Which is the nurse's best
response?

1) "I will look at the appointment book and see what the first available appointment is for
your child."

2) "Sounds like chicken pox, which can be treated at home to avoid exposing other children
to the virus."

3) "Rush your child to the local emergency department where he can receive immediate
treatment."
 4) "Your child has received an immunization against chicken pox, so that will prevent this
disease."
5. Which immunizations are administered during a well-baby examination when the child is 2
months old? (Select all that apply.)
1) DTaP
2) Pneumococcal
3) Haemophilus influenzae
4) Varicella
5) MMR

6. The nurse questions an order to administer an oral polio vaccine on which patient?

1) The child undergoing chemotherapy

2) The child with a temperature of 99.2°F oral

3) The child who had surgery 2 weeks ago

4) The adolescent who is sexually active

7. The neonatal nurse admits a newborn with scarring of the skin, an abnormality in the left arm
and right leg, an abnormality of the left eye, and low birth weight placing the newborn in the
small-for-gestational-age category. Which does the nurse suspect about the mother's pregnancy?

1) Exposure to rubella

2) Exposure to smallpox

3) Exposure to polio

4) Exposure to varicella
8. The mother of a child receiving chemotherapy calls the pediatric clinic to report an outbreak
of measles at the child's day-care center. The child has not been vaccinated because she is
immunocompromised. The mother says the exposure occurred a week ago and her child is not
demonstrating any symptoms. Which recommendation is the most important for the nurse to
make?

1) "If the child is not displaying symptoms by now, he probably was not infected."

2) "Measles are rarely passed by casual contact, so your child is probably safe."

3) "It can take 16 to 18 days from exposure before symptoms are displayed."
 4) "Your child should not come in contact with other cancer patients."
9. The home-care nurse visits a child with varicella and discusses symptomatic care with the
mother. Which statement made by the mother indicates further teaching is needed?

1) "She can return to school when all the lesions have crossed over."

2) "I will freeze some Kool-Aid into popsicles to encourage fluids."

3) "I will check the temperature every 4 hours and give aspirin for fever control."

4) "I will keep her occupied watching TV and playing on the computer till she feels better."
10. Prior to administration of an immunization for Haemophilus influenza type B, the mother
asks the nurse what the immunization protects against. Which does the nurse include in the
response? (Select all that apply.)
1) Meningitis
2) Bone infection
3) Epiglottitis
4) Pneumonia
5) The flu

Chapter 40
1. Which statement made by the nurse indicates a difference in cancer cells compared with
noncancerous cells? (Select all that apply.)
1) Do not perform the function of the cell
2) Proliferate faster
3) Require more cellular nutrition
4) Exhibit contact inhibition
5) Are controlled by the immune system

2. Family members of a child newly diagnosed with cancer express concern over their inability
to manage financial costs of treatment and travel to the medical center. Which is the nurse's
primary responsibility in this situation?

1) Initiating a GoFundMe page to help the family raise money

2) Explaining the importance of following through on the plan of care

3) Obtaining a referral to the oncology social worker

4) Involving the child life specialist

3. Prior to going to the laboratory to obtain a unit of packed cells to be administered, which is the
nurse's responsibility?

1) Ensure that a blood product transfusion consent is signed and in the chart

2) Have two RNs double-check the order

3) Ensure that normal saline is infusing

4) Ensure that the proper product has been ordered

4. Which statement is true of all types of anemia whether iron-deficiency, sickle cell, or any
other type?

1) Can be treated through proper diet

2) Result from a reduction in hemoglobin

3) Reduced production of hemoglobin

4) Result from blood loss

5. Which assessment findings support a diagnosis of iron-deficiency anemia? (Select all that
apply.)
1) Pallor
2) Elevated heart rate
3) Lethargy
4) Severe pain
5) Elevated hematocrit

6. The mother of a newborn with hyperbilirubinemia tells the nurse the baby will not latch on
and seems disinterested in eating. Which is the nurse's priority intervention?

1) Taking the baby back to the nursery and placing it under bili lights

2) Encouraging the mother to keep trying

3) Explaining that hyperbilirubinemia can cause lethargy

4) Stimulating the baby to promote breastfeeding

7. The nurse is caring for a child with severe anemia resulting in poor oxygenation. Which
transfusion product does the nurse anticipate will be administered?

1) Whole blood
 2) Packed red blood cells

3) Platelets

4) Fresh frozen plasma

8. Which is the most common form of malignant cancer found in children?

1) Leukemia

2) Neuroblastoma

3) Wilms' tumor

4) Retinal tumor
9. The nurse reviews a child's laboratory results and notes an increase in monocytes, which he
attributes to which?

1) Bacterial infection

2) Inflammatory reaction

3) Response to specific antigens

4) Hypoxemia
10. Which assessment finding indicates idiopathic thrombocytopenic purpura rather than
hemophilia to the nurse?

1) Large bruises when the child falls

2) Petechiae

3) Blood in the urine or stool

4) Bleeding with rigorous tooth brushing