Intensive Nursing Practice Evaluative Examination

Name Section Date Score .

TEST I Please write the letter before the number for the correct answer. 1. An eighteen month-old has been brought to the emergency room with irritability, lethargy over 2 days, dry skin and increased pulse. Based upon the evaluation of these initial findings, the nurse would assess the child for additional findings of: A)Septicemia B) Dehydration C) Hypokalemia D) Hypercalcemia 2. The nurse is assessing a child for clinical manifestations of iron deficiency anemia. Which factor would the nurse recognize as cause for the findings? A)Decreased cardiac output B) Tissue hypoxia C) Cerebral edema D) Reduced oxygen saturation 3. Which nursing action is a priority as the plan of care is developed for a 7 year-old child hospitalized for acute glomerulonephritis? A)Assess for generalized edema B) Monitor for increased urinary output C) Encourage rest during hyperactive periods D) Note patterns of increased blood pressure 4.A 2 year-old child has just been diagnosed with cystic fibrosis. The child's father asks the nurse "What is our major concern now, and what will we have to deal with in the future?" Which of the following is the best response? A)"There is a probability of life-long complications." B) "Cystic fibrosis results in nutritional concerns that can be dealt with." C) "Thin, tenacious secretions from the lungs are a constant struggle in cystic fibrosis." D) "You will work with a team of experts and also have access to a support group that the family can attend." 5. In a child with suspected coarctation of the aorta, the nurse would expect to find A)Strong pedal pulses B) Diminishing carotid pulses C) Normal femoral pulse D) Bounding pulses in the arms 6.An infant is admitted to the unit with tetralogy of fallot. The nurse would anticipate an order for which medication. A)Digoxin B)Epinephrine C) Aminophyline D)Atropine 7. A priority nursing diagnosis for a child being admitted from a surgery following a tonsillectomy is: A)Altered nutrition B)Impaired communication C)Risk for aspiration D)Altered urinary elimination 8. A 4-year old is admitted with acute leukemia. It will be most important to monitor the child for: A) Abdominal pain and anorexia B) Fatigue and bruising C) Bleeding and pallor D) Petichiae and mucosal ulcers 9. The nurse is caring for an 8-year old following a routine tonsillectomy. Which finding should be reported immediately? A)Reluctance to swallow B)Drooling of blood-tinged saliva C)An axillary temperature of 99F D)Respiratory stridor 10. A 5-year old with congestive heart failure has been receiving Digoxin (Lanoxin). Which finding indicated that the medication is having a desired effect. A)Increased urinary output B)Stabilized weight C)Improved appetite D)Increased pedal edema 11. The nurse is caring for an infant following a cleft lip repair. While comforting the infant, the nurse should avoid: A)Holding the infant B)Offering a pacifier C)Providing a mobile D)Offering sterile water 12. An 18-month old is scheduled for a cleft palate repair. The usual type of restraints for the child with cleft palate repair are: A)Elbow restraints B)Full arm restraints C)Wrist restraints D)Mummy restraints 13.The nurse is assessing an infant with hirschspungs disease. The nurse can expect the infant to: A)Weight less than expected for height and age B) Have infrequent bowel movements C) Exhibit clubbing of fingers and toes D) Have hyperactive deep tendon reflexes 14.The mother of a child with hemophilia asks the nurse which over the counter medication is suitable for her childs discomfort. A)Advil (Ibuprofen) B)Tylenol (Acetaminophen) C)Aspirin (acetylsalicytic acid) D) Naproxen (Naprosyn) 15.The mother of a 3 year old with esophageal reflux asks the nurse what she can do to lessen the babys reflux. The nurse should tell the mother to: A)Feed the baby only when he is hungry B) Burp the baby after feeding is completed C)Place the baby in supine with head elevated D)Burp the baby frequently throughout the feeding

16.While assessing a child with pyloric stenosis, the nurse is likely to note which of the following? A)Regurgitation B) Steatorrhea C)Projectile vomiting D) Currant jelly stools

17. Which of the following should the nurse expect to note as a frequent complication for a child with congenital heart disease? A)Susceptibility to respiratory infection B) Bleeding tendencies C)Frequent vomiting and diarrhea D)Seizure disorder 18.Which of the following is NOT part of the triad of cystic fibrosis? A)pancreatic enzyme deficiency B) fever C) high concentration of sweat electrolytes 19. Which of the following can indicate left-sided heart failure in an infant? A) fever B)low appetite C) increased respiratory rate

D)COPD

D)crying

20. Who among the following pediatric client should be assessed first by the nurse? A)the child with 2 episodes of soft stools during the shift B)the child who had cough for the past three days, with clear nasal discharge and is irritable C)the child with 2 episodes of inconsolable crying while the knees are drawn over the abdomen and plays between the episodes D)the child with skin rashes on his face and trunk 21.A nurse is caring for an infant that has recently been diagnosed with a congenital heart defect. Which of the following clinical signs would most likely be present? A)Slow pulse rate B)Weight gain C) Decreased systolic pressure D)Irregular WBC lab values 22.A nurse has just started her rounds delivering medication. A new patient on her rounds is a 4 year-old boy who is non-verbal. This child does not have on any identification. What should the nurse do? A)Contact the provider B)Ask the child to write their name on paper. C) Ask a co-worker about the identification of the child. D)Ask the father who is in the room the childs name. 23.You are in your office late one cold winter evening, seeing a pair of siblings who have a cold and cough. The mother and paternal grandmother are there. The grandmother notes that the best way to prevent the spread of colds is by wearing a wool hat at all times. What should you say? A)Agree and pull out a cartoon with the trademarked hats promoting your practice B) Wearing a face mask and eye shields is the best method C) Limiting exposure to other children to once weekly would help D)Washing hands and all toys frequently would be fine E) Isolating all children with colds is the best method 24.A newborns failure to pass meconium within 24 hours after birth may indicate which of the following? A)Aganglionic Mega colon B) Celiac disease C) Intussusception D)Abdominal wall defect 25.Which of the following signs and symptoms would observe in a child diagnosed of laryngotracheobronchitis? A)predominant stridor on inspiration B) predominant expiratory wheeze C) high fever D) slow respiratory rate

26.A 6-year-old boy is returned to his room following a tonsillectomy. He remains sleepy from the anesthesia but is easily awakened. The nurse should place the child in which of the following positions? A)Sims. B) Side-lying. C)Supine. D) Prone. 27.A child presents to the emergency room with the history of ingesting a large amount of acetaminophen. For which of the following would the nurse assess? A)hypertension B) frequent urination C) Right upper quadrant pain D) headache 28.Which of the following foods would the nurse encourage the mother to offer to her child with iron-deficiency anemia? A)rice cereal, whole milk, and yellow vegetables B)potato, peas, and chicken C) macaroni, cheese and ham D) pudding, green vegetables and rice 29.When assessing the development of a 15 month old child with cerebral palsy, which of the following milestones would the nurse expect a toddler of this age to have achieved? A)walking up steps B) using a spoon C) copying a circle D) putting a block in cup 30.A school-aged client admitted to the hospital because of decreased urine output and periorbitaledema is diagnosed with glomerulonephritis. Which of the following interventions would receive the highest priority? A)assessing vital signs every four hours B) monitoring intake and output every 12 hours C) obtaining daily weight measurements D) obtaining serum electrolyte levels daily

TEST II

Drug Calculation: Please solve for the correct answer by showing your solution

1.

A client is ordered 50 milligrams of Amoxicillin trihydrate orally. 125 milligrams in 5 millilitres of Syrup is available. How many millilitres will you administer? 250 --------125 50 ------------125 5 X -----1

= 2 ml

2.

A client is ordered 30 milligrams of Frusemide intravenously. 10 milligrams in 1 millilitre of liquid for IV Injection is available. How many millilitres will you administer? 30 ------------10 X 1 -----1 = 30 --------10 = 3 ml

3.

A client is ordered 50 milligrams of Aminophylline intravenously. 250 milligrams in 10 millilitres of liquid for IV Injection is available. How many millilitres will you administer? 50 ------------250 X 10 -----1 = 500 --------250 = 2 ml

IV Fluid calculation: Please solve for the correct rate, show your solution 4. Ordered: 1 litre of Dextrose 5% in water over 8 hours using a giving set which delivers 10 drops/ml.
1000 mls X 10 drops/ml ---------------------------480 min 10000 drops -----------------480 min

= 21 drops / min

5.

You are required to administer 500 mls of Normal Saline over 3.5 hours. The drop factor is 10. How many drops per minute are required to start the flow off at the correct rate?
500 mls X 10 drops/ml ---------------------------210 min = 5000 drops -----------------210 min = 24 drops / min

6.

Calculate the drip rate for 100 mls of IV Fluids to be given over a half hour via a giving set which delivers 10 drops/ml.
100 mls X 10 drops/ml ---------------------------30 min = 1000 drops -----------------30 min = 33 drops / min

TEST III Select the most appropriate answer. Write the letter before the number. 1. A person is said to have fever when the body temperature rises above A. 37.8 B. 37.5 C. 37 D. 36.4 2. Malaria is caused through the bite of a A. fly B. mosquito C. rat 3. Scabies spreads through A. insect bites B. dog bites

D. louse

C. contact with infected person

D. food

4. A child with sore eyes should not be allowed to A. sleep B. wear spectacles C. play with other children

D. bath

5. A person suffering from diarrhoea must be given A. nothing to drink B. only small quantities of water C. a lot of water D. a lot of water containing sugar and salt TEST IV Match the disease in column A with the symptoms in column B: write the letter only before the number Column A E (1) Diphtheria A (2) Influenza D (3) Measles B (4) Chickenpox F (5) Mumps . ***GOD Column B (a) Cold, cough, sneezing (b) Pus-containing rash (c) Stiff neck, back bent like a bow, severe pain (d) Rash that appears first on the face and chest (e) Difficulty in swallowing and breathing (f) Swelling of salivary glands

BLESS***