27.

While assessing a male neonate whose mother desires him to be circumcised,

the nurseobserves that the neonates urinary meatus appears to be located on the
ventral surface of the penis. The physician is notified because the nurse suspects
which of the following?a. Phimosisb. Hydrocelec. Epispadiasd. Hypospadias28.
Which of the following would the nurse expect to assess in a child with
Downssyndrome?a. Large noseb. Small tonguec. Oblique palpebral fissuresd. Low
arched palate29. Which of the following statements by a 14 year old girl who wears
a brace for structuralscoliosis indicates effective use of the brace?a. I wonder if I
can take the brace off when I go to the homecoming dance.b. Ill look forward to
taking this off to take my bath everyday.c. Im sure am glad that I only have to
wear this awful thing at night.d. Im really glad that I can take this thing off
whenever I get tired.30. When assessing a newborn for developmental dysplasia of
the hip, the nurse wouldexpect to assess which of the following?a. Symmetrical
gluteal foldsb. Trendelenburg signc. Ortolanis signd. Characteristic limp31. Which of
the following is the priority nursing action for a child immediately following
theapplication of a spica cast?a. Perform neuromuscular checksb. Elevate the castc.
Cover the perineal aread. Keep the cast clean and dry32. Which of the following
types of immunity does an infant receive when given a DPTinjection?a. Natural,
activeb. Natural, passivec. Artificial, actived. Artificial, passive
Susan, is a newborn with Downs syndrome. Her parents have been told of
thediagnosis and are in the process of trying to adjust to this.
33. Which of the following is most appropriate to include when counseling the
parents of Susan?a. Susans development potential is greatest during infancyb.
Susan will be severely retardedc. Susan will be spastic, so poisoning should be
discussedd. Susan will be as susceptible to colds as her brother increased
susceptibility34. Which of the following is an incorrect statement regarding Downs
syndrome?a. It is associated with higher incidence of congenital heart diseaseb. It is
associated with higher incidence of GI defects duodenal atresia or stenosisc. It is
associated with higher incidence of leukemiad. It is inherited as an autosomal
recessive trait35. Which of the following measures is of primary importance for
parents with a young,mentally retarded child at home?a. Limit the amount of
environmental stimulation the child is exposed tob. Have the same parent teach the
child new skills at all timesc. Teach the child socially acceptable behaviors so she
can join the family outingsd. Maintains consistent routine for daily activities
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Magdalena is at 36 weeks gestation and has been diagnosed as positive for

thehuman immunodeficiency virus. She has had a healthy pregnancy to date but
hasmany questions about how her health problems will affect her newborn.

36. Magdalena asks the nurse if she can breastfeed her baby. Which of the
followingstatements is the basis for the nurses response?a. Because Magdalena
probably wont live to raise this child, breastfeeding will providecloseness and
bonding between mother and child.b. Because the baby is likely to be positive for
the HIV, breastfeeding will provide immunityfor other infectionsc. Because
Magdalena doesnt have symptoms of AIDS, she can breastfeedd. Because HIV may
be transmitted through her breastmilk, breastfeeding isntrecommended for
Magdalena37. Magdalena has delivered a baby girl at 39 weeks gestation. At 4
hours of age, thenewborn has shallow respirations at 54 bpm with periods of apnea
lasting 5 to 7 seconds. The nurses priority action would be to:a. Continue routine
monitoringb. Notify the doctor immediatelyc. Request an order to administer
oxygend. Prepare equipment for a respiratory arrest38. Magdalenas newborn is
jaundiced because of an ABO blood group incompatibility and isreceiving
phototherapy. Which of the following nursing interventions is most appropriate
forher newborn?a. Reposition the infant every 4 hoursb. Limit the infants oral intake
to 1 oz every 4 hoursc. Remove the eye patches every 24 hours to assess for
conjunctivitisd. Turn the phototherapy unit off when drawing blood for bilirubin
levels39. Before discharging Magdalenas newborn on the 2
nd
day of life, the nurse completes herdischarge examination. Which of the following
findings would the nurse report to the doctor?a. A. black, dry umbilical cordb. A dark
greenish-black stoolc. Petechiae covering the chest and abdomend. Bluish purple
discoloration in the lumbosacral area
Carlo, age 8, comes in to the physicians clinic with a sore throat, enlarged
lymphnodes, elevated temperature and malaise. He has history of
frequentstreptococcal throat infection.
40. Carlo has bacterial pharyngitis and is put on a regimen of oral penicillin, which
of thefollowing instructions of Carlos parents is most important at this time?a. Have
him gargle with hot saline solution as neededb. Give Carlo the medicine for 10 days
or until it is consumedc. Feed him soft diet until he feels betterd. Ensure he gets a
lot of Vit C foods41. Carlo returns in 2 months for a tonsillectomy. Preparations for
hospitalization includebooks for him to read. His mother is advised to select a book
with which of the followingcharacteristics?a. Small, paperbackb. Large-size printc.
Regular size printd. Large, with stiffened pages42. After surgery, what assessment
data may indicate that Carlo is hemorrhaging?a. Tachycardia, hypertension,
hemoptysisb. Bradycardia, hypotension, increase swallowingc. Tachycardia,
hypotension, increase swallowingd. Tachycardia, hypotension, decreased
swallowing43. Carlos nurse prepares the family for his discharge. Which of the
following instructionsshould be emphasized?a. Return to school in 1-2 weeksb. No
vigorous activities for 3-4 weeksc. Saline gargles as necessary for controld. Delayed
hemorrhage may occur on the third post-op day

_____________________________________________________________________________ _

10-year-old Tanya is admitted to the hospital with a medical diagnosis of rheumatic

fever. She relates a history of sore throat about a month ago. She isplaced on a bed
rest with BRPs.
44. Which of the following nursing assessment would be given the highest priority
whenassessing Tanya?a. Her response of being hospitalizedb. The presence of a
macular rash on her trunkc. Her sleeping or resting apical pulsed. The presence of
polyarthritis and pain in her joints45. Tanya exhibits manifestation of Sydanhams
chorea. Which of the following is NOT amanifestation of this condition?a. Intellectual
impairmentb. Muscle weaknessc. Purposeless tremorsd. Emotional lability46. Which
of the following nursing plans should receive the highest priority during
Tanyashospitalization?a. Minimize cardiac damage by keeping Tanya on bed restb.
Relieve pain by administering prescribed analgesicc. Help Tanya cope with
hospitalization by providing age-appropriate activitiesd. Prevent injury by padding
the bed side rails47. Which activity is most appropriate for Tanya during the acute
phase of her illness?a. Playing basketballb. Visiting other children in the unitc.
Keeping a written diaryd. Listening to the records of her favorite groups48. Three of
the following lab results are crucial indicators of Tanyas progress. Which onedoes
not?a. Antistreptolysin O titerb. C-reactive proteinc. Protein in the urined.
Erythrocyte sedimentation rate49. Tanya is discharged after 3 weeks of
hospitalization. Which of the following statementsbest indicates that Tanyas
parents have understood the discharge teaching?a. Tanya should lead a sedentary
lifestyle for at least a year.b. Tanya must take daily antibiotics for an extended
period of time to prevent recurrence of rheumatic fever.c. Tanya should not return
to her fifth-grade classroom but should have a home teacher therest of the year.d.
Tanya may have permanent neurologic sequela as a result of the Sydenhams
chorea.

14-year-old Borat has hemophilia. He is seen at the clinic for a periodic check-up.
50. When obtaining a history from Borat, which of the following reported
manifestationswould be the greatest cause for concern?a. Epistaxisb. Pallorc. Easy
bruisingd. Hemarthrosis51. His father tells the nurse that Borat loves football so
much. He wants to try out for his junior high football team. His parents are having a
hard time telling him that it is impossible.Which of the following alternatives is the
best suggestion for Borat?a. Allow him to try out for the team as long as he wears a
helmet and elbow and knee padsall the timeb. Start a collection of football
memorabiliac. Develop an interest in swimming or table tennis insteadd. Try to
become equipment manager for his junior high team

_____________________________________________________________________________ _

52. Borat is admitted to the hospital with an acute bleeding episode in his right
elbow, whichcannot be controlled at home. Which of the following will not be use to
control bleeding?a. Plasmab. Plasma concentratec. Packed c

52. Borat is admitted to the hospital with an acute bleeding episode in his right
elbow, whichcannot be controlled at home. Which of the following will not be use to
control bleeding?a. Plasmab. Plasma concentratec. Packed cellsd. Cryoprecipitate53.
Borat is recovering and will be discharged tomorrow. His father expresses concern
abouthis failure as a family man. The nurse ascertains that Borats father is anxious
to know if Borat can have children who do not have hemophilia. Assuming that
Borats future spouse isnot a carrier, which explanation is most accurate?a. All his
children will be carriersb. His son will have the disease and his children daughters
will be carriersc. There is a 50% chance that each of his children will have
hemophiliad. His sons will be normal and his daughters will be carriers54. Which of
the following is the best indicator of a successful outcome of Borats longtermtreatment?a. Bleeding episodes are prevented or treated early to minimize
sequelaeb. Borat is able to cope with his peers academicallyc. Borats weight is
maintained within age appropriate rangesd. Borat chooses a realistic career goal

9-month-old Torio has been admitted in the pediatric unit with vomiting,
colickyabdominal pain, and abdominal distention. A tentative diagnosis of
intussuceptionis made.
55. When assessing Torio, which type of stool indicates a worsening of Torios
condition?a. Fatty, bulky, foul-smellingb. Dark, red, jelly-likec. Ribbon-like dark
greend. Clay colored56. Torio is not likely to exhibit which of the following
behaviors?a. Loud crying when his parents leave himb. Fear of strangersc.
Searching for hidden objectsd. Saying at least 3 words besides dada and
mama57. Torio is scheduled for surgery. His parents are anxious and ask what will
be done insurgery. Which explanations should be given?a. The sigmoid colon will be
resected with pull-through anastomosisb. The obstruction will be corrected by
manual reductionc. The affected portion of the intestines will be resected with
permanent colostomy createdd. The ileum will be resected and a permanent
ileostomy created58. Torios parents ask what is wrong with his intestines. Which of
the following statementsbest describe Torios condition?a. A telescoping of one part
of the bowel into a more distal partb. Malrotation of the intestinesc. Atresia of the
intestinal tractd. Absence of parasympathetic ganglion cells59. Preoperatively, the
priority-nursing goal for Torio is to:a. Maintain Torios attachment to his parentsb.
Meet Torios need for sucking and comfort while he is NPOc. Maintain adequate
hydrationd. Promote adequate rest and sleep60. Following surgery, Torio returns to
the unit. He is fussy and seems to be in discomfort. The nurse palpates his abdomen
and notes some distention. Which action should beimplemented first?a. Call the
surgeon to report this observationb. Insert a rectal tubec. Sit Torio upright and pat
his backd. Check the NGT for patency
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61. What is the potential greatest threat to Torios continued development while he
ishospitalized?a. Developing mistrust towards the nursing staff b. Separation from
his parentsc. Restricted mobilityd. Disruption in his sleeping and eating routines
Angel, 4 years old, is brought to the clinic with a high fever. She has beenirritable
for several days and is clinging to 2 dolls and her mother says sherefuses to eat.
While performing an initial assessment, the nurse makes severalobservations that
may indicate that Angel is a victim of child abuse.
62. Children are most frequently abused by:a. Babysitterb. Relativec. Teacherd.
Casual acquaintances63. The child least likely at risk for being abused is one whose
family:a. Moves frequentlyb. Owns their own homec. Has experience divorced. Has
problems with chronic illness64. Which test is least likely to indicate that Angel has
been sexually abused?a. A Pap smearb. Urine culturec. Throat cultured. Vaginal
culture65. When interviewing a child suspected of being sexually abused, the nurse
should:a. Ask leading questionsb. Have the parents consentc. Have a security guard

presentd. Use the childs words to describe body parts66. Children who survive
physical abuse are least likely to become:a. Depressedb. Drug abusersc. Abusive
parentsd. Academic achievers67. Playing with her dolls while in the examination
room, Angel was seen engaging inexplicit sexual behavior. The nurse should know
that:a. Angel is mimicking behavior seen on TVb. Angel is acting out a personal
experiencec. Such play is a healthy expression of sexual developmentd. Angel
needs to be directed to a more appropriate play68. When abuse is suspected, the
least appropriate nursing action is to:a. Take a wait-and-see positionb. Call a local
social service agency for helpc. Prevent the childs return to a dangerous
environmentd. Confront the parent with security present69. The nurse is planning
nursing interventions for parents who abuse their children. It isimportant for the
recall that these parents:a. Plans ahead as to when and how to abuse their
childrenb. Ask for help generally only after feeling overwhelmed with the problemc.
Usually feel no guilt concerning the abused. Are always a product of child abuse
environment70. When planning a client education program for sickle cell disease,
the nurse shouldinclude which of the following topics?a. Proper handwashing and
infection avoidanceb. A high-iron, high-protein diet
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c. Fluid restriction to 1 liter per dayd. Aerobic exercises to increase oxygenation71.

Which of the following is the most common form of childhood cancer?a.
Lymphomab. Brain tumorsc. Leukemiad. Osteosarcoma72. The nurse would prepare
the parents of a child with suspected leukemia for which of thefollowing tests that
would confirm this diagnosis?a. Maternal drug useb. Bone marrow aspirationc.
Complete blood countd. Blood culture73. The nurse is caring for a neonate with
erythroblastosis fetalis. The nurse knows that thisdisease results from:a. Maternal
drug useb. Prematurityc. Destruction of red blood cellsd. Gestational diabetes74. Rh
incompatibility results when:a. The neonates blood group is Rh-positive and the
mothers is Rh-positiveb. The neonates blood group is Rh-negative and the
mothers is Rh-negativec. The neonates blood group is Rh-positive and the
mothers is Rh-positived. The neonates blood group is Rh-negative and the
mothers is Rh-negative75. When administering an antipyretic to a child, the nurse
knows that aspirin iscontraindicated for children with viral infections because of the
possibility of developingwhich of the following:a. Reyes syndromeb. Reflux
syndromec. Raynauds diseased. Reiters syndrome76. Which of the following tests
is most helpful in diagnosing hemophilia?a. Bleeding timeb. Partial
prothromboplastin timec. Platelet countd. Complete blood count77. The nurse
explains to the mother of a neonate diagnosed with erthroblastosis fetalis thatthe
exchange transfusion is necessary to prevent damage primarily to which of the
followingorgans in the neonate?a. Kidneysb. Brainc. Lungsd. Liver78. A parent asks
the nurse about head lice infestation during a visit to the clinic. Which of the
following symptoms would the nurse tell the parent is most common in a child

infectedwith head lice?a. Itching of the scalpb. Scaling of the scalpc. Serous
weeping on the scalp surfaced. Pinpoint hemorrhagic spots on the scalp surface79.
In a child with asthma, B-adrenergic agonist agents, such as albuterol, are
administeredprimarily to do which of the following?a. Decrease postnasal dripb.
Dilate bronchioles
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c. Reduce airway inflammationd. Reduce secondary infections80. Which of the

following statements by the family of a child with asthma indicates a needfor
additional home care teaching?a. We need to identify what things trigger these
attacks.b. He is to use his bronchodilator inhaler