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    Exam Review

    1. A 9-year-old presents with scalp pruritus. The nurse finds oval white capsules attached to hair shafts within ¼ inch of the scalp. What is the best interpretation?
      A)Scabies mite infestation
      B)Evidence of fungal infection
      C)Presence of viable head lice nits
      D)Presence of dandruff
    2. Identify which burns count toward total body surface area (TBSA) calculation. Select all that apply.(SATA)
      A)Deep partial-thickness
      B)Full-thickness
      C)Superficial partial-thickness
      D)Superficial/epidermal
    3. An infant with GERD presents with frequent post-feed vomiting, irritability, and poor weight gain. Which nursing interventions are appropriate? Select all that apply.(SATA)
      A)Place infant in supine position immediately after feeding
      B)Encourage large, less frequent feedings
      C)Keep infant upright for 20-30 minutes after feeds
      D)Monitor weight closely
      E)Thicken feeds with rice cereal
    4. An infant with classic salt-wasting congenital adrenal hyperplasia is admitted with vomiting and lethargy.Which findings should the nurse expect? Select all that apply.(SATA)
      A)Hyponatremia
      B)Hyperkalemia
      C)Hypertension
      D)Hypernatremia
      E)Hypotension
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    Exam Review

    1. Children with head lice should be ________
      A)restricted from sharing all classroom materials.
      B)hospitalized until infestation clears.
      C)allowed to stay in school since lice may be present for weeks before detection.
      D)excluded from school until nits are gone to prevent transmission.
    2. A 2-month-old infant is diagnosed with a unilateral cleft lip. Which nursing interventions are appropriate to support feeding? Select all that apply.(SATA)
      A)Provide frequent burping
      B)Continue breastfeeding or chest-feeding as possible
      C)Feed in supine position to promote rest
      D)Use a specialty bottle such as a Pigeon or Haberman feeder
      E)Position the infant semi-upright during feed
    3. A 10-year-old burn patient with 30% TBSA shows the following changes in since the start of your shift three hours ago: Parameter Start of shift Current Heart rate (bpm) 105 145 Blood pressure (mm Hg) 110/70 88/54 Urine output 1.2 mL/kg/hr 0.3 mL/kg/hr Which interpretation is most accurate?
      A)The child is developing burn shock due to inadequate fluid resuscitation.
      B)The child is showing signs of fluid overload from excessive IV fluid administration
      C)The child's low urine output is expected in the first 24 hours after burn
      D)The child is experiencing adequate fluid resuscitation.
    4. A 12-year-old with type 1 diabetes mellitus is preparing to eat lunch. Their meal tray includes: 1 slice of bread = 15 g carbohydrates 1 medium apple = 25 g carbohydrates 1 cup milk = 12 g carbohydrates 1 granola bar = 23 g carbohydrates Their pre-meal blood glucose is 193 g/dL. Insulin parameters are as follows: Target blood glucose: 80-120 mg/dL Insulin-to-carbohydrate ratio: 1 unit of insulin per 15 grams of carbohydrate (1:15) Correction dose of insulin: Pre-meal blood glucose 121-180 mg/dL: 1 unit Pre meal blood glucose 181-200 mg/dL: 2 units What is the total amount of insulin the patient will require?
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    Exam Review

    1. During patient and family teaching, the nurse explains that the most common cause of hemolytic uremic syndrome (HUS) in children is exposure to ▾ E. coli and that long-term follow-up is important because children may later develop ▾ chronic kidney disease.
      Dropdown 1:
      Option 1: vesicoureteral reflux (VUR)
      Option 2: staphylococcus aureus
      Option 3: enuresis influenza
      Option 4: E. coli
      Option 5: appendicitis
      Option 6: varicella
      Dropdown 2:
      Option 1: vesicoureteral reflux (VUR)
      Option 2: staphylococcus aureus
      Option 3: enuresis influenza
      Option 4: appendicitis
      Option 5: chronic kidney disease
      Option 6: varicella
    2. A 2-year-old presents with fever, vomiting, poor appetite, and foul-smelling urine. Which additional findings support a likely diagnosis of a urinary tract infection?(SATA)
      A)Hepatomegaly
      B)Straining or crying with urination
      C)Persistent diaper rash
      D)Cloudy urine with foul odor
      E)Frequent urination
    3. A 1-year-old with suspected intussusception presents with HR 178, BP 72/38, RR 44, T 38.5°C.The abdomen is distended, and the child is lethargic. What is the priority action?
      A)Apply warm compresses to abdomen to decrease pain
      B)Prepare for urgent pneumatic (air) enema reduction
      C)Administer oral rehydration solution (ORS) to treat dehydration
      D)Place child in Trendelenburg position to decrease swelling in the gastrointestinal tract
    4. A school-aged child with acute glomerulonephritis (AGN) has a blood-pressure 136/90 mm Hg, oliguria, and periorbital edema. Which intervention is the nurse's priority?
      A)Encourage oral fluids to maintain hydration
      B)Elevate the head of the bed to ease breathing due to pulmonary edema
      C)Restrict sodium intake as ordered
      D)Monitor daily weight at the same time each day to assess for fluid retention
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    Exam Review

    1. For a child who is post-surgical correction of vesicoureteral reflux (VUR), indicate whether each nursing action is Recommended or Not Recommended.
      Not recommendedRecommended
      Assess for fever and flank pain✓
      Monitor urine output hourly✓
      Encourage low fluid intake to reduce bladder stress✓
      Monitor blood pressure regularly✓
    2. A 6-year-old child with enuresis has the following vital signs at their follow-up pediatrician visit to address enuresis: HR 92, BP 100/64, RR 20, temperature 37.2° C. The nurse discusses first-line management with the family. Which recommendation is most appropriate?
      A)Insert an indwelling catheter at night
      B)Restrict or eliminate fluids and snacks after evening meal
      C)Begin desmopressin acetate (DDAVP) therapy immediately
      D)Punish the child when bedwetting occurs to reinforce responsibility
    3. Over six hours,a 12-year-old with newly diagnosed type 1 diabetes mellitus shows the following trends: Parameter 1000 1600 Serum blood glucose (mg/dL) 180 460 Heart rate (bpm) 113 154 Blood pressure 105/65 82/50 Respiratory rate 22 41 Respiratory pattern Regular Deep irregular What is the priority nursing action?
      A)Provide oral rehydration with electrolyte solution
      B)Restrict oral fluids until blood sugar stabilizes
      C)Begin IV fluid resuscitation and prepare for continuous insulin infusion
      D)Administer subcutaneous rapid-acting insulin
    4. A 4-year-old is diagnosed with scabies. Which nursing interventions are appropriate? Select all that apply.(SATA)
      A)Wash bedding and clothing used in past 3 days in hot water and dry on high heat.
      B)Apply permethrin 5% cream to the entire body and repeat application in 1 week.
      C)Isolate the child until all itching resolves.
      D)Treat only the symptomatic child, not close contacts.
      E)Provide oral antihistamines for nighttime pruritus
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    Exam Review

    1. A 9-year-old with diabetes mellitus type 2 becomes pale and shaky during gym class. Their blood glucose level is 52 mg/dL. What is the school nurse's best first action?
      A)Give 10-15 grams of a fast-acting carbohydrate
      B)Give a subcutaneous insulin injection
      C)Restrict fluids until blood glucose rises
      D)Administer intramuscular glucagon immediately
    2. An infant with pyloric stenosis presents with: HR 180 bpm, BP 70/38 mmHg, RR 62, temperature 37.8°C. The infant has sunken fontanels, poor skin turgor, and their labs are consistent with metabolic alkalosis. What is the nurse's priority?
      A)Administer IV fluids to correct dehydration and electrolyte imbalance
      B)Place infant prone to improve gastric emptying
      C)Offer small, frequent feeds of oral rehydration solution
      D)Prepare infant for immediate surgical pyloromyotomy
    3. The primary goal of conservative therapy in children with vesicoureteral reflux is to _________
      A)increase bladder capacity
      B)prevent dehydration
      C)decrease recurrent urinary
      D)decrease recurrent urinary tract infections
      E)decrease urine production
    4. The nurse reviews the following notes on an infant with cleft palate preparing for surgery: Visit 1:Weight 4.8 kg, pulse 140, RR 40, afebrile, moderate feeding difficulties Visit 2 (2 weeks later): Weight 4.6 kg, pulse 148, RR 42, intermittent respiratory congestion after feeds Visit 3 (2 weeks later): Weight 4.4 kg, pulse 156, RR 44, frequent otitis media What is the nurse's priority interpretation?
      A)The infant requires no intervention beyond routine follow-up
      B)The infant is experiencing complications affecting nutrition and growth
      C)The infant requires emergency surgery cleft palate repair
      D)The infant is meeting expected developmental milestones
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