PREBOARD PEDIA SET 2

PREBOARD – PEDIA SET 2

1.) The nurse is caring for 1-day-old client at term gestation who is irritable, feeding poorly, and only sleeping for very short intervals. The newborn’s mother informs the nurse that she has been taking hydrocodone on a regular basis for several years. Which intervention is appropriate to include in the newborn’s plan of care?

• Avoid giving the newborn a pacifier
• Position the newborn supine after feeding
• Stimulate the newborn with light regularly
• Swaddle and gently rock the newborn

2.) The nurse is performing the initial assessment of a newborn. Which of the following findings should the nurse report to the health care provider? Select all that apply.

• Cyanosis of the hands and feet
• Decreased muscle tone
• Heart rate of 150/min
• Sacral dimple with a 0.4 in (1 cm) skin tag
• Single artery in the umbilical cord

3.) The nurse is evaluating a client’s understanding of postcircumcision care for a 24-hour-old newborn.Circumcision was performed using the clamp method. Which statement by the client demonstrates a need for further teaching?

• “Bleeding should be no longer than the size of a quarter.”
• . “I should cleanse the glans with warm water occasionally.”
• “I should expect at least 2 wet diapers in the next 24 hours.”
• “Yellow exudate on the glans penis indicates infection.”

4.) A 9-year-old has terminal cancer, but the parents do not want the child to know the prognosis. The child has been asking questions such as what dying is like and whether the child will die. Which action by the nurse is most appropriate?

• Encourage the child to ask the parents these questions
• Notify the health care provider (HCP) about the child’s questions
• Reassure the child that everyone is trying to help the child get better
• Tell the parents about the child’s questions

5.) A 10-year-old is implementing behavioural strategies to manage nocturnal enuresis. The client tells the nurse, “I want to go to sleep-away camp during the summer, but if I have an ‘accident,’ I’m afraid that other kids will tease me.” What is the best response by the nurse?

• “Don’t worry. Your problem will be resolved by then.”
• “It would be better if you thought about going to day camp instead.”
• “We can ask your health care provider about a medication trial that may help.”
• “You could always wear a pull-up just in case.”

6.) Within thirty seconds after birth, an unresponsive and limp newborn is placed on the warmer in the “sniffing” position. The nurse clears the airway, dries, and stimulates the newborn. At 1 minute of life, the newborn has shallow, gasping respirations with a heart rate of 62/min. What action should the nurse take?

• Administer epinephrine
• Begin positive pressure ventilation
• Continue stimulating the newborn
• Start chest compressions

7.) The nurse is performing an Apgar assessment on a newborn client at 1 minute of life. The newborn is completely blue, has a heart rate of 110/min, and is emitting a weak cry. Active movement and flexion of extremities are noted and the newborn grimaces when nares are suctioned. Which Apgar score should the nurse assign this newborn?

• Apgar score of 4
• Apgar score of 5
• Apgar score of 6
• Apgar score of 8

8.) The nurse is performing postdelivery care of a newborn delivered at 35 weeks gestation. Which of the following actions by the nurse are appropriate? Select all that apply.

• Covers the scale with warmed blankets before weighing the newborn
• Encourages skin-to-skin contact between the stable newborn and mother
• Performs diaper changes underneath a radiant warmer
• Places the identification band on the newborn before beginning to dry off amniotic fluid
• Transfer the swaddled newborn to the neonatal intensive care unit in an open bassinet

9.) The nurse is caring for a postpartum couplet and notices that the newborn is cyanotic and apneic, with a heart rate of 70/min. The nurse calls for help and begins resuscitation. Which position is appropriate for ventilating the newborn?

10.) What communication strategies would the nurse have in place when establishing rapport with the caregiver and an 8-year-old during a health history interview? Select all that apply.

• Ask only closed-ended questions to obtain information
• Allow the child to describe their current issue
• Isolate the child from the parents and interview them separately
• Maintain an eye level position when speaking with the child
• Use language that both the child and caregiver can understand

11.) The nurse is preparing to teach the perinatal unit staff about caring for newborns with either omphalocele or gastroschisis. Which of the following statements are appropriate for the nurse to include? Select all that apply.

• “An omphalocele with an intact peritoneal sac should be covered with a sterile, nonadherent

dressing immediately after birth.”

• “If immediate surgical repair of the defect is planned, the newborn should be fed via a

nasogastric tube instead of breastfed.”

• “Newborns with omphalocele or gastroschisis require IV access for fluid and electrolyte

replacement.”

• “Newborns with omphalocele or gastroschisis should be monitored closely for temperature

instability and infection.”

• “Petroleum jelly should be applied to the exposed bowel of newborns with gastroschisis

before it is covered with plastic.”

12.) What play behaviour would the nurse be most likely to observe in a group of 4-year-old children?

• Children playing and borrowing blocks from each other without directing others
• Children playing and working together to build a castle out of blocks
• Children playing next to each other with blocks, but not interacting
• Children playing with blocks by themselves in separate areas of the room

13.) The nurse has received report for a term newborn after a vaginal birth. Maternal history includes diagnosis of gestational diabetes at 25 weeks gestation and poorly controlled blood glucose during pregnancy. When assessing the newborn, which finding should the nurse most likely expect?

• Delayed meconium passage
• Elevated hematocrit level
• Shrill cry and frequent yawning
• Smooth philtrum and thin upper lip

14.) A client postpartum 3 days scheduled for discharge today was given education about diaper changes yesterday. The client says to the nurse, “I’m so glad you are here. I think my baby has a dirty diaper. I can’t change it as well as you can. Will you change my baby’s diaper for me?” What is the nurse’s best response?

• Reassure the mother that it takes time to learn how to care for a baby while quickly changing

the diaper

• Suggest that the mother change the diaper as the nurse watches
• Tell the mother that it is time to take over changing the baby’s diaper as she will have to do it

once discharged

• Tell the mother that the nurse will change the baby’s diaper while she watches

15.) The nurse is providing education about the vitamin K injection to the parents of a newborn client.Which statement by the nurse is appropriate?

• “After the first week of life, vitamin K deficiency poses no risk to the newborn.”
• “If your prenatal diet was high in vitamin K, the vitamin K injection provides little benefit to

the newborn.”

• “Vitamin K deficiency is known to cause growth delays in newborns.”
• “Vitamin K is essential for preventing bleeding, which can occur spontaneously or after

procedures such as circumcision.”

16.) The nurse is performing an assessment on a neonate shortly after delivery. The nurse is most concerned about which assessment finding?

• Bilateral rales found on lung auscultation
• Dullness over bladder found on percussion
• Ptosis of right eyelid found on facial inspection
• Single testicle found on genital palpation

17.) The nurse is caring for a 6-hour-old, full-term newborn of a mother with gestational diabetes. A bedside capillary blood glucose measurement reveals that the newborn’s blood glucose level is 45 mg/dL (2.5 mmol/L.) The newborn is asymptomatic. What is the nurse’s first action?

• Feed the newborn
• Notify the health care provider
• Place the newborn under a radiant warmer
• Prepare to administer IV glucose

18.) A 2-month-old infant has been admitted to the hospital with suspected shaken baby syndrome (abusive head trauma). In reviewing the infant’s chart, the nurse expects to encounter which of these clinical findings?

• A reported history of recent trauma
• Abdominal bruising
• External signs of trauma
• Irritability and vomiting