UNIVERSITY OF SAINT LOUIS COLLEGE OF HEALTH SCIENCES UNIT TEST 1.

A nurse in a newborn nursery is monitoring a preterm newborn infant for respiratory distress syndrome. Which assessment signs if noted would alert the nurse to the possibility of this syndrome? a. Hypotension and bradycardia c. Acrocyanosis and grunting b. Tachypnea and retractions d. Barrel chest and acrocyanosis 2.A nurse in the newborn nursery is caring for a neonate. On assessment, the infant is exhibiting signs of cyanosis, tachypnea, nasal flaring and grunting. Respiratory distress syndrome is diagnosed, and the physician prescribes surfactant replacement therapy. The nurse would prepare to administer this therapy by: a. Subcutaneous injection c. Endotracheal tube into the lungs b. Intravenous injection d. Intramuscular injection 3. A 4 year old child was playing near the fireplace when her clothing caught fire & enveloped her in flames. Which of the following actions would be appropriate initially? a. Assess the childs airway, breathing & circulation b. Transport the child to the hospital immediately c. Push the child to the ground & roll her d. Remove the childs clothing as quickly as possible 4. Which emergency treatment is most important for a burn caused by an acid? a. Rinsing the burn with a continuous stream of running water b. Wrapping the burn with a clean sheet or towel c. Cleaning the burn with solution of mild soap & water d. Wrapping the burn with sterile gauze soaked in normal saline solution 5. You are caring for a 2 month old infant admitted in your unit who is just diagnosed with meningitis. What early assessment should you see in this infant? a. hyperextending the head and neck - Opisthotonos b. stiffness of the neck - Nuchal Ridgidity c. inability to extend the legs when thigh is flexed anteriorly at the hip - Kernigs sign d. Hypothermia 6. You are teaching a group of parents in your community health care facility about predisposing factors of developing SIDS in their newborn. Further teaching is necessary when the parents will include which of the following?

a. An infant who was premature b. A sibling of an infant who died of SIDS c. An infant with prenatal drug exposure d. An infant who lies on his back 7. In a child with Asthma, beta adrenergic agonists, such as albuterol, are administered primarily to do which of the following? a. Decrease post nasal drip b. Dilate bronchioles c. Reduce airway inflammation d. Reduce secondary infections 8. An acute, severe prolonged asthma attack that is unresponsive to usual treatment is referred to as which of the following? a. Instrinsic asthma b. Status asthmaticus c. Reactive airway disease d. Extrinsic asthma 9. During a discharge teaching, which of the statements by the family of a child with asthma indicates a need for additional home teaching? a. We need to identify what triggers the attack b. He is to use his bronchodilator inhaler before the steroid inhaler c. Well make sure that he avoids exercise to prevent attacks d. He should increase his fluid intake regularly to thin secretions 10. A neonates failure to meconium within the first 24 hours would alert the nursery nurse of what possible condition? a. Hirschprungs disease b. Celiac Disease c. Intussusception d. Abdominal wall defect 11. When assessing a child with possible intussusception, which of the following would be least likely to provide valuable information? a. Stool inspection b. Pain patterns c. Family history d. Abdominal Palpation

12. You are developing a care plan to prevent urinary tract infection for an adolescent in your unit who is to be discharged, which statement if verbalized by the client will indicate a need for further teaching? a. I will wear an underwear made of synthetic materials such as nylon to ensure a sure fit b. Ill make sure Ill drink at least 2 liters of fluid per day c. I will shower instead of doing tub baths d. Ill drink cranberry juice to keep my urine acidic 13. You are working in the community high school as a nurse, during your interview with Petra, a 16 year old girl who wears a Milwaukee Braces for scoliosis she verbalized the following statement; which should indicate an effective use of the brace? a. I wonder if I can take it off during my senior promenade b. I seriously look forward to taking this off when I take a bath c. I am glad that I only have to wear that awful thing at night when I sleep d. Im happy to take this thing off when Im tired 14. Which of the following statements made by the mother of the 4 month old infant would indicate that the child may have cerebral palsy? a. Im very worried because my baby hasnt rolled over yet b. My babys left hip tilts when I pull him up to a standing position c. My baby wont lift his head up & look at me, he looks so floppy d. He holds his left leg so stiff that I have a hard time putting his diapers 15. Which of the following is the most common form of childhood cancer a. Lymphoma b. Brain tumors c. Leukemia d. Osteosarcoma 16. The nurse would expect to prepare the parents of a child with suspected Leukemia for which of the following tests that would confirm this diagnosis? a. Lumbar Puncture b. Bone Marrow aspiration c. Complete blood count d. Blood culture 17. Which of the following would the nurse expect assess as the most common presenting manifestation of Wilms tumor? a. Hematuria b. Pain on voiding

c. Nausea and vomiting d. Abdominal mass 18. A 4 year- old boy is about to be discharged after undergoing surgery and follow-up treatment for a Wilms tumor. Which of the following points would be a vital part of the teaching program for the childs parents? a. Allowing him to resume activity. Including contact sports b. Monitoring for signs and symptoms of urinary tract infection c. Making arrangements for a return visit in 6 months d. Arranging for hospice care. Because Wilms tumor is fatal 19. Which of the following would the nurse question if found on the care plan for a child with rheumatic fever? a. Providing adequate rest period b. Isolating the child to prevent disease transmission c. Ensuring compliance with medication therapy d. Providing adequate nutritional intake 20. The asthmatic client asked you what breathing techniques he can best practice when asthmatic attack starts. What will be the best position? A. Sit in low-Fowlers position with extended legs B. Sit-up with shoulders back C. Push on abdomen during exhalation D. Lean forward 30-40 degrees with each exhalation 21. A pediatric nurse is assigned to care for a child with a diagnosis of Wilms tumor. In planning care for the child, the nurse understands that this tumor is: a. An abdominal tumor c. A brain tumor b. A renal tumor d. A bone tumor 22. The nurse is caring for a client who was admitted recently for anorexia nervosa. The nurse enters the clients room and notes that the client is engaged in rigorous push-ups. Which nursing action is most appropriate? a. Allow the client to complete her exercise program. b. Tell the client she is not allowed to exercise rigorously. c. Interrupt the client and offer to take her for a walk. d. interrupt the client and weigh her immediately

23. The nurse is preparing a discharge plan for the client who attempted suicide. The plan of care should focus on which of the following? a. Follow-up appointments b. Contracts and immediate available crisis resources c. Encouraging the family always to be with the client always d. Providing the hospital telephone number 24. The nurse is planning care for a client being admitted to the nursing unit who attempted suicide. Which of the following nursing interventions will the nurse include in the plan of care? a. Check whereabouts of the client every 15 minutes. b. Suicide precautions with 30 minute checks c. One-to-one suicide precautions d. Ask the client to report suicidal thoughts immediately. 25. Which of the following interventions would be included in the care plan to prevent the most serious shunt complication? a.Checking for inflammation at operative site and shunt tracts b. Observing behavior, blood pressure, and pulse c. Positioning carefully, flat on operative side d. Providing meticulous skin care 26. Which of the following would be inappropriate to assist a child with cerebral palsy in performing his activities of daily living (ADLs)? a. Allowing for frequent rest periods b. Decreasing calories to prevent weight gain c. Encouraging activity with signs of fatigue d. Praising the child for his accomplishments 27. When planning the postoperative care of an infant with hydrocephalus, which of the following would the nurse expect as the most common type of shunt used? a.. Ventricular bypass b. Ventriculoatrial (VA) c. Ventriculoperitoneal (VP) d. Ventriculopleural 28. The parents of a child who has been newly diagnosed with cerebral palsy question the nurse about the child's prognosis. The nurse bases her response on knowing which of the following? a. Cerebral palsy is nonprogressive with variable outcomes. b. The child will become progressively worse. c. The condition improves gradually with stimulation.

d. The illness progression is variable, but results in predicted patient outcomes. 29. All but one is a characteristic of a post term infant a. long fingernails c. Absence of lanugo b. abudant vernix d. Abundant hair 30. Marcus has been referred to the hospital because of failure-to-thrive syndrome. A plan of care to best meet the needs of this child would not include a. A schedule of stimulation geared to the infants present level of development b. A plan to teach the mother ways to provide stimulation c. A plan to have staff members pick him up and play with him whenever they can d. Consistency in care and caregiver 31. 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 to which the child is exposed b. Have the same parent teach the child new skills c. Teach the child socially acceptable behaviors d. Maintain a consistent routine for daily activities 32. Jessie, 3 years old was admitted for severe burns to the face, neck, chest and hands, sustained from a newly cooked soup. The nurse determines the burns are primarily secondary because they appear to a. An absence of pain and pressure sensation c. Large, black blisters b. White, dry, and leathery appearance d. Visible, thrombosed small vessels 33. All but one is an example of physical abuse a. Inadequate weight gain b. Unexplained bruises, burns, fractures

c. Bald spots on scalp d. All of the these

34. You are assigned to health educate a mother taking care of a son with impetigo. Which of the following statements made by the mother requires further teaching? a. We should separate all linens and clothing of my son when washing our clothes. b. I understand that my son needs to use separate towels, linens and dishes. c. I will apply warm compress to the lesions 2 or 3 times per day. d. The lesions should be dressed to keep dry always. 35. You are providing instructions on how to apply scabicide to parents before discharge. Which of the following statements made by the nurse is incorrect? a. Application should be preceded by a warm soap-and-water bath.

b. Skin must be cool and dry before the application of the lotion. c. Lotion is left in place for 1 hour before it is washed off. d. None of the above 36. You are assigned in the delivery room and asked to observe a suspected preterm newborn. Which of the following assessments would validate the newborn is a preterm? a. Long and thin body c. Muscle wasting on the extremities b. Dry and cracked skin without lanugo d. Minimal creasing on the extremities 37. Maam Ann asked you to take care of a pediatric patient with spina bifida-meningocele type. Which of the following pictures out the condition of the patient? a. Spinal cord remains intact and usually is not visible b. Protrusion of the spinal cord and/or its meninges occurs c. Protrusion involves meninges and a saclike cyst that contains CSF in the midline of the back d. Protrusion of meninges, CSF, nerve roots, and a portion of the spinal cord occurs 38. You are formulating a plan of care to an autistic patient. Which of the following would be a priority? a. Safety c. Activities of daily living b. Coping abilities d. Speech capabilities 39. After assessing the newborn, Marie plots the neonate at or above the 90th percentile on the intrauterine growth curve. Which of the following assessments would validate the result? a. Birth trauma c. Cyanosis b. Jaundice d. Lowered body temperature 40. What is the Body Mass Index (BMI) of a client considered to be obese? a. less than 20 c. Between 20-25 b. Between 25-30 d. More than 30 41. Gloria just had consultation with her pediatrician and was diagnosed to have urinary tract infection (UTI). Which of the following statements made by the mother would mean she understood the health teachings? a. She can stop her medication as soon as she does not feel any signs and/or symptoms b. We can apply cold compress on her abdomen for complaints of discomfort. c. Cola and caffeine products are not discouraged d. I ll instruct her to void every after 2-3 hours 42. Scoliosis can be most easily detected if the clients are asked to assume what position?

a. Bend at the waist, to the right, then to the left. b. Stand straight, and then face the examiner with arms raised overhead. c. bend forward at the waist with head and arms hanging freely d. Stand straight with back to the examiner, and arms held out in front of the body. 43. Which of the following is not characteristic of Hirschsprungs disease in the older infant? a. Failure to thrive c. Diarrhea and vomiting b. Constipation d. Steatorrhea 44. Three of the following conditions are frequently characteristic of a anorexic client. Which one is not? a. Amenorrhea c. Covert dysfunctional family patterns b. Delayed psychosexual development d. Tachycardia 45. When assessing the mothers potential for child abuse, which factor from the mothers history would be most important to know? a. Whether the mother has completed high school b. The mothers age at menarche c. Whether the mother, as a child, was physically abused by her parents d. The socioeconomic status of the mothers family of origin 46. Burn clients need wound management what is the priority goal? a. To debride the wound of dead tissue and eschar. c. To prevent the growth of microorganisms b. To limit fluid loss d. To decrease formation of disfiguring scars 47. As a burn client begins to improve, he becomes interested in eating. What foods would be most appropriate for her? a. Hotdog, French fries and cooked spinach c. Omelet, mashed carrots and crackers b. Hamburger, raisins and cooked beans d. Pureed chicken, cooked peas, bananas 48. A teenager was rushed to the emergency room after experiencing multiple physical injuries due to vehicular accident. Head injury with increased ICP was suspected. All but one is considered to be a late sign of increased ICP, except a. Decerebrate positioning c. Change in pupil size and reaction b. Slight change in LOC d. All of the above 49. An infant with hydrocephalus had just undergone surgical treatment to prevent further CSF accumulation. How would the nurse position the client postoperatively? a. On the operated side c. On the unoperated side

b. Fetal position

d. Prone position

50. You encountered a pediatric patient with rheumatic fever. As you have learned in you reading, one of the related risk factors is an etiologic agent which is a. Streptococcal infection c. Staphylococcal infection b. Mycobacterium infection d. Neisseria infection