NCLEX Preparation Course - Level of Cognitive Ability Answers (1-25) -->
1. A mother brings her 3-week old infant to a clinic for a phenylketonuria re-screening blood test. The test indicates a serum phenylalanine level of 1mg/dL. The nurse interprets this result as:
a) positive
b) negative
c) inconclusive
d) requiring re-screening at age 6 weeks
2. A child has fluid volume deficit. The nurse performs an assessment and determines that the child is improving and the deficit is resolving if:
a) the child has no tears
b) urine specific gravity is 1.030
c) urine output is less than 1 ml/kg/hr
d) capillary refill is shorter than 3 seconds
3. A nurse is performing an admission assessment on a 2-year old child who has been diagnosed with nephrotic syndrome. The nurse knows that the most common characteristic associated with nephrotic syndrome is:
a) hypertension
b) generalized edema
c) increased urinary output
d) frank, bright red blood in the urine
4. A nurse is planning care for a child with hemolytic-uremic syndrome. The child has been anuric and will be receiving peritoneal dialysis treatment. The nurse plans to:
a) restrict fluids as prescribed
b) encourage foods high in potassium
c) administer analgesics as prescribed
d) care for the arteriovenous (AV) shunt
5. A nurse has provided a discharge instructions to the mother of a 2-year old child who had an orchiopexy to correct cryptorchidism. Which statement by the mother of the child indicates that further teaching is necessary?
a) I'll check his temperature
b) I'll give him medication so he'll be comfortable
c) I'll check his voiding to be sure there's no problem
d) I'll let him decide when to return to his play activities
6. A nurse collects a urine specimen preoperatively from a child with epispadias who is scheduled for surgical repair. When the nurse is analyzing the results of the urinalysis, which of the following would the nurse most likely expect to note?
a) hematuria
b) proteinuria
c) bacteriuria
d) glucosuria
7. A priority nursing diagnosis for a child with severe edema caused from nephrotic syndrome would be risk for:
a) constipation
b) impaired skin integrity
c) ineffective thermoregulation
d) imbalanced nutrition: more than body requirements
8. A 1-year old child with hypospadias is scheduled for surgery to correct this condition. The nurse prepares a nursing care plan for this child and understands that this surgery is taking place at a time when:
a) fears of separation
b) sibling rivalry will cause regression to occur
c) concern over size and function of the penis is present
d) embarrassment about voiding irregularities is common
9. A nurse is caring for an infant with a diagnosis of bladder exstrophy. To protect the exposed bladder tissue, the nurse plans to:
a) cover the bladder with petroleum jelly gauze
b) cover the bladder with non-adhering plastic wrap
c) apply sterile distilled water dressings over the bladder mucosa
d) keep the bladder tissue dry by covering it with dry sterile gauze
10. A nurse interviews the parents of a child recently diagnosed with glomerulonephritis. The nurse understands that which information collected during the assessment most often is associated with the diagnosis of glomerulonephritis?
a) child fell off a bike onto the handlebars
b) nausea and vomiting for the last 24 hours
c) urticaria and itching for 1 week before diagnosis
d) streptococcal throat infection 2 weeks before diagnosis
11. A nurse is assigned to care for a child suspected having glumerulonephritis. The nurse review's the child's record and notes that which finding is associated with the diagnosis of glumeronephritis?
a) hypotension
b) red-brown urine
c) low blood urea nitrogen level
d) low urinary specific gravity
12. A nurse is performing an assessment on a child admitted to the hospital with a probable diagnosis of nephrotic syndrome. What assessment findings would the nurse expect to observe? Select all that apply
a) pallor
b) edema
c) anorexia
d) proteinuria
e) weight loss
f) decreased serum lipid
13. A nurse is monitoring a child with burns during the treatment for burn shock. The nurse understands that which of the following assessments provides the most accurate guide to determining the adequacy of fluid resuscitation?
a) skin turgor
b) neurological assessment
c) level of edema at burn site
d) quality of peripheral pulses
14. A school nurse is conducting pediculosis capitis (head lice) assessments. A child with a "positive" head check would have:
a) maculopapular lesions behind the ears
b) lesions in the scalp that extend to the hairline or neck
c) white flaky particles throughout the entire scalp region
d) white sacs attached to the hair shafts in the occipital area
15. The nurse is developing a plan of care for a 12-year old girl with an exacerbation of eczema. Which nursing diagnosis applies to the care for this child?
a) risk for infection related to viral lesions
b) risk for infection related to scratching of pruritic lesions
c) imbalanced nutrition, less than body requirements related to throat edema and mouth ulcers
d) disturbed body image related to the presence of thick white crusty plaques over the elbow and knees
16. A mother of a 3-year old child arrives at a clinic and tells the nurse that the child has been scratching the skin continuously and has developed a rash. The nurse assesses the child and suspects the presence of scabies. The nurse bases this suspicion on which finding noted on assessment of the child's skin?
a) fine-grayish-red lines
b) purple-colored lesions
c) thick, honey-colored crusts
d) clusters of fluid-filled vesicles
17. A clinic nurse is reviewing the physician's orders for a child who has been diagnosed with scabies. Lindane has been prescribed for the child. The nurse questions the order if which of the following is noted in the child's record?
a) the child is 18 months old
b) the child is being bottle-fed
c) a sibling is using lindane for the treatment of scabies
d) the child has a history of frequent respiratory infections
18. A clinic nurse instructs the mother of a child with sickle cell anemia about the precipitating factors related to pain crisis. Which of the following, if identified by the mother as a precipitating factor, indicates the need for further instructions?
a) stress
b) trauma
c) infection
d) fluid overload
19. A 10-year old child with hemophilia A has slipped on the ice and bumped his knee. The nurse should prepare to administer an:
a) injection of factor X
b) intravenous infusion of factor VIII
c) intravenous infusion of croprecipitate
d) intravenous infusion of desmopressin (DDAVP)
20. Laboratory studies are performed for a child suspected of having iron deficiency anemia. The nurse reviews the laboratory results, knowing that which of the following results would indicate this type of anemia?
a) an elevated hemoglobin level
b) a decreased reticulocyte count
c) an elevated red blood cell count
d) red blood cells are microcytic and hypochromic
21. A nurse analyzes the laboratory results of a child wiht hemophilia. The nurse understands that which of the following would most likely be abnormal in this child?
a) platelet count
b) hematocrit level
c) hemoglobin level
d) partial thromboplastin time
22. A child with B-thalassemia is receiving long-term blood transfusion therapy for the treatment of this disorder. Chelation therapy is prescribed to prevent organ damage from the presence of too much iron in the body as a result of the transfusions. Which of the following medications would the nurse anticipate to be prescribed in chelation therapy?
a) meropenem (merrem)
b) metoiprolol (Toprol-XL)
c) deferoxamine (Desferal)
d) dalteparin sodium (Fragmin)
23. A nurse is receiving a physician's orders for a child with sickle cell anemia who was admitted to the hospital for the treatment of vasoocclusive crisis. Which orders documented in the child's record should the nurse question? Select all that apply
a) restrict fluid intake
b) position for comfort
c) avoid strain on painful joints
d) apply nasal oxygen at 12L/min
e) provide a high-calorie, high-protein diet
f) give meperidine (Demerol), 25 mg IV, every 4 hours for pain
24. Which of the following are characteristics of von Willebrand disease? Select all that apply
a) gum bleeding occurs
b) easy bruising occurs
c) it is a hereditary bleeding disorder
d) it is characterized by extremely high creatinine levels
e) the disorder causes platelets to adhere to damaged endothelium
f) treatment and care are similar to those implemented for hemophilia
25. The nurse analyzes the laboratory values of a child with leukemia who is receiving chemotherapy. The nurse notes that the platelet count is 20,000/μL. Based on this laboratory result, which intervention will the nurse document in the plan of care?
a) monitor closely for signs of infection
b) monitor the temperature every 4 hours
c) initiate protective isolation precautions
d) use a soft small toothbrush for mouth care
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