A 10-year-old child presents with peri-umbilical pain, rebound tenderness, nausea, and fever up to 102°F (38.9°C). The pain prevents him from standing up straight. Which of the following should a nurse anticipate first?

A nurse just completed their first-year evaluation and indicates a long-term goal to be a Chief Nursing Officer (CNO). The mentor should recommend the nurse:

A child is admitted following chest trauma, and a small pneumothorax (less than 10%) is noted. A nurse should anticipate which of the following?

A 17-year-old presents with history of progressive exercise intolerance. He is admitted with a diagnosis of hypertrophic cardiomyopathy. The vital signs are as follows:

BP: 78/55

HR: 110

RR: 20

T: 98.3°F (36.8°C)

SpO₂: 89% on room air

The patient's vital signs reflect:

Parent teaching for a child with encephalopathy should include which of the following?

A patient asks the nurse to join in saying bedtime prayers. The nurse is not comfortable with this practice. Which of the following is the nurse’s most appropriate response?

A 17-year-old on home peritoneal dialysis has new-onset fever and abdominal pain. Dialysate WBC is 185. What order should the nurse anticipate?

A patient has a large intracranial hemorrhage and loss of brainstem reflexes. Prior to official brain death declaration, which must be ensured?

An adolescent’s sleep is disrupted by alarms and blood draws. What is the nurse’s best action?

Early management of a child in septic shock includes:

An infant with a sternal wound infection has a negative-pressure wound therapy device in place. A nurse should recognize that the primary purpose of the device is to speed healing of the wound through:

A patient on peritoneal dialysis has high blood glucose. Most likely cause is:

CSF analysis shows: glucose 36 mg/dL, protein 110 mg/dL, and WBCs (PMNs) 1,000/microliters. These findings are indicative of:

Why are unit admission and discharge criteria developed?

For a child with disseminated intravascular coagulation (DIC), administration of fresh frozen plasma (FFP) will replace:

Which therapy is expected in the management of persistent pulmonary hypertension of the newborn (PPHN)?

A child presents with new-onset right-sided weakness, slurred speech, and headache. Which chronic condition most likely predisposes the child to this presentation?

In a pediatric patient with viral myocarditis, clinical manifestations of decreased urine output, cool hands and feet, and pulmonary edema are most likely indicative of:

Following a MVC with prolonged entrapment of the legs, a 7-year-old has:

BP: 75/40

HR: 145

K⁺: 5.9 mEq/L

Hypocalcemia

Elevated CK

What urine output should the nurse expect?

An infant has hypovolemic shock from severe diarrhea. Which of the following assessments demonstrates adequate tissue perfusion following fluid resuscitation?

Capillary Refill

Urine Output

CVP

BP

a. 2 sec

0.5 ml/kg/hr

2 mm Hg

84/50

b. 3 sec

0.5 ml/kg/hr

6 mm Hg

72/44

c. 3 sec

1.2 ml/kg/hr

4 mm Hg

72/48

d. 2 sec

1.2 ml/kg/hr

8 mm Hg

80/54

A 6-year-old patient with ARDS has been mechanically ventilated for 10 days. The patient is being assessed for readiness to wean. The patient will open his eyes spontaneously but not to command. The pupils are equal and reactive but the patient is restless, sleeping only for short intervals. A nurse suspects the patient is demonstrating signs of:

A 2-year-old child in septic shock is receiving nitroprusside (Nipride). Which of the following findings indicates the need to increase the nitroprusside dosage?

The family of a patient with trauma believes that the patient is in pain and requests that a neighbor, a therapeutic touch practitioner, be allowed to see the patient. Unit policy allows visits by immediate family only. Which of the following is the most important consideration in a nurse’s decision about facilitating the visit?

During an exchange transfusion for sickle cell crisis, the patient becomes anxious and reports tingling and numbness around the mouth. The nurse should administer:

A patient’s mother shares with a nurse that the patient has been sleeping more than usual, and has expressed feelings of hopelessness and "unbearable pain". Which of the following is the priority nursing intervention?

Three weeks post-traumatic brain injury, a child has a GCS of 3, no cough or gag, and only agonal respirations. When the family asks about options of care, the nurse should respond:

An irritable child has an acute fever, conjunctivitis, rash, and a strawberry tongue. A prolonged PR interval is observed on the ECG monitor. These findings are most likely due to:

What is the best method to ensure parents of a child with a new tracheostomy are adequately prepared for home care?

An 8-year-old patient who sustained intracerebral hemorrhage after a traumatic incident was intubated in the field. Head CT scan showed a 5 mm midline shift. The patient is difficult to arouse but pulls away from noxious stimuli. The most concerning sign of clinical deterioration is:

The family member of a patient who is receiving mechanical ventilation is to be taught suctioning. When developing a teaching plan, the nurse should first:

A child with hepatic failure received volume replacement. Following this therapy, laboratory tests reveal:

PT: 14 sec

PTT: 40 sec

Hct: 36%

Albumin: 3.5 g/dL

Before the patient undergoes a closed liver biopsy, further replacement should include:

A 2-day-old infant develops a tachycardia of 300. A 12-lead ECG reveals narrow complexes and prominent delta waves. The patient most likely has:

Family members have been complaining about limited visiting hours. To facilitate a potential change in practice, a nurse should first:

A 6-year-old child is admitted following ingestion of an unidentified substance. Assessment reveals:

BP: 120/84

HR: 190

RR: 44

ECG: Sinus rhythm with occasional PVCs

Dilated pupils

Dry mucous membranes

Disorientation

Urinary retention

These findings are consistent with ingestion of:

A patient is postoperative day 1 from a laparotomy for appendicitis. Which intervention best prevents surgical wound infection?

A 9-year-old patient with a history of tachycardia and syncope is connected to a monitor that shows a HR of 190, with regular P-P and R-R intervals. The patient is awake, crying, anxious, and has a BP of 94/60. Which of the following is the initial nursing intervention?

A 3-year-old heart transplant patient is experiencing signs of rejection. Which of the following best supports this?

A 6-year-old child with SIADH was initially treated with a full liquid diet high in sodium. The child is now complaining of headaches, nausea, and muscle cramps. Laboratory results indicate a low sodium level. The revised plan of care should be to:

A child with a right pulmonary contusion is intubated and ventilated. When positioned with the affected side down, O₂ saturation drops. The most likely cause is:

A child with spinal muscular atrophy type I (SMA) is admitted with respiratory syncytial virus (RSV). The child is hypotonic and tachypneic with moderate subcostal retractions and nasal flaring. After suctioning, the child’s respiratory status does not improve. Arterial oxygen saturations are 93% with an FiO₂ of 50%. Which of the following interventions should the nurse anticipate next?

Following placement of a central venous catheter, a mechanically ventilated child develops acute tachycardia, hypotension, and arterial desaturation. A nurse should evaluate the need for:

An infant with acute exacerbation of bronchopulmonary dysplasia (BPD) is placed on mechanical ventilation. The most appropriate ventilator strategy is:

A child with sickle cell anemia develops chest pain, SOB, and tachypnea. What is the most likely diagnosis?

A 3-year-old near-drowning child who is intubated and mechanically ventilated exhibits increased peak inspiratory pressures and decreased O₂ saturation. Stat chest x-ray reveals diffuse pulmonary infiltrates. No improvement is exhibited after an increase in FiO₂. The nurse should suspect:

A child is heading to the OR for internal injuries. The parents refuse blood products due to religious beliefs. What should the nurse do first?