Nursing Quiz NCLEX RN with Answer and Rationale 22th Edition 2019 / 2020 / 2021 - NCLEX Exam Nursing Quiz NCLEX RN with Answer and Rationale 22th Edition 2019 / 2020 / 2021 - NCLEX Exam

Nursing Quiz NCLEX RN with Answer and Rationale 22th Edition 2019 / 2020 / 2021

Nursing Quiz NCLEX RN with Answer and Rationale 22th Edition 2019 / 2020 / 2021 (Child Health)


Nursing Quiz NCLEX RN with Answer and Rationale 22th Edition 2019 / 2020 / 2021
Nursing Quiz NCLEX RN with Answer and Rationale 22th Edition 2019 / 2020 / 2021 (Child Health)


1. A mother of a child who underwent a myringotomy with insertion of tympanostomy tubes calls the nurse and reports that the child is complaining of discomfort. The nurse tells the mother to:

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A. Give the child “children’s aspirin” for the discomfort
B. Give the child acetaminophen (Tylenol) for the discomfort
C. Speak to the physician because the child should not be having any discomfort
D. Be sure that the child is resuming normal activities

Answer: B. Give the child acetaminophen (Tylenol) for the discomfort

Rationale: Following myringotomy with insertion of tympanostomy tubes, the child may experience some discomfort. Acetaminophen can be given to relieve the discomfort. Aspirin should not be administered to the child. The child should rest if discomfort is present.

Test-Taking Strategy: Use the process of elimination. Options 1 and 4 can be eliminated by knowing that aspirin should not be given to a child and that the child should rest if discomfort is present. It seems reasonable that the child may have some discomfort following this surgical procedure; therefore eliminate option C. Review home care instructions for the child following this procedure if you had difficulty with this question.

Level of Cognitive Ability: Application
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Implementation
Content Area: Child Health
References:
  • McKinney, E., James, S., Murray, S., & Ashwill, J. (2005). Maternal-child nursing (2nd ed.). St. Louis: Elsevier, p. 1199.
  • Price, D., & Gwin, J. (2005). Thompson’s pediatric nursing (9th ed.). Philadelphia: W.B. Saunders, p. 136.



2. A nurse provides discharge instructions to the mother of a child who had a myringotomy with insertion of tympanostomy tubes. Which statement by the mother indicates a need for further instructions?

A. “I need to be sure my child uses soft Kleenex to blow his nose.”
B. “I will put earplugs in my child’s ears during bathing.”
C. “I will not allow my child to swim in deep water.”
D. “I will not allow my child to swim in lake water.”

Answer: A. “I need to be sure my child uses soft Kleenex to blow his nose.”

Rationale: Parents need to be instructed that the child should not blow their nose for 7 to 10 days. Bath water and lake water are potential sources of bacterial contamination. Diving into water and swimming deeply under water are prohibited. The child’s ears need to be kept dry. Options 2, 3, and 4 are appropriate statements.

Test-Taking Strategy: Use the process of elimination and note the key words need for further instructions. These words indicate a false response question and that you need to select the incorrect client statement. Options 2, 3, and 4 are similar, and all relate to the concept of keeping the ears dry. Option 1 may cause disruption of the surgical site. Review parent instructions following this procedure if you had difficulty with this question.

Level of Cognitive Ability: Comprehension
Client Needs: Physiological Integrity
Integrated Process: Teaching/Learning
Content Area: Child Health
Reference: McKinney, E., James, S., Murray, S., & Ashwill, J. (2005). Maternal-child nursing (2nd ed.). St. Louis: Elsevier, p. 1199.



3. A nurse is reviewing the laboratory results of a child scheduled for a tonsillectomy. Which laboratory value would be most significant to review?

A. Platelet count
B. Urinalysis results
C. Blood urea nitrogen (BUN) level
D. Creatinine level

Answer: A. Platelet count

Rationale: Before the surgical procedure, the child is assessed for signs of active infection and for redness and exudate of the throat. Because the tonsillar area is extremely vascular, postoperative bleeding is a concern. The prothrombin time (PT), partial thromboplastin time (PTT), platelet count, hemoglobin and hematocrit (H&H) levels, white blood cell (WBC) count, and urinalysis studies are performed preoperatively. The platelet count result would identify a potential for bleeding. The BUN and creatinine values would not determine the potential for bleeding; instead, they would evaluate renal function.

Test-Taking Strategy: The issue of the question relates to the potential for bleeding. Options 2, 3, and 4 can be eliminated because they are similar and relate to kidney function. Review preoperative care for a tonsillectomy if you had difficulty with this question.

Level of Cognitive Ability: Analysis
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Data Collection
Content Area: Child Health
Reference: McKinney, E., James, S., Murray, S., & Ashwill, J. (2005). Maternal-child nursing (2nd ed.). St. Louis: Elsevier, p. 1202.



4. Following a tonsillectomy, which of the following physician orders would the nurse question?

A. Allow clear, cool liquids when awake
B. Allow ice cream when awake
C. Monitor for bleeding
D. Monitor vital signs

Answer: B. Allow ice cream when awake

Rationale: Clear, cool liquids are encouraged. Milk and milk products are avoided initially because they coat the throat, induce throat clearing, and increase the risk of bleeding. Options 3 and 4 are important nursing interventions following any type of surgery.

Test-Taking Strategy: Note the key words would the nurse question. These words indicate a false response question and that you need to select the questionable physician’s order. Consider the anatomical location of the surgery to assist in answering the question. This should direct you to option B. Review postoperative care following a tonsillectomy if you had difficulty with this question.

Level of Cognitive Ability: Analysis
Client Needs: Safe, Effective Care Environment
Integrated Process: Nursing Process/Implementation
Content Area: Child Health
References:
  • Leifer, G. (2003). Introduction to maternity & pediatric nursing (4th ed.). Philadelphia: W.B. Saunders, p. 599.
  • McKinney, E., James, S., Murray, S., & Ashwill, J. (2005). Maternal-child nursing (2nd ed.). St. Louis: Elsevier, pp. 1202-1203.



5. A nurse is monitoring a child following a tonsillectomy. Which finding may indicate that the child is bleeding?

A. A decreased pulse rate
B. An elevation in blood pressure (BP)
C. Complaints of discomfort
D. Restlessness

Answer: D. Restlessness

Rationale: Frequent swallowing, restlessness, a fast and thready pulse, and vomiting bright red blood are signs of bleeding. An elevated BP is not an indication of bleeding. Complaints of discomfort are an expected finding following a tonsillectomy.

Test-Taking Strategy: Use the concepts related to the signs of shock to assist in answering the question. These concepts should assist in eliminating options 1 and B. From the remaining options, knowing that discomfort does not indicate bleeding will direct you to option D. Review the signs of postoperative bleeding if you had difficulty with this question.

Level of Cognitive Ability: Analysis
Client Needs: Physiological Integrity
Integrated Process: Nursing Process/Data Collection
Content Area: Child Health
Reference: McKinney, E., James, S., Murray, S., & Ashwill, J. (2005). Maternal-child nursing (2nd ed.). St. Louis: Elsevier, pp. 1202-1203.



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