Published - Thu, 23 Feb 2023

NCLEX-RN Exam Questions - Part 109

1. A 4-week-old infant is admitted to the emergency room in respiratory distress. Which of the following statements indicates the nurses knowledge of the anatomy of the respiratory system in pediatric clients?

A) The diameter of the trachea is much smaller in children than in adults.
B) The tongue is proportionally smaller in children than in adults.
C) The pediatric airway is more rigid than that of the adults.
D) The length of the pediatric airway is longer in children than in adults.

2. A 10-year-old has been diagnosed with acute poststreptococcal glomerulonephritis. The clinical findings were proteinuria, moderately elevated blood pressure, and periorbital edema. Which dietary plan is most appropriate for this client?

A) Low-protein diet
B) Low-sodium diet
C) Increased fluid intake
D) High-cholesterol diet

3. A 6-year-old girl has been diagnosed with a urinary tract infection secondary to vesicoureteral reflux. Which statement by her mother indicates a need for further teaching?

A) 'I have taught her to wipe from front to back after urinating.'
B) 'I make sure she drinks plenty of fluids every day.'
C) 'She enjoys wearing nylon panties, but I make her change them everyday.'
D) 'She tries to empty her bladder completely after she urinates, like I told her.'

4. A 1-year-old child is to receive an IM injection ordered by his pediatrician. He has fallen asleep in his mothers arms when the nurse approaches. Which approach is most appropriate at this time?

A) Give the injection in the vastus lateralis site before the child awakens.
B) Awaken the child first and give the injection in the ventrogluteal site.
C) Awaken the child first and give the injection in the dorsogluteal site.
D) Ask the mother to place the child on the examination table and leave the room, and then give the injection in an appropriate site.

5. The physician has ordered that ampicillin 250 mg IV be given over 30 minutes. The medication is diluted as recommended in 10 mL in the volume control chamber of a set that has a tubing of 12 mL. Which nursing measure is most accurate considering these facts?

A) Infuse volume at 44 mL/hr.
B) Infuse volume at 22 mL/hr.
C) Infuse volume at 10 mL/hr.
D) Infuse volume at 30 mL/hr.

1. Right Answer: A
Explanation: (A) The airway in children is much smaller than it is in adults. The diameter of the trachea in the newborn is 4 mm and that of the adult is 20 mm. A small change in the diameter of the airway can make a major difference in the pediatric client. (B) The tongue is proportionally larger in children and fills most of the oral cavity, thereby decreasing air space. (C) The entire pediatric airway is elastic. Elasticity diminishes with age, however. (D) The distances between respiratory structures are shorter than that of adults, and therefore organisms are able to move more rapidly down the throat, leading to more extensive respiratory involvement.

2. Right Answer: B
Explanation: (A) A high-protein diet is usually indicated because protein is excreted in urine. Protein restriction is usually prescribed with severe azotemia. (B) The kidneys usually enlarge in these children, and sodium and water are retained. (C) Fluid restriction may be ordered to help reduce edema; however, monitoring for dehydration is indicated. (D) A high-cholesterol diet would not be indicated for any child, especially one with elevated blood pressure.

3. Right Answer: C
Explanation: (A) Wiping from front to back is wiping from an area of lesser contamination (urethra) to an area of greater contamination (rectum). (B) Generous fluid intake reduces the concentration of urine. (C) Cotton is a natural, absorbent fabric. Nylon often predisposes the client to urinary tract infections. Dark, warm, moist areas are excellent media for bacterial growth. (D) With vesicoureteral reflux, urine refluxes into the ureter(s) during voiding and then returns to the bladder (residual), which becomes a source for future infection.

4. Right Answer: B
Explanation: (A) If awakened first, the child will know that nothing painful will be done without the child being alerted. (B) The ventrogluteal site is a safe site for children because it is a large muscle free of major nerves and blood vessels. (C) The dorsogluteal site is not recommended in children who have not been walking for at least 1 year because the muscle is not fully developed. (D) The parent will be able to offer support and comfort during and after the injection.

5. Right Answer: A
Explanation: (A) The volume to be infused should be diluted medication volume added to the volume control chamber (10 mL) plus the tubing volume (12 mL). The general formula for calculating IV medications for children is: Rate = Volume to Be Infused X Administration Set Drop Factor (microdrop: 60 gtts/min)Desired Time toInfuse in Minutes Rate = (10 + 12)22 X 60 30 = 44 mL/hr. (B, C, D) These values are incorrect.

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