Published - Thu, 23 Feb 2023

NCLEX-RN Exam Questions - Part 80

1. A child receiving chemotherapeutic drugs experiences a loss of appetite directly related to the therapy. Which of the following strategies should be most effective in encouraging the child to eat?

A) Provide a well-balanced diet at usual times, and restrict dessert if the child fails to eat well.
B) Schedule procedures immediately after eating so that the child will not be tired or in pain at mealtime.
C) Offer the child a diet with a wider variety of foods and with more seasoning than her usual diet.
D) Offer the child smaller meals more frequently than usual, and include as many of her favorite foods as possible.

2. The parents of a 2-year-old child are ready to begin toilet training activities with him. His parents feel he is ready to train because he is now 2 years old. What would the nurse identify as readiness in this child?

A) Patience by the child when wearing soiled diapers
B) Communicating the urge to defecate or urinate
C) The child awakening wet from his naps
D) The age at which the child - s siblings were trained

3. A 5-year-old child is hospitalized for an acute illness. The nurse encourages the family to bring her favorite objects from home. What is the nurse - s rationale?

A) To reduce fear of the unknown
B) To keep the child calm
C) To establish a trusting relationship
D) To prevent or minimize separation anxiety

4. A 3-year-old child was hospitalized for acute laryngotracheobronchitis. During her hospitalization, the child was placed under an oxygen mist tent. The nurse - s frequent monitoring of the child - s temperature frightened her parents. Which response by the nurse would be most appropriate?

A) Monitoring the temperature prevents undue chilling.
B) Rapid temperature elevations can occur in children.
C) Checking the temperature will prevent febrile seizures.
D) Taking the child - s temperature can prevent airway obstruction.

5. A school-age child with asthma is ready for discharge from the hospital. His physician has written an order to continue the theophylline given in the hospital as an oral home medication. Immediately prior to discharge, he complains of nausea and becomes irritable. His vital signs were normal except for tachycardia. What first nursing actions would be essential in this situation?

A) Hold the child - s discharge for 1 hour.
B) Notify the physician immediately.
C) Discharge the child as the physician ordered.
D) Administer an antiemetic as necessary.

1. Right Answer: D
Explanation: (A) Because the childs appetite is capricious at best, regular servings may be overwhelming. Praise the child for what is eaten. (B) The child will soon learn that procedures follow meals and may play with food rather than eat it to avoid or delay the procedure. (C) Young children usually do not like highly seasoned foods and may need the security of usual foods. Such a change may actually increase anorexia. (D) Small servings appear more achievable to the child, and the inclusion of favorite foods can add a sense of security.

2. Right Answer: B
Explanation: (A) Children experience impatience with soiled diapers when readiness for training is apparent. They often desire to be changed immediately. (B) A child must be able to use verbal or nonverbal skills to communicate needs. (C) A readiness indicator would be awaking dry from naps. (D) The age at which a sibling was toilet trained has no implications for training this child.

3. Right Answer: D
Explanation: (A) Objects from home do not reduce fear of the unknown. Children need explanations, reassurance, and preparation for the unknown. Also, parental presence can promote comfort and feelings of security. (B) A calm, relaxed, and reassuring manner will assist in calming the child. The childs objects from home will not assist in calming the child. (C) A trusting relationship is based on the quality of the nurse-client relationship. Objects from home have no impact. (D) Favorite objects from home assist in creating a familiar setting. Also, these objects may prevent or minimize separation from the childs usual routine and family support.

4. Right Answer: A
Explanation: (A) The refrigerated cool mist tent creates a cool, moist environment. The child as well as bedding and clothing may become dampened. Monitoring the temperature of the child will ensure warmth and prevent chilling. (B) Only a low-grade fever is expected in laryngotracheobronchitis. (C) Febrile seizures are not expected with the low-grade fever. (D) Inflammation of the mucosal lining in the respiratory tract can cause airway obstruction. However, monitoring the childs temperature would not prevent airway obstruction.

5. Right Answer: B
Explanation: (A) Holding the childs discharge alone does not address the clients problem. (B) Nausea, tachycardia, and irritability are all symptoms of theophylline toxicity. The physician should benotified immediately so that a serum theophylline level can be ordered. Theophylline dose should be withheld until the physician is notified. (C)The child must be evaluated for theophylline toxicity before any discharge. (D) Cause of the nausea should be investigated before the administration of an antiemetic.

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