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HC2B UNIT 4 EXAM QUESTIONS AND CORRECT ANSWERS
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A nurse is providing prenatal counseling to a 38-year-old pregnant patient. The patient is concerned about the possibility of her child having Down Syndrome. Which action by the nurse is most appropriate?
**- A. Explain that advanced maternal age is not a significant risk factor.
- B. Discuss the benefits of prenatal diagnostic tests such as amniocentesis.
- C. Advise against prenatal testing due to potential risks to the pregnancy.
- D. Recommend monitoring the child for signs of Down Syndrome after birth. - ANSWER B.**
A newborn is noted to have hypotonia, a single transverse palmar crease, and a small, flat nose. What should the nurse anticipate as the next step in confirming the diagnosis of Down Syndrome?
**- A. Perform a genetic panel to evaluate for chromosomal abnormalities.
- B. Educate the family on supportive care without diagnostic confirmation.
- C. Perform a lumbar puncture to rule out other syndromic conditions.
- D. Start a multidisciplinary care plan based on physical findings alone. - ANSWER A.**
During a routine check-up, the nurse observes that a 2-year-old child with Down Syndrome has signs of a respiratory infection. What should the nurse prioritize in this situation?
**- A. Educating the parents about common childhood respiratory illnesses.
- B. Reviewing the child's immunization record for completeness.
- C. Assessing for cardiac complications commonly associated with Down Syndrome.
- D. Teaching parents the importance of hand hygiene to prevent infections. - ANSWER C.**
A parent of a child with Down Syndrome expresses concern about the child's delayed motor skills. What response by the nurse is most appropriate?
**- A. "Delayed motor skills are uncommon in Down Syndrome."
- B. "Physical therapy may help improve your child's muscle tone and motor abilities."
- C. "These delays will resolve as your child grows older." -** D. "Early intervention programs are not necessary for children with Down Syndrome." - ANSWER B.
The nurse is caring for a 6-year-old with Down Syndrome admitted for leukemia. What is the nurse's priority in planning care? A) Managing the child's nutritional needs due to hypotonia. B) Encouraging social interaction to promote emotional well-being. C) Monitoring for signs of cardiac decompensation. D) Preventing infection during chemotherapy. - ANSWER D.
A nurse is teaching new parents about feeding their newborn with Down Syndrome. What information should be included in the teaching? A) Support the baby's head and neck during feeding due to hypotonia. B) Feed their baby quickly to prevent fatigue. C) Use large feeding utensils to facilitate feeding. D) Avoid specialized feeding techniques as they are unnecessary. - ANSWER A.
A nurse is preparing a presentation on Down Syndrome for a community health fair. Which characteristic is most appropriate to include? A) Advanced verbal skills in childhood. B) Typical life expectancy of less than 20 years. C) Short stature and broad, stubby fingers. D) High susceptibility to autoimmune conditions like lupus. - ANSWER C.
A nurse is educating the parents of a 6-month-old infant diagnosed with RSV. Which statement by the parent indicates the need for further teaching? A) It's okay to give antibiotics to treat RSV because it's a serious infection. B) I should monitor my baby's breathing and notify the doctor if I see rapid breathing or wheezing. C) Normal saline drops and suctioning before feedings can help improve my baby's breathing. D) We should limit visitors while my baby is recovering. - ANSWER A (RSV is a virus).
A 2-month-old premature infant is in the ED with severe RSV. Which finding requires immediate intervention? A) Rhinorrhea and intermittent fever. B) Tachypnea with a RR of 72. C) Diminished breath sounds and cyanosis. D) Intermittent coughing and wheezing. - ANSWER C.
A nurse is reviewing the treatment plan for a 1-year-old hospitalized with RSV. Which order would the nurse question? A) Administer racemic epinephrine as needed for severe respiratory distress. B) Start IV fluids if oral hydration cannot be maintained. C) Begin CPAP therapy for the persistent hypoxia despite oxygen supplementation. D) Administer Ribavirin prophylactically to prevent severe infection. - ANSWER D (Ribavirin is NOT used prophylactically, reserved for high-risk cases).
Which child is at the highest risk for severe RSV infection? A) A 2-month-old born at 28 weeks' gestation, requiring oxygen support after birth. B) A 3-year-old with mild asthma. C) A 10-month-old born at term with no chronic illness. D) A 5-year-old with a history of recurrent ear infections. - ANSWER A.
The nurse is caring for a 6-month-old with RSV who is receiving CPAP via high-flow nasal cannula. What is the nurse's priority when caring for this patient? A) Suctioning the nasal passages every 2 hours. B) Monitoring for skin irritation around the cannula. C) Rotating IV sites. D) Ensuring oxygen saturation remains above 90%. - ANSWER D.
A nurse is preparing discharge teaching for the parents of an infant recovering from RSV. Which statement should the nurse include? A) You can administer over-the-counter cold medications to help with symptoms. B) Your baby may continue coughing from 2-3 weeks after the infection resolves. C) Recurrent infections are unlikely because RSV builds immunity. D) You don't need to suction the baby's nose unless they are actively congested. - ANSWER B.
An infant with RSV is receiving Synagis as part of their care.What is the purpose of this medication? A) To treat the active RSV infection. B) To prevent bacterial co-infections. C) To cure the viral infection by boosting immunity. D) To reduce the severity of symptoms in high-risk infants. - ANSWER D.
A child with RSV is experiencing poor feeding and fatigue. What is the best nursing action? A) Offer small, frequent feedings using a bottle. B) Allow the child to rest without attempting to feed. C) Administer IV fluids to prevent dehydration. D) Encourage oral hydration with an electrolyte solution. - ANSWER C.
A 5-year-old patient presents with mumps. The parent asks how to reduce swelling and pain. What should the nurse recommended? A) Ice packs to the parotid area and NSAIDs. B) Antibiotics and hot packs. C) Massage of the glands and aspirin. D) Warm or cold compresses and analgesics. - ANSWER D.
A child diagnosed with pertussis is in the initial stage of the illness. What is the most appropriate nursing intervention? A) Begin droplet precautions and provide small, frequent fluids. B) Isolate the child using airborne precautions. C) Administer corticosteroids and position the child supine. D) Prepare for intubation and administer antibiotics immediately. - ANSWER A.
A child with measles is exhibiting a persistent cough. Which intervention should the nurse prioritize? A) Provide cold air therapy. B) Restrict fluid intake to reduce coughing. C) Administer cough suppressants as prescribed. D) Discontinue humidified oxygen therapy. - ANSWER C.
A nurse is providing education on the prevention of complications in children with pertussis. What advice is most appropriate for parents? A) Encourage small, frequent meals to prevent dehydration. B) Use over-the-counter cough suppressants for comfort. C) Avoid all vaccinations until illness resolves. D) Minimize fluid intake to reduce coughing. - ANSWER A.
A nurse suspects bacterial infection in the lesions of a child with chickenpox. Which clinical sign would support this suspicion? A) Presence of dry, crusted lesions. B) Red, swollen, and purulent lesions. C) Scattered macular rash over the torso. D) New vesicles forming in clusters. - ANSWER B.
A 7-year-old with mumps is complaining of testicular pain. What complication should the nurse suspect? A) Sterility. B) Aseptic meningitis. C) Encephalitis. D) Orchitis. - ANSWER D.
A child with pertussis is experiencing cyanosis during coughing fits. What is the nurse's priority intervention? A) Administer antipyretics to reduce fever. B) Position the child for optimal oxygenation and apply humidified oxygen. C) Provide small amounts of fluids to prevent dehydration. D) Encourage deep breathing exercises during fits. - ANSWER B.
A parent brings their 4-year-old child to the clinic, reporting that the child has been pulling at their ear and crying inconsolably. Upon assessment, the nurse notes a temperature of 101.5 F and moderate bulging of the tympanic membrane. What is the nurse's priority action? A) Administer acetaminophen for fever. B) Educate the parent about the self-limiting nature of the condition. C) Notify the HCP to prescribe antibiotics. D) Apply warm compress to the ear for pain relief. - ANSWER C.
avoided to prevent bleeding).
A 7-year-old child presents with nasal congestion, a low-grade fever, and fatigue for five days. The parent states that the nasal discharge is now yellow-green. What is the nurse's best response? A) This change indicates a bacterial infection; antibiotics are needed. B) Yellow-green discharge is normal as the cold progresses. C) I will notify the HCP for immediate evaluation. D) You should begin steam inhalation to reduce congestion. - ANSWER B.
A toddler with a suspected case of influenza is brought to the clinic. The parent asks about treatment options. What is the nurse's most appropriate response? A) Your child will need antibiotics to prevent complications. B) We can prescribe antiviral medication if started within 48 hours of symptom onset. C) Influenza resolves on its own, so no specific treatment is needed. D) Cough suppressants should be given to ease breathing issues. - ANSWER B (only effective if started early).
The nurse assesses a child with acute otitis media. Which finding would most likely prompt the nurse to suspect a complication? A) The child is tugging at their ear. B) The child has a fever of 102 F. C) The child has clear fluid draining from the ear. D) The child is irritable and refusing to eat. - ANSWER C (could suggest tympanic membrane perforation).
A nurse is caring for a child diagnosed with viral conjunctivitis. Which action by the parents would indicate the need for further teaching? A) The parents apply warm compresses to the eyes. B) The parents isolate the child's towels and linens.
C) The parents notify the school of the child's condition. D) The parents stop handwashing after symptoms improve. - ANSWER D.
A child with croup is being discharged home. Which discharge instruction is most important for the nurse to provide? A) Keep your child in a warm, humid environment. B) Encourage your child to drink milk to soothe their throat. C) Administer the prescribed corticosteroids for five days. D) Return to the hospital if strider occurs at rest. - ANSWER D.
A 3-year-old child is brought to the ED after being found unconscious. The parent reports the child has no history of health problems and was playing alone prior to the event. On assessment, the child is hypotension and has respiratory depression. Which is the nurse's priority action? A) Administer activated charcoal. B) Perform a thorough physical exam. C) Focus on the child's airway, breathing, and circulation. D) Prepare the child for dialysis. - ANSWER C.
A 15-year-old adolescent presents to the ED with complaints of N/V and abdominal pain. Upon further questioning, the patient admits to recently taking a large number of acetaminophen tablets following an argument with their parents. Which diagnostic test is most important to evaluate liver function? A) ECG. B) Liver function tests. C) Chem panel. D) Urine and blood toxicology screen. - ANSWER B.
A toddler is admitted with suspected poisoning after ingesting an unknown substance at home. The family did not bring any containers or evidence of the substance. What action by the nurse would provide the most information about the substance ingested?
A 6-year-old child with spastic quadriplegic (paralysis of 4 limbs) CP is hospitalized. The parents are concerned about their child's nutritional intake because of difficulty swallowing. Which intervention should the nurse prioritize? A) Recommend the child drink liquids with a straw to strengthen oral muscles. B) Provide meals rich in high-protein and high-calorie foods. C) Collaborate with a dietician and speech therapist to assess swallowing abilities. D) Encourage independent feeding. - ANSWER C.
The parents of a child with CP are learning how to perform passive ROM exercises at home. What is the best instruction the nurse can give to ensure these exercises are done effectively? A) Perform the exercises once daily to prevent muscle stiffness. B) Move each joint slowly to the point of resistance without causing pain. C) Focus only on the affected limbs to conserve energy. D) Use warm compresses before the exercises to reduce spasticity. - ANSWER B.
A 10-year-old with ataxic CP is being prepared for discharge, The nurse plans to provide education about preventing injuries related to balance and depth perception difficulties. What should the nurse include? A) Remove all rugs and keep pathways clear in your home. B) Encourage your child to avoid climbing stairs whenever possible. C) Ensure your child wears a helmet when walking outdoors. D) Limit your child's physical activities to reduce fall risks. - ANSWER A.
During a health check-up, a parent of a child with CP asks why their child often seems frustrated when communicating. What is the best response by the nurse? A) Your child may have difficulty with speech, which can cause frustration. B) CP does not typically affect communication skills. C) Your child needs more patience from caregivers during conversations.
D) This frustration indicates your child may need more intensive therapy. - ANSWER A.
A 4-year-old child with dyskinetic CP has abnormal involuntary movements. Which medication is most likely to be included in their care plan to help manage this condition? A) Baclofen (Lioresal). B) Diazepam (Valium). C) Botulinum toxin (Botox). D) Levetiracetam (Keppra). - ANSWER B.
A parent of a child with CP asks the nurse how they can help their child interact with peers at school despite mobility limitations. What recommendation should the nurse make? A) Request a one-on-one aide to assist your child in school. B) Encourage activities that focus on the child's strengths, such as art or storytelling. C) Avoid social situations where the child may feel overwhelmed. D) Arrange for physical therapy sessions during school hours. - ANSWER B.
The nurse is educating a family about early signs of CP. Which statement indicates a need for further teaching? A) Our baby isn't crawling yet, but they can roll over easily. B) We noticed our baby has stiff muscles and clenched fists most of the time. C) Our baby is showing unusually movements and poor balance when sitting. D) We think our baby will grow out of these symptoms with time. - ANSWER D.
A 12-year-old child with CP uses a wheelchair. The nurse observes redness over the child's sacral area during a routine exam. What is the priority nursing intervention? A) Encourage the child to reposition themselves every hour. B) Apply a barrier cream to the sacral area. C) Assess the child's current seating support and cushion.
C) Educate the patient about Turing using the log roll technique. D) Explain how to administer pain medications at home. - ANSWER C.
A nurse is caring for a post-op patient who had spinal fusion surgery for scoliosis. The patient reports severe pain. What is the nurse's best initial action? A) Encourage the patient to perform deep breathing exercises. B) Administer prescribed pain medications. C) Notify the surgeon immediately. D) Reposition the patient using the log roll technique. - ANSWER B.
During a follow-up visit, a 16-year-old male reports wearing his scoliosis brace for 8 hours daily instead of the prescribed 13-18 hours. What is the nurse's best response? A) Wearing the brace less than the recommended time may not prevent progression of the curve. B) Your current wearing time is sufficient. C) You should increase your wearing time gradually to avoid discomfort. D) Let's talk to your doctor about discontinuing the brace. - ANSWER A.
A school nurse is educating a group of parents about scoliosis screening. Which statement by a parent indicates understanding? A) Boys are usually screened between 10-12 years of age. B) Screening involves an x-ray to detect the curvature of the spine. C) My child's scoliosis will be corrected through bracing. D) Screening requires the child to bend forward at the waist. - ANSWER D.
A 12-year-old patient with scoliosis has been fitted for a brace. What nursing diagnosis is the priority for this patient? A) Risk for impaired skin integrity. B) Risk for activity intolerance.
C) Risk for ineffective airway clearance. D) Risk for disturbed body image. - ANSWER A.
A nurse is assessing a 14-year-old patient with a suspected case of scoliosis. Which finding would confirm this diagnosis? A) Shoulder and hip asymmetry with a curvature of 8 degrees. B) Mild back pain with normal physical results. C) Even waistline and pelvic alignment on radiographs. D) Rib hump on one side when the patient bends forward. - ANSWER D.
A nurse is caring for a patient after spinal fusion surgery. Which intervention should the nurse prioritize? A) Encourage ambulation as soon as the patient wakes up. B) Conduct hourly neuromuscular checks. C) Ensure the patient wears a brace 13-18 hours daily post-op. D) Monitor for signs of infection at the surgical site. - ANSWER B.
The parents of a 10-year-old boy with scoliosis ask the nurse if there are any activities their son should avoid while wearing the brace. What is the nurse's best response? A) He can engage in any activity as long as he wears the brace. B) He should avoid all physical activities, including sports. C) He can remove the brace for sports or other physical activities. D) He should only remove the brace for bathing. - ANSWER C.
A 4-year-old is brought to the clinic by their parents. During the assessment, the nurse uses the Wong-baker faces pain scale. The child selects the face indicating severe pain. What is the next best step for the nurse? A) Administer the prescribed pain medication immediately. B) Document the pain level and inform the parents.
C) 89% on oxygen at 2 L/min. D) 94% on oxygen at 1 L/min. - ANSWER C.
A 3-year-old is in the clinic for a routine physical. The parent expresses concern that the child "always asks why" during conversation. How should the nurse respond? A) It is a normal part of cognitive development at this age. B) It may indicate a lack of discipline at home. C) Your child may be behind in language development. D) Let's schedule a referral to a child psychologist. - ANSWER A.
A nurse is examine the abdomen of a 5-year-old. What sequence of steps should the nurse follow? A) Palpation, auscultation, inspection. B) Auscultation, inspection, palpation. C) Inspection, palpation, auscultation. D) Inspection, auscultation, palpation. - ANSWER D.
The nurse observes a toddler playing with a stethoscope during the exam. What is the primary reason for allowing this behavior? A) It reduces the child's fear of the equipment. B) It distracts the child from the procedure. C) It demonstrates the correct use of the stethoscope. D) It keeps the child entertained while the nurse works. - ANSWER A.
During a clinic visit, a nurse notes that a 6-month-old has a head circumference in the 98th percentile. What is the most appropriate next action? A) Reassess the head circumference in one month. B) Compare measurement to previous visits.
C) Notify the provider immediately for further evaluation. D) Ask the parent about the infant's feeding schedule. - ANSWER B.
A 13-year-old arrives at the clinic for a sports physical. The nurse notices that the adolescent hesitates to answer questions about alcohol and drug use. What should the nurse do? A) Encourage the parent to leave the room. B) Assume there is no alcohol or drug use since the patient is hesitant. C) Direct the questions to the parent for verification. D) Document that the patient refused to answer. - ANSWER A.
A nurse is preparing to administer the first dose of the Hep B vaccine to a newborn in the hospital. The mother has tested positive for Hep B during pregnancy. What is the nurse's priority action? A) Administer the Hep B vaccine only. B) Administer the Hep B immune globulin (HBIG) only. C) Delay the vaccine until the infant is 2 months old. D) Administer both the Hep B vaccine and HBIG at separate sites. - ANSWER D.
A mother brings her 15-month-old child to the clinic for their routine immunizations. Which vaccines are appropriate for this visit? A) DTAP, MMR, and Rotavirus. B) MMR, Varicella, and Hib. C) IPV, PCV, and Rotavirus. D) Varicella, DTAP, and Hep B. - ANSWER B.
A nurse is educating parents about the DTAP vaccine. Which statement indicates the need for further teaching? A) The vaccine protects against tetanus, which is caused by bacteria in soil. B) Our child will receive this vaccine as part of the 2, 4, and 6 month shots.
