ACCS Pediatric Home Health Test
1. A three-month old infant is monitored for increased intracranial pressure. It's noted that the anterior fontanel hasn't closed and is soft and flat. Which action should you take?
A. Document the findings
B. Elevate the head of the bed to 90 degrees
C. Notify the doctor
D. Increase oral fluids
2. An infant has bronchiolitis and is monitored for signs of dehydration. Choose the best method to determine fluid loss.
A. Monitoring for dry mucous membranes
B. Monitoring for sunken fontanel
C. Monitoring I&O
D. Monitoring body weight
3. Which medication should be administered first to a child who had an acute asthma attack in a home care setting?
A. IV corticosteroid
B. A bronchodilator via nebulizer
C. Subcutaneous epinephrine
D. Subcutaneous terbutaline
4. What position should a mother position her new infant for sleeping to prevent SIDS?
A. The infant should be placed on its back.
B. The infant should be placed on its side or on the stomach.
C. The infant should be placed on its side or prone.
D. The infant should be placed on its side or stomach with the face turned.
5. Monitoring a pediatric client for volume deficit you know that the fluid volume is for:
A. Each gram of diaper weight is equivalent to 1mL of urine
B. Each gram of diaper weight is equivalent to 0.5mL of urine
C. Each gram of diaper weight is equivalent to 2mL of urine
D. Each gram of diaper weight is equivalent to 2.5mL of urine
6. Feeding instructions for your pediatric client with gastroesophageal reflux (GER) to reduce episodes of emesis include:
A. Provide less frequent, larger feeding
B. Burp less frequently during feeding
C. Thicken the feedings by adding rice cereal to the formula
D. Thin the feedings by another water to the formula
7. Choose the most appropriate method to collect a urine sample from an eight-month old infant.
A. Attach a urinary collection device to the infant's perineum
B. Obtain the specimen from the diaper, using a syringe, after the infant voids.
C. Catheterize the infant, using a No. 5 French Foley
D. Monitor the urinary patterns and prepare to collect the specimen into a cup when the infant voids
8. One of the following statements is included in a teaching session for acquired immunodeficiency syndrome (AIDS). Choose the correct answer.
A. HIV primarily attacks the hematological system
B. Newborns of HIV-positive women test positive for the HIV virus
C. The virus attacks the immune system by destroying T lymphocytes
D. The B cells are depleted and cannot signal T4 cells to form protective antibodies
9. An HIV infected child is receiving zidovudine (AZT, Retrovir). Select the laboratory study that would indicate that the child is experiencing a positive reaction to this treatment.
A. T-cell count
B. Calcium level
C. Potassium level
D. Sedimentation rate
10. The safe pediatric dosage of the Phenobarbarbital sodium (Luminal Sodium) Medication is 1 to 6 mg/kg/day. The nurse determined that this prescribed medication dosage of 25 mg PO BID, for child with febrile seizures and weighs 7.2 kg is:
A. There isn't enough information to determine the safe dose
B. The dose is within the safe range
C. The dose too low
D. The dose is too high
11. Determine how many milliliters will be administered to a child prescribed to receive Cloxacillin (Tegopen) at 100 mg PO QID. The medication label shows: 125 mg per 5mL.
A. 4 mL
B. 2 mL
C. 7 mL
D. 6 mL
12. A child with an infection has been prescribed penicillin G procaine (Wycillin), 1,000,000 U IM. The medication label shows: 1,200,000 U per 2 mL. What is the milliliter amount to administer per dose?
A. 1.44 mL
B. 1.2 mL
C. 1.66 mL
D. 0.8 mL
13. Acetaminophen (Tylenol) liquid, 450 mg PO every 4 hours PRN, is ordered for pain relief. The medication label shows: 160 mg/5mL. How many milliliters will be administered for one dose?
A. 14 mL
B. 10 mL
C. 5 mL
D. 0.1 mL
14. Your 5 yr old patient with cerebral palsy has not voided in 4 hours what action do you take?
A. Palpate the patient's bladder for distention
B. Catheterize the patient immediately
C. Do nothing
D. Push fluids
15. While assessing the skin of your wheelchair dependent 13 year old patient, you notice a reddened area on her right hip. What action do you take?
A. You will turn her very two hours while in bed and instruct her to do pressure releases every 10 minutes while up in the chair
B. Do nothing; this is normal
C. Call the doctor for wound care orders
16. The best time to perform a skin assessment on your pediatric client is:
A. While the patient is up in a chair
B. While the patient is lying in bed watching TV
C. During the patient's bath
D. After a heavy meal
17. When suctioning your pediatric patient with a tracheostomy you should:
A. Suction as deep as you can
B. Suction only to the end of the cannula
C. Apply suction while inserting the suction catheter into the cannula
D. None of the above
18. Which of the following is a sign of respiratory infection?
A. Thick white secretions
B. Thin clear secretions
C. Copious amounts of secretions
D. Thick green tinged, foul-smelling secretions
19. What is the importance of providing humidification in a person with an artificial airway?
A. To keep the patient hydrated
B. To prevent consolidation of secretions in the airway
C. To keep the CO2 levels within normal limits
20. Which of the following are indications for suctioning a patient with a trach?
C. Wet breathing sounds
E. All of the above
21. A tracheotomy change should be done using:
A Sterile technique
B. Clean technique
C. However the client likes it
22. While documenting the care of your home health client you realize you did not document some important observations during your shift yesterday. What action do you take?
A. You rewrite yesterday's note, discarding the original
B. Include yesterday's information in today's note
C. Document the information in a dated addendum
D. Write "error" and initial after drawing a line through the note
23. Nurses completing incident reports following medication errors should be sure to do all of the following except:
A. Notify the physician
B. Correct the error
C. Notify the supervisor
D. Document in the note that an incident report was filed
24. Which of the following observations would indicate that the nurse should withhold a tube feeding>
A. Oozing at the gastrostomy tube site
B. Absence of a gag reflex
C. Presence of more than 100 ml of residual feedings
D. Absense of residual feeding
25. What intervention can a nurse take with a 2yr old client with a g-tube who continues to pull at the tube
A. Apply tape encircling the child abdomen
B. Smack the child's hand when he pulls at the tape
C. Dress the child in "onesies" that snap between the legs to limit access to the tube when not in use
D. Do nothing; this will cause no harm.
26. Before beginning a tube feeding via an NG tube in your 1 year old client the nurse should:
A. Check placement by instilling 10cc of air into the tube and listening for the sound of air in the stomach
B. Check placement by instilling 2 cc of air into the tube and listening for the sound of air entering the stomach
C. Check placement by instilling 2 cc of feeding and listening for the sound of fluid entering the stomach.
27. Your pediatric client has a low grade fever of 100.5, is pulling at her right ear, is refusing her bottle, and is irritable. You call the doctor because you suspect:
A. Otitis media
28. Your client is admitted to the hospital with RSV. Which of the following is appropriate teaching for the family?
A. RSV is a bacterial infection of the lungs that only affects children under 1 year old
B. Only children with impaired respiratory systems get RSV
C. RSV is a viral infection that is highly contagious and usually affects adults with cold like symptoms, but can cause more severe symptoms in young children
29. When assessing the respiratory rate of a 10 month old infant:
A. Count for 15 seconds and multiply by 4
B. Count for one full minute
C. Note that a rate of 72 is normal
D. Note that a rate of 16 is normal
30. Your pediatric client is having a grand mal seizure. You:
A. Place pillows around the client to ensure his safety from furniture in the room
B. Make note of how long the seizure lasts
C. Note what parts of the body are affected
D. All of the above
31. The same client in question 30 has stopped seizing. What is your first priority?
A. Call the physician to report the seizure
B. Alert the mom
C. Ensure that the patient has an open airway
D. Document your observations
32. Your 10 year old cerebral palsy patient has blood in her diaper (no stool is present). What action do you take?
A. Call the doctor immediately.
B. Note that this may be her first menstrual cycle, document findings, and inform parents.
C. Take a urine sample to the lab
33. A toddler is taking an anti-hypertention medication. What B/P reading would alarm you?
34. Your 6 month old client has RSV. The best way to prevent the spread of the infection is:
A. Wear a mask while in the home
B. Use thorough handwashing
C. Wear gown upon entering the home
35. During a g-tube change you meet resistance when inserting the new tube. What actions do you take first?
A. Push harder--the tube will fit.
B. Retry gently
C. Call the physician
D. Place gauze over the stoma and document your findings for the next nurse to follow up
36. The best way for a nurse to develop a good relationship with a client's family is by:
A. Avoid eye contact whenever possible
B. Answer their questions honestly
C. Refer all questions to the doctor
Keep away from the child's room so you perform the care that is needed
37. What is a nurse's legal responsibility for reporting suspected child abuse or neglect?
A. None, this is the responsibility of the doctor
B. The nurse must report to the doctor
C. None, the nurse can be sued if the finding is unfounded
D. Nurses must report all suspected and confirmed abuse or neglect
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