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Quiz Session - Attempts With Random Questions

PNCB CPN Exam Questions

Page 3 of 20

41.

A nurse is creating a care plan for a 4-year-old child who recently immigrated from Vietnam and speaks limited English. To best meet the child's cultural needs, the nurse should consider including which of the following in the care plan?

  • Arrange for a Vietnamese interpreter for communication

  • Speak slowly and use simple English phrases

  • Encourage the family to learn basic English phrases

  • Limit interactions that are not medically necessary to reduce stress

Correct answer: Arrange for a Vietnamese interpreter for communication

Arranging for an interpreter ensures effective communication, which is crucial for understanding medical information, making informed decisions, and providing comfort to the child and family.

Speaking slowly in simple English does not fully address the communication barrier if the child and family are not proficient in English. Encouraging the family to learn English does not provide an immediate solution to the language barrier and places unnecessary pressure on the family. Limiting interactions with the family can limit their understanding of and involvement in the patient's care, which can negatively affect outcomes.

42.

What advice should a pediatric nurse offer to parents of a 6-year-old who spends considerable time playing video games?

  • Recommend balancing screen time with physical outdoor play.

  • Encouraging video game time can help improve hand-eye coordination.

  • Advise them to restrict all video game activity.

  • Suggest increasing video game difficulty to challenge the child mentally while also disincentivizing overuse.

Correct answer: Recommend balancing screen time with physical outdoor play.

Recommending a balance between screen time and physical play addresses the risks of excessive sedentary activity and promotes a healthier lifestyle. This approach helps in developing a routine that includes both physical and mental stimulation.

While video games can improve hand-eye coordination, promoting them without limits does not address the potential negative effects of excessive screen time, such as decreased physical activity and social interaction. Completely restricting video game activity can be impractical and may not address the underlying issue of finding a healthy balance. It could also lead to resistance from the child. Increasing the difficulty of video games does not address the core issue of excessive screen time and can lead to frustration and further sedentary behavior, which is not beneficial.

43.

A nurse is providing guidance to parents of a 3-year-old about preparing for preschool. What skill is important for the child to develop?

  • Dressing independently

  • Being able to write their name

  • Using scissors with precision

  • Performing basic addition

Correct answer: Dressing independently

Dressing independently is an important skill for a 3-year-old to develop in preparation for preschool, as it promotes self-care abilities and independence. Dressing independently is also a skill that a 3-year-old should be capable of developing at this age.

Being able to write their name is not a crucial preparatory skill for preschool, as many children at this age are still developing fine motor skills. Using scissors with precision is not expected at this age; it is a skill that typically develops later in preschool years. Performing basic addition is an advanced cognitive skill that should not typically be expected from a 3-year-old entering preschool.

44.

A pediatric nurse is caring for an 8-year-old child who is experiencing pain following a tonsillectomy. Given the child’s difficulty swallowing pills, what is the best pharmacologic intervention to manage pain?

  • Administer liquid acetaminophen

  • Administer IV medications until the patient can swallow comfortably

  • Give ibuprofen micro-tablets with sips of water

  • Provide a topical anesthetic spray for the throat prior to taking medications

Correct answer: Administer liquid acetaminophen

Liquid acetaminophen is easy to swallow and effective for managing pain in children who have difficulty with pills, directly addressing pain while considering the child's ability to swallow.

IV medication is more invasive and typically reserved for cases where oral medication is not possible or effective. Micro-tablets still involve swallowing, which might be painful or difficult post-tonsillectomy. Additionally, ibuprofen is not typically manufactured or dispensed as micro-tablets. Topical anesthetic sprays can help with swallowing discomfort but do not provide sustained pain relief like systemic medications.

45.

A pediatric patient is being discharged home from the hospital after an asthma exacerbation. Which of the following is most important for the nurse to ensure before discharge?

  • The family has written instructions on managing asthma triggers

  • The child’s siblings and parents have all participated in asthma education

  • The family has scheduled a follow-up appointment within six months

  • The parents can teach back the rationale for avoiding physical activity

Correct answer: The family has written instructions on managing asthma triggers

Ensuring that the family has written instructions on managing asthma triggers empowers them to prevent future exacerbations and is essential for effective home management.

While education for the entire family is beneficial, it is not as immediately critical as having clear, written instructions for managing triggers that can cause asthma attacks. Scheduling a follow-up appointment is important but secondary to immediate and effective management of the child’s condition at home. Avoiding physical activity might be relevant advice in some situations but is not typically recommended. Understanding how to manage triggers is more important for preventing exacerbations.

46.

A 14-year-old patient presents in the clinic with dilated pupils, increased agitation, and excessive sweating. What is the most likely cause of these symptoms?

  • Opioid withdrawal

  • Diabetic ketoacidosis

  • Hypothyroidism

  • Chronic stress disorder

Correct answer: Opioid withdrawal

Opioid withdrawal symptoms typically include pupil dilation, increased agitation, and excessive sweating as the body reacts to the absence of opioids it has become dependent on. These signs are reflective of the sympathetic nervous system's overactivity during withdrawal.

Diabetic ketoacidosis primarily presents with symptoms such as excessive thirst, frequent urination, nausea, and deep, rapid breathing, rather than dilated pupils or agitation, making it a poor explanation of this patient’s symptoms. Hypothyroidism typically leads to symptoms like fatigue, weight gain, and cold intolerance, not the symptoms of dilated pupils and increased agitation which are more characteristic of a hypermetabolic state. Chronic stress disorder may cause agitation but does not typically lead to physical symptoms like dilated pupils and excessive sweating, which are more indicative of acute physiological distress or withdrawal.

47.

A 6-year-old child with developmental delays is not receiving any structured support. What should the pediatric nurse suggest to the parents?

  • Recommend local early intervention services for professional support

  • Refer the child to a specialist for an updated assessment

  • Encourage the parents to teach the child at home using online resources

  • Emphasize the importance of receiving structured support and the parent’s role in this process

Correct answer: Recommend local early intervention services for professional support

Recommending local early intervention services provides professional support tailored to children with developmental delays, offering specialized assessments and interventions. This approach ensures that the child receives the appropriate guidance and support to maximize their developmental potential.

While an updated assessment by a specialist could be helpful, it does not provide the ongoing support and structured interventions that early intervention services can offer. Encouraging parents to teach their child at home using online resources might not be effective without professional guidance, as developmental delays often require specialized approaches. Emphasizing the importance of structured support without providing a specific resource does not directly help the parents access the necessary services, which is critical for addressing developmental delays.

48.

In preparing to administer intravenous antibiotics to a 2-year-old child with severe pneumonia, which equipment is critical to ensure the safe delivery of the medication?

  • Infusion pump

  • Nebulizer

  • Ventilator

  • A rapid infuser

Correct answer: Infusion pump

An infusion pump is critical for delivering precise doses of intravenous antibiotics, essential in treating severe pneumonia in young children to ensure the medication is administered safely and effectively.

A nebulizer is used for administering aerosolized medications primarily for respiratory conditions, not for intravenous antibiotics. A ventilator assists with breathing and would not be used to administer intravenous medication. A rapid infuser is used for quick delivery of large volumes of fluids and is not typically used for controlled, precise medication doses in pediatric settings.

49.

To create a care plan for a teenager who has experienced trauma, which approach best embodies the principle of trustworthiness and transparency?

  • Include the teen in discussions about their care plan options and next steps

  • Focus on informing the teen’s guardians to facilitate a collaborative approach

  • Decide on the care plan with the healthcare team then explain it to the teen and their family

  • Starts by providing advice to the teen about coping strategies

Correct answer: Include the teen in discussions about their care plan options and next steps

Involving the teen directly in discussions about their care promotes an atmosphere of trust and transparency, key components of trauma-informed care. This approach ensures the teen feels valued, heard, and involved in decisions affecting their health and well-being.

Focusing solely on informing the guardians can undermine the teen’s sense of autonomy and trust, potentially making them feel excluded from important decisions about their health care. Deciding on the care plan without initial input from the teen does not support the principles of trustworthiness or transparency, as it fails to engage the teen as an active participant in their care. Providing advice does not primarily focus on involving the teen in the planning process, which is essential for fostering trust and transparency.

50.

A 15-year-old adolescent with a history of asthma and anxiety is being evaluated in an outpatient clinic. Which aspect of the adolescent's environment is most crucial to assess for potential triggers of their conditions?

  • Bedroom setting for allergens

  • Foods offered at school and at home

  • Type of paint or paper used in the patient’s bedroom

  • Hygiene of the patient’s peers

Correct answer: Bedroom setting for allergens

Assessing the bedroom setting for allergens is crucial for an adolescent with asthma, as common triggers like dust mites, pet dander, and mold can significantly exacerbate symptoms. This environment is also a place where the adolescent spends a considerable amount of time, increasing the potential impact the environment could have on affecting sleep quality and overall health.

While dietary triggers could sometimes play a role in asthma and anxiety, the bedroom environment directly impacts respiratory health more significantly through potential exposure to allergens during sleep. The type of paint or wallpaper used may contribute to environmental triggers but is less likely to be a primary concern compared to the presence of allergens in the bedroom. The hygiene of peers, while relevant in a broader social context, is less critical than the bedroom environment for triggering asthma symptoms directly.

51.

A nurse is preparing a 10-year-old for an IV insertion. Which technique is best to help reduce the child’s anxiety and discomfort?

  • Use a guided imagery technique where the child imagines being on a relaxing beach

  • Tell the child to look away and stay as still as possible

  • Avoid discussing potential pain to avoid anticipation and potential heightening of the pain

  • Explain that moderate pain will be present for up to five minutes

Correct answer: Use a guided imagery technique where the child imagines being on a relaxing beach

Guided imagery is an effective distraction technique that helps reduce anxiety by focusing the child's attention away from the IV insertion to a pleasant and relaxing scenario.

Simply telling the child to look away does not address the anxiety or discomfort they might feel, as it lacks an active distraction or coping mechanism. Not discussing potential pain may actually increase anxiety as it leaves the child unprepared for what to expect, potentially heightening their surprise and sensitivity to any pain. Explicitly stating that pain will last up to five minutes can increase anxiety and anticipation of pain, making the experience more stressful for the child.

52.

A nurse suspects that a 10-year-old patient's injury was caused by abuse. The parents provide a plausible explanation, but the child seems fearful. What is the nurse's legal responsibility?

  • Report the suspicion of abuse to the appropriate child protection services

  • Document the nurse’s suspicions in the medical record

  • Dismiss the suspicion unless empirical evidence arises

  • Confront the parents with the nurse’s suspicion

Correct answer: Report the suspicion of abuse to the appropriate child protection services

Reporting the suspicion of abuse to the appropriate child protection services is a legal and ethical obligation of the nurse when abuse is suspected, regardless of how plausible the parents' explanation is. This approach ensures the safety and well-being of the child, which should be the nurse’s primary concern.

Documenting the nurse’s suspicions in the medical record is important but must be accompanied by a report to child protection services to ensure appropriate actions are taken to safeguard the child. Dismissing the suspicion unless empirical evidence arises fails to protect the child and neglects the nurse's duty to act in the best interests of the child’s safety and health when a reasonable suspicion exists. Confronting the parents with the nurse’s suspicion could potentially escalate the situation and may not be safe for the child if abuse is occurring.

53.

A 3-year-old child with cystic fibrosis is struggling with poor weight gain despite a high-calorie diet. What is the best intervention to facilitate optimal nutrition?

  • Initiate supplemental enteral feeding through a nasogastric tube at night

  • Increase the frequency of enzyme replacement therapy

  • Encourage more frequent, small oral feedings

  • Transition to total parenteral nutrition

Correct answer: Initiate supplemental enteral feeding through a nasogastric tube at night

Supplemental enteral feeding through a nasogastric tube can effectively address poor weight gain by ensuring adequate calorie intake during the night, complementing daytime feeding.

Increasing the frequency of enzyme replacement therapy addresses digestion but does not directly increase caloric intake, which is critical in this scenario. Encouraging more frequent, small feedings is a basic strategy but may not be sufficient on its own for significant weight gain issues in cystic fibrosis where existing dietary modifications have already proven unsuccessful. Transitioning to total parenteral nutrition is an invasive option typically reserved for situations where gastrointestinal absorption is severely compromised. It is not indicated solely by poor weight gain and supplemental enteral feedings should be used first.

54.

What advice should a pediatric nurse give to parents about the introduction of fluoride toothpaste for a toddler?

  • Start using a rice grain-sized amount of fluoride toothpaste when the first tooth appears.

  • Avoid fluoride toothpaste until the child is old enough to spit it out.

  • Use non-fluoride toothpaste until the child is 3 years old.

  • Brush with water only until the child starts school.

Correct answer: Start using a rice grain-sized amount of fluoride toothpaste when the first tooth appears.

It is recommended to begin using a rice grain-sized amount of fluoride toothpaste when a child's first tooth appears to prevent tooth decay while minimizing the risk of fluorosis.

Delaying the introduction of fluoride toothpaste until a child can spit it out may increase the risk of dental caries in early childhood and is not necessary. Recommending non-fluoride toothpaste until the child is 3 years old fails to protect against tooth decay during the early critical stages of tooth development. Using only water to brush a child's teeth until starting school does not provide the fluoride necessary to protect against cavities.

55.

A 14-year-old presents with frequent headaches and has missed several days of school over the past month. The child appears withdrawn and has lost interest in previously enjoyed activities. What should the nurse assess first?

  • Signs of depression

  • Vision problems

  • Peer relationships

  • Sleep patterns

Correct answer: Signs of depression

Given the symptoms of withdrawal, loss of interest in activities, and frequent headaches, assessing for signs of depression is crucial, as these can be indicative of an underlying mood disorder that needs immediate attention and intervention.

While vision problems can contribute to headaches, the combination of symptoms presented suggests a broader issue with a psychological origin, such as depression. Peer relationships are important but secondary to the assessment for depression when the symptoms suggest a significant impact on daily functioning and emotional state. Sleep patterns are relevant but should be assessed in the context of broader psychological evaluation for depression due to the severity and range of symptoms mentioned.

56.

During a routine visit, a pediatric nurse learns that a newborn’s sibling was diagnosed with a developmental delay. What is the most appropriate anticipatory guidance to provide to the parents?

  • Regular developmental screenings and early intervention services as preventative measures

  • Immediate cognitive testing to rule out similar conditions

  • A strict dietary regimen to enhance neurological development

  • Enrollment in advanced educational programs to stimulate early development

Correct answer: Regular developmental screenings and early intervention services as preventative measures

Regular screenings and early intervention can detect developmental delays early and provide timely interventions, which are crucial for improving long-term outcomes in children at risk.

Immediate cognitive testing is premature without indications from screenings or evaluations that suggest a developmental delay similar to the sibling's condition. A strict dietary regimen doesn't prevent or address developmental delays; early intervention and screenings are more directly beneficial. Enrollment in advanced programs without assessing the child’s needs could be inappropriate and may place undue pressure on the child.

57.

During a routine health assessment, a nurse finds old burn marks on a 6-year-old child's arms, which the child is reluctant to discuss. What is the most appropriate nursing action?

  • Reporting the findings to a supervisor for further action

  • Immediately confronting the parents about the marks

  • Observing the child's interaction with the parents

  • Asking the child directly about how the injuries occurred

Correct answer: Reporting the findings to a supervisor for further action

Reporting the findings to a supervisor is a mandatory action for nurses when signs of potential abuse are discovered, ensuring that the observations are escalated properly for further investigation and protection of the child.

Confronting the parents immediately can be confrontational and may not be safe or effective before a proper investigation is conducted. Observing interactions can be insightful but should come after reporting the findings, as the priority is to initiate formal procedures to ensure the child's safety. Asking the child directly about the injuries could lead to distress or fear, especially without appropriate support and investigation frameworks in place.

58.

A pediatric nurse receives a friend request on social media from the parent of a patient currently under their care. How should the nurse respond to maintain professional boundaries?

  • Politely decline the friend request

  • Accept the friend request but limit the parent’s access to personal posts

  • Ignore the friend request to avoid confrontation

  • Accept the friend request to promote a therapeutic relationship

Correct answer: Politely decline the friend request

Politely declining the friend request helps maintain professional boundaries between the nurse and the patient's family, which is crucial for upholding the integrity of the nurse-patient relationship and avoiding potential conflicts of interest or privacy issues.

Accepting the friend request while limiting access to personal posts still blurs the lines between professional and personal relationships and could create misunderstandings or breaches of privacy. Ignoring the friend request may avoid confrontation but does not address the underlying issue of maintaining professional boundaries. Accepting the friend request to promote a therapeutic relationship misinterprets the nature of professional boundaries and could lead to privacy concerns and ethical dilemmas.

59.

To plan end-of-life care for a terminally ill adolescent, which consideration is most critical to ensure culturally sensitive care?

  • Assess the family's understanding and acceptance of the prognosis

  • Ensure all communication is documented to provide a record of the family's wishes

  • Avoid using the word “death” to avoid distressing the adolescent or their family

  • Prioritize interventions that ensure the adolescent comfort over life-prolonging measures

Correct answer: Assess the family's understanding and acceptance of the prognosis

Assessing the family's understanding and acceptance of the prognosis is critical to providing culturally sensitive care as it respects their emotional and cognitive processing of the situation, and allows for care plans that align with their values and beliefs.

While documentation is important, it does not directly address cultural sensitivity. Documentation should support, not define, the approach to culturally aware care. Avoiding the word “death” can be seen as a form of denial and may not respect the family’s need for honesty and openness about the situation, which is essential in many cultures for closure and acceptance. Prioritizing comfort over life-prolonging measures is an important consideration but must be aligned with the cultural values and beliefs of the adolescent and their family, rather than being assumed as a universal preference.

60.

A 3-year-old with frequent nocturnal awakenings is under pediatric care. Which integrative health approach should the nurse suggest to help improve the child’s sleep quality?

  • Using a white noise machine

  • Avoiding screens at least 10 minutes prior to bed

  • Implementing night-time caffeine restriction

  • Increasing daytime naps

Correct answer: Using a white noise machine

Using a white noise machine can help drown out environmental noises that might disrupt sleep, providing a consistent auditory backdrop that can improve sleep quality in children with frequent awakenings.

Avoiding screens at least 10 minutes prior to bed is not sufficient; generally, longer periods free from screens before bedtime are recommended to improve sleep quality. Night-time caffeine restriction is a standard recommendation but irrelevant for a 3-year-old, as they should not be consuming caffeine at all. Increasing daytime naps might actually be counterproductive by reducing the child's sleep drive at night.

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