RN101
Home of the Registered Nurses (RN) and
Licensed Practical Nurses (LPN)

SITUATION I

A two-month-old infant is brought to the clinic by his mother. His abdomen is distended, and he has been vomiting forcefully and with increasing frequency over the past two weeks. On examination, you note signs of dehydration and a palpable mass to the right of the umbilicus.see answer 

 

Question 1:

What condition do you suspect?

1. _____________________________________________________________________________________________________________________________.  

Question 2:

After surgical correction of the defect/patient's condition, in what position should the nurse instruct the parents to place the infant after feeding?

1. _____________________________________________________________________________________________________________________________.

Justify: ________________________________________________________________________________________________________________________.

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SITUATION II

At a previous visit, the parents of a child with Cystic Fibrosis received instruction in the administration of pancrealipase (Pancrease).see answer 

 

Question 1:

At the follow up visit, what findings in the infant stools suggest that the parents require more teaching about administering the pancreatic enzymes?

1. ____________________________________________________________________________________________________________________________.  ­­­­­­­­­­­­ 

 

The nurse is instructing the mother of child with Cystic Fibrosis about appropriate dietary measures.

 

Question 2:

What type of diet will be included in the instructions?

1. _____________________________________________________________________________________________________________________________.  

 

Question 3:

Apart from pancreatic enzyme replacement therapy is undertaken, what other supplements should be taken by the child?

1._____________________________________________________________________________________________________________________________.  

 

Question 4:

Prescribed respiratory treatment includes chest physiotherapy. When should the nurse perform this procedure? 

1._____________________________________________________________________________________________________________________________. 

 

SITUATION III

A 9-month-old infant is admitted for dehydration and gastroenteritis. According to the mother,the infant has lost weight. Physical exam reveals sunken eyes with specific gravity of 1.030 (Normal: 1.005-1.022).see answer 

 

Question 1:

Identify two other signs and symptoms for you to evaluate the infant’s hydration?

1._____________________________________________________________________________________________________________________________. 

2._____________________________________________________________________________________________________________________________. 

3._____________________________________________________________________________________________________________________________.

 

Twenty four hours after admission, the IV is infiltrated and has been removed.

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Question 2:

Will you re-install the IV? Yes ⃝    No ⃝   

Give two (2) factors that justify your answer?

1._____________________________________________________________________________________________________________________________. 

2._____________________________________________________________________________________________________________________________. 

 

While preparing to discharge the 9-month-old infant who’s recovering from gastroenteritis and dehydration, you teach the parents about their infant’s dietary and fluid requirements.

 

Question 3:

Apart from the teachings mentioned above, what would you suggest to the infant’s parents on how to avoid transmission of gastroenteritis at home?

1._____________________________________________________________________________________________________________________________. 

2._____________________________________________________________________________________________________________________________. 

3._____________________________________________________________________________________________________________________________. 

4._____________________________________________________________________________________________________________________________. 

 

SITUATION IV

A 6-year-old child is recovering from acute non infectious gastroenteritis. The physician provides orders to advance the child’s diet to solid food. What food choices are best for the nurse to offer the child initially?see answer 

1._____________________________________________________________________________________________________________________________. 

2._____________________________________________________________________________________________________________________________. 

3._____________________________________________________________________________________________________________________________. 

 

SITUATION V

An infant of 3-month-old undergoes surgical repair of a cleft lip. The physician orders elbow restraint for this infant.

 see answer 

Question 1:

Adjust the TNP as necessary: (1 priority problem and 1 nursing directive)

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Question 2:

After surgery, you should use which equipment to feed the infant?

1._____________________________________________________________________________________________________________________________.  

SITUATION VI

Question 1:

You are about to administer an IM injection to a 12-month-old infant. Apart from the vastus lateralis muscle, what other site should you use?see answer 

1._____________________________________________________________________________________________________________________________.

 

SITUATION VII

You are a nurse conducting an infant nutrition class to new parents. The first food to be provided to a neonate is breast milk or formula.see answer 

 

Question 1:

What foods are appropriate to introduce during the first year of life that you should teach the parents?

1. Sliced beef

2. Whole milk

3. Fruit juice

4. Pureed fruits

5. Rice cereal

6. Pureed vegetables and ground meat

 

SITUATION VIII

A nurse is preparing to care for a child with a diagnosis of intussusception. The nurse reviews the child's record and expects to note what symptoms of this disorder documented?see answer 

1._____________________________________________________________________________________________________________________________.

2._____________________________________________________________________________________________________________________________. 

3._____________________________________________________________________________________________________________________________. 

 

SITUATION IX

A child who had a cast applied after a tibia fracture complains that his pain medication is not working and his pain is still a 9 or 10. You notice some edema of the toes and a capillary refill of 6 seconds.see answer 

 

Question 1:

What priority action you should do?

1._____________________________________________________________________________________________________________________________. 

 

SITUATION X

Patient X, 10-month-old, has a fever associated with a viral illness. The patient has a fever of 102° F and is crying a lot. Available medication is acetaminophen P.O liquid form.see answer 

 

Question 1:

When liquid medication is given to a crying infant, what approach minimizes the possibility of aspiration?

1._____________________________________________________________________________________________________________________________.  

SITUATION XI

Mrs. X your friend, who is a new mother of 5-month-old baby called you and says that her baby was diagnosed with croup. She is worried that last night her baby sounds like a “barking dog”.see answer 

 

Question 1:

What are your teachings to Jenny on how to care for her baby regarding croup?

1._____________________________________________________________________________________________________________________________. 

2._____________________________________________________________________________________________________________________________. 

3._____________________________________________________________________________________________________________________________. 

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SITUATION XII

A first-time mother asks you about breastfeeding. She states, “How can I know that my baby is getting enough milk apart from gaining weight?”  What would be your response?see answer 

1._____________________________________________________________________________________________________________________________. 

2._____________________________________________________________________________________________________________________________. 

3._____________________________________________________________________________________________________________________________. 

 

SITUATION XIII

A nursing student asks you, "where should I assess the pulse of the infant who is less than 1 year old?"see answer 

 

Question 1:

What is your appropriate response?

1._____________________________________________________________________________________________________________________________. 

 

SITUATION XIV

A child has a basilar skull fracture with the following medical orders:see answer 

1. Restrict fluid intake
2. Insert an indwelling urinary catheter
3. Keep an intravenous (IV) line patent
4. Suction via the nasotracheal route as needed

 

Question 1:

Which of the following health care provider's prescriptions should the nurse question?

1._____________________________________________________________________________________________________________________________. 

Justify:________________________________________________________________________________________________________________________.

 

SITUATION XV

A nurse is caring for a hospitalized child with bronchiolitis who is currently on the same room with other patient admitted for asthma exacerbation. Diagnostic tests have confirmed respiratory syncytial virus (RSV).see answer  

 

Question 1:

On the basis of this finding, what is your most appropriate action?

1._____________________________________________________________________________________________________________________________. 

Justify:________________________________________________________________________________________________________________________.

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SITUATION XVI

A nurse prepares a teaching plan regarding the administration of ear drops for the parents of a 2-year-old child.see answer  

 

Question 1:

Apart from proper hand washing and positioning the child to the side, what additional instruction the nurse should teach the mother on how to instill the ear drops properly?

1._____________________________________________________________________________________________________________________________.