NCLEX review

Last week I went to a 4 day review course for the NCLEX exam. The review course was designed to give a broad overview of what we've learned over the past two years in nursing school and highlight important points to remember about specific areas covered.

It did a pretty good job of doing that, actually. Initially, though, I was a bit annoyed on the first day because we were told to be there at 7:30 am so being 1.5 hours away I woke up at 5am and was there promptly at 7:30am. The class didn't get started until 8:15! I was tweaked, to say the least.

Anyway, I was able to work past the initial set back and regain some respect for the tardy teacher and benefit from the course. I was able to identify areas of personal weakness that I need to work on before sitting for the boards.

The biggest area of weakness, I think, personally is pediatric nursing. I took it about 1.5 years ago and it was full of signs, symptoms and treatments that have long since left my immediate recall.

In the next few weeks until I take the NCLEX I will be reviewing everything I ever learned in nursing school....which means I will also be doing a lot of procrastinating (aka my family will be eating good these next few weeks - today already I've made a crock-pot full of chicken corn soup and homemade golden corn bread). :)

My official goal today is to start reviewing pediatric nursing, so to that end, here are some NCLEX style questions on pediatric nursing:

1) The nurse has completed some child and family education for a child diagnosed with thalassemia. The medical plan of treatment includes blood transfusions when the anemia reaches a severe point. Which statement by the parents indicates a need for further education?
a. Because of the anemia, my child will need extra rest periods.
b. My child inherited this disorder from both of us.
c. We should be alert to periods when our child seems paler than usual.
d. My child needs an iron supplement.

2) A 14-year old boy is brought to the ER with a diagnosis of rule out appendicitis. He is complaining of right lower quadrant pain. The nurse's most appropriate action to assist in managing his pain would be to:
a. Insert a rectal tube.
b. Apply an ice bag.
c. Apply a heating pad.
d. Administer an intravenous antispasmodic agent.

3) A nurse performs triage in a pediatric orthopedic clinic. Which of the following should the nurse recognize as a symptom of slipped capitol femoral epiphysis?
a. Pain in the hip of a pre-adolescent child
b. Acute onset of knee pain
c. Presence of a limp in a school-age child
d. Painful external rotation of the affected leg

4) The nurse is providing client education for a family whose child has cerebral palsy and is receiving baclofen epidural therapy to control spasticity. Which of the following is most important for the nurse to include in the discussion?
a. The drug acts to inhibit the neurotransmitter GABA.
b. The child should be able to run with normal gait after insertion of the pump.
c. Parents must bring the child back to the clinic on a regular basis to have more medicine added to the pump.
d. Parents can be taught to regulate the dosage on a sliding scale

5) A toddler with Kawasaki's disease is ordered to receive aspirin therapy. The nurse anticipates that medication therapy with aspirin will follow which principle?
a. High doses of aspirin will be given while fever is high.
b. Length of aspirin therapy is related to child's response.
c. Aspirin dose will be increased after fever is gone.
d. Aspirin dosage is unrelated to platelet count

6) A 2-year old child has a known cardiac defect and is in congestive heart failure. Which assessment findings indicates to the nurse a toxic dose of digoxin?
a. Tachycardia & dysrhythmia
b. Headache & diarrhea
c. Bradycardia & nausea and vomiting
d. Tinnitus & nuchal rigidity

7) The physician orders amoxicillin (Amoxil) 500mg IVPB q 8 hours for a pediatric client with tonsillitis. What is the appropriate nursing action?
a. Question the order because the route of administration is incorrect.
b. Give the medication as ordered.
c. Question the order because the dosage is too high.
d. Question the order because the dosing frequency is incorrect.

8) The mother of a 6-month-old infant is concerned that the infant's anterior fontanel is still open. The nurse would explain to the mother that further evaluation is needed if the anterior fontanel is still open after:
a. 6 months
b. 10 months
c. 18 months
d. 12 months

Questions from : Child Health Nursing Second Edition Reviews & Rationales
Answers: 1) d 2) b 3) a 4) c 5) b 6) c 7) a 8) c