CHAPTER 15 PREPU-QUIZ
A nurse is providing health promotion education to a family of an 11-month-old infant who is eating "finger foods." The nurse knows the parents understand the risk of infant choking when they state which response below?
i can feed our baby cheerios
The parents of a newborn diagnosed with a chronic illness ask the nurse, "How will this effect our newborn's growth and development?" Which nursing respose is most appropriate?
"It is common for newborn with chronic illnesses to grow and develop at a slower pace."
After the nurse provides education to new parents about appropriate sleeping habits for infants, which statement by a parent would indicate to the nurse that teaching needs to reoccur?
"My husband gave the baby a special bear that I will place in the crib."
The nurse brings a 2-day-old infant into the mother's room in the postpartum unit. The mother voices concern that her newborn's hands and feet "look a little blue." How should the nurse respond?
"This is common for newborns up to several days of age. It happens because of the immature circulatory system trying to get used to being outside the uterus."
The nurse is caring for the parents of a newborn who has an undescended testicle. Which comment by the parents indicates understanding of the condition?
Our son's condition may resolve on its own
The nurse is providing teaching to the parents of a newborn prior to a heelstick. The nurse is describing the procedure and recommending various methods for the parents to help comfort their baby. Which statement by the parents indicates a need for further teaching?
"It's better if we are not in the room for this."
A new parent asks the nurse, "About how many wet diapers should my infant have in a day. Which response by the nurse would be most appropriate?
"Typically, an infant has 6 to 8 wet diapers a day."
The nurse is assessing a 1-year-old at the well-child annual visit and notes the child is meeting the growth parameters. After noting the birth weight was 8 pounds (3.6 kg) and length was 20 inches (50.8 cm) long, which measurements would the nurse prepare to document for this visit?
1. 24 pounds (10.8 kg) and 30 inches (75 cm)
What would be a safe temperature of water to bathe baby Ryan in the tub?What would be a safe temperature of water to bathe baby Ryan in the tub?
1. The water should be 118 °F.
The nurse is teaching the parents of an infant about bathing. The nurse will inform the parents to set the home hot water heater to which temperature?
115°F (46.1℃)
The nurse is measuring the head circumference of a newborn during a well-child visit. Until which age should the nurse take this measurement?
24 months
In working with infants, the nurse would expect the posterior fontanel to be closed in an infant who is which age?
3months
The nurse is teaching the parents of a newborn safe medication storage. Which of the following is the most beneficial information for the parents?
Check all medications once a year and flush down the toilet all leftover, outdated, or unlabeled medications.
A 6-month-old infant is admitted to the hospital because of a fever. When the nurse obtains a health history, what data would be obtained first?
Details about the fever
The nurse is preparing to administer a diphtheria, tetanus and pertussis vaccine to a 3-year-old child. Which version of the formulation of the vaccine should be administered?
Dtap
What is the leading cause of neonatal sepsis and death?
Group B streptococcus
A parent asks why her infant is more prone to dehydration. The nurse integrates understanding of which of the following when explaining the reason for why newborns are at greater risk for dehydration?
High body surface area, high metabolic rate, and immature kidneys.
The nurse is assessing Julie, a 3-month-old infant. Which developmental milestone would the nurse expect?
Julie can hold her head erect and steady.
An infant is breastfed. When assessing the stools, which findings would be typical?
Less constipation than bottle-fed infants
The nurse is caring for a 5-week-old infant who is spitting up "all the time." This is the mother's first child. What should be the priority nursing intervention?
Observe the mother while she feeds and burps her infant.
The nurse is preparing to give a 4-month-old an oral medication. Which technique demonstrates the nurse's accurate knowledge of the infant's developmental level?
Position the infant upright, offer the infant a bottle of formula, remove the bottle and squirt the medication on the side of the tongue toward the cheek, then offer the infant the bottle again.
The nurse is identifying outcomes for care provided to a new mother whose infant continues to spit up after feedings. Which outcome would be the most appropriate?
The baby will have less episodes of spitting up after sitting upright after a feeding.
A mother has brought her 5-month-old girl to the clinic because she has caught a cold. Which of the following findings and observations suggests the child may have bronchiolitis?
Rapid breathing and a tight, wheezy cough
A parent asks the nurse what symptoms to expect with normal teething in the infant. How should the nurse respond?
The infant's gumline will be tender.
The nurse is preparing a presentation for a health fair illustrating the major milestones of infants as they grow and develop. Which fact should the nurse point out when illustrating an infant's teeth?
The first tooth usually erupts between 6 to 8 months.
The nurse is providing postsurgical care for an infant who has undergone a hypospadias repair. Which action by the nurse would be most important to help keep the area clean while maintaining proper position of the drainage tubing?
Using a double-diapering technique
When determining the correct therapeutic dose of most medications in children, which assessment would be most important for the nurse to make?
Weight
The neonatal nurse assesses newborns for iron-deficiency anemia. Which newborn is at highestrisk for this disorder?
a premature newborn
Anticipatory guidance for an infant for the 4th month should include the fact that the infant will be able to achieve which developmental milestone?
be able to turn over onto the back
The nurse is measuring an infant's head circumference and charts it to be at the 40th percentile. When completing which other measurement does the nurse anticipate a correlating result?
child's length
The condition in which one or both of the testes does not descend in the male infant is referred to as:
cryptorchidism.
The nurse is reveiwing the diet of an 8-month-old infant with the mother who reveals she has been using evaporated milk to make the formula. Which additional ingredient should the nurse ensure she is including in the formula?
iron
The nurse is assessing a 3-year-old child. The nurse notes the child is able to understand that objects hidden from sight still exist. The nurse correctly documents the child is displaying:
object permanence
A parent must administer a medication in syrup form to a 2-month-old infant. The nurse suggests
placing the medicine in an empty nipple without an attached bottle.
A nurse is assessing an infant's reflexes. The nurse places his or her thumb to the ball of the infant's foot to elicit which reflex?
plantar grasp
A nurse is educating a client being discharged with her newborn baby. What is the highest priority item that must be included in the teaching plan?
restrain the baby in a car seat
To obtain an accurate heart rate in an infant, what would be most important for the nurse to do?
take the apical pulse
The nurse is caring for a 5-month-old boy with an undescended left testis. What would the nurse identify as indicative of true cryptorchidism?
testis cannot be "milked" down inguinal canal
A nurse is collecting a weight on a 6-month-old infant. The weight was 14 lbs 3 oz. The mother states that the infant's birth weight was 8 lbs 8 oz. What is the nurse's assessment of this data?
the weight is too little for age
The nurse goes in to check on a new mother to see how breast-feeding is going with her new son. The nurse observes the infant is on the mother's lap with the blanket unwrapped, and the mother is washing his face, and gently stroking the baby. The mother has had trouble breastfeeding the last few times. What is the appropriate response from the nurse?
you are doing a wonderful job attempting to wake the baby
The nurse is making a home visit and observes the 7-month-old pulling the family dog's hair and ears. Which parenting skill does the nurse determine is most effective?
The parent tells the child "no" with a stern voice and pulls the child's hand away from the dog
Behavioral cues must be used to assess for the presence of pain in infants. Which of the following behaviors suggests pain in a 2-month-old infant?
Continued crying after diaper change and being fed
The home care nurse is conducting the final home care visit before a scheduled delivery. The client states, "My baby will not receive any shots, because I do not believe in them!" What is the most appropriate response by the nurse?
"Immunization helps keep children healthy and from getting diseases."
A teenage mom asks the discharge nurse if it is okay to sleep in bed with the baby. She says her mom always did it with her siblings and it seemed okay. Which response by the nurse would be most appropriate?
"It's okay for comforting or feeding, but it really isn't recommended."
During the health history of a 2-week-old neonate, the nurse discovers the child has not yet had a hearing screening. What test should the nurse schedule?
Auditory brain stem response test
An infant who was born prematurely has been discharged to home. When discussing sleep positions, which condition would warrant avoidance of placing the infant on their back to sleep?
gastroesophageal reflux disease
The pediatric nurse is meeting with a group of young mothers of newborn infants who are questioning the "soft spot" on the head and when it will close. Which fact should the nurse point out to the mothers?
may increase slightly in size the fire few months of life
A parent asks the nurse if her 2-month-old could have bananas yet. The nurse would respond and educate the parent on the nutrition stages of infants by which of these responses?
"In two months you can try bananas if you think she is ready."
1. The nurse is instructing the parents of an infant boy with cryptorchidism. Which nursing statement is correct?
"No treatment is needed unless no change is noted by 6 to 12 months."
Two-year-old Johnny does not like his new sister. When his mom leaves the room he tries to pull her out of her bouncy seat. She cries and Mom comes in running. Mom talks with the nurse at the pediatrician's office about ways to discipline him. What is a positive strategy the nurse can offer the mother?1. "You should try and reinforce to Johnny not to hurt the baby."1. "You should try and reinforce to Johnny not to hurt the baby."
"You should try and reinforce to Johnny not to hurt the baby."
The nurse is examining a 6-month-old girl who was born 8 weeks early. Which finding is cause for concern?
Head size has increased 5 in (12 cm) since birth.
A 2-month-old infant has inconsolable crying, is gassy, and constantly draws the legs up. It has been determined that the infant has colic. What intervention should the nurse recommend to treat colic?
The infant is bottle fed, so the parent needs to try a different formula to assess for sensitivity.
The nurse is caring for a female infant born with a congenital anomaly. Which of the following factors is likely to have the most influence on her mother's ability to cope with the infant's handicap?
The parents perceptions of the handicap
A 9-month-old has been brought to the clinic for a well-child visit. The mother reports her son was born 6 weeks prematurely. During the data collection, the child's mother reports her son seems to be a few months "behind" what she recalls from her older children. What is the best response by the nurse?
delays are normal when a child is premature
The nurse is giving discharge instructions to a mother of a 3-month-old infant who will be receiving oral medication at home. Which of the following would the nurse include in the teaching plan?
Give the medication with a syringe and squirt a small amount at a time beside the tongue while holding the infant upright.
Parents bring their infant to the clinic because the baby has been vomiting and had diarrhea for the past 3 days. The nurse assesses the infant and finds dry mucous membrane and lethargy. Which other finding would support a nursing diagnosis of fluid volume deficit?
Sunken fontanel
The nursing student identifies which technique as the correct one to use when giving oral medications to an infant?
Use a dropper and slowly inject the liquid into the side of the infant's mouth.
