Combined - PEDS QuizzesFinal Exam
What is the physical or psychosocial milestone for: Trust vs. Mistrust?
Object permanence
What is the physical or psychosocial milestone for: Autonomy vs. Shame and Doubt?
Toilet training
Which of the following is an administrator error when conducting a hearing screening? A. Allowing the child to raise either hand for whichever ear is being tested B. Testing in a quiet room with other screeners C. Having the child directly face you during screening D. Having the child drop beads in a cup or make a thumbs up for hearing indication
C. Having the child directly face you during screening
Which vaccines may be contraindicated in a child with immunosuppression? (choose all that apply) A. Polio B. Influenza C. Rotovirus D. MMR ( measles, mumps & rubella) E. Hepatitis B
C. Rotovirus D. MMR ( measles, mumps & rubella)
Which of the following is a possible reason for a child to not meet the hearing screening criteria? A. Viral illness B. Inattention or disinterest C. all answers are correct D. Wax buildup E. headphones placed incorrectly
C. all answers are correct
A child has been unable to hear at 1000 hz in the left ear with the initial and rescreening hearing screens performed. What is the next step? -Meet with the parents to inform them that their child is hearing impaired -Rescreen the child again next year -Call the parents and refer them to their primary doctor or audiologist -Screen the child again in 3 weeks
Call the parents and refer them to their primary doctor or audiologist
What are the stages of psychosocial development in pediatrics?
Trust vs. Mistrust Autonomy vs. Shame & Doubt Initiative vs. Guilt Industry vs. Inferiority Identity vs. Role Confusion
What is the physical or psychosocial milestone for: Industry vs. Inferiority?
Understanding conservation theory
The nurse is administering a number of therapeutic interventions for neonates, infants, and children on the pediatric unit. Which intervention contributes to an increase in chronic illness seen in early childhood? Administering antibiotics to prevent lethal infections. Vaccinating children to prevent childhood diseases. Using mechanical ventilation for premature infants. Using corticosteroids as a treatment for asthma.
Using mechanical ventilation for premature infants. Using mechanical ventilation and medications to foster lung development in premature infants increases their survival rate. Yet the infants who survive are often faced with myriad chronic illnesses. Administering antibiotics to prevent lethal infections, vaccinating children to prevent childhood diseases, and using corticosteroids as a treatment for asthma may cause side effects, but do not contribute to chronic illness in children.
What should be included in the assessment and documentation of an 18 month old?
Weight OFC (Occfiptofrontal circumference) Heart Rate & Respiratory Rate FLACC pain scale rating
The nurse is caring for several clients on the pediatric unit. When interacting with the preschool-age child, which action does the nurse predict will occur? a) Increased attention span and can be interested in an activity for a long length of time b) Takes in new information at a rapid rate and asks "why" and "how" c) Insists doing something and the next moment reverts to being dependent d) Grows and develops skills more rapidly than at any other time in their life
b) Takes in new information at a rapid rate and asks "why" and "how"
Which of the following best describes a developmentally based approach to providing a nebulized medication to a preschooler? A. Allow child to independently administer B. Have the child do the incentive spirometer first C. Have parents educate the child while you observe D. Allow child to explore the equipment prior
D. Allow child to explore the equipment prior
In planning care for a hospitalized school-age child, which of the following actions will best promote the positive aspects of the child's psychosocial developmental stage? A. Encourage parents to perform the child's care. B. Give the child a detailed explanation of all procedures. C. Encourage cooperation through demonstration of the care. D. Allow the child to assist with applicable care.
D. Allow the child to assist with applicable care
You are caring for a toddler in the pediatric unit. The pain assessment scale MOST appropriate for this child is the: A. Numeric (analog) B. NPASS C. FACES D. FLACC behavioral pain scale
D. FLACC behavioral pain scale
Mistrust 0-12 months
Develops when trust-promoting experiences are lacking; when basic needs are inconsistent or unmet. Basic trust in parents stems trust in the world, other people, and oneself.
What is the physical or psychosocial milestone for: Identity vs. Confusion?
Driver's License
You are working with the parents of 5 month old twins. Which of the following topics would be appropriate promotional teaching about the next stage of development (6-12 months) -Toilet training -"Stranger anxiety" -Preparing for the "no" stage -Choosing a booster seat
"Stranger anxiety"
The nurse comes into an infant's room on the pediatric floor. The nurse wants to try to feed the infant for the first time since her surgery. How does the nurse know what state the infant is in by what the mother says, and that it's fine to try and feed the infant? "She has been a chatterbox and smiles just like her brother." "She is so quiet today; that is not like her." "She has been crying every time someone picks her up." "She is still sleeping; I guess she is worn out."
"She has been a chatterbox and smiles just like her brother" The best time to feed an infant is when the child is in the active alert state. This infant is talking and smiling, which shows she is calm and actively awake. In the active alert state the infant has normal respirations, limited movement, and eyes that are bright and shiny and attentive. The other choices put the infant in a crying state, quiet alert or deep sleep, or drowsing. These stages are not optimal for interacting with the child.
How much infant formula should a 4-6 month old have?
100 to 150 mL (4-5 oz) 4 or more times daily
Identity vs. Role Confusion
11-18 years old Adolescence How they look is important Who am I? Where am I going in life? Significant relations: peers Able to be loyal to others Successful =confidence in self-identity and optimism Role confusion occurs if unable to establish meaningful definition of self.
Between what months does the anterior fontanel closes at?
12-18 months
How much infant formula should a 6-12 month have?
180-240 mL (6-8 oz) 4 times daily (with solid foods progressively added to the diet)
What should be assessed at a toddler's well child visit?
- Sleep routines - Eating patterns -Safety -Immunizations and allergies
For a nurse working with a school age child, what strategies will be appropriate to conduct a vision screening?
- Start at the top to establish a feeling of success - Build rapport if possible by asking about school or hobbies -Allow the child to ask questions prior to starting
Preoperational Stage
-The child begins to represent the world symbolically -Age 2-7
At what age should the birth weight triple?
1 year
What testing results is considered normal, average distance visual acuity for a three year old child?
20/50 L and 20/50 R 20/40 Bilaterally
At what age should the birth weight double by?
5 months
How much infant formula should a newborn to 1 month old have?
60 to 90 mL (2-3 oz) every 2-3 hours
How much infant formula should a 2-4 month old have?
90 to 120 mL (3-4 oz) every 3-4 hours
You are working with the parents of 5 m old twins. Which of the following topics would be appropriate promotional teaching about the next stage of development (6 mos to 12 mos)? A. "Stranger anxiety" B. preparing for the 'No' stage C. toilet Training D. choosing a Booster Seat
A. "Stranger anxiety"
A parent calls to report that that their child has a low grade fever, pain and redness at the site of a recent vaccine injection. Which is the best response? A. "This is considered to be a normal, response to the vaccine but please call us if they experience any additional symptoms." B. "You should not get any further vaccines since you had a bad reaction to this one." C. "Your child should be seen at the emergency room." D. "It sounds like your child is experiencing a mild allergic reaction."
A. "This is considered to be a normal, response to the vaccine but please call us if they experience any additional symptoms."
Industry vs. Inferiority
Age 6-10 Middle childhood Learns to follow rules "am I successful or am I worthless?" Central task: education Acquires skills for and develops competence in work Enjoys achievement Develops friendships, skills, self-evaluation Significant relations: school Successful =develops self-confidence, self-identity If compared to others may develop feelings of inadequacy; inferiority may develop if too much is expected.
What is the learning style for preschool aged children?
Attracted by bold, bright colors and pictures Likes to explore Like to role-play with dolls Defer to parents or caregivers when confronted with something new
What kind of food is concerning for a child under 6 months?
High nitrate foods ex: Home-prepared beans, beets, carrots, spinach, and squash
A pregnant mother comes in with her three year old for a well child exam. What should you ask the family in regards to vaccines? (Choose all that apply) A. "Has your child received their dose of HPV? B. "Have you had a pertussis booster with your pregnancy?" C. "Have you all had your yearly flu shot?" D. "Do you have any questions about vaccines that I can answer for you?"
B. "Have you had a pertussis booster with your pregnancy?" C. "Have you all had your yearly flu shot?" D. "Do you have any questions about vaccines that I can answer for you?"
Which size needle and which site would you MOST commonly use to administer an intramuscular shot to a 10 year old? A. 1 inch 22 gauge to the Dorsogluteal muscle B. 1 inch 22 gauge needle to the Deltoid muscle C. 1 1/2 inch 22 gauge needle to the Deltoid muscle D. 1 inch 22 gauge to the Ventrogluteal muscle
B. 1 inch 22 gauge needle to the Deltoid muscle
A parent asks why the human papillomavirus (HPV) vaccine is recommended for her 12 year old son since, "It's for cervical cancer". What is your BEST response? A. "It's just best to get all the vaccines your doctor recommends." B. "It's so they can't spread the infection to girls." C. "HPV infections can also cause cancer of the rectum or penis in men." D. "It also helps prevent meningitis in boys."
C. "HPV infections can also cause cancer of the rectum or penis in men."
Which of the following precautions should be taken in administration of vaccines? CHOOSE ALL THAT APPLY. A. All the vaccines to be administered are in the same syringe. B. The patient's blood sugar is over 60. C. Check the expiration date on the vaccine prior to administration. D. Needle size is appropriate for patient E. Patient is not needle phobic
C. Check the expiration date on the vaccine prior to administration. D. Needle size is appropriate for patient
What kind of food is concerning to give under the age of 1?
Honey Clostridium botulinum spores can lead to botulism in an infant that cannot detoxify these spores
What is the physical or psychosocial milestone for: Initiative vs. Guilt?
Exploration through play
What kind of pain scale is used for PRESCHOOLERS?
FACES
What kind of pain scale is used for a TODDLER?
FLACC
A school aged child with a history of asthma may receive the flu vaccine by the intra-nasal route. A. True B. False
False
Who is Piaget and what did he develop?
Father of cognitive development Observed children Four stages of cognitive development
What kind of solid foods can a 6-8 month old have?
Fruits and veggies
Normal Vital Signs 12-18 yr
HR = 55-85 BP = 110-135/65-85 RR= 12-18
Normal Vital Signs 6-12 yr
HR = 60-95 BP = 100-120/60-75 RR = 14-20
Normal Vital Signs 3-6 yr
HR = 65-110 BP = 95-110/60-75 RR= 20-25
Normal Vital Signs 6-12 months
HR = 80-120 BP= 80-100/55-65 RR = 25-40
Normal Vital Signs 3-6 months
HR = 90-120 BP = 70-90/50-65 RR = 30-45
Normal Vital Signs Age 0-3 months
HR= 100-150 BP = 65-85/45/55 RR = 35-55
Normal Vital Signs 1-3 yr
HR= 70-110 BP= 90-105/55-70 RR= 20-30
A pediatric nurse will state that the priority reason to have a thorough grasp of the growth and development of children is to: identify developmental risks or delays promptly. thoroughly enjoy working with the different age groups. give parents anticipatory guidance as their children grow and change. interact with children in age-appropriate, nonthreatening ways.
Identify developmental risks or delays promptly Finding risks for developmental delays early allows for prompt intervention likely to result in a more positive outcome. Having thorough knowledge of growth and development does enhance the joy of working with children, does assist with providing anticipatory guidance for parents, and does promote effective communication with the various ages. These are all important, but not the priority.
You are doing education on immunizations and vaccines for the family of a 5 month old. You recommend that the PARENTS receive which of the following vaccines at this time? Influenza Hepatitis B Hib (Haemophilus influenzae) Polio
Influenza
The father of a 5-year-old child reports that he uses a series of local urgent care centers for routine care. What is the greatest concern about this practice? The cost of using these options for medical treatment is excessive. Seeking routine care at this type of facility often will not be covered by health insurance. It is difficult to have continuity of care with these practices. These facilities are not well versed in the care of children.
It is difficult to have continuity of care with these practices. The American Academy of Pediatrics discourages children and families from using urgent care centers or the emergency department for routine care, since it is difficult to provide coordinated, comprehensive family-centered care consistent with a "medical home" concept.
What kind of solid foods can an 8-10 month old have?
Meats
What kind of pain scale is used for an INFANT?
NPASS
The nurse is monitoring a playgroup of children on the pediatric unit. The nurse predicts the school-age child will most likely be participating in which activity? pretending to be mommies and daddies in the playhouse playing with the plastic vacuum cleaner, pushing it around the room painting pictures in the art corner of the room watching a movie with other children their age
Painting pictures in the art corner of the room The school-aged child enjoys group activities and making things, such as drawings, paintings, and craft projects. Preschool children enjoy imitative play, pretending to be the mommy, the daddy, a police officer, a cowboy, or other familiar characters. Playtime for the toddler involves imitation of the people around them, such as adults, siblings, and other children. Push-pull toys allow them to use their developing gross motor skills. The adolescent enjoys activities he or she can participate in with peers.
Sensorimotor (0-2 years):
Physical interaction with the environment - sensory & motor activity. Reflex activity to imitating behaviors. Learns cause and effect, curiosity, experimentation, and exploration Object permanence: child comes to realize an object may still be there even when out of sight.
What is the learning style for school-age children?
Pictures and text (books, videos, cartoons, computers) Games Respond to group learning Need repetition
The nursing staff at the clinic are discussing the best way to encourage cooperation from young pediatric clients during screenings. Which suggestion would be appropriate? Encourage the children to play with the dressings, syringes, and medication before using them. Allow the children to choose whether to get the screening completed that day or another day. Make a coloring page and allow the child to color it completely before beginning the screening. Purchase stickers or make coloring pages to be given to the children after the screening is completed.
Purchase stickers or make coloring pages to be given to the children after the screening is completed. Young children respond well to a reward system. Allowing them to have a sticker or a coloring page after the screening is finished will encourage cooperation. They should not be permitted to play with equipment that is dangerous (syringes/medication) or should be sterile when used on them. Playing with medication is contraindicated also because it gives the illusion that medication is a toy. Allowing a child the choice of completing the reward before the screening will hinder cooperation; the child should only complete the reward after screening.
What is the learning style for adolescence?
Respond best to peers and "peer idols" May not respond to formal education Problem-solving may be successful Environment should be reassuring but not adult dominated Prefer as much self-management as possible
What kind of solid foods can be introduced to a 6 month old?
Rice cereal -easy to digest -low risk of allergy -fortified with iron
What are the 4 stages of Piaget's Cognitive Theory?
Sensorimotor Stage (0-2) Preoperational Stage (2-6 or 7) Concrete Operational Stage (7-11 or 12) Formal Operational Stage (12-adulthood)
What are some negative effects that chronic pain can have on the pediatric population?
Sleep Disturbances Exhaustion Irritability Mood Disturbances Depression Chronic pain is defined as pain that continues past the expected point of healing for the injured tissue. This pain has many effects as the child continues in pain. These effects may include sleep disturbances, exhaustion, irritability, mood disturbances, and depression. Heart rate, respiratory rate, and blood pressure increases are seen more with acute pain. Children in any type of pain have a decreased (not increased) appetite.
What kind of solid foods can be introduced at 10-12 months old?
Soft table foods 3x a day with family during meals
The nurse is assessing a 9-month-old boy for a well-baby checkup. Which of the following observations would of most concern? -The mother has not given him finger foods -The child does not sit unsupported -The baby cries whenever the mother leaves the room -The baby cannot say "mama" when he wants his mother
The child does not sit unsupported
The nurse is observing a 4-year-old child in the play room of the medical unit of the hospital. The child uses the toy medical equipment and proceeds to change the bandage on a doll, pretends to give the doll medication, and talks elaborately to the doll. How does the nurse accurately interpret this play? The child wants to be a doctor and is copying the pediatrician's behaviors. The child is portraying anxiety about the hospitalization through play. The child is using parallel play while in the hospital. The child is demonstrating behavior suggestive of a developmental delay.
The child is portraying anxiety about hospitalization through play Preschool-aged children often use dramatic play to express anxiety, try out negative feelings, or conquer their fears. This child, at 4 years of age, is demonstrating behavior that is developmentally appropriate. Parallel play involves children playing adjacent to each other but not engaging in interaction or affecting each other's play. Pretend play, such as acting like the pediatrician, is more common among toddlers.
Formal operations (11-15):
Thinking process becomes like an adult. Able to think abstractly and can perform conceptual reasoning. Adaptable and flexible Able to deal with contradictions. Uses scientific approach to problem solve. Able to conceive distant future.
Autonomy vs. Shame and Doubt
Years 1-3 Early childhood Ability to control self and environment; gains/simulates independence by saying "No". Self-conscience begins to develop Can I do it by myself? Imitation Determination to exercise free choice and self-control Fantasy play Parents are still significant relationship Successful = developing self-confidence and will power. Shame and doubt occur if criticized
The mother of a 13-year-old boy confides to the pediatric nurse practitioner that her son has recently had a nocturnal seminal emission. The mother is concerned, and the nurse explains "wet dreams" and the other male traits of puberty to the mother. Which response indicates a need for further discussion? a) "My son must be sexually active or having overly sexual thoughts to have a nocturnal emission." b) "My son's spontaneous erections and nocturnal emissions are very normal." c) "My son is not doing anything to cause the nocturnal emissions; they occur spontaneously. d) "My son is developing normally and the traits of puberty vary from child to child."
a) "My son must be sexually active or having overly sexual thoughts to have a nocturnal emission"
The nurse is caring for a preoperative pediatric client. What would it be best for the nurse to do with this client? a) Determine how much the child knows and is capable of understanding. b) Teach technical terminology to the caregivers so they will understand what is being said postoperatively. c) Keep the child away from any food or drinks to ensure the child is NPO. d) Explain how the therapeutic plan can be used in preparing the child for surgery.
a) Determine how much the child knows and is capable of understanding The nurse must determine how much the child knows and is capable of learning in order to best prepare the child for surgery. Keeping terminology at the child's and caregivers' level of understanding is important when doing teaching. Teaching the therapeutic plan is important, but it has to be done on the level of the child's and caregivers' knowledge and build on what they already know. The child going to surgery will be NPO, but the nurse needs to know on what level to teach the child the reason for this.
A hospitalized child needs a peripheral IV inserted. What action is the nurse's priority? a) Take the child to the treatment room for the procedure. b) Place the smallest IV catheter for the medication to be given. c) Involve the child life services department prior to the procedure. d) Have the parent wait in the child's room.
a) Take the child to the treatment room for the procedure.
The nurse working in the emergency department is caring for an 8-year-old boy who was hit by a car while running across the street and has suffered extensive abrasions, contusions, and broken bones. IV morphine analgesia has been given. The child is unable to follow simple directions to allow for procedures to be completed. What is the best action to take for this child? a) The child should be sedated. b) Give the child another dose of morphine. c) Restrain the child in order to keep him safe. d) Explain the procedure to the child.
a) The child should be sedated If a child is unable to follow directions and allow a procedure to proceed safely with analgesia alone, the child should be sedated. Children are routinely restrained without sedation or analgesia for painful procedures, something that would be unthinkable with an adult. This would not be an appropriate intervention. The child is in too much pain to understand an explanation at this point.
During a physical assessment of a 5-month-old child, the nurse observes the first tooth has just erupted and uses the opportunity to advise the mother to schedule a dental examination for her baby. When is the correct time for the dentist visit? a) by the first birthday b) by the second birthday c) by entry into kindergarten d) by entry into first grade
a) by the first birthday The American Academy of Pediatric Dentistry recommends that a dentist examine the infant by his or her first birthday. Besides assessing routine oral health care, establishing a dental contact by the first birthday provides a resource for emergency dental care if it is needed.
The nurse is preparing a variety of projects for the pediatric clients on the unit to work on in the playroom. In deciding on projects, the nurse determines the 8-year-old will be best suited to work on which activity? a. stacks blocks in a tower b. build a sandcastle with a water-filled moat c. form vases from blocks of clay d. put together a model plane
c. Form vases from blocks of clay
The parents of four and a half year old Sadie state she frequently talks to an imaginary bear and they are concerned. In discussing this behavior, what is the nurse's BEST response? a. The child's behavior is concerning and should be discussed with a psychologist b. Whenever she discusses the "bear" to remind her that it doesn't exist c. Imaginary playmates are common in this age group and serve a developmental purpose d. This may represent a desired friend and purchasing a stuffed bear will help.
c. Imaginary playmates are common in this age group and serve a developmental purpose
How can the nurse best meet the developmental needs of school-age child who is frequently hospitalized with a chronic illness? a) Offer the child opportunities to work puzzles, read books, and watch movies in the room. b) Encourage the child to write or journal his or her feelings regarding the illness and the hospitalization. c) Permit the child to put cards and notes from family and friends on the wall in the hospital room. d) Provide fun, competitive games and/or contests with the child's peers on the pediatric unit.
d) Provide fun, competitive games and/or contests with the child's peers on the pediatric unit. The school-age child will develop a sense of industry by participating in competitive activities with peers. The other choices are activities that are done alone or do not allow the child to socialization.
It is important for a nurse working in pediatrics to understand problems that children face when they have grown up around abuse. Studies indicate that children who witness intimate partner violence are at risk for developing which problems? Select all that apply. psychiatric disorders developmental problems failure to thrive syndrome school failures violence against others low self-esteem
psychiatric disorders developmental problems school failures violence against others low self-esteem Children who witness intimate partner violence are at risk for developing psychiatric problems, developmental problems, school failure, violence against others, and low self-esteem. It has not been proven that these children will suffer from failure-to-thrive syndrome.
Which of the following should be assessed at a toddler's well child visit? A. All of the above B. Eating patterns C. Immunizations and Allergies D. Sleep routines E. Safety
A. All of the above
A child working on toilet training is in which stage according to Erikson? A. Autonomy vs. Shame & Doubt B. Initiative vs. Guilt C. Trust vs. Mistrust D. Industry vs. Inferiority
A. Autonomy vs. Shame & Doubt
Which of the following should be included in the assessment and documentation of an 18 month old? (Choose all that apply) A. Heart rate & Respiratory rate B. FLACC pain scale rating C. Incentive spirometry reading D. OFC E. weight
A. Heart rate & Respiratory rate B. FLACC pain scale rating D. OFC E. weight
A 6 month old has only received the first dose of the recommended vaccines. What would you recommend that the child get at this appointment? A. Hepatitis B, RV, DTAP, HIB, PCV13, IPV and Flu B. None. We will need to start over. C. RV, Dtap, Hib, PCV 13 & IPV D. RV, DTAP, HIb and Flu
A. Hepatitis B, RV, DTAP, HIB, PCV13, IPV and Flu
In considering the developmental needs of an infant, which of the following non-pharmalogical interventions will BEST support an infant in pain? A. Rock the infant swaddled in a blanket B. Reposition the child prone C. Place the infant near the nurse's station in a swing D. Remove all the noxious stimuli
A. Rock the infant swaddled in a blanket
Which of the following BEST describes a developmentally based approach for educating a teen on behavioral therapy after a depression diagnosis? A. Inquire as to what question the teen has B. Discuss options for adolescent group therapy C. Ask the family if they have any insurance or transport concerns D. Provide privacy for the discussion
A. Inquire as to what question the teen has B. Discuss options for adolescent group therapy D. Provide privacy for the discussion
Which of the following vaccine types is NOT used for people of all ages? A. Intra-nasal B. Toxoid vaccine C. Intramuscular D. Attenuated vaccine
A. Intra-nasal
The nurse is educating a client who is breastfeeding her 2-week-old newborn regarding the nutritional requirements of newborns, according to the recommendations of the American Academy of Pediatrics (AAP). Which response by the mother would validate her understanding of the information she received? "I will feed him at least 30 cc of water daily." "I need to give him iron supplements daily." "I will give him vitamin D supplements daily for the first 2 months of life." "Since we live in a rural area, I must ensure he receives adequate fluoride supplementation."
"I will give him vitamin D supplements daily for the first 2 months of life." As per the recommendations of AAP, all newborns should receive a daily supplement of vitamin D during the first 2 months of life to prevent rickets and vitamin D deficiency. There is no need to feed the newborn water, as breast milk contains enough water to meet the newborn's needs. Iron supplements need not be given, as the newborn is being breastfed. Infants over 6 months of age are given fluoride supplementation if they are not receiving fluoridated water.
What are the general considerations and recommendations for human breast milk feeding?
-Feeding is on demand at birth -Feedings every 1.5-3 hours -8 to 12 feedings a day -Volume is not measured -Pattern of feeding is similar to pattern for formula feeding
For a nurse working with a Preschool child, which of the following strategies will be appropriate to conduct a vision screening? (Select all that apply) Introduce yourself at eye level You Answered Have child cover eye firmly with fingers. Keep directions simple. If possible offer small rewards for completion
-Introduce yourself at eye level -Keep directions simple -If possible offer small rewards for completion
An adolescent would benefit from being out of his hospital room. What can the nurse do to promote this? Select all that apply. Invite the adolescent to meet with other teens for lunch in a common space. Challenge the adolescent to a video game in the recreation area. Encourage the teen to investigate the playroom. Suggest the adolescent visit other areas within the hospital that are away from the pediatric unit.
-Invite the adolescent to meet with other teens for lunch in a common space - Challenge the adolescent to a video game in the recreation area - Encourage the teen to investigate the playroom A video game in the "recreation area" is more appealing than investigating the "playroom." If only one activity space is available, avoid calling it the playroom to school-agers and teens. Arranging for teens to spend time together and socialize over lunch may stimulate appetites and new supportive friendships. Suggesting the adolescent leave the unit may not be safe based on his knowledge of the hospital or his condition. Doing so accompanied would be appropriate.
Sensorimotor Stage
-The child beings to interact with the environment -Birth two age 2
Which of the following testing results is considered normal, average distance visual acuity for a three year old child? (choose all that apply) A. 20/40 bilaterally B. 10/100 L and 10/30 R C. 20/50 L and 20/50 R D. 10/25 and 10/100 R
A. 20/40 bilaterally C. 20/50 L and 20/50 R
Which of the following BEST describes a developmentally based approach for an IM flu shot administered to a toddler? (Choose all that apply) A. Tell the child just before administration to keep the shot out of sight until ready to begin B. Give the child simple choices for a band-aid or reward C. Allow the child to choose the site of injection d) Have the parent hold the child and provide distraction if possible
A. Tell the child just before administration and keep the shot out of sight until ready to begin B. Give the child simple choices for a band-aid or reward D. Have the parent hold the child and provide distraction if possible
The nurse is assessing a 9-month-old boy for a well-baby check-up. Which of the following observations would be of most concern? A. The child does not sit unsupported. B. The baby cannot say "mama" when he wants his mother. C . The baby cries whenever the mother leaves the room. D. The mother has not given him finger foods.
A. The child does not sit unsupported.
A milestone in the development of the SCHOOL AGE child includes the concept of: A. Theory of conservation B. Egocentricity C. Self-Actualization Theory D. Object permanence
A. Theory of conservation
Concrete operations (7-11)
As physical, concrete experiences increase, the child begins to create logical structures that explain his or her physical experiences. Able to shift attention from one perceptual attribute to another - decentration. Some abstract thinking is possible: problem solving, sorting, solving math with numbers, not just with objects. Conversation skills develop.
Which needle size and route would be MOST appropriate for an intramuscular shot for a 6 month old child? A. 1 inch 25 gauge needle to the Dorsogluteal muscle B. 1 inch 25 gauge needle to the anterior thigh C. 1 inch 22 gauge needle to the Deltoid muscle D. 1 inch 22 gauge needle to the anterior thigh
B. 1 inch 25 gauge needle to the anterior thigh
Which of the following activities would be MOST helpful developmentally to prepare a preschooler prior to an IM shot? A. A video for distraction B. A needless syringe and doll with Band-Aids to apply C. A medical coloring book D. A period of free play in the playroom
B. A needless syringe and doll with Band-Aids to apply
You are teaching parents about providing oral medication to an infant. Which of the following should be included in your teaching? (choose all that apply) A. Add the medication to an 8 oz bottle of formula B. Administer to the side of the cheek in small amounts. C. Hold the infant in an upright position D. Use the dropper from the child's last round of medication.
B. Administer to the side of the cheek in small amounts. C. Hold the infant in an upright position
A milestone in the development of the PRESCHOOL includes the concept of: A. Theory of conservation B. Egocentricity C. Self-Actualization Theory D. Object permanence
B. Egocentricity
Which of the following BEST describes a developmental approach to PO medication administration for an infant based on Erickson's stages? A. Provide the medication in 60 ml of breast milk or formula. B. Have the parent hold the infant during administration. C. Swaddle the infant in your arms D. Touch the cheek to illicit rooting and administer quick
B. Have the parent hold the infant during administration.
You are doing education on immunizations and vaccines for the family of a 5 month old. You recommend that the PARENTS receive which of the following vaccines? A. Polio B. Influenza C. Hepatitis B D. Hib (Haemophilus influenzae)
B. Influenza
For a nurse working with a school age child, which of the following strategies will be appropriate to conduct a vision screening? (Select all that apply) A. Refer for rescreening if they miss more than 1 letter on the 20/20 line B. Start at the top to establish a feeling of success C. Build rapport if possible by asking about school or hobbies D. Allow the child to ask questions prior to starting E. Praise a child with above average vision
B. Start at the top to establish a feeling of success C. Build rapport if possible by asking about school or hobbies D. Allow the child to ask questions prior to starting
Which of the following best describes a developmentally based approach to assisting a school-age child with physical therapy exercises? A. Tell them that lots of famous athletes need physical therapy B. Use favorite activities in school as a motivator C. Use fantasy and "play pretend" in performing the exercises. D. Tell the child they can play video games after they are done.
B. Use favorite activities in school as a motivator
Preoperational (2-7):
Concepts are concrete (literal): what they can see, feel, hear. Can only concentrate on one object at a time - centration. Unable to think abstractly or reason. Unable to understand conservation - clay shapes, glasses of liquid, etc. Uses and builds upon language. Play becomes socialized. Egocentric—difficulty seeing another's viewpoint
Trust 0-12 months
Corresponds to Freud's oral stage - getting and taking in through all of the senses Influence depends largely on the maternal relationship This concept is present throughout life. Able to form healthy relationships as a result Trust in themselves as well as significant caretaker
Which size needle and which site would you use to administer influenza ordered IM for a 10 year old? A. 1 1/2 inch 22 gauge needle to the Deltoid muscle B. 1 inch 22 gauge to the Ventrogluteal muscle C. 1 inch 22 gauge to the Dorsogluteal muscle D. 1 inch 22 gauge needle to the Deltoid muscle
D. 1 inch 22 gauge needle to the Deltoid muscle
A milestone in the development of an INFANT includes which of the following concepts? A. Theory of conservation B. Egocentricity C. Self-Actualization Theory D. Object permanence
D. Object permanence
Which of the following is a possible reason for a child to not meet the vision screening criteria? A. Consistently answering heart for an apple symbol B. Using play to make the screening fun C. Missing one symbol or letter on the 20/20 line D. Pushing too hard with their hand
D. Pushing too hard with their hand
The nurse is preparing a 4-year-old to go visit an older sibling in the pediatric intensive care unit (PICU). What teaching method would best help in this child's preparation? a) dolls b) video c) story d) pictures
Dolls Preschool-age children tend to be frightened of intrusive procedures. Explaining to preschool-age children what the sibling may look like or what the environment may look like is difficult for them to comprehend. Explaining to children why the tubes are necessary, why the sibling cannot talk, and what the sibling will look like is best taught with dolls or puppets. Using dolls or puppets help children visualize details. Pointing to a place on a doll's body is not as intrusive as pointing to the child's own body. Visualizing the tubes coming out of the doll helps the child visualize details. Explaining to children why the tubes and the machines are necessary calls for clear understanding and praise for learning. Pictures, videos, and stories do not allow the child to actively participate in the learning process.
What kind of pain scale is used for SCHOOL AGE?
Numeric
What is the learning style for preadolescence?
Prefer interactive, "hands on" and skill learning Models Prefer to self-manage
What is the learning style of the elderly?
Prefer personal care Need repetition May require print/louder sound
The parents of a 2 year old are concerned because the toddler only says a few words. What strategies should the nurse suggest to the parents? Select all that apply. Read books aloud to the toddler. Name aloud the objects being played with. Always answer questions using correct grammar. Have the toddler watch educational television. Use pronouns when speaking. Use baby talk when speaking.
Read the books aloud to the toddler. Name aloud the objects being played with. Always answer questions using correct grammar. Have the toddler watch educational TV. Reading aloud is an effective way to strengthen vocabulary. Also, urge parents to encourage language development by naming objects as they play with their child or when they give their toddler something. This helps children grasp the fact words are not meaningless sounds; they apply to people and objects and have uses. Always answering a child's questions is another good way to do this. Watching television promotes little learning as the activity is passive and it is difficult to discern how language caused the action. The American Academy of Pediatrics recommends television viewing should be severely limited until at least 2 years of age. Because children learn language from imitating what they hear, if they are spoken to in baby talk, their enunciation of words can be poor; if they hear examples of bad grammar, they will not use good grammar. Remind parents pronouns are difficult for children to use correctly; many children are 3½ or 4 years of age before they can separate the different uses of "I," "me," "him," and "her."
During a visit to the pediatric clinic the mother of a 2-year-old tells the nurse that her husband is concerned that their son isn't potty trained yet. The mother states, "There is no way he could be potty trained. His bladder is too small." How should the nurse respond? a) "Two years old is rather early for a boy to be potty-trained." b) "The bladder of a 2-year-old is actually the size of an adult's bladder, but there are a lot of variables to when a child is potty-trained." c) "Your husband is correct, at the age of 2 your son should have a good amount of urine control." d) "You should talk to the physician about your son not being potty-trained in case there are issues preventing him from being able to control his urine flow."
b) "The bladder of a 2-year-old is actually the size of an adult's bladder, but there are a lot of variables to when a child is potty-trained." Bladder and kidney function reach adult levels by 16 to 24 months of age, but there are many factors that determine when a child is ready to be potty-trained. The other options are misleading the parent regarding potty-training.