MC-M4 PRACTICE QUESTIONS

how should solid foods be introduced & what age?

-6 months. -1 new food every 5-7 days (assess for allergies) -start w fruits & vegetables

When can cow's milk be introduced?

12 months

Where is the apical HR assessed in children <7 y/o?

4th intercostal space

Where is the apical HR assessed in children >7 y/o?

5th intercostal space

Breast milk is a complete diet until ___ months?

6

How many teeth should infants have by 1 yr of age

6-8

At what age should posterior fontanels close by?

8 weeks

Which of the following pieces of information should the nurse include in the teaching to the guardians of an infant with failure to thrive? A. add fortified rice to the formula B. alternate feedings between several family members C. offer the infant juice between feedings D. feed on demand rather than on a schedule

A. add fortified rice to the formula

The parents of a child who has possible intussusception asks the nurse how the diagnosis is determined? Which of the following responses should the nurse make? A. an abd ultrasound will confirm the pocket in the intestine B. genotyping will be done to identify this condition C. biopsy will be done on a small amount of tissue from the colon D. An upper GI series should identify the area involved

A. an abd ultrasound will confirm the pocket in the intestine

Education about the introduction of solid foods to the parents of an infant. Which of the following instructions should the nurse include? A. begin after the extrusion reflex has diminished B. introduce solid foods between 2-3 months C. wait until infants first tooth erupts D. add sweetener such as light corn syrup to bland foods

A. begin after the extrusion reflex has diminished

A nurse is caring for a preschool-aged pt who is dying. Which of the following findings is an age appropriate reaction to death by the child? SATA A. child views death as similar to sleep B. child is interested in what happens to his body after death C. child recognizes that death is permanent D. child believes his thoughts can cause death E. child thinks death is a punishment

A. child views death as similar to sleep D. child believes his thoughts can cause death E. child thinks death is a punishment

2- year old toddler, the nurse should expect which of the following behaviors during the assessment? A. prefers to sit in the parent's lap during exam B. child interested in how the exam equipment works C. child asks specific questions about body functions D. child questions how her development compares to other children the same age

A. prefers to sit in the parent's lap during exam

Which of the following findings should the nurse report to the provider as a delay in the development of a 9 month old infant? A. using pincer grasp to pick up blocks B. requiring support to sit for prolonged periods C. turning head toward parents voice D. reaching for mother & saying mama

B. requiring support to sit for prolonged periods

A nurse is caring for a child who is in the ED after ingesting a bottle of acetaminophen. Which of the following medications should the nurse plan to administer? A. digoxin immune fab B. acetylcysteine C. naloxone D. vitamin k

B. acetylcysteine

A nurse is assessing a 7 yo child's psychosocial development. Which of the following findings should the nurse recognize as requiring further evaluation? A. child prefers playmates of the same sex B. child is competitive when playing board games C. child complains daily about going to school D. child enjoys spending time alone

C. child complains daily about going to school

the parents of a child recently diagnosed with cerebral palsy ask the nurse about the limitations of the disorder. The nurse responds by explaining that the limitations occur as a result of which pathophysiological process? A. infectious disease of the central nervous system B. inflammation of the brain as result of viral illness C. chronic disability characterized by impaired muscle movement & posture D. congenital condition that results in moderate to severe intellectual disabilities

C. chronic disability characterized by impaired muscle movement & posture

A nurse assessing a 24 month old who has a new diagnosis of autism spectrum disorder (ASD). Which of the following findings should the nurse expect? A. wanting to be held frequently B. ability to build a tower of 10 cubes C. impaired language skills D. ability to stand on 1 foot

C. impaired language skills

RN is providing anticipatory nutritional guidance for caregivers of a 5 month old infant. Which of the following should the nurse include in the teaching? A. switch infant from formula to low fat cows milk at 6 months B. heat fruit juice before offering to infant C. introduce a new food every other day D. allow infant to try finger foods such as crackers after 6 months of age

D. allow infant to try finger foods such as crackers after 6 months of age

the nurse is preparing to care for a child w a diagnosis of intussusception. The nurse reviews the child's record & expects to note which sign of this disorder documented? A. watery diarrhea B. ribbon-like stools C. profuse projectile vomiting D. bright red blood & mucus in the stools

D. bright red blood & mucus in the stools

Color vision is assessed using what test?

Ishihara color test or the Hardy-rand-rittler test?

In what order should vital signs be assessed on an infant?

RR, HR, BP, Temp

What test is used to assess visual acuity in older children?

Snellen or Symbol Chart

What do sunken fontanels indicate?

dehydration

Where is skin turgor checked on an infant? (LOCATION)

on the abdomen

How to see internal ear of infants & toddlers? (<3 years old)

pull pinna down & back to visualize tympanic membrane

How to see internal ear of children >3 years old?

pull pinna up & back to visualize tympanic membrane

gross motor skill for 3 years?

rides tricycle & stands on one foot

Manifestations of nutritional deficiency?

stringy, dull, brittle, & dry hair.

gross motor skill for 4 years?

throws & catches ball -plays mom &. dad, cooperates w other children. plays board/card games

Which of the following findings in a child's medical record should the nurse identify as a risk factor for ADHD? A. pt's family has a middle class socioeconomic background B. child had prenatal exposure to alcohol on a regular basis C. both siblings of the child show moderate activity levels in school & play activities D. childs mother currently has DM

B. child had prenatal exposure to alcohol on a regular basis

Nurse is preparing to administer a liquid med to an infant. Which of the following actions should the nurse take? A. Admin med while infant is supine B. give med at the side of the mouth C. add the med to a full bottle of the infants formula D. admin the med slowly while holding the nares closed

B. give med at the side of the mouth

A nurse is providing anticipatory guidance about accidental ingestion of a toxic substance to the parents of a toddler. The nurse should instruct the parents to take which of the following actions first if the child ingests a hazardous substance? A. give the toddler milk B. go to an ED C. call the poison control center D. induce vomiting

C. call the poison control center

a child is hospitalized bc of persistent vomiting. The nurse should monitor the child closely for which problem? A. diarrhea B. metabolic acidosis C. metabolic alkalosis D. hyperactive bowel sounds

C. metabolic alkalosis

A nurse is teaching the parents of a child who has cerebral palsy. Which of the following statements should the nurse make? A. you child will be unable to eat by mouth B. your child will be unable to participate in recreational activities C. your child will need a botulinum toxin A injection to reduce muscle spasticity D. your child will need throw rugs placed over non-carpeted areas

C. your child will need a botulinum toxin A injection to reduce muscle spasticity

When teaching a toddler's parent about the correlation of nutrition with lead poisoning, which of the following info is appropriate for the nurse to include in the teaching. A. decrease the childs vitamin c intake until the blood level decreases to 0 B. admin a folic acid supplement each day C. give pancreatic enzymes to the child w meals & snacks D. ensure the child's dietary intake of calcium & iron is adequate

D. ensure the child's dietary intake of calcium & iron is adequate

Clinic nurse reviews the record of an infant & notes that the primary HCP has documented a diagnosis of suspected Hirschsprung's disease. The nurse reviews the assessment findings documented in the record, knowing that which sign most likely led the mother to seek health care for the infant? A. diarrhea B. projectile vomiting C. regurgitation of feedings D. foul-smelling ribbon like stools

D. foul-smelling ribbon like stools

Nutrition education for a 12 month old, what statement by the parent indicates a need for further teaching? A. i can give my baby 4 oz of juice to drink each day B. i will offer my baby dry cereal & chilled banana slices as snacks C. i am introducing my baby to the same foods the family eats D. my infant drinks at least 2 qt of skim milk/day

D. my infant drinks at least 2 qt of skim milk/day

The nurse provides feeding instructions to a parent of an infant diagnosed with gastroesophageal reflux disease. Which instruction should the nurse give to the parent to assist in reducing the episodes of emesis? A. provide less frequent, larger feedings B. burp the infant less frequently during feedings C. thin the feedings by adding water to the formula D. thicken the feedings by adding rice cereal to the formula

D. thicken the feedings by adding rice cereal to the formula

a nurse is providing education about introducing new foods to the guardians of a 4-month-old infant. The nurse should recommend that the caregiver introduce which of the following foods first? a. Stained yellow vegetables b. Iron-fortified foods c. Pureed fruits d. Whole milk

b. Iron-fortified foods

A nurse is preparing to assess a preschooler. Which of the following actions should the nurse take to prepare the child? a. Allow child to role-play using mini equipment b. Use medical terminology to describe what will happen c. Separate the child from the caregiver during exam d. Keep medical equipment visible to the child.

a. Allow child to role-play using mini equipment

What should we teach parents to do when infant has diaper dermatitis?

leave the zinc oxide ointment intact & reapply as necessary during diaper changes

At what age should anterior fontanels close by?

between 12-18 months

A nurse is assessing a 12-month-old infant during a well-child visit. Which of the following findings should the nurse report to the provider? a. Closed anterior fontanel b. Eruption of six teeth c. Birth weight doubled d. Birth length increased by 50%

c. Birth weight doubled

fine motor skill for 2 years?

draws w crayons good finger/hand coordination

A nurse is caring for a 6 month old who has intussusception. Which of the following actions should the nurse take? A. prepare to administer high-dose steroids B. give the child magnesium hydroxide PO C. prepare the child for a barium enema D. inform the parents that the child will need a colostomy

C. prepare the child for a barium enema

4 yr old who ingested toilet bowl cleaner. The child has hemoptysis, is crying, & states "it burns". which of the following actions should the nurse perform? SATA A. identify how much cleaner was in the bottle B. administer activated charcoal C. perform immediate gastric lavage D. insert an iv for morphine administration E. apply a pulse oximeter

A. identify how much cleaner was in the bottle D. insert an iv for morphine administration E. apply a pulse oximeter

A nurse providing teaching about promoting sleep with the parent of a 3 yo toddler. Which of the following information should the nurse include? A. follow a nightly routine & established bedtime B. encourage active play prior to bedtime C. let the child remain awake until tired enough to go to sleep D. reward the child with a food treat prior to sleep if the child goes to bed on time

A. follow a nightly routine & established bedtime

RN teaching the parent of an infant about home safety. Which of the following pieces of info should the nurse include? (SATA) A. wheeled infant walker B. soft pillows around the edge of the infant's crib C. rear facing car seat position D. safety gate at top & bottom of stairs E. water heater temperature at 120 f

C. rear facing car seat position D. safety gate at top & bottom of stairs E. water heater temperature at 120 f

A nurse is assessing a 6-month-old. Which of the following reflexes should the infant exhibit? A. moro B. plantar grasp C. stepping D. tonic neck

B. plantar grasp

Nurse on pediatric unit is admitting a 4 yo child. Which of the following toys should the nurse plan to provide for the child to engage in independent play? A. brightly colored mobile B. plastic stethoscope C. small piece jigsaw puzzle D. book of short stories

B. plastic stethoscope

A nurse is creating a plan of care for an 18 month old who has cerebral palsy. which of the following interventions should the nurse include? A. use a mobile walker B. discourage activities involving repetitive joint movement C. use manual jaw control when feeding the toddler D. discourage the use of wrist splints

C. use manual jaw control when feeding the toddler

A pt is starting therapy with an amphetamine/dextroamphetamine mixture for ADHD. Which of the following manifestations should the nurse instruct the pt to identify as an adverse effect & report to the provider? A. restlessness B. insomnia C. palpitations D. weight gain

C. palpitations

Rn caring for a 4 month old child who is hospitalized. Which of the following toys should the nurse provide for the child? A. board book w large pics B. toy w moveable parts C. plastic mirror D. push-pull toy

C. plastic mirror

A nurse is caring for a 6 month of infant who has intussusception. which of the following actions should the nurse take? A. prepare to administer high-dose steroids B. give the child magnesium hydroxide PO C. prepare the child for a barium enema D. inform the parents that the child will need a colostomy

C. prepare the child for a barium enema

Nurse providing teaching to the family of a child who has autism . Which of the following statements indicates that the family understands the teaching? A. Donepezil might slow the progression of the disorder B. my child will prefer group therapy with other children C. we can help our child by structuring our daily routine D. our child probably has this condition as a result of prematurity

C. we can help our child by structuring our daily routine

A nurse on a pediatric unit is caring for a child who has Autism. Which of the following actions should the nurse take? A. provide activities to stimulate the child's interest in the environment B. make frequent eye contact when talking to the child C. offer the child choices when scheduling planned care D. ensure that the staff visits w the child are kept short

D. ensure that the staff visits w the child are kept short

A nurse is checking the vs of a 3 y/o child during a well-child visit. Which of the following findings should the nurse report to the provider? a. Temp 99.0 f b. HR 106/min c. RR 30/min d. b/p 88/54

c. RR 30/min

a nurse is assessing a child's ears. Which of the following findings should the nurse expect? a. Light reflex is located at the 2 o'clock position b. Tympanic membrane is red in color c. Bony landmarks are not visible d. Cerumen is present bilaterally

d. Cerumen is present bilaterally

Cerumen is a _________ finding?

expected

are vesicular sounds over the lungs expected or unexpected?

expected

What do bulging fontanels indicate?

increased ICP

Red reflex should be present in what age group?

infants

What is first food given to infant

iron-fortified cereal

gross motor skill for 5 years?

jump rope, walk backward -wants to be like friends, more independent

A nurse is providing teaching about baclofen to the guardian of a toddler who has cerebral palsy. Which of the following adverse effects should the nurse include? A. bradycardia B. muscle weakness C. diarrhea D. dry skin

B. muscle weakness

Plan of care for 18-month old with cerebral palsy. Which of the following interventions should the nurse include? A. use mobile walker for the toddler B. discourage activities involving repetitive joint movement C. use manual jaw control when feeding the toddler D. discourage the use of wrist splints

C. use manual jaw control when feeding the toddler

What test is used to assess visual acuity in children who can read letters & numbers?

Tumbling E & HOTV test

a nurse is performing a developmental screening on a 10-month-old infant. Which of the following fine motor skills should the nurse expect the infant to perform? (SATA) a. grasp a rattle by the handle b. try building a 2-block tower c. use a crude pincer grasp d. place objects into a container e. walks w one handheld

a. grasp a rattle by the handle

A nurse is performing a neurologic assessment on an adolescent. Which of the following responses should the nurse expect the adolescent to exhibit when assessing the trigeminal nerve? (SATA) a. Clenching teeth together tightly b. Recognizing sour tastes on back of tongue c. Identifying smells though each nostril d. Detecting facial touches w eyes closed e. Looking down & in with the eyes

a. Clenching teeth together tightly d. Detecting facial touches w eyes closed

A nurse is teaching a guardian of an infant about administration of oral medications. Which of the following should the nurse include in the teaching? (SATA) a. Use a universal dropper for medication administration b. Ask the pharmacy to add flavoring to the medication c. Add the med to a formula bottle before feeding d. Use the nipple of a bottle to administer the medication e. Hold the infant in a semi-reclining position

b. Ask the pharmacy to add flavoring to the medication d. Use the nipple of a bottle to administer the medication e. Hold the infant in a semi-reclining position

A nurse is providing teaching about dental care & teething to the caregiver of a 9-month-old infant. Which of the following statements by the caregiver indicates an understanding of the teaching? a. I can give my baby a warm teething ring to relieve discomfort b. I should clean my baby's teeth w a cool, wet wash cloth c. I can give advil for up to 5 days while my baby is teething d. I should place diluted juice in the bottle my baby drinks while falling asleep

b. I should clean my baby's teeth w a cool, wet wash cloth

A nurse is preparing to administer medication to a toddler. Which of the following actions should the nurse take (SATA) a. Identify the toddler by asking the caregiver b. Tell the caregiver to administer the medication c. Calculate the safe dosage d. Ask the toddler to pick a toy to hold during administration e. Offer juice after the medication

c. Calculate the safe dosage d. Ask the toddler to pick a toy to hold during administration e. Offer juice after the medication

A nurse is preparing to administer an IM injection to a child. Which of the following muscle groups is contraindicated? a. Deltoid b. Ventrogluteal c. Vastus lateralis d. dorsogluteal

d. dorsogluteal

gross motor skill for 2 years?

throws ball overhand pushes/pulls toys walk up/down the stairs

What ages should children remain rear-facing?

up until 2 years of age.

fine motor skill for 18 months?

uses cup & spoon. build tower of blocks

gross motor skill for 18 months?

walks well, jumps, pulls/pushes toys

Is an easily removed white coating on an infants tongue an expected finding?

yes - wipe mouth w washcloth. -oral candidiasis is not easily removed.

are sinus arrhythmias associated with respirations expected?

yes this is normal