NURS 2050 Maternal Child Health EXAM 1 Practice questions
Which percentage of birth weight will typically be lost by an infant within the first 4 days following delivery? a) 1% to 3% b) 5% to 10% c) 15% to 20% d) 25% to 30%
ANSWER: b) 5% to 10% Rationale Approximately 5% to 10% of the birth weight is lost by age 3 or 4 days as the result of the passage of stools and a limited fluid intake.
How many erupted teeth would the nurse expect a healthy 8-month-old infant to have? a) 2 b) 4 c) 6 d) 8
ANSWER a) 2
Which intervention would the nurse discuss with a child's parents whose primary tooth was knocked out on the playground? a) Use of a tooth spacer b) Disinfection with chlorhexidine c) Administration of tetanus prophylaxis d) Use of moist gauze to prevent infection
ANSWER a) use a tooth spacer Rationale When a primary tooth is knocked out because of trauma, a spacer is usually prescribed to maintain tooth alignment until the permanent tooth erupts. Chlorhexidine helps reduce oral lesions associated with chemotherapy. A tetanus prophylaxis or an antibiotic is preferable in case of open wounds to oral tissues. Use of moist gauze is suggested to prevent infection and bleeding in a child who is undergoing chemotherapy and whose platelet count is less than 20,000/mm
Arrange the following developmental milestones in the order they typically occur. a) Separation anxiety b) First responsive smile c) Pincer action d) First steps e) Recognize and prefer parent f) First repetitive syllables
ANSWER: 1. b) First responsive smile 2. e) Recognize and prefer parent 3. f) First repetitive syllables 4. c) Pincer action 5. a) Separation anxiety 6. d) First steps Generally, a baby will smile responsively by 2 months; recognize and prefer a parent by 4 months; produce repetitive syllables at 6 months; mimic the pincer action between 6-9 months and master it between 10-12 months; experiences separation anxiety beginning at 9 months; takes first steps around 12 months.
Which number of teeth does a 16-month old infant possess? Record your answer using a whole number.
ANSWER: 10 Rationale The formula for finding out the number of teeth is age in months, minus 6. This calculation gives the expected number of teeth in the child under 2 years of age. Therefore, the number of teeth expected in a 16-month old infant would be (16 - 6 = 10).
A newborn infant will typically lose 5-_______ % of his or her birth weight by day 3 or 4.
ANSWER: 10% Approximately 5% to 10% of the birth weight is lost by age 3 or 4 days as the result of the passage of stools and a limited fluid intake
Protective arm extension that occurs when an infant is suddenly thrust downward when prone is known as the parachute reflex and usually appears by age _________ months.
ANSWER: 9 The parachute reflex appears by age 7 to 9 months. This is a protective arm extension that occurs when an infant is suddenly thrust downward when prone.
Which assessment finding would cause the nurse to be concerned that an infant is underfed? Select all that apply. One, some, or all responses may be correct. a) Crying b) Restlessness c) Regurgitation d) Mild diarrhea e) Abdominal distention
ANSWER: a and b Rationale If an infant is not fed properly, the infant will cry frequently as a result of hunger. Restlessness also is an indication of underfeeding in an infant. Regurgitation involves spitting out of the stomach contents through the mouth. It happens when the infant is overfed. As a result of excess feeding, more pressure is exerted on the abdominal sphincter, and the infant may have mild diarrhea. Abdominal distention in the infant indicates the presence of high amounts of fat in the diet. It is not associated with underfeeding or overfeeding of the infant.
Which of the following foods contains sorbitol, which can prevent constipation in young children? 1. a and b 2. c and d 3. d only 4. All of the above a. Prunes b. Pears c. Fruit juice d. Watermelon
ANSWER: a and b Prune juice and apple juice contain sorbitol and can be useful administered to prevent constipation in children.
Which food would be avoided to prevent dental caries in children? Select all that apply. One, some, or all responses may be correct. a) Cakes b) Cheese c) Peanuts d) Dried fruits e) Raw vegetables
ANSWER: a and d Rationale Cakes and dried fruits are rich in sugar and most likely to contribute to dental caries in children. The bacteria in the oral cavity act on these sugars, releasing acids as a by-product that cause dental caries. Foods like cheese, peanuts, and raw vegetables do not cause dental caries in children because these do not contain fermentable carbohydrates
Which age would the nurse inform a parent to expect his other child to run well? a) 2 years b) 2.5 years c) 15 months d) 18 months
ANSWER: a) 2 years Rationale By 2 years of age, the child should run well. At 2.5 years, the child should be able to go up the stairs by alternating his or her feet. At the age of 15 months, the child is able to walk alone and crawl up the stairs. At 18 months, the child is able to run stiffly.
It is most appropriate to first introduce competitive games at age: a) 3 to 5 years. b) 5 to 6 years. c) 7 to 9 years. d) 12 to 15 years
ANSWER: a) 3 to 5 years. Nursing interventions with children should focus on encouraging optimal play activities and experiences that are age appropriate. Between the ages of 7 and 10 years, the development of play is competitive. Children at this age start to accept competition with structured rules.
During late adolescence, which amount of daily dietary fiber meets the American Academy of Pediatrics requirement? a) 30 g b) 70 g c) 50 g d) 60g
ANSWER: a) 30 g Rationale According to the American Academy of Pediatrics, the dietary requirement of fiber during late adolescence is 20 to 35 g/day, which is equal to the amount of fiber required for an adult. Therefore, 30 g fiber per day during late adolescence helps maintain a healthy digestive system. Providing 50 g, 60 g, or 70 g of fiber per day may cause bloating, gas, constipation, and cramping so should be avoided.
Which symptom of the child would the nurse address first according to Maslow's hierarchy of basic needs for a child who has constipation, is hypersensitive to touch, expresses feelings of loneliness, and needs constant attention? a) Constipation b) Hypersensitivity c) Lack of attention d) Feelings of loneliness
ANSWER: a) Constipation Rationale The nurse would first address the physiological needs of a child, according to Maslow's hierarchy of basic needs. Constipation is a physiological symptom. Hypersensitivity to touch comes under the next level of Maslow's hierarchy of basic needs because the child requires stimulation and motivation. Lack of attention and feelings of loneliness are the emotional needs of the child. Therefore, the nurse should address them after addressing the symptoms of constipation in the child.
The nurse is reducing the risk of which complication when instructing the parents of a 2-year-old child to provide only a pea-sized amount of toothpaste for brushing? a) Fluorosis b) Gingivitis c) Oral bleeding d) Tooth erosion
ANSWER: a) Fluorosis Rationale Excess ingestion of fluoride may result in mottling of teeth or fluorosis. Using a pea-sized amount of toothpaste for brushing minimizes the amount of fluoride ingestion and thus prevents fluorosis. To prevent damage to the gingival tissues, the nurse should instruct the child's parents to follow an up-and-down motion while flossing. The nurse instructs the child's parents to use mouthwash containing disinfectants, such as chlorhexidine, to minimize oral bleeding. When the teeth come in contact with acids during episodes of vomiting and trauma, it may lead to erosion of the teeth. Appropriate protective devices can minimize tooth erosion, but using a pea-sized amount of toothpaste while brushing would not minimize tooth erosion.
What is the most important nursing intervention to promote a positive hospital experience for a 1-month-old infant? a) Provision of consistent caregivers b)Provision of consistent sensorimotor stimulation c)Maintenance of a rigid schedule d)Encouraging parents to bring in familiar toys from home
ANSWER: a) Provision of consistent caregivers The infant is in Erikson's developmental stage of trust versus mistrust. Provision of a consistent caregiver is the best way to meet the infant's security needs at this
What characteristic of physical development best describes the development of an 8-month-old? a) Sits steadily alone b) Shows preference for one hand c) Cruises on furniture d) Development of tears appear
ANSWER: a) Sits steadily alone Physical development of the 8-month-old includes sitting steadily alone, using the index finger and thumb as pincers, poking at objects, and enjoying dropping an article into a cup and emptying it.
Which expectation would the nurse include when reviewing the expected language skills of a 4-year-old child with the parents? a) Tells a story b) Names four colors c) Counts 10 pennies correctly d) Repeats a sentence with six syllables
ANSWER: a) Tells a story Rationale A 4-year-old child should be able to tell a story. A 5-year-old should be able to name four colors and count 10 pennies correctly. A 3-year-old should be able to repeat a sentence with six syllables
Which interpretation would the nurse make when there is a difference between the height and weight of two percentile levels on the growth chart? a) The nutrition of the child should be evaluated. b) The child is experiencing a normal growth pattern. c) The development of the child should be evaluated. d) The child is above the median expectation for height.
ANSWER: a) The nutrition of the child should be evaluated. Rationale A difference of two or more percentile levels between height and weight may suggest an under- or overweight condition and warrants follow-up. A two percentile difference does not indicate that the child is experiencing a normal growth pattern or above the median expectation for height. The growth chart is not a developmental tool
Which milestone would the nurse be most concerned with for a 12-month-old infant during a well-child checkup? a) Unable to pull up to a sitting position b) Unable to walk 10 to 15 steps c) Doesn't drink from a sippy cup d)Provides frequent objections to foods
ANSWER: a) Unable to pull up to a sitting position A 12-month-old infant who is unable to pull up to a sitting position may have delays. The other actions usually have occurred by 12 months, but not necessarily.
Which condition would the nurse assess for in an adolescent patient who reports irritability, fatigue, and lack of appetite? a) Anemia b) Sleep apnea c) Hypertension d) Type 2 diabetes mellitus
ANSWER: a) anemia Rationale Signs of fatigue are common in adolescents because of their higher level of physical activity and irregular sleep patterns. If irritability and lack of appetite also accompany the fatigue, then the nurse should further assess for anemic conditions in the adolescent. The anemic conditions may be caused by malnutrition. The adolescent may develop type 2 diabetes and sleep apnea from the complications associated with obesity. Obesity can also result in hypertension. Hypertension is not associated with lack of appetite, fatigue, and irritability. Rather, hypotension may occur in a malnourished adolescent.
Which instruction would the nurse provide to an adolescent patient to promote a healthy lifestyle? Select all that apply. One, some, or all responses may be correct. a) Drink skim milk." b) "Include fruits in your diet." c) "Perform physical exercise." d) "Increase intake of electrolytes." e) "Include high-calorie fast foods in your diet
ANSWER: a, b and c Rationale The nurse would provide instruction to an adolescent patient in order to meet the nutritional demands of a healthy individual. The adolescent should be encouraged to drink skim milk because it provides an adequate amount of calcium without the excess fats. Fruits are an appropriate source of essential vitamins and minerals and are important to maintain a healthy lifestyle. Regular exercise is a relaxation technique that helps reduce the risk for heart disease and controls cholesterol levels. Intake of electrolytes is an intervention provided to a dehydrated patient; it is not necessary in an otherwise healthy adolescent. Adolescents are encouraged to avoid high-calorie fast foods to help reduce the risk for cardiovascular disease, high blood pressure, diabetes, and obesity.
Which characteristics are present in a well-nourished child? (Select all that apply.) a) Shiny hair b) Regular elimination c) Pale mucous membranes d) Protruding abdomen e) Erect posture
ANSWER: a, b and e Well-nourished children show steady gains in weight and height; are alert; have shiny hair, no fatigue circles beneath the eyes, skin color within normal limits, a flat abdomen, erect posture, well-developed muscles, firm and pink mucous membranes in the mouth and gums, no mouth or tongue lesions, teeth that erupt on schedule, good appetite, regular elimination, and energy and vitality; sleep well at night; and are not irritable
Which instruction by the nurse will promote optimal nutrition in a toddler who is reported to be a "picky eater " by the parents? Select all that apply. One, some, or all responses may be correct. a) Reduce sweets in the diet b) Provide nutritious snacks c) Avoid adding salt to the food d) Invite the child's playmate to lunch e) Provide vitamin supplements to the child
ANSWER: a, b, c and d Rationale Toddlers who are picky eaters should be given special care to prevent malnutrition. Reduction of sweets in the diet stimulates the child's appetite. Because picky eaters do not show interest in eating all kinds of foods, it is beneficial for them to have nutritious snacks to make sure the child is getting adequate nutrition. Inviting the child's playmate to lunch may increase the child's interest in eating lunch. This helps promote nutrition in the child. It is necessary to avoid adding salt in foods for infants to avoid high sodium intake. Vitamin supplements are necessary for a child if there is a documented vitamin deficiency. Ideally, the child gets needed vitamins and nutrients from their food.
Which characteristic is present in a well-nourished child? Select all that apply. One, some, or all responses may be correct. a. shiny hair b. Erect posture c. Regular elimination d. Protruding abdomen e. Pale mucous membranes
ANSWER: a,b and c Rationale Well-nourished children show steady gains in weight and height. They have shiny hair, and their skin color is within normal limits with no fatigue circles beneath the eyes. Their abdomen is flat, not protruding, and they have erect posture and well-developed muscles. The mucous membranes in the mouth and gums are firm and pink, not pale, and there are no mouth or tongue lesions; their teeth erupt on schedule. Their appetite is good, and they have regular elimination patterns. They are alert and energetic, and they have good vitality; they sleep well at night and are not irritable.
Which instruction would the nurse provide to a mother of a 6- month-old who reports the infant is vomiting milk after being bottle-fed and has frequent mild diarrhea? a) "Give the child more fluids." b) "Avoid overfeeding the child." c) "Feed the child more iron-rich foods." d) "Eliminate breastfeeding for a few days."
ANSWER: b) "Avoid overfeeding the child." Rationale The symptoms of overfeeding include regurgitation, mild diarrhea, and rapid weight gain. Regurgitation involves the expulsion of milk from the pharynx or esophagus. The mother would be instructed to avoid overfeeding the child. Stopping breastfeeding for few days may lead to malnutrition in the child. Increasing fluids helps compensate for fluid loss in such conditions as diarrhea. This intervention does not help prevent regurgitation and diarrhea in the child. Iron-rich foods prevent anemia and are not related to regurgitation and mild diarrhea in the child.
The nurse should encourage the parent to introduce tooth brushing to the child by age: a) 6 months. b) 1 year. c) 3 years. d) 7 years
ANSWER: b) 1 year. The nurse checks that all patients ages 1 year and older have toothbrushes. The Academy of Pediatric Dentistry recommends that the first dental visit occur by 1 year.
Which age range of children would the nurse expect to see playing house in which each child is assigned a specific role? a) Between 1 and 2 years old b) Between 3 and 5 years old c) Between 7 and 10 years old d) Between 10 and 13 years old
ANSWER: b) Between 3 and 5 years old Rationale Cooperative play is the type of play commonly seen with children 3 to 5 years of age. Children play with each other, each taking a specific role. Parallel play is the type of play commonly seen with children 1 to 2 years of age. Competitive play is seen with children 7 to 10 years of age. Group sports, explorative Internet activities, and electronic or computer games are seen in 10 to 13 years of age.
Which complication is the nurse trying to prevent in a 7- month-old infant by providing instructions to the parent to cook vegetables thoroughly when preparing food for the infant? a) Anorexia b) Choking c) Diarrhea d) Hyperthermia
ANSWER: b) Choking Rationale A 7-month-old infant does not have teeth for chewing. The nurse would instruct the parent to cook all seeded vegetables thoroughly to soften them and prevent the infant from choking on them. Complete cooking of vegetables would not prevent anorexia because the cooking process itself does not stimulate the appetite in the child. Thorough cooking of vegetables would not prevent diarrhea. Proper cooking of seeded vegetables does not prevent hyperthermia.
Which complication would the nurse discuss with a mother who feeds her infant with a bottle of milk at bedtime and the milk remains in the mouth throughout the night? a) Malocclusion b) Dental abscesses c) Periodontal disease d) Hyperplastic gingivitis
ANSWER: b) Dental abscesses Rationale The teeth become more vulnerable to decay at night as a result of the decreased production of saliva. If an infant drinks milk or sweetened juice at bedtime, the sugar combines with the bacterial flora in the mouth and causes tooth decay. Signs of early tooth decay include chalky white spots on tooth enamel near the gum line of the maxillary incisors. If left untreated, tooth decay can cause dental abscesses, which can lead to various other serious complications. Malocclusion is associated with nonnutritive sucking with a pacifier or thumb sucking. It does not result in tooth decay. Malpositioning of the erupting teeth can cause periodontal disease in later years if left untreated. Hyperplastic gingivitis is associated with the usage of orthodontic appliances that trap plaque and food and result in increased tooth decay.
Which nutrient would the nurse be most concerned about in a child who eats a vegetarian diet? a) High fat b) High fiber c) High protein d) High carbohydrates
ANSWER: b) High fiber Rationale Children on vegetarian diets often consume diets that are high in fiber. High-fiber diets in children can result in an increased loss of minerals and iron in the stool. High fat, protein, and carbohydrates are not usually a concern for a child consuming a vegetarian diet.
What food might cause botulism if given to an infant? a) Sugar b) Honey c) Egg yolk d) Green beans
ANSWER: b) Honey To prevent the development of botulism, honey should not be given to children younger than 2 years.
A group of children are observed playing house. Each child is assigned a specific role as mommy, daddy, or child. At what age does this type of play typically begin? a) Between 1 and 2 years old b) Between 3 and 5 years old c) Between 7 and 10 years old d) Between 10 and 13 years old
ANSWER: b) between 3 and 5 years old
During the first week of life, the newborn's weight: a) increases about 5% to 10%. b) decreases about 5% to 10%. c) stabilizes d) fluctuates widely.
ANSWER: b) decreases about 5% to 10 % Approximately 5% to 10% of the birth weight is lost by age 3 or 4 days as the result of the passage of stools and a limited fluid intake
Which age group of children enjoys finger foods and exhibits dawdling and regression? a) Infant b) Preschool c) School age Adolescent
ANSWER: b) preschool Rationale Dawdling and regression behaviors are common in toddlers and preschoolers. These children also enjoy finger foods. Dawdling and regression are not common in school-age children between the ages of 6 and 12. Adolescents aged 12 to 18 do not exhibit dawdling and regression, and they enjoy different types of foods. Infants aged 6 months to 1 year old do not show dawdling and regression.
What are the best foods for the nurse to recommend for a 2-year-old child diagnosed with mild constipation? a) Wheat crackers and apples b) Shredded wheat and cooked prunes c) Bananas and bran muffins d) Rice and black beans
ANSWER: b) shredded wheat and cooked prunes Shredded wheat and cooked prunes are high-fiber foods that can be recommended for relief of mild constipation in children older than 12 months of age
A mother expresses concern that her 1-year-old infant is overweight. She states that her family has a tendency to be overweight and wishes to discontinue formula feedings and start the infant on low-fat milk. The nurse assesses that the present weight of the infant is 24 lb. The infant's birth weight was 8 lb 2 oz. The best response of the nurse would be: a) to place the infant on low-fat milk because the infant is slightly overweight at this time. b) to place the infant on regular whole milk because the infant's weight is appropriate for his age. c) to indicate that the infant is underweight for his age and needs to have supplemental formula added to the diet. d) to note that infancy is a period of rapid growth and weight loss will occur as the infant becomes more active
ANSWER: b) to place the infant on regular whole milk because the infant's weight is appropriate for his age Weight doubles by age 6 months and triples by age 1 year. Whole cow's milk can be introduced after age 1 year, and low-fat milk can be introduced after age 2 years.
A mother verbalizes concern that her second-born son is reaching milestones but not as quickly as her first-born child. What would the nurse's best response be? a)"I will let the physician know right away." b)"Norms can vary greatly for the individual child." c)"Milestones should be reached consistently by each child." d)"A psychology consult should be ordered."
ANSWER: b)"Norms can vary greatly for the individual child."
A 9-month-old infant starts crying when the nurse takes him to sit on the exam table. The mother seems upset and states, "My baby knows that you will be doing something that hurts." What is the best response by the nurse? a)"The injections will be over quickly. I will let you provide comfort then." b)"Your baby is scared to be away from you. I will let you provide further comfort when I am done." c)"Your baby probably has a wet or dirty diaper. This will probably go better if you change it first." d)"Your baby will not remember this, and we have to do it so your baby can go to school when it is time.
ANSWER: b)"Your baby is scared to be away from you. I will let you provide further comfort when I am done." Babies exhibit separation anxiety at this age
Which statement made by the parents of a 4-year-old child indicates the need for additional teaching about behavioral patterns? Select all that apply. One, some, or all responses may be correct. a) "The child should be able to tell stories." b) "The child should be able to skip rope." c) "The child should be able to count 10 pennies accurately." d) "The child is likely to ask the meanings of several words." e) "The child should be able to use scissors to cut out pictures."
ANSWER: b, c and d Rationale A 4-year-old child may be able to hop on one foot but will not have the coordination to skip rope. The child would be unlikely to be able to count more than four pennies because language is not well developed at this age. Asking the meaning of words is behavior associated with children at the age of 5. Therefore, these statements made by the parents need correction. The 4-year-old child may tell stories and play with several children and can also use scissors to cut pictures under supervision.
What techniques should be used to soothe the irritable infant? (Select all that apply.) a) Vigorous rocking b) Singing c) Nonnutritive sucking d) Changing position frequently e) Swaddling snugly with the hands near the face
ANSWER: c and e Techniques to cope with an irritable infant include shielding the infant's eyes from bright light; sitting quietly without talking or singing; eliminating noise from radio, television, and computer; talking in a soft voice; changing the infant's position slowly; stopping the interaction and reducing environmental stimuli if the infant runs away, squirms, grimaces, or puts the hands in front of the face; swaddling the infant snugly in a lightweight blanket with extremities flexed and hands near the face; providing nonnutritive sucking; rocking the infant slowly and gently; avoiding sudden movements; cradling the infant firmly in the lap during feeding; and remaining still during sucking efforts.
Which information would the nurse share with the parents of a 15-month-old boy who do not understand why the child is not walking when all of their other children walked much earlier? a) Sometimes males have a tendency to walk later than females." b) "Hereditary traits play a role in motor development, which may contribute to delay." c) "Sometimes the younger child is pampered more, which may contribute to the delay. d) "If the family is very busy, it may be easy to forget to encourage the child to try and walk.
ANSWER: c) "Sometimes the younger child is pampered more, which may contribute to the delay. Rationale The ordinal position in a family can affect the growth and development of a child. The younger child has a tendency to be more pampered, which may contribute to the delay in walking. Males do not have a tendency to walk later than females. Hereditary traits contribute to the physical features of a child. It is not necessary to encourage a child to walk; the child will attempt to walk as they continue to develop.
An infant will experience passive immunity from the mother for approximately which number of weeks? a) 4 b) 8 c) 12 d) 24
ANSWER: c) 12 Rationale An infant experiences passive immunity for approximately 3 months, or 12 weeks.
For how many weeks will the infant experience passive immunity from his or her mother? a) 4 b) 8 c) 12 d) 24
ANSWER: c) 12 The infant experiences passive immunity for approximately 3 months, or 12 weeks
What age range is considered infancy? a) Birth to 6 weeks of age b) Birth to 1 year of age c) 4 weeks to 1 year of age d) 4 weeks to 2 years of age
ANSWER: c) 4 weeks to 1 year of age
Which intervention would the nurse use to help a parent determine how to develop the infant' s trust? a) Help the parents identify positive responses b) Help the parents cope with transient independence c) Assist the parents in assessing and interpreting needs d) Help the parents understand the development of limits and self discipline
ANSWER: c) Assist the parents in assessing and interpreting needs Rationale Assisting the parent in assessing and interpreting the needs of the infant will help develop the infant's trust. Helping parents identify positive responses promotes the newborn's adjustment to the environment. Helping the parents cope with transient independence will support the autonomy of a toddler. Assisting the parents in understanding that a child is developing his or her limits and self-discipline is a nursing intervention for a school-age child.
Which condition would the nurse be concerned about in an infant who is frequently fed purees of spinach, beets, and broccoli? a) Cystic fibrosis b) Phenylketonuria c) Methemoglobinemia d) Hypercholesterolemia
ANSWER: c) Methemoglobinemia Rationale Purees of spinach, broccoli, and beets contain high nitrite content. Nitrate triggers the oxidation of oxyhemoglobin, which results in the production of methemoglobin. The nurse would be concerned about a risk for methemoglobinemia in this infant. Cystic fibrosis is an autosomal recessive genetic disorder that affects the lungs. Feeding the child with puree of spinach, broccoli, and beets does not cause genetic disorders like cystic fibrosis. Ingestion of foods containing nitrites does not cause phenylketonuria in the young infant. Hypercholesterolemia in the infant is caused by the consumption of foods rich in fat but not caused by consumption of high nitrite-containing foods.
Which concern would the nurse expect to see most frequently when performing health screenings for children at risk in an urban community? a) Neglect b) Hygiene c) Nutrition d) Education
ANSWER: c) Nutrition Rationale Children in an urban community are most at risk for malnutrition. Nutrition and asthma are the most common problems in children worldwide. Nutrition is the most important because it is a basic need. Neglect, hygiene, and education should be assessed but are not the most frequently occurring problems for children at risk in an urban community. Children in urban communities may have limited access to care and clean water
The nurse is discussing home safety with the mother of a 4-month-old infant. Which of the following is a priority topic? a) Placing locks on cabinet doors that contain cleaning supplies b) Covering electrical outlets c) Raising and securing crib side rails d) Encouraging reading and talking to the infant
ANSWER: c) Raising and securing crib side rails Crib rails should be raised and securely locked. An infant should never be left unattended on a flat surface, such as a changing table. Infants younger than 4 months have rounded backs and can accidentally roll off a flat surface. Infants older than 4 months can voluntarily roll over.
Which substance would the nurse feed a 4-month-old infant who has intestinal bleeding resulting from an allergy to milk proteins? a) Low-fat milk b) Rice cereal c) Soybean mixture d) Carbohydrate-rich food
ANSWER: c) Soybean mixture Rationale Hypersensitivity to milk proteins may result in an allergy, intestinal bleeding, or other complications. Soybean mixture is rich in proteins, and it acts as a substitute for milk proteins. The nurse would feed a soybean mixture to the infant who is allergic to milk proteins. Intake of low-fat milk for an infant younger than 2 years may result in improper neurological development. The diet of the infant should include solid foods, such as rice cereal, after reaching 6 months of age. A 4-month-old infant may not be able to swallow solid foods, such as rice cereal. The nurse would not provide foods rich in carbohydrates because they may cause distention, flatus, and excessive weight gain in a 4-month-old infant.
To meet the needs (as described by Erikson) of a school-age child diagnosed with diabetes, the nurse should: a) explain carefully to the mother the need to adhere rigidly to dietary modifications. b) allow the child to eat whatever he or she wants and administer insulin to maintain optimum glucose levels. c) allow the child to perform his or her own blood glucose checks and administer his or her own insulin. d) perform blood glucose checks four times a day and at bedtime.
ANSWER: c) allow the child to perform his or her own blood glucose checks and administer his or her own insulin. School-age children are in Erikson's stage of industry, where the child gets results from his or her own efforts at performance. Patience is needed to allow school-age children to do things for themselves, even if it takes longer
Which instruction would the nurse provide the parent to improve oral hygiene in their child who has a disability? Select all that apply. One, some, or all responses may be correct. a) Use mouth protectors." b) "Use a normal toothbrush." c) "Use an aspirating catheter." d) "Use padded tongue depressors." e) "Use a battery-operated toothbrush."
ANSWER: c,d and e Rationale The nurse would instruct the parent to use an aspirating catheter, padded tongue depressors, and a battery-operated toothbrush to provide effective oral hygiene for a disabled child. An aspirating catheter connected to suction helps in removing food and toothpaste remnants from the oral cavity. A padded tongue depressor is used to hold the child's tongue against the floor of the mouth, which helps in effective cleaning of the oral cavity. A battery-operated toothbrush promotes optimal brushing in a disabled child. Mouth protectors are intended for children ages 6 to 12 years to avoid mouth injuries. They do not help in improving oral hygiene. The child's parents may not be able to properly maneuver a normal toothbrush, so this may not improve oral hygiene in a child with a disability
Which fiber-containing food accelerates the intestinal transit time and slows down the digestion of starch? Select all that apply. One, some, or all responses may be correct. a) Oats b) Apple c) Citrus fruit d) Wheat bran e) Whole-grain bread
ANSWER: d and e Rationale Water-insoluble fibers found in wheat bran, whole-grain breads, and some cereals accelerate the intestinal transit time and slow the digestion of starch. The water-soluble fiber found in oats, apples, and citrus fruits decreases the serum cholesterol levels by delaying the intestinal transit time.
An obese child is at risk for which psychosocial disorder? a) Mania b) Dementia c) Confusion d) Depression
ANSWER: d) Depression Rationale A child who is obese may have increased cholesterol, orthopedic problems, sleep apnea, high blood pressure, or type 2 diabetes mellitus. The child may not be able to participate in physical activities with friends and may remain isolated. Therefore, the child is more likely to have depression. Mania is a mood disorder in which the patient has both elevated moods and depressed moods. An obese child would not be more likely to have such mood swings. Dementia is a disorder in which the patient may have temporary or permanent memory loss. It is not associated with obesity. Confusion is the lack of abstract thinking. An obese child would not be more likely to have this disorder.
Which term describes the way in which a person grows and develops as dictated by genetics? a) Holism b) Genetics c) Genomics d) Maturation
ANSWER: d) Maturation Rationale Maturation is defined as the total way in which a person grows and develops as dictated by genetics. Maturation can also be affected by the environment. Holism is when the whole person is treated. Genetics is the study of genes and heredity. Genomics is concerned with the structure, function, evolution, and mapping of genomes
Which medication, when used by a pregnant patient, can result in yellowish-brown stains on the primary teeth of the infant? a) Iron supplements b) Phenytoin c) Vitamin supplements d) Tetracycline
ANSWER: d) Tetracycline Rationale Administration of tetracycline during pregnancy causes yellowish brown discoloration of the infant's teeth. Therefore, it is not safe for the pregnant patient to take tetracycline during pregnancy or for an adolescent to take under the age of 8. Administering iron supplements would be beneficial to the mother because they help maintain the hemoglobin levels during pregnancy. Iron supplements do not have any effect on the teeth of the developing infant. Administration of phenytoin during pregnancy leads to decreased salivary secretions and gingival overgrowth in the infant. Administration of vitamin supplements during pregnancy promotes healthy growth and development of the infant. Vitamin supplements do not have any effect on the teeth of the infant.
Which laboratory findings in a 12-year-old child with hypercholesterolemia would prompt a change in management from dietary therapy to drug therapy after 6 months of treatment? a) Total cholesterol levels of 140 mg/dL and low-density-lipoprotein cholesterol levels of 90 mg/dL b) Total cholesterol levels of 150 mg/dL and low-density-lipoprotein cholesterol levels of 100 mg/dL c) Total cholesterol levels of 180 mg/dL and low-density-lipoprotein cholesterol levels of 120 mg/dL d) Total cholesterol levels of 220 mg/dL and low-density-lipoprotein cholesterol levels of 150 mg/dL
ANSWER: d) Total cholesterol levels of 220 mg/dL and low-density-lipoprotein cholesterol levels of 150 mg/dL Rationale Hypercholesterolemia refers to elevated levels of cholesterol in the blood. Dietary therapy includes setting limits by planning daily requirements for an individual. This helps in preventing further increases in cholesterol levels by preventing further weight gain. Drug therapy is prescribed when the patient has very high levels of cholesterol that, if left untreated, may cause further severe damage to the heart and blood vessels. A patient with total cholesterol levels of 220 mg/dL and low-density-lipoprotein cholesterol levels of 150 mg/dL even after 6 months of treatment is at risk for heart failure, and therefore drug therapy is recommended. Total cholesterol levels of 140 and 150 mg/dL and low-density-lipoprotein cholesterol levels of 90 and 100 mg/dL in the body are desirable, and therefore drug therapy is not recommended. Total cholesterol levels of 180 mg/dL and low-density-lipoprotein cholesterol levels of 120 mg/dL indicate that the lipid levels are in borderline. Planning an appropriate diet may help prevent further increases in cholesterol levels thereby minimizing future risks
A 3-month-old infant is observed during a clinic visit. Highlight the observations in the following report that would suggest a follow-up would be indicated: "The infant appears well-developed and weighs 16 pounds today. The mother initially placed the infant on his abdomen. The infant made no effort to lift his head or roll over. The mother then places the infant on his back and engages in animated speech with him. The infant reaches out toward the mother's face with an open hand but does not smile responsively. The infant sucks energetically while breastfeeding and accepts strained baby food offered by the mother
ANSWER: weighs 16 pounds, The infant made no effort to lift his head, does not smile responsively and accepts strained baby food offered by the mother Rationale: A 3-month-old is expected to weigh between 12-13 pounds, lift up their head and chin, and smile spontaneously. First solid foods may be introduced cautiously at 6 months. Attempts to roll over are generally observed in a 4-month-old.
