Nursing Care of Children Health Promotion and Maintenance Quiz

A nurse correctly understands which of the following characteristics is a possible developmental delay for a 3-month-old client? Select one: a. The infant demonstrates stranger anxiety b. The infant is unable to point to objects c. The infant is unable to sit with support d. The infant does not raise his head when placed on his abdomen

d. The infant does not raise his head when placed on his abdomen When placed on the abdomen the 3 month old should attempt to raise his head. Some sources refer to this as "tummy time" which provides the infant with the stimulation to strengthen upper body and neck muscles in preparation for good head control when sitting upright and the some of the muscles required for crawling.

There are different parenting styles that are exhibited within a family. Which of the following parenting styles is exhibited when a parent states, "My child can play video games for one hour a day after his homework is completed"? Select one: a. Permissive b. Democratic c. Dictatorial d. Passive

b. Democratic This parent is exhibiting a democratic/authoritative parenting style. The parent directs the child's behavior by setting rules and explaining the reason for each rule setting.

A nurse is caring for a client with respiratory syncytial virus (RSV). The nurse is aware that which of the following strategies would not prevent the spread of infection? Select one: a. Performing good hand hygiene. b. Discouraging the sharing of eating utensils. c. Covering the nose and mouth. d. Encouraging children to participate in school activities.

d. Encouraging children to participate in school activities. Infected children should be kept away from contact with well children.

A nurse is planning community education focusing on the principles of first aid. Which of the following strategies is likely to be most effective with adolescent learners? Select one: a. Actively involve the participants in practice of techniques. b. Simple lecture format. c. Teach the most crucial content early in the session. d. Divide the planned program into several sessions over several weeks.

a. Actively involve the participants in practice of techniques. Adolescent learners will learn best when actively involved in participation and use of psychomotor skills.

A 3-month-old infant has just undergone a cheiloplasty. The nurse is conducting an assessment following the procedure and needs to complete a pain assessment. Which of the following pain assessment tools will the nurse use to conduct this pain assessment? Select one: a. FLACC b. Oucher c. Numeric scale d. FACES

a. FLACC This pain assessment tool is recommended for infants and children 2 months to 7 years of age. Pain is rated on a scale of 0 to 10. Face (F), Legs (L), Activity (A), Cry (C), and Consolability(C)are assessed.

The parent of a two-year-old child reports feeling frustrated with the fact that her son is saying no to everything. The nurse should teach the parent that this behavior is a normal expression of the child's desire to accomplish which of the following? Select one: a. Increase their independence. b. Gratify their oral fixation. c. Develop their sense of trust. d. Finish a project they set out to do.

a. Increase their independence. The drive for independence is expressed by the toddler opposing the desires of those in authority (tantrums) and attempting to do everything for themselves. The Erickson developmental stage for this age is "Autonomy vs. Shame and Doubt."

A nurse is helping parent's select appropriate independent activities for their 8-year-old child. Which of the following would be an appropriate activity? Select one: a. Providing frequent trips to the library b. Encouraging the child to assume care of the family pet c. Allowing the child to play video games d. Playing touch football

a. Providing frequent trips to the library

A nurse has administered the first DTaP (diphtheria toxoid, tetanus and pertussis) immunization to a two-month-old infant. For which of the following symptoms should the nurse teach the parents to seek immediate medical attention? Select one: a. The baby is crying inconsolably for more than three hours b. The baby develops swelling or redness at the injection site c. The baby develops a localized or generalized rash d. The baby has an axillary temperature of 100.4o F. (38o C)

a. The baby is crying inconsolably for more than three hours Inconsolable crying lasting more than three hours and/or seizures within 48 hours of vaccination is a sign of encephalopathy that must be treated immediately.

The nurse is assisting the parents of a school-aged child with a plan to prepare him for the impending death of a family member. What would be the potential behavior of the school-aged child when faced with this stressor? Select one: a. Uncooperative behavior b. Believe that death is temporary c. Same emotional demonstration as his parents d. Accepting behavior of this situation

a. Uncooperative behavior

A nurse is teaching a community health class on communicable diseases to adolescents. During the discussion on infectious mononucleosis, which statement would lead the nurse to conclude that further teaching is needed? Select one: a. "Mononucleosis can be confirmed by a blood test." b. "Mononucleosis is a bacterial infection." c. "A person with mononucleosis is at risk for a ruptured spleen." d. "A person with mononucleosis would have flu-like symptoms including a low grade fever, sore throat and fatigue."

b. "Mononucleosis is a bacterial infection." Mononucleosis is a viral infection caused by the Epstein-Barr virus.

At a well-child visit, the parents report that their toddler occasionally touches and fondles her genital area. The parents ask the nurse if this behavior is something to be concerned about. Which of the following is a correct response? Select one: a. This is an early emergence of sexual expression that should be discouraged b. Awareness of body structures and sensations is normal and expected c. Your child is probably imitating behaviors that she has observed d. This is a possible infection or irritation in the genital area

b. Awareness of body structures and sensations is normal and expected Genital self-stimulation by the toddler is normal and expected. It is a new area to explore, similar to exploring the toes at an earlier age, but it has pleasurable sensations too! It should be ignored unless the behavior becomes pervasive, and then it should still be ignored and the child should be distracted to come and do some fun and exciting activity

A nurse is collecting data on a 5-month-old infant. Which of the following is an expected finding? Select one: a. Respirations 21 to 24/min b. Babinski reflex present c. Stepping reflex present d. Pulse rate 70 to 80/min

b. Babinski reflex present

A nurse is caring for a client being discharge home who has hemophilia. Which of the following points would be taught to the parents prior to discharge? Select one: a. Report to the provider a pink, nonpruritic macular rash. b. Encourage child to participate in team activity sporting events. c. Provide heat to control bleeding episodes. d. Dress toddlers in extra layers of clothing.

d. Dress toddlers in extra layers of clothing.

A school-aged child has been recently diagnosed with attention deficit hyperactivity disorder (ADHD). What activities can the school nurse provide to the parents to help improve school performance? Select one: a. Encourage the child to sit at the dining room table until all homework is done b. Divide tasks into small projects, allowing frequent breaks. c. Allow the child to work when they feel like it. d. Insist that the child read quietly to himself until he understands the instructions.

b. Divide tasks into small projects, allowing frequent breaks. Children with ADHD have a hard time focusing for extended periods of time. Parents and teachers should obtain the child's attention prior to giving directions, and allow tasks to be completed in small increments. Efforts should be made to time tasks to time of day when the child has the best attention span. Creating 'games' out of homework can also help obtain academic success.

A nurse is changing a dressing on a preschool-aged child who has a healing wound on a lower extremity. Which of the following nonpharmacologic comfort measures would be most appropriate for this child? Select one: a. Promising the child a special treat in exchange for cooperation. b. Encouraging the child to watch a favorite cartoon on television. c. Assisting the child to take deep breaths and focus on relaxing. d. Teaching the child how to go 'to a different place' using their imagination.

b. Encouraging the child to watch a favorite cartoon on television.

A nurse is caring for a child who has leukemia. What discharge teaching would be provided to the parents prior to discharge? Select one: a. Report developmental delays to the provider. b. How to properly use vascular access devices. c. Side effects of radiation therapy. d. Encourage parents not to palpate the stomach.

b. How to properly use vascular access devices. Children who have Leukemia will not go thru radiation treatment therapy. Depending on the type of Leukemia will determine the chemotherapy treatment.

The nurse is caring for a child with cystic fibrosis. What provider order would the nurse question? Select one: a. Administer the influenza vaccine b. Limit physical activity c. Oxygen therapy via nasal cannula at 2 L/min d. High protein diet

b. Limit physical activity

A distracted 7-year-old student is sent to the school nurse by his teacher. When the nurse checks his hair and scalp, the nurse notes the evidence of pediculosis capitis. What are recognizable signs of this form of skin infestation? Select one: a. Multiple tiny pustules on the scalp with no abnormal findings on the hair shafts. b. Small white spots that adhere to the hair shaft, close to the scalp. c. Scaly, circumscribed patches on the scalp, with mild alopecia in these areas. d. Flaking of the scalp with pink, irritated skin exposed

b. Small white spots that adhere to the hair shaft, close to the scalp. The small white spots that adhere to the hair shafts are the eggs, or nits of lice (pediculosis capitis).

A nurse is taking the health history of a school-age girl. Which statement by the client's mother indicates a need for further teaching regarding the client's nutritional status? Select one: a. "We increase her protein intake when she's playing sports." b. "She enjoys helping to prepare her snacks in the kitchen." c. "We allow her to pick out a treat at the grocery store for good behavior." d. "She eats a large breakfast every morning."

c. "We allow her to pick out a treat at the grocery store for good behavior." This statement indicates a need for further teaching. This client's mother should be educated about the importance of praising the client's abilities and skills rather than using food as a reward, which may lead to an increased risk for obesity.

A nurse has provided discharge education to a school age client and his parents following a radius fracture with cast application. Which of the following statements by the client's parent indicates a need for additional teaching? Select one: a. "We will notify the provider if his fingers become swollen and dark." b. "We will reposition him every 2 hours until the cast is dry." c. "When we get home we will use a hair dryer to finish drying the cast." d. "We will keep the cast elevated about his heart for the next 24 hours."

c. "When we get home we will use a hair dryer to finish drying the cast." This statement indicates a need for additional education. Heat lamps/hair dryers should not be used to dry the cast as it could cause injury to the tissue under the cast.

A nurse is educating the parents of an infant about symptoms that should be reported to the provider. What finding should be immediately reported? Select one: a. Mild diarrhea b. Difficulty evacuating bowels c. Decreased urine output d. Abdominal distension

c. Decreased urine output

The nurse is conducting a physical examination of a 2-month-old with suspected pyloric stenosis. Which finding indicates pyloric stenosis? Select one: a. Abdominal pain and irritability b. Perianal fissures and skin tags c. Hard, moveable "olive-like mass" in the upper right quadrant d. Sausage-shaped mass in the upper mid abdomen

c. Hard, moveable "olive-like mass" in the upper right quadrant A hard, moveable "olive-like mass" in the right upper quadrant is the hypertrophied pylorus. The client will experience vomiting often after feedings, demonstrates constant hunger and shows signs of dehydration and failure to gain weight.

A client is diagnosed with rheumatic fever. Which clinical manifestation would the nurse recognize associated with the presentation of rheumatic fever? Select one: a. Cough b. Purulent nasal discharge c. Polyarthritis d. Irritability, poor concentration and behavioral problems

c. Polyarthritis

A nurse concludes that additional teaching about the Diabetic Sick Rule is needed when the mother of the child states which of the following? Select one: a. "I will continue to give my child the oral antidiabetic agent." b. "I will encourage my child to sugar-free, non-caffeinated liquids." c. " I will notify my health care provider if vomiting occurs more than once." d. "I will take my child blood sugar every 6 hours."

d. "I will take my child blood sugar every 6 hours." The blood glucose level should be taken at minimum every 3 hours. Additional teaching will be required.

A nurse is providing education to the mother of a 10-year-old child about to undergo scoliosis screening. Which of the following statements by the mother indicates a need for further teaching? Select one: a. "My child should be undressed down to her under wear." b. "The examiner will be looking for symmetry in alignment of shoulders or hips." c. "The examiner will be looking for asymmetry of the ribs and flanks." d. "My child will be asked to stand upright, arms stretched above the head."

d. "My child will be asked to stand upright, arms stretched above the head." The adolescent client should be leaning forward at the waist with arms hanging down; upright with arms stretched above the head would not allow proper screening.