Pediatric Exam 1 Test Questions

4. By what age does the posterior fontanel usually close? 1. 6-8 weeks 2. 10-12 weeks 3. 4-6 months 4. 8-10 months

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A 3-month-old infant, born at 38 weeks' gestation, will hold a rattle if it is put in her hands, but she will not voluntarily grasp it. The nurse should interpret this as: 1. Normal development. 2. Significant developmental lag. 3. Slightly delayed development due to prematurity. 4. Suggestive of a neurologic disorder such as cerebral palsy.

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A 9-year-old girl often comes to the school nurse complaining of stomach pains. Her teacher says she is completing her school work satisfactorily, but lately, has been somewhat aggressive and stubborn in the classroom. The school nurse should recognize this as which of the following? 1. Signs of stress 2. Developmental delay 3. Physical problem causing emotional stress 4. Lack of adjustment to school environment.

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A child has an evulsed (knocked-out) tooth. The parents are reluctant to try to reimplant the tooth. In which of the following should the tooth be placed for transport to the dentist? 1. Cold milk 2. Cold water 3. Warm salt water 4. Dry, clean jar

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A parent of an 18-month-old boy tells the nurse that he says "no" to everything and has rapid mood swings. If he is scolded, he shows anger and then immediately wants to be held. The nurse's best interpretation of this behavior is which of the following? 1. This is normal behavior for his age. 2. This is unusual behavior for his age. 3. He is not effectively coping with stress. 4. He is showing he needs more attention

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An 8-year-old girl tells the nurse that she has cancer because God is punishing her for "being bad." She shares her concern that if she dies, she will go to hell. The nurse should interpret this as being which of the following? 1. A belief common at this age 2. A belief that forms the basis for most religions 3. Suggestive of excessive family pressure 4. Suggestive of a failure to develop a conscience

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In terms of fine motor development, what should the infant of 7 months be able to do? 1. Transfer objects from one hand to the other 2. Use thumb and index finger in crude pincer grasp 3. Hold crayon and make a mark on paper 4. Release cubes into a cup

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In terms of gross motor development, what would the nurse expect a 5-month-old infant to do? 1. Roll from abdomen to back 2. Roll from back to abdomen 3. Sit erect without support 4. Move from prone to sitting position

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Parents tell the nurse that their toddler daughter eats little at mealtime, only sits at the table with the family briefly, and wants snacks "all the time." Which of the following should the nurse recommend? 1. Give her nutritious snacks. 2. Offer rewards for eating at mealtimes. 3. Avoid snacks so she is hungry at mealtimes. 4. Explain to her in a firm manner what is expected of her.

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Sara, age 4 months, was born at 35 weeks' gestation. She seems to be developing normally, but her parents are concerned because she is a "more difficult" baby than their other child, who was term. The nurse should explain that: 1. Infants' temperaments are part of their unique characteristics. 2. Infants become less difficult if they are not kept on scheduled feedings and structured routines. 3. Sara's behavior is suggestive of failure to bond completely with her parents. 4. Sara's difficult temperament is the result of painful experiences in the neonatal

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Steven, 16 months old, falls down a few stairs. He gets up and "scolds" the stairs as if they caused him to fall. This is an example of which of the following? 1. Animism 2. Ritualism 3. Irreversibility 4. Delayed cognitive development

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Teasing can be common during the school-age years. The nurse should recognize that which of the following applies to teasing? 1. Can have a lasting effect on children 2. Is not a significant threat to self-concept 3. Is rarely based on anything that is concrete 4. Is usually ignored by the child who is being teased

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The most fatal type of burn in the toddler age group is: 1. Flame burn from playing with matches. 2. Scald burn from high-temperature tap water. 3. Hot object burn from cigarettes or irons. 4. Electric burn from electrical outlets.

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The nurse is doing a routine assessment on a 14-month-old infant and notes that the anterior fontanel is closed. This should be interpreted as which of the following? 1. Normal finding 2. Questionable finding—infant should be rechecked in 1 month 3. Abnormal finding—indicates need for immediate referral to practitioner 4. Abnormal finding—indicates need for developmental assessment

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The nurse is guiding parents in selecting a daycare facility for their child. Which of the following is especially important to consider when making the selection? 1. Health practices of facility 2. Structured learning environment 3. Socioeconomic status of children 4. Cultural similarities of children

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The nurse is interviewing the father of 10-month-old Megan. She is playing on the floor when she notices an electrical outlet and reaches up to touch it. Her father says "No" firmly and removes her from near the outlet. The nurse should use this opportunity to teach the father that Megan: 1. Is old enough to understand the word "No." 2. Is too young to understand the word "No." 3. Should already know that electrical outlets are dangerous. 4. Will learn safety issues better if she is spanked

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The nurse notices that a 10-month-old infant being seen in the clinic is wearing expensive, inflexible, high-top shoes. The nurse should explain that: 1. Soft and flexible shoes are generally better. 2. High-top shoes are necessary for support. 3. Inflexible shoes are necessary to prevent in-toeing and out-toeing. 4. This type of shoe will encourage the infant to walk sooner

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The parent of 16-month-old Chris asks, "What is the best way to keep Chris from getting into our medicines at home?" The nurse should advise which of the following? 1. "All medicines should be locked securely away." 2. "The medicines should be placed in high cabinets." 3. "Chris just needs to be taught not to touch medicines." 4. "Medicines should not be kept in the homes of small children."

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The parents of a 2-year-old tell the nurse that they are concerned because the toddler has started to use "baby talk" since the arrival of their new baby. The nurse should recommend which of the following? 1. Ignore the "baby talk." 2. Explain to the toddler that "baby talk" is for babies. 3. Tell the toddler frequently "you are a big kid now." 4. Encourage the toddler to practice more advanced patterns of speech.

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What information could be given to the parents of a 12-month-old child regarding appropriate play activities for this age? 1. Give large push-pull toys for kinetic stimulation. 2. Place cradle gym across crib to facilitate fine motor skills. 3. Provide child with finger paints to enhance fine motor skills. 4. Provide stick horse to develop gross motor coordination

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What is the leading cause of death during the toddler period? 1. Injuries 2. Infectious diseases 3. Congenital disorders 4. Childhood diseases

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Which of the following is an appropriate play activity for a 7-month-old infant to encourage visual stimulation? 1. Playing peek-a-boo 2. Playing pat-a-cake 3. Imitating animal sounds 4. Showing how to clap hands

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Which of the following statements characterizes moral development in the older school-age child? 1. They are able to judge an act by the intentions that prompted it rather than just by the consequences. 2. Rules and judgments become more absolute and authoritarian. 3. They view rule violations in an isolated context. 4. They know the rules but cannot understand the reasons behind them

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Which of the following would be the best play activity for a 6-month-old infant to provide tactile stimulation? 1. Allow to splash in bath. 2. Give various colored blocks. 3. Play music box, tapes, or CDs. 4. Use infant swing or stroller.

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Which one of the following techniques is best for dealing with the negativism of the toddler? 1. Offer the child choices. 2. Remain serious and intent. 3. Provide few or no choices for child. 4. Quietly and calmly ask the child to comply.

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At what age should the nurse expect an infant to begin smiling in response to pleasurable stimuli? 1. 1 month 2. 2 months 3. 3 months 4. 4 months

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Kimberly's parents have been using a rearward-facing, convertible car seat, since shewas born. Most car seats can be safely switched to the forward-facing position when the child weighs how many pounds? 1. 10 2. 20 3. 30 4. 40

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The clinic is lending a federally approved car seat to an infant's family. The nurse should explain that the safest place to put the car seat is: 1. Front facing in back seat. 2. Rear facing in back seat. 3. Front facing in front seat with airbag on passenger side 4. Rear facing in front seat if an air bag is on the passenger side

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The most effective way to clean a toddler's teeth is: 1. For the child to brush regularly with a toothpaste of his or her choice. 2. For the parent to stabilize the chin with one hand and brush with the other. 3. For the parent to brush the mandibular occlusive surfaces, leaving the rest for the child. 4. For the parent to brush the front labial surfaces, leaving the rest for the child

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The nurse is assessing a 6-month-old healthy infant who weighed 7 pounds at birth. The nurse should expect the infant to now weigh approximately how many pounds? 1. 10 2. 15 3. 20 4. 25

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The nurse is discussing development and play activities with the parent of a 2-month-old boy. Recommendations should include giving him his first rattle at about what age? 1. 2 months 2. 4 months 3. 7 months 4. 9 months

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Two toddlers are playing in a sandbox when one child suddenly grabs a toy from the other child. Which of the following is the best interpretation of this behavior? 1. This is typical behavior because toddlers are aggressive. 2. This is typical behavior because toddlers are egocentric. 3. Toddlers should know that sharing toys is expected of them. 4. Toddlers should have the cognitive ability to know right from wrong.

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What information should the nurse give a mother regarding the introduction of solid foods during infancy? 1. Solid foods should not be introduced until 8 to 10 months, when the extrusion reflex begins to disappear. 2. Foods should be introduced one at a time, at intervals of 4 to 7 days. 3. Solid foods can be mixed in a bottle to make the transition easier for the infant. 4. Fruits and vegetables should be introduced into the diet first

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What is normally the earliest age at which an infant begins teething with eruption of lower central incisors? 1. 4 months 2. 6 months 3. 8 months 4. 12 months

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What is the best age for solid food to be introduced into the infant's diet? 1. 2 to 3 months 2. 4 to 6 months 3. When birth weight has tripled 4. When tooth eruption has started

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When teaching injury prevention during the school-age years, which of the following should the nurse include? 1. Teach the need to fear strangers. 2. Teach basic rules of water safety. 3. Avoid letting child cook in microwave ovens. 4. Caution child against engaging in competitive sports

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Which of the following is a characteristic of a toddler's language development at age 18 months? 1. Vocabulary of 25 words 2. Increasing level of comprehension 3. Use of holophrases 4. Approximately one third of speech understandable

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Which of the following is an appropriate recommendation in preventing tooth decay in young children? 1. Substitute raisins for candy. 2. Substitute sugarless gum for regular gum. 3. Use honey or molasses instead of refined sugar. 4. When sweets are to be eaten, select a time not during meals

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Which of the following is an important consideration for the school nurse who is planning a class on bicycle safety? 1. Most bicycle injuries involve collision with an automobile. 2. Head injuries are the major causes of bicycle-related fatalities. 3. Children should wear a bicycle helmet if they ride on paved streets. 4. Children should not ride double unless bicycle has an extra-large seat

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Which of the following is characteristic of development of a 2 -year-old child? 1. Birth weight has doubled. 2. Primary dentition is complete. 3. Anterior fontanel is open. 4. Binocularity may be established.

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Which of the following is descriptive of a toddler's cognitive development at age 20 months? 1. Searches for an object only if he or she sees it being hidden 2. Realizes that "out of sight" is not out of reach 3. Puts objects into a container but cannot take them out 4. Understands the passage of time, such as "just a minute" and "in an hour"

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Which of the following is descriptive of the play of school-age children? 1. Individuality in play is better tolerated than at earlier ages. 2. Knowing the rules of a game gives an important sense of belonging. 3. They like to invent games, making up the rules as they go. 4. Team play helps children learn the universal importance of competition and winning

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Which of the following statements accurately describes physical development during the school-age years? 1. Child's weight almost triples. 2. Child grows an average of 2 inches per year. 3. Few physical differences are apparent among children at the end of middle childhood. 4. Fat gradually increases, which contributes to child's heavier appearance.

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Which of the following statements is correct about toilet training? 1. Bladder training is usually accomplished before bowel training. 2. Wanting to please the parent helps motivate the child to use the toilet. 3. Watching older siblings use the toilet confuses the child. 4. Children must be forced to sit on the toilet when first learning.

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Which one of the following statements best describes fear in the school-age child? 1. They are increasingly fearful for body safety. 2. Most of the new fears that trouble them are related to school and family. 3. They should be encouraged to hide their fears to prevent ridicule by peers. 4. Those that have numerous fears need continuous protective behavior by parents to eliminate these fears.

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A group of boys ages 9 and 10 years have formed a "boys-only" club that is open to neighborhood and school friends who have skateboards. This should be interpreted as which of the following? 1. Behavior that encourages bullying and sexism 2. Behavior that reinforces poor peer relationships 3. Characteristic of social development of this age 4. Characteristic of children who later are at risk for membership in gangs

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A mother tells the nurse that she is discontinuing breast-feeding her 5-month-old infant. The nurse should recommend that the infant be given: 1. Skim milk. 2. Whole cow's milk. 3. Commercial iron-fortified formula. 4. Commercial formula without iron

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A toddler's parent asks the nurse for suggestions on dealing with temper tantrums. Which of the following is the most appropriate recommendation? 1. Punish the child. 2. Leave the child alone until the tantrum is over. 3. Remain close by the child but without eye contact. 4. Explain to child that this is wrong.

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According to Piaget, the 6-month-old infant would be in what developmental stage? 1. Use of reflexes 2. Primary circular reactions 3. Secondary circular reactions 4. Coordination of secondary schemata

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Although a 14-month-old girl received a shock from an electrical outlet recently, her parent finds her about to place a paper clip in another outlet. Which of the following is the best interpretation of this behavior? 1. Her cognitive development is delayed. 2. This is typical behavior because toddlers are not very developed. 3. This is typical behavior because of inability to transfer knowledge to new situations. 4. This is not typical behavior because toddlers should know better than to repeat an act that caused pain

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At about what age does an infant start to recognize familiar faces and objects, such as a feeding bottle? 1. 1 month 2. 2 months 3. 3 months 4. 4 month

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At what age can most infants sit steadily unsupported? 1. 4 months 2. 6 months 3. 8 months 4. 10 months

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At what age do most infants begin to fear strangers? 1. 2 months 2. 4 months 3. 6 months 4. 12 months

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At what age is it safe to give infants whole milk instead of commercial infant formula? 1. 6 months 2. 9 months 3. 12 months 4. 18 months

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By what age should the nurse expect that an infant will be able to pull to a standing position? 1. 6 months 2. 8 months 3. 11-12 months 4. 14-15 months

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Developmentally, most children at age 12 months: 1. Use a spoon adeptly. 2. Relinquish the bottle voluntarily. 3. Eat the same food as the rest of the family. 4. Reject all solid food in preference to the bottle

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Generally the earliest age at which puberty begins is: 1. 13 years in girls, 13 years in boys. 2. 11 years in girls, 11 years in boys. 3. 10 years in girls, 12 years in boys. 4. 12 years in girls, 10 years in boys.

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In the clinic waiting room, a nurse observes a parent showing an 18-month-old child how to make a tower out of blocks. The nurse should recognize which of the following in this situation? 1. Blocks at this age are used primarily for throwing. 2. Toddlers are too young to imitate the behavior of others. 3. Toddlers are capable of building a tower of blocks. 4. Toddlers are too young to build a tower of blocks.

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Latasha is a breast-fed infant being seen in the clinic for her 6-month checkup. Her mother tells the nurse that she recently began to suck her thumb. Which of the following is the best nursing intervention? 1. Recommend mother substitute a pacifier for her thumb. 2. Assess Latasha for other signs of sensory deprivation. 3. Reassure mother that this is very normal at this age. 4. Suggest mother breast-feed Latasha more often to satisfy sucking needs

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The developmental task with which the child of 15 to 30 months is likely to be struggling is a sense of what? 1. Trust 2. Initiative 3. Autonomy 4. Intimacy

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The parent of 2-week-old Sarah asks the nurse if Sarah needs fluoride supplements, because she is exclusively breast-fed. The nurse's best response is which of the following? 1. "She needs to begin taking them now." 2. "They are not needed if you drink fluoridated water." 3. "She may need to begin taking them at age 6 months." 4. "She can have infant cereal mixed with fluoridated water instead of supplements."

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The parents of a 4-month-old infant tell the nurse that they are getting a microwave oven and will be able to heat the baby's formula faster. The nurse should recommend which of the following? 1. Never heat a bottle in a microwave oven. 2. Heat only 10 ounces or more. 3. Always leave bottle top uncovered to allow heat to escape. 4. Shake bottle vigorously for at least 30 seconds after heating

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Which of the following behaviors indicates that an infant has developed object permanence? 1. Recognizes familiar face, such as mother 2. Recognizes familiar object, such as bottle 3. Actively searches for a hidden object 4. Secures objects by pulling on a string

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Which of the following describes moral development in younger school-age children? 1. The standards of behavior now come from within themselves. 2. They do not yet experience a sense of guilt when they misbehave. 3. They know the rules and behaviors expected of them but do not understand the reasons behind them. 4. They no longer interpret accidents and misfortunes as punishment for misdeeds.

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Which of the following statements best describes the infant's physical development? 1. Anterior fontanel closes by age 6 to 10 months. 2. Binocularity is well established by age 8 months. 3. Birth weight doubles by age 5 months and triples by age 1 year. 4. Maternal iron stores persist during the first 12 months of life

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Which of the following statements best describes the relationship school-age children have with their families? 1. Children desire to spend equal time with family and peers. 2. Children are prepared to reject parental controls. 3. Children need and want restrictions placed on their behavior by the family. 4. The peer group replaces the family as the primary influence in setting standards of behavior and rules

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1. Which one of the following factors is most important in predisposing toddlers to frequent infections? 1. Respirations are abdominal. 2. Pulse and respiratory rates are slower than those in infancy. 3. Defense mechanisms are less efficient than those during infancy. 4. A short straight internal ear canal and large lymph tissue are found in toddlers

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A 17-month-old child would be expected to be in what stage according to Piaget? 1. Trust 2. Preoperations 3. Secondary circular reaction 4. Tertiary circular reaction

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A father tells the nurse that his daughter wants the same plate and cup used at every meal, even if they go to a restaurant. The nurse should explain that this is which of the following? 1. A sign the child is spoiled 2. A way to exert unhealthy control 3. Regression, common at this age 4. Ritualism, common at this age

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A mother tells the nurse that she doesn't want her infant immunized because of the discomfort associated with injections. The nurse should explain that: 1. This cannot be prevented. 2. Infants do not feel pain as adults do. 3. This is not a good reason for refusing immunizations. 4. A topical anesthetic, EMLA, can be applied before injections are given.

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A parent asks the nurse about negativism in toddlers. The most appropriate recommendation is which of the following? 1. Punish the child. 2. Provide more attention. 3. Ask child not always to say "no." 4. Reduce the opportunities for a "no" answer.

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At what age should the nurse expect a toddler to give both first and last names when asked? 1. 15 months 2. 18 months 3. 24 months 4. 30 months

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Austin, age 6 months, has six teeth. The nurse should recognize that this is which of the following? 1. Normal tooth eruption 2. Delayed tooth eruption 3. Unusual and dangerous 4. Earlier-than-normal tooth eruption

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Parents tell the nurse that their 1-year-old son often sleeps with them. They seem unconcerned about this. The nurse's response should be based on which of the following? 1. Children should not sleep with their parents. 2. Separation from parents should be completed by this age. 3. Daytime attention should be increased. 4. This is a common and accepted practice, especially in some cultural groups.

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The father of 12-year-old Ryan tells the nurse that he is concerned about his son getting "fat." Ryan is at the 50th percentile for height and the 75th percentile for weight on the growth chart. The most appropriate nursing action is which of the following? 1. Reassure father that Ryan is not "fat." 2. Reassure father that Ryan is just a growing child. 3. Suggest a low-calorie, low-fat diet. 4. Explain that this is typical of the growth pattern of boys at this age

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The nurse is discussing with a parent group the importance of fluoride for healthy teeth. Which of the following should the nurse recommend? 1. Use fluoridated mouth rinses in children older than 1 year. 2. Brush teeth with fluoridated toothpaste unless fluoride content of water supply is adequate. 3. Give fluoride supplements to breast-fed infants beginning at age 1 month. 4. Determine whether water supply is fluoridated

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The nurse recommends to parents that peanuts are not a good snack food for toddlers. The nurse's rationale for this action is which of the following? 1. They are low in nutritive value. 2. They are very high in sodium. 3. They cannot be entirely digested. 4. They can be easily aspirated

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The parents of a 12-month-old child ask the nurse if the child can eat hot dogs as do their other children. The nurse's reply should be based on which of the following? 1. Child is too young to digest hot dogs. 2. Child is too young to eat hot dogs safely. 3. Hot dogs must be sliced into sections to prevent aspiration. 4. Hot dogs must be cut into small, irregular pieces to prevent aspiration.

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The parents of a 3-month-old infant report that their infant sleeps supine (face up) but is often prone (face down) while awake. The nurse's response should be based on knowledge that this is: 1. Unacceptable because of the risk of sudden infant death syndrome (SIDS). 2. Unacceptable because it does not encourage achievement of developmental milestones. 3. Acceptable to encourage fine motor development. 4. Acceptable to encourage head control and turning over

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The parents of a 9-month-old infant tell the nurse that they have noticed foods such as peas and corn are not completely digested and can be seen in their infant's stools. On which of the following should the nurse base her explanation of this? 1. Child should not be given fibrous foods until digestive tract matures at age 4 years. 2. Child should not be given any solid foods until this digestive problem is resolved. 3. This is abnormal and requires further investigation. 4. This is normal because of the immaturity of digestive processes at this age

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The parents of a newborn say that their toddler "hates the baby . . .he suggested that we put him in the trash can so the trash truck could take him away." The nurse's best reply is which of the following? 1. "Let's see if we can figure out why he hates the new baby." 2. "That's a strong statement to come from such a small boy." 3. "Let's refer him to counseling to work this hatred out. It's not a normal response." 4. "That is a normal response to the birth of a sibling. Let's look at ways to deal with this."

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The psychosocial developmental tasks of toddlerhood include which of the following? 1. Development of a conscience 2. Recognition of sex differences 3. Ability to get along with age mates 4. Ability to withstand delayed gratification

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The school nurse has been asked to begin teaching sex education in the 5th grade. The nurse should recognize that: 1. Children in 5th grade are too young for sex education. 2. Children should be discouraged from asking too many questions. 3. Correct terminology should be reserved for children who are older. 4. Sex can be presented as a normal part of growth and development

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What is the role of the peer group in the life of school-age children? 1. Gives them an opportunity to learn dominance and hostility 2. Allows them to remain dependent on their parents for a longer time 3. Decreases their need to learn appropriate sex roles 4. Provides them with security as they gain independence from their parents

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Which of the following characteristics best describes the gross motor skills of a 24- month-old child? 1. Skips 2. Rides tricycle 3. Broad jumps 4. Walks up and down stairs

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Which of the following describes the cognitive abilities of school-age children? 1. Have developed the ability to reason abstractly 2. Become capable of scientific reasoning and formal logic 3. Progress from making judgments based on what they reason to making judgments based on what they see 4. Have the ability to classify, to group and sort, and to hold a concept in their minds while making decisions based on that concept

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Which of the following is characteristic of dishonest behavior in children age 8 to 10 years? 1. Cheating during games is now more common. 2. Lying results from the inability to distinguish between fact and fantasy. 3. They may steal because their sense of property rights is limited. 4. They may lie to meet expectations set by others that they have been unable to attain.

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Which of the following statements is true concerning susceptibility to pertussis? 1. Neonates will be immune the first few months. 2. If mother has had the disease, infant will receive passive immunity. 3. Children younger than 1 year seldom contract this disease. 4. Most children are highly susceptible from birth.

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