Pediatric Quiz 1
What advice is appropriate for a growing child to prevent obesity? Select all that apply. A "You should skip breakfast and eat a healthy lunch and dinner." B "You should put a video game system in your bedroom." C "You should drink fewer sweetened beverages every day." D "You should eat small meals throughout the day." E "You should watch television for less than 2 hours every day."
(C, D, E) Sweetened beverages are high in sugar and calories, which increase the risk of obesity. Therefore, the nurse instructs the patient to avoid sweetened beverages. Eating small meals at regular intervals keeps the person feeling full, reduces overeating, and improves metabolism. A sedentary lifestyle also increases the risk of obesity. Playing video games is primarily a sedentary activity. The nurse should instruct the patient to reduce television watching to less than 2 hours a day. Breakfast is a very important meal, and the nurse should instruct the patient to eat a healthy breakfast every day. Test-Taking Tip: Make certain that the answer you select is reasonable and obtainable under ordinary circumstances and that the action can be carried out in the given situation.
Upon interacting with the parent of an 8-month-old infant, the nurse anticipates that the infant is at risk of childhood obesity. Which statement from the parent supports the nurse's assumption? 1 "I often give my child potato chips." 2 "I often feed my child cereal." 3 "I feed my child mashed ripe banana." 4 "I often feed my child oatmeal."
(1) Foods like potato chips, candy, ice cream, cake, soda pop, and other sweetened drinks increase cholesterol levels and result in obesity. High-protein cereals do not increase cholesterol levels in the body, and do not contribute to childhood obesity. Mashed ripened banana does not increase cholesterol levels in the body and does not contribute to childhood obesity. Oatmeal reduces the risk of obesity in the child. Test-Taking Tip: You have at least a 25% chance of selecting the correct response in multiple-choice items. If you are uncertain about a question, eliminate the choices that you believe are wrong and then call on your knowledge, skills, and abilities to choose from the remaining responses.
The nurse is instructing the parents of a 6-month-old infant about sleeping patterns and the best sleeping positions for their child. Which instruction regarding sleep position is most important? 1 "Place the infant in a supine position for sleep." 2 "Avoid positioning the head on alternating sides." 3 "A prone position is more beneficial for sleeping." 4 "If the infant is restless, place it on one side to sleep."
(1) The nurse instructs the parent to place the infant in a supine position so the infant does not roll over to a prone position. When the infant is less than 6 months old, the infant is placed in a supine position and the head is positioned on alternating sides to prevent positional plagiocephaly. There is a risk for sudden infant death syndrome (SIDS) if the infant is placed in a prone position. If the infant is restless, it should be assessed, but not put to sleep on one side, as the infant can easily roll over to the prone position if placed on the side.
A child has been diagnosed with hemophilia type A after experiencing excessive bleeding from a minor trauma. The mother states that the toddler being seen for the trauma is very active and is difficult, constantly saying no. An appropriate response would be: 1 Toddlers are curious, trying to make decisions and be independent. 2 Saying no at this stage is a signal that the child may need some therapy. 3 You must show the child from a young age that you are the boss and in charge. 4 Responsible parenting means you must protect the child from all future injuries.
(1) Toddlers are curious, trying to make decisions and being independent, and learning autonomy, which is a normal developmental stage for this age group. Saying no is the toddler's means of developing independence rather than a need for therapy. The developmental task according to Erikson is autonomy verses shame, so caregivers need to allow some independence. No person can protect absolutely another individual from all injuries.
The nurse is assessing head growth in a 7-month-old infant. The nurse observes that the rate of the growth has been 0.5 cm since the 6-month check-up. What does the nurse tell the parents about the child's development? 1 "The child needs to be screened." 2 "The child's head growth is normal." 3 "There may be some developmental issues." 4 "The child's posterior fontanel is not fused."
(2) After the sixth month, the infant's head grows at 0.5 cm every month. Therefore, the nurse informs the parents that the head growth rate is normal for the child. There is no need for screening, as the child has not received any head injuries. There may be developmental issues if the head growth is not normal. The posterior fontanel is fused at 6-8 weeks of age, so this is not a plausible finding at the 8-month mark.
When assessing the reflexes of a 4-month-old infant, the nurse observes that the infant is extending an arm to the side while the head is turned. Which reflex does the nurse observe? 1 Extrusion reflex 2 Trunk incurvation 3 Tonic neck reflex 4 Ankle clonus reflex
(3) A 4-month-old child extending an arm to the side while the head is turned indicates the tonic neck reflex. The extrusion reflex occurs when the child pushes the tongue forward when the nurse touches or depresses it. When assessing trunk incurvation, the nurse presses the infant's spine to assess if the infant's hips move in response. When assessing the ankle clonus reflex, the nurse performs dorsiflexion of the infant's foot while supporting the knee.
Which finding indicates that a newborn has vernix caseosa? 1 Brown hair on the skin 2 Rosy to yellowish skin 3 Cheese-like substance on the skin 4 Light-pink to reddish-brown skin
(3) Sebum and desquamating cells on the newborn's skin give it a white, cheesy appearance, which is called vernix caseosa. Brown hair on a newborn's skin is called lanugo. Newborns of Asian descent will have rosy to yellowish skin. Light-pink to reddish-brown skin indicates that the newborn is of Native American descent.
A child who has persistent inattentive behavior is prescribed methylphenidate hydrochloride. Which behavior indicates that the child needs further treatment? 1 The child remains attentive during long classes while seated at a desk. 2 The child follows instructions given by teachers on a regular basis. 3 The child experiences difficulty keeping school supplies organized. 4 When instructed to wait, the child sits in one place without complaint.
(3) The child has persistent inattentive behavior and is on methylphenidate hydrochloride therapy, which indicates that the child has attention deficit hyperactivity disorder (ADHD). A child with ADHD will have difficulty organizing belongings and tasks. Therefore, the child who has difficulty organizing school supplies even after treatment with methylphenidate hydrochloride will require further treatment. After successful treatment of ADHD, the child will be able to remain attentive for prolonged periods of time. Successful treatment with methylphenidate hydrochloride makes the child more attentive to instructions. The child with ADHD is hyperactive, so he or she does not stay quiet. If the child is obedient and stays quiet, the treatment has been effective.
The parents of a child often try to persuade their preschooler to touch their pet dog because they want to reduce the child's fear of dogs. Instead, the child's fears and anxiety increase. What does the nurse suggest the parents do to help overcome their child's fear? 1 "Ask the child to touch the dog's back gently." 2 "Keep the child away from dogs for a few years." 3 "Let the child watch other children playing with dogs." 4 "Bring in a pet cat to familiarize the child with animals."
(3) The parents should allow the child to become comfortable with animals at a gradual pace, while maintaining the child's feeling of well-being. One way to do this is to encourage the child to watch as other children play with dogs. Encouraging the child to touch the dog's back gently is not effective for overcoming the child's fear because the child should not be forced to touch the animal until he or she is comfortable. Trying to keep the child away from dogs will not be effective in reducing fear, and may not be practical. Introducing the child to other animals, such as cats, may be ineffective because the child's fear may be specific to dogs.
The nurse observes an infant using his thumb and index finger to hold an object. What does the nurse infer from this? 1 The infant is exhibiting Moro reflex. 2 The infant is showing tonic neck reflex. 3 The infant is exhibiting parachute reflex. 4 The infant is showing crude pincer grasp reflex.
(4) An infant using his thumb and index finger to hold an object would indicate that the infant has crude pincer grasp reflex. As the infant is not startled, the nurse does not conclude that the infant is showing Moro reflex. If the infant extends his or her arm and leg to the side where the infant's head is turned, it indicates that the infant has tonic neck reflex. The infant is not showing protective response towards falling. Therefore, the infant does not show parachute reflex.
The parents inform the nurse that their child often engages in 'doctor play' with other kids, with an aim to learn more about the sexual organs. The parents have often expressed their disapproval to the child, but it has no effect on the child's behavior. What does the nurse suggest to the parents? 1 "Offer a reward for not engaging in such activities." 2 "Tell the child it is dangerous to engage in such activities." 3 "Encourage the child to engage in some other sports activity." 4 "Tell the child to talk about any questions related to sexuality."
(4) It is not effective to condemn the child's curiosity about sexual matters. Instead, the parents should clarify any question that the child has about sexuality and then encourage the child to engage in some other activity. Offering a reward for not engaging in such behaviors will not alleviate the child's sexual curiosity. Telling the child that it is dangerous to engage in such activities is reinforcing negative information that may build up a false image in the child's mind. As an alternative, the parents need to be honest about such explanations. Asking the child to engage in some sports activity will not help reduce the child's interest in sexual matters, if this curiosity is not addressed promptly.
The nurse is preparing the diet plan for a child whose body mass index (BMI) is 29. Which instructions included in the child's diet plan will be beneficial? Select all that apply. A Provide low-fat milk. B Avoid protein-rich foods. C Avoid carbonated drinks. D Limit the intake of calcium. E Increase the intake of leafy greens
(A,C,E) A body mass index greater than 25 indicates that the child is overweight. Fat causes accumulation of cholesterol, thereby causing weight gain. Low-fat milk can be used to prevent weight gain. Carbonated drinks often contain excess amounts of sugar and cause weight gain. Leafy greens contain cellulose, which creates a feeling of fullness in the stomach and limits the intake of food. Proteins are the building blocks of the body. They increase the muscle mass, but are not associated with fat levels. Calcium is good for the bones and teeth. Limited intake of calcium will not be beneficial for weight loss but will affect the development of bones and teeth. Test-Taking Tip: Be alert for details about what you are being asked to do. In this question type, you are asked to select all options that apply to a given situation or patient. All options likely relate to the situation, but only some of the options may relate directly to the situation.