Peds: Chapter 25 & 41

47. The nurse is monitoring the urinary output of a 3- year- old child admitted with a severe burn. The child weighs 44lb (20 kg). Which would be a desirable and adequate urinary output for this child? A. 1 to 2 mL/kg/hr B. 10 to 12 mL/kg/hr C. 15 to 25 mL/kg/hr D. 30 to 50 ml/kg/hr

A. 1 to 2 mL/kg/hr

23. The mother of a 4-year-old is concerned her child is not eating well. In addressing the concerns of this mother, which foods should the nurse point out are high in protein? Select all that apply. A. cheese and crackers B. cookies and juice C. whole grain granola with yogurt D. strawberries and bananas E. turkey sandwich

A. cheese and crackers C. whole grain granola with yogurt E. turkey sandwich

33. The nurse is caring for a 16-year-old child with a diagnosis of acquired immunodeficiency syndrome (AIDS). What treatment goal has the highest priority for this child? A. preventing spread of infection B. promoting comfort C. maintaining skin integrity D. improving nutrition

A. preventing spread of infection

45. A 6-year-old child is diagnosed with tinea pedis. Which prescription will the nurse question? A. luliconazole cream daily for 2 weeks B. The child may return to school in 1 week. C. Cleanse the skin with antibacterial soap. D. Perform warm foot soaks daily.

B. The child may return to school in 1 week.

18. Which of the following infections is often contracted by having contact with an infected dog or cat? A. tinea capitis B. tinea corporis C. tinea pedis D. tinea cruris

B. tinea corporis

3. During a well-child visit, the caregiver expresses concern that the 3-year-old child often stutters when speaking. Which response should the nurse prioritize to best assist this family? A. "Stuttering is common in young children because they are not physically capable of forming all the sounds." B. "Stuttering is usually indicative of a hearing loss." C. "Difficulties with speaking generally indicate that the adults in the child's life are not reading to the child enough." D. "Children of this age may stutter while they search for just the right word."

D. "Children of this age may stutter while they search for just the right word."

36. The nurse is doing an in-service training on clinical manifestations seen in communicable diseases. Which skin condition best describes pustule? A. redness of the skin produced by congestion of the capillaries B. small, circumscribed, solid elevation of the skin C. discolored skin spot not elevated at the surface D. small elevation of epidermis filled with a viscous fluid

D. small elevation of epidermis filled with a viscous fluid

5. The nurse admits a 10-year-old who has just eaten lobster and has hives over much of the body. In collecting data regarding this child, which question should the nurse ask the caregiver first? A. "Has the child ever eaten shellfish before now?" B. "Is your child allergic to peanuts or other foods?" C. "Does anyone in your family have any food allergies?" D. "Have you ever given your child antihistamines?"

A. "Has the child ever eaten shellfish before now?"

16. The nurse has brought a group of preschoolers to the playroom to play. Which activity would the nurse predict the children to become involved in? A. Pretending to be mommies and daddies in the playhouse B. Playing a board game C. Painting pictures in the art corner of the room D. Watching a movie with other children their age

A. Pretending to be mommies and daddies in the playhouse

11. When teaching a group of caregivers of infants, the nurse is discussing the topic of diaper rash. The caregivers in the group make the following statements. Which statement is the most accurate related to the child with diaper rash. A. "The formula she drinks sometimes causes her to have a diaper rash." B. "My child gets diaper rash if I wash her clothes in the same detergent we use for the family." C. "Sometimes if I leave the diaper off and let him be in the sunshine he gets diaper rash." D. "They told me to use baby powder every time I change her so she won't get diaper rash."

B. "My child gets diaper rash if I wash her clothes in the same detergent we use for the family."

8. The nurse instructor is reviewing the integumentary system during a presentation to a group of student nurses. Which statement made by the instructor is the most accurate regarding the integumentary system? A. "The sebaceous and sweat glands are fully functional in the infant." B. "The largest organ of the body helps regulate body temperature." C. "The integumentary system is not in place until after the child is born and then takes many years to mature." D. "One role of the integumentary system is to distribute oxygen to the body cells."

B. "The largest organ of the body helps regulate body temperature."

2. A pediatric client who has been seriously burned is being given IV fluid replacements. It has been determined that the client will initially need 24 ounces of replacement fluids. In following a normal burn replacement treatment for this child, if the treatment is started at 10:00 AM, which of the following would be correct? The child would have received: A. 12 ounces of IV fluid replacement by 4:00 PM. B. 12 ounces of IV fluid replacement by 6:00 PM. C. 18 ounces of IV fluid replacement by 4:00 PM. D. 18 ounces of IV fluid replacement by 6:00 PM.

B. 12 ounces of IV fluid replacement by 6:00 PM.

18. The nurse is assessing a 3-year-old at a well-child visit and the child appears to be progressing well. Which activity will the nurse ask the child to attempt to appropriately assess the fine motor skills of this preschooler? A. Use scissors. B. Button clothes. C. Tie shoelaces. D. Print a few letters.

B. Button clothes.

1. The nurse is assessing a 3-year-old at a routine well-child visit. Which assessment should the nurse prioritize in the vision check? A. visual acuity B. eye coordination C. depth perception D. color perception

B. eye coordination

10. The nurse is presenting an in-service to a group of nurses who will be working in a dermatology clinic. They are discussing various disorders related to the integumentary system. One of the nurses describes a disorder by telling the group that it is common in children during the summer when it is hot or when the child is overdressed. Which disorder is the nurse most likely referring to? A. seborrheic dermatitis B. miliaria rubra C. candidiasis D. impetigo

B. miliaria rubra

15. The nurse is caring for an infant who has impetigo and is hospitalized. Which nursing action is priority? A. The nurse soaks the skin with warm water. B. The nurse applies topical antibiotics to the lesions. C. The nurse follows contact precautions. D. The nurse applies elbow restraints to the infant.

C. The nurse follows contact precautions.

40. The nurse is caring for a child diagnosed with Haemophilus Influenzae type B. Which of the following nursing interventions would be the highest priority in the prevention of complications seen with this disorder? A. The nurse will monitor for seizure activity. B. The nurse will elevate the head of the bed. C. The nurse will administer antibiotics. D. The nurse will monitor fluid intake.

C. The nurse will administer antibiotics.

5. The nurse is meeting with a group of young parents to discuss nutrition and their preschooler. Which response should the nurse prioritize when asked if using desserts as a reward for good behavior is an appropriate idea? A. The child may only behave on days when dessert is something that is liked. B. The child will learn to choose sweets over nutritious food. C. This will result in the child being overweight. D. The child can use food to manipulate others' behavior.

D. The child can use food to manipulate others' behavior.

24. A mother brings her 2-year-old son to the clinic with a bumpy rash. Which statement by the mother would lead the nurse to suspect that the child may have atopic dermatitis? A. "I feel so bad for him because he has asthma, and now he gets this rash." B. "It started as a flat red rash in between his legs." C. "We just had him to the barber for his first haircut." D. "He just started swim lessons at the YMCA."

A. "I feel so bad for him because he has asthma, and now he gets this rash."

4. The dermatologist treating a 16-year-old girl with a history of severe acne has ordered a pregnancy test so she can be started on a course of isotretinoin. The teen's caregiver has said that her daughter is a virgin and she refuses to allow her to have the required pregnancy testing. What would be the best action for the nurse to take? A. Acknowledge the caregiver's discomfort about the pregnancy testing but encourage her to allow the daughter to have the testing so that she can use the medication. B. Speak with the teen alone to ask her if she is sexually active. If she says she is not sexually active, let the provider know that it is okay to write the prescription. C. Arrange for the daughter to have the pregnancy testing without the caregiver's knowledge. D. Have the caregiver sign a permission form acknowledging that the girl has been given the drug without pregnancy testing.

A. Acknowledge the caregiver's discomfort about the pregnancy testing but encourage her to allow the daughter to have the testing so that she can use the medication.

43. The nurse is assessing a child who presents with a history of fever, malaise, fatigue, and headache. The nurse notes a bulls-eye rash on the child's right leg. Which action will the nurse take? A. Notify the primary health care provider. B. Place the child on contact precautions. C. Obtain an electrocardiography (ECG). D. Clean the rash with rubbing alcohol.

A. Notify the primary health care provider.

39. The nurse is caring for a child hospitalized with pertussis. Which nursing intervention would be the highest priority for this child? A. The nurse will administer oxygen. B. The nurse will encourage bed rest. C. The nurse will administer antibiotics. D. The nurse will monitor caloric intake.

A. The nurse will administer oxygen.

21. The nurse is discussing allergies with a group of caregivers of children who have food allergies. Which statement made by the caregivers indicates the most concerning issue faced by the caregivers of children with food allergies? A. "My daughter loves milk; it is so hard to tell her that she can't drink it." B. "I read all the labels, but sometimes it is not easy to understand the ingredients." C. "When he goes to a friend's house I always have to pack a bag of snacks for him." D. "We have had to change all of the things we prepare for meals at our house."

B. "I read all the labels, but sometimes it is not easy to understand the ingredients."

8. The nurse is preparing a safety presentation for a health fair for families. Which instruction should the nurse prioritize when illustrating car safety and the family? A. "Stop the car any time the preschooler unbuckles the restraints." B. "Explain that wearing a seat belt is a law and the police officer will give a ticket ifthe seat belt is not buckled." C. "Set a good example. Wear your own seat belt every time you drive." D. "Reward the child with candy or some other treat each time the child keeps the seat belt on."

C. "Set a good example. Wear your own seat belt every time you drive."

22. The nurse is presenting nutritional information at a community health fair. Which suggestion should the nurse prioritize when illustrating proper nutrition for preschoolers? A. Need three big meals a day due to rapid growth B. Need extra calcium for proper muscle growth C. Snacks throughout the day help the child meet nutritional requirements D. Should drink at least 4 cups of milk each day

C. Snacks throughout the day help the child meet nutritional requirements

38. A nurse is promoting vaccine administration. When instructing on the physiological changes, which statement best explains what occurs in the child when vaccines are administered? A. The child develops a passive immunity. B. The child becomes a carrier of the disease. C. The child develops an active immunity. D. The child becomes a host for the disease.

C. The child develops an active immunity.

12. The nurse is collecting data on a 4-month-old child brought to the clinic by the caregiver. The nurse observes the child's mouth and notes a white coating that looks like milk curds. Which of the following questions would be most important for the nurse to ask the caregiver? A. "Did you have a vaginal delivery with this baby?" B. "Has your child been treated for any type of infection recently?" C. "Are you breastfeeding or bottle feeding your baby?" D. "Does everyone in your house wash their hands often?"

B. "Has your child been treated for any type of infection recently?"

17. The nurse is discussing skin disorders with a group of caregivers. Which caregiver statement indicates an understanding of tinea capitis? A. "That is an infection that you get under your fingernails." B. "I always tell my daughter to use her own hairbrush." C. "My son got that infection when he was at the swimming pool." D. "My husband had that once and his groin itched so much."

B. "I always tell my daughter to use her own hairbrush."

15. A nurse is preparing a presentation for a health fair discussing various aspects of preschoolers. Which example should the nurse use to best illustrate dramatic play? A. Playing apart from others without being part of a group B. Acting out a troubling or stressful situation C. Playing a video game with several other children D. Watching television or videos

B. Acting out a troubling or stressful situation

12. The nurse is monitoring children playing in the unit's playroom. The nurse notes that some children are involved in associative play by which actions? A. drawing pictures in the art area B. pushing toy cars around on a large rug with roads C. playing a board game with each other D. several children engrossed in their own tool-and-bench set

B. pushing toy cars around on a large rug with roads

46. The nurse is working with the caregiver of a neonate. The caregiver states, "My first baby had a disorder they called seborrheic dermatitis; what can I do to prevent this baby from having that?" Which response is the most appropriate? A. "There is nothing you can do to prevent this disorder; it will go away by the time your neonate is a toddler." B. "Be careful to not get any lotion or oil on the neonate's head, and that will help prevent the disorder." C. "You should wash your neonate's hair every day to help prevent this disorder." D. "If you will keep hats and bonnets off your neonate's head, you will not have to worry about the neonate getting the disorder."

C. "You should wash your neonate's hair every day to help prevent this disorder."

30. The nurse admits a child who has sustained a severe burn. The child's immunizations are up to date. Which immunization would the child most likely be given at this time? A. hepatitis A vaccine B. hepatitis B vaccine C. tetanus toxoid vaccine D. Haemophilus influenzae type B vaccine

C. tetanus toxoid vaccine

19. The nurse caring for children with fungal infections most often administers which medication? A. benadryl B. acetaminophen C. prednisone D. griseofulvin

D. griseofulvin

42. A 17-year-old is diagnosed with infectious mononucleosis. The nurse should discuss which intervention with the teenager's caregiver to best assure an uncomplicated recovery? A. admission to the hospital for about 7 days B. a 10-day course of antibiotics C. a high-protein, high-fiber, low-fat diet D. precautions to avoid secondary infections

D. precautions to avoid secondary infections

24. The nurse is assessing a 4-year-old on a routine well-child visit. When assessing the gross motor skills of this preschooler, which activity will the nurse predict the child to be able to successfully accomplish? A. Hop on one foot B. Walk backwards with heel to toe C. Ride a bicycle D. Jump rope

A. Hop on one foot

2. The pediatric nurse is discussing the daily activities of a 4-year-old with the caregiver to assess growth and development status. The nurse would document that the child has reached the initiative stage of development if the caregiver indicates the child participates in which activity? A. tries to sweep up spilled cereal but cries when can't do well B. broke a dish but blamed it on a friend the caregivers don't know C. refuses to hold anyone's hand while crossing the street D. gets upset when a babysitter is in charge, but will do what is asked by the babysitter

A. tries to sweep up spilled cereal but cries when can't do well

16. The nurse is discussing acne vulgaris with a group of adolescents. The teenagers make the following statements regarding the topic. Which statement is the most accurate regarding acne vulgaris? A. "My mom says I have acne because I eat too much chocolate." B. "Sometimes I get acne when I use my sister's makeup." C. "My next door neighbor told me that acne was caused by a fungus." D. "There is a new immunization that you can get to keep from having acne."

B. "Sometimes I get acne when I use my sister's makeup."

26. The camp nurse is caring for a child who was bitten on the leg by a dangerous spider. The child is being taken to a health care provider. What is the most appropriate action for the nurse to do with this child? A. Administer pain medication. B. Apply ice to the affected area. C. Splint the leg. D. Briskly scrub the site.

B. Apply ice to the affected area.

41. The school nurse is teaching a group of teachers about various skin disorders seen in children. The nurse would identify the most obvious symptom of pediculosis as: A. scaly rings with clear centers located on the scalp. B. white flecks that are firmly attached to the hair shafts. C. small papule on the scalp. D. scaling or cracking of the skin on the scalp.

B. white flecks that are firmly attached to the hair shafts.

28. A school-aged child is brought to the office of the camp nurse with a small, superficial burn (first-degree burn). Which action by the nurse would be most appropriate to take first? A. Apply a topical anesthetic ointment. B. Administer acetaminophen. C. Cover the area with a sterile bandage. D. Apply cold compresses to the area.

D. Apply cold compresses to the area.

7. A first-time father calls the pediatric nurse stating he is concerned that his 4- year-old daughter still wets the bed almost every night. Remembering his own experience of being punished for wetting the bed at 4 years old, he is not sure punishment is the best approach to address this. Which nursing instruction is the most appropriate? A. "Disciplining is not likely to be effective, but if the child keeps wetting the bed it may be necessary." B. "Bedwetting is not uncommon in young children. Try to calmly change the bed without showing your frustration." C. "Setting rules is a parent's job to help the child have acceptable social behavior, so take away a privilege each time she wets the bed." D. "Nightly bedwetting up to age 12 is developmentally typical, so you will need to practice patience with your daughter."

B. "Bedwetting is not uncommon in young children. Try to calmly change the bed without showing your frustration."

23. In working with infants diagnosed with atopic dermatitis, the nurse anticipates that when these children are older they will likely have a tendency to have which disorder? A. hemophilia B. asthma C. rheumatoid arthritis D. otitis media

B. asthma

27. The nurse is collecting data on a child admitted to the burn unit with a partial- thickness or second-degree burn. What is most accurate regarding this type of burn? A. The nerve endings are destroyed. B. The child will have minimal pain. C. The child will likely have blisters. D. There is no destruction of tissue.

C. The child will likely have blisters.

20. The nurse is reinforcing teaching regarding the treatment for head lice with the caregiver of a child who has the disorder. Which of the following is most accurate related to the treatment for the child with an infection of head lice? A. The treatment will be done every day for about 2 weeks. B. The treatment will need to be repeated about once per month for a year. C. The treatment will need to be repeated in about 7 to 9 days. D. The treatment is done one time and won't need to be repeated.

C. The treatment will need to be repeated in about 7 to 9 days.

25. The nurse is observing 4-year-old twins during their well-child appointment. Which observation by the nurse would indicate the children are demonstrating cooperative play? A. They competitively stack blocks and keep score of who stacks the highest number of blocks. B. They play with dollhouse furniture, each with different room furnishings. C. They are building a house for their dolls with blocks in the room. D. They sit on the floor, near each other, and look at different picture books.

C. They are building a house for their dolls with blocks in the room.

31. The nurse is caring for an adolescent diagnosed with genital herpes. The drug of choice for treating genital herpes is: A. griseofluvin B. ceftriaxone C. acyclovir D. penicillin

C. acyclovir

22. Which treatment will most likely be the best long-term benefit for the child with an allergic condition in which it is difficult to remove or avoid the allergen? A. use of corticosteroids B. electrical stimulation C. use of antihistamines D. hyposensitization

D. hyposensitization

14. The nurse is presenting an in-service to a group of nurses who will be working in a dermatology clinic. One participant asks the nurse about a bacterial skin infection that she has seen in children that involves honey-colored crusted lesions. The nurse most likely is referring to: A. seborrheic dermatitis. B. miliaria rubra (heat rash). C. candidiasis. D. impetigo.

D. impetigo.

13. The nurse is discussing medications to be given to a child who has been diagnosed with oral candidiasis (thrush). Which medication would most likely be prescribed for the child? A. acetaminophen B. ampicillin C. aspirin D. nystatin

D. nystatin

14. The nursing instructor is illustrating the various types of play. The instructor determines the class is successful when the students correctly choose which example as best representing onlooker play? A. playing apart from others without being part of a group B. acting out a troubling situation C. playing in an organized group with each other D. observing without participating

D. observing without participating

32. The nurse is caring for an adolescent diagnosed with syphilis. The drug of choice for treating syphilis is: A. griseofluvin B. ceftriaxone C. acyclovir D. penicillin

D. penicillin

25. The nurse caring for a child with a skin allergy recognizes that the highest priority in the treatment for skin allergies is aimed at: A. regulating skin and body temperature. B. controlling nausea and vomiting. C. reducing swelling and relieving itching. D. managing pain and discomfort.

C. reducing swelling and relieving itching.

29. The nurse is collecting data on a 4-year-old child admitted to the burn unit. The nurse is concerned about the possibility of the child going into hypovolemic shock. Which of the following data would the nurse recognize as an indication that this may be occurring? A. The child is complaining of intense pain. B. The child's blood pressure is 128/86. C. The child's face is bright red in color. D. The child's apical pulse is 140 bpm.

D. The child's apical pulse is 140 bpm.

13. The parents of a toddler are concerned their child is not developing correctly and are questioning the nurse concerning the child's lack of effort to join other children in a group activity. Which response should the nurse prioritize in answering the parents? A. "This is normal for this age group. It's referred to as solitary independent play." B. "You should try to get your child involved in a local Boys and Girls club to encourage more interaction." C. "Perhaps getting your child interested in sports will improve their other play habits." D. "Your child is involved with others, just indirectly. See how they sit next to the other children and play with the same toys?"

A. "This is normal for this age group. It's referred to as solitary independent play."

6. While the nurse is taking a blood pressure on a 4-year-old, the child states that the blood-pressure cuff is too tight and angrily says, "That hurt, you big poo-poo head." What is the most appropriate response by the nurse? A. Scold the child for the insult while apologizing for hurting her, and loosen the cuff. B. Calmly explain that you don't mean to hurt her, loosen the cuff, and tell her that is isn't nice to call you names. C. Explain that the cuff will only hurt for minute and ask the child's caregiver to please tell the child not to speak to you that way. D. Ask the child's caregiver to please hold the child on their lap until she calms down.

B. Calmly explain that you don't mean to hurt her, loosen the cuff, and tell her that is isn't nice to call you names.

44. The nurse is caring for a 9-year-old child with partial-thickness (second-degree) burns. The client rates the pain at an 8 on a 1 to 10 numerical pain scale. The nurse notes the client is sitting in the bed playing with toys and smiling. Which action will the nurse take? A. Administer pain medication as prescribed. B. Reassess the client's pain in 30 minutes. C. Ask the parents to rate the client's pain. D. Use another pain scale to measure the client's pain.

A. Administer pain medication as prescribed.

9. The public health nurse is discussing immunizations with a group of caregivers of infants. One of the mothers asks the nurse why the child will need immunizations. Which statement would be the most appropriate for the nurse to make to this mother? A. "The infant is born with immunity to some diseases, but those immunities decrease over the first year of life." B. "The antibodies the fetus gets from the mother are in the placenta, so after birth they are no longer available to the infant." C. "The immunities that the infant is born with are not for the same diseases they will be immunized against." D. "Infants are unable to develop antibodies to protect them from diseases so they must be immunized."

A. "The infant is born with immunity to some diseases, but those immunities decrease over the first year of life."

9. The nurse is caring for a 5-year-old who has been hospitalized after an episode of asthma. As the nurse prepares to teach the child how to use the nebulizer, which action should the nurse prioritize? A. Allow the child to touch and play with the nebulizer for a few minutes before the treatment. B. Show the child how to use the nebulizer and tell the child how much easier it is to breathe afterward. C. Explain that the child will feel better after the treatment and allow the child to ask questions. D. Use a poster or brochure to illustrate to the child how the machine works.

A. Allow the child to touch and play with the nebulizer for a few minutes before the treatment.

35. The nurse is doing an in-service training on clinical manifestations seen in communicable diseases. Which skin condition best describes erythema? A. redness of the skin produced by congestion of the capillaries B. small, circumscribed, solid elevation of the skin C. discolored skin spot not elevated at the surface D. small elevation of epidermis filled with a viscous fluid

A. redness of the skin produced by congestion of the capillaries

19. The parent of a 4-year-old is expressing concern that this child is not talking as much—or as well—as her other children did at that age. Which question should the nurse prioritize when assessing this preschooler for this concern? A. "How often do you or a family member read to your child?" B. "Has your child had their hearing tested?" C. "Does your child have opportunities to have conversations with other people?" D. "Do you praise and give your child encouragement when the child tries to talk with you?"

B. "Has your child had their hearing tested?"

34. Infectious mononucleosis ("mono") is caused by which of the following? A. Treponema pallidum B. Epstein-Barr virus C. Microsporum canis D. Streptococcal bacterium

B. Epstein-Barr virus

7. An adolescent girl and her caregiver present at the pediatrician's office. The adolescent reports severe abdominal pain. A diagnosis of pelvic inflammatory disease (PID) is made. The nurse notes in the child's chart that this is the third time she has been treated for PID. Which action by the nurse would be most appropriate? A. Contact the necessary authorities to report a suspected case of sexual abuse. B. Take the child to a private room and interview her regarding her sexual history and partners. C. Take the caregiver to a private room and tell her that the child's diagnosis can only come from sexual activity. D. Talk to the child and caregiver together and explain that the condition is often a result of a sexually transmitted infection and discuss the importance of safe sex practices.

B. Take the child to a private room and interview her regarding her sexual history and partners.

10. The nurse is caring for several clients on the pediatric unit. When interacting with the preschool-age child, which action does the nurse predict will occur? A. Increased attention span and can be interested in an activity for a long length of time B. Takes in new information at a rapid rate and asks "why" and "how" C. Insists doing something and the next moment reverts to being dependent D. Grows and develops skills more rapidly than at any other time in their life

B. Takes in new information at a rapid rate and asks "why" and "how"

3. The caregiver of a fifth-grade boy calls the pediatrician's office and reports that her son has been scratching at his groin for a week or so. Despite his need for privacy, he's finally allowed the caregiver to look at the groin area. The caregiver describes the area to the nurse saying, "It looks like black pin dots that seem to have dark tails." The nurse suspects that the child may have which of the following? A. lice B. scabies C. ringworm D. prickly heat

B. scabies

20. The father of a 4-year-old is concerned his child is not telling the truth and blaming others for things that have happened. Which response should the nurse prioritize after the father shares that the child is blaming someone named "Andrew" for a broken tool, and they have no idea who this is? A. "You should punish your son because no child should be telling lies at this age." B. "You need to show your child the broken tool since at this age they must see something in order to understand." C. "Your son may have a friend named Andrew, but it could be an imaginary friend." D. "You should watch this type of behavior closely since most children this age tell the truth."

C. "Your son may have a friend named Andrew, but it could be an imaginary friend."

11. The nurse is presenting an in-service on the types of playing that children may engage in. The nurse determines the session is successful when the attending nurses correctly choose which example as representing cooperative play? A. Playing apart from others without being part of a group. B. Playing together in an activity without organization. C. Playing in an organized group with each other. D. Playing independently and are side-by-side.

C. Playing in an organized group with each other.

4. The parents of 5-year-old boy are concerned about the how a recent motorcycle accident to his father will affect the child. Although the father has fully recovered, the child is very concerned if the father is away longer than expected; the child is not as talkative but appears withdrawn and quiet. The nurse should point out the child's behavior is likely related to which factor? A. The child is afraid of losing his father and trying show how much he loves him. B. The boy is afraid of being hurt himself and thinks being "especially good" will protect him from accidents. C. The boy believes he caused the accident by telling his father he "hoped he crashed" when the boy couldn't go along. D. The child is imitating the adults' behavior and just trying to be nice to everyone.

C. The boy believes he caused the accident by telling his father he "hoped he crashed" when the boy couldn't go along.

17. When collecting data on a preschool-aged child during a well-child visit, the nurse discovers the child has gained 12 lb (5.4 kg) and grown 2.5 inches (6.3 cm) in the last year. The nurse interprets these findings to indicate which situation? A. Weight and height are within expected patterns of growth. B. Weight falls within an expected range and height is less than what would be expected. C. Weight is above an expected range and height is within an expected range. D. Weight is below an expected range and height is above an expected range.

C. Weight is above an expected range and height is within an expected range.

37. The nurse is doing an in-service training on clinical manifestations seen in communicable diseases. Which best describes a macule? A. redness of the skin produced by congestion of the capillaries B. small, circumscribed, solid elevation of the skin C. discolored skin spot not elevated at the surface D. small elevation of epidermis filled with a viscous fluid

C. discolored skin spot not elevated at the surface

21. The pediatric nurse is meeting with a group of preschoolers' family members to discuss various health topics. The nurse determines the sexual development session is successful after overhearing which comment by one of the participants? A. "When I find my son masturbating, I will tell him that is unacceptable." B. "I will tell my daughter that she will have time to explore her body as she gets older." C. "I will encourage my son to ask his father any questions that are sexual in nature." D. "I feel better knowing that her curiosity is normal."

D. "I feel better knowing that her curiosity is normal."

1. An 8-month-old has been diagnosed with infantile eczema. At a follow-up appointment, the child's caregiver seems exhausted and angry. He explains that he has done all of the child's care because his wife is repulsed by the child's raw and uncomfortable appearance. What responses would be appropriate for the nurse to say to this caregiver? A. "He will be better soon and your family can get back to normal." B. "I understand her feelings. It is hard to see a child in pain sometimes." C. "That's not fair to you; she should get some counseling to learn how to cope with illness better." D. "That's not an uncommon reaction, although it's hard on you and on your child."

D. "That's not an uncommon reaction, although it's hard on you and on your child."

6. The caregiver of a 4-year-old girl who lives in a heavily wooded area calls the clinic nurse to report that the child has a swollen tick on her arm. What would be the best action for the caregiver to follow in removing the tick? A. The caregiver should take the child to a health care facility where the tick can be removed aseptically. B. The caregiver should have another adult hold the child still, light a match and let it burn for 1 second, then blow out the match and quickly hold it on the tick. C. The caregiver should hold a gauze pad beneath the tick to catch the blood and carefully crush the tick. D. The caregiver should use tweezers to carefully remove the tick without crushing it.

D. The caregiver should use tweezers to carefully remove the tick without crushing it.