PEDS: Practice Questions (Exam 2)

Which accurately describes the speech of the preschool child? a. Dysfluency in speech patterns is normal. b. Sentence structure and grammatic usage are limited. c. By age 5 years, child can be expected to have a vocabulary of about 1000 words. d. Rate of vocabulary acquisition keeps pace with the degree of comprehension of speech.

a. Dysfluency in speech patterns is normal. Dysfluency includes stuttering and stammering, a normal characteristic of language development. Children speak in sentences of three or four words at age 3 to 4 years and eight words by age 5 years. At 5 years, children have a vocabulary of 2100 words. Children often gain vocabulary beyond degree of comprehension.

Which is usually the only symptom of pediculosis capitis (head lice)? a. Itching b. Vesicles c. Scalp rash d. Localized inflammatory response

a. Itching

A nurse is preparing to accompany a medical missions team to a third world country. Marasmus is seen frequently in children 6 months to 2 years in this country. Which symptoms should the nurse expect for this condition? a. Loose, wrinkled skin b. Edematous skin c. Depigmentation of the skin d. Dermatoses

a. Loose, wrinkled skin Marasmus is characterized by gradual wasting and atrophy of body tissues, especially of subcutaneous fat. The child appears to be very old, with loose and wrinkled skin, unlike the child with kwashiorkor, who appears more rounded from the edema

Cows milk allergy (CMA) is diagnosed in a 6-month-old infant. Which should the nurse recommend as a substitute formula? a. Nutramigen b. Goats milk c. Similac d. Enfamil

a. Nutramigen Treatment of CMA is elimination of cows milk based formula and all other dairy products. For infants fed cows milk formula, this primarily involves changing the formula to a casein hydrolysate milk formula

Which technique is best for dealing with the negativism of the toddler? a. Offer the child choices. b. Remain serious and intent. c. Provide few or no choices for child. d. Quietly and calmly ask the child to comply.

a. Offer the child choices.

Which toys should a nurse provide to promote imaginative play for a 3-year-old hospitalized child? (Select all that apply.) a. Plastic telephone b. Hand puppets c. Jigsaw puzzle (100 pieces) d. Farm animals and equipment e. Jump rope

a. Plastic telephone b. Hand puppets d. Farm animals and equipment A 100-piece jigsaw puzzle and a jump rope would be appropriate for a young, school-age child but not a 3-year-old child

Which is an important nursing consideration in the care of the newborn with PKU? a. Suggest ways to make formula more palatable. b. Teach proper administration of phenylalanine hydroxylase. c. Encourage the breastfeeding mother to adhere to low-phenylalanine diet. d. Give reassurance that dietary restrictions are a temporary inconvenience.

a. Suggest ways to make formula more palatable.

A nurse is assessing a child with kwashiorkor disease. Which assessment findings should the nurse expect? a. Thin wasted extremities with a prominent abdomen b. Constipation c. Elevated hemoglobin d. High levels of protein

a. Thin wasted extremities with a prominent abdomen

The nurse is caring for a child receiving intravenous (IV) morphine for severe postoperative pain. The nurse observes a slower respiratory rate, and the child cannot be aroused. The most appropriate management of this child is for the nurse to: a. administer naloxone (Narcan). b. discontinue IV infusion. c. discontinue morphine until child is fully awake. d. stimulate child by calling name, shaking gently, and asking to breathe deeply.

a. administer naloxone (Narcan).

The management of a child who has just been stung by a bee or wasp should include the application of: a. cool compresses. b. warm compresses. c. antibiotic cream. d. corticosteroid cream.

a. cool compresses. Bee or wasp stings are initially treated by carefully removing stinger, cleansing with soap and water, applying cool compresses, and using common household agents such as lemon juice or a paste made with aspirin and baking soda

The newborn with severe jaundice is at risk for developing: a. encephalopathy. b. bullous impetigo. c. respiratory distress. d. blood incompatibility.

a. encephalopathy.

A 4-month-old was born at 35 weeks of 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: a. infants temperaments are part of their unique characteristics. b. infants become less difficult if they are not kept on scheduled feedings and structured routines. c. the infants behavior is suggestive of failure to bond completely with her parents. d. the infants difficult temperament is the result of painful experiences in the neonatal period.

a. infants temperaments are part of their unique characteristics.

The most immediate threat to life in children with thermal injuries is: a. shock. b. anemia. c. local infection. d. systemic sepsis.

a. shock.

What is the best age for solid food to be introduced into the infants diet? a. 2 to 3 months b. 4 to 6 months c. When birth weight has tripled d. When tooth eruption has started

b. 4 to 6 months Physiologically and developmentally, the 4- to 6-month-old infant is in a transition period. The extrusion reflex has disappeared, and swallowing is a more coordinated process. In addition, the gastrointestinal tract has matured sufficiently to handle more complex nutrients and is less sensitive to potentially allergenic food

A parent asks the nurse when will my infant start to teethe? The nurse responds that the earliest age at which an infant begins teething with eruption of lower central incisors is _____ months. a. 4 b. 6 c. 8 d. 12

b. 6

A nurse is conducting discharge teaching for parents of a newborn. The nurse instructs the parents on which method of care for the umbilical cord? (Select all that apply.) a. Covering the cord with the diaper b. Cleansing the cord with water daily c. Keeping the cord area free of urine and stool d. Monitoring for signs of infection e. Applying bacitracin ointment to the cord daily

b. Cleansing the cord with water daily c. Keeping the cord area free of urine and stool d. Monitoring for signs of infection

A nurse is conducting education classes for parents of infants. The nurse plans to discuss sudden infant death syndrome (SIDS). Which risk factors should the nurse include as increasing an infants risk of a sudden infant death syndrome incident? (Select all that apply.) a. Breastfeeding b. Low Apgar scores c. Male sex d. Birth weight in the 50th or higher percentile e. Recent viral illness

b. Low Apgar scores c. Male sex e. Recent viral illness

The American Academy of Pediatrics recommends that the best form of newborn nutrition is: a. exclusive breastfeeding until age 2 months. b. exclusive breastfeeding until at least age 1 year. c. commercially prepared newborn formula for 1 year. d. commercially prepared newborn formula until age 4 to 6 months.

b. exclusive breastfeeding until at least age 1 year.

Tinea capitis (ringworm), frequently found in schoolchildren, is caused by a(n): a. virus. b. fungus. c. allergic reaction. d. bacterial infection.

b. fungus. Ringworm is caused by a group of closely related filamentous fungi that invade primarily the stratum corneum, hair, and nails. They are superficial infections that live on, not in, the skin. Virus and bacterial infection are not the causative organisms for ringworm. Ringworm is not an allergic response.

A nurse is conducting a teaching session for parents of infants. The nurse explains that which behavior indicates that an infant has developed object permanence? a. Recognizes familiar face, such as mother b. Recognizes familiar object, such as bottle c. Actively searches for a hidden object d. Secures objects by pulling on a string

c. Actively searches for a hidden object

The child of 15 to 30 months is likely to be struggling with which developmental task? a. Trust b. Initiative c. Autonomy d. Intimacy

c. Autonomy

Which explains physiologically the edema formation that occurs with burns? a. Vasoconstriction b. Decreased capillary permeability c. Increased capillary permeability d. Decreased hydrostatic pressure within capillaries

c. Increased capillary permeability

Which statement best represents the first stage of the first period of reactivity in the newborn? a. It begins when the newborn awakes from a deep sleep. b. It ends when the amount of respiratory mucus has decreased. c. It is an excellent time to acquaint the parents with the newborn. d. It is an excellent time for mother to sleep and recover.

c. It is an excellent time to acquaint the parents with the newborn.

.Which snack should the nurse recommend parents offer to their slightly overweight preschool child? a. Carbonated beverage b. 10% fruit juice c. Low fat chocolate milk d. Whole milk

c. Low fat chocolate milk

The nurse is planning care for a low-birth-weight newborn. Which is an appropriate nursing intervention to promote adequate oxygenation? a. Place in Trendelenburg position periodically. b. Suction at least every 2 to 3 hours. c. Maintain neutral thermal environment. d. Hyperextend neck with nose pointing to ceiling.

c. Maintain neutral thermal environment.

Vitamin A supplementation may be recommended for the young child who has which disease? a. Mumps b. Rubella c. Measles (Rubeola) d. Erythema Infectiosum

c. Measles (rubeola) Evidence shows vitamin A decreases morbidity and mortality in measles. Mumps is treated with analgesics for pain and antipyretics for fever. Rubella is treated similarly to mumps. Erythema infectiosum is treated similarly to mumps and rubella.

The parent of a 2-week-old infant, exclusively breastfed, asks the nurse if fluoride supplements are needed. The nurses best response should be: a. She needs to begin taking them now. b. They are not needed if you drink fluoridated water. c. She may need to begin taking them at age 4 months. d. She can have infant cereal mixed with fluoridated water instead of supplements.

c. She may need to begin taking them at age 4 months.

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

c. This is typical behavior because of the inability to transfer knowledge to new situations. During the tertiary circular reactions stage, children have only a rudimentary sense of the classification of objects. The appearance of an object denotes its function for these children. The slot of an outlet is for putting things into. Her cognitive development is appropriate for her age

A nurse is assessing a preschool-age child and notes the child exhibits magical thinking. According to Piaget, which describes magical thinking? a. Events have cause and effect. b. God is like an imaginary friend. c. Thoughts are all-powerful. d. If the skin is broken, the child's insides will come out

c. Thoughts are all-powerful. Because of their egocentrism and transductive reasoning, preschoolers believe that thoughts are all-powerful.

A parent reports to the nurse that her child has inflamed conjunctivae of both eyes with purulent drainage and crusting of the eyelids, especially on awakening. These manifestations suggest: a. viral conjunctivitis. b. allergic conjunctivitis. c. bacterial conjunctivitis. d. conjunctivitis caused by foreign body

c. bacterial conjunctivitis. Bacterial conjunctivitis has these symptoms. Viral or allergic conjunctivitis has watery drainage. Foreign body causes tearing and pain, and usually only one eye is affected

At what age should the nurse expect a child to give both first and last names when asked? a. 15 months b. 18 months c. 24 months d. 30 months

d. 30 months At 30 months, the child is able to give both first and last names and refer to self with an appropriate pronoun.

By which age should the nurse expect that most children could obey prepositional phrases such as under, on top of, beside, and behind? a. 18 months b. 24 months c. 3 years d. 4 years

d. 4 years

In terms of fine motor development, which should the 3-year-old child be expected to do? a. Lace shoes and tie shoelaces with a bow. b. Use scissors to cut pictures, and print a few numbers. c. Draw a person with seven parts and correctly identify the parts. d. Draw a circle and name what has been drawn

d. Draw a circle and name what has been drawn Three-year-olds are able to accomplish this fine motor skill. Being able to lace shoes and tie shoelaces with a bow, use scissors to cut pictures, and print a few numbers, or draw a person with seven parts and correctly identify the parts are fine motor skills of 4- or 5-year-olds

A parent has asked the nurse about how her child can be tested for pinworms. The nurse responds by stating that which is the most common test for diagnosing pinworms in a child? a. Lower gastrointestinal (GI) series b. Three stool specimens, at intervals of 4 days c. Observation for presence of worms after child defecates d. Laboratory examination of a fecal smear

d. Laboratory examination of a fecal smear Laboratory examination of substances containing the worm, its larvae, or ova can identify the organism. Most are identified by examining fecal smears from the stools of persons suspected of harboring the parasite. Fresh specimens are best for revealing parasites or larvae.

. A nurse is preparing to feed a 12-month-old infant with failure to thrive. Which intervention should the nurse implement? a. Provide stimulation during feeding. b. Avoid being persistent during feeding time. c. Limit feeding time to 10 minutes. d. Maintain a face-to-face posture with the infant during feeding

d. Maintain a face-to-face posture with the infant during feeding

A parent asks the nurse whether her infant is susceptible to pertussis. The nurses response should be based on which statement concerning susceptibility to pertussis? a. Neonates will be immune the first few months. b. If the mother has had the disease, the infant will receive passive immunity. c. Children younger than 1 year seldom contract this disease. d. Most children are highly susceptible from birth.

d. Most children are highly susceptible from birth. The acellular pertussis vaccine is recommended by the American Academy of Pediatrics beginning at age 6 weeks. Infants are at greater risk for complications of pertussis. The vaccine is not given after age 7 years, when the risks of the vaccine become greater than those of pertussis. The infant is highly susceptible to pertussis, which can be a life-threatening illness in this age group.

Which refers to a newborn whose rate of intrauterine growth was slowed and whose birth weight falls below the 10th percentile on intrauterine growth charts? a. Postterm b. Postmature c. Low birth weight d. Small for gestational age

d. Small for gestational age

The screening test for PKU is most reliable if the blood sample is: a. from cord blood. b. taken 14 days after birth. c. taken before oral feedings are initiated. d. fresh blood from the heel.

d. fresh blood from the heel.

A healthy, stable, preterm newborn will soon be discharged. The nurse should recommend which position for sleep? a. Prone b. Supine c. Side lying d. Position of comfort

b. Supine

Although infants may be allergic to a variety of foods, the most common allergens are: a. fruit and eggs. b. fruit, vegetables, and wheat. c. cows milk and green vegetables. d. eggs, cows milk, and wheat.

d. eggs, cows milk, and wheat.

In a newborns eyes, strabismus is a normal finding because of: A. congenital cataracts. B. lack of binocularity. C. absence of red reflex. D. inability of pupil to react to light.

B. lack of binocularity.

A nurse, instructing parents of a hospitalized preschool child, explains that which is descriptive of the preschoolers understanding of time? a. Has no understanding of time b. Associates time with events c. Can tell time on a clock d. Uses terms like yesterday appropriately

b. Associates time with events

Which finding on a newborn assessment should the nurse recognize as suggestive of a clavicle fracture? a. Negative scarf sign b. Asymmetric Moro reflex c. Swelling of fingers on affected side d. Paralysis of affected extremity and muscles

b. Asymmetric Moro reflex

A mother tells the nurse that she is discontinuing breastfeeding her 5-month-old infant. The nurse should recommend that the infant be given: a. skim milk. b. whole cows milk. c. commercial iron-fortified formula. d. commercial formula without iron.

c. commercial iron-fortified formula.

CHAPTER 7 The nurse is presenting an in-service session on assessing gestational age in newborns. Which information should be included? A. The newborns length and weight are the most accurate indicators of gestational age. B. The newborns Apgar score and the mothers estimated date of confinement (EDC) are combined to determine gestational age. C. The newborns posture at rest and arm recoil are two physical signs used to determine gestational age. D. The newborns chest circumference compared to the head circumference is the determinant for gestational age.

C. The newborns posture at rest and arm recoil are two physical signs used to determine gestational age.

CHAPTER 5 A 2-year-old child has been returned to the nursing unit after an inguinal hernia repair. Which pain assessment tool should the nurse use to assess this child for the presence of pain? a. FACES pain rating tool b. Numeric scale c. Oucher scale d. FLACC tool

D. FLACC tool A behavioral pain tool should be used when the child is preverbal or doesn't have the language skills to express pain. The FLACC (face, legs, activity, cry, consolability) tool should be used with a 2-year-old child. The FACES, numeric, and Oucher scales are all self-report pain rating tools. Self-report measures are not sufficiently valid for children younger than 3 years of age because many are not able to accurately self-report their pain

The nurse is examining 12-month-old Amy, who was brought to the clinic for persistent diaper rash. The nurse finds perianal inflammation with satellite lesions that cross the inguinal folds. This is most likely caused by: a. impetigo. b. Candida albicans. c. urine and feces. d. infrequent diapering.

b. Candida albicans.

A parent asks the nurse at what age do most infants begin to fear strangers? The nurse should give which response? a. 2 months b. 4 months c. 6 months d. 12 months

c. 6 months

A nurse is assessing a 6-month-old infant. The nurse recognizes the posterior fontanel usually closes at which age? a. 6 to 8 weeks b. 10 to 12 weeks c. 4 to 6 months d. 8 to 10 months

a. 6 to 8 weeks

CHAPTER 10 Recent studies indicate that a deficiency of which vitamin correlates with increased morbidity and mortality in children with measles? a. A b. C c. Niacin d. Folic acid

a. A

Which is the most appropriate nursing action when intermittently gavage-feeding a preterm newborn? a. Allow formula to flow by gravity. b. Insert tube through nares rather than mouth. c. Avoid letting newborn suck on tube. d. Apply steady pressure to syringe to deliver formula to stomach in a timely manner.

a. Allow formula to flow by gravity. The formula is allowed to flow by gravity. The length of time to complete the feeding will vary. Preferably, the tube is inserted through the mouth. Newborns are obligatory nose breathers, and the presence of the tube in the nose irritates the nasal mucosa. Passage of the tube through the mouth allows the nurse to observe and evaluate the sucking response

The most fatal type of burn in the toddler age group is: a. flame burn from playing with matches. b. scald burn from high-temperature tap water. c. hot object burn from cigarettes or irons. d. electric burn from electric outlets

a. flame burn from playing with matches.

Which interventions should the nurse implement when caring for a family of a sudden infant death syndrome (SIDS) infant? (Select all that apply.) a. Allow parents to say goodbye to their infant. b. Once parents leave the hospital, no further follow-up is required. c. Arrange for someone to take the parents home from the hospital. d. Avoid requesting an autopsy of the deceased infant. e. Conduct a debriefing session with the parents before they leave the hospital.

a. Allow parents to say goodbye to their infant. c. Arrange for someone to take the parents home from the hospital. e. Conduct a debriefing session with the parents before they leave the hospital.

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

a. Allow to splash in bath. The feel of the water while the infant is splashing will provide tactile stimulation. Various colored blocks would provide visual stimulation for a 4- to 6-month-old infant. Music box, tapes, and CDs provide auditory stimulation. Swings and strollers provide kinesthetic stimulation

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? a. Animism b. Ritualism c. Irreversibility d. Delayed cognitive development

a. Animism

The nurse needs to obtain blood for ongoing assessment of a high-risk newborns progress. Which tests should the nurse monitor? (Select all that apply.) a. Blood glucose b. Complete blood count (CBC) c. Calcium d. Serum electrolytes e. Neonatal prothrombin time (PTT)

a. Blood glucose c. Calcium d. Serum electrolytes The most common blood tests done on high-risk newborns are blood glucose, bilirubin, calcium, hematocrit, serum electrolytes, and blood gases. Hematocrits rather than CBCs are performed. This will monitor the red cell volume.

Which dietary recommendations should a nurse make to an adolescent patient to manage constipation related to opioid analgesic administration? (Select all that apply.) a. Bran cereal b. Decrease fluid intake c. Prune juice d. Cheese e. Vegetables

a. Bran cereal d. Cheese e. Vegetables

CHAPTER 8 Which is defined as a vaguely outlined area of edematous tissue situated over the portion of the scalp that presents in a vertex delivery? a. Caput succedaneum b. Hydrocephalus c. Cephalhematoma d. Subdural hematoma

a. Caput succedaneum A vaguely outlined area of edematous tissue situated over the portion of the scalp that presents in a vertex delivery is the definition of a caput succedaneum. The swelling consists of serum and/or blood accumulated in the tissues above the bone, and it may extend beyond the bone margin. Hydrocephalus is caused by an imbalance in production and absorption of cerebrospinal fluid. When production exceeds absorption, fluid accumulates within the ventricular system, causing dilation of the ventricles. A cephalhematoma has sharply demarcated boundaries that do not extend beyond the limits of the (bone) suture line. A subdural hematoma is located between the dura and the cerebrum. It would not be visible on the scalp

Recommendations for hepatitis B (HBV) vaccine include which statement? a. First dose is given between birth and age 2 days. b. First dose is given between ages 12 and 15 months. c. It is not recommended for neonates who are at low risk for hepatitis B. d. It is not recommended for neonates whose mothers are positive for HBV surface antigen.

a. First dose is given between birth and age 2 days. To reduce the incidence of HBV in children and its serious consequences in adulthood, the first of three doses is recommended soon after birth and before hospital discharge.

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 intervention should the nurse recommend? a. Give her nutritious snacks. b. Offer rewards for eating at mealtimes. c. Avoid snacks so she is hungry at mealtimes. d. Explain to her in a firm manner what is expected of her.

a. Give her nutritious snacks. Most toddlers exhibit a physiologic anorexia in response to the decreased nutritional requirement associated with the slower growth rate. Parents should help the child develop healthy eating habits. The toddler is often unable to sit through a meal. Frequent nutritious snacks are a good way to ensure proper nutrition

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

a. Give large push-pull toys for kinetic stimulation. The 12-month-old child is able to pull to standing and walk holding on or independently. Appropriate toys for a child this age include large pull toys for kinesthetic stimulation. A cradle gym should not be placed across the crib. Finger-paints are appropriate for older children. A 12-month-old child does not have the stability to use a stick horse

A nurse is teaching a class on breastfeeding to expectant parents. Which are contraindications for breastfeeding? (Select all that apply.) a. Human immunodeficiency virus (HIV) in mother b. Mastitis c. Inverted nipples d. Maternal cancer therapy e. Twin births

a. Human immunodeficiency virus (HIV) in mother d. Maternal cancer therapy

The nurse is caring for a newborn whose mother is diabetic. Which clinical manifestations should the nurse expect to see? a. Hypoglycemic, large for gestational age b. Hyperglycemic, large for gestational age c. Hypoglycemic, small for gestational age d. Hyperglycemic, small for gestational age

a. Hypoglycemic, large for gestational age The clinical manifestations of a newborn born to a mother with diabetes include being large for gestational age, being plump and full-faced, having abundant vernix caseosa, being listless and lethargic, and having hypoglycemia. These manifestations appear a short time after birth. The newborn is hypoglycemic from increased fetal production of insulin and large for gestational age

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 intervention? a. Ignore the baby talk. b. Explain to the toddler that baby talk is for babies. c. Tell the toddler frequently, You are a big kid now. d. Encourage the toddler to practice more advanced patterns of speech.

a. Ignore the baby talk. The baby talk is a sign of regression in the toddler. It should be ignored, while praising the child for developmentally appropriate behaviors. Regression is children's way of expressing stress.

Which gross motor milestones should the nurse assess in an 18-month-old child? (Select all that apply.) a. Jumps in place with both feet b. Takes a few steps on tiptoe c. Throws ball overhand without falling d. Pulls and pushes toys e. Stands on one foot momentarily

a. Jumps in place with both feet c. Throws ball overhand without falling d. Pulls and pushes toys Taking a few steps on tiptoe and standing on one foot momentarily is not acquired until 30 months of age.

A nurse is admitting a child to the hospital with a diagnosis of giardiasis. Which medication should the nurse expect to be prescribed? a. Metronidazole (Flagyl) b. Amoxicillin clavulanate (Augmentin) c. Clarithromycin (Biaxin) d. Prednisone (Orapred)

a. Metronidazole (Flagyl) The drugs of choice for treatment of giardiasis are metronidazole (Flagyl), tinidazole (Tindamax), and nitazoxanide (Alinia). These are classified as antifungals.

Which is an appropriate play activity for a 7-month-old infant to encourage visual stimulation? a. Playing peek-a-boo b. Playing pat-a-cake c. Imitating animal sounds d. Showing how to clap hands

a. Playing peek-a-boo Because object permanence is a new achievement, peek-a-boo is an excellent activity to practice this new skill for visual stimulation. Pat-a-cake and showing how to clap hands will help with kinetic stimulation. Imitating animal sounds will help with auditory stimulation.

The nurse is caring for a 5-year-old child with impetigo contagiosa. The parents ask the nurse what will happen to their childs skin after the infection has subsided and healed. Which answer should the nurse give? a. There will be no scarring. b. There may be some pigmented spots. c. It is likely there will be some slightly depressed scars. d. There will be some atrophic white scars.

a. There will be no scarring.

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 nurses best interpretation of this behavior is included in which statement? a. This is normal behavior for his age. b. This is unusual behavior for his age. c. He is not effectively coping with stress. d. He is showing he needs more attention.

a. This is normal behavior for his age. Toddlers use distinct behaviors in the quest for autonomy. They express their will with continued negativity and the use of the word no. Children at this age also have rapid mood swings. The nurse should reassure the parents that their child is engaged in expected behavior for an 18-month-old. Having a rapid mood swing is an expected behavior for a toddler.

Which is a useful skill that the nurse should expect a 5-year-old child to be able to master? a.Tie shoelaces. b. Use knife to cut meat. c. Hammer a nail. d. Make change out of a quarter

a. Tie shoelaces

In terms of fine motor development, what should the infant of 7 months be able to do? a. Transfer objects from one hand to the other and bang cubes on a table. b. Use thumb and index finger in crude pincer grasp and release an object at will. c. Hold a crayon between the fingers and make a mark on paper. d. Release cubes into a cup and build a tower of two blocks.

a. Transfer objects from one hand to the other and bang cubes on a table. By age 7 months, infants can transfer objects from one hand to the other, crossing the midline, and bang objects on a hard surface. The crude pincer grasp is apparent at about age 9 months, and releasing an object at will is seen around 8 months. The child can scribble spontaneously at age 15 months. At age 12 months, the child can release cubes into a cup and build a small tower

A nurse is planning care for a premature newborn. Which interventions should the nurse implement for skin care? (Select all that apply.) a. Use cleaning agents with neutral pH. b. Rub skin during drying. c. Use adhesive remover solvent when removing tape. d. Avoid removing adhesives for at least 24 hours. e. Consider pectin barriers beneath adhesives.

a. Use cleaning agents with neutral pH. d. Avoid removing adhesives for at least 24 hours. e. Consider pectin barriers beneath adhesives.

The nurse is caring for a school-age child with a tinea capitis (ringworm) infection. The nurse should expect that therapeutic management for this child includes: a. administering oral griseofulvin. b. administering topical or oral antibiotics. c. applying topical sulfonamides. d. applying Burow solution compresses to affected area.

a. administering oral griseofulvin. Oral griseofulvin therapy frequently continues for weeks or months

The nurse is caring for a preterm newborn who requires mechanical ventilation for the treatment of respiratory distress syndrome. The nurse should recognize that, because of the mechanical ventilation, there is an increased risk of: a. alveolar rupture. b. meconium aspiration. c. transient tachypnea. d. retractions and nasal flaring.

a. alveolar rupture. Positive pressure introduced by mechanical apparatus has created an increase in the incidence of ruptured alveoli and subsequent pneumothorax and bronchopulmonary dysplasia.

Clinical manifestations of failure to thrive caused by behavioral problems resulting in inadequate intake of calories include: a. avoidance of eye contact. b. an associated malabsorption defect. c. weight that falls below the 15th percentile. d. normal achievement of developmental landmarks.

a. avoidance of eye contact. One of the clinical manifestations of nonorganic failure to thrive is the childs avoidance of eye contact with the health professional. A malabsorption defect would result in a physiologic problem, not behavioral. Weight (but not height) below the 5th percentile is indicative of failure to thrive. Developmental delays, including social, motor, adaptive, and language, exist.

The parents of a newborn plan to have him circumcised. They ask the nurse about pain associated with this procedure. The nurses response should be based on the knowledge that newborns: a. experience pain with circumcision. b. do not experience pain with circumcision. c. quickly forget about the pain of circumcision. d. are too young for anesthesia or analgesia.

a. experience pain with circumcision.

The nurse is interviewing the father of a 10-month-old infant. She is playing on the floor when she notices an electric 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 the infant: a. is old enough to understand the word no. b. is too young to understand the word no. c. should already know that electric outlets are dangerous. d. will learn safety issues better if she is spanked.

a. is old enough to understand the word no.

Nonpharmacologic strategies for pain management: a. may reduce pain perception. b. make pharmacologic strategies unnecessary. c. usually take too long to implement. d. trick children into believing they do not have pain.

a. may reduce pain perception.

A 3-month-old infant, born at 38 weeks of 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: a. normal development. b. significant developmental lag. c. slightly delayed development due to prematurity. d. suggestive of a neurologic disorder such as cerebral palsy.

a. normal development. Holding a rattle but not voluntarily grasping it is indicative of normal development. Reflexive grasping occurs during the first 2 to 3 months and then gradually becomes voluntary. The infant is expected to be able to perform this task by age 3 months. If the child's age is corrected because of being 2 weeks preterm, the child is at the midpoint of the range for this developmental task and the behavior is age appropriate.

The nurse is doing a routine assessment on a 14-month-old infant and notes that the anterior fontanel is closed. The nurse should interpret this as a(n): a. normal finding. b. finding requiring a referral. c. abnormal finding. d. normal finding, but requires rechecking in 1 month.

a. normal finding.

The nurse is careful to place the incubator away from cold windows or air-conditioning units. This is to conserve the newborns body heat by preventing heat loss through: a. radiation. b. conduction. c. convection. d. evaporation.

a. radiation. Radiation is the loss of heat to a cooler solid object. The cold air from either the window or the air conditioner will cool the incubator walls and subsequently the newborns body

Early this morning, a baby boy was circumcised by using the Plastibell method. The nurse should tell the mother that the baby can be discharged after: a. the newborn voids. b. receiving vitamin K. c. yellow exudate forms over glans. d. the Plastibell rim falls off.

a. the newborn voids. The circumcision site is evaluated for excessive bleeding every 30 minutes for at least 2 hours. After these observations and voiding, the newborn can be discharged. The Plastibell rim will separate and fall off within 5 to 8 days. The newborn should be discharged before this

The stump of the umbilical cord usually separates in how many days? a. 3 b. 10 to 14 c. 16 to 20 d. 28

b. 10 to 14

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? a. 10 b. 15 c. 20 d. 25

b. 15 Birth weight doubles at about age 5 to 6 months

. Kimberlys parents have been using a rearward-facing, convertible car seat since she was born. Most car seats can be safely switched to the forward-facing position when the child reaches which age? a. 1 b. 2 c. 3 d. 4

b. 2 It is now recommended that all infants and toddlers ride in rear-facing car safety seats until they reach the age of 2 years or height recommended by the car seat manufacturer.

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

b. 2 months

The nurse is discussing development and play activities with the parent of a 2-month-old. Recommendations should include giving a first rattle at about which age? a. 2 months b. 4 months c. 7 months d. 9 months

b. 4 months It is recommended that a brightly colored toy or rattle be given to the child at age 4 months. Grasping has begun as a deliberate act, and the infant grasps, holds, and begins shaking to hear a noise; 2 months is too young. The infant still has primarily reflex grips; 7 to 9 months is too old for the first rattle. The child should be given toys that provide for further exploration

A nurse is assessing a premature newborn for the possibility of necrotizing enterocolitis (NEC). Which assessment findings should the nurse expect to find if NEC is confirmed? (Select all that apply.) a. Minimal gastric residual b. Abdominal distention c. Apnea d. Urinary output at 2 ml/kg/hr e. Unstable temperature

b. Abdominal distention c. Apnea e. Unstable temperature The nurse should observe for indications of early development of NEC by checking the appearance of the abdomen for distention (measuring abdominal girth, measuring residual gastric contents before feedings, and listening for bowel sounds) and performing all routine assessments for high-risk neonates. The premature newborn may have apnea and unstable temperature if NEC is developing. The urinary output will be decreased and will be below the expected 2 ml/kg/hr

The nurse observes that a new mother avoids making eye contact with her newborn. The nurse should perform which action? a. Examine newborns eyes for ability to focus. b. Assess for other attachment behaviors. c. Recognize this as a common reaction in new mothers. d. Ask mother why she wont look at newborn.

b. Assess for other attachment behaviors.

Which intervention should the nurse implement to maintain the skin integrity of the premature newborn? a. Cleanse skin with a gentle alkaline-based soap and water. b. Cleanse skin with a neutral pH solution only when necessary. c. Thoroughly rinse skin with plain water after bathing in a mild hexachlorophene solution. d. Avoid cleaning skin.

b. Cleanse skin with a neutral pH solution only when necessary. The premature newborn should be given baths no more than two or three times per week with a neutral pH solution. The eyes, oral and diaper areas, and pressure points should be cleansed daily

A 4-year-old child is hospitalized with a serious bacterial infection. The child tells the nurse that he is sick because he was bad. Which is the nurses best interpretation of this comment? a. Sign of stress b. Common at this age c. Suggestive of maladaptation d. Suggestive of excessive discipline at home

b. Common at this age Preschoolers cannot understand the cause and effect of illness. Their egocentrism makes them think they are directly responsible for events, making them feel guilty for things outside their control.

A nurse recognizes which physiologic responses as a manifestation of pain in a neonate? (Select all that apply.) a. Decreased respirations b. Diaphoresis c. Decreased SaO2 d. Decreased blood pressure e. Increased heart rate

b. Diaphoresis c. Decreased SaO2 e. Increased heart rate The physiologic responses that indicate pain in neonates are increased heart rate, increased blood pressure, rapid, shallow respirations, decreased arterial oxygen saturation (SaO2), pallor or flushing, diaphoresis, and palmar sweating

A nurse is teaching parents about prevention and treatment of colic. Which should the nurse include in the teaching plan? a. Avoid use of pacifiers. b. Eliminate all second-hand smoke contact. c. Lay infant flat after feeding. d. Avoid swaddling the infant.

b. Eliminate all second-hand smoke contact.

In terms of language and cognitive development, a 4-year-old child would be expected to have which traits? (Select all that apply.) a. Think in abstract terms. b. Follow directional commands. c. Understand conservation of matter. d. Use sentences of eight words. e. Tell exaggerated stories. f. Comprehend another persons perspective

b. Follow directional commands. e. Tell exaggerated stories.

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

b. Foods should be introduced one at a time, at intervals of 4 to 7 days.

A toddler sustains a minor burn on the hand from hot coffee. Which is the first action the nurse should recommend in treating this burn?a. Apply ice to burned area. b. Hold burned area under cool running water. c. Break any blisters with a sterile needle. d. Cleanse wound with soap and warm water

b. Hold burned area under cool (or tepid) running water.

Which should the nurse expect for a toddlers language development at age 18 months? a. Vocabulary of 25 words b. Increasing level of comprehension c. Use of holophrases d. Approximately one third of speech understandable

b. Increasing level of comprehension During the second year of life, level of comprehension and understanding of speech increases and is far greater than the childs vocabulary. This is also true for bilingual children, who are able to achieve this linguistic milestone in both languages. The 18-month-old child has a vocabulary of 10 or more words. At this age, the child does not use the one-word sentences that are characteristic of the 1-year-old child. The child has a limited vocabulary of single words that are comprehensible

Which is the primary treatment for hypoglycemia in newborns with feeding intolerance? a. Oral glucose feedings b. Intravenous (IV) infusion of glucose c. Short-term insulin therapy d. Feedings (formula or breast milk) at least every 2 hours

b. Intravenous (IV) infusion of glucose

A nurse is assessing a child and notes Koplik spots. In which of these communicable diseases are Koplik spots present? a. Rubella b. Measles (rubeola) c. Chickenpox (varicella) d. Exanthema subitum (roseola)

b. Measles (rubeola) Koplik spots are small irregular red spots with a minute, bluish white center found on the buccal mucosa 2 days before systemic rash. Rubella occurs with rash on the face, which rapidly spreads downward. Varicella appears with highly pruritic macules, followed by papules and vesicles. Roseola is seen with rose-pink macules on the trunk, spreading to face and extremities.

Which drug is usually the best choice for patient-controlled analgesia (PCA) for a child in the immediate postoperative period? a. Codeine b. Morphine c. Methadone d. Meperidine

b. Morphine The most commonly prescribed medications for PCA are morphine, hydromorphone, and fentanyl. Parenteral use of codeine is not recommended.

The nurse is caring for a newborn who was born 24 hours ago to a mother who received no prenatal care. The newborn is a poor feeder but sucks avidly on his hands. Clinical manifestations also include loose stools, tachycardia, fever, projectile vomiting, sneezing, and generalized sweating. Which should the nurse suspect? a. Seizure disorder b. Narcotic withdrawal c. Placental insufficiency d. Meconium aspiration syndrome

b. Narcotic withdrawal Newborns exposed to drugs in utero usually show no untoward effects until 12 to 24 hours for heroin or much longer for methadone. The newborn usually has nonspecific signs that may coexist with other conditions such as hypocalcemia and hypoglycemia. In addition, these newborns may have loose stools, tachycardia, fever, projectile vomiting, sneezing, and generalized sweating, which is uncommon in newborns

Parents tell the nurse that they found their 3-year-old daughter and a male cousin of the same age inspecting each other closely as they used the bathroom. Which is the most appropriate recommendation the nurse should make? a. Punish children so this behavior stops. b. Neither condone nor condemn the curiosity. c. Allow children unrestricted permission to satisfy this curiosity. d. Get counseling for this unusual and dangerous behavior.

b. Neither condone nor condemn the curiosity. Three-year-olds become aware of anatomic differences and are concerned about how the other works. Such exploration should not be condoned or condemned. Children should not be punished for this normal exploration.

Which describes marasmus? a. Deficiency of protein with an adequate supply of calories b. Not confined to geographic areas where food supplies are inadequate c. Syndrome that results solely from vitamin deficiencies d. Characterized by thin, wasted extremities and a prominent abdomen resulting from edema (ascites)

b. Not confined to geographic areas where food supplies are inadequate Marasmus is a syndrome of emotional and physical deprivation. It is not confined to geographic areas were food supplies are inadequate. Marasmus is a deficiency of both protein and calories.

Which are characteristic of physical development of a 30-month-old child? (Select all that apply.) a. Birth weight has doubled. b. Primary dentition is complete. c. Sphincter control is achieved. d. Anterior fontanel is open. e. Length from birth is doubled. f. Left or right handedness is established

b. Primary dentition is complete. c. Sphincter control is achieved. Usually by age 30 months, the primary dentition of 20 teeth is completed, and the child has sphincter control in preparation for bowel and bladder control. Birth weight doubles at approximately ages 5 to 6 months. The anterior fontanel closes at age 12 to 18 months. Birth length is doubled around age 4. Left or right handedness is not established until about age 5.

A nurse has completed an assessment on a newborn. Which finding is considered abnormal? a. Nystagmus b. Profuse drooling c. Dark green or black stools d. Slight vaginal reddish discharge

b. Profuse drooling Profuse drooling or salivation is a potential sign of a major abnormality. Newborns with esophageal atresia cannot swallow their oral secretions, resulting in excessive drooling.

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

b. Realizes that out of sight is not out of reach At this age, the child is in the final sensorimotor stage. Children will now search for an object in several potential places, even though they saw only the original hiding place. Children have a more developed sense of objective permanence. They will search for objects even if they have not seen them hidden. When a child puts objects into a container but cannot take them out, this is indicative of tertiary circular reactions

A nurse is monitoring a patient for side effects associated with opioid analgesics. Which side effects should the nurse expect to monitor for? (Select all that apply.) a. Diarrhea b. Respiratory depression c. Hypertension d. Pruritus e. Sweating

b. Respiratory depression d. Pruritus e. Sweating

Which play item should the nurse bring from the playroom to a hospitalized toddler in isolation? a. Small plastic Lego b. Set of large plastic building blocks c. Brightly colored balloon d. Coloring book and crayons

b. Set of large plastic building blocks Play objects for toddlers must still be chosen with an awareness of danger from small parts. Large, sturdy toys without sharp edges or removable parts are safest. Large plastic blocks are appropriate for a toddler in isolation.

Which statement best describes the clinical manifestations of the preterm newborn? a. Head is proportionately small in relation to the body. b. Sucking reflex is absent, weak, or ineffectual. c. Thermostability is well established. d. Extremities remain in attitude of flexion.

b. Sucking reflex is absent, weak, or ineffectual.

The nurse is caring for a hospitalized 4-year-old boy. His parents tell the nurse that they will be back to visit at 6 PM. When the child asks the nurse when his parents are coming, the nurses best response is a. They will be here soon. b. They will come after dinner. c. Let me show you on the clock when 6 PM is. d. I will tell you every time I see you how much longer it will be.

b. They will come after dinner.

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

b. This is typical behavior because toddlers are egocentric. Play develops from the solitary play of infancy to the parallel play of toddlers. The toddler plays alongside other children, not with them. This typical behavior of the toddler is not intentionally aggressive. Shared play is not within their cognitive development.

Parent guidelines for relieving colic in an infant include: a. avoiding touching abdomen. b. avoiding using a pacifier. c. changing infants position frequently. d. placing infant where family cannot hear the crying.

c. changing infants position frequently.

An infant has been diagnosed with cows milk allergy. What are the clinical manifestations the nurse expects to assess? (Select all that apply.) a. Pink mucous membranes b. Vomiting c. Rhinitis d. Abdominal pain e. Moist skin

b. Vomiting c. Rhinitis d. Abdominal pain An infant with cows milk allergy will possibly have vomiting, rhinitis, and abdominal pain. The mucous membranes may be pale due to anemia from blood lost in the GI tract, and the skin will be itchy with the possibility of atopic dermatitis

Which statement is correct about toilet training? a. Bladder training is usually accomplished before bowel training. b. Wanting to please the parent helps motivate the child to use the toilet. c. Watching older siblings use the toilet confuses the child. d. Children must be forced to sit on the toilet when first learning.

b. Wanting to please the parent helps motivate the child to use the toilet. Voluntary control of the anal and urethral sphincters is achieved sometime after the child is walking. The child must be able to recognize the urge to let go and to hold on. The child must want to please parent by holding on rather than pleasing self by letting go. Bowel training precedes bladder training

A nurse is teaching parents about caring for their child with chickenpox. The nurse should let the parents know that the child is considered to be no longer contagious when which occurs? a. When fever is absent b. When lesions are crusted c. 24 hours after lesions erupt d. 8 days after onset of illness

b. When lesions are crusted When the lesions are crusted, the chickenpox is no longer contagious. This may be a week after onset of disease. Chickenpox is still contagious when child has fever. Children are contagious after lesions erupt. If lesions are crusted at 8 days, the child is no longer contagious

A mother is upset because her newborn has erythema toxicum neonatorum. The nurse should reassure her that this is: a. easily treated. b. benign and transient. c. usually not contagious. d. usually not disfiguring.

b. benign and transient. Erythema toxicum neonatorum, or newborn rash, is a benign, self-limiting eruption of unknown cause that usually appears within the first 2 days of life. The rash usually lasts about 5 to 7 days. No treatment is indicated. Erythema toxicum neonatorum is not contagious.

The parents of a newborn ask the nurse what caused the baby's facial nerve paralysis. The nurses response is based on knowledge that this is caused by a(n): a. genetic defect. b. birth injury. c. spinal cord injury. d. inborn error of metabolism.

b. birth injury. Pressure on the facial nerve during delivery may result in injury to cranial nerve VII, which can occur with birth injury

CHAPTER 13 Airborne isolation is required for a child who is hospitalized with: a. mumps. b. chickenpox. c. exanthema subitum (roseola). d. erythema infectiosum (fifth disease).

b. chickenpox. Chickenpox is communicable through direct contact, droplet spread, and contaminated objects. Mumps is transmitted from direct contact with saliva of infected person and is most communicable before onset of swelling. The transmission and source of the viral infection exanthema subitum (roseola) is unknown. Erythema infectiosum (fifth disease) is communicable before onset of symptoms.

Newborns are highly susceptible to infection as a result of: a. excessive levels of immunoglobulin A (IgA) and immunoglobulin M (IgM). b. diminished nonspecific and specific immunity. c. increased humoral immunity. d. overwhelming anti-inflammatory response.

b. diminished nonspecific and specific immunity.

A child is admitted with extensive burns. The nurse notes that there are burns on the child's lips and singed nasal hairs. The nurse should suspect that the child has a(n): a. chemical burn. b. inhalation injury. c. electrical burn. d. hot-water scald.

b. inhalation injury. Evidence of an inhalation injury is burns of the face and lips, singed nasal hairs, and laryngeal edema. Clinical manifestation may be delayed for up to 24 hours

Phenylketonuria (PKU) is a genetic disease that results in the bodys inability to correctly metabolize: a. glucose. b. phenylalanine. c. phenylketones. d. thyroxine.

b. phenylalanine.

A 3-month-old infant dies shortly after arrival to the emergency department. The infant has subdural and retinal hemorrhages but no external signs of trauma. The nurse should suspect: a. unintentional injury. b. shaken-baby syndrome. c. sudden infant death syndrome (SIDS). d. congenital neurologic problem.

b. shaken-baby syndrome.

By which age should the nurse expect an infant to be able to pull to a standing position? a. 6 months b. 8 months c. 11 to 12 months d. 14 to 15 months

c. 11 to 12 months Most infants can pull themselves to a standing position at age 9 months. Infants who are not able to pull themselves to standing by age 11 to 12 months should be further evaluated for developmental dysplasia of the hip. At 6 months, infants have just obtained coordination of arms and legs. By age 8 months, infants can bear full weight on their legs. Any infant who cannot pull to a standing position by age 1 year should be referred for further evaluation.

The nurse should teach parents that which age is safe to give infants whole milk instead of commercial infant formula? a. 6 months b. 9 months c. 12 months d. 18 months

c. 12 months

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

c. 3 months

At what age can most infants sit steadily unsupported? a. 4 months b. 6 months c. 8 months d. 10 months

c. 8 months Sitting erect without support is a developmental milestone usually achieved by 8 months. At age 4 months, an infant can sit with support. At age 6 months, the infant will maintain a sitting position if propped. By 10 months, the infant can maneuver from a prone to a sitting position.

Which play is most typical of the preschool period? a. Solitary b. Parallel c. Associative d. Team

c. Associative Associative play is group play in similar or identical activities but without rigid organization or rules. Solitary play is that of infants. Parallel play is that of toddlers. School-age children play in teams

CHAPTER 9 A nurse is assessing a 12-month-old infant. Which statement best describes the infants physical development a nurse should expect to find? a. Anterior fontanel closes by age 6 to 10 months. b. Binocularity is well established by age 8 months. c. Birth weight doubles by age 5 months and triples by age 1 year. d. Maternal iron stores persist during the first 12 months of life.

c. Birth weight doubles by age 5 months and triples by age 1 year.

Which nursing consideration is important when caring for a child with impetigo contagiosa? a. Apply topical corticosteroids to decrease inflammation. b. Carefully remove dressings so as not to dislodge undermined skin, crusts, and debris. c. Carefully wash hands and maintain cleanliness when caring for an infected child. d. Examine child under a Wood lamp for possible spread of lesions.

c. Carefully wash hands and maintain cleanliness when caring for an infected child. A major nursing consideration related to bacterial skin infections, such as impetigo contagiosa, is to prevent the spread of the infection and complications. This is done by thorough hand washing before and after contact with the affected child.

Parents report that they have been giving a multivitamin to their 1-year-old infant. The nurse counsels the parents that which vitamin can cause a toxic reaction at a low dose? a. Niacin b. B6 c. D d. C

c. D Hypervitaminosis of vitamin D presents the greatest problem because this fat-soluble vitamin is stored in the body. Vitamin D is the most likely of all vitamins to cause toxic reactions in relatively small overdoses

Which best describes a full-thickness (third-degree) burn? a. Erythema and pain b. Skin showing erythema followed by blister formation c. Destruction of all layers of skin evident with extension into subcutaneous tissue d. Destruction injury involving underlying structures such as muscle, fascia, and bone

c. Destruction of all layers of skin evident with extension into subcutaneous tissue

A lumbar puncture is needed on a school-age child. The most appropriate action to provide analgesia during this procedure is to apply _____ before the procedure. a. TAC (tetracaine-adrenaline-cocaine) 15 minutes b. transdermal fentanyl (Duragesic) patch immediately c. EMLA (eutectic mixture of local anesthetics) 1 hour d. EMLA (eutectic mixture of local anesthetics) 30 minutes

c. EMLA (eutectic mixture of local anesthetics) 1 hour

The single parent of a 3-year-old child who has just been diagnosed with chickenpox tells the nurse that she cannot afford to stay home with the child and miss work. The parent asks the nurse if some medication will shorten the course of the illness. Which is the most appropriate nursing intervention? a. Reassure the parent that it is not necessary to stay home with the child. b.Explain that no medication will shorten the course of the illness. c. Explain the advantages of the medication acyclovir (Zovirax) to treat chickenpox. d.Explain the advantages of the medication VCZ immune globulin (VariZIG) to treat chickenpox

c. Explain the advantages of the medication acyclovir (Zovirax) to treat chickenpox. Acyclovir is effective in treating the number of lesions; shortening the duration of fever; and decreasing itching, lethargy, and anorexia. It is important the parent stay with the child to monitor fever. Acyclovir lessens the severity of chickenpox. VariZIG is given only to high-risk children.

The nurse is caring for a very low birth-weight (VLBW) newborn with a peripheral intravenous infusion. Which statement describes nursing considerations regarding infiltration? a. Infiltration occurs infrequently because VLBW newborns are inactive. b. Continuous infusion pumps stop automatically when infiltration occurs. c. Hypertonic solutions can cause severe tissue damage if infiltration occurs. d. Infusion site should be checked for infiltration at least once per 8-hour shift.

c. Hypertonic solutions can cause severe tissue damage if infiltration occurs. Hypertonic fluids can damage cells if the fluid leaks from the vein. Careful monitoring is required to prevent severe tissue damage. Infiltrations occur for many reasons, not only activity. The vein, catheter, and fluid used all contribute to the possibility of infiltration. The continuous infusion pump may alarm when the pressure increases, but this does not alert the nurse to all infiltrations. Infusion rates and sites should be checked hourly to prevent tissue damage from extravasations, fluid overload, and dehydration.

Which is the most appropriate nursing intervention for the newborn who is jittery and twitching and has a high-pitched cry? a. Monitor blood pressure closely. b. Obtain urine sample to detect glycosuria. c. Obtain serum glucose and serum calcium levels. d. Administer oral glucose or, if newborn refuses to suck, IV dextrose

c. Obtain serum glucose and serum calcium levels. These are signs and symptoms of hypocalcemia and hypoglycemia. A blood test is useful to determine the treatment. Laboratory analysis for calcium and blood glucose should be the priority intervention

The commonly used Guthrie blood test is performed on newborns to diagnose: a. Down syndrome. b. isoimmunization. c. PKU. d. congenital hypothyroidism (CH).

c. PKU.

A 4-year-old child tells the nurse that she does not want another blood sample drawn because I need all my insides, and I don't want anyone taking them out. Which is the nurses best interpretation of this? a. Child is being overly dramatic. b. Child has a disturbed body image. c. Preschoolers have poorly defined body boundaries. d. Preschoolers normally have a good understanding of their bodies.

c. Preschoolers have poorly defined body boundaries.

A nurse is planning a teaching session for parents of a newborn who plan to bottle-feed. Which should the nurse include in the teaching session? (Select all that apply.) a. Limiting the feeding to 15 minutes b. Propping the bottle for night feedings is acceptable c. Proper technique for cleansing the bottles and nipples d. Feeding infant on alternate sides of the lap e. Use of bottled water without fluoride should be avoided to mix powdered formula.

c. Proper technique for cleansing the bottles and nipples d. Feeding infant on alternate sides of the lap e. Use of bottled water without fluoride should be avoided to mix powdered formula.

The nurse is taking care of a child with scabies. Which primary clinical manifestation should the nurse expect to assess with this disease? a. Edema b. Redness c. Pruritus d. Maceration

c. Pruritus Scabies is caused by the scabies mite. The inflammatory response and intense itching occur after the host has become sensitized to the mite. This occurs approximately 30 to 60 days after initial contact

A nurse is gathering a history on a school-age child admitted for a migraine headache. The child states, I have been getting a migraine every 2 or 3 months for the last year. The nurse documents this as which type of pain? a. Acute b. Chronic c. Recurrent d. Subacute

c. Recurrent

A toddlers parent asks the nurse for suggestions on dealing with temper tantrums. Which is the most appropriate recommendation? a. Punish the child. b. Leave the child alone until the tantrum is over. c. Remain close by the child but without eye contact. d. Explain to child that this is wrong.

c. Remain close by the child but without eye contact.

Which is an important nursing action related to the use of tape and/or adhesives on premature newborns? a. Avoid using tape and adhesives until skin is more mature. b. Use solvents to remove tape and adhesives instead of pulling on skin. c. Remove adhesives with warm water or mineral oil. d. Use scissors carefully to remove tape instead of pulling tape off.

c. Remove adhesives with warm water or mineral oil. Warm water, mineral oil, or petrolatum can be used to facilitate the removal of adhesive. In the premature newborn, often it is impossible to avoid using adhesives and tape. The smallest amount of adhesive necessary should be used. Solvents should be avoided because they tend to dry and burn the delicate skin.

Stroking the newborns cheek along the side of the mouth causes the newborn to turn the head toward that side and begin to suck. This is which reflex? a. Perez b. Sucking c. Rooting d. Extrusion

c. Rooting

According to Piaget, the 6-month-old infant should be in which developmental stage? a. Use of reflexes b. Primary circular reactions c. Secondary circular reactions d. Coordination of secondary schemata

c. Secondary circular reactions Infants are usually in the secondary circular reaction stage from ages 4 to 8 months. This stage is characterized by a continuation of the primary circular reaction for the response that results. The use of reflexes is primarily during the first month of life.

CHAPTER 6 A child steps on a nail and sustains a puncture wound of the foot. Which is the most appropriate method for cleansing this wound?a. Wash wound thoroughly with chlorhexidine. b. Wash wound thoroughly with povidone-iodine. c. Soak foot in warm water and soap. d. Soak foot in solution of 50% hydrogen peroxide and 50% water.

c. Soak foot in warm water and soap. Puncture wounds should be cleansed by soaking the foot in warm water and soap. Chlorhexidine, hydrogen peroxide, and povidone-iodine should not be used because they have a cytotoxic effect on healthy cells and minimal effect on controlling infection.

A father calls the clinic nurse because his 2-year-old child was bitten by a black widow spider. The nurse should advise which to the father? a. Apply warm compresses. b. Carefully scrape off stinger. c. Take child to emergency department. d. Apply a thin layer of corticosteroid cream.

c. Take child to emergency department. The venom of the black widow spider has a neurotoxic effect. The father should take the child to the emergency department for treatment with antivenin and muscle relaxants as needed. Warm compresses increase the circulation to the area and facilitate the spread of the venom.

What is oral candidiasis (thrush) in the newborn? a. Bacterial infection that is life threatening in the neonatal period b. Bacterial infection of mucous membranes that responds readily to treatment c. Yeastlike fungal infection of mucous membranes that is relatively common d. Benign disorder that is transmitted from mother to newborn during the birth process only

c. Yeastlike fungal infection of mucous membranes that is relatively common Oral candidiasis is usually a benign disorder in the newborn, often confined to the oral and diaper regions. It is caused by a yeastlike organism and is treated with good hygiene, application of a fungicide, and correction of any underlying disorder. Thrush can be transmitted in several ways, including by maternal transmission during delivery; person-to-person transmission; and contaminated bottles, hands, or other objects.

Imaginary playmates are beneficial to the preschool child because they: a. take the place of social interactions. b. take the place of pets and other toys. c. become friends in times of loneliness. d. accomplish what the child has already successfully accomplished

c. become friends in times of loneliness.

Nursing care of the newborn with oral candidiasis (thrush) includes: a. avoiding use of pacifier. b. removing characteristic white patches with a soft cloth. c. continuing medication for a prescribed number of days. d. applying medication to oral mucosa, being careful that none is ingested.

c. continuing medication for a prescribed number of days. The medication must be continued for the prescribed number of days. To prevent relapse, therapy should continue for at least 2 days after the lesions disappear. Pacifiers can be used. The pacifier should be replaced with a new one or boiled for 20 minutes once daily. One of the characteristics of thrush is that the white patches cannot be removed.

Developmentally, most children at age 12 months: a. use a spoon adeptly. b. relinquish the bottle voluntarily. c. eat the same food as the rest of the family. d. reject all solid food in preference to the bottle

c. eat the same food as the rest of the family. By age 12 months, most children are eating the same food that is prepared for the rest of the family. Using a spoon usually is not mastered until age 18 months. The parents should be engaged in weaning a child from a bottle if that is the source of liquid. Toddlers should be encouraged to drink from a cup at the first birthday and be weaned from the bottle totally by 14 months

A mother calls the emergency department nurse because her child was stung by a scorpion. The nurse should recommend: a. administering an antihistamine. b. cleansing area with soap and water. c. keeping the child quiet and coming to the emergency department. d. removing the stinger and applying cool compresses.

c. keeping the child quiet and coming to the emergency department. Venomous species of scorpions inject venom that contains hemolysins, endotheliolysins, and neurotoxins. The absorption of the venom is delayed by keeping the child quiet and the involved area in a dependent position.

Herpes zoster is caused by the varicella virus and has an affinity for: a. sympathetic nerve fibers. b. parasympathetic nerve fibers. c. posterior root ganglia and posterior horn of the spinal cord. d. lateral and dorsal columns of the spinal cord.

c. posterior root ganglia and posterior horn of the spinal cord.

A preterm newborn has been receiving orogastric feedings of breast milk. The nurse initiates nipple feedings, but the newborn tires easily and has weak sucking and swallowing reflexes. The most appropriate nursing intervention is to: a. encourage mother to breastfeed. b. try nipple-feeding preterm newborn formula. c. resume orogastric feedings of breast milk. d. resume orogastric feedings of formula.

c. resume orogastric feedings of breast milk. If a preterm newborn tires easily or has weak sucking when nipple feedings are initiated, the nurse should resume orogastric feedings with the milk of mothers choice.

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 in this situation that: a. blocks at this age are used primarily for throwing. b. toddlers are too young to imitate the behavior of others. c. toddlers are capable of building a tower of blocks. d. toddlers are too young to build a tower of blocks

c. toddlers are capable of building a tower of blocks. Building with blocks is a good parent-child interaction. The 18-month-old child is capable of building a tower of three or four blocks. The ability to build towers of blocks usually begins at age 15 months. The 18-month- old child imitates others around him/her

A newborn is being discharged at age 48 hours. The parents ask how the newborn should be bathed this first week home. The nurses best recommendation is to bathe the newborn: a. daily with mild soap. b. daily with an alkaline soap. c. two or three times this week with plain water. d. two or three times this week with mild soap.

c. two or three times this week with plain water. The newborn newborns skin has a pH of approximately 5. This acidic pH has a bacteriostatic effect. The parents should be taught to use only plain warm water for the bath and to bathe the child no more than two or three times a week for the first 2 weeks. Soaps are alkaline.

The psychosocial developmental tasks of toddlerhood include which characteristic? a. Development of a conscience b. Recognition of sex differences c. Ability to get along with age-mates d. Ability to delay gratification

d. Ability to delay gratification If the need for basic trust has been satisfied, then toddlers can give up dependence for control, independence, and autonomy. One of the tasks that the toddler is concerned with is the ability to delay gratification. Development of a conscience occurs during the preschool years. The recognition of sex differences occurs during the preschool years. The ability to get along with age-mates develops during the preschool and school- age years.

CHAPTER 12 Which should the nurse expect of a healthy 3-year-old child? a. Jump rope. b. Ride a two-wheel bicycle. c. Skip on alternate feet. d. Balance on one foot for a few seconds

d. Balance on one foot for a few seconds Three-year-olds are able to accomplish this gross motor skill. Jumping rope, riding a two-wheel bicycle, and skipping on alternate feet are gross motor skills of 5-year-old

The nurse is caring for a 6-year-old girl who had surgery 12 hours ago. The child tells the nurse that she does not have pain, but a few minutes later she tells her parents that she does. Which should the nurse consider when interpreting this? a. Truthful reporting of pain should occur by this age. b. Inconsistency in pain reporting suggests that pain is not present. c. Children use pain experiences to manipulate their parents. d. Children may be experiencing pain even though they deny it to the nurse.

d. Children may be experiencing pain even though they deny it to the nurse.

The nurse is teaching parents of toddlers about animal safety. Which should be included in the teaching session? a. Petting dogs in the neighborhood should be encouraged to prevent fear of dogs. b. The toddler is safe to approach an animal if the animal is chained. c. It is permissible for your toddler to feed treats to a dog. d. Teach your toddler not to disturb an animal that is eating.

d. Teach your toddler not to disturb an animal that is eating.

A young child has sustained a minor burn to the foot. Which is recommended for treatment of a minor burn? a. Apply ice to foot. b. Apply cortisone ointment. c. Apply an occlusive dressing. d. Cleanse the wound with a mild soap and tepid water.

d. Cleanse the wound with a mild soap and tepid water. In minor burns, the best method of treatment is to cleanse the wound with a mild soap and tepid water. Ice is not recommended. Most practitioners favor covering the wound with an antimicrobial ointment (not cortisone) to reduce the risk of infection and to provide some form of pain relief. The dressing is not occlusive but consists of nonadherent fine-mesh gauze placed over the ointment and a light wrap of gauze dressing that avoids interference with movement. This helps keep the wound clean and protects it from trauma.

Which vitamin is recommended for all women of childbearing age to reduce the risk of neural tube defects such as spina bifida? a. A b. C c. Niacin d. Folic acid

d. Folic acid

Which is the causative agent of scarlet fever? a. Enteroviruses b. Corynebacterium organisms c. Scarlet fever virus d. Group A -hemolytic streptococci (GABHS)

d. Group A -hemolytic streptococci (GABHS)

Which is characteristic of newborns whose mothers smoked during pregnancy? a. Large for gestational age b. Preterm, but size appropriate for gestational age c. Growth retardation in weight only d. Growth retardation in weight, length, and head circumference

d. Growth retardation in weight, length, and head circumference

Which should the nurse anticipate in the newborn whose mother used cocaine during pregnancy? a. Seizures b. Hyperglycemia c. Cardiac and respiratory problems d. Neurobehavioral depression or excitability

d. Neurobehavioral depression or excitability

Which is most descriptive of the clinical manifestations observed in neonatal sepsis? a. Seizures and sunken fontanels b. Sudden hyperthermia and profuse sweating c. Decreased urinary output and frequent stools d. Nonspecific physical signs with hypothermia

d. Nonspecific physical signs with hypothermia The clinical manifestations of neonatal sepsis are usually characterized by the newborn generally not doing well. Poor temperature control, usually with hypothermia, lethargy, poor feeding, pallor, cyanosis or mottling, and jaundice, may be evident

Which are clinical manifestations of postmaturity in the newborn? (Select all that apply.) a. Excessive lanugo b. Increased subcutaneous fat c. Absence of scalp hair d. Parchment-like skin e. Minimal vernix caseosa f. Long fingernails

d. Parchment-like skin e. Minimal vernix caseosa f. Long fingernails

A parent asks the nurse about negativism in toddlers. Which is the most appropriate recommendation? a. Punish the child. b. Provide more attention. c. Ask child not always to say no. d. Reduce the opportunities for a no answer

d. Reduce the opportunities for a no answer The nurse should suggest to the parent that questions be phrased with realistic choices rather than yes or no answers. This provides the toddler with a sense of control and reduces the opportunity for negativism. Negativism is not an indication of stubbornness or insolence and should not be punished. The negativism is not a function of attention; the child is testing limits to gain an understanding of the world. The toddler is too young to be asked to not always say no.

An adolescent girl is cooking on a gas stove when her bathrobe catches fire. Her father smothers the flames with a rug and calls an ambulance. She has sustained major burns over much of her body. Which is important in her immediate care? a. Wrap her in a blanket until help arrives. b. Encourage her to drink clear liquids. c. Place her in a tub of cool water d. Remove her burned clothing and jewelry.

d. Remove her burned clothing and jewelry. In major burns, burned clothing should be removed to avoid further damage from smoldering fabric and hot beads of melted synthetic materials. Jewelry is also removed to eliminate the transfer of heat from the metal and constriction resulting from edema formation. The burns should be covered, not wrapped with a clean cloth. A blanket can be used initially to stop the burning process. Fluids should not be given by mouth to avoid aspiration and water intoxication. The child should be kept warm. Placing her in a tub of cool water will exacerbate heat loss

The nurse is caring for a high-risk newborn with an umbilical catheter in a radiant warmer. The nurse notes blanching of the feet. Which is the most appropriate nursing action? a. Elevate feet 15 degrees. b. Place socks on newborn. c. Wrap feet loosely in prewarmed blanket. d. Report findings immediately to the practitioner.

d. Report findings immediately to the practitioner.

Which is a common childhood communicable disease that may cause severe defects in the fetus when it occurs in its congenital form? a. Erythema infectiosum b. Roseola c. Rubeola d. Rubella

d. Rubella Rubella causes teratogenic effects on the fetus. There is a low risk of fetal death to those in contact with children affected with fifth disease. Roseola and rubeola are not dangerous to the fetus

Parents tell the nurse that their child keeps scratching the areas where he has poison ivy. The nurses response should be based on which knowledge? a. Poison ivy does not itch and needs further investigation. b. Scratching the lesions will not cause a problem. c. Scratching the lesions will cause the poison ivy to spread. d. Scratching the lesions may cause them to become secondarily infected.

d. Scratching the lesions may cause them to become secondarily infected. Poison ivy is a contact dermatitis that results from exposure to the oil urushiol in the plant. Every effort is made to prevent the child from scratching because the lesions can become secondarily infected.

Which characteristic best describes the language of a 3-year-old child? a. Asks meanings of words b. Follows directional commands c. Describes an object according to its composition d. Talks incessantly regardless of whether anyone is listening

d. Talks incessantly regardless of whether anyone is listening Because of the dramatic vocabulary increase at this age, 3-year-olds are known to talk incessantly regardless of whether anyone is listening. A 4- to 5-year-old asks lots of questions and can follow simple directional commands. A 6-year-old can describe an object according to its composition

A nurse is planning care for a 17-month-old child. According to Piaget, which stage should the nurse expect the child to be in cognitively? a. Trust b. Preoperational c. Secondary circular reaction d. Tertiary circular reaction

d. Tertiary circular reaction The 17-month-old child is in the fifth stage of the sensorimotor phase, tertiary circular reactions. The child uses active experimentation to achieve previously unattainable goals. Trust is Erikson's first stage. Preoperational is the stage of cognitive development usually present in older toddlers and preschoolers. Secondary circular reactions last from about ages 4 to 8 months.

A parent of a child with major burns asks the nurse why a high-calorie and high-protein diet is prescribed. Which response should the nurse make? a. The diet promotes growth. b. The diet will improve appetite. c. The diet will diminish risks of stress-induced hyperglycemia. d. The diet will avoid protein breakdown.

d. The diet will avoid protein breakdown.

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 infants stools. The nurses explanation of this is based on which statement?a. Child should not be given fibrous foods until digestive tract matures at age 4 years. b. Child should not be given any solid foods until this digestive problem is resolved. c. This is abnormal and requires further investigation. d. This is normal because of the immaturity of digestive processes at this age.

d. This is normal because of the immaturity of digestive processes at this age. The immaturity of the digestive tract is evident in the appearance of the stools. Solid foods are passed incompletely broken down in the feces. An excess quantity of fiber predisposes the child to large, bulky stools. This is normal for the child and is a normal part of the maturational process; no further investigation is necessary.

CHAPTER 11 Which factor is most important in predisposing toddlers to frequent infections? a. Respirations are abdominal. b. Pulse and respiratory rates are slower than those in infancy. c. Defense mechanisms are less efficient than those during infancy. d. Toddlers have a short, straight internal ear canal and large lymph tissue.

d. Toddlers have a short, straight internal ear canal and large lymph tissue. Toddlers continue to have the short, straight internal ear canal of infants. The lymphoid tissue of the tonsils and adenoids continues to be relatively large. These two anatomic conditions combine to predispose the toddler to frequent infections. The abdominal respirations and lowered pulse and respiratory rate of toddlers do not affect their susceptibility to infection. The defense mechanisms are more efficient compared with those of infancy

Which characteristic best describes the gross motor skills of a 24-month-old child? a. Skips and can hop in place on one foot b. Rides tricycle and broad jumps c. Jumps with both feet and stands on one foot momentarily d. Walks up and down stairs and runs with a wide stance

d. Walks up and down stairs and runs with a wide stance The 24-month-old child can go up and down stairs alone with two feet on each step and runs with a wide stance. Skipping and hopping on one foot are achieved by 4-year-old children. Jumping with both feet and standing on one foot momentarily are achieved by 30-month-old children. Tricycle riding and broad jumping are achieved at age 3

The nurse is talking to the parents of a child with pediculosis capitis. Which should the nurse include when explaining how to manage pediculosis capitis? a. You will need to cut the hair shorter if infestation and nits are severe. b. You can distinguish viable from nonviable nits, and remove all viable ones. c. You can wash all nits out of hair with a regular shampoo. d. You will need to remove nits with an extra-fine tooth comb or tweezers.

d. You will need to remove nits with an extra-fine tooth comb or tweezers. Treatment consists of the application of pediculicide and manual removal of nit cases. An extra-fine tooth comb facilitates manual removal. Parents should be cautioned against cutting the child's hair short; lice infest short hair as well as long. It increases the child's distress and serves as a continual reminder to peers who are prone to tease children with a different appearance. It is not possible to differentiate between viable and nonviable eggs. Regular shampoo is not effective; a pediculicide is necessary

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 nurses response should be based on knowledge that this is: a. unacceptable because of the risk of sudden infant death syndrome (SIDS). b. unacceptable because it does not encourage achievement of developmental milestones. c. acceptable to encourage fine motor development. d. acceptable to encourage head control and turning over.

d. acceptable to encourage head control and turning over. These parents are implementing the guidelines to reduce the risk of SIDS. Infants should sleep on their backs and then be placed on their abdomens when awake to enhance development of milestones such as head control

A new mother wants to be discharged with her newborn as soon as possible. Before discharge, the nurse should make certain that: a. newborn has voided at least once. b. newborn does not spit up after feeding. c. jaundice, if present, appeared before 24 hours. d. appointment is made for home care or a primary care practitioner office visit within next 2 or 3 days.

d. appointment is made for home care or a primary care practitioner office visit within next 2 or 3 days.

Austin, age 6 months, has six teeth. The nurse should recognize that this is: a. normal tooth eruption. b. delayed tooth eruption. c. unusual and dangerous. d. earlier-than-normal tooth eruption.

d. earlier-than-normal tooth eruption. Six months is earlier than expected. Most infants at age 6 months have two teeth. Although unusual, it is not dangerous

The mother of a preterm newborn asks the nurse when she can start breastfeeding. The nurse should explain that breastfeeding can be initiated when her newborn: a. achieves a weight of at least 3 pounds. b. indicates an interest in breastfeeding. c. does not require supplemental oxygen. d. has adequate sucking and swallowing reflexes.

d. has adequate sucking and swallowing reflexes.

After the acute stage and during the healing process, the primary complication from burn injury is: a. asphyxia. b. shock. c. renal shutdown. d. infection.

d. infection. During the healing phase, local infection and sepsis are the primary complications. Renal shutdown is not a complication of the burn injury, but may be a result of the profound shock

An important nursing responsibility when dealing with a family experiencing the loss of an infant from sudden infant death syndrome (SIDS) is to: a. explain how SIDS could have been predicted and prevented. b. interview parents in depth concerning the circumstances surrounding the child's death. c. discourage parents from making a last visit with the infant. d. make a follow-up home visit to parents as soon as possible after the child's death

d. make a follow-up home visit to parents as soon as possible after the child's death A competent, qualified professional should visit the family at home as soon as possible after the death and provide the family with printed information about SIDS

Physiologic measurements in children's pain assessment are: a. the best indicator of pain in children of all ages. b. essential to determine whether a child is telling the truth about pain. c. of most value when children also report having pain. d. of limited value as sole indicator of pain

d. of limited value as sole indicator of pain Physiologic manifestations of pain may vary considerably, not providing a consistent measure of pain. Heart rate may increase or decrease. The same signs that may suggest fear, anxiety, or anger also indicate pain. In chronic pain, the body adapts, and these signs decrease or stabilize. Physiologic measurements are of limited value and must be viewed in the context of a pain-rating scale, behavioral assessment, and parental report. When the child states that pain exists, it does. That is the truth

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: a. a sign the child is spoiled. b. a way to exert unhealthy control. c. regression, common at this age. d. ritualism, common at this age.

d. ritualism, common at this age. The child is exhibiting the ritualism that is characteristic at this age. Ritualism is the need to maintain sameness and reliability. It provides a sense of comfort to the toddler. It will dictate certain principles in feeding practices, including rejecting a favorite food because it is served in a different container.