Chapter 22

A newborn is scheduled for a circumcision and the parent is concerned with the newborn feeling pain. How will the nurse respond? -"A local anesthetic will be used to prevent pain." -"There is no need to be concerned, it only lasts for a minute or two." -"Your baby will not feel any pain due to his age." -"Your baby will be under general analgesia."

"A local anesthetic will be used to prevent pain."

The mother of a girl 6 years of age is exasperated at her daughter's persistent enuresis. How can the nurse best respond to this mother's concern? -"Have you spoken to your primary care provider about a referral to a specialist?" -"This is especially common among girls, and is very normal." -"Does your daughter ever complain of pain or burning when she urinates?" -"Most children outgrow their bedwetting at around your daughter's age or shortly after."

"Does your daughter ever complain of pain or burning when she urinates?"

A mother brings her 28-month old boy to the clinic for a well-child visit. During the visit, the mother tells the nurse, "Whenever I ask my child to do something, all I get is term-0no. It seems like that's the only word he knows." Which response by the nurse would be most appropriate? -"His 'no' is his way of trying to gain control over his surroundings." -"Don't worry, saying 'no' is just a carryover from infancy." -"Your son is experiencing anxiety about you not being around." -"This might mean that your son is having trouble with language development."

"His 'no' is his way of trying to gain control over his surroundings."

The pregnant young adult asks the nurse when she will be able to hear the fetal heart beat. Which is the nurse's best response? -"Let's see if we can hear the heart beat today at 8-weeks-gestation." -"You will not be able to hear the heart beat until halfway through your pregnancy." -"Only the health care provider is able to hear the fetal heart beat until late in the pregnancy." -"At your 12-week appointment, you will be able to hear the heart beat by Doppler."

"Let's see if we can hear the heart beat today at 8-weeks-gestation."

A parent brings the 18-month-old to the clinic for treatment of a head cold. The child has been coughing for the last two days and nights. The parent says, "When my older kids were this age, the only thing that would stop their cough was a cough syrup containing codeine." How should the nurse respond? -"We are using hydrocodone now instead." -"We have discovered that codeine does not work well with young children." -"Be sure to give the nurse practitioner that information." -"Do you remember which preparation you used with your older children?"

"We have discovered that codeine does not work well with young children."

A nurse is providing care to a preschooler who is hospitalized. The preschooler is about to have an intravenous line inserted for fluid replacement. The child asks the nurse, "Will this hurt?" Which response by the nurse would be best? -"Don't worry, you won't feel a thing." -"It will probably hurt a lot, so we'll give you something to fall asleep." -"It won't hurt going in but it might hurt afterwards." -"You might feel a short pinch but it won't be for very long."

"You might feel a short pinch but it won't be for very long."

A nurse is providing education to a group of new parents about ways to minimize the risk for sudden infant death syndrome (SIDS). The nurse determines that the teaching was successful based on which statement by the group? Select all that apply. -"It's not a good idea to offer a pacifier at naptime." -"The crib should be free of any soft objects or toys." -"The sleeping surface should be firm." -"We should put our baby on the back to sleep." -"It's okay to keep a pillow in the crib for comfort."

-"The crib should be free of any soft objects or toys." -"The sleeping surface should be firm." -"We should put our baby on the back to sleep."

A nurse is teaching a "Preschool Childcare" class and Tiffany, one of the parents, asks when her toddler will have all of her baby teeth. Which of the following responses would be appropriate? -4 years -5 years -7 years -3 years

-3 years

A school nurse is assessing school-age children for developmental milestones. Which students would be a concern for the nurse? Select all that apply. -A 9-year-old student who has not developed a set of values -A 12-year-old student who still has baby teeth -An 8-year-old student whose height hasn't changed since preschool -A 10-year-old student who has not begun puberty -An 11-year-old student who is not developing skills for physical games -An 8-year-old student who is not writing with a pencil

-A 12-year-old student who still has baby teeth -An 8-year-old student whose height hasn't changed since preschool -A 10-year-old student who has not begun puberty -An 11-year-old student who is not developing skills for physical games -An 8-year-old student who is not writing with a pencil

A school nurse is preparing a presentation for the parent-teacher association at the local elementary school. The nurse is focusing on the topic of nutrition in this age group. Which suggestion would be appropriate for the nurse to include? Select all that apply. -Avoiding foods that contain empty calories -Encouraging foods high in vitamin D -Increasing intake of foods high in fat -Providing foods that are high in calcium -Limiting foods that are low in salt

-Avoiding foods that contain empty calories -Encouraging foods high in vitamin D -Providing foods that are high in calcium

The school nurse is teaching a class of 12-year-old children about nutrition for their age group. Which information should the nurse include? Select all that apply. -Calcium is an important part of your diet. -Be sure you are getting enough vitamin D through milk and enriched grains. -Most children your age do not eat enough. -You have a few years yet before you need to worry about eating too much fat and sugar. -Try to reduce the amount of salt you are adding to your food.

-Calcium is an important part of your diet. -Be sure you are getting enough vitamin D through milk and enriched grains. -Try to reduce the amount of salt you are adding to your food.

The nurse is teaching child safety and nutrition to a group of parents at a public health clinic. In answer to a question about childhood obesity, the nurse talks about the causes of school-age children being overweight. The nurse should include which of the following? Choose all that apply. -Genetic and health factors -Consuming more calories than expended -Consuming too much fiber and calcium -Diets that are high in saturated fats -Lack of adequate, appropriate exercise

-Genetic and health factors -Consuming more calories than expended -Diets that are high in saturated fats -Lack of adequate, appropriate exercise

The nurse has admitted a school-aged child with a diagnosis of asthma. Based on the child's developmental level, what actions would be appropriate? Select all that apply. -Inquire about school, friends, and activities -Supply the child with quiet activities from the playroom -Answer the child's questions with clear and direct information -Ask the child what medications are taken for asthma -Offer child foods high in vitamin D

-Inquire about school, friends, and activities -Supply the child with quiet activities from the playroom -Answer the child's questions with clear and direct information -Offer child foods high in vitamin D

While providing education to a young adult during an annual health exam, the nurse discusses health problems common during this stage of development. What is the most common cause of mortality during this stage? -Drug overdose -Suicide -Eating disorders -Motor vehicle crashes

-Motor vehicle crashes

A nurse is assessing neonates in a hospital nursery. Which neonates are exhibiting expected developmental characteristics? Select all that apply. -Neonate who inherits a transient immunity from infections from the mother -Neonate whose body temperature responds slowly to environmental temperature -Neonate who eliminates urine and stool -Neonate who displays the Moro and stepping reflex -Neonate whose senses are not developed enough to feel pain from a heel-stick -Neonate who exhibits both an active crying state and a quiet alert state

-Neonate who inherits a transient immunity from infections from the mother -Neonate who eliminates urine and stool -Neonate who displays the Moro and stepping reflex -Neonate who exhibits both an active crying state and a quiet alert state

A nurse is working as part of a community health team addressing the issue of child abuse in the community. The team assesses the community for possible risk factors that may be contributing to the increased incidence. Which factor would the team likely identify? Select all that apply. -Married caregivers -Poverty -Community violence -Social isolation of families -Substance use by caregivers

-Poverty -Community violence -Social isolation of families -Substance use by caregivers

A nurse is assessing a 12-month-old infant who is brought to the clinic by the parents for well-child visit. The nurse reviews the infant's health history and notes that the infant weighed 8 lb at birth. When assessing the infant's weight at this visit, the nurse would anticipate that the infant would weight approximately how much at this time? -30 lb -16 lb -36 lb -24 lb

24 lb

When a nurse is working on a pediatric unit, which of the following clients would the nurse know has the greatest need for good nutrition? -15 year-old -10 year old -3 year old -5 month old

5 month old

During a well-child visit, a mother says, "My child received a meningococcal vaccine at age 11." Which information should the nurse provide to this mother? -A booster shot at age 16 is recommended. -Your child will need booster shots every 5 years. -That immunization should not be given until the child is 15. -Your child should be immune to meningococcal disease for life.

A booster shot at age 16 is recommended.

A nurse is providing prenatal education to a group of pregnant teenagers. One of the group members asks how the baby develops soon after conception. Which is an accurate statement from the nurse about the embryonic stage? -Bones are completely ossified -Cell growth and differentiation are slowed -All basic organs are established here -Embryo no longer vulnerable to toxins

All basic organs are established here

A 2-year-old toddler just underwent a tonsillectomy and adenoidectomy surgery. The postanesthesia care unit (PACU) nurse is checking on him. What is the best course of action regarding the developmental care of this child? -Administer acetaminophen before the child wakes. -Extubate the child as soon as possible. -Give the child a new teddy bear. -Allow the parents into the PACU before the child wakes.

Allow the parents into the PACU before the child wakes.

Of the following components of psychosocial development in the neonate and infant, which one facilitates emotional linkage between a baby and caregiver? -Attachment -Bonding -Play -Temperament

Bonding

A nurse is providing anticipatory guidance to a new mother who has just given birth to a healthy neonate. The mother asks the nurse, "I've heard that breast-feeding helps to prevent infections in my baby. But how does this happen?" Which response by the nurse would be appropriate? -Breast milk contains substances that protect your baby against infection." -"It's important because you're baby has no way to defend against infection when born." -"You'll bond with your baby, which helps prevent infection." -"Breast milk gives your baby more calories to help fight off any germs."

Breast milk contains substances that protect your baby against infection."

A nurse is participating in a local community health fair. The nurse is providing information about sexually transmitted infections. Which infection would the nurse describe as being the most common? -Herpes simplex type II -Gonorrhea -Syphilis -Chlamydia

Chlamydia

During assessment the 5-year-old child says, "I feel good today. I am filled with the Holy Spirit." How does the nurse evaluate this statement? -Concepts such as this are rarely understood by children this age. -This statement is not unusual for a 5-year-old child who attends church. -Children this age have no understanding of religious concepts. -There is concern that this child is being raised in a hyper-religious atmosphere.

Concepts such as this are rarely understood by children this age.

The nurse is providing care for an 11-year-old child who has been diagnosed with central auditory processing disorder. Which strategy should the nurse use when teaching this child how to apply a wrist brace? -Explaining the process in detail -Showing a video -Providing written instructions -Demonstration-return demonstration

Demonstration-return demonstration

Which would be an expected reaction from a 5 year old when his 3-month-old infant sibling dies from Sudden Infant Death Syndrome (SIDS)? -Lack of concern where infant is -Guilt he may have caused the death -Acceptance of infant's death -Understanding infant is dead

Guilt he may have caused the death

You are the nurse providing prenatal education to a group of pregnant teenagers. One of the group members asks you to talk about how the baby develops soon after conception. An accurate statement from you about the zygote and pre-embryonic stage would be which of the following? -Some reflexes are already present -Outer layer becomes the respiratory system -Has a total of three distinct cell layers -All basic organs are well established

Has a total of three distinct cell layers

A school nurse is aware of the importance of creating and carrying out interventions that resonate with the developmental tasks of the adolescent population. Such interventions should appeal to adolescents' prioritization of their what? -Vulnerability -Identity -Goals -Skepticism

Identity

A nurse is teaching a parenting class for parents with infants. What is an example of an appropriate teaching point for this developmental age? -Wean the infant from the breast or bottle when 9 months old. -Line the crib with bumpers to keep the infant from hitting the posts. -Place the infant on the side or stomach when sleeping. -If choking occurs, give back blows and chest thrusts or CPR.

If choking occurs, give back blows and chest thrusts or CPR.

A more thorough medical examination of a 30-month-old is indicated when the nurse observes that the child has difficulty -Kicking a ball -Tying his shoes -Dressing himself -Brushing his teeth

Kicking a ball

A school-aged child is attentive to following the rules at school, respects his teachers, and views justice as a means of fair play. These are characteristics of which type of development typical of this age group? -Physiologic development -Moral development -Spiritual development -Psychosocial development

Moral development

Accurate instruction regarding the typical growth and development patterns for adolescents would include which of the following guidelines? -Emotional stability and ethnocentrism define this stage. -A growth spurt occurs 2 years later in boys than girls. -Complete maturation occurs by age 16 years. -Peer relationships characterize the adolescent years.

Peer relationships characterize the adolescent years.

A nurse is providing care to an adolescent recently hospitalized for a sports-related injury. When planning this client's care, which group would the nurse identify as being extremely important to him or her? -Parents -Health care providers -Sibling(s) -Peers

Peers

After assessing a female adolescent, a nurse collects the following data: development of breast tissue, growth spurt in height and weight, appearance of axillary hair, and initiation of menarche. Which stage of sexual development does this data confirm? -Postpubescence -Pubescence -Prepubescence -Precocious puberty

Pubescence

The nurse is conducting a preoperative assessment of a girl 5 years of age who is scheduled for surgery later that day. The nurse should be aware that the client's imminent surgery is likely to cause what? -Impaired psychosocial development. -Risk for shame and guilt. -Mistrust of authority. -Separation anxiety and fear of pain.

Separation anxiety and fear of pain.

Which of the following points should the nurse prioritize when educating school-aged children about nutrition? -Limiting complex carbohydrate intake -The importance of organic food -Sources of iron and folate -Sources of calcium and vitamin D

Sources of calcium and vitamin D

An 18 year old with a chronic illness tells the school nurse that he has recently started using marijuana with his friends on weekends. Which of the following should be the nurse's next action? -Tell him not to do this or it will be reported to the proper authorities and risk losing his driver's license -Recommend counseling so that he understands the serious consequences of using marijuana -Ask him why he is using marijuana and what is his relationship with his friends -Teach him about effects of marijuana on his illness and potential complications with marijuana use

Teach him about effects of marijuana on his illness and potential complications with marijuana use

An 8-year-old girl is brought to the health care provider's office for a well-child visit. During the visit, the child's mother asks the nurse, "When should she get the human papillomavirus (HPV) vaccine? Which response by the nurse would be best? -"The first dose should be given at about 9 or 10 years of age." -"She needs to get it now and then again when she's 18 years old." -"She really doesn't need to get it until she's at least 16 years old." -"Your daughter should have it before she's 10 years of age."

The first dose should be given at about 9 or 10 years of age."

The nurse is providing prenatal education to a group of pregnant teenagers. One of the group members asks how the baby develops after the first trimester. An accurate statement from the nurse about the fetal stage would be which of the following? -No kidney function happens before birth -Embryo no longer vulnerable to toxins -The heartbeat can be heard -Bones are completely ossified

The heartbeat can be heard

Which of the following characteristics of a neonate would be reflected in her Apgar score? -The infant is hypersensitive to noise. -The infant coughs up mucus shortly after delivery. -The infant does not open her eyes to verbal stimulus. -The infant's hands and feet appear blue.

The infant's hands and feet appear blue.

The nurse is providing prenatal education to a group of pregnant teenagers. One of the group members asks about how the baby develops soon after birth. An accurate statement from the nurse about neonatal development would be which of the following? -The neonate is able to hear and turn toward sound -The Braden scale is used to assess newborns -Stool and urine elimination are not yet begun -Body temperature is well regulated by the baby's brain

The neonate is able to hear and turn toward sound

The nurse is providing prenatal education to a group of pregnant teenagers. One of the group members asks what the baby can do physically right after birth. Which is an accurate statement about neonatal ability following birth? -The newborn can suck, swallow, sneeze, and yawn -The neonatal period lasts from birth to six months -The Braden scale is used to assess newborns -The elimination of stool and urine has not yet begun

The newborn can suck, swallow, sneeze, and yawn

A school nurse is reviewing the medical record of a child who was just diagnosed with a learning disability. The record reveals that the child has problems with letters and activities that require hand-eye coordination. The nurse interprets this as which type of learning disability? -Nonverbal learning disorder -Visual perceptual/visual motor deficit -Aphasia -Dyslexia

Visual perceptual/visual motor deficit

The nurse is teaching a class to pregnant adolescents and young adults. What does the nurse explain is the most important reason for breastfeeding instead of bottle feeding? -breastfeeding promotes closeness with the neonate -breastfeeding is cheaper than bottle feeding -breastfeeding provides protection against infections -breastfeeding is easier to do during the night

breastfeeding provides protection against infections

At which stage of pregnancy is the developing fetus most at risk for developing congenital anomalies? -embryonic stage -fetal stage -ovum stage -pre-embryonic stage

embryonic stage