EXAM 1: Pediatrics Practice Questions

A mother of a 4-year-old expresses concern because her hospitalized child has begun thumb sucking. The mother states that this behavior began 2 days after hospital admission. Which response by the nurse is most appropriate?

"It is best to ignore the behaviour."

The clinic nurse has provided instructions regarding dental care for toddlers to the mother of a 2-year-old child. Which statement, if made by the mother, indicates a need for further instruction?

"Proper dental care is not necessary for a toddler until the permanent teeth erupt."

A 16 year old female comes for a sport's physical in the clinic. During the nursing history, the teenage states she is bothered that she "towers over her companions and everyone is staring at her at school." What would be the most therapeutic response by the nurse?

"Tell me more about how this embarasses you."

The mother of a 16-year-old tells a nurse that she is concerned because her child sleeps about 8 hours every night and until noontime every weekend. Which nursing response is most appropriate?

"Adolescents need that amount of sleep every night."

The mother of an 8-year-old child tells the clinic nurse that she is concerned about the child because the child seems to be more attentive to friends than anything else. Using Erikson's psychosocial development theory, the nurse should make which response?

"At this age, the child is developing his own personality."

The clinic nurse provides information to the mother of a toddler regarding toilet training. Which statement by the mother indicates a need for further information regarding toilet training?

"Bladder control usually is achieved before bowel control."

A 6-month-old infant is admitted to the hospital. The nurse weighs the infant and notes that the infant weighs 14 pounds. Which statement by the mother indicates that further teaching is needed?

"I will have to increase his milk intake because he is not gaining enough weight."

The 2-year-old child is treated in the emergency department for a burn to the chest and abdomen. The child sustained the burn by grabbing a cup of hot coffee that was left on the kitchen counter. The nurse reviews safety principles with the parents before discharge. Which statement by the parents indicates an understanding of measures to provide safety in the home?

"We will be sure not to leave hot liquids unattended."

A 2-year-old child has been admitted to the hospital for management of pneumonia. The child is placed in an oxygen tent. Taking into consideration the child's age and developmental level and the treatment being administered, which statement is appropriate for the nurse to make to the parents?

"You can sit next to him and hold his hand through the tent, but he needs to remain inside of it."

The nurse is instructing the caregiver of a child about reprimanding the child. The nurse recognizes that additional teaching is needed if the caregiver makes which statement to the child?

"You need to stop hitting your sister."

The nurse is caring for a 14-year-old girl who is hospitalized and has been placed in traction using Crutchfield tongs. The child is having difficulty adjusting to the prolonged hospital confinement. Which nursing action would be most appropriate to meet the child's needs?

Let the child wear her own clothing when friends visit.

The pediatric nurse is caring for a hospitalized toddler. What does the nurse determine is the most appropriate play activity for the toddler?

Playing with a push-pull toy

With which age group should the nurse use "magical thinking" as a developmental strategy when administering medications?

Preschool

A nurse is assigned to care for a hospitalized toddler. The nurse plans care, knowing that what should be the highest priority?

Protecting the toddler from injury

Which interventions are appropriate for the care of an infant? SATA

Provide swaddling. Hang mobiles with black and white contrast designs. Caress the infant while bathing or during diaper changes.

The nurse is admitting a 10-month-old infant who is being hospitalized for a respiratory infection. The nurse develops a plan of care for the infant and includes which most appropriate intervention?

Providing a consistent routine with touching, rocking, and cuddling throughout hospitalisation

A parent of a 3-year-old tells a clinic nurse that the child is rebelling constantly and having temper tantrums. Using Erikson's psychosocial development theory, which instructions should the nurse provide to the parent? SATA

Set limits on the child's behaviour. Provide a simple explanation of why the behaviour is unacceptable.

A 9 month old is sitting on his father's lap at the bedside. The nurse needs to do a shift assessment. How should the nurse proceed?

Talk with the father for a few minutes, before examining child.

Which hospitalised child would the nurse be most worried about as needing support or follow-up?

The 2-year-old that holds still during an IV start.

The parents of a 2-year-old arrive at a hospital to visit their child. The child is in the playroom when the parents arrive. When the parents enter the playroom, the child does not readily approach the parents. Which is the correct interpretation of the behavior?

The child exhibits detachment.

The nurse at a well-baby clinic is assessing the motor development of a 24-month-old child. On the basis of the age of the child, the nurse expects to note what as the highest-level developmental milestone?

The child opens a door by turning the door knob.

A 1-year-old child with hypospadias is scheduled for surgery to correct this condition. While preparing the nursing care plan for this child, which factor should the nurse take into consideration?

This surgery is taking place at a time when fears of separation are great.

The nurse prepares to take the blood pressure of a school-age child. To obtain an accurate measurement, how should the nurse position the blood pressure cuff?

Two thirds of the distance between the antecubital fossa and the shoulder

The nurse is evaluating the developmental level of a 2-year-old. Which does the nurse expect to observe in this child?

Uses a cup to drink

The clinic nurse assesses the communication patterns of a 5-month-old infant. Which assessment finding should lead the nurse to determine that the infant is demonstrating the highest level of developmental achievement expected?

Uses monosyllabic babbling

The nurse is caring for a 4-year-old child. When experiencing pain, the nurse anticipates which about the child? SATA

Views pain as a punishment Blames someone else for the pain Believes pain will disappear magically

Which would be the highest expected growth and development occurrence expected at 12 months of age for an infant who has had appropriate growth assessed at each well-child visit?

Walks holding on to someone's hand

A nurse is conducting an admission interview with the mother of a 2 year old child. What history question is most important at this time?

What is your child's normal routine?

The nurse in the pediatric unit is admitting a 2½-year-old child. The nurse plans care, knowing that the child is in which stage of Erikson's psychosocial stages of development?

Autonomy versus Shame and Doubt

The nurse is preparing to care for a 5-year-old who has been placed in traction following a fracture of the femur. The nurse plans care, knowing that which is the most appropriate activity for this child?

Crayons and a colouring book

The nurse is monitoring a 3-month-old infant for signs of increased intracranial pressure. On palpation of the fontanels, the nurse notes that the anterior fontanel is soft and flat. On the basis of this finding, which nursing action is most appropriate?

Document the finding.

The nurse assesses the vital signs of a 12-month-old infant with a respiratory infection and notes that the respiratory rate is 35 breaths/minute. On the basis of this finding, which action is most appropriate?

Document the findings.

A 4-year-old child diagnosed with leukemia is hospitalized for chemotherapy. The child is fearful of the hospitalization. Which nursing intervention should be implemented to alleviate the child's fears?

Encourage the child's parents to stay with the child.

A six year old is in the recovery room following an appendectomy. He is not yet fully awake, though he opens his eyes when his name is called. Which pain assessment tool would be most effective for the nurse to use at this time?

FLAACC pain assessment tool.

The nurse is developing a plan of care for a 4-year-old child scheduled for a renal biopsy. What developmental characteristic of this child should the nurse consider?

Fears of mutilation may be present in the child.

A mother tells the nurse in a pediatrician's office that she is concerned because her children must let themselves into the house after school each day while she is at work. The nurse explores which suggestion with the mother to decrease the children's sense of isolation and fear?

Find community after-school programs or activities.

A nurse enters the room of an 8-year-old child newly admitted and diagnosed with type I diabetes. His mother is sitting in a chair at his bedside. What should the nurse do first?

Go the bedside and meet the child.

A mother arrives at a clinic with her toddler and tells the nurse that she has a difficult time getting the child to go to bed at night. What measure is most appropriate for the nurse to suggest to the mother?

Inform the child of bedtime a few minutes before it is time for bed.

The maternity nurse is providing instructions to a new mother regarding the psychosocial development of the newborn infant. Using Erikson's psychosocial development theory, the nurse instructs the mother to take which measure?

Allow the newborn infant to signal a need.

A 7-year-old child is hospitalized with a fracture of the femur and is placed in traction. In meeting the psychosocial needs of the child, the nurse most appropriately selects which play activity for the child?

A board game

A mother of a 3-year-old asks a clinic nurse about appropriate and safe toys for the child. The nurse should tell the mother that the most appropriate toy for a 3-year-old is which?

A wagon

Which nursing intervention best supports the concept of atraumatic care for a hospitalized child?

Allowing adolescent to keep the hospital door shut.

The mother of a 5-year-old child tells the nurse that the child scolds the floor or a table if she hurts herself on the object. According to Piaget's Theory of Cognitive Development, what term or phrase best describes this behavior?

Animism

A 15-year-old is injured and sustains a fractured jaw. The fractured jaw has been surgically wired, and the health care provider has prescribed a full liquid diet. Which nursing action would best promote compliance and provide an adequate nutrient value with the full liquid diet for this teenager?

Ask the teenager for food preferences and blenderise these foods into liquids.

The mother of a 3-year-old is concerned because her child still is insisting on a bottle at nap time and at bedtime. Which is the most appropriate suggestion to the mother?

Allow the bottle if it contains water.

A 16-year-old is admitted to the hospital for acute appendicitis and an appendectomy is performed. Which nursing intervention is most appropriate to facilitate normal growth and development postoperatively?

Allow the child to interact with others in his or her same age group.

What nursing intervention would be most appropriate for a 10-year-old child with type I diabetes in order to meet their needs (as described by Erikson).

Allow the child to perform his or her own Accuchecks and administration of insulin.

The nurse at a well-baby clinic is assessing the language and communication developmental milestones of a 4-month-old infant. On the basis of the age of the infant, what should the nurse expect to note as the highest-level developmental milestone?

Babbling sounds

The nurse is caring for a 4-year-old child with human immunodeficiency virus (HIV) infection. The nurse should plan care with the understanding that which childhood psychosocial need occurs at this age?

Beginning to conceptualise the death process as involving physical harm

Which car safety device should be used for a child who is 8 years old and is 4 feet tall?

Booster seat

The nurse at a well-baby clinic is providing nutrition instructions to the mother of a 1-month-old infant. What instruction should the nurse give to the mother?

Breast milk or formula is the main food